A BILL TO BE ENTITLED
AN ACT requiring the department of health and human services, division of mental health, developmental disabilities, and substance abuse services, to develop a two‑tiered system of payment for local inpatient psychiatric beds or bed days based on acuity level; requiring the department to establish and annually report on performance measures for this two‑tiered system of payment; and appropriating funds to the department to implement this two‑tiered system of payment.
The General Assembly of North Carolina enacts:
SECTION 1.(a)  The Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (Department), shall develop and implement a two‑tiered system of payment for purchasing local inpatient psychiatric beds or bed days to meet the needs of individuals experiencing a mental health, developmental disability, or substance abuse crisis. The two‑tiered system of payment shall be based on acuity level, with an enhanced rate of payment for inpatient psychiatric beds or bed days for individuals with higher acuity levels, as defined by the Department. The enhanced rate of payment for inpatient psychiatric beds or bed days for individuals with higher acuity levels shall not exceed the lowest average cost per patient bed day among the State psychiatric hospitals. The Department shall ensure that beds or bed days for individuals with higher acuity levels are distributed across the State in LME catchment areas, including any catchment areas served by managed care organizations, and according to greatest need based on hospital bed utilization data.
SECTION 1.(b)  The Department shall establish performance measures to assess the effectiveness of the two‑tiered system of payment for local inpatient psychiatric beds or bed days established in accordance with subsection (a) of Section 1 of this act. By no later than June 30, 2013, the Department shall develop and provide a description of these performance measures in a report to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, the Fiscal Research Division, and, if the 2013 Session of the 2013‑2014 General Assembly has adjourned as of the date of the report, to the Joint Legislative Oversight Committee on Health and Human Services. The Department shall submit a report on its assessment of this two‑tiered system of payment utilizing these performance measures to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, the Joint Legislative Oversight Committee on Health and Human Services, and the Fiscal Research Division by no later than March 1, 2014, and annually thereafter.
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of two million dollars ($2,000,000) for the 2013‑2014 fiscal year and the sum of two million dollars ($2,000,000) for the 2014‑2015 fiscal year. These funds shall only be used to purchase local inpatient psychiatric beds or bed days at an enhanced rate of payment for individuals with higher acuity levels under the two‑tiered system of payment established by the Department in accordance with subsection (a) of Section 1 of this act.
SECTION 3.  This act becomes effective July 1, 2013.