A BILL TO BE ENTITLED
AN ACT to cap reimbursement by COUNTIES, TO MAKE ADDITIONAL PROVISIONS RELATING TO PAYMENT, for medical services provided to inmates in county jails, to allow counties to utilize medicaid for eligible prisoners, and TO PROVIDE THAT VACANCIES IN THE OFFICE OF DISTRICT COURT JUDGE SHALL BE FILLED BY APPOINTMENT OF THE GOVERNOR.
The General Assembly of North Carolina enacts:
SECTION 1.  Article 10 of Chapter 153A of the General Statutes is amended by adding a new section to read:
"§ 153A‑225.2.  Payment of medical care of prisoners.
(a)	Counties shall reimburse those providers and facilities providing requested or emergency medical care outside of the local confinement facility to prisoners or other persons under arrest by, or in the lawful custody of, county law enforcement officers the lesser amount of either a rate of seventy percent (70%) of the provider's then‑current prevailing charge or two times the then‑current Medicaid rate for any given service. Each county shall have the right to audit any provider from whom the county has received a bill for services under this section, but only to the extent necessary to determine the actual prevailing charge to ensure compliance with this section.
For the purposes of this section, "requested or emergency medical care" shall include all medically necessary and appropriate care provided to an individual from the time that individual presents to the provider or facility in the custody of county law enforcement officers until the time that the individual is safely transferred back to the care of county law enforcement officers or medically discharged to another community setting, as appropriate.
Nothing in this section shall preclude a county from contracting with a provider for services at rates that provide greater documentable cost avoidance for the county than do the rates contained in this subsection or at rates that are less favorable to the county but that will ensure the continued access to care.
(b)	No county may avoid liability for payment of medical care by discharging or otherwise releasing a prisoner or other person under arrest or in lawful custody of county law enforcement officers for the purposes of avoiding liability for payment of medical care for which the county is otherwise responsible.
(c)	The county shall make reasonable efforts to equitably distribute prisoners among all hospitals or other appropriate health care facilities located within the same county and shall do so based upon the licensed acute care bed capacity at each of the hospitals located within the same county. Counties with more than one hospital or other appropriate health care facility shall provide semiannual reports conspicuously posted on the county's Web site that detail compliance with this section, including information on the distribution of prisoner health care services among different hospitals and health care facilities."
SECTION 2.  G.S. 153A‑225(a) reads as rewritten:
"(a)	Each unit that operates a local confinement facility shall develop a plan for providing medical care for prisoners in the facility. The plan:
(1)	Shall be designed to protect the health and welfare of the prisoners and to avoid the spread of contagious disease;
(2)	Shall provide for medical supervision of prisoners and emergency medical care for prisoners to the extent necessary for their health and welfare;
(3)	Shall provide for the detection, examination and treatment of prisoners who are infected with tuberculosis or venereal diseases; and
(4)	May utilize Medicaid coverage for inpatient hospitalization or for any other Medicaid services allowable for eligible prisoners, provided that the plan includes a reimbursement process which pays to the State the State portion of the costs, including the costs of the services provided and any administrative costs directly related to the services to be reimbursed, to the State's Medicaid program.
The unit shall develop the plan in consultation with appropriate local officials and organizations, including the sheriff, the county physician, the local or district health director, and the local medical society. The plan must be approved by the local or district health director after consultation with the area mental health, developmental disabilities, and substance abuse authority, if it is adequate to protect the health and welfare of the prisoners. Upon a determination that the plan is adequate to protect the health and welfare of the prisoners, the plan must be adopted by the governing body.
As a part of its plan, each unit may establish fees of not more than twenty dollars ($20.00) per incident for the provision of nonemergency medical care to prisoners. In establishing fees pursuant to this section, each unit shall establish a procedure for waiving fees for indigent prisoners."
SECTION 3.  In preparation for the July 1, 2014, effective date of Section 2 of this act, the Department of Health and Human Services, Division of Medical Assistance, shall work with the North Carolina Association of County Commissioners to prepare for the change to G.S. 153A‑225(a)(4) contained in Section 2 of this act. The Department of Health and Human Services, Division of Medical Assistance, shall use a uniform method, developed by the North Carolina Association of County Commissioners, which will allow all counties to interface with the Division of Medical Assistance to implement this act. The Department of Public Safety shall provide technical assistance as needed.
SECTION 4.  G.S. 7A‑142 reads as rewritten:
"§ 7A‑142.  Vacancies in office.
A vacancy in the office of district judge shall be filled for the unexpired term by appointment of the Governor. The Governor may select from nominations submitted by the bar of the judicial district as defined in G.S. 84‑19, except that in judicial District 9, when vacancies occur in District Court District 9 or 9B, only those members who reside in the district court district shall participate in the selection of the nominees. When vacancies occur in District Court District 18, all members who reside in the district court district shall participate in the selection of the nominees. If the district court district is comprised of counties in more than one judicial district, the nominees shall be submitted jointly by the bars of those judicial districts, but only those members who reside in the district court district shall participate in the selection of the nominees. If the district court judge was elected as the nominee of a political party, then the district bar shall submit to the Governor the names of three persons who are residents of the district court district who are duly authorized to practice law in the district and who are members of the same political party as the vacating judge; provided that if there are not three persons who are available, the bar shall submit the names of two persons who meet the qualifications of this sentence. If the district court judge was not elected as the nominee of a political party, then the district bar shall submit to the Governor the names of three persons who are residents of the district court district and who are duly authorized to practice law in the district; provided that if there are not three persons who are available, the bar shall submit the names of two persons who meet the qualifications of this sentence. The bar of the judicial district shall have 30 days to submit nominations to the Governor."
SECTION 5.  Sections 1 and 3 of this act become effective September 1, 2013.  Section 2 of this act becomes effective July 1, 2014. The remainder of this act is effective when it becomes law.