A BILL TO BE ENTITLED
AN ACT TO EXAMINE AND ESTABLISH A NEW PAYMENT METHODOLOGY FOR ADULT CARE HOMES providing CARE TO north carolina MEDICAID BENEFICIARIES THAT PROMOTES HEALTH As well as FAIR AND REASONABLE COMPENSATION FOR THE SERVICES PROVIDED.
Whereas, approximately 30,000 adults reside in North Carolina's adult care homes; and
Whereas, the average age of an adult care home resident is over 75 years old; and
Whereas, adult care homes provide care to some of North Carolina's most vulnerable senior citizens; and
Whereas, adult care homes have not had a rate increase for State and county special assistance since 2009; and
Whereas, the General Assembly recognizes that with Medicaid managed care there are opportunities to explore new programs and payment methodologies that can provide a stable and reliable funding stream to ensure access, choice, and quality of care within adult care homes; Now, therefore,
The General Assembly of North Carolina enacts:
SECTION 1.  It is the intent of the General Assembly to provide funding to adult care homes in the State in a manner that recognizes the importance of a stable and reliable funding stream to ensure access, choice, and quality of care within the adult care home segment of the care continuum. In furtherance of this intent, and as the North Carolina Medicaid program transitions to a managed care delivery system, the Department of Health and Human Services is directed to establish and convene a workgroup to evaluate reimbursement options under managed care for adult care homes that considers all funding streams and to develop a service definition or definitions under managed care that may accomplish this intent. The workgroup shall consist of adult care home industry representatives and other relevant stakeholders. In development of the service definition, the workgroup shall include all of the following components:
1)	Support for alternative payment models, including pay‑for‑performance initiatives, available under the State's 1115 Medicaid waiver and Medicaid transformation.
2)	Best practices for long‑term services and supports.
3)	Efficient payment methodologies.
SECTION 2.  No later than October 1, 2020, the Department of Health and Human Services shall submit a report on the new service definition to the Joint Legislative Oversight Committee on Health and Human Services, the Joint Legislative Oversight Committee on Medicaid and NC Health Choice, and the Fiscal Research Division. After submission of this report, DHHS shall submit to the Centers for Medicare and Medicaid Services any amendments to the NC Medicaid State Plan necessary to implement the new service definition.
SECTION 3.  This act is effective when it becomes law.