Source: https://www.ncleg.net/EnactedLegislation/SessionLaws/HTML/2001-2002/SL2001-437.html
Timestamp: 2018-11-16 00:02:34
Document Index: 593419077

Matched Legal Cases: ['ART 1', '§ 122', '§ 122', '§ 122', 'art 1', '§ 122', 'art 2', '§ 122', 'art 2', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', 'art 1', '§ 143', '§ 143', 'art 4', '§ 143', 'ART 2', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', '§ 122', 'ART 3', 'ART 4']

S.L. 2001-437
SESSION LAW 2001-437
AN ACT TO PHASE IN IMPLEMENTATION OF MENTAL HEALTH SYSTEM REFORM AT THE STATE AND LOCAL LEVEL.
Whereas, the 1999 General Assembly, Regular Session 2000, established the Joint Legislative Oversight Committee ("Committee") on Mental Health, Developmental Disabilities, and Substance Abuse Services; and
Whereas, the Committee was directed to develop a Plan for Mental Health System Reform; and
Whereas, the General Assembly expressed the intent that the Plan be fully implemented not later than July 1, 2005; and
Whereas, the General Assembly directed the Committee to "Report to the 2001 General Assembly upon its convening the changes that should be made to the governance, structure, and financing of the State's mental health system at the State and local levels"; and
Whereas, the Committee reviewed the governance, structure, and financing of the current mental health system and reported its findings and recommendations to the 2001 General Assembly for legislative action; Now, therefore,
PART 1. MENTAL HEALTH SYSTEM GOVERNANCE CHANGES
SECTION 1.1. G.S. 122C-2 reads as rewritten:
"§ 122C-2. Policy.
The policy of the State is to assist individuals with needs for mental illness, health, developmental disabilities, and substance abuse problems services in ways consistent with the dignity, rights, and responsibilities of all North Carolina citizens. Within available resources it is the obligation of State and local government to provide mental health, developmental disabilities, and substance abuse services to eliminate, reduce, or prevent the disabling effects of mental illness, developmental disabilities, and substance abuse through a service delivery system designed to meet the needs of clients in the least restrictive available setting, if the least restrictive setting is therapeutically most appropriate, restrictive, therapeutically most appropriate setting available and to maximize their quality of life. It is further the obligation of State and local government to provide community-based services when such services are appropriate, unopposed by the affected individuals, and can be reasonably accommodated within available resources and taking into account the needs of other persons for mental health, developmental disabilities, and substance abuse services.
As used in this Chapter, the phrase 'within available resources' means State funds appropriated and non-State funds and other resources appropriated, allocated or otherwise made available for mental health, developmental disabilities, and substance abuse services.
The furnishing of services to implement the policy of this section requires the cooperation and financial assistance of counties, the State, and the federal government."
SECTION 1.2.(a) G.S. 122C-3 is amended by adding the following new subdivisions in alphabetical order to read:
"(1) 'Area director' means the administrative head of the area authority program appointed pursuant to G.S. 122C-121.
(2) 'Board of county commissioners' includes the participating boards of county commissioners for multicounty area authorities and multicounty programs.
(3) 'Core services' are services that are necessary for the basic foundation of any service delivery system. Core services are of two types: front-end service capacity such as screening, assessment, and emergency triage, and indirect services such as prevention, education, and consultation at a community level.
(4) 'County program' means a mental health, developmental disabilities, and substance abuse services program established, operated, and governed by a county pursuant to G.S. 122C-115.1.
(5) 'Program director' means the director of a county program established pursuant to G.S. 122C-115.1.
(6) 'Public services' means publicly funded mental health, developmental disabilities, and substance abuse services, whether provided by public or private providers.
(7) 'Specialty services' means services that are provided to consumers from low-incidence populations.
(8) 'State' or 'Local' Consumer Advocate means the individual carrying out the duties of the State or Local Consumer Advocacy Program Office in accordance with Article 1A of this Chapter.
(9) 'State Plan' means the State Plan for Mental Health, Developmental Disabilities, and Substance Abuse Services.
(10) 'Targeted population' means those individuals who are given service priority under the State Plan.
(11) 'Uniform portal process' means a standardized process and procedures used to ensure consumer access to, and exit from, public services in accordance with the State Plan."
SECTION 1.2.(b) G.S. 122C-3(5) reads as rewritten:
"(5) 'Catchment area' means the geographic part of the State served by a specific area authority. authority or county program."
SECTION 1.2.(c) G.S. 122C-3(34) and G.S. 122C-3(35) are repealed.
SECTION 1.3. G.S. 122C-64 reads as rewritten:
"§ 122C-64. Human rights committees.
Human rights committees responsible for protecting the rights of clients shall be established at each State facility and may be established for area authorities. The Commission shall adopt rules for the establishment of committees. These rules shall include the composition and duties of the committees and procedures for appointment of the members by the Secretary for State facilities and by the area board for area authorities. facility and for each area authority and county program. The Commission shall adopt rules for the establishment, composition, and duties of the committees and procedures for appointment and coordination with the State and Local Consumer Advocacy programs. In multicounty area authorities and multicounty programs, the membership of the human rights committee shall include a representative from each of the participating counties."
SECTION 1.4. G.S. 122C-101 reads as rewritten:
"§ 122C-101. Policy.
Within the public system of mental health, developmental disabilities, and substance abuse services, there are both area area, county, and State facilities. An area authority or county program is the locus of coordination among public services for clients of its catchment area. To assure the most appropriate and efficient care of clients within the publicly supported service system, area authorities are encouraged to develop and secure approval for a single portal of entry and exit policy for their catchment areas for mental health and substance abuse authorities. Effective January 1, 1994, an area authority shall develop and secure approval for a single portal of entry and exit policy for public and private services for individuals with developmental disabilities."
SECTION 1.5. Part 1 of Article 4 of Chapter 122C of the General Statutes is amended by adding the following new section to read:
"§ 122C-102. State Plan for Mental Health, Developmental Disabilities, and Substance Abuse Services.
The Department shall develop and implement a State Plan for Mental Health, Developmental Disabilities, and Substance Abuse Services. The State Plan shall include the following:
(12) Strategies and schedules for implementing a phased in plan to eliminate disparities in the allocation of State funding across county programs and area authorities by January 1, 2007, including methods to identify service gaps and to ensure equitable use of State funds to fill those gaps among all counties."
SECTION 1.6. G.S. 122C-111 reads as rewritten:
The Secretary shall administer and enforce the provisions of this Chapter and the rules of the Commission and shall operate State facilities. An area director or program director shall administer the programs of the area authority or county program, as applicable, and enforce the rules of the area board, applicable State laws, rules of the Commission, and rules of the Secretary. The Secretary in cooperation with area and county program directors and State facility directors shall provide for the coordination of public services between area authorities authorities, county programs, and State facilities."
SECTION 1.7.(a) G.S. 122C-112 is repealed.
SECTION 1.7.(b) Part 2 of Article 4 of Chapter 122C of the General Statutes is amended by adding the following new section to read:
(1) Oversee development of the State Plan for Mental Health, Developmental Disabilities, and Substance Abuse Services.
(3) Establish a process and criteria for the submission, review, and approval or disapproval of business plans submitted by area authorities and counties for the management and provision of mental health, developmental disabilities, and substance abuse services.
(4) Adopt rules specifying the content and format of business plans.
(5) Review business plans and, upon approval of the business plan, certify the submitting area authority or county program to provide mental health, developmental disabilities, and substance abuse services.
(6) Establish comprehensive, cohesive oversight and monitoring procedures and processes to ensure continuous compliance by area authorities, county programs, and all providers of public services with State and federal policy, law, and standards. Procedures shall include performance measures and report cards for each area authority and county program.
(7) Conduct regularly scheduled monitoring and oversight of area authority, county programs, and all providers of public services. Monitoring and oversight shall include compliance with the program business plan, core administrative functions, and fiscal and administrative practices and shall also address outcome measures, consumer satisfaction, client rights complaints, and adherence to best practices.
(9) Assist area authorities and county programs in the establishment and operation of community-based programs.
(11) Develop a unified system of services provided in area, county, and State facilities, and by providers enrolled or under a contract with the State.
(9) Require reports of client characteristics, staffing patterns, agency policies or activities, services, or specific financial data of the area authority, county program, and providers of public services. The reports shall not identify individual clients of the area authority or county program unless specifically required by State law or by federal law or regulation or unless valid consent for the release has been given by the client or legally responsible person."
SECTION 1.8. G.S. 122C-115 reads as rewritten:
"§ 122C-115. Powers and duties of counties and cities. Duties of counties; appropriation and allocation of funds by counties and cities.
(a) Except as provided in G.S. 153A-77, a county shall provide mental health, developmental disabilities, and substance abuse services through an area authority. A county shall provide mental health, developmental disabilities, and substance abuse services through an area authority or through a county program established pursuant to G.S. 122C-115.1. To the extent this section conflicts with G.S. 153A-77(a), the provisions of G.S. 153A-77(a) control.
(c) Within Except as authorized in G.S. 122C-115.1, within a catchment area designated by the Commission in the business plan pursuant to G.S. 122C-115.2, a board of county commissioners or two or more boards of county commissioners jointly shall establish an area authority with the approval of the Secretary.
(d) Except as otherwise provided in this subsection, counties shall not reduce county appropriations and expenditures for current operations and ongoing programs and services of area authorities or county programs because of the availability of State-allocated funds, fees, capitation amounts, or fund balance to the area authority. authority or county program. Counties may reduce county appropriations by the amount previously appropriated by the county for one-time, nonrecurring special needs of the area authority. authority or county program."
SECTION 1.9. Part 2 of Article 4 of Chapter 122C of the General Statutes is amended by adding the following new sections to read:
(6) Appointment of an advisory committee. The interlocal agreement shall designate a county manager to whom the advisory committee shall report. The interlocal agreement shall also designate the appointing authorities. The appointing authorities shall make appointments that take into account sufficient citizen participation, equitable representation of the disability groups, and equitable representation of participating counties. At least fifty percent (50%) of the membership shall conform to the requirements provided in G.S. 122C-118.1(b)(1)-(4).
(g) In a single-county program, an advisory committee shall be appointed by the board of county commissioners and shall report to the county manager. The appointments shall take into account sufficient citizen participation, equitable representation of the disability groups, and equitable representation of participating counties. At least fifty percent (50%) of the membership shall conform to the requirements in G.S. 122C-118.1(b)(1)-(4). In a multicounty program, the advisory committee shall be appointed in accordance with the terms of the interlocal agreement.
(i) Except as otherwise specifically provided, this Chapter applies to counties that provide mental health, developmental disabilities, and substance abuse services through a county program. As used in the applicable sections of this Article, the terms 'area authority', 'area program', and 'area facility' shall be construed to include 'county program'. The following sections of this Article do not apply to county programs:
(8) G.S. 122C-158.
"§ 122C-115.2. Business plan required; content, process, certification.
(a) Every county, through an area authority or county program, shall provide for development, review, and approval of a business plan for the management and delivery of mental health, developmental disabilities, and substance abuse services. A business plan shall provide detailed information on how the area authority or county program will meet State standards, laws, and rules for ensuring quality mental health, developmental disabilities, and substance abuse services, including outcome measures for evaluating program effectiveness. The business plan shall be in effect for at least three State fiscal years.
b. Provider network development. - Ensuring available, qualified providers to deliver services based on the business plan. Development of new providers and monitoring provider performance and service outcomes. Provider network development shall address consumer choice and fair competition. For the purposes of this section, a 'qualified provider' means a provider who meets the provider qualifications as defined by rules adopted by the Secretary.
(c) The county program or area authority proposing the business plan shall submit the proposed plan as approved by the board of county commissioners to the Secretary for review and certification. The Secretary shall review the business plan within 30 days of receipt of the plan. If the business plan meets all of the requirements of State law and standards adopted by the Secretary, then the Secretary shall certify the area authority or county program as a single-county area authority, a single-county program, a multicounty area authority, or a multicounty program. Implementation of the certified plan shall begin within 30 days of certification. If the Secretary determines that changes to the plan are necessary, then the Secretary shall so notify the submitting county program or area authority and the applicable participating boards of county commissioners and shall indicate in the notification the changes that need to be made in order for the proposed program to be certified. The submitting county program or area authority shall have 30 days from receipt of the Secretary's notice to make the requested changes and resubmit the amended plan to the Secretary for review. The Secretary shall provide whatever assistance is necessary to resolve outstanding issues. Amendments to the business plan shall be subject to the approval of the participating boards of county commissioners.
"§ 122C-115.3. Dissolution of area authority.
(a) Whenever the board of commissioners of each county constituting an area authority determines that the area authority is not operating in the best interests of consumers, it may direct that the area authority be dissolved. In addition, whenever a board of commissioners of a county that is a member of an area authority determines that the area authority is not operating in the best interests of consumers of that county, it may withdraw from the area authority. Dissolution of an area authority or withdrawal from the area authority by a county shall be effective only at the end of the fiscal year in which the action of dissolution or withdrawal transpired.
(b) Notwithstanding the provisions of subsection (a) of this section, no county shall withdraw from an area authority nor shall an area authority be dissolved without first demonstrating that continuity of services will be assured and without prior approval of the Secretary.
(c) Prior to withdrawal of a county from an area authority, the county board of commissioners shall hold a public hearing with notice published at least 10 days before the hearing.
(d) Prior to dissolution of an area authority, the area authority shall hold a public hearing with notice published in every participating county at least 10 days before the hearing.
(e) Any budgetary surplus available to an area authority at the time of its dissolution shall be distributed to those counties comprising the area authority on the same pro rata basis that the counties appropriated and contributed funds to the area authority's budget during the current fiscal year. Distribution to the counties shall be determined on the basis of an audit of the financial record of the area authority. The area authority board shall select a certified public accountant or an accountant who is subsequently certified by the Local Government Commission to conduct the audit. The audit shall be performed in accordance with G.S. 159-34. The same method of distribution of funds described in this subsection shall apply when one or more counties of an area authority withdraw from the area authority.
(f) Funds distributed to counties pursuant to subsection (e) of this section shall be placed in the fund balance of the county program or area authority subsequently established or joined pursuant to G.S. 122C-115.
(g) Any liabilities at the time of its dissolution shall be paid from unobligated surplus funds available to the area authority. If unobligated surplus funds are not sufficient to satisfy the total indebtedness of the area authority, then the remaining unsatisfied indebtedness shall be apportioned on the same pro rata basis that the counties appropriated and contributed funds to the area authority's budget during the current fiscal year."
SECTION 1.10. G.S. 122C-117 reads as rewritten:
(a) The area authority shall: shall do all of the following:
(1) Engage in comprehensive planning, budgeting, implementing, and monitoring of community-based mental health, developmental disabilities, and substance abuse services; services.
(2) ProvideEnsure the provision of services to clients in the catchment area, including clients committed to the custody of the Department of Juvenile Justice and Delinquency Prevention; Prevention.
(3) Determine the needs of the area authority's clients and coordinate with the Secretary and with the Department of Juvenile Justice and Delinquency Prevention the provision of services to clients through area and State facilities; facilities.
(4) Develop plans and budgets for the area authority subject to the approval of the Secretary; Secretary. The area authority shall submit the approved budget to the board of county commissioners and the county manager and provide quarterly reports on the financial status of the program in accordance with subsection (c) of this section.
(5) Assure that the services provided by the county through the area authority meet the rules of the Commission and Secretary; Secretary.
(6) Comply with federal requirements as a condition of receipt of federal grants; and grants.
(7) Appoint an area director, chosen through a search committee on which the Secretary of the Department of Health and Human Services or the Secretary's designee serves as a nonvoting member. Appoint an area director in accordance with G.S. 122C-121(d). The appointment is subject to the approval of the board of county commissioners except that one or more boards of county commissioners may waive its authority to approve the appointment. The appointment shall be based on a selection by a search committee of the area authority board. The search committee shall include consumer board members, a county manager, and one or more county commissioners. The Secretary shall have the option to appoint one member to the search committee.
(c) Within 30 days of the end of each quarter of the fiscal year, the area director and finance officer of the area authority shall provide to each member of the board of county commissioners the quarterly report of the area authority. This information shall be presented in a format prescribed by the county. At least twice a year, this information shall be presented in person and shall be read into the minutes of the meeting at which it is presented. In addition, the area director or finance officer of the area authority shall provide to the board of county commissioners ad hoc reports as requested by the board of county commissioners.
(d) A multicounty area authority shall provide to each board of county commissioners of participating counties a copy of the area authority's annual audit. The audit findings shall be presented in a format prescribed by the county and shall be read into the minutes of the meeting at which the audit findings are presented."
SECTION 1.11.(a) G.S. 122C-118 is repealed.
SECTION 1.11.(b) Article 4 of Chapter 122C of the General Statutes is amended by adding the following new section to read:
(a) An area board shall have no fewer than 11 and no more than 25 members. In a single-county area authority, the members shall be appointed by the board of county commissioners. Except as otherwise provided, in areas consisting of more than one county, each board of county commissioners within the area shall appoint one commissioner as a member of the area board. These members shall appoint the other members. The boards of county commissioners within the multicounty area shall have the option to appoint the members of the area board in a manner other than as required under this section by adopting a resolution to that effect. The boards of county commissioners in a multicounty area authority shall indicate in the business plan each board's method of appointment of the area board members in accordance with G.S. 122C-155.2(b). These appointments shall take into account sufficient citizen participation, equitable representation of the disability groups, and equitable representation of participating counties. Individuals appointed to the board shall include an individual with financial expertise or a county finance officer, an individual with expertise in management or business, and an individual representing the interests of children. A member of the board may be removed with or without cause by the initial appointing authority. Vacancies on the board shall be filled by the initial appointing authority before the end of the term of the vacated seat or within 90 days of the vacancy, whichever occurs first, and the appointments shall be for the remainder of the unexpired term.
(b) At least fifty percent (50%) of the members of the area board shall represent the following:
(3) A family member or an individual from citizens' organizations composed primarily of consumers or their family members, representing the interests of individuals:
b. In recovery from addiction; and
(4) Openly declared consumers:
b. With developmental disabilities; and
(c) The board of county commissioners may elect to appoint a member of the area authority board to fill concurrently more than one category of membership if the member has the qualifications or attributes of more than one category of membership.
(d) Any member of an area board who is a county commissioner serves on the board in an ex officio capacity. The terms of county commissioners on an area board are concurrent with their terms as county commissioners. The terms of the other members on the area board shall be for four years, except that upon the initial formation of an area board one-fourth shall be appointed for one year, one-fourth for two years, one-fourth for three years, and all remaining members for four years. Members other than county commissioners shall not be appointed for more than two consecutive terms.
SECTION 1.11.(c) G.S. 122C-119 reads as rewritten:
"§ 122C-119. Organization of area board.
(d) The area board shall establish a finance committee that shall meet at least six times per year to review the financial strength of the area program. The finance committee shall have a minimum of three members, two of whom have expertise in budgeting and fiscal control. The member of the area board who is the county finance officer or individual with financial expertise shall serve as an ex officio member. All other finance officers of participating counties in a multicounty area authority may serve as ex officio members. If the area board so chooses, the entire area board may function as the finance committee; however, its required meetings as a finance committee shall be distinct from its meetings as an area board."
SECTION 1.12. G.S. 122C-121 reads as rewritten:
"§ 122C-121. Area director.
(a) The area director is an employee of the area board and shall serve at the pleasure of the area board. The director is responsible for the staff appointments, for implementation of the policies and programs of the board in compliance with rules of the Commission and the Secretary, and for the supervision of all service programs and staff. The area director is an employee of the area board and shall be appointed in accordance with G.S. 122C-117(7). The area director is the administrative head of the area program.
(c) In addition to the duties under G.S. 122C-111, the area director shall:
(1) Appoint and supervise area program staff.
(d) Except when specifically waived by the Secretary, the area director shall meet the following minimum qualifications:
(1) Masters degree;
(2) Related experience; and
(3) Management experience."
SECTION 1.13.(a) G.S. 122C-124, 122C-125.1, and 122C-126 are repealed.
SECTION 1.13.(b) Article 4 of Chapter 122C of the General Statutes is amended by adding the following new section to read:
"§ 122C-124.1. Actions by the Secretary when area authority or county program is not providing minimally adequate services.
(b) Suspension of Funding; Assumption of Service Delivery or Management Functions. - If the Secretary determines that a county, through an area authority or county program, is not providing minimally adequate services, in accordance with rules adopted by the Secretary or the Commission, to persons in need in a timely manner, or fails to demonstrate reasonable efforts to do so, the Secretary, after providing written notification of the Secretary's intent to the area authority or county program and to the board of county commissioners of the area authority or county program, and after providing the area authority or county program and the boards of county commissioners of the area authority or county program an opportunity to be heard, may:
The Secretary may assign any of the powers and duties of the area director or program director or of the area authority board or board of county commissioners of the area authority or county program pertaining to the operation of mental health, developmental disabilities, and substance abuse services to the caretaker board or to the caretaker administrator as it deems necessary and appropriate to continue to provide direct services to clients, including the powers as to the adoption of budgets, expenditures of money, and all other financial powers conferred on the area authority or county program by law pertaining to the operation of mental health, developmental disabilities, and substance abuse services. County funding of the area authority or county program shall continue when the State has assumed control of the financial affairs of the program. At no time after the State has assumed this control shall a county withdraw funds previously obligated or appropriated to the area authority or county program. The caretaker administrator and the caretaker board shall perform all of these powers and duties. The Secretary may terminate the area director or program director when it appoints a caretaker administrator. Chapter 150B of the General Statutes shall apply to the decision to terminate the area director or program director. Neither party to any such contract shall be entitled to damages. After a caretaker board has been appointed, the General Assembly shall consider, at its next regular session, the future governance of the identified area authority or county program."SECTION 1.14. G.S. 122C-132 and G.S. 122C-132.1 are repealed.
SECTION 1.15. G.S. 122C-141 reads as rewritten:
"§ 122C-141. Provision of services.
(a) The area authority may provide services directly and may contract with other public or private agencies, institutions, or resources for the provision of services.or county program shall contract with other qualified public or private providers, agencies, institutions, or resources for the provision of services, and, subject to the approval of the Secretary, is authorized to provide services directly. The area authority or county program shall indicate in its local business plan how services will be provided and how the provision of services will address issues of access, availability of qualified public or private providers, consumer choice, and fair competition. The Secretary shall take into account these issues when reviewing the local business plan and considering approval of the direct provision of services. The Secretary shall develop criteria for the approval of direct service provision by area authorities and county programs in accordance with this section and as evidenced by compliance with the local business plan. For the purposes of this section, a qualified public or private provider is a provider that meets the provider qualifications as defined by rules adopted by the Secretary.
(c) The area authority or board of county commissioners of a county program may contract with a health maintenance organization, certified and operating in accordance with the provisions of Article 67 of Chapter 58 of the General Statutes for the area authority, authority or county program, to provide mental health, developmental disabilities, or substance abuse services to enrollees in a health care plan provided by the health maintenance organization. The terms of the contract must meet the requirements of all applicable State statutes and rules of the Commission and Secretary governing both the provision of services by an area authority or county program and the general and fiscal operation of an area authority or county program and the reimbursement rate for services rendered shall be based on the usual and customary charges paid by the health maintenance organization to similar providers. Any provision in conflict with a State statute or rule of the Commission or the Secretary shall be void; however, the presence of any void provision in that contract does not render void any other provision in that contract which is not in conflict with a State statute or rule of the Commission or the Secretary. Subject to approval by the Secretary and pending the timely reimbursement of the contractual charges, the area authority or county program may expend funds for costs which may be incurred by the area authority or county program as a result of providing the additional services under a contractual agreement with a health maintenance organization."
SECTION 1.16. G.S. 122C-143.2 is repealed.
SECTION 1.17.(a) G.S. 122C-151.2 reads as rewritten:
"§ 122C-151.2. Appeal by area authorities. authorities and county programs.
(c) Appeals shall be conducted according to rules adopted by the Commission and Secretary and in accordance with Chapter 150B of the General Statutes."
SECTION 1.17.(b) G.S. 122C-151.3 reads as rewritten:
"§ 122C-151.3. Dispute with area authorities. authorities or county programs.
An area authority or county program shall establish written procedures for resolving disputes over decisions of an area authority or county program that may be appealed to the Area Authority State MH/DD/SA Appeals Panel under G.S. 122C-151.4. The procedures shall be informal and shall provide an opportunity for those who dispute the decision to present their position."
SECTION 1.17.(c) G.S. 122C-151.4 reads as rewritten:
"§ 122C-151.4. Appeal to Area Authority State MH/DD/SA Appeals Panel.
(1) "Contract" means a contract with an area authority or county program to provide services, other than personal services, to clients and other recipients of services.
(4) "Appeals Panel" means the State MH/DD/SA Appeals Panel established under this section.
(5) "Client" means an individual who is admitted to or receiving public services from an area facility. "Client" includes the client's personal representative or designee.
(b) Appeals Panel. - The Area Authority State MH/DD/SA Appeals Panel is established. The Panel shall consist of three members appointed by the Secretary. The Secretary shall determine the qualifications of the Panel members. Panel members serve at the pleasure of the Secretary.
(c) Who Can Appeal. - The following persons may appeal to the Area Authority State MH/DD/SA Appeals Panel after having exhausted the appeals process at the appropriate area authority or county program:
(1) A contractor or a former contractor who claims that an area authority or county program is not acting or has not acted within applicable State law or rules in imposing a particular requirement on the contractor on fulfillment of the contract;
(4) A client or a person who was a client in the previous fiscal year, who claims that an area authority or county program has acted arbitrarily and capriciously in reducing funding for the type of services provided or formerly provided to the client directly by the area authority; authority or county program; and
(5) A person who claims that an area authority or county program did not comply with a State law or a rule adopted by the Secretary or the Commission in developing the plans and budgets of the area authority or county program and that the area authority's failure to comply has adversely affected the ability of the person to participate in the development of the plans and budgets.
(d) Hearing. - All members of the Area Authority State MH/DD/SA Appeals Panel shall hear an appeal to the Panel. An appeal shall be filed with the Panel within the time required by the Secretary and shall be heard by the Panel within the time required by the Secretary. A hearing shall be conducted at the place determined in accordance with the rules adopted by the Secretary. A hearing before the Panel shall be informal; no sworn testimony shall be taken and the rules of evidence do not apply. The person who appeals to the Panel has the burden of proof. The Panel shall not stay a decision of an area authority during an appeal to the Panel.
(e) Decision. - The Area Authority State MH/DD/SA Appeals Panel shall make a written decision on each appeal to the Panel within the time set by the Secretary. A decision may direct a contractor or contractor, an area authority authority, or a county program to take an action or to refrain from taking an action, but it shall not require a party to the appeal to pay any amount except payment due under the contract. In making a decision, the Panel shall determine the course of action that best protects or benefits the clients of the area authority. authority or county program. If a party to an appeal fails to comply with a decision of the Panel and the Secretary determines that the failure deprives clients of the area authority or county program of a type of needed service, the Secretary may use funds previously allocated to the area authority or county program to provide the service.
(f) Chapter 150B Appeal. - A person who is dissatisfied with a decision of the Panel may commence a contested case under Article 3 of Chapter 150B of the General Statutes. Notwithstanding G.S. 150B-2(1),G.S. 150B-2(1a), an area authority or county program is considered an agency for purposes of the limited appeal authorized by this section. The Secretary shall make a final decision in the contested case."
SECTION 1.18. G.S. 122C-154 reads as rewritten:
Employees under the direct supervision of the area authority director are employees of the area authority. For the purpose of personnel administration, Chapter 126 of the General Statutes applies unless otherwise provided in this Article. Employees appointed by the county program director are employees of the county. In a multicounty program, employment of county program staff shall be as agreed upon in the interlocal agreement adopted pursuant to G.S. 122C-115.1."
SECTION 1.19. G.S. 122C-181 reads as rewritten:
"§ 122C-181. Secretary's jurisdiction over State facilities.
(1) For the mentally ill:
a. Cherry Hospital;
b. Dorothea Dix Hospital;
c. John Umstead Hospital; and
d. Broughton Hospital; and
(2) For the mentally retarded:
a. Caswell Center;
b. O'Berry Center;
c. Murdoch Center;
d. Western Carolina Center; and
e. Black Mountain Center; and
(3) For substance abusers:
a. Walter B. Jones Alcohol and Drug Abuse Treatment Center at Greenville;
b. Alcohol and Drug Abuse Treatment Center at Butner; Center at John Umstead Hospital; and
c. Julian F. Keith Alcohol and Drug Abuse Treatment Center at Black Mountain;Center; and
(4) As special care facilities:
a. Wilson North Carolina Special Care Center;
b. Whitaker School; and
c. Wright School; and School.
d. Butner Adolescent Treatment Center.
(b) The Subject to the requirements of subsection (c) of this section, the Secretary may, with the approval of the Governor and Council of State, close any State facility.
(c) Closure of a State facility under subsection (b) of this section becomes effective on the earlier of the 31st legislative day or the day of adjournment of the next regular session of the General Assembly that begins at least 10 days after the date the closure is approved, unless a different effective date applies under this subsection. If a bill that specifically disapproves the State facility closure is introduced in either house of the General Assembly before the thirty-first legislative day of that session, the closure becomes effective on the earlier of either the day an unfavorable final action is taken on the bill or the day that session of the General Assembly adjourns without ratifying a bill that specifically disapproves the State facility closure. If the Secretary specifies a later effective date for closure than the date that would otherwise apply under this subsection, the later date applies. Closure of a State facility does not become effective if the closure is specifically disapproved by a bill ratified by the General Assembly before it becomes effective. Notwithstanding any rule of either house of the General Assembly, any member of the General Assembly may introduce a bill during the first 30 legislative days of any regular session to disapprove closure of a facility that has been approved by the Governor and Council of State as provided in subsection (b) of this section. Nothing in this subsection shall be construed to impair the Secretary's power or duty otherwise imposed by law to close a State facility temporarily for the protection of health and safety."
SECTION 1.20.(a) G.S. 122C-112(13) is repealed.
SECTION 1.20.(b) Part 1 of Article 3 of Chapter 143B of the General Statutes is amended by adding the following new section to read:
"§ 143B-139.6A. Secretary's responsibilities regarding availability of early intervention services.
The Secretary shall adopt rules to implement the early intervention system, in consultation with all other appropriate agencies."
SECTION 1.21.(a) G.S. 143B-147 reads as rewritten:
"§ 143B-147. Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services - creation, powers and duties.
(a) There is hereby created the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services of the Department of Health and Human Services with the power and duty to adopt, amend and repeal rules to be followed in the conduct of State and local mental health, developmental disabilities, alcohol and drug abuse substance abuse programs including education, prevention, intervention, treatment, rehabilitation screening, assessment, referral, detoxification, treatment, rehabilitation, continuing care, emergency services, case management, and other related services. Such rules shall be designed to promote the amelioration or elimination of the mental health, illness, developmental disabilities, or alcohol and drug abuse substance abuse problems of the citizens of this State. The Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services shall have the authority:
b. Operation of education, prevention, intervention, treatment, rehabilitation and other related services as provided by area mental health, developmental disabilities, and substance abuse authorities authorities, county programs, and all providers of public services under Part 4 of Article 4 of Chapter 122C of the General Statutes;
d. Requirements of the federal government for grants-in-aid for mental health, developmental disabilities, alcohol or drug abuse programs which may be made available to local programs or the State. This section is to be liberally construed in order that the State and its citizens may benefit from such grants-in-aid; and
e. Implementation of single uniform portal process and policies of entry and exit policies established pursuant to Chapter 122C of the General Statutes.
(2) To adopt rules for the licensing of facilities for the mentally ill, developmentally disabled, and substance abusers, under Article 2 of Chapter 122C of the General Statutes.
c. Alcohol abuse, and Substance abuse.
d. Drug abuse;
(4) To review and advise the Secretary of the Department of Health and Human Services regarding all State plans required by federal or State law and to recommend to the Secretary any changes it thinks necessary in those plans; provided, however, for the purposes of meeting State plan requirements under federal or State law, the Department of Health and Human Services is designated as the single State agency responsible for administration of plans involving mental health, developmental disabilities, alcohol abuse, and drug abuse services; and substance abuse services.
(5) To adopt rules relating to the registration and control of the manufacture, distribution, security, and dispensing of controlled substances as provided by G.S. 90-100; G.S. 90-100.
(6) To adopt rules to establish the professional requirements for staff of licensed facilities for the mentally ill, developmentally disabled, and substance abusers. Such rules may require that one or more, but not all staff of a facility be either licensed or certified. If a facility has only one professional staff, such rules may require that that individual be licensed or certified. Such rules may include the recognition of professional certification boards for those professions not licensed or certified under other provisions of the General Statutes provided that the professional certification board evaluates applicants on a basis which protects the public health, safety or welfare; welfare.
(7) Except where rule making authority is assigned under that Article to the Secretary of the Department of Health and Human Services, to adopt rules to implement Article 3 of Chapter 122C of the General Statutes; Statutes.
(d) All rules adopted by the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services shall be enforced by the Department of Health and Human Services."
SECTION 1.21.(b) G.S. 143B-148 reads as rewritten:
"§ 143B-148. Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services - members; selection; quorum; compensation.
(a) The Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services of the Department of Health and Human Services shall consist of 26 members:
(1) Four of whom shall be appointed by the General Assembly, two upon the recommendation of the Speaker of the House of Representatives, and two upon the recommendation of the President Pro Tempore of the Senate in accordance with G.S. 120-121. These members shall be individuals who are concerned about the needs of individuals for mental health, developmental disabilities, and substance abuse services. have concern for the problems of mental illness, developmental disabilities, alcohol and drug abuse. Members shall serve for two-year terms beginning July 1 of odd-numbered years. A member shall serve not more than three consecutive two-year terms. Vacancies in appointments made by the General Assembly shall be filled in accordance with G.S. 120-122;
(2) Twenty-two of whom shall be appointed by the Governor, one from each congressional district in the State in accordance with G.S. 147-12(3)b, and 10 at-large members.
a. Of these 22 members, three shall have a special interest in mental health, three shall have a special interest in mental retardation, three shall have a special interest in developmental disabilities other than mental retardation, three shall have a special interest in alcohol abuse and alcoholism and three shall have a special interest in drug abuse. Each group of three shall be made up of one member who is a consumer representative; one other who is a representative of a local or State citizen organization or association; and one other who is a professional in the field.
b. The remaining seven members shall be appointed from the general public, other citizen groups, area mental health, developmental disabilities, and substance abuse authorities, or from other related agencies.
c. Of these 22 appointments, at least one shall be a licensed physician and at least one other shall be a licensed attorney.
d. The Governor shall appoint members to the Commission in accordance with the foregoing provisions. The terms of all Commission members appointed by the Governor shall be four years. The initial term of the person representing the 12th Congressional District shall begin January 3, 1993, and expire June 30, 1996. All Commission members shall serve their designated terms and until their successors are duly appointed and qualified. All Commission members may succeed themselves.
(e) All clerical and other services required by the Commission shall be supplied by the Secretary of the Department of Health and Human Services."
PART 2. MH/DD/SA CONSUMER ADVOCACY PROGRAM
SECTION 2. Effective July 1, 2002, Chapter 122C of the General Statutes is amended by adding the following new Article to read:
"MH/DD/SA Consumer Advocacy Program.
"§ 122C-10. MH/DD/SA Consumer Advocacy Program.
The General Assembly finds that many consumers of mental health, developmental disabilities, and substance abuse services are uncertain about their rights and responsibilities and how to access the public service system to obtain appropriate care and treatment. The General Assembly recognizes the importance of ensuring that consumers have information about the availability of services and access to resources to obtain timely quality care. There is established the MH/DD/SA Consumer Advocacy Program. The purpose of this Program is to provide consumers, their families, and providers with the information and advocacy needed to locate appropriate services, resolve complaints, or address common concerns and promote community involvement. It is further the intent of the General Assembly that the Department, within available resources and pursuant to its duties under this Chapter, ensure that the performance of the mental health care system in this State is closely monitored, reviews are conducted, findings and recommendations and reports are made, and that local and systemic problems are identified and corrected when necessary to promote the rights and interests of all consumers of mental health, developmental disabilities, and substance abuse services.
"§ 122C-11. MH/DD/SA Consumer Advocacy Program/definitions.
(1) 'MH/DD/SA' means mental health, developmental disabilities, and substance abuse.
(2) 'State Consumer Advocate' means the individual charged with the duties and functions of the State MH/DD/SA Consumer Advocacy Program established under this Article.
(3) 'State Consumer Advocacy Program' means the State MH/DD/SA Consumer Advocacy Program.
(4) 'Local Consumer Advocate' means an individual employed and certified by the State Consumer Advocate to perform the duties and functions of the MH/DD/SA Local Consumer Advocacy Program in accordance with this Article.
(5) 'Local Consumer Advocacy Program' means a local MH/DD/SA Local Consumer Advocacy Program.
(6) 'Consumer' means an individual who is a client or a potential client of public services from a State or area facility.
"§ 122C-12. State MH/DD/SA Consumer Advocacy Program.
The Secretary shall establish a State MH/DD/SA Consumer Advocacy Program office in the Office of the Secretary of Health and Human Services. The Secretary shall appoint a State Consumer Advocate. In selecting the State Consumer Advocate, the Secretary shall consider candidates recommended by citizens' organizations representing the interest of individuals with needs for mental health, developmental disabilities, and substance abuse services. The State Consumer Advocate may hire individuals to assist in executing the State Consumer Advocacy Program and to act on the State Consumer Advocate's behalf. The State Consumer Advocate shall have expertise and experience in MH/DD/SA, including expertise and experience in advocacy. The Attorney General shall provide legal staff and advice to the State Consumer Advocate.
"§ 122C-13. State Consumer Advocate duties.
(11) Submit a report annually to the Secretary, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Joint Legislative Health Care Oversight Committee containing data and findings regarding the types of problems experienced and complaints reported by or on behalf of providers, consumers, and employees of providers, as well as recommendations to resolve identified issues and to improve the administration of MH/DD/SA facilities and the delivery of MH/DD/SA services throughout the State.
"§ 122C-14. Local Consumer Advocate; duties.
(12) Perform any other related duties as directed by the State Consumer Advocate.
"§ 122C-15. State/Local Consumer Advocate; authority to enter; communication with residents, clients, patients; review of records.
(a) For purposes of this section, G.S. 122C-16 and G.S. 122C-17, 'Consumer Advocate' means either the State Consumer Advocate or any Local Consumer Advocate.
(d) Notwithstanding G.S. 8-53, G.S. 8-53.3, or any other law relating to confidentiality of communications involving a consumer, in the course of performing the Consumer Advocate's duties, the Consumer Advocate may access any information, whether recorded or not, concerning the admission, discharge, medication, treatment, medical condition, or history of any consumer to the extent permitted by federal law and regulations. Notwithstanding any State law pertaining to the privacy of personnel records, in the course of the Consumer Advocate's duties, the Consumer Advocate shall have access to personnel records of employees of State, area authority, or county program facilities.
"§ 122C-16. State/Local Consumer Advocate; resolution of complaints.
(d) Complaints or conditions adversely affecting consumers that cannot be resolved in the manner described in subsection (a) of this section shall be referred by the Consumer Advocate to the appropriate licensing agency under Article 2 of this Chapter.
"§ 122C-17. State/Local Consumer Advocate; confidentiality.
(c) All confidential or privileged information obtained under this section and the names of persons providing information to a Consumer Advocate are exempt from disclosure pursuant to Chapter 132 of the General Statutes. Access to substance abuse records and redisclosure of protected information shall be in compliance with federal confidentiality laws protecting medical records.
"§ 122C-18. State/Local Consumer Advocate; retaliation prohibited.
No one shall discriminate or retaliate against any person, provider, or facility because the person, provider, or facility in good faith complained or provided information to a Consumer Advocate.
"§ 122C-19. State/Local Consumer Advocate; immunity from liability.
(b) A State or area facility, its employees, and any other individual interviewed by a Consumer Advocate are immune from liability for damages resulting from disclosure of any information or documents to a Consumer Advocate pursuant to this Article.
"§ 122C-20. State/Local Consumer Advocate; penalty for willful interference.
Willful interference by an individual other than the consumer or the consumer's representative with the State or a Local Consumer Advocate in the performance of the Consumer Advocate's official duties is a Class 1 misdemeanor."
PART 3. PHASED IN IMPLEMENTATION
SECTION 3.(a) The Department of Health and Human Services shall do the following to prepare for the certification of area authorities and county programs to administer and deliver mental health, developmental disabilities, and substance abuse services.
(1) Develop the State Plan for Mental Health, Developmental Disabilities, and Substance Abuse Services in accordance with G.S. 122C-102. Not later than December 1, 2001, the Department shall submit the State Plan to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services for its review.
(2) Review all rules currently in effect and adopted by the Secretary, the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services and identify areas of duplication, vagueness, or ambiguity in content or in application. In conducting this review, the Department shall solicit input from current area authorities and providers on perceived problems with rules. The review may also include review of rules pertaining to mental health, developmental disabilities, and substance abuse services that are in effect and adopted by agencies other than the Secretary and the Commission.
(3) Review the oversight and monitoring functions currently implemented by the Department to determine the effectiveness of the activities in achieving the intended results. Improve the oversight and monitoring functions and activities, if necessary.
(4) Develop service standards, outcomes, and a financing formula for core and targeted services to prepare for their administration, financing, and delivery by area authorities and county programs.
(5) Develop format and required content for business plans submitted by boards of county commissioners and for contractual agreements between the Department and area authorities or county commissioners for county programs. Develop a method for departmental evaluation of local business plans. Contractual agreements for the provision of services shall provide for:
a. Terms of a minimum of three years.
b. Annual review and renewal.
c. Specific conditions under which the Department will provide technical assistance, impose sanctions, or terminate participation.
d. Terms of the business plan.
e. Award of start-up funds for consolidation of area or county programs.
(6) Report on the Department's readiness to implement system reform.
(7) Establish criteria and operational procedures for the Consumer Advocacy Program and make a report to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services on or before March 1, 2002.
(8) Develop a catchment area consolidation plan. The Secretary shall anticipate receiving letters of intent from boards of county commissioners on or before October 1, 2002, indicating the intent of a county or counties to provide services through an existing area authority or through a county program established pursuant to G.S. 122C-115.1. The Secretary shall develop the consolidation plan based on the letters of intent, the State Plan, geographic and population targeted thresholds, and capacity to implement the business plan. The consolidation plan shall provide for consolidation target of no more than 20 area authorities and county programs. The Secretary, in consultation with county commissioners and area authorities, shall complete the consolidation plan by September 1, 2004, and shall submit it no later than January 1, 2005, to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, the Governor, and each board of county commissioners. The total number of area authorities and county programs shall be reduced to no more than a target of 20 by January 1, 2007.
(9) Develop a readiness plan to conduct readiness reviews and certify all county programs and area authorities based on readiness by July 1, 2004. Each area authority and county program shall submit its approved business plan to the Secretary pursuant to G.S. 122C-115.2 by January 1, 2003. The Secretary shall review the business plans as provided in G.S. 122C-115.2(c), conduct readiness reviews, and provide necessary assistance to resolve outstanding issues. The Secretary shall complete certification of one-third of the area authorities and county programs by July 1, 2003; two-thirds of the area authorities and county programs by January 1, 2004; and shall complete certification of all area authorities and county programs by July 1, 2004.
The activities required under subdivisions (1) through (6) of this section shall be completed by December 1, 2001. On or before December 1, 2001, and quarterly thereafter, the Department shall submit a progress report on each of the activities required under this section. The Department shall make its reports to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services.
SECTION 3.(b) Rules adopted by the Secretary of Health and Human Services and the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services shall be adopted in accordance with Chapter 150B of the General Statutes.
SECTION 3.(c) The Secretary shall study consolidating the Quality of Care Consumer Advocacy Program as provided in Section 2 of this act with other consumer advocacy or ombudsman programs in the Department of Health and Human Services. The study shall include:
(1) An analysis of the budgetary implications of consolidation;
(2) Strategies for local interagency collaboration and coordination of ombudsman and consumer assistance services; and
(3) The possible effects of the consolidation on quality of care, service delivery, and consumer assistance for each affected consumer population.
The Secretary shall report the findings and recommendations, including enabling legislation, to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services on or before March 1, 2002.
SECTION 3.(d) The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services shall conduct an in-depth review of the current methods of and disparities in the allocation of State funding to area authorities and county programs for mental health, developmental disabilities, and substance abuse services and shall recommend necessary changes in allocation formulae, methods, and procedures that will ensure equitable allocation and use of State funds to provide these services throughout the State. Not later than May 1, 2002, the Committee shall report its findings and recommendations, including fiscal information on the cost to address funding allocation disparities, to the General Assembly, the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, and the Fiscal Research Division.
PART 4. EFFECTIVE DATE
SECTION 4. Sections 1.1 through 1.21(b) of this act become effective July 1, 2002. Section 2 of this act becomes effective July 1, 2002, only if funds are appropriated by the 2001 General Assembly, Regular Session 2002, for that purpose. The remainder of this act becomes effective when it becomes law.
In the General Assembly read three times and ratified this the 4th day of October, 2001.
Approved 7:40 p.m. this 15th day of October, 2001