Bill Text: NC S1306 | 2010 | Regular Session | Amended
Bill Title: Pilot Independent Assessments by LMEs
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2010-05-20 - Ref To Com On Health Care [S1306 Detail]
Download: North_Carolina-2010-S1306-Amended.html
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2009
S 1
SENATE BILL 1306*
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Short Title: Pilot Independent Assessments by LMEs. |
(Public) |
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Sponsors: |
Senators Nesbitt; and Atwater. |
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Referred to: |
Health Care. |
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May 20, 2010
A BILL TO BE ENTITLED
AN ACT to require the department of health and human services, division of Mental Health, Developmental Disabilities, and Substance Abuse Services, to implement a pilot project to evaluate the cost and program efficacy of independent assessments for integrated program and reporting system enhanced services and medicaid enhanced services.
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, shall establish a pilot project within four local management entities (LMEs) for the purpose of evaluating the cost and program efficacy of conducting independent assessments of individuals seeking or receiving services provided through LMEs, in order to determine their eligibility and need for Integrated Program and Reporting System (IPRS) enhanced services and Medicaid enhanced services. The Department shall select the four participating LMEs as follows:
(1) The Department shall select at least one LME with utilization management responsibilities and at least one LME without utilization management responsibilities. The two LMEs selected pursuant to this subdivision shall establish a process for assessing individuals seeking or receiving IPRS enhanced services or Medicaid enhanced services provided through the LMEs that is independent of the delivery of those services.
(2) The Department shall select two additional LMEs, one with utilization management responsibilities and one without utilization management responsibilities, that are comparable to the first two LMEs selected pursuant to subdivision (1) of this subsection in population, demographics, location, and number of individuals currently enrolled in IPRS enhanced services or Medicaid services. The LMEs selected pursuant to this subdivision shall assess individuals seeking or receiving IPRS enhanced services or Medicaid enhanced services provided through the LMEs without regard to whether the professional conducting the assessment is independent from the delivery of those services.
All assessments conducted by LMEs participating in the pilot project should be as close to identical as possible, except for the independence of the professional conducting the assessment.
SECTION 1.(b) The Department shall submit to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services an interim report on the implementation plan for the pilot project authorized by Section 1(a) of this act by October 1, 2010, and a final report on the pilot project by October 1, 2011. In addition to the Department's findings and recommendations, the final report shall include all of the following information:
(1) The number of clients assessed at each project site.
(2) The number of persons recommended for IPRS enhanced services or Medicaid enhanced services at each project site, along with a listing of those services.
(3) Any costs associated with independent assessment, broken down by each project site.
(4) Comparative data on utilization of IPRS enhanced services and Medicaid enhanced services at project sites conducting independent assessments and project sites conducting nonindependent assessments.
(5) Comparative costs among the four project sites.
SECTION 2. This act is effective when it becomes law.
