A BILL TO BE ENTITLED
AN ACT to permit Continuing Care retirement communities to provide or arrange for Home care services without providing lodging When those services are provided adjunct to a contract for continuing care and to require the Department of Insurance and the Department of health and Human Services to study issues related to continuing care retirement communities providing home care services without providing lodging.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 58‑64‑5 reads as rewritten:
"§ 58‑64‑5.  License.
(a)	No provider shall engage in the business of offering or providing continuing care in this State without a license to do so obtained from the Commissioner as provided in this Article. It is a Class 1 misdemeanor for any person, other than a provider licensed under this Article, to advertise or market to the general public any product similar to continuing care through the use of such terms as "life care", "continuing care", or "guaranteed care for life", or similar terms, words, or phrases. The licensing process may involve a series of steps pursuant to rules adopted by the Commissioner under this Article.
(b)	The application for a license shall be filed with the Department by the provider on forms prescribed by the Department and within a period of time prescribed by the Department; and shall include all information required by the Department pursuant to rules adopted by it under this Article including, but not limited to, the disclosure statement meeting the requirements of this Article and other financial and facility development information required by the Department. The application for a license must be accompanied by an application fee of one thousand dollars ($1,000).
…."
SECTION 2.  G.S. 58‑64‑1 reads as rewritten:
"§ 58‑64‑1.  Definitions.
As used in this Article, unless otherwise specified:
(1)	Continuing care. – The furnishing to an individual other than an individual related by blood, marriage, or adoption to the person furnishing the care, of lodging together with nursing services, medical services, or other health related services, under a contract approved by the Department in accordance with this Article effective for the life of the individual or for a period longer than one year. "Continuing care" may also include home care services provided or arranged by a provider of lodging at a facility to an individual who has entered into a continuing care contract with the provider but is not yet receiving lodging.(2)	 Entrance fee. – A payment that assures a resident a place in a facility for a term of years or for life.
(3)	Facility. – The retirement community or communities in which a provider undertakes to provide continuing care to an individual.
(4)	Health-related services. – At a minimum, nursing home admission or assistance in the activities of daily living, exclusive of the provision of meals or cleaning services.
(4a)	Home care services. – Defined in G.S. 131E‑136.
(5)	Living unit. – A room, apartment, cottage, or other area within a facility set aside for the exclusive use or control of one or more identified residents.
(5a)	Lodging. – A living unit as set forth in a contract approved by the Department in accordance with this Article.
(6)	Provider. – The promoter, developer, or owner of a facility, whether a natural person, partnership, or other unincorporated association, however organized, trust, or corporation, of an institution, building, residence, or other place, whether operated for profit or not, or any other person, that solicits or undertakes to provide continuing care under a continuing care facility contract, or that represents himself, herself, or itself as providing continuing care or "life care."
(7)	Resident. – A purchaser of, a nominee of, or a subscriber to, a continuing care contract.
(8)	Hazardous financial condition. – A provider is insolvent or in eminent danger of becoming insolvent."
SECTION 3.  G.S. 58‑64‑25 reads as rewritten:
"§ 58‑64‑25.  Contract for continuing care; specifications.
(a)	Each contract for continuing care shall provide that:
…
(b)	Each contract shall include provisions that specify the following:
(1)	The total consideration to be paid.
(2)	Services to be provided.
(3)	The procedures the provider shall follow to change the resident's accommodation if necessary for the protection of the health or safety of the resident or the general and economic welfare of the residents.
(4)	The policies to be implemented if the resident cannot pay the periodic fees.
(5)	The terms governing the refund of any portion of the entrance fee in the event of discharge by the provider or cancellation by the resident.
(6)	The policy regarding increasing the periodic fees.
(7)	The description of the living quarters.
(8)	Any religious or charitable affiliations of the provider and the extent, if any, to which the affiliate organization will be responsible for the financial and contractual obligations of the provider.
(9)	Any property rights of the resident.
(10)	The policy, if any, regarding fee adjustments if the resident is voluntarily absent from the facility.(11)	Any requirement, if any, that the resident apply for Medicaid, public assistance, or any public benefit program. 
(12)	The procedures for determining when the individual will transition to receiving lodging and health-related services in the event that a contract allows for the provision or arrangement of continuing care without lodging."
SECTION 4.   Article 64 of Chapter 58 of the General Statutes is amended by adding a new section to read:
"§ 58‑64‑7 Continuing care services without lodging.
(a)	A provider of continuing care who has obtained a license pursuant to this Article and desires to provide or arrange for continuing care services, including home care services, to an individual who has entered into a continuing care contract with the provider but is not yet receiving lodging must submit the following to the Commissioner:
(1)	An application to offer continuing care services without providing lodging.
(2)	An amended Disclosure Statement containing a description of the proposed continuing care services that will be provided without lodging, including the target market, the types of services to be provided, and the fees to be charged.
(3)	A copy of the written service agreement which must contain those provisions as prescribed in G.S. 58‑64‑25(b).
(4)	A summary of an actuarial report that presents the impact of providing continuing care services without lodging on the overall operation of the continuing care retirement community.
(5)	A financial feasibility study prepared by a certified public accountant that shows the financial impact of providing continuing care services without lodging on the applicant and the continuing care retirement facility or facilities. The financial feasibility study shall include a statement of activities reporting the revenue and expense details for providing continuing care services without lodging, as well as any impact the provision of these services will have on operating reserves.
(6)	Evidence of the license required under Part 3 of Article 6 of Chapter 131E of the General Statutes to provide home care services, or a contract with a licensed home care agency for the provision of home care services to the individuals under the continuing care services without lodging program. (b)	A provider issued a start‑up certificate for the provision of continuing care services without lodging must enter into binding written service agreements with subscribers to provide continuing care services without lodging.
(c)	When providing the financial statements and five-year forecasts required by G.S. 58‑64‑20, a provider offering continuing care services without lodging must account for the related revenue and expenses generated from the provision of these services separate from the facility's on‑site operation."
SECTION 5.  The Department of Insurance and the Department of Health and Human Services shall identify any statutory, regulatory, or practical barriers that prevent or discourage individuals that contract with continuing care retirement communities from receiving home care services for as long as they need home care services and are able to be safely cared for in their homes.  The Departments shall jointly provide an interim status report on or before November 1, 2010, and a final report on or before September 1, 2011, to the North Carolina Study Commission on Aging and the Joint Legislative Health Care Oversight Committee.  Each report shall include findings and recommendations made to date on statutory changes and a timetable for promulgation of rules to eliminate any identified barriers to providing appropriate levels of care.
SECTION 6.  Section 1 of this act becomes effective July 1, 2010, and applies to applications filed on or after that date. The remainder of the act is effective when it becomes law, and Sections 2, 3, and 4 expire July 1, 2012.  Contracts executed on or after the effective date of this act that allow for the provision or arrangement of continuing care without lodging remain effective after July 1, 2012, and the continuing care retirement community may provide home care services without lodging under the terms of the contract after July 1, 2012.