A BILL TO BE ENTITLED
AN ACT establishing a certification process for adult day care and adult day health overnight respite programs; establishing certification and construction project fees for these overnight respite programs; appropriating funds to the department of health and human services, division of health service regulation, for additional staff to support this certification process; adding overnight respite as an approved service under the home and community care block grant; and allowing certified adult day care and adult day health overnight respite programs to become allowable providers of respite services under the state's innovations waiver and community alternatives program for disabled adults waiver.
The General Assembly of North Carolina enacts:
SECTION 1.  Article 1 of Chapter 131D of the General Statutes is amended by adding a new section to read:
"§ 131D‑6A.  Certification to offer overnight respite in adult day care and adult day health facilities; rules; enforcement.
(a)	As used in this section, "overnight respite services" means the provision of group care and supervision in a place other than their usual place of abode on a 24‑hour basis to adults who may be physically or mentally disabled.
(b)	Any facility certified to provide adult day care services pursuant to G.S. 131D‑6, adult day health services pursuant to 10A NCAC 06S, or both, may apply to the Department for certification to offer a program of overnight respite services. The Department shall annually certify all overnight respite programs in facilities certified to provide adult day care services, adult day health services, or both, under rules adopted by the Department pursuant to subsection (c) of this section. As part of the certification process, the Division of Health Service Regulation shall inspect each overnight respite program for compliance with the rules adopted by the Department pursuant to subsection (c) of this section.
(c)	The Department shall establish rules governing the certification of overnight respite programs in facilities certified to provide adult day care services, adult day health services, or both. The rules shall limit the provision of 24‑hour care for each adult to (i) not more than 14 consecutive calendar days, or not more than 60 total calendar days, during a 365‑day period or (ii) the amount of respite allowed under the State's Innovations waiver or Community Alternatives Program for Disabled Adults (CAP/DA) waiver, as applicable. The rules shall include minimum requirements to ensure the health and safety of adult day care overnight respite participants. These requirements shall address all of the following:
(1)	Program management.
(2)	Staffing.
(3)	Building specifications.
(4)	Fire safety.
(5)	Sanitation.
(6)	Nutrition.
(7)	Enrollment.
(8)	Bed capacity limitations, which shall not exceed six beds in each adult day care program.
(9)	Medication Management.
(10)	Program activities.
(d)	The Division of Health Service Regulation shall have the authority to enforce the rules adopted by the Department under subsection (c) of this section and shall be responsible for the investigation of complaints pertaining to overnight respite programs in facilities certified to provide adult day care services, adult day health services, or both.
(e)	Each facility that is certified to provide a program of overnight respite services under this section shall periodically report the number of individuals served and the average daily census to the Division of Health Service Regulation on a schedule determined by the Division.
(f)	The Division of Health Service Regulation shall have the authority to suspend or revoke a facility's certification to provide a program of overnight respite services at any time due to noncompliance with regulatory requirements which has resulted in death or serious physical harm, or when there is a substantial risk that death or serious physical harm will occur.
(g)	Nothing in this section shall be construed to prevent a certified adult day care overnight respite program or a certified adult day health overnight respite program from receiving State funds or participating in any government insurance plan, including the Medicaid program, to the extent authorized or permitted under applicable State or federal law.
(h)	The Department shall charge each adult day care overnight respite program and each adult day health overnight respite program a nonrefundable initial certification fee of three hundred fifty dollars ($350.00) and a nonrefundable renewal certification fee in the amount of three hundred fifteen dollars ($315.00)."
SECTION 2.  G.S. 131E‑267(g) reads as rewritten:
"(g)	The fee imposed for the review of the following residential construction projects is:
Residential Project	Project Fee
Family Care Homes	$225.00 flat fee
ICF/MR Group Homes	$350.00 flat fee
Group Homes: 1‑3 beds	$125.00 flat fee
Group Homes: 4‑6 beds	$225.00 flat fee
Group Homes: 7‑9 beds	$275.00 flat fee
Adult Day Care Overnight Respite Facility	$225.00 flat fee
Adult Day Health Overnight Respite Facility	$225.00 flat fee
Other residential:
	More than 9 beds	$275.00 plus $0.15 per square foot of project space."
SECTION 3.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Service Regulation, the sum of eighty‑eight thousand dollars ($88,000) for the 2015‑2016 fiscal year and the sum of eighty‑eight thousand dollars ($88,000) for the 2016‑2017 fiscal year. These funds shall be used to create one full‑time equivalent Nursing Consultant position and one full‑time equivalent Engineer/Architect position within the Division dedicated to inspecting adult day care and adult day health facilities seeking certification to provide overnight respite in accordance with G.S. 131D‑6A, as enacted by Section 1 of this act.
SECTION 4.  The Department of Health and Human Services, Division of Aging and Adult Services, shall add adult day care overnight respite programs as a service category under the Home and Community Care Block Grant. Counties may elect to use adult day care overnight respite programs or adult day health overnight respite programs certified under G.S. 131D‑6A, as enacted by Section 1 of this act, to provide overnight respite services to caregivers of older adults from funds received under the Home and Community Care Block Grant.
SECTION 5.  The Department of Health and Human Services, Division of Medical Assistance, shall take any and all action necessary to amend the North Carolina Innovations waiver and the North Carolina Community Alternatives Program for Disabled Adults (CAP/DA) waiver for the purpose of allowing facilities certified to provide adult day care overnight respite programs and adult day health overnight respite programs under G.S. 131D‑6A, as enacted by Section 1 of this act, to become allowable providers of overnight respite under each waiver.
SECTION 6.  This act becomes effective July 1, 2015.