2014 State Legislative Summary

By Mary Bethel and Charmaine Fuller Cooper

This summary provides highlights of legislation passed by the NC General Assembly in 2014 which impacts people 50 and older.

Included in this summary is an overview of some of the significant provisions of the budget bill (Senate Bill 744) as well as other relevant bills that passed.  This document is not a comprehensive review of every piece of legislation from this session.  To find out more details about the work of the legislature or to review specific bills, visit the General Assembly’s website at http://www.ncga.state.nc.us/.

AARP Priorities for the Session


The number one issue for AARP this legislative session was funding for the Home and Community Care Block Grant, which provides home and community based services for people 60 years of age and older and also helps supports family caregivers of older adults.  Currently, there are approximately 16,000 people on the waiting list statewide for services funded by the Block Grant such as home delivered meals and in-home aid services.

As the legislative session unfolded, it also became clear that Medicaid for aged, blind, and disabled adults – particularly those who reside in adult care homes and receive Special Assistance to help pay for their room and board and those who qualify for Medicaid as Medically Needy – was at risk of being cut and needed to become a priority.  In total, about 38,000 older and disabled adults potentially stood to lose Medicaid under proposals pushed by the Senate.  A third, and often recurring, issue also surfaced pertaining to amending laws that govern product liability. The pharmaceutical industry sought to remove the consumer’s right to seek legal recourse in the event of harm or death caused by adverse drug reactions. AARP opposed this measure.

What Happened?

AARP volunteers staged a strong defense to protect Medicaid for the aged, blind, and disabled, and the General Assembly listened – no cuts.  However, the Senate made it known that reductions to Medicaid for these populations will be re-examined.  In addition, the legislature passed Senate Bill 648 without the objectionable provision related to product liability for drugs. This issue, also, is expected to come back up next year.  Meanwhile, funding for the Home and Community Care Block Grant was cut by almost $970,000, reducing services for an estimated 1,500 older adults.

In summary, there were some victories but also shortcomings this session.  One thing remains clear, there will be plenty of challenges ahead in 2015 that will call for continuing vigorous advocacy as we work to ensure North Carolina remains a good place to live and grow older each year.

Our 141 AARP Key Legislative Contact volunteers were outstanding this legislative session keeping our issues front and center among elected officials.  We also greatly appreciate the support and assistance of AARP activists who took action on-line or over the phone, as did many of our partners.  Finally, many service recipients, and in many cases their family members, stepped forward and told their stories, becoming the faces of issues for which we all worked so hard.  AARP gives our special thanks and appreciation to all those who stood up and took action for the benefit of others in our state.

Key Provisions from Senate Bill 744 (Budget Bill)

• Cuts $969,549 in funding for the Home and Community Care Block Grant.  This is a 3% reduction in funding for the program.

• Reinstates the Volunteer Development Program as a service category under the Home and Community Care Block Grant.  As service providers depend more on volunteers to help provide services such as home delivered meals, volunteer program development takes on increasing importance.

• Provides $100,000 in non-recurring funding for Senior Center capital projects.

• Cuts funding to the Competitive Block Grant appropriation to the NC Department of Health and Human Services by 4.5%.  This is the funding source that has provided a grant to NC Senior Games.

• Requires the NC Division of Aging and Adult Services to collaborate with the Administrative Office of the Courts to develop a plan regarding the NC Department of Health and Human Services investigation of complaints pertaining to wards served by publically funded guardians.  Also requires the Division of Aging and Adult Services to work with a variety of stakeholders to develop a model plan for transitioning wards to alternative guardianship arrangements when the individual guardian of the person becomes unable or unwilling to serve.  The plan is to focus on ways to prevent the appointment of a publically funded guardian.  In addition, changes are made to the status report that is filed by corporations or disinterested public agents (county Departments of Social Services) serving as guardians.

• Requires the NC Division of Aging and Adult Services to develop a strategic plan for Alzheimer’s disease.

• Establishes, with a few exceptions, a moratorium on home care agency licenses for in-home aid services until June 30, 2016. 

• Extends, with a few exceptions, a moratorium on Alzheimer’s special care unit licenses until June 30, 2016. 

• Directs county Departments of Social Services to submit an outreach plan for the Low-Income Energy Assistance Program by August 1 of each year for targeting households with 60-year old household members.

• Retains Medicaid for thousands of persons, most of who are aged, blind, or disabled, who qualify for Medicaid as Medically Needy.  The Medically Needy program extends Medicaid eligibility to those whose income exceeds the Medicaid limit (100% of the federal poverty level for older and disabled adults), but who would otherwise be eligible for Medicaid.  Many individuals who qualify as Medically Needy have medical expenses that overwhelm their income and they need assistance with health care services to help them live in their homes.  They are responsible for paying for a portion of their care based on their income before being eligible for Medicaid.  The Senate had proposed eliminating the Medicaid Medically Needy program.

• Changes the income eligibility for State-County Special Assistance (SA) residents who reside in adult care homes from a method that bases income eligibility on the payment rate for the facility type where the resident resides to a method based on the federal poverty level for all recipients regardless of where they reside.  Current residents (those approved prior to November 1, 2014) are grandfathered in and will continue to receive SA.  This change is contingent on the federal Center for Medicare and Medicaid Services (CMS) approving the state plan amendment allowing the grandfathered recipients to continue to receive Medicaid.  If CMS does not approve the continuation of Medicaid for these individuals, then this eligibility change will not be implemented.  It is estimated that 5,238 people, or approximately one-fourth of the residents of adult care homes, would lose SA and Medicaid if this policy change is implemented.

• Further stipulates that to be eligible for State-County Special Assistance (SA) a person must be a resident of North Carolina for 90 days prior to receiving this assistance or must be a person discharged from a State facility who was a patient in the facility as a result of an interstate mental health compact that requires the State to continue treating the person within the State.  Eliminates the provision which allowed a person to be eligible upon coming to North Carolina if they were coming to the state to join a close relative who has resided in North Carolina for at least 180 consecutive days.

• Undertakes a number of changes to the Medicaid program which will impact providers of Medicaid services including reducing provider rates by 1.0% effective January 1, 2015 (this is on top of rate cuts taken last year), freezing the nursing home case-mix index adjustments, and establishing a single base rate for all hospitals.  A 3% reduction implemented for nursing home rates in FY 2013-14 is restored effective June 1, 2015.

• Provides funding in the amount of $300,000 to the NC Department of Health and Human Services to contract for a study to define a new limited Medicaid Personal Care Services optional service program.  The report from this study is due December 1, 2015.  In addition, the Department is to study and report on Adult Care Home inspections, procedures, and processes.

• Directs the NC Department of Health and Human Services, Division of Medical Assistance, to modify the service definition for the Medicaid Intensive In-Home Service to reflect a team-to-family ratio of one Intensive In-Home team to 12 families.

• Directs the NC Department of Health and Human Services, Division of Medical Assistance, to compile a report on the Program of All-Inclusive Care for the Elderly (PACE).  Among other things, the report is to offer recommendations on how to make the program sustainable.

• Provides funding for one year in the amount of $2,000,000 for supplemental short-term assistance for group home residents who were determined to be ineligible for Medicaid personal care services on or after January 1, 2013.  The maximum monthly payment is set at $464.30 and is based on providing 33 hours of service per eligible recipient.

• Directs the NC Department of Health and Human Services, Division of Medical Assistance, to draft one or more Medicaid waivers that would expand primary care case management for persons eligible for both Medicaid and Medicare (dual eligibles).

• Eliminates the Veterans’ Affairs grant-in-aid program in the amount of $138,000 to county governments for the provision of veteran’s services.  This program gave county veterans’ services offices administration a supplement for the provision of veterans’ services.

• Appropriates funds from the State Veteran’s Trust Fund to fully operate the two recently opened State Veterans’ Homes in Black Mountain and Kinston.

• Provides a 1% cost-of-living increase for retirees of the Teachers’ and State Employees’ Retirement System, the Judicial Retirement System, and the Legislative Retirement System.

• Clarifies that re-hired state retirees shall be offered coverage in the State Health Plan as active employees rather than as retirees.

• Authorizes the NC Division of Motor Vehicles to offer remote renewal of drivers’ license.  Remote renewal means by mail, telephone, electronic device, or other secure means approved by the Commissioner.  A person seeking a license must meet specified criteria.  Persons18 years old but less than 66 years of age may get an eight year license and those 66 years or older may get a five year license.

For further highlights of the Budget Bill, go to the following summary compiled by the News and Observer:  http://www.newsobserver.com/2014/07/31/4042652/highlights-of-the-nc-budget.html.

Other Bills

House Bill 625 – Zoning/Health Care Structure

• Exempts temporary family health care structures used by a caregiver in providing care for a mentally or physically impaired person from zoning requirements applicable to single family residential zoning by counties and cities and requires issuance of a permit for installation.

House Bill 1034 – Volunteer Fire and Rescue Squad Finances

• Among other things, this bill specifies that any person who has served 20 years as an eligible firefighter or eligible rescue squad worker in the State of North Carolina who has attained the age of 55 is entitled to be paid a monthly pension in the amount of $170.00.

House Bill 1050 – Omnibus Tax Law Changes

• Further amends the revenue laws of the state.  Also makes some clarifications to the changes in the revenue laws enacted last legislative session.  Included in the bill is a provision to tax e-cigarettes at 5 cents per milliliter of nicotine-containing liquid used in the vapor devices.

House Bill 1069 – Unemployment Insurance Law Changes  

• Amends the unemployment insurance laws as recommended by the Joint Legislative Oversight Committee on Unemployment Insurance.  Provisions in the bill address confidentiality of unemployment insurance information, authorize the DMV to disclose Social Security numbers, require unemployment claimants to contact five potential employers per week, eliminate the procedure to request reconsideration of decisions, address garnishment and attachment for the collection of unpaid unemployment insurance taxes,  set the duration of unemployment benefits based only on the unemployment rate, require photo identification to receive unemployment insurance benefits, and detail the specifics of the Board of Review for Unemployment Insurance.  In vetoing the bill, the Governor noted that he was unhappy with the legislature’s changes to the three member Board of Review.

House Bill 1133 – Technical and Other Changes (awaiting Governor’s signature 8/8/14)

• Section 44 of this bill clarifies the procedures for obtaining and challenging a subpoena to investigate financial exploitation of disabled and older adults by specifying the following procedures: (1) an investigating entity may obtain a subpoena by filing a petition in district court, (2) financial institutions may challenge the subpoena by filing a motion based on specified grounds, and (3) court records of the proceedings are not public documents and must be maintained accordingly.

House Bill 1177 – Conform Pledge of Joint Account Laws

• Conforms the law governing the pledge of joint accounts in credit unions, savings and loan associations, and savings banks to the laws governing the pledge of joint accounts in banks, as recommended by the General Statutes Commission.

House Bill 1193 – Retirement Technical Corrections Act of 2014

• Makes technical changes to the statutes affecting the State Retirement System.

House Bill 1194 – Retirement Administrative Changes Act of 2014

• Makes changes to the administration of the State Retirement System including a provision that would allow both current and prospective retirees in the state and local retirement systems who elected to take the contributory death benefit when they retired to designate a beneficiary other than a spouse.

House Bill 1195 – Fiscal Integrity/Pension Spiking Prevention

• Includes several provisions related to the public pension system.  Enacts anti-pension spiking legislation by establishing a contribution-based benefit cap, allows members of the Teachers’ and State Employees Retirement System and the Local Governmental Employees’ Retirement System who leave employment within five years to receive a return of the contributions with accumulated interest, returns to a five-year vesting period (previously ten year vesting) for members of the Teachers’ and State Employees’ Retirement System and the Consolidated Judicial Retirement System who became members on or after August 1, 2011, and makes a conforming change to the special separation allowance for law enforcement officers.

Senate Bill 403 – Omnibus Election Clarifications

• Amends and clarifies various provisions of the elections laws.  Also includes a provision to require electronic filing of campaign reports.   All political campaigns or committees raising and/or spending more than $5,000 is required to submit electronic reports to the NC Board of Elections beginning January 1, 2017.

Senate Bill 477 – No Set Fee/Noncovered Vision Services

• Prohibits insurers and health benefit plans from limiting or fixing the fee an optometrist may charge patients for services or materials unless the services or materials are covered by reimbursement under the plan or insurer contract with the optometrist.

Senate Bill 773 – Implement General Statute Commission Recommendations

• Implements the recommendations of the General Statutes Commission to modify the Slayer Statute due to the need to account for property held in joint tenancy in unequal shares, clarifies the provisions for filing certified copies of probated wills in other counties where a decedent has real property, and deletes the statutory forms for judgment debtors claiming exemptions under G.S. 1C-1601 because the Administrative Office of the Courts already has widely used form for that purpose.  Among other provisions, also implements the recommendations from the NC Bar Association to clarify the requirements for the timely substitution of a personal representative in place of a decedent in an action pending at the decedent’s death and clarifies that the common law rule against accumulations does not apply to trusts in this state.

Senate Bill 648 – NC Commerce Protection Act of 2014

• As passed, this bill creates transparency in contracts between the Attorney General and private attorneys, prevents the abuse of patents, allows for shareholders assent to exclusive forum, and limits asbestos-related liabilities for certain successor corporations.  A provision which had been originally in the bill but did not pass, and was opposed by AARP NC, provided immunity from liability claims for a drug manufacturer for any drug sold in compliance with regulatory requirements or in compliance with federal or state standards.  This provision would have removed the right of the consumer for any legal recourse in the event they were harmed or died from problems with prescription drugs.

MCDickerson

AARP and other organizations held a lobby day in May to preserve important funds that help family caregivers.