North Carolina § 122C-22 - Exclusions from licensure; deemed status.

§ 122C-22. Exclusions from licensure; deemed status.

All of the following are excluded from the provisions of this Article and are not required to obtain licensure under this Article: Physicians and psychologists engaged in private office practice. General hospitals licensed under Article 5 of Chapter 131E of the General Statutes, that operate special units for patients with a mental health disorder diagnosis, one or more developmental disabilities, or a substance use disorder. State and federally operated facilities. Adult care homes licensed under Chapter 131D of the General Statutes. Developmental child care centers licensed under Article 7 of Chapter 110 of the General Statutes. Persons subject to licensure under rules of the Social Services Commission. Persons subject to rules and regulations of the Division of Vocational Rehabilitation Services. Facilities that provide occasional respite care for not more than two individuals at a time; provided that the primary purpose of the facility is other than as defined in G.S. 122C-3(14). Twenty-four-hour nonprofit facilities established for the purposes of shelter care and recovery from alcohol or other substance use disorder through a 12-step, self-help, peer role modeling, and self-governance approach. Inpatient chemical dependency or substance abuse facilities that provide services exclusively to inmates of the Division of Adult Correction and Juvenile Justice of the Department of Public Safety, as described in G.S. 148-19.1. A charitable, nonprofit, faith-based, adult residential treatment facility that does not receive any federal or State funding and is a religious organization exempt from federal income tax under section 501(a) of the Internal Revenue Code. A home in which up to three adults, two or more having a disability, co-own or co-rent a home in which the persons with disabilities are receiving three or more hours of day services in the home or up to 24 hours of residential services in the home. The individuals who have disabilities cannot be required to move if the individuals change services, change service providers, or discontinue services. The Commission may adopt rules establishing a procedure whereby a facility that would otherwise require licensure under this Article that is certified by a nationally recognized agency, such as the Joint Commission on Accreditation of Hospitals, may be deemed licensed under this Article by the Secretary. Any facility licensed under the provisions of this subsection shall continue to be subject to inspection by the Secretary. The Secretary shall collaborate with relevant agencies to ensure that any facilities deemed licensed under this Article maintain the required certification. History (1983, c. 718, s. 1; 1983 (Reg. Sess., 1984), c. 1110, s. 5; 1985, c. 589, s. 2; c. 695, s. 13; 1987, c. 345, s. 2; 1989, c. 625, s. 5; 1995, c. 535, s. 7; 1997-506, s. 43; 2000-67, s. 11.25A; 2001-424, s. 25.19(b); 2004-199, s. 32; 2011-145, s. 19.1(h); 2011-202, s. 1; 2012-15, s. 1; 2013-410, s. 11; 2017-186, s. 2(jjjjj); 2021-77, s. 7.3(a).) Cross References. - As to exemption from reporting of death of a client, see G.S. 122C-31(i) . Overnight Respite Services in Adult Day Care Facilities Pilot Program. - The preamble to Session Laws 2011-104, provides: "Whereas, the population of adults who are elderly or disabled in North Carolina is expected to increase, thereby increasing the need for safe and available overnight respite care; and "Whereas, adult day care provides group care and supervision to adults who may be physically or mentally disabled; and "Whereas, adult day care provides care and supervision during the day, allowing caregivers a time of respite or allowing caregivers to attend to other duties, including work; and "Whereas, adult day care allows individuals to remain in their communities and/or in familiar surroundings, thereby prolonging or eliminating the need for placement in a long-term care facility; Now, therefore, The General Assembly of North Carolina enacts." Session Laws 2011-104, ss. 1-3, as amended by Session Laws 2015-52, ss. 1, 2, provides: "1.(a) Notwithstanding G.S. 131D-6(b) , the Department of Health and Human Services shall conduct a pilot program to assess the provision of overnight respite services in adult day care programs. The Secretary shall select a minimum of two, and a maximum of four, stable and successful certified adult day care programs in which to conduct the pilot. At least two of the programs selected shall be operated by an organization that has been offering adult day care in North Carolina since 1980 and has received national recognition including all of the following criteria: designated as a National Model Adult Day Care Center by the Robert Wood Johnson Foundation, designated as the only Teaching Day Center for recipients of North Carolina adult day care startup funds, received the North Carolina Non-Profit Center's Non-Profit Sector Stewardship Award for exemplary stewardship of resources, and received Leadership in Energy and Environmental Design (LEED) certification. "(b) The provision of 24-hour care under this act shall not exceed 14 consecutive calendar days, or more than 60 total calendar days, during a 365-day period, for each participant receiving overnight respite services. The capacity of the 24-hour overnight respite program authorized under this act shall not exceed six beds. The State is not authorized to pay for any overnight respite services offered through this pilot, and the pilot shall not be eligible to enroll or otherwise participate in the Medicaid program. "(c) An adult day care program participating in this pilot shall be currently certified by the Department to provide adult day care. An adult day care program participating in the pilot shall be exempt from adult care home licensure pursuant to Article 1 of Chapter 131D of the General Statutes and shall be exempt from licensure under Chapter 131E and Chapter 122C of the General Statutes. The Department of Health and Human Services shall adopt rules to include minimum requirements to ensure the health and safety of adult day care overnight respite participants. These requirements shall specify program management, staffing, building specifications, fire safety, sanitation, nutrition, enrollment, medication management, and program activities. Participant assessments conducted by the adult day care pilot programs shall provide sufficient information to ensure appropriate care and to protect the health and safety of participants but shall not be more onerous than current adult day care assessments. The Division of Health Service Regulation shall have the authority to enforce the rules adopted by the Department. Prior to the provision of overnight respite services, an adult day care program participating in the pilot shall receive an initial inspection by the Division of Health Service Regulation for compliance with the rules. On a basis not less than every six months, the Division of Health Service Regulation shall conduct monitoring visits and shall also be responsible for the investigation of complaints. Each adult day care program participating in the pilot 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. The Division of Health Service Regulation shall have the authority to suspend admissions or terminate the pilot program 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. "2(a). The Department of Health and Human Services shall report on the status of the pilot once a year to the Program Evaluation Division. The Program Evaluation Division shall evaluate the provision of overnight respite services in an adult day care program through the experiences of this pilot. The evaluation shall include whether this pilot was successful as measured by the participants in receipt of overnight respite, the primary caregivers of participants, the adult day care programs participating in the pilot, and the Department of Health and Human Services. On or before October 1, 2014, the Program Evaluation Division shall provide a report to the General Assembly on the feasibility of continuing to provide overnight respite in an adult day care program. "(b) Following the 2014 report and in order to provide a more comprehensive evaluation of the pilot, the Department of Health and Human Services shall coordinate with the Program Evaluation Division regarding the collection of additional information. The Program Evaluation Division shall specify what information the Department needs to collect and the timeframe for reporting the information. Based on information collected through the Department, the Program Evaluation Division shall provide information on each of the items below which will assist in determining whether the provision of overnight respite in an adult day care setting is a worthwhile service. "(1) The actual number of overnight respite participants per month. "(2) The percentage of an adult day care entity's clients that need overnight respite; the percentage of clients that use overnight respite; the percentage of clients using the service more than once if they had a need arise; the percentage of clients using overnight respite that are not regular adult day care clients; and the average monthly bed utilization for overnight respite at each location. "(3) Customer satisfaction levels for individuals who participate and their families. "(4) Satisfaction levels of adult day care entities offering overnight respite services. "(5) The viability of an adult day care offering overnight respite from a cost/benefit standpoint "(6) The need for overnight respite options in the State currently and the need forecast through 2025. "(7) The degree to which overnight respite provided in an adult day care setting supports older and disabled adults who wish to live in the least restrictive and supportive setting possible. "(8) The potential for saving public dollars due to delayed institutionalization when overnight respite is readily available. "(9) Based on the pilot, a recommendation regarding whether the State should allow the provision of overnight respite in an adult day care setting beyond the pilot. "(10) A recommendation regarding whether the current regulations are sufficient to ensure the safety and well-being of residents participating in overnight respite in an adult day care setting. "(11) A recommendation regarding whether adult day care overnight respite should require certification or licensure. "(12) If a recommendation is made to expand overnight respite in an adult day care setting, the feasibility of funding sources other than private pay, including the possibility of coverage for the service under Medicaid. "The Program Evaluation Division shall provide an interim report on the criteria specified in this section on or before December 1, 2015, and a final report on or before October 1, 2016, to the Joint Legislative Program Evaluation Oversight Committee and to the Joint Legislative Oversight Committee on Health and Human Services. "3. This act becomes effective when it becomes law [June 2, 2011]; adult day care programs participating in the pilot shall be selected and have received an initial inspection by January 1, 2012; and this act is repealed June 30, 2017." Editor's Note. - Session Laws 1999-237, s. 18.8(a), provides that inpatient chemical dependency or substance abuse facilities that provide services exclusively to inmates of the Department of Correction shall be exempt from licensure by the Department of Health and Human Services under Chapter 122C of the General Statutes. If an inpatient facility provides services to inmates of the Department of Correction and to members of the general public, the portion of the facility that serves inmates shall be exempt from licensure. Session Laws 1999-237, s. 18.8(b), provides that any person who contracts to provide inpatient chemical dependency or substance abuse services to inmates of the Department of Correction may construct and operate a new chemical dependency or substance abuse facility for that purpose without first obtaining a certificate of need from the Department of Health and Human Services pursuant to Article 9 of Chapter 131E of the General Statutes. However, a new facility or addition developed for that purpose without a certificate of need shall not be licensed pursuant to Chapter 122C of the General Statutes and shall not admit anyone other than inmates unless the owner or operator first obtains a certificate of need. Session Laws 1999-237, s. 18.8(c), provides that section 18.8 applies to existing facilities, as well as future facilities contracting with the Department of Correction. For prior similar legislation, see Session Laws 1995, c. 507, s. 19.9. Session Laws 1999-237, s. 1.1, provides: "This act shall be known as the 'Current Operations and Capital Improvements Appropriations Act of 1999'." Session Laws 1999-237, s. 30.2, provides: "Except for statutory changes or other provisions that clearly indicate an intention to have effects beyond the 1999-2001 fiscal biennium, the textual provisions of this act apply only to funds appropriated for, and activities occurring during, the 1999-2001 biennium." Session Laws 1999-237, s. 30.4, is a severability clause. Session Laws 2021-77, s. 7.3(b)-(d), provides: "(b) The Department of Health and Human Services shall establish a database or expand upon a currently existing database that makes publicly available a searchable listing of all applicable facilities and programs with all of the following information: "(1) The facility or program name. "(2) The location, including street and mailing addresses, city, and county, for the facility or program. "(3) The contact information for the owners, director, or other individual in charge of the facility or program. "(4) The dates and types of visits conducted by the Division of Health Services Regulation. "(5) A description of the findings, including whether a complaint was substantiated or unsubstantiated, and identification of the violation cited if substantiated. "(6) Any action taken under G.S. 122C-28.1 by the Division of Health Services Regulation. "(c) The Department of Health and Human Services shall coordinate with the Department of Insurance to establish a toll-free number or website for individuals, providers, and insurers to use in verifying the licensure status of a facility providing mental health, behavioral health, and substance use disorder services. "(d) The Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS), shall collaborate with community organizations, such as the National Alliance for Mental Illness (NAMI), for a public information campaign about the appropriate types of care for individuals with mental health disorders that, at a minimum, includes information on the importance of receiving care from a licensed facility or program with medical personnel licensed by the North Carolina Medical Board." Effect of Amendments. - Session Laws 2004-199, s. 32, effective August 17, 2004, added subdivision (a)(11); and made minor stylistic changes. Session Laws 2011-202, s. 1, effective June 23, 2011, added subdivision (a)(12). Session Laws 2017-186, s. 2(jjjjj), effective December 1, 2017, inserted "and Juvenile Justice" in subdivision (a)(10). Session Laws 2021-77, s. 7.3(a), effective January 1, 2022, substituted "patients with a mental health disorder diagnosis, one or more developmental disabilities, or a substance use disorder” for "the mentally ill, developmentally disabled, or substance abusers” in subdivision (a)(2); substituted "substance use disorder” for "drug addiction” in subdivision (a)(9); in subsection (b), in the first sentence, deleted "licensable” preceding "facility” and inserted "that would otherwise require licensure under this Article that is”, and added the last sentence.