(a) The area authorityor county program shall contract with other qualified public or privateproviders, agencies, institutions, or resources for the provision of services,and, subject to the approval of the Secretary, is authorized to provideservices directly. The area authority or county program shall indicate in itslocal business plan how services will be provided and how the provision ofservices will address issues of access, availability of qualified public orprivate providers, consumer choice, and fair competition. The Secretary shalltake into account these issues when reviewing the local business plan andconsidering approval of the direct provision of services. Unless an area authorityor county program requests a shorter time, any approval granted by theSecretary shall be for not less than one year. The Secretary shall developcriteria for the approval of direct service provision by area authorities andcounty programs in accordance with this section and as evidenced by compliancewith the local business plan. For the purposes of this section, a qualifiedpublic or private provider is a provider that meets the provider qualificationsas defined by rules adopted by the Secretary.
(b) All area authorityor county program services provided directly or under contract shall meet therequirements of applicable State statutes and the rules of the Commission andthe Secretary. The Secretary may delay payments and, with written notification ofcause, may reduce or deny payment of funds if an area authority or countyprogram fails to meet these requirements.
(c) The area authorityor board of county commissioners of a county program may contract with a healthmaintenance organization, certified and operating in accordance with theprovisions of Article 67 of Chapter 58 of the General Statutes for the areaauthority or county program, to provide mental health, developmentaldisabilities, or substance abuse services to enrollees in a health care planprovided by the health maintenance organization. The terms of the contract mustmeet the requirements of all applicable State statutes and rules of theCommission and Secretary governing both the provision of services by an areaauthority or county program and the general and fiscal operation of an areaauthority or county program and the reimbursement rate for services renderedshall be based on the usual and customary charges paid by the healthmaintenance organization to similar providers. Any provision in conflict with aState statute or rule of the Commission or the Secretary shall be void;however, the presence of any void provision in that contract does not rendervoid any other provision in that contract which is not in conflict with a Statestatute or rule of the Commission or the Secretary. Subject to approval by theSecretary and pending the timely reimbursement of the contractual charges, thearea authority or county program may expend funds for costs which may beincurred by the area authority or county program as a result of providing theadditional services under a contractual agreement with a health maintenanceorganization.
(d) If two or morecounties enter into an interlocal agreement under Article 20 of Chapter 160A ofthe General Statutes to be a public provider of mental health, developmentaldisabilities, or substance abuse services ("public provider"), beforean LME may enter into a contract with the public provider, all of the followingmust apply:
(1) The public providermust meet all the provider qualifications as defined by rules adopted by theCommission. A county that satisfies its duties under G.S. 122C‑115(a)through a consolidated human services agency may not be considered a qualifiedprovider for purposes of this subdivision.
(2) The LME must adopt aconflict of interest policy that applies to all provider contracts.
(3) The interlocalagreement must provide that any liabilities of the public provider shall bepaid from its unobligated surplus funds and that if those funds are notsufficient to satisfy the indebtedness, the remaining indebtedness shall beapportioned to the participating counties.
(e) When enforcingrules adopted by the Commission, the Secretary shall ensure that there is faircompetition among providers. (1977, c. 568, s. 1; c. 679, s. 7; 1979, c. 358, ss.7, 18; 1981, c. 51, s. 3; c. 539, ss. 3, 4; c. 614, s. 7; 1985, c. 589, s. 2;1987, c. 839; 1989, c. 625, s. 16; 2001‑437, s. 1.15; 2006‑142, s.4(l); 2007‑504, s. 2.4(a).)
(a) The area authorityor county program shall contract with other qualified public or privateproviders, agencies, institutions, or resources for the provision of services,and, subject to the approval of the Secretary, is authorized to provideservices directly. The area authority or county program shall indicate in itslocal business plan how services will be provided and how the provision ofservices will address issues of access, availability of qualified public orprivate providers, consumer choice, and fair competition. The Secretary shalltake into account these issues when reviewing the local business plan andconsidering approval of the direct provision of services. Unless an area authorityor county program requests a shorter time, any approval granted by theSecretary shall be for not less than one year. The Secretary shall developcriteria for the approval of direct service provision by area authorities andcounty programs in accordance with this section and as evidenced by compliancewith the local business plan. For the purposes of this section, a qualifiedpublic or private provider is a provider that meets the provider qualificationsas defined by rules adopted by the Secretary.
(b) All area authorityor county program services provided directly or under contract shall meet therequirements of applicable State statutes and the rules of the Commission andthe Secretary. The Secretary may delay payments and, with written notification ofcause, may reduce or deny payment of funds if an area authority or countyprogram fails to meet these requirements.
(c) The area authorityor board of county commissioners of a county program may contract with a healthmaintenance organization, certified and operating in accordance with theprovisions of Article 67 of Chapter 58 of the General Statutes for the areaauthority or county program, to provide mental health, developmentaldisabilities, or substance abuse services to enrollees in a health care planprovided by the health maintenance organization. The terms of the contract mustmeet the requirements of all applicable State statutes and rules of theCommission and Secretary governing both the provision of services by an areaauthority or county program and the general and fiscal operation of an areaauthority or county program and the reimbursement rate for services renderedshall be based on the usual and customary charges paid by the healthmaintenance organization to similar providers. Any provision in conflict with aState statute or rule of the Commission or the Secretary shall be void;however, the presence of any void provision in that contract does not rendervoid any other provision in that contract which is not in conflict with a Statestatute or rule of the Commission or the Secretary. Subject to approval by theSecretary and pending the timely reimbursement of the contractual charges, thearea authority or county program may expend funds for costs which may beincurred by the area authority or county program as a result of providing theadditional services under a contractual agreement with a health maintenanceorganization.
(d) If two or morecounties enter into an interlocal agreement under Article 20 of Chapter 160A ofthe General Statutes to be a public provider of mental health, developmentaldisabilities, or substance abuse services ("public provider"), beforean LME may enter into a contract with the public provider, all of the followingmust apply:
(1) The public providermust meet all the provider qualifications as defined by rules adopted by theCommission. A county that satisfies its duties under G.S. 122C‑115(a)through a consolidated human services agency may not be considered a qualifiedprovider for purposes of this subdivision.
(2) The LME must adopt aconflict of interest policy that applies to all provider contracts.
(3) The interlocalagreement must provide that any liabilities of the public provider shall bepaid from its unobligated surplus funds and that if those funds are notsufficient to satisfy the indebtedness, the remaining indebtedness shall beapportioned to the participating counties.
(e) When enforcingrules adopted by the Commission, the Secretary shall ensure that there is faircompetition among providers. (1977, c. 568, s. 1; c. 679, s. 7; 1979, c. 358, ss.7, 18; 1981, c. 51, s. 3; c. 539, ss. 3, 4; c. 614, s. 7; 1985, c. 589, s. 2;1987, c. 839; 1989, c. 625, s. 16; 2001‑437, s. 1.15; 2006‑142, s.4(l); 2007‑504, s. 2.4(a).)
(a) The area authorityor county program shall contract with other qualified public or privateproviders, agencies, institutions, or resources for the provision of services,and, subject to the approval of the Secretary, is authorized to provideservices directly. The area authority or county program shall indicate in itslocal business plan how services will be provided and how the provision ofservices will address issues of access, availability of qualified public orprivate providers, consumer choice, and fair competition. The Secretary shalltake into account these issues when reviewing the local business plan andconsidering approval of the direct provision of services. Unless an area authorityor county program requests a shorter time, any approval granted by theSecretary shall be for not less than one year. The Secretary shall developcriteria for the approval of direct service provision by area authorities andcounty programs in accordance with this section and as evidenced by compliancewith the local business plan. For the purposes of this section, a qualifiedpublic or private provider is a provider that meets the provider qualificationsas defined by rules adopted by the Secretary.
(b) All area authorityor county program services provided directly or under contract shall meet therequirements of applicable State statutes and the rules of the Commission andthe Secretary. The Secretary may delay payments and, with written notification ofcause, may reduce or deny payment of funds if an area authority or countyprogram fails to meet these requirements.
(c) The area authorityor board of county commissioners of a county program may contract with a healthmaintenance organization, certified and operating in accordance with theprovisions of Article 67 of Chapter 58 of the General Statutes for the areaauthority or county program, to provide mental health, developmentaldisabilities, or substance abuse services to enrollees in a health care planprovided by the health maintenance organization. The terms of the contract mustmeet the requirements of all applicable State statutes and rules of theCommission and Secretary governing both the provision of services by an areaauthority or county program and the general and fiscal operation of an areaauthority or county program and the reimbursement rate for services renderedshall be based on the usual and customary charges paid by the healthmaintenance organization to similar providers. Any provision in conflict with aState statute or rule of the Commission or the Secretary shall be void;however, the presence of any void provision in that contract does not rendervoid any other provision in that contract which is not in conflict with a Statestatute or rule of the Commission or the Secretary. Subject to approval by theSecretary and pending the timely reimbursement of the contractual charges, thearea authority or county program may expend funds for costs which may beincurred by the area authority or county program as a result of providing theadditional services under a contractual agreement with a health maintenanceorganization.
(d) If two or morecounties enter into an interlocal agreement under Article 20 of Chapter 160A ofthe General Statutes to be a public provider of mental health, developmentaldisabilities, or substance abuse services ("public provider"), beforean LME may enter into a contract with the public provider, all of the followingmust apply:
(1) The public providermust meet all the provider qualifications as defined by rules adopted by theCommission. A county that satisfies its duties under G.S. 122C‑115(a)through a consolidated human services agency may not be considered a qualifiedprovider for purposes of this subdivision.
(2) The LME must adopt aconflict of interest policy that applies to all provider contracts.
(3) The interlocalagreement must provide that any liabilities of the public provider shall bepaid from its unobligated surplus funds and that if those funds are notsufficient to satisfy the indebtedness, the remaining indebtedness shall beapportioned to the participating counties.
(e) When enforcingrules adopted by the Commission, the Secretary shall ensure that there is faircompetition among providers. (1977, c. 568, s. 1; c. 679, s. 7; 1979, c. 358, ss.7, 18; 1981, c. 51, s. 3; c. 539, ss. 3, 4; c. 614, s. 7; 1985, c. 589, s. 2;1987, c. 839; 1989, c. 625, s. 16; 2001‑437, s. 1.15; 2006‑142, s.4(l); 2007‑504, s. 2.4(a).)
