rBr/v<s\=N/74-34/A.2/NJ67
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RECEIVED
AUG 3 1994
KATHT^TNE R E\1ERETT
LAW LII?RARY
NORTH CAROLINA
REGISTER
IN THIS ISSUE
3
^IN LBGIBUS^
EXECUTIVE ORDERS
IN ADDITION
Voting Rights Act
PROPOSED RULES
Environment, Health, and Natural Resources
Human Resources
Insurance
Justice
Secretary of State
LIST OF RULES CODIFIED
RRC OBJECTIONS
CONTESTED CASE DECISIONS
ISSUE DATE: August 1, 1994
Volume 9 • Issue 9 • Rages 588 - 666
INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATrVE CODE
NORTH CAROLINA REGISTER
The North Carolina Register is published twice a month and
contains information relating to agency, executive, legislative and
judicial actions required by or affecting Chapter 150B of the General
Statutes. All proposed administrative rules and notices of public
hearings filed under G.S. 1 50B-2 1 .2 must be published in the Register.
The Register will typically comprise approximately fifty pages per
issue of legal text.
State law requires that a copy of each issue be provided free of
charge to each county in the state and to various state officials and
institutions.
The North Carolina Register is available by yearly subscription at
a cost of one hundred and five dollars ($105.00) for 24 issues.
Individual issues may be purchased for eight dollars ($8.00).
Requests for subscription to the North Carolina Register should be
directed to the Office ofAdministrative Hearings, P. O. Drawer 27447,
Raleigh, N. C. 27611-7447.
ADOPTION, AMENDMENT, AND REPEAL OF
RULES
The following is a generalized statement of the procedures to be
followed for an agency to adopt, amend, or repeal a rule. For the
specific statutory authority , please consult Article 2A ofChapter 150B
of the General Statutes.
Any agency intending to adopt, amend, or repeal a rule must fint
publish notice of the proposed action in the North Carolina Register.
The notice must include the time and place of the public hearing (or
instructions on how a member of the public may request a hearing); a
statement of procedure for public comments; the text of the proposed
rule or the statement of subject matter; the reason for the proposed
action; a reference to the statutory authority for the action and the
proposed effective date.
Unless a specific statute provides otherwise, at least 15 days must
elapse following publication of the notice in the North Carolina
Registerhefore the agency may conduct the public hearing and at least
30 days must elapse before the agency can take action on the proposed
rule. An agency may not adopt a rule that differs substantially from the
proposed form published as part of the public notice, until the adopted
version has been published in the North Carolina Register for an
additional 30 day comment period.
When final action is taken, the promulgating agency must file the
rule with the Rules Review Commission (RRC). After approval by
RRC, the adopted rule is filed with the Office of Administrative
Hearings (OAH).
A rule or amended rule generally becomes effective 5 business
days after the rule is filed with the Office of Administrative Hearings
for publication in the North Carolina Administrative Code (NCAC).
Proposed action on rules may be withdrawn by the promulgating
agency at any time before final action is taken by the agency or before
filing with OAH for publication in the NCAC.
TEMPORARY RULES
Under certain emergency conditions, agencies may issue temp
rary rules. Within 24 hours of submission to OAH, the Codifier
Rules must review the agency's written statement of findings of ne<
for the temporary rule pursuant to the provisions in G.S. 150B-21.1.
the Codifier determines that the findings meet the criteria in G.
150B-21.1, the rule is entered into the NCAC. If the Codifi
determines that the findings do not meet the criteria, the rule is retumt
to the agency. The agency may supplement its findings and resubn
the temporary rule for an additional review or the agency may respoi
that it wiU remain with its initial position. The Codifier, thereafter, w
enter the rule into the NCAC. A temporary rule becomes effecti
either when the Codifier of Rules enters the rule in the Code or on I
sixth business day after the agency resubmits the rule without chanj
The temporary rule is in effect for the period specified in the rule or 1
days, whichever is less. An agency adopting a temporary rule mi
begin rule-making procedures on the permanent rule at the same tii
the temporary rule is filed with the Codifier.
NORTH CAROLINA ADMINISTRATIVE CODE
The North Carolina Administrative Code (NCAC) is a compilati*
and index of the administrative rules of 25 state agencies and
occupational licensing boards. The NCAC comprises approximate
15,000 letter size, single spaced pages of material of which appro;
mately 35% is changed aimually. Compilation and publication of t
NCAC is mandated by G.S. 150B-21.18.
The Code is divided into Titles and Chapters. Each state agency
assigned a separate title which is further broken down by cl
Title 21 is designated for occupational licensing boards.
The NCAC is available in two formats.
(1) Single pages may be obtained at a minimum cost of ^
dollars and 50 cents ($2.50) for 10 pages or less, plus fifte
cents ($0.15) per each additional page.
(2) The full publication consists of 53 volumes, totaling
excess of 15,000 pages. It is supplemented monthly w
replacement pages. A one year subscription to the f
publication including supplements can be purchased
seven hundred and fifty doDars ($750.00). Individual v
umes may also be purchased with supplement service. I
newal subscriptions for supplements to the initial pubUcati
are available.
Requests for pages of rules or volumes of the NCAC should
directed to the Office of Administrative Hearings.
CITATION TO THE NORTH CAROLINA
REGISTER
The North Carolina Register is cited by volume, issue, pi
number and date. 1:1 NCR 101-201, April 1, 1986 refers to Vohi
1 , Issue 1 , pages 101 through 201 ofthsNorth Carolina Registerissi
on April!, 1986.
FOR INFORMATION CONTACT: Office of Administra-tive
Hearings, ATTN: Rules Division, P.O. Drawer 27447,
Raleigh, North Carohna 2761 1-7447, (919) 733-2678.
NORTH
CAROLINA
REGISTER
ISSUE CONTENTS
I. EXECUTIVE ORDERS
Executive Orders 54-58 . 588
II, IN ADDITION
Voting Rights Act 594
Office of Administrative Hearings
P. O. Drawer 27447
Raleigh, North Carolina 27611-7447
(919) 733-2678
Julian Mann III,
Director
James R. Scarcella Sr.,
Deputy Director
Molly Masich,
Director ofAPA Services
Staff:
Ruby Creech,
Publications Coordinator
Teresa Kilpatrick,
Editorial Assistant
Jean Shirley,
Editorial Assistant
This publication is printed on permanent,
acid-free paper in compliance with
as. 125-11.13.
in. PROPOSED RULES
Environment, Health, and
Natural Resources
Environmental Management .... 616
Human Resources
Medical Assistance 597
Social Services 595
Insurance
Medical Database Commission . . 605
Justice
N.C. Alarm Systems Licensing
Board 614
Secretary of State
Securities Division 616
rV. LIST OF RULES CODIFIED ... 635
V. RRC OBJECTIONS 643
VI. CONTESTED CASE DECISIONS
Index to ALJ Decisions 647
Text of Selected Decisions
93 OSP 1607 655
94 EHR 0035 660
VII. CUMULATIVE INDEX 664
NORTH CAROLINA REGISTER
Publication Schedule
(April 1994 - January 1995)
Volume
and
Issue
Number
Issue
Date
Last Day
for
Filing
Last Day
for Elec-tronic
Filing
Earliest
Date for
Public
Hearing
15 days
from
notice
* End of
Required
Comment
Period
30 days
from
notice
T flst Day
to Submit
toRRC
** EarUest
EflFective
Date
9:1 04/04/94 03/11/94 03/18/94 04/19/94 05/04/94 05/20/94 07/01/94
9:2 04/15/94 03/24/94 03/31/94 05/02/94 05/16/94 05/20/94 07/01/94
9:3 05/02/94 04/11/94 04/18/94 05/17/94 06/01/94 06/20/94 08/01/94
9:4 05/16/94 04/25/94 05/02/94 05/31/94 06/15/94 06/20/94 08/01/94
9:5 06/01/94 05/10/94 05/17/94 06/16/94 07/01/94 07/20/94 09/01/94
9:6 06/15/94 05/24/94 06/01/94 06/30/94 07/15/94 07/20/94 09/01/94
9:7 07/01/94 06/10/94 06/17/94 07/18/94 08/01/94 08/22/94 10/01/94
9:8 07/15/94 06/23/94 06/30/94 08/01/94 08/15/94 08/22/94 10/01/94
9:9 08/01/94 07/11/94 07/18/94 08/16/94 08/31/94 09/20/94 11/01/94
9:10 08/15/94 07/25/94 08/01/94 08/30/94 09/14/94 09/20/94 11/01/94
9:11 09/01/94 08/11/94 08/18/94 09/16/94 10/03/94 10/20/94 12/01/94
9:12 09/15/94 08/24/94 08/31/94 09/30/94 10/17/94 10/20/94 12/01/94
9:13 10/03/94 09/12/94 09/19/94 10/18/94 11/02/94 11/21/94 01/01/95
9:14 10/14/94 09/23/94 09/30/94 10/31/94 11/14/94 11/21/94 01/01/95
9:15 11/01/94 10/11/94 10/18/94 11/16/94 12/01/94 12/20/94 02/01/95
9:16 11/15/94 10/24/94 10/31/94 11/30/94 12/15/94 12/20/94 02/01/95
9:17 12/01/94 11/07/94 11/15/94 12/16/94 01/03/95 01/20/95 03/01/95
9:18 12/15/94 11/22/94 12/01/94 12/30/94 01/17/95 01/20/95 03/01/95
9:19 01/03/95 12/08/94 12/15/94 01/18/95 02/02/95 02/20/95 04/01/95
9:20 01/17/95 12/21/94 12/30/94 02/01/95 02/16/95 02/20/95 04/01/95
This table is published as a public service, and the computation of time periods are not to be deemed binding
or controlling. Time is computed according to 26 NCAC 2B .0103 and the Rules of Civil Procedure, Rule
6.
* An agency must accept comments for at least 30 days after the proposed text is published or until the date
of any public hearing, whichever is longer. See G.S. 150B-21. 2(f) for adoption procedures.
** The "Earliest Effective Date " is computed assuming that the agency follows the publication schedule above,
that the Rules Review Commission approves the rule at the next calendar month meeting after submission, and
that RRC delivers the rule to the Codifier of Rules five (5) business days before the 1st business day of the next
calendar month.
Revised 03/94
EXECUTIVE ORDERS
EXECUTIVE ORDER NO. 54
TO CREATE THE NORTH CAROLINA
HEALTH CARE INFORMATION AND
COMMUNICATIONS ALLL^NCE
WHEREAS, the provision of high quality health
care to all residents is a desirable state objective;
WHEREAS, optimizing the use of health care
resources is necessary for all residents to receive
high quality health care at reasonable cost;
WHEREAS, state government has need of
detailed, current information on the quantity,
quality, content, and cost of health care services
rendered in the State of North Carolina for purpos-es
of policy development and implementation of
health care reform;
WHEREAS, the technology to allow interactive
and real time exchange of medical information is
necessary to optimize the use of health care re-sources
on a continuous basis;
WHEREAS, the public sector must work with
the private sector to develop information, telecom-munications
and telemedicine technologies applica-ble
to health care in all settings;
WHEREAS, the development of a statewide
health care information and telecommunications
network is the most logical next step in meeting
these goals; and
WHEREAS, upon direction by me the Articles of
Incorporation of the North Carolina Health Care
Information and Communications Alliance, Inc., a
North Carolina non-profit corporation, have been
filed with the Secretary of State of North Carolina
and the formalities of organization of said corpora-tion
have been effected;
NOW, THEREFORE, by the power vested in me
as Governor by the Constitution and laws of North
Carolina, IT IS ORDERED:
Section 1. Establishment
The North Carolina Health Care Information and
Communications Alliance, Inc. (the "Alliance") is
hereby established.
Section 2. Powers and Duties of the Alliance
The Alliance shall be operated in the public
interest exclusively for charitable, scientific and
educational purposes within the meaning of Section
501(c)(3) of the Internal Revenue Code (or the
corresponding provision of any future federal tax
law), including, without limiting the generality of
the foregoing, to foster the development and
implementation of a statewide health care informa-tion
system for the purpose of improving the
delivery, quality, accessibility and efficiency of
health care services in North Carolina by utiliza-tion
of advanced information, telecommunications,
and telemedicine technologies.
Solely for the above purposes, but not by way of
limitation, the Alliance is empowered:
A. To research, test, develop and promote
the optimum application of information,
telecommunications, and telemedicine
technologies to health care services in all
settings;
B. To effect the on-going development and
implementation of open architecture,
interoperable, integrated and interactive
information systems in health care in all
settings with fully articulated linkages to
a statewide health care information net-work
and with attention to national and
international health care information
systems and standards;
C. To effect the on-going design, develop-ment
and implementation of distributed
database management capability on a
scale necessary to support a wide range
of applications on the health care infor-mation
network including, among others,
clinical, emergency response, administra-tive,
research and educational applica-tions;
D. To foster development and installation of
on-line standardized, computerized medi-cal
record and information systems in
regional medical centers to enable utiliza-tion
by remote providers of centralized
diagnostic, treatment planning, expert
consultation services, and medical refer-ence,
resource and traimng materials,
with interactive question, answer and
messaging capabilities;
E. To improve health care information
systems utilized by participants in com-munity-
level health care delivery net-works
comprised, among others, of
hospitals, clinics, physician and dental
offices, group practices, emergency
medical systems, nursing homes, home
care services, pharmacies, company and
school medical and wellness programs.
9:9 NORTH CAROLINA REGISTER August 1, 1994 588
EXECUTIVE ORDERS
social service agencies, medical, nursing
and health administration schools, and
telemedicine providers;
F. To assist small and remote rural hospi-tals,
clinics, provider groups and other
health-related organizations in becoming
an integral part of the statewide health
care information system;
G. To provide education and training in, and
coordination with respect to, the use of
information, telecommunications, and
telemedicine technologies by health care
providers, suppliers, patients, educators
and public agencies;
H. To provide to the State of North Carolina
and the United States federal government
and other governmental units data and
analysis for the purpose of health care
policy development and decision-making;
I. To provide a mechanism for on-going
evaluation of hardware and software
performance, clinical effectiveness and
administrative efficiency of the statewide
health care information system and to
provide a mechanism for feedback, rede-sign
and upgrade of system capabilities;
J. To support the adoption and implementa-tion
of standards for computerized patient
records and computerized patient histo-ries;
K. To support clinical and health services
research by providing confidentiality-protected
patient histories and other
information databases for use by qualified
f)ersonnel;
L. To encourage the development of emerg-ing
businesses in the medical informa-tion,
computer science, telecommunica-tions,
and telemedicine fields in North
Carolina through research and education;
and
M. To exercise all rights and powers con-ferred
by the laws of North Carolina
upon nonprofit corporations.
Section 3. Board of Directors.
Consistent with the Articles of Incorporation of
the Alliance, the members of the Board of Direc-tors
shall represent each of the following classes of
members: (i) major medical centers; (ii) rural
health care centers or organizations; (iii) telecom-munications
and information technology compa-nies;
(iv) pharmaceutical, clinical trial companies
and health care applications device development
and manufacturing companies; (v) other health
care providers, local public health departments and
nonprofit organizations; and (vi) persons who
represent the interests of the State of North Caroli-na.
The initial directors of the Alliance shall serve
until their successors are duly elected and qualified
as set forth in the Articles of Incorporation and
By-Laws of the Alliance.
Section 4. Chair of the Board.
The Governor shall appoint the Chair of the
Board of Directors of the Alliance to serve until
the third annual meeting of members of the Alli-ance.
Section 4. Responsibilities o{ the Board of
Directors in the First Year of Alliance Opera-tions.
The Board of Directors shall complete the fol-lowing
tasks in the first year of operations:
A. Review and, if necessary, refine the By-laws
of the Alliance.
B. Take such steps as are necessary to apply
for and receive certification as an Internal
Revenue Code Section 501(c)(3) non-profit
corporation;
C. Identify initiatives to be undertaken im-mediately
to effect the purposes of the
Alliance and make arrangements to im-plement
these initiatives;
D. Develop and adopt a six-year work plan
for the Alliance, to be updated as neces-sary
but no less than every two years;
E. Develop and adopt a proposal for staffing
the Alliance;
F. Develop and adopt an operating budget
for the Alliance;
G. Op)en Alliance membership to a range of
health provider organizations and health
care information technology corporations,
each of which, by virtue of its research,
experience, services and/or products, will
bring to the Alliance assets and commit-ments
necessary to achieve the goals of
the Alliance as delineated in this Order
and the Alliance's corpxjrate charter; and
H. Establish the terms for Alliance member-ship,
a fee schedule for membership
participation in the Alliance, and other
funding sources such that the Alliance
will be self-sustaining and not dependent
on government financing.
This Order shall be eflFective immediately and
shall remain in effect until rescinded.
589 9:9 NORTH CAROLINA REGISTER August 1, 1994
EXECUTIVE ORDERS
E)one in the Capital City of Raleigh, this 1st day
of July, 1994.
EXECUTIVE ORDER NO. 55
NORTH CAROLINA - HEAD CTART
COLLABORATION PROJECT
ADVISORY COUNCIL
WHEREAS, the State's impoverished children
will be more effectively assisted if local, state, and
national service resources and responsibilities are
shared; and
WHEREAS, this pooling of resources and re-sponsibilities
can be better achieved if the various
service providers for impoverished children have
a forum for communicating ideas and coordinating
collaborative projects;
NOW, THEREFORE, by the authority vested in
me as Governor by the Constitution and laws of
North Carolina, IT IS ORDERED:
Section 1. Establishment.
The North Carolina ~ Head Start Collaboration
Project Advisory Council is hereby established.
Section 2. Membership.
(a) The following individuals or their designees
shall serve as members of the Council:
(1) The Senior Education Advisor in the
Office of the Governor;
(2) The Secretary of Human Resources;
(3) The Secretary of Environment, Health,
and Natural Resources;
(4) The Secretary of Commerce;
(5) The Director of the Division of Family
Development in the Department of Hu-man
Resources;
(6) The Director of the Division of Child
Development in the Department of Hu-man
Resources;
(7) The Director of the Division of Medical
Assistance in the Department of Human
Resources;
(8) The Director of the Division of Mental
Health, Developmental Disabilities, and
Substance Abuse Services in the Depart-ment
of Human Resources;
(9) The Director of the Division of Social
Services in the Department of Human
Resources;
(10) The Director of the Office of Rural
Health and Development Services in the
Department of Human Resources;
(11) The Director of the Division of Vocation-al
rehabilitation Services in the Depart-ment
of Human Resources; and
(12) A Representative from the North Caroli-na
Interagency Coordinating Council.
(b) The following individuals or their designees
shall be invited to serve as members of the Coun-cil:
(1) The President of the System of Commu-nity
Colleges;
(2) The Superintendent of Public Instruction;
(3) The President of the North Carolina
Head Start Association;
(4) The President of the North Carolina
Partnership for Children, Inc.; and
(5) The President of the North Carolina
Community Action Association.
(c) In addition, nine other members shall be
named by the Governor, of which at least three
shall be former Head Start participants or parents.
Five of these members shall serve an initial term
of four years. Four of these members shall serve
an initial term of two years. Thereafter, all terms
shall be for four years.
Section 3. Chair.
The Governor shall designate the chair of the
Council, who shall serve at his pleasure.
Section 4. Meetings.
The Council shall meet at least quarterly at the
call of the chair.
Section 5. Purpose.
The purpose of this Council is to build coopera-tion
between Head Start and other programs for
impoverished children to ensure these children the
fullest possible access to such programs within
North Carolina. It creates a forum for state
agencies, Head Start representatives, private
businesses, and other appropriate organizations to
develop an understanding among themselves of the
importance of collaboration among the various
existing service programs for impoverished chil-dren.
Section 6. Duties.
Together with the Head Start Coordinator within
the Department of Human Resources, the Council
shall:
(a) Identify possible projects for collabora-tion
between state and Head Start agen-cies;
(b) Sponsor and advise such collaborative
ventures; and
9:9 NORTH CAROLINA REGISTER August 1, 1994 590
EXECUTIVE ORDERS
(c) Serve as an information resource con-cerning
the goals and objectives of such
inter-agency collaborative projects. The
office of the Head Start Coordinator shall
serve as the central collection and dis-semination
point for this information.
Section 7. Administration.
Administrative support for the Council and its
subcommittees shall be provided by the Special
Assistant for Head Start in the Department of
Human Resources ("DHR"). The U.S. Depart-ment
of Health and Human Services has provided
$100,000 for the Council under grant number 90-
CD-0997, "Head Start in North Carolina: Build-ing
a Better Partnership." This amount includes
reimbursement for necessary subsistence and travel
expenses.
Section 8. Effect on Other Executive Orders.
Executive Order Number 186 of the Martin
Administration is hereby rescinded.
This Order shall be effective immediately.
Done in Raleigh, North Carolina, this the 7th
day of July, 1994.
EXECUTIVE ORDER NO. 56
GOVERNOR'S TASK FORCE ON HEALTH
OBJECnVES FOR THE YEAR 2000
By the authority vested in me as Governor by the
Constitution and laws of the State of North Caroli-na,
FT IS ORDERED:
Section i. Establishment and Rescission of
Prior Orders.
The Governor's Task Force on Health Objectives
for the Year 2000 ("Governor's Task Force") is
hereby re-established. The Governor's Task Force
established herein is the successor organization to
the one established in Executive Orders 148 and
176 of the Martin Administration. Those Orders
are hereby rescinded.
Section 2. Membership.
The Governor shall appoint 25 persons including
a Chair, to serve four year terms. Thereafter, all
vacancies shall be filled by the Governor.
The membership shall include representatives
from the following:
(a) Department of Human Resources;
(b) Department of Enviroimient, Health, and
Natural Resources;
(c) Association of North Carolina Boards of
Health;
(d) North Carolina Hospital Association;
(e) North Carolina Medical Society;
(f) North Carolina Academy of Family
Physicians;
(g) North Carolina Association of Local
Health Directors;
(h) The University of North Carolina School
of Public Health;
(i) North Carolina Citizens for Business and
Industry;
(j) North Carolina Commission on Indian
Affairs;
(k) North Carolina Association of County
Commissioners;
(1) NAACP;
(m) North Carolina Minority Health Council;
(n) Governor's Council on Physical Fitness
and Health;
(o) North Carolina Dental Society;
(p) North Carolina Nurses' Association;
(q) Old North State Medical Society; and
(r) Eight at-large members, including a
representative of local education.
Section 3. Functions.
A. The Governor's Task Force shall meet regu-larly
at the call of the Chair.
B. The Governor's Task Force shall provide
encouragement and guidance to communities
establishing their own local groups to accomplish
the objectives developed by the Governor's Task
Force.
C. The Governor's Task Force shall have the
power to designate the Healthy Carolinians 2000
Task Forces, comprised of representatives of
public and private organizations which support the
goals of the Governor's Task Force. They shall
seek to further the objectives of the Governor's
Task Force and they shall exist so long as the
Governor's Task Force does, unless earlier termi-nated.
Section 4. Administration.
A. Administrative support for the Governor's
Task Force shall be provided by the Department of
Enviromnent, Health, and Natural Resources.
Additional support shall be provided by the De-partment
of Human Resources.
B. Members of the Governor's Task Force shall
be reimbursed for necessary travel and subsistence
expenses as authorized under General Statutes 138-
5 and 138-6. Funds for the reimbursement of such
expenses shall be made available from funds
591 9:9 NORTH CAROLINA REGISTER August 1, 1994
EXECUTIVE ORDERS
authorized by the Department of Environment,
Health, and Natural Resources.
C. It shall be the responsibility of each Cabinet
department to make every reasonable effort to
cooperate with the Governor's Task Force in
carrying out the provisions of this Order.
This Executive Order shall become effective
immediately.
Done in Raleigh, North Carolina, this the 13th
day of July, 1994.
EXECUTIVE ORDER NO. 57
GEORGIA EMERGENCY FLOOD RELIEF
WHEREAS, on July 7, 1994, the United States
Department of Transportation declared a regional
emergency justifying an exemption from 49
C.ER. 390-399 (Federal Motor Carrier Safety
Regulations) for a period of thirty days in response
to the severe flooding in the Georgia area;
NOW, THEREFORE, pursuant to N.C.G.S.
166A-6(c), the North Carolina Emergency
Management Act, by the authority vested in me as
Governor by the laws and Constitution of the State
of North Carolina, and with the concurrence of the
Council of State, IT IS ORDERED:
Section 1.
The State of North Carolina, under the
supervision and direction of its Department of
Transportation, shall waive weight restrictions on
the gross weight of vehicles transporting food,
supplies, and equipment to the victims of the
severe flooding in the State of Georgia, subject to
the following conditions:
(a) vehicle weight shall not exceed the
maximum gross vehicle weight criteria
established by the manufecturer or
90,000 pounds gross vehicle weight,
whichever is less.
(b) Tandem axle weights shall not exceed
50,000 pounds and single axle weights
shall not exceed 25,000 pounds.
(c) The vehicles shall, upon entering the
State of North Carolina, stop at the first
available vehicle weigh station and
produce identification sufficient to
establish that the load contained thereon
is part of the relief effort for the severe
flooding in the State of Georgia.
(d) This Order shall not be in effect on
bridges posted pursuant to N.C.G.S. 136-
72.
Section 2.
The vehicles described above shall be exempt
from the vehicle licensing and tax requirements of
N.C.G.S. 105, Subchapter 5, Article 36B (motor
fuels tax).
Section 3.
As a result of the 7 July 1994 declaration of
regional emergency by the United States
Department of Transportation and its
corresponding exemption from 49 C.F.R. 390-399,
nonparticipants in North Carolina's International
Registration Plan shall be permitted to operate in
North Carolina without penalty under N.C.G.S.
20-382.
Section 4.
If returning vehicles are loaded with some other
backhaul, all normal weight and permit restrictions
apply.
Section 5.
The North Carolina Department of
Transportation shall enforce the conditions set
forth in Sections 1, 2, and 3 in a manner which
would best accomplish the purposes of this Order
without endangering motorists on North Carolina
highways.
This Order is effective immediately and shall
remain in effect for thirty days.
Done in the Capital City of Raleigh, North
Carolina, this the 14th day of July, 1994.
EXECUTIVE ORDER NO. 58
PUBLIC GREENWAYS ACROSS
STATE LANDS
WHEREAS, greenways are linear open spaces
that can provide many benefits to the State's
environment and growing population; and
WHEREAS, North Carolina has earned a
national reputation for greenways because
approximately forty local governments have begun
greenway programs under their own initiative; and
WHEREAS, the environmental and
socioeconomic benefits of greenways are
numerous, and have been set out in the North
Carolina Greenways Advisory Panel Report to the
Governor; and
9:9 NORTH CAROLINA REGISTER August 1, 1994 592
EXECUTIVE ORDERS
WHEREAS, existing and potential greenways
and their related benefits typically cross the
jurisdictional boundaries of governments; and
WHEREAS, state support for locally initiated
greenways is unfocused because responsibility for
the various functions through which greenway
benefits arise are distributed among separate
departments; and
WHEREAS, there are opportunities to improve
state government responsiveness to local
governments in their efforts to develop greenway
systems for the environmental, socioeconomic, and
overall quality of life benefits of our citizens;
NOW, THEREFORE, by the power vested in me
as Governor by the laws and Constitution of the
State of North Carolina, IT IS ORDERED:
Section 1. Policy.
(a) It shall be the policy of the State to make
every reasonable effort to anticipate and otherwise
accommodate local government requests related to
the development of greenway systems.
(b) In recognition of the broad and
comprehensive character of greenway benefits and
the narrow and specific focus of State government
programs, it shall be the responsibility of every
State agency to cooperate between and among
themselves, to the maximum extent feasible, to
address the multiple objectives of local greenway
development.
(c) To the extent practicable, institutional
solutions shall be implemented to enhance the
development of greenway systems, rather than
resolving issues on a case-by-case basis.
Section 2. Action.
The following actions shall be taken as initial
steps toward realization of the "Public Greenways
across State Lands" recommendation presented in
the North Carolina Greenway Advisory Panel's
Report to the Governor:
(a) The State Property Office and the
Department of Transportation shall work
with local governments to integrate local
greenways with State lands.
Every reasonable effort shall be made to
integrate greenways with State lands in a
manner that is compatible with the
function and management of the
property.
Severance of greenway corridors is to be
avoided whenever possible, and the
(b)
identification of comparable alternative
routes is preferred to the exclusion of
greenways altogether,
(d) Appropriate easement conditions may be
negotiated wdth the interested local
governments to mitigate for the greenway
corridor and assure adequate maintenance
and management.
Section 3. Role of the Department of
Environment. Health, and Natural Resources.
(a) The Department of Environment, Health,
and Natural Resources shall continue the
leadership role it began with establishment of the
North Carolina Greenways Advisory Panel
(NCGAP).
(b) The Department shall encourage, coordinate
and monitor progress toward fulfillment of the
recommendations presented in the NCGAP Report
to the Governor, and the provisions of this Order.
(c) The Department shall emphasize the
development of educational information on
greenways for use within State programs, and
through them to local governments and individual
citizens.
This Executive Order shall be effective
immediately.
Done in the Capital City of Raleigh, North
Carolina, this the 14th day of July, 1994.
(c)
593 9:9 NORTH CAROLINA REGISTER August 1, 1994
IN ADDITION
I his Section contains public notices that are required to be published in the Register or have been
approved by the Codifier of Rules for publication.
U.S. Department of Justice
Civil Rights Division
DLP:DLK:NG:lss:gmh Voting Section
DJ 166-012-3 P.O. Box 66128
94-2134 Washington, DC. 20035-6128
July 11, 1994
Z. Creighton Brinson, Esq.
Taylor, Brinson & Moore
P. O. Drawer 308
Tarboro, North Carolina 27886-0308
Dear Mr. Brinson:
This refers to the annexations (Ordinance Nos. 92-5, 92-6 and 94-5) and the designation of the
annexed areas to election districts of the City of Tarboro in Edgecombe County, North Carolina, submitted
to the Attorney General pursuant to Section 5 of the Voting Rights Act of 1965, as amended, 42 U.S.C.
1973c. We received your submission on May 10, 1994.
The Attorney General does not interpose any objection to the specified changes. However, we note
that Section 5 expressly provides that the failure of the Attorney General to object does not bar subsequent
litigation to enjoin the enforcement of the changes. See the Procedures for the Administration of Section 5
(28C.ER. 51.41).
Sincerely,
Deval L. Patrick
Assistant Attorney General
Civil Rights Division
By:
Steven H. Rosenbaum
Chief, Voting Section
9:9 NORTH CAROLINA REGISTER August I, 1994 594
PROPOSED RULES
TITLE 10 - DEPARTMENfT OF HUMAN RESOURCES
I\otice is hereby given in accordance with G.S. 150B-21.2 that the Social Services Commission intends to
amend rules cited as 10 NCAC 35F .0306. 43L .0201, adopt 41F .0706 and .0812.
1 he proposed effective date of this action is November 1 , 1994.
1 he public hearing will be conducted at 10:00 a.m. on September 7, 1994 at the Albemarle Building, Room
943-2. 325 N. Salisbury Street. Raleigh. NC 27603.
ixeason for Proposed Action:
10 NCAC 35F . 0306 - This rule is being amended to correct an inadvertent error in the service cost-sharing
schedule.
10 NCAC 41F .0706 & 41F .0812 - These rules are being proposed to better protect the health, safety, and
well-being of foster children by requiring that crimiruil record checks be conducted on all foster parent
applicants and by disqualifying applicants who have been convicted of certain crimes from becoming foster
parents.
10 NCAC 43L .0201 - To clarify that Adult Placement services are reimbursable under the Social Services
Block Grant.
Lyomment Procedures: Comments may be presented in writing anytime before or at the public hearing or
orally at the hearing. Time limitsfor oral remarks may be imposed by the Commission Chairman. Any person
may request copies of these rules by calling or writing to Shamese Ransome. Division of Social Services, 325
N. Salisbury Street, Raleigh, NC 27603; 919/733-3055.
CHAPTER 35 - FAlVflLY SERVICES
SUBCHAPTER 35F - SERVICE COST-SHARING
SECTION .0300 - SERVICE COST SHARING REQUIREMENTS
.0306 SERVICE COCT-SHARING SCHEDULE
(a) The amount of cost-sharing to be requested from clients shall be in accordance with the following cost-sharing
schedule:
COST-SHARING SCHEDULE
Size of Income Unit
Minimum
Percentage
(Percentage of
Service Cost)
Monthly
Estab. Income
1
$ 852-970
971-1,090
1,091-1,209
1,210-1,328
1,329-1,447
1 ,448-above
2
$1,149-1,301
1,302-1,516
1,517-1,600
1,601-1,761
1,762-1,952
1 ,953-above
3
$1,446-1,648
1,649-1,850
1,851-2,053
2,054-2,255
2,256-2,458
2,459-above
30%
40%
50%
60%
75%
100%
Monthly
4
$1,744-1,987
5
$2,041-2,326
6
$2,339-2,665 30%
595 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
Estab. Income 1,988-2,231 2,327-2,612 2,666-2,992 40%
2,232-2,475 2,613-2,897 2,993-3,320 50%
2,476-2,719 2,898-3,183 3,321-3,647 60%
2,720-2,963 3,184-3,469 3,648-3,975 75%
2,964-above 3,470-above 3,976-above 100%
Monthly
7
$2,636-3,004
8
$2,934-3,343
9
$3,231-3,««83 30%
Estab. Income 3,005-3,373 3,344-3,754 3,684-4,135 40%
3,374-3,743 3,755-4,165 4,136-4,587 50%
3,744-4,112 4,166-4,576 4,588-5,040 60%
4,113-4,481 4,577-4,986 5,041-5,492 75%
4,482-above 4,987-above 5,493-above 100%
10 11 12
Monthly $3,529-4,022 $3,826-4,361 $4,124-4,700 30%
Estab. Income 4,023-4,516 4,362-4,897 4,701-5,277 40%
4,517-5,010 4,898-5,432 5,278-5,856 50%
5,011-5,504 5,433-5,968 5,857-6,432 60%
5,505-5,998 5,969-6,504 6,433-7,009 75%
5,999-above 6,505-above 7,010-above 100%
Established Income (Estab. Income) as used in this Rule is defined in 10 NCAC 35E .0104, which is
incorporated by reference, including subsequent amendments and editions; Income Unit as used in this Rule
is defined in 10 NCAC 35E .0103, which is incorporated by reference, including subsequent amendments and
editions. Copies of these Rules may be obtained from the Office of Administrative Hearings, Post Office
Drawer 27447, Raleigh, N.C. 27611-7447, (919) 733-2678, at a cost of two dollars and fifty cents ($2.50)
for up to ten pages and fifteen cents ($.15) for each additional page at the time of adoption of this Rule.
(b) Agencies must establish a cost-sharing schedule for clients whose gross monthly income is less than the
established income as defined in 10 NCAC 35E .0104, which is incorporated by reference, including
subsequent amendments and editions. Copies of these Rules may be obtained from the Office of
Administrative Hearings, Post Office Drawer 27447, Raleigh, NC 2761 1-7447, (919) 733-2678, at a cost of
two dollars and fifty cents ($2.50) for up to 10 pages and fifteen cents ($.15) for each additional page at the
time of adoption of this Rule. In developing this schedule, agencies may establish percentages of the cost of
the service or an amount that will be requested from clients.
(c) Agencies must distribute a copy of the cost-sharing schedule to all clients receiving services subject to
cost-sharing as defined in Rule .0301 of this Section. The cost-sharing schedule must reflect the income
ranges and minimum percentages outlined in Paragraph (a) of this Rule.
(d) Agencies may negotiate higher service cost-sharing percentages or lower service cost-sharing percentages
than those outlined in Paragraph (a) of this Rule, based on individual client circumstances. The client will
determine the amount of service cost-sharing he will pay based upon his individual financial circumstances.
Statutory Authority as. 143B-153.
CHAPTER 41 - CHILDREN'S
SERVICES
SUBCHAPTER 41F - LICENSING
OF FAMILY FOSTER HOMES
SECTION .0700 - STANDARDS
FOR LICENSING
.0706 CRIMINAL CONVICTIONS
An applicant shall not be eligible for licensure as
a foster parent if the applicant, or an^ member of
the applicant's household 14 years or older, has
been convicted or entered a plea of no contest to
a crime, and there is a relationship between the
nature of the crime and the ability of the prospec-tive
foster parent to assure the health, safety and
well being of foster children: provided a license
shall be denied if the applicant or any member of
the household 14 years or older has been convicted
or entered a plea of no contest to a felony involv-ing
violent behavior, unlawful sexual conduct,
minor children or controlled drugs.
9:9 NORTH CAROLINA REGISTER August 1, 1994 596
PROPOSED RULES
Statutory Authority G.S. 131D-10.5; 143B-153.
SECTION .0800 - LICENSING
REGULATIONS AND PROCEDURES
.0812 CRIMINAL BACKGROUND
CHECKS
The supervising agency shall conduct a criminal
background investigation through access of the
Department of Corrections Inmate/Probation
Inquiry System for all members of the foster
family household 14 years and older at the time of
initial application and annually thereafter. The
results of the criminal background investigation
shall be reported to the Division of Social Services
on the application form.
Statutory Authority G.S. 131D-10.5; 143B-153.
CHAPTER 43 - SERVICES
PROGRAM PLAN
SUBCHAPTER 43L - SOCIAL
SERVICES BLOCK GRANT
SECTION .0200 - SERVICES TO BE
PROVIDED
.0201 SOCLU. SERVICES BLOCK
GRANT FUNDED SERVICES
Services which may be reimbursed with Social
Services Block Grant Funds are:
(1) adjustment services for the blind or visu-ally
impaired;
(2) adoption services;
(3) adult developmental activity programs for
individuals who are substantially mentally
retarded or severely physically disabled;
(4) adult placement services;
(5) f4) before/after school and summer de-velopmental
day centers for children who
are mentally retarded;
(6) f5^ child day care services;
(7) i4>j chore services for the blind;
(8) f^ community living services;
(9) f8) day care services for adults;
(10) i^ day treatment programs for children
and adolescents who are emotionally
disturbed;
(11) ^W) delinquency prevention services;
(12) tW-) developmental day centers for pre-school
children who are mentally retard-ed;
(13) {¥3r) early childhood intervention services
for children who are mentally retarded or
at high risk for mental retardation;
(14) (4-^ employment and training support
services;
(15) (44) family planning services;
(16) iiSj foster care services for adults;
(17) (i4) foster care services for children;
(18) (W) health support services;
(19) f4-8) housing and home improvement
services;
(20) fW) individual and family adjustment
services;
(21) (30) in-home aide services (levels I
through IV);
(22) (^4) nutrition services;
(23) f33) outpatient services for individuals of
all disability groups;
(24) {5^ partial hospitalization services for
adults and elderly individuals who are
acutely mentally ill or are substance
abusers;
(25) f34) personal and family counseling;
(26) f35) preparation and delivery of meals;
(27) f3^ problem pregnancy services;
(28) i¥fj protective services for adults;
(29) f3*) protective services for children;
(30) (39) residential treatment for the emotion-ally
disturbed;
(31) f^O) residential treatment programs for
children and adolescents who are emo-tionally
disturbed;
(32) i^^ residential treatment/rehabilitation
programs for individuals who are alcohol
or other drug abusers;
(33) f^ respite care services;
(34) (^^ social setting and non-hospital medi-cal
detoxification services for individuals
who are alcoholics;
(35) 04) transitional residence programs for
adult and elderly individuals who are
mentally ill;
(36) 0#) transportation services;
(37) 0^ youth services.
Statutory Authority
143B-153.
G.S 108A-71; 1438-10;
******************
jyiotice is hereby given in accordance with G.S.
150B-21.2 that the DHR/Division of Medical
Assistance intends to amend rules cited as 10
NCAC SOB . 031 1 and . 0403.
597 9:9 NORTH CAROLINA REGISTER August I, 1994
PROPOSED RULES
The proposed effective date of this action L
November 1, 1994.
IS
Ihe public hearing will be conducted at 1:30
p.m. on September 1, 1994 at the North Carolina
Division of Medical Assistance, 1985 Umstead
Drive, Room 297, Raleigh, NC 27603.
iXeason for Proposed Action: Rules necessary to
bring the State into compliance with federal law.
C^omment Procedures: Written comments con-cerning
these rules must be submitted by August
31, 1994, to: Division of Medical Assistance,
1985 Umstead Drive, Raleigh, NC 27603 ATTN:
Clarence Ervin, APA Coordinator. Oral comments
may be presented at the hearing. In addition, a
fiscal impact statement is available upon written
request from the same address.
CHAPTER 50 - MEDICAL ASSISTANCE
SUBCHAPTER SOB - ELIGIBILITY
DETERMINATION
SECTION .0300 - CONDITIONS
FOR ELIGIBILITY
.0311 RESERVE
North Carolina has elected the option under
Section 1902(f) of the Social Security Act to limit
Medicaid eligibility for the aged, blind or the
disabled to individuals who meet eligibility re-quirements
more restrictive than those under
Supplemental Security Income. Applicants for and
recipients of Medicaid shall use their own resourc-es
to meet their needs for living costs and medical
care to the extent that such resources can be made
available. Certain resources shall be protected to
meet specific needs such as burial and transporta-tion
and a limited amount of resources shall be
protected for emergencies.
(1) The value of resources currently available
to any budget unit member shall be con-sidered
in determining financial eligibil-ity.
A resource shall be considered
available when it is actually available and
when the budget unit member has a legal
interest in the resource and he, or some-one
acting in his behalf, can take any
necessary action to make it available,
(a) Resources shall be excluded in deter-mining
financial eligibility when the
budget unit member having a legal
interest in the resources is incompetent
unless:
(i) A guardian of the estate, a general
guardian or an interim guardian has
been lawfully appointed and is able to
act on behalf of his ward in North
Carolina and in any state in which
such resources are located; or
(ii) A durable power of attorney, valid in
North Carolina and in any state in
which such resource is located, has
been granted to a person who is au-thorized
and able to exercise such
power.
(b) When there is a guardian, an interim
guardian, or a person holding a valid,
durable power of attorney for a budget
unit member, but such person is unable,
foils, or refuses to act promptly to
make the resources actually available to
meet the needs of the budget unit mem-ber,
a referral shall be made to the
county department of social services of
a determination of whether the guardian
or attorney in fact is acting in the best
interests of the member and if not,
contact the clerk of court for interven-tion.
The resources shall be excluded
in determining financial eligibility
pending action by the clerk of court.
(c) When a Medicaid application is filed on
behalf of an individual who:
(i) is alleged to be mentally incompetent,
(ii) has or may have a legal interest in a
resource that affects the individual's
eligibility, and
(iii) does not have a representative with
legal authority to use or dispose of the
individual's resources, the individual's
representative or family member shall
be instructed to file within 30 calen-dar
days a judicial proceeding to
declare the individual incompetent and
appoint a guardian. If the representa-tive
or femily member either foils to
file such a proceeding within 30
calendar days or fails to timely con-clude
the proceeding, a referral shall
be made to the services unit of the
county department of social services
for guardianship services. If the
allegation of incompetence is support-ed
by a physician's certification or
9:9 NORTH CAROLINA REGISTER August 1, 1994 598
PROPOSED RULES
other competent evidence from sourc-es
including but not limited to physi-cians,
nurses, social workers, psy-chologists,
relatives, friends or others
with knowledge of the condition of
the individual, the resources shall be
excluded except as provided in Sub-items
(l)(d) or (e) of this Rule.
(d) The budget unit member's resources
shall be counted in determining his
eligibility for Medicaid beginning the
first day of the month following the
month a guardian of the estate, general
guardian or interim guardian is appoint-ed,
provided that after the appointment,
property which cannot be disposed of
or used except by order of the court
shall continue to be excluded until
completion of the applicable procedures
for disposition specified in Chapters 1
or 35A of the North Carolina General
Statutes.
(e) When the court rules that the budget
unit member is competent or no ruling
is made because of the death or recov-ery
of the member, his resources shall
be counted except for periods of time
for which it can be established by com-petent
evidence from sources including
but not limited to physicians, nurses,
social workers, psychologists, relatives,
friends or others with knowledge of the
condition of the individual that the
member was in fact incompetent. Any
such showing of incompetence is sub-ject
to rebuttal by competent evidence
as specified herein and in Sub-item
(l)(c) of this Rule.
(2) The limitation of resources held for
reserve for the budget unit shall be as
follows:
(a) For Family and Children's related
categorically needy cases, one thousand
dollars ($1,000) per budget unit;
(b) For aged, blind or disabled cases and
Family and Children's related medically
needy cases, one thousand five hundred
dollars ($1,500) for a budget unit of
one person, two thousand two hundred
fifty dollars ($2,250) for a budget unit
of two persons and increases of one
hundred dollars ($100.00) for each
additional person in the budget unit
over two, not to exceed a total of three
thousand, fifty dollars ($3,050).
(3) If the value of countable resources of the
budget unit exceeds the reserve allowance
for the unit, the case shall be ineligible:
(a) For Family and Children's related cases
and aged, blind or disabled cases pro-tected
by grandfathered provisions, and
medically needy cases not protected by
grandfethered provision, eligibility shall
begin on the day countable resources
are reduced to allowable limits or ex-cess
income is spent down, whichever
occurs later;
(b) For categorically needy aged, blind or
disabled cases not protected by grand-fathered
provisions, eligibility shall
begin no earlier than the month count-able
resources are reduced to allowable
limits as of the first moment of the first
day of the month.
(4) Resources counted in the determination
of financial eligibility for categorically
needy and medically needy aid to the
aged, blind, or disabled cases protected
by grandfathered provisions are:
(a) Cash on hand;
(b) The current balance of savings
accounts, except savings of a student
saving his earnings for educational
purposes;
(c) The current balance of checking
accounts;
(d) Cash value of life insurance policies
when the total face value of all policies
that accrue cash value exceeds one
thousand five hundred dollars ($1,500);
(e) Equity in motor vehicles, including
motor homes, determined to be
non-essential according to Rule .0403
of this Subchapter;
(f) Equity in excess of one thousand
dollars ($1,(XX)) in motor vehicles,
including motor homes, determined to
be essential according to Rule .0403 of
this Subchapter;
(g) Stocks, bonds, mutual fund shares,
certificates of deposit and other liquid
assets;
(h) Negotiable and salable promissory notes
and loans;
(i) Trust funds;
(j) The portion of lump sum payments
remaining after the month of receipt;
(k) Individual Retirement Accounts or other
retirement accounts or plans;
(1) Equity in real property not used as the
599 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
homesite or not producing an income;
(m) Value of burial spaces other than spaces
designated for the eligible individual,
the eligible individual's spouse, and the
eligible individual's immediate family
which includes the eligible individual's
minor and adult children, stepchildren,
and adopted children, brothers, sisters,
parents, adoptive parents, and the
spouses of those persons;
(n) Salable remainder interest in life-estate
property not used as the budget unit's
homesite;
(0) Patient accounts in long term care
facilities.
(5) Resources counted in the determination
of financial eligibility for aid to categori-cally
needy aged, blind or disabled cases
not protected by grandfethered provisions
are:
(a) Cash on hand;
(b) The balance of savings accounts, except
savings of a student saving his earnings
for educational purposes;
(c) The balance of savings account, except
for aged, blind or disabled individuals
who have a plan for achieving self-support
(PASS) that is approved by the
Social Security Administration;
(d) The balance of checking accounts less
the current monthly income which had
been deprosited to meet the budget unit's
needs when reserve was verified or
lump sum income from
self-employment deposited to pay
annual expenses;
(e) Cash value of life insurance policies
when the total face value of all policies
that accrue cash value exceeds one
thousand five hundred dollars ($1,500);
(f) Trust fundst and annuities in
accordance with 42 USC 1396p(d) and
Mi
(g) Stocks, bonds, mutual fund shares,
certificates of deposit and other liquid
assets;
(h) Negotiable and salable promissory notes
and loans;
(i) Revocable burial contracts and burial
trusts;
(j) The portion of lump sum payments
remaining after the month of receipt;
(k) Individual Retirement Accounts or other
retirement accounts or plans;
(1) I^tient accounts in long term care fecilities
;
(m) Equity in motor vehicles determined to
be non-essential under Rule .0403 of
this Subchapter or, if no motor vehicle
is excluded as essential, any equity in
excess of four thousand five hundred
dollars ($4,500) in a motor vehicle;
(n) Equity in real and/or personal property
when the combined equities is six
thousand dollars ($6,(XX)) or less and
the property does not yield a net annual
income of at least six percent of the
equities;
(o) Equity in real and/or personal property
when the combined equities exceed six
thousand dollars ($6,000);
(p) Equity in personal property, subject to
(5) (m) and (n) of this Rule, is limited
to:
(i) Mobile homes not used as homesite,
(ii) Boats, boat trailers and boat motors,
(iii) Campers,
(iv) Farm and business equipment;
(q) Equity in real property, subject to (5)
(m) and (n) of this Rule, is limited to:
(i) Value of burial spaces other than
spaces designated for the eligible
individual, the eligible individual's
spouse, and the eligible individual's
immediate family which includes the
eligible individual's minor and adult
children, stepchildren, and adopted
children, brothers, sisters, parents,
adoptive parents, and the spouses of
those persons;
(ii) Fee simple interest;
(iii) Salable remainder interest;
(iv) Tenancy by the entireties interest
only.
(6) Resources counted in the determination
of financial eligibility for aid to medically
needy aged, blind or disabled cases not
protected by grandfethered provisions
are:
Cash on hand;
The balance of savings accounts, except
savings of a student saving his earnings
for educational purposes;
The balance of savings accounts, except
for aged, blind or disabled individuals
who have a plan for achieving self-support
(PASS) that is approved by the
Social Security Administration;
(d) The balance of checking accounts less
the current monthly income which had
been deposited to meet the budget unit's
(a)
(b)
(c)
NORTH CAROLINA REGISTER August 1, 1994 600
PROPOSED RULES
needs when reserve was verified or
lump sum income from
self-employment deposited to pay
annual expenses;
(e) Cash value of life insurance policies
when the total face value of all policies
that accrue cash value exceeds one
thousand dollars ($1,000);
(f) Trust fundst and annuities in
accordance with 42 USC 1396p(d) and
lei;
(g) Stocks, bonds, mutual fund shares,
certificates of deposit and other liquid
assets;
(h) Negotiable and salable promissory notes
and loans;
(i) Revocable burial contracts and burial
trusts;
(j) The portion of lump sum payments
remaining after the month of receipt;
(k) Individual Retirement Accounts or other
retirement accounts or plans;
(1) Patient accounts in long term care
facilities;
(m) Equity in motor vehicles determined to
be non-essential under Rule .0403 of
this Subchapter or, if no motor vehicle
is excluded as essential, any equity in
excess of four thousand five hundred
dollars ($4,500) in a motor vehicle;
(n) Equity in real property and f>ersonal
property that does not produce a net
annual income;
(o) Equity in personal property, subject to
(6)(m) of this Rule, is limited to:
(i) Mobile homes not used as homesite,
(ii) Boats, boat trailers and boat motors,
(iii) Campers,
(iv) Farm and business equipment;
(p) Equity in real property, subject to Sub-item
(6)(m) of this Rule, is limited to
interest in real estate other than that
used as the budget unit's homesite and
includes:
(i) Fee simple interest,
(ii) Tenancy by the entireties interest
only,
(iii) Salable remainder interest,
(iv) Value of burial spaces other than
spaces designated for the eligible
individual, the eligible individual's
spouse, and the eligible individual's
immediate family which includes the
eligible individual's minor and adult
children, stepchildren, and adopted
(a)
(b)
(c)
children, brothers, sisters, parents,
adoptive parents, and the spouses of
those jjersons.
(7) Resources counted in the determination
of financial eligibility for categorically
needy Family and Children's related
cases are:
Cash on hand;
The balance of savings accounts,
including savings of a student saving
his earnings for school expenses;
The balance of checking accounts less
the current monthly income which had
been deposited to meet the budget unit's
monthly needs when reserve was
verified;
The portion of lump sum payments
remaining after the month of receipt;
Cash value of life insurance policies
owned by the budget unit;
Revocable tf»9t Trust funds-j and
annuities in accordance with 42 USC
1396p(d) and (e);
Stocks, bonds, mutual fund shares,
certificates of deposit and other liquid
assets;
Negotiable and salable promissory notes
and loans;
Revocable pre-paid burial contracts;
Patient accounts in long term care
facilities;
Individual Retirement Accounts or other
retirement accounts or plans;
Equity in non-essential personal
property limited to:
Mobile homes not used as home.
Boats, boat trailers and boat motors.
Campers,
Farm and business equipment;
Equity in excess of one thousand five
hundred dollars ($1 ,500) in one motor
vehicle determined to be essential
under Rule .0403 of this Subchapter;
Equity in motor vehicles determined
to be non-essential under Rule .0403
of this Subchapter;
(m) Equity in real profjerty is limited to
interest in real estate other than that
used as the budget unit's homesite and
is limited to:
(i) Fee simple interest,
(ii) Tenancy by the entireties interest
only,
(iii) Salable remainder interest,
(iv) Value of burial plots.
(d)
(e)
(f)
(g)
(h)
(i)
0)
(k)
0)
(i)
(ii)
(iii)
(iv)
(V)
(vi)
601 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
(a)
(b)
(c)
(8) Resources counted in the determination
of financial eligibility for medically
needy Family and Children's related
cases are:
Cash on hand;
The balance of savings accounts,
including savings of a student saving
his earnings for school expenses;
The balance of checking accounts less
the currently monthly income which
had been deposited to meet the budget
unit's monthly needs when reserve was
verified or lump sum income from
self-employment deposited to pay
annual expenses;
(d) Cash value of life insurance policies
when the total fece value of all policies
that accrue cash value exceeds one
thousand five hundred dollars ($1,500);
(e) Trust fiinds-; and annuities in
accordance with 42 USC 1396p(d) and
Mi
(f) Stocks, bonds, mutual fund shares,
certificates of deposit and other liquid
assets;
(g) Negotiable and salable promissory notes
and loans;
(h) Revocable prepaid burial contracts;
(i) Patient accounts in long term care
fecilities;
(j) Individual Retirement Accounts or other
retirement accounts or plans;
(k) Equity in non-essential, non-income
producing personal property limited to:
(i) Mobile home not used as home,
(ii) Boats, boat trailers and boat motors,
(iii) Campers,
(iv) Farm and business equipment,
(v) Equity in motor vehicles determined
to be non-essential under Rule .0403
of this Subchapter;
(1) Equity in real property is limited to
interest in real estate other than that
used as the budget unit's homesite and
is limited to:
Fee simple interest.
Tenancy by the entireties interest
only.
Salable remainder interest.
Value of burial plots.
(i)
(ii)
(iii)
(iv)
Authority G.S. 108A-54; 108A-55; 108A-58; 42
U.S.C. 703. 704 1396; 42 CF.R. 435.121; 42
C.F.R. 435.210; 42 CF.R. 435.711; 42 CF.R.
435.712; 42 CF.R. 435.734; 42 CF.R. 435.823;
42 CF.R. 435.840; 42 CF.R. 435.841; 42 CF.R.
435-845; 42 CF.R. 445.850; 42 CFR. 435.851;
45 CFR. 233.20; 45 CFR. 233.51; 42 U.S.C.
1396p(d) and (e).
SECTION .0400 - BUDGETING
PRINCIPALS
.0403 RESERVE
(a) The value of resources held by the client or
by a financially responsible person shall be
considered available to the client in determining
countable reserve for the budget unit.
(b) Jointly owned resources shall be counted as
follows:
(1) The value of resources owned jointly
with a non-financially responsible
person who is a recipient of another
public assistance budget unit shall be
divided equally between the budget
units;
(2) The value of liquid assets and personal
property owned jointly with a
non-financially responsible person who
is not a client of another public
assistance budget unit shall be available
to the budget unit member if he can
dispose of the resource without the
consent and participation of the other
owner or the other owner consents to
and, if necessary, participates in the
disposal of the resource;
(3) The client's share of the value of real
property owned jointly with a
non-financially responsible p)erson who
is not a member of another public
assistance budget unit shall be available
to the budget unit member if he can
dispose of his share of the resource
without the consent and participation of
the other owner or the other owner
consents to and, if necessary,
participates in the disposal of the
resource.
(c) The terms of a separation agreement, divorce
decree, will, deed or other legally binding
agreement or legally binding order shall take
precedence over ownership of resources as stated
in Paragraphs (a) and (b) of this Rule, except as
provided in Paragraph (o) of this Rule.
(d) The reserve limit for the budget unit for
aged, blind or disabled cases shall be determined
as follows:
(1) The reserve limit for two persons shall
be allowed when spouses live together
9:9 NORTH CAROLINA REGISTER August 1, 1994 602
PROPOSED RULES
in a private living situation or when the
couple share the same room in long
term care;
(2) Allow the reserve limit for one person
for the Community Alternative Program
(CAP) client with a spouse at home and
only count the resources that are
available to the CAP client in
determining his countable reserve;
(3) The reserve limit for one person is
allowed for the client who is in long
term care and the spouse remains in the
home;
(4) The reserve allowance for one person is
allowed for the client who is in long
term care and the spouse is in
domiciliary care;
(5) The reserve limit allowed for a blind or
disabled minor child who lives with his
parent or parents or is temporarily
absent includes the child and the parent
or parents with whom the child lives;
(6) The reserve limit allowed for a blind or
disabled dependent child under age 19
who is in long term care shall include
only the child if his care and treatment
are expected to exceed 12 months, as
certified by the child's physician.
(e) Countable resources for Family and
Children's related cases will be determined as
follows:
(1) The resources of a spouse, who is not a
stepparent, shall be counted in the
budget unit's reserve allowance if the
spouses live together or one spouse is
temporarily absent in long term care
and the spouse is not a member of
another public assistance budget unit;
(2) The resources of a client and a
financially responsible parent or parents
shall be counted in the budget unit's
reserve limit if the parents live together
or one parent is temporarily absent in
long term care and the parent is not a
member of another public assistance
budget unit;
(3) The resources of the parent or parents
shall not be considered if a child under
age 21 requires care and treatment in a
medical institution and his physician
certifies that the care and treatment are
expected to exceed 12 months.
(f) The homesite shall be excluded from
countable resources as follows:
(1) For all aged, blind or disabled cases
and family and children's related cases,
the homesite is the client's principal
place of residence, which includes the
house and in the city the lot on which
the house sits and all the buildings on
the lot, or in a rural area the land on
which the house sits, up to one acre,
and all buildings on the acre, and, for
all aged, blind, or disabled cases and
medically needy family and children's
related cases, the homesite also includes
up to twelve thousand dollars ($12,000)
tax value in real property contiguous to
the principal place of residence,
regardless of whether the principal
place of residence is owned by the
client.
(2) Additional value in real property
contiguous to the principal place of
residence shall be a countable resource.
(3) The exclusion of the homesite from
countable resources set forth in
Subparagraphs (f)(1) and (2) of this
Rule shall also be applicable for all
aged, blind, or disabled cases when the
client is in long term care and his
spouse, minor children, or adult
disabled children remain in the home or
a physician has certified in writing that
the client will return home within six
months from the date of entry into the
hospital or long term care facility.
(g) For categorically needy aged, blind or
disabled cases without grandfethered protection,
nonhome property and personal property that is
income producing shall be excluded from
resources when the budget unit's equity in the
property does not exceed six thousand dollars
($6,000) and the property produces a net annual
return of at least six percent of the excludable
equity value for each income producing activity.
(h) For medically needy Families and Children
cases and medically needy aged, blind or disabled
cases without grandfethered protection, if the client
or any member of the budget unit has ownership in
a probated estate, the value of the individual's
proportionate share of the countable property shall
be a countable resource unless the property can be
excluded as the homesite or as income producing
property, as stated in Paragrp\aphs (e) and (f) of
this Rule.
(i) The equity in non-excluded real property
shall be counted toward the reserve level of the
budget unit.
(j) A motor vehicle shall be determined an
603 9:9 NORTH CAROLINA REGISTER August I, 1994
PROPOSED RULES
essential vehicle as follows:
(1) For aged, blind or disabled individuals
with grandfethered protection, if public
transpjortation cannot be used because it
is not available or because of his physi-cal
or mental condition and the vehicle
is needed to:
(A) Obtain regular medical treatment, or
(B) Retain employment, or
(C) Go shopping if the shopping area is
more than one-half mile from the
client's home, or
(D) Go shopping if the client is responsi-ble
for shopping and is physically
limited from walking one-half mile,
or
(E) Transport children to and from school
and the school is not within reason-able
walking distance;
(2) For aged, blind or disabled cases with-out
grandfethered protection and medi-cally
needy Family and Children's
related cases, a vehicle must be special-ly
equipped for use by a handicapped
individual, used to obtain regular medi-cal
treatment, or used to retain employ-ment.
(k) The value of non-excluded motor vehicles is
the Current Market Value, less encumbrances. If
the applicant/recipient disagrees with the assigned
value, he has the right to rebut the value.
(1) The current market value of a remainder
interest in life estate shall be determined by apply-ing
the remainder interest p)ercentage from the
chart in the Medicaid Eligibility Manual to the tax
value of the property. A lower current market
value for remainder interest may be established by
offering the interest for sale and the highest offer
received, if any, is less than the value determined
by application of the values chart to the tax value.
(m) For all aged, blind or disabled cases, up to
one thousand five hundred dollars ($1,500) may be
excluded from countable resources for the client
and his spouse under the burial exclusion. Apply
the one thousand five hundred dollar ($1,500)
burial exclusion for each individual separately.
Only the following resources may be excluded and
they must be excluded in the following order:
(1) Irrevocable pre-need burial contracts,
burial trusts, or other irrevocable ar-rangements
established for burial ex-penses;
(2) Face value of life insurance policies
that accrue cash value when the total
face value of all policies for the budget
unit is one thousand five hundred dol-lars
($ 1 ,500) or less and the cash value
was not counted in reserve;
(3) Revocable burial contracts or trusts
established for burial expenses. Any
excess remains a countable resource;
(4) Cash value of life insurance that has
been designated for burial expenses if
the cash value was considered in deter-mining
countable reserve. Any cash
value in excess of one thousand five
hundred dollars ($1,500) remains a
countable resource.
{a)
—
For all aged, blind or di sabled coacs and
medically needy Family—and
—
Children's
—
related
oases, the value of trust funds established for the
client or for any member of the budget unit is—
a
countable resource unless it is determined by the
courts that the funds arc not available for the
beneficiary of the trust.
(e)in) For a married individual:
(1) Resources available to the individual
are available to his or her spouse who
is a noninstitutionalized applicant or
recipient and who is either living with
the individual or temporarily absent
from the home, irrespective of the
terms of any will, deed, contract, ante-nuptial
agreement, or other agreement,
and irrespective of whether or not the
individual actually contributed the
resources to the applicant or recipient.
All resources available to an applicant
or recipient under these rules must be
considered when determining his or her
countable reserve.
(2) For an institutionalized spouse as de-fined
in 42 U.S.C. 1396r-5(h), avail-able
resources shall be determined in
accordance with 42 U.S.C. 1396r-5(c),
except as specified in Paragraph (p) of
this Rule.
^(o) For an institutionalized individual, the
availability of resources are determined in accor-dance
with 42 U.S.C. 1396r-5. Resources of the
community spouse are not counted for the institu-tionalized
spouse when:
(1) Resources of the community spouse
cannot be determined or cannot be
made available to the institutionalized
spouse because the community spouse
cannot be located; or
(2) The couple has been continuously sepa-rated
for 12 months at the time the
institutionalized spouse enters the insti-
9:9 NORTH CAROLINA REGISTER August 1, 1994 604
PROPOSED RULES
tution.
Authority G.S. 108A-54; 108A-55; 143-127. 1(d);
S.L. 1983, c. 1116; 42 U.S.C. 1396r-5; 42 U.S.C.
1396a(a)(17); 42 U.S.C. 1396a(a)(51); 42 C.F.R.
435.602; 42 C.F.R. 435.711; 42 C.F.R. 435.712;
42 C.FR. 435.723; 42 C.FR. 435.734; 42 CFR.
435.821; 42 C.FR 435.822; 42 C.FR. 435.823;
42 C.FR. 435.845; 45 C.FR. 233.20; 45 C.FR.
233.51; Deficit Reduction Act of 1984 (P.L.
98-369). Section 2373; Correll v. DSS/DMA/DHR,
No. 406PA91 (North Carolina Supreme Court);
Schweiker v. Gray Panthers, 453 U.S. 34. 101
S. a. 2633, 69 L. Ed. 2d 460 (1981).
TITLE 11 - DEPARTMENT OF
INSURANCE
jyiotice is hereby given in accordance with G.S.
150B-21.2 that the N.C. Medical Database Com-mission
intends to amend rules cited as 1 1 NCAC
15 .0001 - .0002, .0004 - .0010, and .0012.
1 he proposed effective date of this action is
November 1, 1994.
1 he public hearing will be conducted at 2:00
p.m. on August 25, 1994 at the Medical Database
Commission, Conference Room, 112 Cox Avenue,
Raleigh, NC 27605.
MXeason for Proposed Action; lb establish mone-tary
penalty guidelines for failure to comply with
rules, and to clarify definitions.
i^omment Procedures: Written comments may be
sent to Jim Hazelrigs at 112 Cox Ave., Raleigh,
N. C. 27605. Oral presentations may be made at
the public hearing. Anyone having questions
should call Jim Hazelrigs at (919) 733-7141.
CHAPTER 15 - MEDICAL
DATABASE COMMISSION
.0001 SCOPE AND PURPOSE
1 1 NCAC 1 5 sets forth the requirements that
health care providers defined in 11 NCAC 15
.0002 must meet in submitting to the Medical
Database Commission a uniform data set describ-ing
the case mix of its patients and the charges for
services provided to these patients. That data will
be used for grouping health care providers and
patients, comparing data provider hospital charges
and utilization, and disseminating information to
researchers and others as indicated in G.S.
131 E-2 1 0(b) . Eventually the information base will
include data on different types of health care
services, including ambulatory care services and
long term care services. The Commission may
collect health care data from physicians, nursing
homes, ambulatory surgical centers, and other
types of health care providers.
Statutory Authority G.S 131E-212(b).
.0002 DEFINITIONS
As used in this Chapter, unless specifically stated
otherwise, the following words have the following
meanings:
(1) Act. The North Carolina Medical
Database Commission Act, G.S.
131E-210 through 213.
(2) Aggregate data. A grouping or
categorization of the raw data such that
the unit of observation is something other
than an individual discharge. Reports of
aggregate data with small cell counts will
be edited to prevent potential
identification of individual patients.
(3) Ambulatory surgery billing form. Either
the HCFA 1450 UB 82 or HCFA 1500
claim form required by the payor of
services for ambulatory surgical services
billing.
(4) Ambulatory surgical case. An individual
who receives one or more ambulatory
surgical procedures in either a dedicated
ambulatory surgical operating room or in
an operating room that is used for both
inpatient and ambulatory surgical
procedures during a single operative
encounter.
(5) Ambulatory surgical facility. As defined
in G.S. 131E-176(1) means a facility
designed for the provision of any
ambulatory surgical program. An
ambulatory surgical facility serves
patients who require local, regional or
general anesthesia, and a period of post-operative
observation. An ambulatory
surgical facility may only admit patients
for a period of less than 24 hours and
must provide at least one designated
operating room and at least one
designated recovery room, have available
the necessary equipment and trained
personnel to handle emergencies, provide
605 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
adequate quality assurance and
assessment by an evaluation and review
committee. and maintain adequate
medical records for each patient. An
ambulatory surgical facility may be
operated as a part of a physician or
dentist's office, provided the facility is
licensed under G.S. 13 IE. Article 6^ Part
D, but the performance of incidental,
limited ambulatory surgical procedures
which do not constitute an ambulatory
surgical program as defined G.S. 131E-
176 subdivision (la) and which are
performed in a physician's or dentist's
office does not make that office an
ambulatory surgical facility .
(6) Ambulatory surgical program. As
defined in G.S. 131E-176(la) means a
formal program for providing on a same-day
basis those surgical procedures which
require local, regional or general
anesthesia and a period of post-operative
observation to patients whose admission
for more than 24 hours is determined,
prior to surgery, to be medically
unnecessary .
(7) Ambulatory surgical services. Those
surgical services provided to patients as
part of an ambulatory surgical program
within a licensed ambulatory surgical
facility or a general acute care hospital
licensed under G.S. 131E, Article 5, Part
A.
(8) Case mix data. Case specific discharge
dafa which describe socio-demographic
characteristics of the patient; total and
component charges; principal and other
diagnoses; treatment and services
provided to the patient; as well as
duration and status of the patient's stay in
the hospital. Case mix data refers to the
actual data elements abstracted from the
HCFA 1450 UB 82 claim form as well as
classifications resulting from groupings of
specific data elements, e.g., DRG
category.
(9) Cases ; episodes of treatment of patients
regardless of the physical setting.
Includes but is not limited to hospital
inpatient discharges, and outpatient
encounters. Usually identifiable because
of the creation of a claim form (such as
HCFA 1450 and HCR\ 1500) which
identifies the date of treatment, the
diagnosis treated and the procedures
performed.
(10) (9) Charge data. Charge data shall
consist of the HCFA 1450 UB 82 data
elements and codes specified in 11
NCAC 15 .0005.
(a) Hospital inpatient rep)orting will consist
of HCFA 1450 UB 82 data elements
and codes; and
(b) Hospital ambulatory surgical programs
and ambulatory surgical facilities
reporting cases of ambulatory/outpatient
surgery will consist of either or both
the HCFA 1450 UB 82 or HCFA 1500
data elements and codes.
(11) f+0) Commission. The Medical Database
Commission established under G.S.
I31E-21I.
(12) fH^ Compilations. The arrangement of
data collected by and furnished to the
Commission by any corporation,
association, or entity acting under
agreement with the Commission for
release and dissemination to the public.
(13) fi5) Data Provider. The legal entity
responsible for submitting data to the
Commission as specified in this Chapter
and for which the administrative rules
currently apply. These Rules currently
apply to the following: Hospitals and
Ambulatory surgical facilities .
(14) {\i) Dataset. The full collection of the
data submitted by each data provider for
a particular reporting period in the
possession of the Commission or the
contractor designated by the Commission
to collect and process the data.
(15) fi4) Executive Director. The chief
operating officer of the Commission.
(16) ^HCFA. The Health Care Financing
Administration of the U.S. Department of
Health and Human Services, or any
successor agency.
(IT) {\€) Health Care Provider. Any f)erson,
organization, or entity that renders health
care services, e.g., hospital, as defined in
II NCAC 15 .0002.
(18) {¥f) Hospital. Any facility licensed by
the North Carolina Division of Facility
Services under G.S. 131E-77 (Hospital
Licensure Act) or under G.S. 122C-23
(Licensure of Facilities for the Mentally
111, the Mentally Retarded and Substance
Abusers), but does not include:
(a) a facility with all of its beds designated
for medical type "LTC" Gong term
9:9 NORTH CAROLINA REGISTER August 1, 1994 606
PROPOSED RULES
care)
;
(b) a facility with the majority of its beds
designated for medical type "PSY-3"
(mental retardation); or
(c) a fecility operated by the North
Carolina Department of Corrections.
(19) {W, Billing Forms.
(a) Uniform billing hospital billing form.
Form UB-8S/HCFA-1450 £and its
variations UB 82 and UB 92}, the
hospital billing form develop>ed by the
National Uniform Billing Committee or
its successor.
(b) Ambulatory surgery billing form.
Either the HCFA 1450 UB 82 or
HCFA 1500 form required by the payor
of services for ambulatory surgical
services billing.
(20) ^4^ Raw data. Patient specific records
including those which have been stripped
of all patient identifying information.
(21) <^0) Reporting facility. Any of the hos-pitals,
ambulatory surgical facilities,
nursing homes, physicians, or other
health care providers from which collec-tion
of information is authorized in 1
1
NCAC 15 .0001 and for which adminis-trative
rules are published and currently
apply.
Statutory Authority G.S. 131E-212(b).
.0004 UNIFORM BILLING FORiM
(a) All hospitals shall complete the uniform
hospital billing form for every inpatient discharged
after June 30, 1987, from any bed other than one
designated medical type "LTC" regardless of the
source of payment. For patients discharged after
June 30, 1987 who were admitted prior to July 1,
1987, hospitals shall submit to the Commission
either an admit-through-discharge claim or the
complete set of interim claims necessary to reflect
the total length of stay and charges.
(b) The information submitted to the Commis-sion
shall be reported only for the primary payer,
including Medicare, Medicaid, other government
programs, private insurance, health maintenance
organizations, self-insured, private pay patients,
and others. Claims for secondary payers will be
considered duplicate information and should not be
submitted to the Commission.
(c) Unless otherwise indicated in this Chapter,
completion of the uniform hospital billing form for
inpatient cases shall be in accordance with the
instructions and definitions in the manual devel-oped
by the National Uniform Billing Committee
as adopted and finalized by the North Carolina
Uniform Billing Committee. A copy of the manu-al
is available for reference by contacting the
Executive Director at 112 Cox Avenue, Suite 208,
Raleigh, North Carolina 27605.
(d) All hospital ambulatory surgical programs
and all ambulatory surgical fecilities shall complete
either the HCFA 1450 UB 82 or the HCFA 1500
form for every ambulatory surgical patient "re-leased"
from care after September 30, 1993. The
choice of form will be dictated by the requirements
of the payor for whom the bill is prepared for the
case involved, however, the HCFA 1500 1450
form will be prepared in cases where the payor has
not stipulated which billing form to use.
(e) The HCFA 1450 UB 82 and the HCFA 1500
forms will be completed in accordance with the
instructions and definitions issued by the Commis-sion.
A copy of these instructions is available for
reference by contacting the Executive Director at
112 Cox Avenue, Suite 208, Raleigh, North
Carolina, 27605.
Statutory Authority G.S. 131E-212(b).
,0005 DESCRIPTION OF DATA TO BE
SUBMITTED
(a) In accordance with all pertinent state and
federal regulations on patient confidentiality, the
following HCFA 1450 UB 82 data elements must
be submitted to the Commission for every inpatient
discharged regardless of payer:
DATA ELEMENT DESCRIPTION
(1) Patient Control Number Form locator 3
- As stated in the North Carolina
HCFA 1450 UB 82 Manual.
(2) Bill Type Form locator 4 - As stated in
the North Carolina HCFA 1450 UB 82
Manual
.
(3) Provider Identification:
(A) Medicaid Base Provider Number
Form locator 8 - The number as-signed
to the provider by Medicaid or
as assigned by the Commission (for
batching only) .
(B) Federal Tax Number Form Locator 5
; As stated in the North Carolina
HCFA 1450 Manual.
(4) Zip Code of Patient Address Form
locator 44 13 - Only the zip code por-tion
of this field is required. Code as
stated in the North Carolina HCFA
1450 UB 82 Manual.
(5) Patient Birth Date Form locator 45 H
607 9:9 NORTH CAROLINA REGISTER August I, 1994
PROPOSED RULES
- As stated in the North Carolina HCFA
1450 UB 82 Manual.
(6) Patient Sex Form locator 4^ 15 - As
stated in the North Carolina HCFA
1450 UB 82 Manual.
(7) Admission Date Form locator +5 j_7 -
As stated in the North Carolina HCFA
1450 UB 82 Manual.
(8) Admission Type Form locator ^ 19 -
As stated in the North Carolina HCFA
1450 UB 82 Manual.
(9) Source of Admission Form locator +8
20 - As stated in the North Carolina
HCFA 1450 UB 82 Manual.
(10) Patient Status Form locator ^ 22 - As
stated in the North Carolina HCFA
1450 UB 82 Manual.
(11) Discharge Date (Covers Period) (State-ment
Form locator S3 6 - As stated in
the North Carolina HCFA 1450 UB 82
Manual.
(12) All Revenue Codes and Associated
Charges
Form locators 51 and 53 42 and 47 -
As stated in the North Carolina HCFA
1450 UB 82 Manual.
(13) Payer Identification Form locator #7A
50a - Classification code and specific
carrier identification code for primary
payer.
(14) Certificate/Social Security/Health Insur-ance
Claim/Identification Number Form
locator €S 60a - As stated in the North
Carolina HCFA 1450 UB 82 Manual.
(15) Insurance Group Number Form locator
70 62a - As stated in the North Caroli-na
HCFA 1450 UB 82 Manual.
(16) Principal Diagnosis Form locator 77 67
- As stated in the North Carolina
HCFA 1450 UB 82 Manual.
(17) Other Diagnoses ; 8 (4 others maxi
mum) Form locators 78 8 1 68-75 - As
stated in the North Carolina HCFA
1450 UB 82 Manual.
(18) External Cause of Injury Code (E-Code
Form Locator 77 ; As stated in the
North Carolina HCFA 1450 Manual/
whenever the principal diagnosis is an
injury, poisoning or adverse effect.
(19) {i%^ Principal Procedure and Date
Form locator 84 80 - As stated in the
North Carolina HCFA 1450 UB 82
Manual.
(20) ^W) Other Procedures and Dates Form
locators 85 & 86 81a - e - As stated in
the North Carolina HCFA 1450 UB-83
Manual.
(21) ^30) Attending Physician Identification
Form locator 93 82 - Only the State
lioonso number of this field UPIN is
required. Code as stated in the North
Carolina HCFA 1450 UB 82 Manual.
(22) f3I^ Other Physician Identification
Form locator 93 83 - Only the State
license number of thia field UPIN is
required. Code as stated in the North
Carolina HCFA 1450 UB 82 Manual.
(b) In accordance with all pertinent State and
federal laws or regulations on patient confidentiali-ty,
the following HCFA 1450 UB 82 data elements
must be submitted to the Commission for every
ambulatory surgical patient released regardless of
payor:
DATA ELEMENT DESCRIPTION
(1) Patient Control Number Form locator 3
- As stated in the North Carolina
HCFA 1450 UB-«3 Manual.
(2)
(3)
£A1
mi
Bill Typ)e Form locator 4 - As stated in
the North Carolina HCFA 1450 UB 82
Manual.
Provider Identification:
Medicaid Base Provider Number
Form locator 8 - The number as-signed
to the provider by Medicaid or
as assigned by the Commission (for
batching only) .
Federal Tax Number Form Locator 5
; As stated in the North Carolina
HCFA 1450 Manual.
(4) Zip Code of Patient Address Form
locator 44 n - Only the zip code por-tion
of this field is required. Code as
stated in the North Carolina HCFA
1450 UB 82 Manual.
(5) Patient Birth Date Form locator 43 JJ
- As stated in the North Carolina
HCFA 1450 UB-83 Manual.
(6) Patient Sex Form locator 4^ 15 - As
stated in the North Carolina HCFA
1450 UB 82 Manual.
(7) Admission DateForm locator 45 17 -
As stated in the North Carolina HCFA
1450 UB 82 Manual.
(8) Admission Type Form locator 47 19 -
As stated in the North Carolina HCFA
1450 UB 82 Manual.
(9) Source of Admission Form locator 48
20 - As stated in the North Carolina
HCFA 1450 UB 82 Manual.
(10) Patient Status Form locator 34 22 - As
9:9 NORTH CAROLINA REGISTER August 1, 1994 608
PROPOSED RULES
stated in the North Carolina HCFA 1450
UB 82 Manual.
(11) Discharge Date (System Covers Period)
Form locator S3 6 - As stated in the
North Carolina HCFA 1450 yB-«3
Manual.
(12) All Revenue Codes and Associated
Charges Form locators 51 and 53 42
and 47 - As stated in the North Caroli-na
HCFA 1450 UB 82 Manual.
(13) Payer Identification Form locator 5^
50a - Classification code and specific
carrier identification.
(14) Certificate/Social Security/Health Insur-ance
Claim/Identification Number Form
locator 68 60a - As stated in the North
Carolina HCFA 1450 UB 82 Manual.
(15) Insurance Group NumberForm locator
70 62a - As stated in the North Caroli-na
HCFA 1450 UB 82 Manual.
(16) Principal Diagnosis Form locator^ 67
- As stated in the North Carolina
HCFA 1450 UB 82 Manual.
(17) Other Diagnoses ; 8 (4 others maxi
mum) Form locators 78 8 1 68-75 - As
stated in the North Carolina HCFA
1450 UB 82 Manual.
(18) External Cause of Injury Code (E-Code)
Form Locator 77 ; As stated in
the North Carolina HCFA 1450 Manu-al/
whenever the principal diagnosis is
an injury, poisoning or adverse efl'ect.
(19) fl-8) Principal Procedure and Date
Form locator 84 80 - As stated in the
North Carolina HCFA 1450 UB 82
Manual.
(20) (W) Other Procedures Form locators S5
&-86 8ia I e - As stated in the North
Carolina HCFA 1450 UB 82 Manual.
(21) (30) Attending Physician Form locator
93 82 - Only the State Identification
number—license UPIN is required.
Code as stated regardless of payer.
(22) fSi^ Other Physician Identification
Form locator 93 83 - Only the State
number of this field UPIN is required.
Code as stated in the North Carolina
HCFA 1450 UB 82 Manual.
(c) In accordance with all pertinent State and
federal laws or regulations on patient confidentiali-ty,
the following HCFA 1500 data elements must
be submitted to the Commission for every ambula-tory
surgical patient released.
DATA ELEMENT DESCRIPTION
(1) Payer Identification
Form locator 1 - as stated in the Com-mission
issued ambulatory surgery data
submission manual.
(2) Insured's ID Number Form locator la
- as stated in the Commission issued
ambulatory surgery data submission
manual.
(3) Patient's Date of Birth Form locator 3
- as stated in the Commission issued
ambulatory surgery data submission
manual.
(4) Sex Form locator 3 - as stated in the
Commission issued ambulatory surgery
data submission manual.
(5) Zip code of Patient Address Form
locator 5 - only the zip code is required
as stated in the Commission issued
ambulatory surgery data submission
manual.
(6) Diagnosis or Nature of Illness or Injury
Form locator 21 - using the ICD-9-CM
code and stated in the Commission
issued ambulatory surgery data submis-sion
manual.
(7) Dates of Service Form locator 24A - as
stated in the Commission issued ambu-latory
surgery data submission manual.
(8) Place of Service Form locator 24B - as
stated in the Commission issued ambu-latory
surgery data submission manual.
(9) Type of Service Form locator 24C - as
stated in the Commission issued ambu-latory
surgery data submission manual.
(10) Procedures, Services, Supplies Form
locator 24D - as stated in the Commis-sion
issuedambulatory surgery data
submission manual.
{4-t) Diagnosis Code Form locator 24E—as
stated in the Commission issued ambu
an
(12)
(13)
(14)
latory surgery data submission manual.
fi3) Charges Form locator 24F - as
stated in the Commission issued ambu-latory
surgery data submission manual.
{^ Days or Units Form locator 24G -
as stated in the Commission issued
ambulatory surgery data submission
manual
.
fW) Federal Tax ID Form locator 25 -
as stated in the Commission issued
ambulatory surgery data submission
manual.
f4-^ Patient's Account No. Form loca-tor
26 - as stated in the Commission is-sued
ambulatory surgery data submis-sion
manual.
609 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
(15) f4^ Total Charge Form locator 28 - as
stated in the Commission issued ambu-latory
surgery data submission manual.
(16) fi^ Attending Physician's WN UPIN
Number Form locator H 17A - as
stated in the Commission issued ambu-latory
surgery data submission manual.
(d) Any hospital or ambulatory surgical facility
which does not have a Medicaid Base provider
number shall contact the Commission for assign-ment
of an identification number. This number
shall be used in the Medicaid Provider Number
field for all UB 82 rcoorda submitted to the Com
mission for batching purposes only .
Statutory Authority as. 131E-212(b).
.0006 DATA SUBMISSION
(a) Data Submission Requirements:
(1) At a minimum, hospitals and ambulato
ry surgical fhoilitioa data providers shall
submit the required data within 45
calendar days following the close of the
calendar quarter during which the pa-tient
was discharged or died; therefore,
data for the calendar quarters ending
March 3 1 , June 30, September 30, and
December 31 shall be submitted on or
before May 15, August 14, November
14, and February 14, respectively.
However, hospitals data providers may
submit data more frequently during the
calendar quarter in which the patient
was discharged or died.
(2) Upon receipt of a written request for an
extension from the data provider, the
Commission may, for good cause,
extend the time for submitting data for
a particular reporting period.
(b) Format for Data Submission:
(1) All hospitals and ambulatory surgical
fiioilitios data providers may submit
HCFA 1450 UB 82 and HCFA 1500
(ambulatory surgery only), discharge
data to the Commission on one of three
acceptable types of media: on paper
HCFA 1450 UB 82 forms, and HCFA
1500 forms (ambulatory surgery only),
on a magnetic tape, or on a personal
computer (PC) diskette. Other types of
media used to submit the required data,
such as on-line transmission, must be
approved by the Commission.
(2) On and after July 1 , 1 99 1 , each hospital
with 1,000 or more annual discharges
(3)
(4)
or cases, as reported on the most cur-rent
hospital licensure application, must
submit the required HCFA 1450 UB 82
inpatient discharge data on one of the
acceptable electronic media specified m
this Rule and in the format as required
by the Commission. By Ae end of six
months after first reporting to the Com-mission,
any data provider with 1.000
or more annual discharges or reportable
cases, as reported on the most current
Licensure application, will submit the
required data on one of the acceptable
electronic media specified in this Rule
and in the format as required by the
Commission. An exemption will be
considered by the Commission if the
hospital data provider's can demonstrate
that it lacks the technical capability and
computer resources to produce the
required data electronically. The re-quest
for exemption must be made in
writing by the hospital's data provider's
chief executive officer. Each hospital
data provider granted an exemption
must submit an annual certification
signed by the hospital's data provider's
chief executive officer verifying that the
hospital data provider continues to meet
the exemption criteria. The annual
certification form received from the
Commission must be returned to the
Commission no later than July 1 of
each year.
The physical specifications of the mag-netic
tape shall be any size reel, record-ed
in nine track. Extended Binary
Coded Decimal Interchange Code
(EBCDIC) mode or ASCII, with densi-ty
equal to 1600 BPI or 6250 BPI,
unlabeled or with IBM standard labels.
Acceptable specifications for submis-sion
of data on a floppy disk shall be 5
1/4 or 3 1/2 inch IBM-PC compatible
diskette.
Data submitted via magnetic tape shall
conform to the uniform record layout as
required by the Commission. Data
submitted via PC diskette shall also
conform to a uniform record layout as
required by the Commission. Copies of
the required format may be obtained by
contacting the Executive Director of the
Medical Database Commission at 112
Cox Avenue, Suite 208, Raleigh, North
9:9 NORTH CAROLINA REGISTER August I, 1994 610
PROPOSED RULES
Carolina, 27605.
(c) Edit Criteria:
(1) Data elements that are considered criti-cal
fields on the HCFA 1450 UB 82
form for record editing purposes are
Patient Control Number, Bill TVpe,
Medicaid Provider Number Federal Tax
ID, Zip Code, Date of Birth, Sex,
Admission Date, Admission Type,
Source of Admission, Patient Status,
Statement Covers Period, Revenue
Codes and Charges, Primary Payer,
Principal Diagnosis, Attending Physi-cian
Identification. Records containing
invalid HCFA 1450 UB 82 codes or
all-blank fields for any of these data
elements will be designated as error
records.
(2) Data elements that are considered criti-cal
fields on the HCFA 1500 form for
record editing purposes are Payer Iden-tification
Insured's I.D. Number, Med
icaid Provider number Federal Tax ID.
Zip Code, Date of Birth, Sex, Dates of
Service, place of service, type of ser-vice,
procedures defined with
CPT/HCPCS codes with modifiers,
principle diagnosis codes, principle and
secondary surgical procedure, patient's
account number, physician's PIN at-tending
physician identification . Re-cords
containing invalid HCFA 1500
form codes or all blank fields for any
of these data elements will be designat-ed
as error records.
(3) The last revenue code listed must be
0W- 0001 , Total Charge, and this
charge must equal the sum of charges
for all other revenue codes reported.
(HCFA 1450)
(4) On the HCFA 1450 UB 82 form for
inpatient cases, the following data
elements must contain valid codes if
present: Primary—Payer Specific
Carrier Identification, Other Diagnoses,
Principal Procedure Code and Date,
Other Procedure Codes and Dates,
External Cause of Injury Code. Other
Physician Identification (if a procedure
was performed).
(5) For ambulatory surgery cases the fol-lowing
data elements must contain valid
codes if present:
(7\) reported on HCFA 1450 UB 82 :
Other Diagnoses. Other Procedure
Codes and Dates. External Cause of
Injury Code. Primary Payer—Specif-ic
Carrier Identification, Other Diag-noses,
Principal Proocduro Code and
Date,—Other—Procedure—Codes—aad
Dates, Identification of Surgeon per -
forming the procedure.
^B)
—
reported on HCFA 1500: Type cov-erage
and insured ID number, specific
carrier—identification,—procedures,
services—ef
—
supplies—m—CPT4—©f
HCPC code, dates of service, Physi
cian PIN.
(6) Upon completion of the data error
assessment, the Commission or the
designated contractor shall promptly
notify each hospital—ef
—
ambulatory
surgical facility data provider whose
records do not pass the critical edit
checks. This notification shall identify
the discharge records and the data items
within them which do not pass the
edits. Each hospital data provider
receiving an error notification report
shall respond within 30 calendar days
of the notification by making the neces-sary
changes.
(7) Upon receipt of a written request for an
extension from the data provider, the
Commission may, for good cause,
extend the time for submitting the
necessary changes for a particular
reporting period.
(d) Data Submission Arrangements:
(1) Each hospital or ambulatory surgical
facility data provider or its designated
agent shall submit the required UB 82
data directly to the Commission or to
the designated contractor.
(2) Resubmissions of data as required by
the Commission or upon the initiative
of a hospital or ambulatory surgical
facility will be accepted for the purpos-es
of adding records, amending data
elements or otherwise making modifica-tions
to a previous data submission.
Resubmissions shall conform to the
requirements of 11 NCAC 15 .0006(b).
(e) Reimbursement for Data Submission:
For HCFA 1450 UB 82 and HCFA 1500
discharge records generated solely for
submission to the Commission due to the
absence of a third party payer, hospitals
or ambulatory surgical facilities shall be
reimbursed 40 cents ($0.40) per dis-
611 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
charge, regardless of the choice of medi-um
for submission.
Statutory Authority as. 131E-212(b).
.0007 PROVIDER VERIFICATION
Data Providers shall be given an opportunity to
review and verify information pertaining to them
in the database as follows:
(1) Within ten calendar days after aW error
corrections have been made and prepara-tion
of the individual hospital's data
provider's dataset by the Commission is
complete, each hospital data provider will
be notified in writing of the opportunity
to review its dataset. A summary compi-lation
of the dataset, including number of
discharges and total charges, will be
attached to each data provider's data
verification notice. Within 15 calendar
days of the date of the notice, each hospi
tal data provider shall return the notice to
the Commission indicating that the accu-racy
of the dataset summary compilation
has been verified by the hospital data
provider .
(2) Within 15 calendar days of the date of
the verification notice and summary
compilation, a hospital data provider that
wishes to review its dataset shall submit
a written request to the Executive Direc-tor.
The Commission shall provide the
requested data within ten calendar days
after receipt of the written request.
(3) Within 30 calendar days of the
Commission's release of the requested
dataset, the hospital data provider shall
notify the Commission in writing of those
portions of the dataset which the hospital
data provider believes are inaccurate.
The hospital data provider shall include a
written statement explaining why the
identified portions are believed to be
inaccurate and enclose any data which
would assist in clarifying the possible
inaccuracies.
(4) If the Commission finds any error in a
dataset, the dataset shall be corrected
before the release of compilations from
that dataset for public use. A notification
of corrections made to a hospital's data
provider's dataset shall be provided to the
appropriate hospital data provider by the
Commission in writing prior to public
release. If the Commission finds changes
to the dataset are unnecessary or
unwarranted, it shall notify the
appropriate hospital data provider of this
conclusion in writing prior to public
release, including a brief but complete
explanation of its determination. The
compilations from the dataset will be
available to the public seven calendar
days following commission acceptance of
the accurate dataset.
(5) The Commission may, for good cause,
grant an extension of these time limits
upon receipt of written request from the
hospital data provider.
Statutory Authority as. 131E-212(b).
.0008 COMPLIANCE
(a) Compliance with these regulations and the
act will be determined on a quarterly basis. The
Commission shall consider a hospital data provider
out of compliance with these regulations and the
act when any of the following conditions apply:
(1) The hospital data provider knowingly
^Is to submit data in accordance with
the provisions of these regulations.
(2) More than three percent of the hospital's
data provider's discharge records
submitted during a quarter, are excluded
from the database by the Commission
because the records do not pass the
critical edit checks as specified in 11
NCAC 15 .0006(c) and the total
percentage of discharge records felling
critical edits for the preceding three
quarters and the submitting quarter
exceeds three percent. Upon notification
by the Commission, hospitals data
providers will be allowed to submit the
corrected records in accordance with the
requirements of 11 NCAC 15 .0006.
Discharge records resubmitted to correct
errors will not be counted in the
determination of the error rate.
(3) The hospital data provider has not
submitted data for all of its discharges to
the Commission in accordance with the
required submission deadlines in 11
NCAC 15 .0006(a).
(h) Penalties ; penalties will apply for data for
discharges or cases with date of service on or after
1 October 1994. The Commission staff determine
which data provider meets the criteria for penalties
in accordance with Subparagraph (b)(1) and (2) of
this Rule and provide the calculations of the
9:9 NORTH CAROLINA REGISTER August I, 1994 612
PROPOSED RULES
penalties to the Commission board members. The
board members will then consider these findings
and vote deciding to invoke the entire penalty, a
portion thereof, or none at alL The criteria to be
used in deciding what level of the eligible penalty
to invoke will include but not be limited to: the
historic compliance of the data provider, and
mitigating circumstances that prevented the data
provider from supplying the information.
(1) Penalty for late submission of data will
be calculated in accordance with the
following formula: one hundred dollars
($100.00) Eei day for each day the
information is late (regardless of the
number of records) PLUS:
(A) for the lateness of a whole quarter of
data = one dollar ($1.00) x 1/4 x total
number of last years cases as reported
to the North Carolina Division of
Facilities Services; or
(B) for the lateness of a month of data =
one dollar ($1.00) x l/ll x total
number of last years cases as reported
to the North Carolina Division of
Facilities Services.
(2) Penalty for not meeting the 3% critical
error rate ; effective October l^ 1994
using previous 4 quarters of data to
calculate the error rate - Minimum
charge of ten dollars ($10. (X)). and
would be calculated as follows: 30
cents per discharge case with a critical
error based upon statistic for critical
errors as calculated in the control
reports generated by
database.
the system
Statutory Authority as. 131E-212(b).
.0009 DATA ACCESSIBILITY
(a) In accordance with G.S. 131E-213, the data
collected from data providers shall not be
considered public records.
(1) The raw data shall be released by the
Commission only to data providers
which have submitted that particular
data to the Commission, and which
request to see and review its dataset for
purposes of verifying information in the
Commission's database pertaining to
that data provider. These datasets are
not public records.
(2) State agencies will have access only to
public record information as specified
in G.S. 131E-212(f).
(b) Only those reports and compilations
prepared by the designated contractor in
accordance with G.S. 131E-213 and with the
provisions in 11 NCAC 15 .0009 and .0010 are
public record. These reports shall include, but not
be limited to comparative information on average
charges, total and ancillary charge components,
utilization rates, length of stay on diagnosis
specific and procedure specific categories, and
number of discharges, compiled in aggregate by
health care provider, by diagnosis, and by primary
payer category.
(1) Compilations are not available for
release and dissemination and are not
public records until the data provider
verification process has been
completed.
(2) The Commission shall not release any
compilation of data for special studies
and analysis for a purpose other than
one authorized by the act.
Compilations of data shall not contain
patient identifying information. Only
the data which can be released under
requirements of the act shall be
released.
(3) Nothing in the act or these regulations
shall prevent a hospital data provider
from receiving upon request a copy of
that hospital's data provider's final
edited dataset as it exists in the
possession of the Commission.
(c) Requests for Special Compilations. Any
person, organization, govenmiental agency, or
other entity may request the preparation of
compilations of data collected by and furnished to
the Commission in a specific manner or format not
already used by the Commission. This includes
requests for subsets of information already
available from the Commission in compiled form.
(1) All requests for compilations of data
shall be made in writing to the
Executive Director of the Commission.
At minimum, the written request shall
contain the name, address, and
telephone number of the requester, a
description of the requested compilation
of data, a concise statement of the
reason for the request, and the
relationship of the requested
compilation to a legitimate purpose. A
"legitimate purpose" is a purpose
consistent with the intent, policies, and
purposes of the act.
(2) The Commission shall review each
613 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
request for a compilation of data and
determine whether to approve or deny
the request. The Commission shall
notify the public of requests made for
compilations by listing the requester,
and providing a short description of the
request on its official meeting agenda.
Such requests shall be approved by the
Commission which shall designate the
form in which the information shall be
made available. The approval or denial
by the Commission of requests for
compilations of data shall be within the
discretion of the Commission. The
Commission may deny a request for a
compilation of data for reasons
including, but not limited to,
unavailability of data, the requested
compilation is already available from
the Commission or another source, the
requested compilation of data would
endanger patient confidentiality, the
Commission lacks sufficient resources
to fulfill the request, or the request is
not related to a legitimate purpose.
(3) The Commission shall notify the
requester in writing of its decision.
Denial of a request shall include a brief
explanation of the reason for the denial.
(4) The Commission or the designated
contractor in consultation with the
Commission shall also determine a fee
to be charged to the requesting agency
or private sector organization to cover
the direct and indirect costs for
producing special compilations. The
fee should include staff time, computer
time, copying costs, and supplies. For
charging purposes, each compilation
will be considered an original.
(5) No f)erson, organization, governmental
agency, or other entity receiving data
from the Commission shall redisclose
or redistribute that information for a fee
in the same form without prior written
approval from the Commission.
Statutory Authority G.S. 131E-212(b).
.0010 CONFTOENTIALITY OF DATA
(a) The Commission shall ensure that any
contract entered into with other parties for the
purposes of processing and analysis of data
collected under this regulation shall contain
assurances that such other parties shall also comply
with the provisions of pertinent state and federal
regulations on patient confidentiality.
(b) The Patient Control Number (HCFA 1450
UB 82 form locator 3 ) and the Certificate/Social
Security/Health Insurance Claim/Identification
Number (HCFA 1450 UB 82 form locator 68) and
Insured's I.D. Number (HCFA 1500 form locator
4«) and the Patient Account Number (HCFA 1500
form locator 26) shall be used only for the purpose
of establishing an audit trail in the event that it is
necessary to retrieve the primary source document
for validation of the abstracted data. Data
collected under these regulations and disclosed to
other parties shall be purged of Patient Control
Numbers, Certificate/Social Security/Health
Insurance Claim/Identification Numbers and Dates
of Birth prior to disclosure.
(c) Raw data submitted to the Commission or to
the designated contractor by data providers
pursuant to the act shall be privileged and
confidential, and shall not be disclosed in any
manner. The foregoing includes, but shall not be
limited to, disclosure, inspection or copying under
the State's Public Record Act. However, these
prohibitions shall not apply to the reports prepared
for release and dissemination by the Commission.
(d) For compilations released, the Commission
will develop procedures to prevent small cell
counts from potentially identifying an individual
patient.
Statutory Authority G.S. 131E-212(b).
.0012 SUCCESSOR FORMS
All references in this Section to claim forms,
such as "HCFA 1500" and "HCFA 1450"
"UB 82"
, include references to their successor
forms, such as "HCFA 1450" and "UB-92", that
are developed pursuant to federal law under the
auspices of HCFA, the National Uniform Billing
Committee, or the North Carolina State Uniform
Billing Committee.
Statutory Authority G.S. 131E-212(b).
TITLE 12 - DEPARTMEP^ OF
JUSTICE
I\otice is hereby given in accordance with G.S.
150B-21.2 that the N.C. Alarm Systems Licensing
Board intends to amend rule cited as 12 NCAC 11
.0209.
NORTH CAROLINA REGISTER August 1, 1994 614
PROPOSED RULES
1 he proposed effective date of this action is
November 1, 1994.
1 he public hearing will be conducted at 2:00
p.m. on August 30, 1994 at the State Bureau of
Investigation, Conference Room, 3320 Old Gamer
Road, Raleigh, N.C. 27626-0500.
Jxeason for Proposed Action: Clarify language in
the rule to specifically exempt a sole proprietor-ships
that is owned and operated by a licensee.
Lyomment Procedures: Interested persons may
present their views either orally or in writing at
the hearing. The Record of Hearing will be open
for receipt of written comments until the hearing.
Written comments must be delivered to the Private
Protective Services Board, 3320 Old Gamer Road,
Raleigh, N. C. 27626-0500
CHAPTER 11 - N.C ALARM
SYSTEMS LICENSING BOARD
SECTION .0200 - PROVISIONS
FOR LICENSEES
.0209 COMPANY BUSINESS LICENSE
(a) Any firm, association, or corporation re-quired
to be licensed pursuant to G.S. 74D-2(a)
shall submit an application for a corporate business
license on a form provided by the Board. This
application for license shall call for such informa-tion
as the firm, association, or corporation name;
the address of its principal ofiice within the State;
any past conviction for criminal off'enses of any
corporate director or officer; information concern-ing
the past revocation, susjjension or denial of a
business or professional license to any director or
officer; a list of all directors and officers of the
firm, association, or corporation; a list of all
persons, firms, associations, corporations or other
entities owning 10 percent or more of the outstand-ing
shares of any class of stock; and the name and
address of the qualifying agent.
(b) In addition to the items required in Para-graph
(a) of this Rule, a foreign corporation shall
further qualify by filing with its application for a
license, a copy of its certificate of authority to
transact business in this state issued by the North
Carolina Secretary of State in accordance with
G.S. 55-131 and a consent to service of process
and pleadings which shall be authenticated by its
corporate seal and accompanied by a duly certified
copy of the resolution of the board of directors
authorizing the proper officer or officers to exe-cute
said consent.
(c) After filing a completed written application
with the Board, the Board shall conduct a back-ground
investigation to ascertain if the qualifying
agent is in a management position. The Board
shall also determine if the directors or officers
have the requisite good moral character as defined
in G.S. 74D-6(3). It shall be prima facie evidence
of good moral character if a director or officer has
not been convicted by any local. State, federal, or
military court of any crime involving the use,
carrying, or possession of a firearm; conviction of
any crime involving the use, possession, sale,
manufacture, distribution, or transportation of a
controlled substance, drug, narcotic, or alcoholic
beverage; conviction of a crime involving assault
or an act of violence; conviction of a crime involv-ing
breaking or entering, burglary, larceny, or any
offense involving moral turpitude; or does not
have a history of addiction to alcohol or a narcotic
drug; provided that, for purposes of this Section,
"conviction" means and includes the entry of a
plea of guilty or no contest or a verdict rendered
in open court by a judge or jury.
(d) Upon satisfactory completion of the back-ground
investigation, a corporate business license
may be issued. This license shall be conspicuously
displayed at the principle place of business within
the State of North Carolina.
(e) The corporate business license shall be
issued only to the corporation and shall not be
construed to extend to the licensing of its direc-tors,
officers, or employees.
(f) The issuance of the corporate business
license is issued to the firm, association, or corpo-ration
in addition to the license issued to the
qualifying agent. Therefore, the qualifying agent
for the firm, association, or corporation which has
been issued the corporate business license shall be
responsible for assuring compliance with G.S.
74D.
(g) A sole proprietorship that is owned and
operated by an individual holding a current alarm
systems business license shall be exempt from this
Rule.
Statutory Authority G.S 74D-2(a); 74D-5.
615 9:9 NORTH CAROLINA REGISTER August I, 1994
PROPOSED RULES
TITLE 15A - DEPARTMENT OF
ENVIRONMENT, HEALTH, AND
NATURAL RESOURCES
Notice is hereby given in accordance with G.S.
150B-21.2 that the EHNR - Environmental Man-agement
Commission intends to adopt rule cited
as 15A NCAC 2Q .0112, with changes from the
proposed text noticed in the Register, \blume 8,
Issue 23, page 2319.
Ihe proposed effective date of this action is
October 1, 1994.
Jxeasonfor Proposed Action: Based on comments
received at public hearings held on March 28 and
30, 1994, revisions of the proposed rule on requir-ing
a professional engineer's seal on air permit
applications are being considered. The Environ-mental
Management Commission seeks comments
on these revisions before making its final decision.
Lyommsnt Procedures: All persons interested in
this matters are invited to send in written com-ments.
Written comments will be accepted through
September 1, 1994. Comments should be sent to
and additional information concerning this matter
may be obtained by contacting:
Mr Thomas C. Allen
Division of Environmental Management
PO. Box 29535
Raleigh. North Carolina 27626-0535
(919) 733-1489
iLditor's Note: This proposed different rule does
not affect the fiscal note previously submitted in
accordance with 150B-21.4(b).
CHAPTER 2 - ENVIROIVMENTAL
MANAGEMENT
SUBCHAPTER 2Q - AIR QUALITY
PERMIT PROCEDURES
SECTION .0100 - GENERAL
PROVISIONS
.0112 APPLICATIONS REQUIRING
PROFESSIONAL ENGINEER SEAL
(a) A professional engineer registered in North
Carolina shall be required to seal technical por-tions
of air permit applications consiatcnt with the
practice of engineering as defined by G.S. 89 C
ftfid that directly involve engineering tasks, inolud
ing'
(1) design, the evaluation or design of air
pollution capture and control aystems;
ef
(2) determination of applicability and ap-propriateness,
or and interpretation of
cmiaaiona by calculation, such as ther
modynamica, chemical reaction kinot
io8 , heat balances , material balanooa, or
published—cmiaaion—factors
—
where—
a
range of values are given
(3) determination and interpretation of
performance.
of air pollution capture and control systems .
(b) The requirements of Paragraph (a) of this
Rule do not apply to A professional engineer is not
required to seal the following:
(1) any source with non-optional air pollu-tion
control equipment that constitutes
an integral part of the process equip-ment
as originally designed and manu-factured
by the equipment supplier:
(2) sources that are permitted under Rule
.0310 or .0509 of this Subchapter;
(3) paint spray booths without air pollution
capture and control systems for volatile
organic compound emissions :
(4) particulate emission sources with air
flow rates of less than 10,000 actual
cubic feet per minute; or
(5) permit renewal if no modifications are
included in the permit renewal applica-tion.
Statutory Authority G.S. 143-215. 3(a)(1); 143-
215.108.
TITLE 18 - SECRETARY
OF STATE
J\otice is hereby given in accordance with G.S.
150B-21.2 that the N. C. Department of the Secre-tary
of State, Securities Division intends to amend
rules cited as 18 NCAC 6 . 1205 - . 1206, . 1208 -
. 1209, . 1302 - . 1305, . 1310, . 1313 - . 1314, . 1401
- .1402, .1405, .1407, .1409, .1412 - .1413,
.1702, .1704. .1713, .1901 - .1903 and adopt
.1416.
Ihe proposed effective date of this action is
9:9 NORTH CAROLINA REGISTER August 1, 1994 616
PROPOSED RULES
December 1, 1994.
1 he public hearing will be conducted at 10:00
a.m. on October 3, 1994 at the Securities Division
Conference Room, Suite 100, 300 N. Salisbury
Street, Raleigh, NC 27603.
ixeason for Proposed Action:
18 NCAC 6 .1205 - .1206, .1208 -.1209, .1302 -
.1305, .1310, .1313 - .1314, .1401 - .1402, .1405,
.1407, .1409, .1412 -.1413, .1702, .1704, .1713,
.1901 - .1903 - To generally update and clarify
the administrative rules dealing with the regulation
of securities in North Carolina.
18 NCAC 6 .1416 - To define what actions and
occurrences a securities dealer must report to the
Securities Division of the Secretary of State's
office, as well as the time period in which these
reports must be submitted
Lyomment Procedures: Interested persons may
present oral or written statements at the public
hearing, or in writing prior to the hearing by mail
addressed to Mr Gene Cella, Administrator,
Securities Division, N. C Dept. of the Secretary of
State, 300 N. Salisbury St., Raleigh, NC 27603.
For copies of any information related to the hear-ing
call (919) 733-3924, or write to the aforemen-tioned
address. The comment period will end on
October 3, 1994.
CHAPTER 6 - SECURITIES
DIVISION
SECTION ,1200 - EXEMPTIONS
.1205 LIMITED OFFERINGS
PURSUANT TO G.S. 78A- 17(9)
(a) Any issuer relying upon the exemption
provided by G.S. 78A-17(9) in connection with an
offering of a security made in reliance upon Rule
505 or Rule 506 of Regulation D promulgated by
the Securities and Exchange Commission under the
Securities Act of 1933, as amended, 17 C.F.R.
230.505 (1982) and 17 C.FR. 230.506 (1982)
(and as subsequently amended) shall comply with
the provisions of Rules .1206, .1207 and .1208 of
this Section; provided that such compliance shall
not be required if the security is offered and sold
only to persons who will be actively engaged, on
a regular basis, in the management of the issuer's
business; and provided further, that compliance
with provisions of Paragraphs (a), (b), and (c) of
Rule .1208 of this Section shall not be required if
the security is offered to not more than five indi-viduals
who reside in this State.
(b) Any issuer relying upon the exemption
provided by G.S. 78A-17(9) in connection with an
offering of a direct portioipation program security
made solely in reliance upon an exemption from
registration contained in Section 4(2) or Section
3(a)(ll) of the Securities Act of 1933, as amend-ed,
or made solely in reliance upon Rule 504 of
Regulation D promulgated by the Securities and
Exchange Commission under the Securities Act of
1933, as amended, 17 C.FR. 230.504 (1982),
(and as subsequently amended), shall comply with
the following conditions and limitations:
(1) No commission, discount, finder's fee
or other similar remuneration or com-pensation
shall be paid, directly or
indirectly, to any person for soliciting
any prospective purchaser of the securi-ty
sold to a resident of this State unless
such jjerson is either registered pursuant
to G.S. 78A-36 or exempt from regis-tration
thereunder or the issuer reason-ably
believes that such p>erson is so
registered or exempt therefrom.
(2) In all sales of direct participation pro-gram
securities. Real Estate Investment
Trusts, and Limited Liability Compa-nies
, the provisions of Rule .1313 of
this Chapter regarding registered offer-ings
of direct participation program
securities. Real Estate Investment
Trusts, and Limited Liability Compa-nies
shall be applicable.
(3) Any prospectus or disclosure document
used in offering the securities in this
state shall disclose conspicuously the
legend(s) required by the provisions of
Rule . 1 316(a)(2) and .1316(a)(3) of this
Chapter.
(4) Not less than 10 business days prior to
any sale offer of the securities to a
resident of this State which shall in
elude but not be limited to the receipt
by the issuer, or any person acting on
the issuer's behalf of a signed subserip
tion agreement of, or the receipt of
consideration from, a purohasor, the
issuer shall file with the administrator,
or cause to be so filed:
(A) A statement signed by the issuer and
acknowledged before a notary public
or other similar officer:
(i) identifying the issuer (including
617 9:9 NORTH CAROLINA REGISTER August 1, 1994
PROPOSED RULES
name, form of organization,
address and telephone number);
(ii) identifying the person(s) who will
be offering and selling the securi-ties
in this State and their titles
(and in the case of such persons
other than the issuer and its offi-cers,
partners and employees,
describing their relationship with
the issuer in connection with the
transaction and the basis of their
compliance with or exemption
from the requirements of G.S.
78A-36) and describing any com-missions,
discounts, fees or other
remuneration or compensation to
be paid to such persons;
fiii)
—
containing—a—
s
ummary—ef—the
proposed offering including!
^ a description of the socuritioa
to be sold;
^S)—the
namc(8)—of all—general
partners of an issuer which is
a partnership and, with respect
to a oorpwmtc issuer or any
oorporote general partncr(s) of
any i ssuer which i s a partner
ship, the date and place of
incorporation and the names of
the
—
directors—and
—
cxocutivc
officers of such oorporation(s);
(ffi)
—
the anticipated aggregate dollar
amount of the offering;
^IV)
the anticipated required mini
mum investment,—if any,—h^
each purchaser of the securities
to be offered;
fV)—a
—
brief—description—ef—the
issuer's business and the antio
ipatcd use of the proceeds of
the offering; and
(V})
a list of the states in which the
securities arc proposed to be
fv) containing—an
—
undertaking—te
furnish to the administrator, upon
written request, a copy of any
written—document—©f
materials
used or proposed to be used in
oonncction with the offer and sale
of the securities.
(iii) containing an undertaking that no
securities offerings by the issuer
have occurred in the last three
years or submit infbrmation con-cerning
the prior offerings.
(B) A consent to service of process nam-ing
the North Carolina Secretary of
State as service agent using the Uni-form
Consent to Service of Process
(Form U-2) signed by the issuer and
acknowledged before a notary public
or other similar officer; and accompa-nied
by a properly executed Corporate
Resolution (Form U-2A), if applica-ble;
(C) A non-refundable filing fee in the
amount of twenty five—dollars
($25.00) one-hundnsd fif