Section 1.

Designates the Department of Health and Human Services (DHHS) as the agency tasked under GS 130A-4.3 to ensure that school nurses funded with State funds comply with the tasks outlined in the statute (currently Division of Public Health oversees those obligations under GS 130A-4.3).

Section 2.

Extends DHHS’s end-date for using the federally facilitated healthcare marketplace to make Medicaid decisions from June 30, 2025, to June 30, 2028, set forth in Section 1.8 of SL 2023-7, as amended. Makes technical correction to statutory citation.   

Changes the eligibility date for reinstatement for eligibility for Medicaid benefits for inmates and other persons who are released from carceral settings under GS 108D-40 to the first day of the month following the twelfth month after their release (currently, earlier of their initial Medicaid eligibility certification post release or 365 days). Effective when the act becomes law and applies to (1) inmates released on or after that date and (2) inmates released on or after January 1, 2025, who are not enrolled with a prepaid health plan (PHP) on the date the act becomes law.

Amends GS 108C-3 relating to Medicaid provider screening. Effective retroactively to January 1, 2023, specifies that nursing facilities categorized as "limited" risk do not include skilled nursing facilities, whereas prospective (newly enrolling) skilled nursing facilities and those undergoing a change in ownership are designated as "high" risk, and revalidating skilled nursing facilities are "moderate" risk unless the facility meets the description for "high" risk designation.

Further amends GS 108C-3 as follows. Moves portable X-ray suppliers from "low" categorical risk to "moderate". Designates prospective (newly enrolling) hospice organizations and those undergoing a change in ownership as "high" risk. Designates as "high" categorical risk the following revalidating providers that are revalidating for the first time since newly enrolling and for which fingerprinting requirements as a newly enrolling provider were waived due to a national, State, or local emergency: opioid treatment programs that have not been fully and continuously certified by the Substance Abuse and Mental Health Services Administration since October 23, 2018; agencies providing durable medical equipment; adult care homes delivering Medicaid-reimbursed services; agencies providing private-duty, home health, personal care services, in-home care services, or home infusion; skilled nursing facilities; and hospice organizations. Designates other revalidating hospice organizations which do not meet the description for those designated "high" risk as "moderate". Makes conforming changes. Effective retroactively to January 1, 2024.

Amends GS 108A-57 relating to the State's subrogation rights to medical beneficiary Medicaid claims. Adds new language authorizing DHHS to designate one or more PHPs to receive all or a portion of payments due under the statute to DHHS for a Medicaid claim by sending a notice of designation to the beneficiary who has the claim against the third party and any PHP designated in the notice. Defines "designated PHP" as used in the statute to refer to a PHP designated in this notice. Adds that if a PHP made payments on behalf of a Medicaid beneficiary that are in the Medicaid claim, that the beneficiary's application to a court to dispute the presumptions established by subsection (a1) of the statute must be served on that PHP within the same time frame as service required on DHHS by current law. Includes non-payment and payment to a designated PHP, as an alternative to DHHS, within the required determinations of a court regarding a beneficiary who disputes the statue's presumption. Requires notification of any designated PHP of the receipt of proceeds of a settlement or judgment related to a Medicaid claim by the beneficiary, and includes designated PHPs as an alternative to DHHS for specified distribution of the proceeds. Applies to Medicaid claims brought by medical assistance beneficiaries against third parties on or after the date the act becomes law.

Section 3.

Lowers the limit on the number of persons under the supervision of the US Veterans Administration that a facility must care for to qualify for an exemption from licensure as an adult care home under GS 131D-2.3 from no more than four to no more than three people.

Increases the criminal consequences for failure to register as a multiunit assisted housing under GS 131D-2.5 from a Class 3 misdemeanor to Class H felony. Raises the fine from $50 for the first offense and not more than $500 for each subsequent offense to $1,000 per day the facility operates in violation of Article 1 of GS Chapter 131D. Authorizes DHHS and county departments of social services, in actions taken under GS 131D-2.6, to inspect (1) a residence or facility that DHHS believes is operating without an appropriate license or registration or (2) a registered multiunit assisted housing with services facility to determine if it is operating as a licensable adult care home facility without a license. Increases the criminal consequences and raises the fines for operating an assisted living facility in the same way as the act does for failure to register as a multiunit housing. Effective December 1, 2025, and applies to offenses committed on or after that date.

Adds Division of Health Service Regulation (DHSR) as defined term to the GS 131E-76 (definitions provision of the Hospital Licensure Act). Changes the hospital reporting duties under GS 131E-88.2 so that each hospital must provide the requested data for the prior fiscal year ending September 30 to DHSR by February 28 annually (currently, DHSR collects the specified data for the prior calendar year by October 1). Changes the due date for DHHS’s report to the specified NCGA committee from December 1 to May 1. Makes a technical change.

Repeals the NC New Organizational Vision Award Special Licensure Designations, Part 6 to Article 6, GS Chapter 131E.

Changes the entity tasked with approving individuals to administer epinephrine under GS 143-509 from the NC Medical Care Commission to the Office of Emergency Medical Services.

Section 4.

Increases the membership of local teams that are part of the NC Child Fatality Prevention System (System) in GS 7B-1407, so that they include a staff member of the county department of social services or of the consolidated human services agency, appointed by the county department of social services or the consolidated human services agency. Authorizes the director of the local department of health to designate a member of senior management to serve on the local team. Removes the limit on the number of additional individuals that the chair of a local team may invite to join the team. Substitutes references to the “Commission for Public Health” with “DHHS” in GS 15A-534.2 and GS 20-138.7; makes technical changes. Replaces the member of the Advisory Committee on Cancer Coordination and Control (Advisory Committee) who represented the Cancer Committee of the NC Medical Society with member who represents the NC Medical Society in GS 130A-33.50. Makes technical changes. Requires DHHS to consult with the Advisory Committee instead of the Cancer Committee of the NC Medical Society in implementing Part 1 to Article 7 of GS Chapter 130A, concerning cancer. Removes references to copies of birth and death certificates in GS 130A-97, instead tasks local registrars with using the registration method prescribed by the State Registrar. Makes technical changes.

Removes required script that is issued with mammogram results in GS 130A-215.5, and instead requires the health care facility performing the exam to provide each patient with a summary of the mammography report in language understandable by a layperson that includes an assessment of the patient's breast density consistent with FDA guidelines. Requires additional information, as specified, if the facility determines that a patient has heterogeneously or extremely dense breasts. Makes technical changes. Extends the sunset date on the program authorizing a person to elect to contribute all or part of their tax refund to be used for early detection of breast and cervical cancer at DHHS’s Cancer Prevention and Control Branch from January 1, 2026, to January 1, 2030.

Section 5.

Enacts GS 108A-106.1 and GS 108A-106.2 as part of the Protection of the Abused, Neglected, or Exploited Disabled Adult Act, as follows. Grants a magistrate emergency authority to accept a petition for an order authorizing the provision of emergency services to a disabled adult with the clerk’s office is closed. Allows the chief district court judge to authorize one or more magistrates to hear ex parte motions for the provision of emergency services to disabled adults when the district court is not in session and there is no judge available to hear such motions. Makes the orders effective when they are reduced to writing and signed by a district court judge or magistrate. Prevents a child care institution from employing an applicant on a conditional basis prior to the results of a criminal history check (currently, child care facility can employ a person conditionally so long as the individual has consented to a criminal history check and the request is submitted within the described time period).

Modifies the background check provisions of GS 48-3-309 (adoptive parents) and GS 131D-10.3A (foster parents and prospective foster parents) to allow DHHS to provide the prospective adoptive parent/foster parent/prospective foster parent or any other individual required to submit to a criminal history record check a copy of that applicant's criminal history information for the purpose of reviewing or challenging the accuracy of the criminal history (currently, no such review right exists). Requires public child placing agencies, including supervising county departments of social services, to have an employee on staff that is trained and certified to receive criminal history record information to the extent required by federal policy, law, and standards. Allows prospective foster parents who disagree with DHHS’s decision under GS 131D-10.3A to request a hearing under the APA’s contested case provisions.

Section 6.

Enacts GS 122C-256 authorizing DHHS or a Local Management Entity/Managed Care Organization (LME/MCO) to contract for three or more community-based capacity restoration programs (CBCRPs), and up to three Detention Center Capacity Restoration Programs (DCCRP). Allows CBCRPs and DCCRPs to be county- or regionally-based and provides specified requirements for regionally-based programs. Allows DHHS to consult with one or more LME/MCOs for contracting purposes. Authorizes a court to order capacity restoration to be completed at either program as an alternative to a State-operated psychiatric hospital for individuals recommended for participation in either program by a forensic evaluator.