Part I.

Requires the Department of Health and Human Services, Division of Health Benefits (Division), to amend the North Carolina Innovations waiver to increase the number of slots available under the waiver by a maximum of 1,000 slots to be made available on January 1, 2020, and by a maximum of 1,000 slots to be made available on January 1, 2021.

Appropriates $10,250,000 in recurring funds for 2019-20 and $30,750,000 in recurring funds for 2020-21 fiscal year from the General Fund to the Division to be used to fund these additional slots.

Part II.

Repeals GS Chapter 131E, Article 9 (Certificate of Need). Makes conforming changes to GS 6-19.1, GS 113A-12, GS 122C-23.1, GS 131E-13, GS 131E-136, GS 148-19.1, GS 130A-45.02, GS 150B-2, and GS 150B-21.1; makes conforming repeals of GS 143B-1292. Makes further conforming changes to GS 58-50-61 (defining health service facility as it was defined in the repealed Article) and GS 58-55-35 (defining hospice and intermediate care facility for the mentally retarded as they were defined in the repealed Article).

Effective January 1, 2020.

Part III.

Recodifies Article 18A (Psychology Practice Act) of GS Chapter 90 as Article 18G.

Enacts new Article 18H, Psychology Interjurisdictional Licensure Compact, in GS Chapter 90. Sets out six purposes and objectives of the Psychology Interjurisdictional Licensure Compact (Compact), including increasing public access to professional psychological services by allowing telepsychological practice across state lines and temporary in-person, face-to-face services into a state in which the psychologist is not licensed to practice and enhancing the states’ ability to protect public health and safety. Defines terms that are used in the Article, including telepsychology, which is defined as the provision of psychological services using telecommunication technologies.

Specifies that the home state is a compact state where a psychologist is licensed to practice psychology. Allows a psychologist to hold one or more compact state licenses at a time and allows a compact state to require a psychologist not previously licensed in a compact state to obtain and retain a license to practice in the compact state under circumstances not allowed by the Authority to Practice Interjurisdictional Telepsychology under the terms of the Compact. Also allows a compact state to require a psychologist to obtain and retain a license to be authorized to practice in a compact state under circumstances not authorized by Temporary Authorization to Practice under the Compact terms. Temporary Authorization to Practice is a licensed psychologist’s authority to conduct temporary in-person, face-to-face practice, within the limits authorized under the Compact, in another compact state. Temporary in-person, face-to-face practice is where a psychologist is physically present (not through the use of telecommunications technologies) in the distant state to provide for the practice of psychology for 30 days within a calendar year and based on notification to the distant state. Sets out five conditions that must be met in order for a home state’s license to authorize a psychologist to practice in a receiving state (defined as a compact state where the client/patient is physically located when the telepsychological services are delivered), including that the compact state has a mechanism in place for receiving and investigating complaints about licensed individuals and the compact state complies with the bylaws and rules of the Psychology Interjurisdictional Compact Commission (Commission). Sets out five similar conditions that must be met in order for a home state’s license to grant Temporary Authorization to Practice to a psychologist in a distant state.

Establishes requirements that psychologists licensed to practice in a compact state must meet in order to exercise the Authority to Practice Interjurisdictional Telepsychology (defined as a licensed psychologist’s authority to practice telepsychology, within the limits authorized under the Compact, in another compact state), including holding a graduate degree in psychology that meets specified criteria; possessing a current, full, and unrestricted license to practice in a home state that is also a compact state; and having no criminal record history reported on an identity history summary that violates Commission rules. Provides that the home state maintains authority over the license of any psychologist practicing into a receiving state and makes a psychologist practicing into a receiving state subject to the receiving state’s scope of practice. Prohibits a psychologist from practicing telepsychology in a compact state if the psychologist’s license is restricted, suspended, or otherwise limited.

Establishes requirements that psychologists licensed to practice in a compact state must meet in order to exercise the Temporary Authorization to Practice, including holding a graduate degree in psychology that meets specified criteria; possessing a current, full, and unrestricted license to practice in a home state that is also a compact state; and having no criminal record history that violates Commission rules. Requires a psychologist practicing in a distant state under the Temporary Authorization to Practice to practice within the scope of practice authorized by the distant state; psychologists practicing in a distant state are subject to the distant state’s authority and law. Prohibits a psychologist from practicing telepsychology in a compact state if the psychologist’s license is restricted, suspended, or otherwise limited.

Allows a psychologist to practice in a receiving state only in the performance of the scope of practice for psychology as assigned by the appropriate state psychology regulatory authority and under the following circumstances: (1) the psychologist initiates a client/patient contact in a home state via telecommunications technologies with a client/patient in a receiving state or (2) other conditions regarding telepsychology as determined by Commission rules.

Sets out conditions under which a home state or receiving state may take adverse action against a psychologist and the procedures that are to be followed.

Sets out additional authority granted to a compact state’s psychology regulatory authority, including issuing cease and desist and/or injunctive relief orders to revoke a psychologist’s Authority to Practice Interjurisdictional Telepsychology and/or Temporary Authorization to Practice.

Requires the Commission to develop and maintain a coordinated licensure information system (coordinated database) and reporting system that contains licensure and disciplinary action information on all psychologists to whom the Compact is applicable. Sets out information that compact states must provide to the coordinated database. Sets out additional procedures for not sharing designated information and expunging information in the coordinated database.

Provides for the creation of a joint public agency by the compact states to be known as the Psychology Interjurisdictional Compact Commission (Commission). Sets out requirements for Commission membership, voting, and meetings, which are to occur at least once during each calendar year. Requires the Commission to prescribe bylaws and/or rules to govern its conduct. Establishes the Commission’s 14 powers, including bringing and prosecuting legal proceedings or actions in the name of the Commission; borrowing, accepting, or contracting for services of personnel; disposing of any property; and establishing a budget and making expenditures. Sets out requirements for the Executive Board, made up of six elected officers. Sets out provisions governing the financing of the Commission. Provides for qualified immunity, defense, and indemnification of Commission members, officers, the executive director, employees, and representatives.

Establishes criteria that must be met and procedures that must be followed when the Commission exercises its rule-making powers. Provides that if a majority of the legislatures of the compact states reject a rule by enactment of a statute or resolution in the same manner used to adopt the Compact, then the rule has no further force and effect in any compact state. Includes situations when public hearing requirements must be met before a rule or amendment is adopted. Sets out conditions for adoption of emergency rules.

Requires the executive, legislative, and judicial branches in each compact state to enforce the Compact and gives the Compact’s provisions and rules standing as statutory law. Sets out actions that are taken when a compact state has defaulted in the performance of its obligations or responsibilities, including termination of membership only after all other means of securing compliance have been exhausted. Provides for dispute resolution upon request by a compact state. Requires the Commission to enforce Compact provisions and rules and sets out further enforcement requirements.

Provides that the Compact comes into effect on the date on which the Compact is enacted into law in the seventh compact state. Any state that joins after the initial adoption of the rules will be subject to the rules as they exist on the date on which the Compact becomes law in that state. Sets out provisions governing withdrawing from the Compact. Allows the Compact to be amended by the compact states.

The above provisions are effective when at least seven states have enacted the PSYPACT. Requires the North Carolina Psychology Board to report to the Revisor of Statutes when the Compact has been enacted by the seven member states.

Part IV.

Amends GS 122C-263.1(a), which sets criteria for the Department of Health and Human Services (DHHS) to individually certify certain health, mental health, and substance abuse professionals to perform the first commitment examinations for involuntary commitment of individuals with mental illness or substance use disorders required by law. Expands upon those eligible classes of providers to also include a licensed marriage and family therapist. Provides that certification of a licensed marriage and family therapist under the statute does not authorize the therapist to expand the therapist's scope of practice. Makes technical changes. Effective October 1, 2019.

Part V.

Amends GS 131E-138, which sets out licensure requirements for home care agencies to create an exemption when home care services are provided to participants of the Program for All-Inclusive Care for the Elderly through an organization that has a valid program agreement with the Centers for Medicare and Medicaid Services and the Divisions of Health Benefits of the Department of Health and Human Services. Amends GS 131D-2.1 to amend the definitions of adult care home, assisted living residence, and multiunit assisted housing with service to include those residences that provide the specified services with a Program for All-Inclusive Care for the Elderly organization that has a valid program agreement with the Centers for Medicare and Medicaid Services and the Division of Health Benefits of the Department of Health and Human Services. Makes conforming, clarifying, and technical changes.

Amends GS 131D-2.2, which prohibits multiunit assisted housing with service from caring for individuals with the specified conditions or needs to prohibit caring for individuals who require maximum physical assistance as documented by a uniform assessment instrument, unless the individual is enrolled in the Program for All-Inclusive Care for the Elderly, or the physician determines otherwise (was, only if the physician determines otherwise). Further amends the statute to give the resident of an assisted living facility the right to select the Program for All-Inclusive Care for the Elderly as the resident's health care provider without jeopardizing residence in the facility.  

Amends GS 131D-2.16 to require that the Medical Care Commission consider, when adopting rules, the need to ensure comparable quality of services, whether these services are provided by the listed entities or a Program for All-Inclusive Care for the Elderly organization that has a valid program agreement with the Centers for Medicare and Medicaid Services and the Division of Health Benefits of the Department of Health and Human Services.

Amends GS 131D-6 concerning the certification of adult day care programs by exempting from the statute a Program for All-Inclusive Care for the Elderly organization that has a valid program agreement with the Centers for Medicare and Medicaid Services and the Division of Health Benefits of the Department of Health and Human Services.

Effective October 1, 2019.

Part VI.

Amends GS 131D-2.11 by adding that if the annual inspection of an adult care home is conducted separately from the inspection required every two years to determine compliance with physical plant and life-safety requirements, the Division of Health Service Regulation must not cite, as part of the annual inspection, any violation that overlaps with an area addressed by the physical plant and life-safety inspection, unless failure to address the violation poses a risk to resident health or safety. 

Part VII.

Includes a severability clause.