Senate committee substitute to the 1st edition makes the following changes.

Section 4

Amends new GS 122C-115.5, pertaining to alignment of counties with an area authority to also require the DHHS Secretary (Secretary) to direct the dissolution of an area authority upon the Secretary's assumption of full control of all powers of an area authority under GS 122-125.

Amends GS 122C-115 (pertaining to the duties of counties and appropriation and allocation of funds by counties and cities) by reinstating the deleted provision that made this statute control when there is a conflict with GS 153A-77 (Authority of boards of commissioners over commissions, boards, agencies, etc.) or GS 122C-115.1 (County governance and operation of mental health, developmental disabilities, and substance abuse services program).

No longer repeals GS 122C-215 and instead makes the following changes to the statute. Expands upon when the Secretary may assume control of an area authority by providing that when the Secretary determines that an area authority is in imminent danger of failing financially; of failing to provide minimally adequate services to clients in need in a timely manner; or failing to execute on priority infrastructure, services, and supports needed across the State related to mental health, intellectual or other developmental disabilities and substance use disorder, the Secretary may assume control, in part or full, of the area authority and appoint an administrator to exercise the powers assumed by the Secretary. Requires the Secretary to give written notice to the area board and give the area authority an opportunity to be heard before assuming control. Makes conforming changes. Specifies that the assumption of control divests the area authority of its authority as to the powers assumed, which may include service delivery, in addition to the already included adoption of budgets, expenditure of money, and all other financial powers. Makes the existing provisions related to assumption of control applicable to the Secretary's assumption of partial control. Requires that when the Secretary assumes full control that the Secretary direct the dissolution of the area authority. Requires the Department of Health and Human Services (DHHS) to define specified terms as they are used in this statute and sets out requirements for adopting and changing those definitions.

Further amends GS 150B-1 to exempt DHHS from rulemaking with respect to the development of definitions under GS 122C-125.

Amends GS 108D-60 and GS 150B-1(e) by correcting statutory cross-references.

Section 5

Amends GS 122C-112.1 to require the Secretary to direct and oversee the allocation and use of single-stream funding to support the priority infrastructure, services, and supports, including those (was, limited to those) identified in the State Plan.

Makes a technical change to GS 122C-112.1.

Section 10

Amends GS 108A-55.4 as follows. Requires health insurers to respond within 60 days (previously no timeframe as specified) of receiving an inquiry from the Division of Health Benefits regarding a claim for payment for any health care item or service that is submitted no later than three years after the date of the provision of the health care item or service. Adds that all third parties requiring prior authorization of an item or service furnished to an individual eligible to receive medical assistance must accept an authorization provided by DHHS that the item or service for which third-party reimbursement is being sought is a covered service or item for that individual under the North Carolina Medicaid State Plan, or under a relevant waiver of the State Plan, as if that authorization is the prior authorization made by the third party for the item or service. Makes additional clarifying changes. Effective January 1, 2024.