Bill Summaries: H190 DEPT. OF HEALTH AND HUMAN SERVICES REVISIONS.-AB

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  • Summary date: Jun 29 2023 - View Summary

    AN ACT MAKING TECHNICAL, CONFORMING, AND OTHER MODIFICATIONS TO LAWS PERTAINING TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND TO MAKE TECHNICAL AND CONFORMING CHANGES TO SESSION LAW 2023-14. SL 2023-65. Enacted June 29, 2023. Section 9.1 is effective October 1, 2023. Section 11.1, Section 11.2, and Section 11.2A are effective March 1, 2024. Section 11.3 of this act is effective March 1, 2025. Section 12.2 is effective January 1, 2024. Section 13A.1, 13B.1 and 14.1 are effective July 1, 2023. Remainder is effective June 29, 2023.


  • Bill H 190
    Summary date: Jun 26 2023 - View Summary

    Senate amendments amend the 4th edition, as amended, as follows.

    Senate amendment #2 amends amendment #1 to change the content of the consent form required for surgical and medical abortions required under GS 90-21.82(b)  (surgical abortions) and GS 90-21.83A (medical abortions) so it discloses whether the physician accepts the pregnant woman’s insurance (was, whether the treatment or procedure to be performed is covered by the pregnant woman’s insurance) in addition to other listed requirements.

    Senate amendment #3 makes the following changes to the 4th edition, as amended. 

    Part IX.

    Section 9.2.

    Amends Section 9G.7 of SL 2022-74, authorizing the state health director to issue statewide standing orders to facilitate the administration of COVID-19 vaccinations, diagnostic tests or other treatments to extend the authorization’s expiration date from December 31, 2023, to December 31, 2024.

    Section 9.3.

    Makes a technical correction to a cross-reference in GS 90-85.15B (pertaining to immunizing pharmacists).

    Part X.

    Section 10.3

    Changes references from Medical Care Commission to Commission for Mental Health, Developmental Disabilities, and Substance Use Services as the body authorized to adopt emergency, temporary, and permanent rules to implement new GS 122C-35 (licensure of opioid treatment program medication units and opioid treatment program mobile units).

    Part XI.

    Section 11.2A.

    Amends GS 90-113.73 (pertaining to requirements for controlled substances reporting system) to exempt a dispenser from being required to report gabapentin to the controlled substances reporting system when gabapentin is a component of a compounded prescription that is dispensed in dosages of 100 milligrams or less. Effective March 1, 2025.

    Part XII.

    Section 12.1

    Amends GS 90-106 (pertaining to prescriptions and labeling) so that the requirement for electronic prescription does not apply to any product authorized under GS 90-93(b)-(d) (Schedule V controlled substance) to be sold at retail without a prescription by a pharmacist (was, the requirement applied to all controlled substances under GS 90-93(a)(1)a [listing compounds containing narcotics]).

    Part III.

    Section 13A.1

    Amends GS 126-8.6 (paid parental leave), as enacted by SL 2023-14, to also extend paid parental leave to probationary or time-limited full-time/part-time State employees (was, permanent full-time/part-time State employees only). Extends the prorated amount of paid leave that part-time employees can take to up to eight weeks after giving birth (was, four weeks) and up to four weeks (was, two weeks) for any other qualifying event. Directs the State Human Resources Commission (SHRC) to adopt rules and policies providing for a period of  minimum service before an employee  becomes  eligible for parental  leave, the maximum number of uses of paid parental leave within a 12-month period, and how much leave is to be provided in the event of miscarriage or the death of a child during birth.

    Amends GS 126-5 (applicability of paid parental leave), as enacted by SL 2023-14, to change the individuals to whom the leave applies from all exempt and nonexempt State employees in the executive branch, public school employees, and community college employees to all State employees, public school employees, and community college employees. Clarifies that the leave does not apply to officers and employees of the Judicial Department or officers and employees of the General Assembly.

    Amends GS 115C-336.1, as amended by SL 2023-14 (paid leave for public school teachers) to specify that, to the extent funds are made available for this purpose, the Department of Public Instruction (DPI) must administer funds to public school units for the payment of substitute teachers for any public school unit teacher using paid parental leave as described in GS 126-8.6, set forth above.

    Amends GS 115C-218.90 (charter schools), GS 115C-238.68 (regional schools), and GS 116-239.10 (UNC lab schools) so that teachers at these institutions are eligible for paid parental leave as provided in GS 126-8.6, set forth above (subject to approval by the board for charter schools). Specifies that each institution will be eligible to receive funds for substitute teachers.

    Amends the appropriation set forth in Section 5.1(e) of SL 2023-14 so that the recurring appropriation of $10 million to DPI is for substitute teachers (was, to fund paid parental leave) for teachers using paid parental leave.

    Effective July 1,2023, and applies to requests for paid parental leave related to births occurring on or after that date.

    Part XIII-B.

    Amends GS 90-21.83A, as enacted by SL 2023-14 (pertaining to informed consent for medical abortion) to change the required in-person consultation from a consultation in which the physician is able to ask questions of the patient and the patient is able to ask questions of the physician to an in-person consultation conducted by a qualified professional or a qualified physician. Specifies that a physician must be able to ask and answer questions within the statutory time frame upon request of the patient or qualified professional. Effective July 1, 2023.


  • Summary date: Jun 22 2023 - View Summary

    Senate amendment to the 4th edition makes the following changes. Inserts new Part XIV, which amends SL 2023-14, pertaining to abortion laws, as follows.

    Section 14.1

    Amends GS 14-23.7 (exceptions to criminal prosecution for acts against the unborn) by removing references to now repealed GS 14-45.1 (definitions of unlawful abortions) and replacing those references with provisions of new GS Chapter 90, Article 1I (Abortion Laws). 

    Amends GS 90-21.81A(a) (defining unlawful types of abortion), as enacted by SL 2023-14, as follows. Removes advising a miscarriage or abortion as an act that is illegal under the statute. Now specifies that it is illegal after the twelfth week of pregnancy to procure or cause a miscarriage or abortion in the State of North Carolina (previously, no reference to the state).  Makes conforming changes to GS 90-21.81B (specifying when abortion is lawful), as enacted by SL 2023-14.

    Amends GS 90-21.82(b)(1a) as amended by SL 2023-14 (informed consent for surgical abortions) and GS 90-21.83A(b)(2) as enacted by SL 2023-14, to add the following required information to the consent form for a surgical/medical abortion: specific information for the physician’s hospital admitting privileges, and whether the treatment or procedure to be performed is covered by the pregnant woman’s insurance (was, just the name of the physician performing the abortion).  

    Amends the examination duties of a physician prescribing, administering, or dispensing an abortion‑inducing drug under GS 90-21.83B, as enacted by SL 2023-14 (distribution of abortion inducing drugs and duties of physician), to verifying the probable gestational age (was, verify that the probable gestational age is no more than 70 days).  Now requires the physician document the existence of an intrauterine pregnancy (was, document the intrauterine location of the pregnancy) in addition to other required documentation upon exam. Makes a technical correction.  

    Repeals GS 90-83C, as enacted by SL 2023-14, which requires that at least 72 hours prior to any medical or surgical abortion performed in accordance with Article 1I, the physician providing the abortion‑inducing drug, performing the surgical abortion, or conducting any other appointment where an abortion is to be induced or performed must provide the pregnant woman the physician's full name and specific information for the physician's hospital admitting privileges and whether the treatment or procedure to be performed is covered by the pregnant woman's insurance.

    Amends GS 90-21.85(a) (general requirement of real time view prior to performing an abortion) to change statutory cross-reference from now repealed GS 14-45.1 to GS 90-21.81B (describing when abortion is lawful).

    Amends GS 131E-269 (authorization to charge fee for certification of facilities suitable to perform abortions) to change statutory cross-reference from now repealed GS 14-45.1 to GS 90-21.81C (pertaining to abortion reporting, objection, and inspection requirements).

    Amends GS 90-21.93, as enacted by SL 2023-14 (pertaining to required reporting to the Department of Health and Human Services [DHHS] by a physician or healthcare provider performing a surgical or medical abortion) to change the time such report must be sent for a minor to DHHS and the Division of Social Services from within three days to within 30 days.

    Effective July 1, 2023.

    Part XV.

    Makes conforming changes to the act’s effective date.  


  • Summary date: May 31 2023 - View Summary

    Senate committee substitute to the 3rd edition adds the following content.

    Part X.

    Amends GS 122C-3, which defines terms as they are used in GS Chapter 122C (Mental Health, Developmental Disabilities, and Substance Abuse Act of 1985), as follows. Adds and defines the terms mobile unit, opioid treatment program, opioid treatment program medication unit, and opioid treatment program mobile unit. Amends the definition of facility to include an opioid treatment program facility licensed to operate an opioid treatment program medication unit, and an opioid treatment program mobile unit.

    Enacts new GS 122C-35 requiring a licensed opioid treatment program facility intending to establish, maintain, or operate an opioid treatment program medication unit or opioid treatment program mobile unit to apply to the Division of Health Service Regulation for certified services provided from an opioid treatment program medication unit or opioid treatment program mobile unit to be added to its license. Requires the Medical Care Commission (Commission) to adopt rules establishing the requirements for obtaining licensure, including requiring that each opioid treatment program medication unit and each opioid treatment program mobile unit seeking to operate in this State prove that it has obtained approval from the State Opioid Treatment Authority, and registered with the Drug Control Unit and the federal Drug Enforcement Agency. Allows for the issuance of a license to an opioid treatment program facility to provide certified services at an opioid treatment program medication unit or an opioid treatment program mobile unit if the program is in compliance with all rules adopted by the Commission regarding opioid treatment programs. Sets out issues that must be considered when approving or denying an application. Prohibits an opioid treatment program facility from establishing, maintaining, or operating an opioid treatment program medication unit or opioid treatment program mobile unit without a current license that includes and covers that specific unit and without first obtaining certification from the Substance Abuse and Mental Health Services Administration. Deems a unit that is added to an opioid treatment program facility license as part of the opioid treatment program facility license and allows it to be subject to inspections that the Department of Health and Human Services (DDHS) deems necessary, applicable rules, and all applicable federal laws and regulations. Substantial failure to comply may result in an adverse action on a license and administrative penalties. Specifies that any required services not provided in an opioid treatment program mobile unit or opioid treatment program medication unit must be conducted at the opioid treatment program facility, including medical, counseling, vocational, educational, and other assessment and treatment services. Requires licenses to provide services at an opioid treatment program mobile unit or an opioid treatment program medication unit to be renewed annually; sets out requirements for license renewal. Allows DHHS to charge a nonrefundable annual license fee plus a nonrefundable annual per-unit fee of $265 for each medication or mobile unit. Makes an opioid treatment program facility with no previous violations subject to inspection once every other year; those with medication or mobile units may be subject to annual inspections. Requires the Commission to adopt emergency, temporary, or permanent rules for the licensure, inspection, and operation of opioid treatment program medication units and opioid treatment program mobile units, including rules concerning 10 specified issues, including maintenance and location of records, emergency staffing requirements, and number of clients allowed per medication unit and mobile unit. These provisions become effective on the effective date of the emergency rules adopted by the Medical Care Commission.

    Requires the Commission to adopt emergency rules for the implementation of new GS 122C-35 without prior notice or hearing or upon any abbreviated notice or hearing that the agency finds practical because adhering to the notice and hearing requirements would be contrary to the public interest and the immediate adoption of the rule is required by a serious and unforeseen threat to the public health or safety. Also authorizes the Commission to adopt temporary or permanent rules for licensure, inspection, and operation of opioid treatment medication units and opioid treatment program mobile units.

    Part XI.

    Amends GS 90-113.73 to also require a dispenser to report when a prescription is for gabapentin, whether the dispenser has a DEA number. Also requires for a prescriber prescribing gabapentin to report if the prescriber has a DEA number and the number is known by the dispenser. Makes additional technical and clarifying changes. Provides that a dispenser is not required to report instances in which gabapentin is provided directly to the ultimate user and the quantity does not exceed a 48-hour supply. Effective January 1, 2024.

    Further amends GS 90-113.73, effective January 1, 2025, by specifying that for the purposes of the statute, a dispenser includes a person licensed to practice veterinary medicine when that person dispenses gabapentin.

    Part XII.

    Amends GS 90-106 to require a practitioner to electronically prescribe all controlled substances in GS 90-93(a)(1)a (not more than 200 milligrams of codeine or any of its salts per 100 milliliters or per 100 grams). Makes conforming changes. Effective January 1, 2024.

    Part XIII.

    Amends GS 90-12.7 to allow a governmental or nongovernmental organization to distribute an opioid antagonist obtained over the counter to a person at risk of experiencing an opiate-related overdose or to a family member, friend, or other person in a position to assist a person at risk of experiencing an opiate-related overdose. Allows a person who receives an opioid antagonist over the counter to administer the antagonist to another person if the person has a good faith belief that the other person is experiencing a drug-related overdose and the person exercises reasonable care in administering the drug.


  • Summary date: Mar 28 2023 - View Summary

    House committee substitute to the 2nd edition makes the following changes. Removes the changes to Section 2 of SL 2022-52 that amended the time within which the Fiscal Research Division must provide the specified information for non-state entities receiving directed grants to be within 15 days after the date of the Current Operations Appropriations Act instead of the Appropriations Act of 2022.

    Deletes the proposed changes to GS 131D-2.11 concerning adult care home inspections, monitoring, and review by State agency and county departments of social services. 

    Makes organizational changes.  


  • Summary date: Mar 14 2023 - View Summary

    House committee substitute to the 1st edition makes the following changes. Amends GS 7B-1402 (pertaining to the North Carolina Child Fatality Task Force) to replace the following Department of Health and  Human Services (Department) department heads on the task force with other department heads of the Department: (1) the Director of the Division of Public Health instead of the Director of the Maternal and Child Health Section and (2) the Director of the Division of Child and Family Well-Being for the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. Makes clarifying changes to the titles of certain appointees to reflect their agency.  Makes the same changes to membership of the State Team under GS 7B-1404(b). 


  • Summary date: Feb 23 2023 - View Summary

    Part I.

    Enacts GS 143B-139.1A allowing the Secretary of Health and Human Services (Secretary) to adopt rules to implement the Emergency Solutions Grant Program. Require the rules to be enforced by the Department of Health and Human Services (DHHS).

    Amends GS 108A-41 which sets out eligibility for State-County Special Assistance, under which assistance is given to persons residing in adult care homes, special care units, and in-home living arrangements for essential care. Amends that items that are excluded when determining if a person has sufficient resources to provide a reasonable subsistence compatible with decency and health, to now excluded from consideration real property contiguous with the person’s primary place of residence (was, limited to the real property contiguous with the person’s primary place of residence in which the property tax value is less than $12,000).

    Amends GS 108A-47.1 to set the amount of the monthly payment to individual enrolled in the Special Assistance in-home program at 100% of the monthly payment the individual would receive if the individual resided in an adult care home and qualified for Special Assistance, no longer allowing paying a lesser amount when determined to be appropriate by the local case manager. Requires the Special Assistance policies and procedures to include the use of an assessment (was, use of a functional assessment).

    Part II.

    Amends Section 2 of SL 2022-52, pertaining to contracting with nonprofit grantees receiving state and federal funds, by providing that this also include grantees receiving a combination of state and federal funds. Expands upon the instances in which DHHS is required to enter into a contract agreement for at least two years to also include nonprofit grantees receiving any combination of recurring and nonrecurring funds for each year of the fiscal biennium. Amends the provisions governing an automatic contract extension when a formal contract extension or renewal process has not been completed within 10 business days after the expiration of the original contract (was, within 10 business days of the subsequent contract start date), if the specified requirements are met. Adds that when there is an automatic contract extension, the terms of the expired contract govern the relationship and obligations of the party until the earlier of the end of three-month contract extension period or until execution of a formal contract extension or renewal. Amends the time within which the Fiscal Research Division must provide the specified information for non-state entities receiving directed grants, to be within 15 days after the date of the Current Operations Appropriations Act (was, the Appropriations Act of 2022). Amends the provisions governing the reimbursable amount of overhead, as follows. Provides that for grantees, including nonprofits, that (1) are receiving financial assistance and do not have a federally approved indirect rate from a federal agency or (2) have a previously negotiated but expired rate, DHHS may allow the grantee to use the de minimis rate or 10% of modified total direct costs. Allows the grantee, in the alternative, to negotiate or waive an indirect cost rate with DHHS. Provides that if state or federal law or regulations establish a limitation on the amount of funds the grantee may use for administrative purposes, then that limit controls. Changes language throughout to refer to grantees instead of grantee/recipients. Makes additional conforming, clarifying, and technical changes. Makes organizational changes to the section.

    Part III.

    Amends GS 7B-1402 and GS 7B-1404 to replace references to the Division of Maternal and Child Health with the Division of Child and Family Well-Being. Also includes the Division of Child and Family Well-Being among those entities int GS 122C-1123 that are responsible for intervention and treatment in non-school based programs. Adds the Division of Child and Family Well-Being to the membership of the Rapid Response Team in GS 122C-142.2.

    Part IV.

    Amends GS 131D-2.11 to make the provisions that apply to annual and biennial licensure inspections of adult care homes also applicable o triennial licensure inspections. Allows the Division of Health Service Regulation to waive the required adult care home annual inspection for one year for any adult care home that has achieved the highest rating according to rules adopted by the North Carolina Medical Care Commission and allows waiving the annual inspection for two years for any adult care home that has achieved the highest rating for five consecutive years. Makes conforming deletions. Removes outdated language. Effective October 1, 2023.

    Amends GS 143B-165 concerning the DHHS North Carolina Medical Care Commission (Commission), as follows. Gives the Commission the power to adopt rules (was, promulgate rules and regulations) for the construction and maintenance of public and private hospital, medical, centers, and facilities regulated under GS Chapters 131D and 131E (previously did not require that the facilities be regulated under those GS Chapters). Gives the Commission the power to adopt, amend and rescind rules as necessary to protect the health, safety, and welfare of the individuals served by those facilities. Provides that the Commission must adopt rules establishing standards for the licensure, inspection, and operation of, and the provision of care and services by the different types of licensed hospitals. Provides that the Commission may adopt rules necessary to establish standards for the licensure, inspection, and operation of, and the provision of care and services (was, rules necessary to carry out he specified provisions) by, specified licensed facilities. Removes references to the adoption of temporary rules for the accreditation of facilities performing mammography procedures and for labs evaluating screen pap smears. Requires the Commission to adopt rules establishing standards for the provision of care and services by (in addition to the already allowed licensure, inspection, and operation of) adult care homes. Adds the requirement that the Commission adopt rules establishing standards for the following with respect to facilities used as multiunit assisted housing with service: registration and deregistration, disclosure statements, agreements for service, personnel requirements, and resident admissions and discharges. Updates internal statutory cross references. Makes additional conforming, clarifying, and technical changes.

    Part V.

    Amends GS 122C-115 to require, beginning on July 1, 2021, that LME/MCOs cease managing Medicaid services for recipients who are enrolled in a standard benefit plan. Makes conforming changes. Makes conforming changes to GS 108D-60. Amends GS 122C-3, setting out the definitions of terms used in GS Chapter 122C, by making organizational and technical changes. Removes the term state or local consumer advocate. Adds and defines standard benefit plan as it is defined in GS 108D-1.

    Directs the Revisor of Statutes to replace Division of Mental Health, Developmental Disabilities, and Substance Abuse Services with Division of Mental Health, Developmental Disabilities, and Substance Use Services. Makes that change in GS 143B-138.1. Also requires the Revisor of Statutes to replace MH/DD/SAS with MH/DD/SUS.

    Part VI.

    Amends GS 130A-125 by expanding the allowable uses of funds from the Newborn Screening Equipment Replacement and Acquisition Fund, to also allow maintaining or supporting lab instruments, equipment, and information technology systems used in the Newborn Screening Program.

    Amends GS 130A-382 by expanding upon the types of individuals who may be appointed as county medical examiners to also include NC licensed dentists, physical therapists (also requires the already listed physicians assistants, nurse practitioners, and nurses to be licensed in this state), (2) pathologists’ assistants certified by the American Society for Clinical Pathology;  and (3) pathologists' assistants or medicolegal death investigators certified by a nationally recognized certifying body determined by the Chief Medical Examiner to have an appropriate certification process for pathologists' assistants or medicolegal death investigators to demonstrate readiness to serve as a county medical examiner. Also requires the already listed medical technicians (now, emergency medical technicians) and paramedics to be credentialed. Adds that during a state of emergency the Chief Medical Examiner may appoint temporary county medical examiners to serve for the duration of the declared state of emergency. Requires such an appointee to have the appropriate training, education, and experience to serve as a county medical examiner during a declared state of emergency.

    Part VII.

    Amends the following statutes to refer to county TANF plans as being triennial instead of biennial: GS 108A-24, GS 108A-27.3, and GS 108A-27.4.

    Amends GS 115C-12 which requires a document and display providing information to public school students in grades 6-12 about child abuse and neglect, by no longer requiring the information to include available resources developed under the specified statute, which included an anonymous safety tip line app.

    Amends GS 110-129, which sets out and defines terms that are used in Article 9, Child Support, of GS Chapter 110 by adding and defining financial management service, internal revenue service, and offset. Amends GS 110-129.1to add to DHHS's powers and duties: (1) certify obligors to the federal Office of Child Support Enforcement (OCSE) for the Passport Denial Program (discussed below); (2) certify to the federal OCSE determinations that an obligor in a IV-D case owes support arrears in an amount equal to or greater than the federally mandated thresholds for offset of federal income tax refunds under the specified provision depending upon whether the arrears are assigned to the State; and (3) certify obligors to the federal OSCE for the Administrative Offset Program (discussed below). Enacts new GS 110-143 requiring DHHS to participate in the federal Passport Denial Program for the denial, revocation, or limitation of an obligor's passports under the specified federal provisions. Requires DHHS to annually certify to the OSCE an obligor in a IV-D case whose support arrears exceed the federally mandated threshold. Requires OSCE to then transmit the certification to the US Department of State. Sets out items that must be included in a written notice of the certification sent to the obligor. Allows the obligor, in limited circumstances, to appeal through a contested case petition with the NC Office of Administrative Hearings. Requires notifying OCSE when the obligor's support arrears are paid in full. Enacts GS 110-144 requiring DHHS to participate in the federal Administrative Offset Program for the offset of certain federal payments. Requires DHHS to annually certify to OCSE an obligor in a IV-D case whose support arrears are (1) equal to or greater than $150 if the arrears are assigned to the State and (2) equal to or greater than $500 if the arrears are not assigned to the State. Sets out items that must be included in a written notice of the certification sent to the obligor. Allows the obligor, in limited circumstances, to appeal through a contested case petition with the NC Office of Administrative Hearings. 

    Amends GS 131D-10A by adding an exemption from the required training for child welfare services staff for child welfare workers who have child welfare work experience in another state and have completed child welfare training equivalent to this State's training. Makes organizational changes to the statute.

    Amends GS 143B-153 by specifying that the county department of social services or a designee of the board of county commissioners set the maximum daily rate for adult day care services, adult day health services, and associated transportation services (was, they are more generally set at the local level).

    Part VIII.

    Makes changes in the following statues to refer to the Division of Inclusive Employment and Independence instead of the Division of Vocational Rehabilitation Services: GS 108A-26, GS 111-11.1, GS 122C-22, GS 131D-2.3, GS 143-545.1, GS 143-547, and GS 143-548.

    Part IX.

    Amends GS 90A-53 by amending the educational requirements to met for certification as a registered environmental health specialist  or registered environmental health specialist intern, to now require meeting any of the following combinations of education and practice: (1) graduated with a bachelor's degree or postgraduate degree from a program accredited by the National Environmental Health Science and Protection Accreditation Council; (2) graduated with a bachelor's degree or postgraduate degree and earned a minimum of 30 semester hours or 45 quarter hours in the physical, biological, natural, life, or health sciences and has one or more years of experience in the field of environmental health practice, or (3) graduated with a bachelor's degree or postgraduate degree in public health and has one or more years of experience in the field of environmental health practice. Allows issuing a certificate to a person serving as a registered environmental health specialist intern without the person meeting the full requirements for experience for a period not to exceed two years (was, three year) from the date of initial registration, as long as the person meets the educational requirements and is in the field of environmental health practice. Effective October 1, 2023.