Senate committee substitute makes the following changes to 3rd edition. Amends GS 62-133.1A to require that three separate appraisals conducted by accredited, impartial valuation experts be used to determine the fair value of a system. Previously two appraisals were required. Requires the third appraiser to represent the Public Staff of the Commission (Commission). Requires the Commission to issue its final order approving or denying an application which meets all of the relevant requirements within six months of the application filing date. Previously the order was required within four months. Provides the Commission the authority to adjust the fair value of a system as appropriate and in the public interest if it deems that the average of the appraisals will not result in a reasonable fair value. Makes other clarifying changes. 

Senate committee substitute makes the following technical change to 1st edition. Amends GS 163A-1114, rather than GS 163-165.6, due to recodification. Adds that notwithstanding GS 163A-1114, elections held in 2018 must be conducted using the random selection process previously determined by the State Board of Elections and Ethics Enforcement for all primaries and elections in 2018. Prohibits any further drawing from being conducted for any ballot item for the 2018 election.

Senate committee substitute makes the following changes to 2nd edition. Adds to title INDIVIDUALS WITH TRAUMATIC BRAIN INJURY; AUTHORIZING TOWNSHIP HOSPITALS STILL OPERATING UNDER PRE 1983 PUBLIC HOSPITAL LAWS TO EXERCISE SOME OF THE ADDITIONAL POWERS AND AUTHORITIES GRANTED TO PUBLIC HOSPITALS OPERATING UNDER ARTICLE 2 OF CHAPTER 131E OF THE GENERAL STATUTES; REDEFINING THE TERM "LEGACY CARE MEDICAL FACILITY" FOR PURPOSES OF CERTIFICATE OF NEED REVIEW: REQUIRING THAT LEGACY MEDICAL CARE FACILITIES EXEMPTED FROM CERTIFICATE OF NEED REVIEW OPERATE WITHIN THE SAME SERVICE AREA AS THE FACILITY THAT CEASED CONTINUOUS OPERATIONS; PROVIDING FOR AN EXTENSION OF THE TIME BY WHICH A FACILITY MUST BE OPERATIONAL IN ORDER TO QUALIFY FOR CERTIFICATE OF NEED EXEMPTION AS A LEGACY MEDICAL CARE FACILITY; AND TO EXEMPT OFFICE BASED, VASCULAR ACCESS CENTERS FROM CERTIFICATE OF NEED REVIEW. 

Corrects the October 1, 2017, start date for the 1915(c) waiver report to October 1, 2018. 

Adds new section allowing all hospitals that continue to operate under GS Chapter 131, Article 2, pursuant to SL 1983-775, Section 3, to exercise the powers, authorities, and exemptions in 17 various subsections of GS 131E-7 through GS 131E-47.1, and the powers and authorities conveyed by SL 1999-377, Section 3. Amends GS 131E-176(14f), which sets out the definition of Legacy Medical Care Facility, to include facilities which provided care to outpatients in the last 24 months. Makes other clarifying change. 

Amends GS 131E-184(h), which sets out conditions for exemption from certificate of need review for acquiring or reopening a Legacy Medical Care Facility (Facility). The person seeking to operate the Facility must give written notice of the intention to reopen a Facility within 36 months, and must state whether the Facility is in the same location as the previous facility or in a new location. Allows the Department to extend the 36-month time period for an additional 36 months on timely written notice that the person has made all reasonable efforts to meet the deadline.

Senate committee substitute makes the following technical change to 1st edition. Amends GS 163A-12, rather than GS 163-12, as GS 163-12 has been recodified as GS 163A-12. 

Senate committee substitute makes the following changes to the 2nd edition.

Deletes all content of the previous edition and replaces it with the following.

Amends GS 14-159.12 to include in the offense of first degree trespass, when a person enters or remains, without authorization, on the lands of the Eastern Band of Cherokee Indians after the person has been excluded by a resolution passed by the Eastern Band of Cherokee Indian Tribal Council. A person's second or subsequent violation of this prohibition is a Class I felony, to include a fine of no less than $1,000 for each violation.

Effective December 1, 2018, and applies to offenses committed on or after that date.

Makes conforming changes to the act's short and long titles.

Senate committee substitute makes the following changes to the 4th edition.

Deletes all provisions of the previous edition and replaces it with the following. Amends GS 18B-600 to allow a city with a population of 400 or more but less than 500 according to the most recent census and that had a population of 500 or more according to the prior census to hold a malt beverage or unfortified wine election only if the county in which the city is located has already held such an election and the vote was against the sale. Amends existing law to require that a city holding such an election have a population of 500 or more according to the most recent census.

Makes conforming changes to the act's titles.

Senate committee substitute makes the following changes to the 2nd edition. 

Adds the following provisions.

Sections 3 and 4

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 into a distant state under the Temporary Authorization to Practice to practice within the scope of practice authorized by the distant state; psychologists practicing into 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 state 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, 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.

Effective when at least seven states have enacted the Compact. Requires the North Carolina Psychology Board to report to the Revisor of Statutes when the Compact has been enacted by the seven member states.

Section 5

Amends GS 58-50-130 by prohibiting small employer carriers, insurers and subsidiaries, or controlled individuals of an insurance holding company from providing stop loss, catastrophic, or reinsurance coverage to small employers employing fewer than 16 (was, 26) employees that does not comply with the applicable standards. Effective January 1, 2020.

Section 6

Enacts new GS 58-3-8 requiring a nonprofit organization that sponsors a self-funded health benefit plan to (1) be incorporated in the state, (2) have been in existence for 10 continuous years, (3) have been determined to be tax exempt under Section 501(c) of the Internal Revenue Code, (4) provide membership opportunities for eligible individuals or business entities in all counties in the state, and (5) provide its members with representation on its governing board and committees. A self-funded health benefit plan sponsored by a nonprofit organization that meets these conditions is deemed not be insurance and is not subject to GS Chapter 58 (Insurance). Allows two or more nonprofits that individually meet these conditions to jointly sponsor a plan. Requires the nonprofit to file an annual certification with the Secretary of State demonstrating compliance. Effective January 1, 2020.

Makes conforming changes to the act's long title.

House amendments make the following changes to the 3rd edition.

Amendment #1 adds a section to the bill that provides as follows. Requires the Director of the Budget to allocate no more than a cumulative total of $300 million from any credit balances in the Highway Fund and the Highway Trust Fund to a nonreverting account in the Highway trust Fund to pay only for any costs, damages, or monetary penalties owed by the State from the cancellation or modification of the Comprehensive Agreement (meaning the Comprehensive Agreement for the I-77 HOT Lanes project in Mecklenburg and Iredell counties, dated as of June 26, 2014, including any amendments to the agreement), and allocates funds for that purpose. Requires any funds expended from the account to be repaid by toll revenues collected on I-77 for a period of ten years. If there is still an amount to be repaid after that time, allows the Department of Transportation to fully repay the amount from the Highway Fund Maintenance Funds allocation to Mecklenburg County and by reducing the allocation made to Division 10. Requires that the account be fully repaid no later than twenty years after the payment from the cancellation or modification of the Comprehensive Agreement. Effective June 20, 2018. Requires any unexpended or unencumbered funds from the account to be returned to the source upon the earlier of (1) the payment of all costs, damages, and monetary penalties determined to be owed by the State from the cancellation or modification of the Comprehensive Agreement or (2) July 1, 2023.

Amendment #2 adds a section to the bill that requires the Department of Transportation to study and identify all potential and existing funding sources to pay for any costs, damages, or monetary penalties determined to be owed by the State from the cancellation or modification of the Comprehensive Agreement, or a change in scope of the project covered by the agreement. Requires a report to the Joint Legislative Transportation Oversight Committee by October 1, 2018. 

House amendment makes the following changes to the 2nd edition.

Makes Section 1(c), which amends GS 150B-1 effective when the act becomes law, with the exemption applicable to actuarial tables, assumptions, and contribution-based cap factors changed on or after that date.