House committee substitute amends the 1st edition as follows.

Revises the definition of emergency vehicle in new GS 14-34.1A to include State or local emergency management vehicles and vehicles owned or operated by the Department of Adult Correction and the Division of Juvenile Justice of the Department of Public Safety.

Makes a technical change to the proposed changes to GS 14-34.8(b).

Makes conforming changes to the long title.

House committee substitute to the 1st edition makes the following changes. Changes the effective date of the changes GS 14-269.2 and GS 14-415.11 from December 1, 2023, to when the act becomes law. Retains the July 1 2023, effective date for the changes to GS 14-415.27.

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

Deletes proposed GS 14-32.5, which made it a Class A1 misdemeanor to use or attempt to use physical force, or threaten the use of a deadly weapon, against another person if the person committing the offense is a: (1) current or former spouse, parent, or guardian of the victim; (2) person with whom the victim shares a child; (3) person who is cohabitating with or has cohabitated with the victim as a spouse, parent, or guardian; or (4) person similarly situated to a spouse, parent, or guardian of the victim. Make a conforming deletion of the amendment to GS 14-415.12. Make conforming changes to the act’s long title.

House amendments to the 1st edition make the following changes.

Amendment #1 adds the requirement that if there is any indication that work requirements as a condition of participation in the Medicaid program may be authorized by the Centers for Medicare and Medicaid Services (CMS), then the Department of Health and Human Services, Division of Health Benefits (DHB), must negotiate with CMS to develop a plan for those work requirements and to obtain approval of that plan. Requires DHB, within 30 days of entering into negotiations with CMS, to provide written notification to the specified NCGA committee and division of the negotiations. Requires DHB to report to those same entities, within 30 days of approval by CMS of a plan for work requirements as a condition of participation in the Medicaid program, on the details of the approved work requirements, including the approved date of implementation of the requirements.

Amendment #2 appropriates $50 million for 2023-24 from the General Fund to the DHB to be distributed to all counties for the administrative costs of Medicaid eligibility determinations and for inmate medical costs. Effective the later of July 1, 2023, or the date the Current Operations Appropriations Act for the 2023-24 fiscal year becomes law.

Requires funds to be distributed on a per capita basis, with each county receiving at least $100,000. Specifies that the provisions of GS 143C-5-2 (Order of appropriations bills) do not apply to this act.

Amendment #3 adds the following. Establishes the Doctors and Nurses in Rural Areas Forgivable Loan Pilot Program to be administered by the State Education Assistance Authority (Authority) to provide forgivable loans to eligible students who agree to practice medicine or nursing on a full-time basis in a rural area (an NC county designated by the NC Rural Center as a rural county). Defines an eligible student as either of the following types of students enrolled in an eligible postsecondary institution (as defined) in the 2024-25 academic year as a first-year student in a program of study approved by the Authority for students to receive funds under the Forgivable Education Loans for Service Program related to the following degrees: (1) a student enrolled in a medical school for purposes of becoming a licensed physician or (2) a student enrolled in an associate, bachelor, masters, or doctoral degree program in nursing for purposes of becoming a licensed nurse.

Requires the Authority to establish the criteria for initial and continuing eligibility for participation in the program, including at least: (1) requiring loan recipients to be NC residents attending an eligible postsecondary institution; (2) standards necessary to ensure only qualified persons receive a loan, including priority for applicants from rural areas; and (3) to the extent funds provided pursuant to this section are insufficient to award forgivable loans to all interested, eligible students, the Authority may establish a lottery process to select recipients.

Requires promissory notes have an interest rate established by the Authority that does not exceed 10% and is in relation to the current interest rate for non-need-based federal loans made pursuant to Title IV of the Higher Education Act of 1965, as amended. Sets out the loan amounts, with amounts varying for degrees in Doctor of Medicine, Doctor in Nursing, Masters in Nursing, Bachelor in Nursing, and Associate in Nursing. Requires forgiving loans based on the amount received by the eligible student for each year that the recipient works as a licensed physician or nurse practicing on a full-time basis in a rural area, up to the total amount initially awarded to the recipient. Requires the Authority to establish any other necessary criteria for loan forgiveness for qualifying employment. Requires the Authority to collect cash repayments when service repayment is not completed.

Requires the Authority to report annually while loans are held or forgiven by the Authority, beginning by December 1, 2024, to the specified NCGA committees on the program and loans that are awarded, including specified information on the forgivable loans awarded by the Authority, placement and repayment rates, and on recommendations to expand the program and increase the number of licensed physicians and nurses practicing in rural areas.

Appropriates $14.4 million for 2023-24 from the General Fund to the UNC Board of Governors to be allocated to the Authority to provide forgivable loans to an estimated 200 eligible students in accordance with the program. Requires the funds to remain available until expended. Allows the Authority to use up to $200,000 of the funds for administrative costs.

Effective the later of July 1, 2023, or the date the Current Operations Appropriations Act for the 2023-24 fiscal year becomes law.

Specifies that the provisions of GS 143C-5-2 (Order of appropriations bills) do not apply to this act.

Enacts Article 5A, Safe Surrender of Infants, to GS Chapter 7B. States the Article's purpose and scope, limiting the scope exclusively to safely surrendered infants, defined to mean an infant reasonably believed to be under seven days of age and without signs of abuse or neglect who is voluntarily delivered to an individual pursuant to new Article 5A by the infant's parent who does not express an intent to return for the infant, as enacted in GS 7B-101. Explicitly excludes from the Article's scope surrendered infants not reasonably believed to be seven days old, infants that show signs of abuse or neglect, when there's reasonable belief that the surrendering individual was not the infant's parent, or when there was reason to believe the parent intended to return for the infant at the time of surrender. 

Creates a duty for the following individuals to take temporary custody of an infant reasonably believed to be under seven days of age that is voluntarily delivered to the individual by the infant's parent who does not express an intent to return for the infant: a health care provider on duty or at a hospital or at a local or district health department or a nonprofit community center; a first responder; and a social services worker on duty or at a local department of social services. Does not require a court order. Details duties of the individual taking temporary custody of the surrendered infant, including immediately notifying the department of social services of the county. Allows the individual to inquire about personal information of the parents or the child so long as the individual discloses that the parent is not required to provide the information. Requires the individual to provide the surrendering parent information created by the Department of Health and Human Services (DHHS), Division of Social Services (DSS) regarding the surrender of infants and parental rights. Grants full immunity to individuals to whom an infant is surrendered, less conduct that constitutes gross negligence, wanton conduct, or intentional wrongdoing. 

Details confidentiality requirements for the surrendering parent's identity. Requires the individual taking an infant into temporary custody to provide any personal information obtained about the infant or the infant's parents and the circumstances of surrender to the director of the department of social services (dss director), which may only be disclosed to local law enforcement to determine if the infant is a missing child, contact with the non-surrendering parent, or as ordered by a court. Identifies authorized disclosure of the information by the dss director, including to a health care provider, placement provider, agencies involved in adoption placement, court, and guardian ad litem. Deems the confidentiality provisions do not apply if dss determines the juvenile is not a safely surrendered infant or is the victim of a crime.

Deems the dss director to have the surrendering parents' rights to legal and physical custody of the infant without obtaining a court order. Authorizes dss to apply ex parte after properly published notice for a district court order finding that the infant has been safely surrendered and confirming dss has the surrendering parent's right to custody for purposes of obtaining certified identifying documents of the child or benefits for the minor. Enumerates seven duties of the dss director, including verifying the infant's age and that there are no signs of abuse or neglect (with treatment as a juvenile who has been reported to be an abused, neglected, or dependent juvenile if the infant is found to be over seven days old or has signs of abuse or neglect); notifying law enforcement to investigate whether the infant is a missing child; contacting the non-surrendering parent if known; arrange genetic testing if there is uncertainty and a parent seeks custody; and initiate a termination of parental rights for the surrendering parent after 60 days of surrender if the surrendering parent has not sought custody and the infant has not been placed with the non-surrendering parent. Sets out procedures to be followed when the dss director determines that the infant's legal residence is in another county. Establishes three criteria for the infant to be placed with the non-surrendering parent. Provides for treating the juvenile as if reported of abuse, neglect or dependency if the known non-surrendering parent is suspected to have created such circumstances; bars the surrendering parent from being party to the dss assessment or a petition filed under GS 7B-302.

Sets extensive requirements for the dss director to publish notice in a qualified newspaper within 14 days from the date of surrender that an infant has been surrendered and taken into dss custody. Requires the notice to be published once a week for three successive weeks. Details content requirements. Requires the publisher to file an affidavit at the preliminary hearing for termination of parental rights for the safely surrendered infant, if commenced. 

Provides for the surrendering parent's right to seek custody prior to the filing of a termination of parental rights petition; requires the dss director to treat such a request as a report of neglect and comply with the provisions of GS 7B-302. Specifies a surrendering parent can execute relinquishment of their parental rights for adoption. Provides for immunity under GS 14-322.3 for the surrendering parent. Directs DSS to create information about infant safe surrender and parental rights, which must be posted on its website and available for distribution to agencies where individuals who may receive surrendered infants are on duty, and other agencies upon request. Details required content. Directs DSS to create a printable and downloadable medical history form that is optional for surrendering parents, that includes instructions on completion and return.

Amends GS 7B-101 to exclude safely surrendered infants from the defined term neglected juvenile. Adds non-surrendering parent and surrendering parent to the defined terms. 

Enacts GS 7B-1105.1 to establish parameters for a preliminary hearing regarding a safely surrendered infant. Requires a preliminary hearing within 10 days of filing of a petition to terminate parental rights of the surrendering or non-surrendering parent, or during the next term of court if no court is held in that county during that period. Provides for a closed hearing unless the surrendering parent appears and requests for the hearing to be open. Provides for the purpose of the hearing and the court's required inquiries of the dss director. Directs the court to determine whether any diligent efforts are required to identify or locate the surrendering parent, and specifies the required efforts of dss and required service. Provides for service of the non-surrendering parent. Requires the court to order service by publication and specify notice content, meeting enumerated requirements. Requires an affidavit of the publisher to be filed upon completion of the service by publication. Requires the court to issue the order within 30 days of the hearing unless additional time is needed for investigation. Specifies that no summons is required for a parent who is served by publication. 

Amends GS 7B-1111 to exclude from the grounds warranting a court to terminate parental rights upon finding the parental rights of the parent has been terminated involuntarily with respect to another child of the parent, instances when the parent's parental rights were terminated as a result of the other child being a safely surrendered infant. 

Makes conforming changes to GS 7B-401.1 (regarding when a parent cannot be a party to a abuse, neglect, dependency proceeding); GS 7B-500 (repealing existing law regarding taking temporary custody of a safely surrendered infant); GS 7B-501 (regarding duties for individuals taking a juvenile into temporary custody); GS 7B-1111 (regarding termination of parental rights); GS 14-322.3 (regarding abandonment of an infant); and GS 115C-47, GS 115C-218.75, GS 115C-548, GS 115C-556, and GS 115C-565 (regarding local boards of education, charter schools, and nonpublic schools' duty to ensure certain students annually receive information on lawfully abandoning an infant).

Effective October 1, 2023.

Part I.

Amends GS 58-21-10, which sets out the definitions for terms as they are used in Article 21, Surplus Lines Act, as follows. Excludes from the definition of surplus lines insurance: (1) insurance of property and operations of railroads engaged in interstate or foreign commerce and (2) personal and commercial automobile liability insurance required to be written by licensed insurers under GS 58-37-5, excluding excess automobile liability insurance. Amends the definition of wet marine and transportation insurance by adding that it includes ocean marine insurance. Makes additional technical and clarifying changes.

Amends GS 58-21-40 by adding to the functions of the North Carolina Surplus Lines Association providing other services to its members that are identical or related to the association’s purpose.

Amends GS 58-21-85 by amending the due date of the premium receipts tax paid by a surplus lines licensee so that payment is now due: (1) for risk purchasing groups, at the same time the licensee files a quarterly report with the Commissioner of Insurance (Commissioner) or (2) for surplus lines insurers receiving invoices from the North Carolina Surplus Lines Stamping Office SLIP system, 30 days after the end of each quarter.

Part II.

Amends GS 58-3-179 to require health benefit plans to provide coverage for colorectal cancer exams and labs test for cancer, for any non-symptomatic covered individual who is: (1) at least 45 (was, 50) years old or (2) less than 45 (was, 50) years old and at high risk for colorectal cancer. Applies to insurance contracts issued, renewed, or amended on or after October 1, 2023.

Part III.

Amends the following statutes by changing the name of the ThomsonMicromedex DrugDex to the Micromedex DrugDex System: GS 58-51-59, GS 58-65-94, and GS 58-67-78.

Part IV.

Amends GS 58-48-20, which sets out the definitions for terms as they are used in Article 48, the Insurance Guaranty Association Act, by making clarifying and technical changes.

Amends GS 58-48-35 the North Carolina Insurance Guaranty Association’s (Association) obligation as follows. The Association is obligated, under current law, to the extent of the covered claims that exist before the determination of insolvency and arising within 30 days after the determination of insolvency, or before the policy expiration date if less than 30 days after the determination, or before the insured replaces the policy or causes its cancellation, if done within 30 days of the determination. Increases the upper limit, so that this obligation includes only the amount of each covered claim that exceeds $50 and is less than $500,000 (was, $300,000). Makes conforming changes. Specifies that the Association’s lack of obligation in an amount in excess of the obligation of the insolent insurer under the policy from which the claim arises include an applicable specific and aggregate limit. Applies to covered claims arising from orders of liquidation becoming final on or after October 1, 2023.

Part V.

Amends GS 58-19-30, as follows. Adds the following to the standards that apply to transactions within an insurance holding company system to which an insurer subject to registration is a party. (1) If the Commissioner determines that the continued operation of an insurer subject to Article 19 (Insurance Holding Company System Regulatory Act) is hazardous to the insurer's policyholders, creditors, or the general public, then the Commissioner may require the insurer to choose between securing and maintaining either a deposit held by the Commissioner or a bond with respect to any contract or agreement entered into by the insurer. Sets out additional requirements for the duration and amount of the bond or deposit. (2) Provides that all of the insurer’s records and data (as defined) held by an affiliate remain the property of the insurer and are subject to the insurer’s control. Require an affiliate holding an insurer’s records and data to: (a) ensure, at no additional cost to the insurer, that the records and data the insurer controls are identifiable and segregated, or readily capable of segregation, from all other persons' records and data; (b) provide to any receiver of the insurer, upon request: a complete set of all records and data of any type that pertain to the insurer's business, access to the operating systems on which the records and data are maintained, and the software that runs those systems; and (c) if the affiliate defaults under a lease or other agreement, secure a waiver of any landlord lien or other encumbrance to provide the insurer access to all records and data. (3) Makes the insurer’s premiums or other funds collected by or held by an affiliate the exclusive property of the insurer and subject to the insurer’s control. Makes any right of offset in the event an insurer is placed into receivership subject to Article 30 (Insurers Supervision, Rehabilitation, and Liquidation) of GS Chapter 58.

Amends GS 58-19-30(b), which sets out transactions involving a domestic insurer and any person in its holding company system that must give the specified notice to the Commissioner before entering into the transaction. Makes the following changes to the provisions in (b)(4) applicable to all management agreements, service contracts, tax allocation agreements, or cost-sharing arrangements.

Requires defining records and data (was, books and records) of the insurer to include all information developed or maintained under or related to the contract or agreement that are otherwise the insurer’s property (was, developed or maintained under or related to the agreement). Defines records and data.

Requires specifying that all of the insurer’s records and data (was, books and data) remain the insurer’s property and are subject to the insurer’s control; adds that the records and data must be held, at no additional cost to the insurer, in a manner that ensures that the records and data controlled by the insurer are identifiable and segregated, or readily capable of such, from all other persons’ records and data.

Requires including standards for termination of a contract with and without cause.

Adds the instances providing indemnification of the insurer, to also include when the affiliate violates the specified terms.

Amends the conditions that must be met if the insurer is placed in supervision, conservatorship, or receivership (was, in receivership), or seized by the Commissioner as follows. (1) Requires all of the insurer’s rights under the contract or agreement to extend to the receiver, conservator, or Commissioner. (2) Requires all of the insurer’s books and data to be, at no additional cost to the receiver or Commissioner, identifiable and segregated, or readily capable of such, from all other persons’ records and data. (3) Adds requirements for the insurer’s records and data that are being turned over to the receiver or Commissioner upon request. (4) Requires the affiliate, at the direction of the receiver or Commissioner, to make available all employees required to maintain the continued performance of operations or services of the insurer deemed essential by the receiver or Commissioner.

Requires specifying that the affiliate has no automatic right to terminate the agreement if the insurer is placed in supervision, conservatorship or receivership, or seized by the Commissioner (was, placed in receivership).

Requires specifying the following with respect to the performance of services after termination of the contract or agreement if the insurer is placed in supervision, conservatorship, receivership, or seized by the Commissioner: (1) that the affiliate must, at the direction of the conservator or Commissioner, provide services deemed essential after termination of the contract or agreement; (2) that the contract or agreement must specify the minimum period of time essential services must be performed after termination; and (3) that, until the insured is released by the receiver, Commissioner, or a court order, performance of essential services after the contract or agreement’s termination must be provided without regard to pre-receivership unpaid fees, if the affiliate continues to receive timely payment for post-receivership services rendered.

Requires specification that if the insurer is placed in supervision, conservatorship, receivership, or is seized by the Commissioner, the affiliate will: (1) maintain any infrastructure necessary to the performance of the contract or agreement and (2) until the insured is released, make any infrastructure necessary to the performance of the contract or agreement available to the receiver or Commissioner, if the affiliate continues to receive timely payment for post-receivership services rendered.

Requires specifying that if the insurer is placed into receivership and portions of the insurer's policies or contracts are eligible for coverage by one or more guaranty associations, then, subject to the receiver's authority over the insurer, the affiliate's specified commitments extend to the affected guaranty associations.

Further amends the statute by adding the following.

Subjects any affiliate party to an agreement or contract with a domestic insurer that is subject to (b)(4) (as discussed above) to the jurisdiction of any supervision, seizure, conservatorship, or receivership proceedings against the insurer and to the authority of the Commissioner or any supervisor, conservator, rehabilitator, or liquidator for the insurer appointed for the purpose of interpreting, enforcing, and overseeing the affiliate’s obligations under the agreement or contract to perform services for the insurer that (1) are an integral part of the insurer’s operations or (2) essential to the insurer’s ability to fulfill its obligations under insurance policies. Allows the Commissioner to require that an agreement or contract under (b)(4) for the provision of these services specify that the affiliate consents to the jurisdiction.

Applies to contracts issued, renewed, or amended on or after October 1, 2023.

Part VI.

Amends GS 58-30-1 by removing an outdated cross-reference.

Part VII.

Enacts new GS 58-30-262, providing as follows.

Defines large deductible policy as including: (1) A combination of one or more workers' compensation policies and endorsements issued to an insured and contracts or security agreements entered into between the insurer and the insured in which the insured has agreed with the insurer to do either of the following: (a) pay directly the initial portion of any claim under the policy up to a specified dollar amount, or the expenses related to any claim or (b) reimburse the insurer for its payment of any claim or related expenses under the policy up to the specified dollar amount of the deductible. (2) Any policy which contains an aggregate limit on the insured's liability for all deductible claims in addition to a per claim deductible limit. Provides that the primary purpose and distinguishing characteristic of a large deductible policy is the shifting of a portion of the ultimate financial responsibility under the large deductible policy to pay claims from the insurer to the insured, even though the obligation to initially pay claims may remain with the insurer. (3) Any policy with a deductible of $100,000 or greater. Sets out exclusions from the term.

Provides that the statute applies to workers’ compensation large deductible policies insuring workers’ compensation liabilities under the Workers’ Compensation Act issued by an insurer subject to an order of liquidation that has become final in the state of entry, whether the liquidation order is entered in this State or a reciprocal state. Applicability does not extend to claims funded by the Association or a foreign guaranty association net of the deductible unless (d) applies. Subsection (d) requires large deductible polices to be administered in accordance with their terms, except to the extent that those terms conflict with this statute. Requires all large deductible claims resulting from the handling or administration of one or more covered claims of a claimant to be turned over to the Association for handling and administration or be turned over to the foreign guaranty association in the state where the claim is pending for handling and administration. Provides that to the extent the insured funds or pays the deductible claim, the funding or payment of a deductible claim directly or to the Association or a foreign guaranty association by or on behalf of the insured extinguishes any obligations of the liquidator, the Association, or the foreign guaranty association to pay the claim. Prohibits making any charge or claim against the liquidator, the Association, or a foreign guaranty association on the basis of the funding or payment of a deductible claim by or on behalf of an insured.

Provides that to the extent the Association or a foreign guaranty association pays any deductible claim for which the insurer would have been entitled to reimbursement from the insured, the Association or foreign guaranty association is entitled to the full amount of the reimbursement and available collateral as provided for under this statute to the extent necessary to reimburse the Association or the foreign guaranty association. Provides that to the extent that the Association or a foreign guaranty association pays a deductible claim that is not reimbursed either from collateral or by payments by an insured, or incurred expenses in connection with large deductible policies that are not reimbursed under this statute, the Association or a foreign guaranty association is entitled to assert a claim for those amounts in the liquidation proceeding in this State or in the domiciliary state.

Requires the Association or a foreign guaranty association to collect reimbursements owed for deductible claims and take all commercially reasonable actions to collect those reimbursements, unless otherwise agreed to with the liquidator. Sets out additional billing requirements and process for collecting late payments.

Requires the liquidator of the insurer to use collateral, when available, to secure the insured’s obligation to fund or reimburse deductible claims or other secured obligations. Sets out the order to paying claims against the collateral. Requires liquidators of the insurer to draw down collateral to the extent necessary in the event that the insurer fails to: (1) perform its funding or payment obligations under any large deductible policy, (2) pay deductible claim reimbursements within the specified time frames, (3) pay amounts due the estate for pre-liquidation obligations, (4) timely fund any other secured obligation, or (5) timely pay expenses. Sets out when excess collateral may be returned to the insured.

Applies to insurance contracts issued, renewed, or amended on or after October 1, 2023.

Part VIII.

Amends GS 58-33-5 by making a technical correction.

Enacts new GS 160A-203.3 (applicable to cities) and GS 153A-145.11 (applicable to counties), forbidding ordinances that would prohibit the connection, reconnection, modification, or expansion of energy services to a consumer if the prohibition is based on the type of energy to be delivered. Defines “energy service” as the energy source a consumer may choose to use to illuminate, heat, or cool buildings; produce hot water; operate equipment; operate appliances; or any other similar activities where the energy source is derived from one or more of a variety of sources such as natural gas, renewable gas, hydrogen, liquified petroleum gas, renewable liquified petroleum gas, or other liquid petroleum products and that is delivered to the consumer by an entity legally authorized to provide such service, or electricity that is derived from one or more sources of electric generation and is delivered to the consumer by an entity legally authorized to provide such service and the distribution of the electricity occurs according to the specified territorial rights. Specifies activities that are not prohibited by the statutes. 

Enacts new GS 143-162.6 (applying to executive branch state agencies but not judicial or legislative branches of State government), GS 153A-461 (applicable to county agencies), and GS 160A-499.6 (applicable to city agencies), providing as follows.

Requires each agency set forth above, by July 1, 2023, to establish a policy to send any permits issued by the agency to permittees using one of the following methods instead of requiring the permittee to receive in-person delivery at an agency office: (1) via United States mail (may charge mailing costs to the permittee) or (2) by email, as appropriate, if the permittee consents to email delivery in advance. Allows a permittee to opt to receive a permit in person. 

Emphasizes that the new laws should not be construed to prohibit an agency from adopting policies to exercise due diligence in verifying a permittee’s identity.