House committee substitute to the 1st edition makes the following changes.  Makes changes to the act’s long title. Deletes the limitation specifying that local educational agencies are only able to contract with private special education facilities when the local entity is unable to provide the service set forth in GS 115C-111.2 so that local educational agencies may contract with private providers for any service. Defines nursing services. Enacts new GS 115C-111.2(b) specifying the following conditions that must be met before a local education agency must make available a parent’s choice of nurse when providing nursing services under an IEP: (1) the IEP requires nursing services; (2) the child received nursing services from the nurse (i) prior to the nursing services being required by the child's IEP or (ii) prior to the child enrolling in his or her current school; (3) the parent's choice of nurse is employed by a nursing agency and willing to provide the nursing services required by the child's IEP; (4) the nursing agency employing the parent's choice of nurse meets all standard contract terms required for any other nursing agency contracted by the local educational agency, including licensing and liability requirements; (5) the contracted rate is equal to or less than the contracted rate of other nurses contracted by the local educational agency. Specifies that GS 115C-111.2 should not be construed to limit the local education agency’s responsibility to provide a free public education. Deletes proposed amendments to GS 115C-111.6.    

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). 

Identical to S 305, filed 3/14/23.

Includes whereas clauses. Requires the designated Protection and Advocacy Agency (Agency) to submit a quarterly report of the actions the Agency has taken in its efforts to advocate for persons with disabilities to the specified joint NCGA agencies. Encourages the NCGA to examine the activities of the Agency to determine the impact on current and future State budgets.  Clarifies that the act should not be construed to impact the Agency’s ability to perform work within its governing laws.

Amends the definitions provisions of the Public Safety Employees’ Death Benefits Act (GS 143-166.2) to have official duties include duties performed by an individual while they are en route to, engaged in, or returning from duty or training. (Currently, just returning from training.)

Effective retroactively as of January 1, 2022, and applies to applicable deaths of covered persons occurring on or after that date when the covered person was en route to, engaged in or returning from duty at the time of the covered person’s death.

Amends GS 9-3 as the title indicates. Makes additional organizational, technical and clarifying changes. 

Enacts Article 11C, GS Chapter 131E, to be cited as the Medical Debt Protection Act (Act). States the Article's legislative purpose. Includes 15 defined terms. Requires all large health care facilities (defined to include licensed hospitals, outpatient clinics and facilities affiliated with licensed hospitals, licensed ambulatory surgical centers, and other practices and professionals offering specified health care services) to develop a written financial assistance policy called a medical debt mitigation policy (MDMP) pursuant to the Article and any implementing rules. Defines an MDMP to include seven components, including the basis for calculating amounts charged to patients and the method for applying for financial assistance, as well as eligibility criteria for financial assistance. Makes the requirements applicable regardless of federal law requirements. Further details required content of an MDMP and requires its approval and annual review by the owners or governing body of the health care provider. 

Establishes five steps a large health care facility (facility) must take before seeking payment for any emergency or medically necessary care, including determining the patient's health care insurance status, offering to screen a patient for insurance eligibility and other public programs that assist in health care costs, determining qualifications for free or discounted care under the MDMP, and determining eligibility for financial assistance within 14 days of application with billing and collections stayed while determination is pending. Sets forth four categories of eligibility for patients to qualify for financial assistance under the MDMP based on household income and poverty level, with assistance ranging from no cost to discounted costs, applicable to any charges for health care services that are not covered by insurance and would be otherwise billed to the patient. Details acceptable methods for establishing eligibility for financial assistance, with authority for a facility to grant financial assistance notwithstanding the patient's failure to provide the acceptable documentation or can require other evidence of eligibility. Requires facilities to notify a patient in writing within 30 days of receipt of an application for financial assistance of its eligibility determination. Requires acceptance and consideration of applications submitted within one year of the date of the first bill after provision of health care services. Provides for review of applications for patients subject to collection activity by the facility or medical debt collector at any time, with medical debt collectors required to forward any application submitted within two business days and to cease activity until notified by the facility of the outcome. Bars charging late fees or interest to patients who qualify for financial assistance. Requires facilities and medical debt collectors to offer payment plans to qualifying patients of at least 24 months with payments never exceeding more than 5% of the patient's gross monthly income, with the first payment required to be at least 90 days after the services were provided. Bars prepayment and early payment fees or penalties. 

Sets forth requirements of a large health care facility to publicize its MDMP, including making the policy and financial assistance application easily accessible online. Requires that the patient by informed of any financial assistance policy with every written and oral attempt by a medical creditor or debt collector to collect medical debt for health care services provided by a large health care facility. Includes translation requirements for MDMPs and other language access accommodations required by a large health care facility. 

States four prohibited collection actions, including causing arrest or garnishing wages or tax refunds. Prohibits medical creditors and medical debt collectors from engaging in permissible extraordinary collection actions, as defined, until 180 days after the first bill for a medical debt has been sent, and before which specified notice requirements must be met at least 30 days prior to taking such actions. Prohibits a large health care facility or medical debt collector from taking extraordinary collection actions to collect debt for health care services provided by the facility unless the actions are described in the facility's billing and collections policy. Requires reversal of extraordinary collection actions taken when a patient is later found eligible for financial assistance. 

Requires large health care facilities to post price information online as described, including using gross charges for services and listing amounts Medicare would reimburse for the service. 

Deems parents and legal guardians jointly liable for any medical debts incurred by minors. Provides immunity from liability for spouses or other persons for the medical debt or nursing home debt of another adult, with requirements listed for voluntary consent to assume such liability.

Requires and described required content of itemized bills provided by medical creditors or medical debt collectors upon request, free of cost. Prohibits medical creditors and medical debt collectors from communicating with or reporting to consumer reporting agencies regarding a consumer medical debt for one year from the date of the first bill for the medical debt, whereby creditors and collectors must send one additional bill before such communications. Places restrictions on collection agency communications. 

Details prohibited acts of medical creditors and medical debt collectors while health insurance decisions review or appeal is pending. 

Establishes a formula to cap interest on medical debt. Establishes requirements for medical creditors and medical debt collectors relating to payment plans for medical debt, including providing a written copy of the plan to the consumer within five business days of entry that includes prominent disclosure of the interest rate and maturity date, and satisfaction of notice and negotiation requirements prior to accelerating or defaulting a plan.

Provides requirements for providing receipts of medical debt payments to consumers. Provides for debt forgiven by a medical center to not constitute a breach of contract between the medical center and the insurer or payor. 

Creates a private right of action for a consumer against whom a violation of the Article occurs for up to treble the amount of damages incurred. Allows for injunction or other equitable relief. Prohibits MDMPs from waiving the patient's right to resolve a dispute by equitable relief, the award of damages, attorneys' fees and costs, or an evidentiary hearing. Deems any waiver by any patient or consumer of rights and protections under the Article void. Grants enforcement authority to the Attorney General, and requires the AG to establish a complaint process, which are deemed public records.

Requires large health care facilities to annually file its MDMP with the Department of Health and Human Services (DHHS), as specified, with DHHS required to post the reports in a searchable online database, and annually prepare a consolidated report. Creates reporting requirements for facilities that retain or initiate the process to retain a patient's State tax refund through GS Chapter 105 setoff other other state law. 

Includes a severability clause. 

Exempts federally qualified health centers from GS 131E-214.23 through GS 131E-214.26, GS 131E-214.28, and GS 131E-214.40.

Deems the act supersedes GS 131E-91, GS 131-99, and GS 131E-147.1 in the event of conflict. 

Appropriates $100,000 in recurring funds from the General Fund to DHHS for 2023-24 to administer the collection of MDMPs and annual reports for public availability. 

Applies to medical debt collection activities occurring after October 1, 2023. 

Contains whereas clauses. Names the act the Responsible Firefighting Foam Management Act. Enacts GS 143-215.104FF setting forth the following defined terms: Class B firefighting foam, fixed system, PFAS chemicals, testing, and testing facility. Enacts GS 143-215.104GG (prohibiting certain firefighting foams for training practice or testing), which bars any state agency, person, or local government from discharging Class B firefighting foam that contains intentionally added PFAS chemicals for training, practice, or testing (unless otherwise required for testing purposes by law or an authority having jurisdiction and a testing facility has implemented appropriate containment, treatment, and disposal measures to prevent releases of Class B firefighting foam into the environment). Requires non-fluorinated training foams or other non-fluorinated surrogates to be used for firefighting training. Requires training to be conducted under conditions conducive to the collection of spent foam, regardless of foam type. Authorizes the Office of the State Fire Marshal to adopt rules to implement the act. Effective December 1, 2023.

Identical to S 313, filed 3/14/23.

Part I.

Enacts GS 163-275.1, creating the following crimes related to voting in elections. Makes it a Class H felony to do any of the following: (1) threaten or attempt to threaten a person for voting or attempting to vote, for voting or attempting to vote for or against a particular candidate, for registering to vote, for urging or aiding any individuals to vote or attempt to vote as authorized by law, or for exercising any lawful powers or duties as an election official or enlisting another person to do so; (2) knowingly challenge a person’s right to vote on fraudulent or spirituous grounds; (3) engage in mass, indiscriminate, and groundless challenging of voters solely for the purpose of preventing voters from voting or to delay the process of voting or the lawful and orderly administration of an election; or (4) fraudulently advise any person that the person is not eligible to vote or is not registered to vote.

Makes it a Class H felony for an employer to (1) enclose an employees’ pay in envelopes upon which or in which there is written or printed the name of any candidate or political mottoes, devices, or arguments containing threats, intended or calculated to influence the political opinions or actions of the employees; or (2) in any way communicate that an employees’ pay or continued employment is conditioned on voting or not voting, or voting or not voting for a specific candidate.

Makes it a Class A1 misdemeanor to intimidate or coerce, or attempt to intimidate or coerce, any person for voting or attempting to vote, for voting or attempting to vote for or against a particular candidate, urging or aiding any persons to vote or attempt to vote as allowed by law, or exercising any lawful powers or duties as an election official or enlisting another person for the purpose of doing the same.

Establishes that a person will be found to have intimidated or coerced another person if the person knew or reasonably should have known that his or her actions would produce that effect. Defines coerce, intimidate, and threaten. Establishes a right of action for a person aggrieved by a violation of new GS 163-275.1 for preventative relief; permits a court to award the prevailing party reasonable attorneys’ fees.

Enacts new GS 153-275.3, authorizing a court to order any person convicted of violating Article 22 of the Chapter, which governs corrupt practices and other offenses against the elective franchise, to pay a restitution fine, at an amount at the court’s discretion, to be deposited in the Voter Intimidation Restitution Fund (Fund), established by the act. Directs that funds appropriated to the Fund are to be allocated to the State Board of Elections (State Board) for voter education campaigns relating to these crimes, as specified.

Part II.

Makes organizational changes to Article 22, GS Chapter 163. Enacts GS 163-278.1A, making any person who intimidates, threatens, coerces, or attempts to do the same to an election worker, with the intent to impede, intimidate, or interfere with their official duties, liable for civil damages of up to $100,000, imprisonment of up to five years, or both. Defines election worker to include election volunteers. Provides immunity for election workers acting in good faith to prevent election interference or preserve ballot access. Amends GS 163-278 to authorize the State Board and district attorneys to investigate, prosecute, and seek increased penalties for violations of new GS 163-275.1.

Part III.

Enacts new Article 15B, GS Chapter 163, cited as the Safeguard Fair Elections Act. Sets forth legislative findings and defined terms. Makes it a Class 1 misdemeanor punishable by a fine of up to $10,000 for a public official to perform or communicate the intention to perform an official act in which the official, without substantial evidence (as defined) refuses to certify the actual results or count of an election. Makes such action or communication of intention an automatic resignation from office, and deems any such official act void.

Part IV.

Amends GS 163-182.12A, establishing seven criteria with which the State Board of Elections must ensure post-election audits comply, including being conducted by nonpartisan officials with expertise in elections, preserving ballot secrecy and voter privacy, and requiring audit procedures to be established before election day and before results are known. Prohibits public officials from providing funding for or participating in a post-election audit or review that fails to comply with the State Board’s best practices that meet the described criteria.

Enacts GS 163-182.12B, directing the State Board to conduct, in each county, a risk-limiting audit after the general election, where a hand-to-eye recount is made of randomly selected ballot samples in a contest that provides strong statistical evidence that the machine-counted results are correct and based on a risk limit, meaning the largest chance that an incorrect outcome of a contest could escape correction by the audit. Specifies that the audit must not change the results of an election.

Part V.

Amends GS 163-45, which gives the chair of each political party in the county the right to designate two observers to attend each voting place at each primary and election. Adds the requirement that the observers complete training before acting as an observer and complete additional training at least once every two years. Requires the State Board to establish training standards and requirements for observers. Makes conforming changes. Removes the provision prohibiting observers from taking an oath of office; instead requires that observers sign a sworn oath that the observer will not do any electioneering at the voting place, and will not impede the voting process or interfere or communicate with or observe any voter in casting a ballot. Adds the requirement that while observing, observes must wear clear identification, that includes the observer's name, role, and partisan affiliation.

Requires the State Board, to collaborate with county boards of elections, to: (1) ensure election administrators are adequately compensated equitably throughout the State; (2) ensure clear and conspicuous notices are placed at voting locations establishing clear rights and responsibilities for voters, poll workers, and observers; and (3) develop a statewide, uniform system of reporting incidents of voter intimidation anonymously.

Part VI.

Enacts new GS 163-49 allowing a precinct official to file written notice with the State Board requesting that the precinct official and the precinct official's immediate family be placed on a list that prohibits disclosing personally identifiable information in public records when the precinct official deems the official or the official's immediate family is at risk of intimidation, threat, or coercion in response to official election duties. Defines personally identifiable information to include any of the following: (1) a person's home address, home or mobile phone number, pager number, or personal email address; (2) a photo of a person; (3) directions to a person's home; (4) a photo or description of a person's home, vehicle, or vehicle license plate. Requires the State Board to develop the process and criteria for precinct officials requesting this nondisclosure, including providing a way to notify the county boards of elections and other entities of the request.

Makes conforming changes to GS 132-1.2.

Part VII. 

Amends GS 163-182.13A to allow review by the court (previously prohibited) of the NCGA's decision in determining the contest of an election for a Council of State office. Requires, if judicial review is granted, that the court issue findings of fact on whether the contestee is eligible and qualified, or if the contest is as to the conduct or results of the election, which candidate received the highest number of votes.

Part VIII.

Appropriates $250,000 in recurring funds for 2023-25 from the General Fund to the State Board for biennial security training for election officials and their immediate family members. Requires that the training include, at least: (1) best practices for using social media and other forms of online engagement and maintaining online privacy; (2) home security program and maintenance; (3) understanding removal programs and requirements for election officials' personally identifiable information in accordance with this act; and (4) any other security training deemed relevant. Effective July 1, 2023.

Part IX.

Appropriates $2 million for 2023-24 from the General Fund to the State Board to establish, in coordination with the Department of Public Safety, a new threat management capability for monitoring all-source information that will: (1) provide a threat monitoring and analysis capability for the protection of election officials and their immediate family members; (2) coordinate social media monitoring and threat assessments; (3) proactively manage the monitoring of websites for election officials' personally identifiable information and report violations to the appropriate law enforcement authorities; (4) maintain files of escalating behaviors and work in conjunction with the appropriate law enforcement to counteract overt acts of aggression; (5) maintain a database of each election official to catalogue complaints, including the specified information of the individual(s) engaging in threatening behavior; and (6) coordinate complaints by election officials of all sources and other online threats, whether direct or indirect, with law enforcement partners. Effective July 1, 2023.

Part X.

Includes a severability clause.

Amends GS 14-309.15 (pertaining to when real property is offered as a prize in a raffle) to increase the total allowable appraised value of all real estate prizes offered by any nonprofit organization for raffle from $500,000 to $2 million in a calendar year. Deletes provision limiting the value of any real property prize offered for any one raffle to $500,000. Applies to raffles conducted on or after the act becomes law.