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

Amends GS 163-278.8 to require campaign expenditure for nonmedia expenses of more than $100 (was, $75) to be made by a verifiable form of payment; makes conforming changes to provisions related to payment type, accounting, and reporting.

Amends GS 163-278.8A, concerning the exemption of certain sales made by a political party executive or affiliated committee from being considered campaign donations, to require that no purchaser make total purchases exceeding $100 (was, $50).

Amends GS 163-278.310 to provide that the name of any donor making a total legal expense donation of $100 (was, $50) or less in a calendar quarter does not have to be reported; makes conforming changes.

Amends GS 163-278.316 to require legal expense donations in excess of $100 (was, $50) be made by a noncash method that can be subject to written verification.

Makes additional technical changes to GS 163-278.8A, GS 163-287.11, and GS 163-278.14.

Makes conforming changes to the effective date and the act's titles.

House committee substitute to the 1st edition makes the following changes. Changes the definition of genetic counseling to the provision of services by an individual who qualifies for a license under new Article 44 and provides services to individuals located in the State (was, the provision of services by an individual who qualifies for a license under Article 44). Adds newly defined term genetic testing.

Changes the composition and initial term length of the gubernatorial appointees to the new five-member Genetic Counselors Licensure Board (Board) set forth in GS 90-751 by now requiring the governor to appoint a physician for a three-year term (was, a licensed genetic counselor for a two-year term) and extends the term of the member of the public appointee from one year to three years.  Expands the powers and duties of the Board under GS 90-752 by permitting the Board to adopt rules that establish the standard of ethical practice, in addition to six other listed powers and duties. 

Expands the scope of the Board’s publishing requirements under GS 90-753 by also requiring the Board to make available to the public the names of all licensed genetic counselors, along with any disciplinary information, and to publish that information on its website.

Amends the scope of practice under GS 90-755 as follows. Removes reference to other diagnostic studies in powers describing genetic assessments and makes conforming changes to other powers describing use of testing to remove references to other diagnostic studies. Specifies that written documentation of medical, genetic, and counseling information for families and health care professionals may include genetic testing results and findings along with published guidelines that comply with the acceptable and prevailing standards of practice and ethics of both genetic counseling and medicine. Specifies that the practice of genetic counseling does not include diagnosis, treatment, recommendations for treatment or any final interpretation of genetic testing, except as provided in the Article. Requires all genetic counselors to consult with the referring provider or refer all clients back to the referring health care provider for diagnosis, treatment, recommendations for treatment, final interpretations and any necessary follow up. Requires genetic counselors to provide all records, including genetic laboratory test results, to the referring health care provider.

Requires all genetic counselors to follow the identification requirements set forth in Article 37 of GS Chapter 90. Specifies that a person practicing genetic counseling without being licensed and registered in the State is guilty of a Class 1 misdemeanor and a Class I felony if they falsely represent themselves in a manner as being licensed or registered in the State. Specifies that any person practicing without being duly licensed and registered in the State, and who is an out-of-state practitioner, is guilty of a Class I felony.

Amends the violations constituting unprofessional conduct as follows. Removes language calling the statutory violations a code of conduct violation. Changes the conviction language constituting a violation to a conviction in any court (was, also plea of guilty or nolo contendere) of a crime involving moral turpitude, misrepresentation, fraud (was, misrepresentation or fraud in dealing with the public), fitness or ability to practice, the violation of a law involving the practice of genetic counseling (was, a misdemeanor charge reflecting the inability to practice genetic counseling relating to the health and safety of clients or patients), or a conviction of a felony (was, also plea of guilty or nolo contendere). Expands the out-of-state disciplinary measures violation to having a license revoked, suspended, restricted, or acted against or having a license to practice genetic counseling denied in any other jurisdiction or by a certifying entity (was, only revocation or suspension of license or disciplinary action for conduct that would subject the licensee to discipline under Article 44). Changes violation relating to treatment from failing to provide competent treatment, consultation, or supervision, in keeping with standards of usual and customary practice in the State to departing from or failing to conform to the acceptable and prevailing standards of care and ethics of the practice of genetic counseling in the State as determined by the Board, irrespective of whether or not a patient is injured. Exempts all records, papers, investigative files, investigative reports, other investigative information, and other documents containing information in the possession of or received or gathered by the Board, or its members or employees or consultants, as a result of investigations, inquiries, assessments, or interviews conducted in connection with a licensing, complaint, assessment, potential impairment matter, disciplinary matter, or report of professional liability insurance awards or settlements from State public records law and designates such documents as privileged, confidential, and not subject to discovery, subpoena, or other means of legal compulsion for release to any person other than the Board or its employees or consultants. Specifies that investigative information includes information relating to the identity of, and a report made by, any person performing an expert review for the Board and transcripts of any deposition taken by Board counsel in preparation for or anticipation of a hearing held pursuant to this Article but not admitted into evidence at the hearing.

Authorizes the Board to apply for injunctive relief in superior court to prevent violations of Article 44. Sets forth rules for venue. Allows the Board's officers to administer oaths and subpoena witnesses, records, and other materials. Provides for withholding of patient information from the public for any records so obtained. Requires the Board, upon written request, to revoke a subpoena if, upon a hearing, it finds that the evidence the production of which is required does not relate to a matter in issue, or if the subpoena does not describe with sufficient particularity the evidence the production of which is required, or if for any other reason in law the subpoena is invalid.

Specifies Board retains jurisdiction over an inactive license, regardless of how it became inactive, including a request for inactivation, surrender of a license, or by operation of an order entered by the Board. Provides that the Board's jurisdiction over the licensee extends for all matters, known and unknown to the Board, at the time of the inactivation or surrender of the license.

Makes technical and organizational changes.

House committee substitute to the 1st edition makes the following changes. Amends Part II, as follows. Changes references from "children" to "youth" in findings.

Now requires the Department of Health and Human Services (DHHS), Division of Health Benefits (DHB), to convene a workgroup composed of county child welfare agencies, representatives with lived experience in child welfare, the nonprofit corporation Benchmarks, prepaid health plans, and local management entities/managed care organizations (LMEs/MCOs) to identify innovative Medicaid service options to address any gaps in the care of children receiving foster care services. Requires each LME/MCO to identify any innovative practices it is using that could be an innovative Medicaid service option and requires communicating with healthcare providers in its catchment area about the opportunity to submit concept papers to the workgroup to aid in the identification of these innovative Medicaid service options. Specifically, requires the workgroup to identify options that: (1) model community evidence-based practices that support a foster child returning to the child's family in a timely manner and divert from higher level foster care placements or (2) model short-term residential treatment options that serve children with high acuity needs that divert a child from higher level placements such as psychiatric residential treatment facility placement. Allows considering providing stepdown options from higher levels of care.

(Previously, DHB had to develop, to the extent allowed under the State Medicaid Plan [Plan], new “in-lieu-of” services under the Plan for children receiving foster care services no later than 90 days after the act becomes law to be implemented statewide and apply a Children and Families specialty plan if one is implemented. Required DHB to use Early and Periodic Screening, Diagnostic and Treatment (EPSDT) to ensure access to the recommended interventions and therapies for Medicaid beneficiaries not enrolled in managed care. Required DHB to partner with certain stakeholders to identify innovative service options to address any gaps in the care of children receiving foster care services. The Plan had to (1) identify models of community evidence-based practices that support a foster child returning to their family in a timely manner and diverting higher level foster care placements and (2) identify model short-term residential treatment options that serve children with high acuity needs that divert a child from higher level placements such as psychiatric residential treatment facility placement.)

Now requires DHB to begin distributing funding, as appropriated by the act and to the extent allowed under GS 108A-54.1A (amendments to State Medicaid Plan), through capitated contracts with LMEs/MCOs and through capitated prepaid health plan contracts under Article 4 of GS Chapter 108D, to be used for the innovative Medicaid service options identified by the workgroup no later than three months after the workgroup has completed its work. Permits the funding to be used for (1) new services identified by the workgroup that may be implemented regionally or Statewide or (2) expanding a service or modality to a county or region where the service or modality was not previously implemented. Requires DHB to require all of the following from any entity receiving such funding: (1) timelines for, and establishment of, first- and second-year deliverables for any service that may be a phased-in service; (2) identification of required funding, including start-up funding and a three-year budget, including projected revenue sources and amounts; and (3) specific outcome measures with the attestation of the timely submission of the data to the applicable prepaid health plan and DHB. Makes other conforming changes to account for new workgroup and LMEs/MCOs.

(Previously, required DHB to issue requests for proposal (RFPs) for any services identified through the Plan development process as lacking and targeted towards any geographic location with identified inadequate provider access by no later than three months after the Plan is developed. Permitted services to be phased in over a period of two years.  Required that the RFPs be developed in partnership with the stakeholders developing the Plan and include the five following things: (1) the development of newly identified Medicaid services for foster children that may be implemented regionally or statewide; (2) expansion of a Medicaid service not located in the particular county or region; (3) timelines for, and establishment of, first- and second-year deliverables for any service that may be a phased-in service; (4) identification of required funding, including start-up funding and a three-year budget including projected revenue sources and amounts; (5) specific outcome measures with the attestation of the timely submission of the data to the responsible prepaid health plan and DHB. Set forth the review process for DHB review of the RFPs. Required DHB to train all county departments of social services and offer training to tribal welfare offices on the Medicaid services recommended for implementation by the stakeholders involved with developing the Plan, and to continue to provide status implementation within the impacted counties and region.)