Conference report makes the following changes to the 3rd edition.

Part II-A.

Amends proposed GS 90-337(b) to remove the qualification of other states which the Board of Licensed Clinical Mental Health Counselors may enter into reciprocity agreements with that required other states to have requirements for licensure as a clinical mental health counselor that are substantially similar or that exceed requirements established under Article 24 of GS Chapter 90, as amended, Licensed Clinical Mental Health Counselors Act.

Part II-C.

Amends the effective date of Section 4, which amends the definitions provisions set out in GS 90-113.31A under Article 5C, NC Substance Abuse Professionals Practice Act. Changes the effective date from October 1, 2019, to January 1, 2020.

Part II-D.

Amends proposed GS 90-113.32(c2), adding two more members appointed by the Governor to the NC Addictions Specialist Profession Practice Board (Board). Requires these members to be licensed or certified under Article 5C. Requires the Governor to consider the ethnicity and gender of the Board's members in order to reflect the composition of the State's composition, and consider the experience and knowledge of the drug and alcohol recovery community when selecting members to serve on the Board. Reduces the members appointed to the Board by the General Assembly by two. Makes conforming changes to proposed GS 90-113.32(e1) concerning initial terms of Board members.

Part II-E.

Amends the proposed changes to GS 90-113.40(a)(6), concerning substance abuse counselor certification and substance abuse prevention consultant certification, and (d1)(1), concerning criminal justice addictions professional certification, to maintain the existing education and/or training hours required of each. Changes the effective date of the Part's provisions from October 1, 2019, to January 1, 2020, and no longer includes a scope provision.

Part II-F.

Eliminates the previous provisions of the Part, which enacted GS 90-113.48, establishing the NC Impaired Professionals Program.

Instead, amends GS 90-113.33 to require the North Carolina Substance Abuse Professional Practice Board (Board) to establish a program for licensees who may be experiencing substance abuse disorders, burnout, compassion fatigue, and other mental health concerns. Allows the Board to enter into agreements with existing professional health care programs, and to refer licensees to the program as part of the disciplinary process. Authorizes the Board to adopt rules to implement the program. Effective January 1, 2020.

Part II-G.

Changes the effective date of the proposed changes to Article 5C, NC Addictions Specialist Professional Practice Act, as amended, of GS Chapter 90. Now provides that the provisions apply to licenses granted or renewed on or after January 1, 2020 (was, October 1, 2019).

Part II-I.

Amends the proposed changes to GS 90B-7(e), concerning qualifications for a certificate for a certified social work manager, to require a bachelor's degree rather than a masters or doctoral degree in social work. Makes conforming clarifications to reflect requirements for program accreditation or admission to candidacy for accreditation by the Council on Social Work Education for undergraduate curricula.

Removes the provision limiting the qualifications for the certificate of Certified Social Work Manager, as amended, to applications for certification received by the NC Social Work Certification and Licensure Board on or after January 1, 2021.

Part III-E.

Eliminates the provisions of previous Part III-E, which contained proposed changes to GS 122C-71 and related directives regarding the State Consumer and Family Advisory Committee.

Part III-G.

Makes technical changes to GS 48-3-303, regarding preplacement assessments.

Adds the following new provisions.

Part III-N.

Directs the Department of Health and Human Services (DHHS), Division of Social Services (Division), to postpone deployment of the NC FAST system to the extent it relates to case-management functionality for the child welfare system and aging and adult services programs. Prohibits the Division from deploying the child welfare case-management component of NCFAST statewide prior to July 1, 2020. Permits the Division to continue the development and improvement of case-management functionality for the child welfare component of NC FAST only in the counties that participated in the initial pilot program prior to January 1, 2019. Authorizes counties that were phased into the NC FAST Child Welfare System after January 1, 2019, to elect to utilize the Intake and Assessment functionality of the NCFAST system.

Directs the Division to move forward with developing and issuing requests for information to consider a vehicle for improving or replacing the child welfare case-management component of NC FAST. Requires legislative approval prior to issuing any contracts. Requires the Division to consult with the Executive Committee of the NC Association of County Directors of Social Services. Requires the Division to report to the specified NCGA committee chairs by May 1, 2020.

Directs the Joint Legislative Program Evaluation Oversight Committee to revise the 2019-20 work plan for PED to include a study of the case management functionality of the child welfare component of NC FAST. Directs PED to submit its evaluation to the specified NCGA committees by May 1, 2020.

Part III-O

Enacts GS 108A-133 to require an offer of employment by a child care institution, or by a contract agency of a child care institution, as well as acceptance of a volunteer in a child care institution, to be conditioned on consent to a state and national criminal history record check of the applicant. Prohibits employing or accepting to volunteer an individual who refuses to consent to a criminal history check, including a check of the applicant's fingerprints. Details procedures of the check, with the Department of Public Safety to conduct the check and return the results to DHHS, Criminal Records Check Unit (Unit). Provides that a check that reveals a conviction of a relevant offense, as defined, is not an automatic bar to employment. Requires the Unit to consider seven enumerated factors in determining whether to recommend the applicant to be hired or the individual be allowed to volunteer, and inform the child care institution or a contract agency whether an applicant should be hired or an individual should be allowed to volunteer. Prohibits DHHS from providing the results of the check to the child care institution or a contract agency of a child care institution. Makes it a Class A1 misdemeanor for any applicant to willfully give false information on an employment application that is the basis for a criminal history check under the statute. Allows for conditional employment pending the results of the criminal history check so long as the applicant or individual wishing to volunteer has consented to the check or completed fingerprint cards and the child care institution submits the record request within five days after the individual begins conditional employment. Requires child care institutions to make available upon request verification that the check was completed on all staff and volunteers. Grants limited civil liability to the Unit, child care institutions, contract agencies, and their officers or employees acting in good faith and in compliance with the statute who deny employment to an applicant or the opportunity to volunteer based on information provided in the criminal history record check. Additionally, provides civil immunity for child care institutions and contract agencies, and their officers and employees, who fail to check an applicant, employee, or volunteer's criminal history if the record check was requested and received in compliance with the statute. 

Makes conforming changes to GS 131D-10.6, regarding powers and duties of the Department of Health and Human Services, to require the Department to make licensing actions in accordance with new GS 108A-133.

Enacts GS 143B-968 to require DPS to provide DHHS, Criminal Records Check Unit, the criminal history of any current or prospective employee or volunteer in a child care institution, including those working with a contract agency. Sets forth the requirements and procedure for conducting the checks. Deems all information received by the Criminal Records Check Unit confidential and kept pursuant to GS 108A-133. Authorizes DPS to charge a fee to conduct the checks. 

Part IV.

Amends GS 122C-3 to amend the definition for legally responsible person. Qualifies the definition applicable to adults who have been adjudicated incompetent, a guardian, as subject to the limitations of specified state law. Applicable to an adult who has a health care power of attorney and who is incapable, defines the term as a health care agent named pursuant to a valid health care power of attorney (HCPOA) unless the adult is adjudicated incompetent following the execution of the HCPOA and the health care agent's authority is suspended pursuant to state law (previously, applicable to an adult who is incapable and who has not been adjudicated incompetent; did not provide for suspension of the HCPOA).

Amends GS 122C-4 to remove the qualification that an adult have not been adjudicated incompetent as it applies to the phrase client or the legally responsible person in GS Chapter 122C, wherein a client who is an incapable adult must have his or her duties or rights involved exercised by a health care agent named by a valid HCPOA.

Makes technical changes to GS 122C-55's information sharing provisions in subsections (a2) and (a3).

Makes technical changes to GS 122C-77, concerning the statutory form for advance instruction for mental health treatment. Modifies the form to prohibit the form from providing consent to retain the individual in a facility for more than 15 days (was, 10 days).

Enacts GS 122C-216 to provide for the legally responsible person for an incapable adult in need of treatment that has no HCPOA or advance instruction for mental health treatment that addresses the needed treatment, to include an appointed agent, spouse, a majority of the patient's reasonably available parents and adult children, a majority of the patient's reasonably available adult siblings, or an individual who has established a relationship with the patient. Restricts authority to admit an incapable adult to a 24-hour facility where the adult will be subject to the same or similar restrictions on freedom of movement present in the State facilities for the mentally ill to an agent appointed by the patient, subject to authority granted.

Makes technical corrections to GS 122C-251(h), regarding the cost and expenses of custody and transportation of a respondent required by involuntary commitment placed on the county of residence.

Amends GS 122C-261(d)(8), concerning immunity for sites of first examination and their responsible individuals, to include civil and criminal immunity for taking measures to temporarily detain an individual for the period of time necessary to complete a commitment examination, submit an affidavit to the magistrate or clerk of court, and await issuance of a custody order, as authorized (was, immunity for taking measures prior to the inpatient admission of the individual to a 24-hour facility).

Makes technical corrections to GS 122C-263.1, regarding certification of examiners to perform first examinations. 

Amends GS 122C-294 to refer to local area crisis services plans (rather than the local plan). Requires submission of plans beginning October 1, 2019, but no later than August 1, 2020 (previously, required submission on or before October 1, 2019). Makes conforming changes.

Repeals Section 44 of SL 2018-33, which required every LME/MCO to submit a copy of its current community crisis service plan to DHHS.

Part V.

Designates GS 131A-1 through GS 131A-25 as Article 1 of GS Chapter 135, the Health Care Facility Finances Act. Directs the Revisor of Statutes to make necessary changes to statutory cross-references. Makes conforming changes to GS 113A-12 (environmental document exemption) and GS 142-15.16 (defining State-supported financing arrangement). 

Enacts new Article 2, Rural Health Care Stabilization Program, to GS Chapter 131A. Sets forth nine defined terms. Establishes the Rural Health Care Stabilization Program (Program) to provide loans for the support of eligible hospitals located in rural areas that are in financial crisis due to operation of oversized and outdated facilities and recent changes to the viability of health care delivery in their communities, with loans to be used to finance construction of new health care facilities or to provide for operational costs during the transition period, or both, including while the construction of new facilities is undertaken. Requires UNC Health Care to administer the Program. Sets out specific UNC Health Care responsibilities, including assessing Plans submitted by loan applicants, evaluating the applicant's ability to repay the loan under the proposed Plan, determining the security interests necessary to enforce repayment, and implementing approved loan agreements. Excludes UNC Health Care from applying for a loan or being a partner in a partnership that applies for a loan under the Program. Specifies that the Local Government Commission (Commission) cannot approve a loan application if the issuance of the loan would result in a material, direct benefit to UNC Health Care at the time the application and Plan are submitted for approval. Grants UNC Health care rulemaking authority necessary for the Program's implementation.

Establishes the Rural Health Care Stabilization Fund (Fund) as a nonreverting special fund in the Office of State Budget and Management. Directs that the Fund operate as a revolving fund under the custody of the State Treasurer, with funds restricted to use pursuant to the Article. The Fund consists of funds appropriated to or received by the Program and funds received as repayment of the principal of or interest on Fund loans.

Sets out the loan application process. Deems a public agency, an owner of a health care facility, or a partnership of one or more of those entities eligible to apply for a loan under the Program. Requires applicants to develop and submit a hospital stabilization plan for an eligible hospital to UNC Health Care during the application period, as established by UNC Health Care. Requires UNC Health Care to evaluate each Plan submitted to determine whether the applicant's Plan demonstrates a financially sustainable health care service model for the community in which the eligible hospital is located. Also allows UNC Health Care to assist an applicant with revisions to its Plan. Requires UNC Health Care to notify the applicant and the Commission of its recommendation on whether to approve or disapprove a loan application. Allows UNC Health Care to assign priority in the event of more than one application during the application period. Allows, when a loan application is disapproved, for an applicant to engage a disinterested and qualified third party approved by the Commission to evaluate the applicant's Plan to determine if the applicant demonstrates the required financial sustainability, and permits the applicant to seek Commission approval of the loan based on the third party's written evaluation of the Plan.

Requires the Commission to approve all loans under the Program prior to UNC Health Care's awarding the loan. Explicitly states that if the Commission enters an order denying the loan, the proceedings under new Article 2 are at an end. Requires UNC Health Care to disclose to the Commission any potential conflict of interest in its review of an application and Plan. Prohibits the Commission from approving an eligible applicant if the issuance of a loan would result in a material, direct financial benefit to UNC Health Care at the time the application and Plan are submitted to the Commission for its approval. Requires the Commission to review UNC Health Care's recommendations, an applicant's Plan and any other relevant information, as well as the third party evaluation, if applicable. Sets forth additional information the Commission can require the applicant and eligible hospital (if different) to provide for consideration. Establishes the following four findings that must be satisfied for the Commission to approve a loan application: (1) that the loan is necessary or expedient; (2) that the amount proposed is adequate and not excessive for the proposed purpose of the loan; (3) that the Plan demonstrates a financially sustainable health care service model for the community in which the eligible hospital is located; and (4) that the applicant's debt management procedures and policies are good, or that reasonable assurances have been given that the debt will be repaid.

Requires UNC Health Care to execute the terms of the loan agreement upon approval of the loan by the Commission. Authorizes UNC Health Care to require changes to the governance structure of the eligible hospital. Limits the loan interest rate at the interest rate obtained by the State in its most recent general obligation bond offering, and sets the maximum maturity at 20 years. Requires execution of a debt instrument to evidence the obligation. Requires UNC Health Care to annually publish a report on the Fund by November 1 to cover the preceding year. Requires the report to be publicly available as well as a copy submitted to the specified NCGA committee and division. Details required content of the report, including the Fund balance at the beginning and end of the fiscal year, the amount of revenue and its source credited to the Fund during the fiscal year, the total amount of loans awarded from the Fund, and specified information regarding each loan awarded.

Amends GS 116-37 to require General Fund appropriations for the Program to be deposited in the Fund, with use restricted to the purposes set forth in new Article 2 of GS Chapter 131A. Requires the UNC Health Care System to administer the Program pursuant to new Article 2 in order to further its mission.

Changes the act's titles.