Enacts new Article 43, Peer Support Specialist Certification Act, in GS Chapter 90, providing for the following. Provides that the purpose of the Article is to protect the public safety and welfare by certifying individuals to provide peer support services, including Medicaid or State-funded peer support. Prohibits a person from claiming or holding out oneself to the public as certified under the provisions of this Article unless the individual possesses a current certification as a peer support specialist.

Establishes the 11-member North Carolina Peer Support Specialist Certification Oversight Board (Board). Establishes member appointment authority and requirements and sets out qualifications to be met by a member who is a certified peer support specialist. Sets out the Board's 14 powers and duties, including: deny, issue, suspend, revoke, and renew certifications in accordance with the provisions of this Article; conduct administrative hearings in accordance with Article 3A of GS Chapter 150B; develop standards for curricula certifications and standards for accreditation; develop and maintain a Board website that includes an online complaint filing system and procedure; and submit an annual report to the Department of Health and Human Services.

Requires applicants for certification as a peer support specialist to: (1) be 18 or older; (2) have a lived experience of a mental health or substance use disorder; (3) have been in recovery for at least one year; (4) have completed a training course approved by the Board; (5) paid any applicable fees; (6) provide written proof to the Board of a high school diploma or its equivalent; and (7) submit a completed application, with two letters of reference, provided by the Board for certification under this Article. Requires individuals certified under this Article to renew certification every two years through the submission of an approved application; certifications expire two years after the date of issuance unless they are renewed. Provides that after the first two years, a certification is to be renewed every two years on or before the date of birth on the certification. Sets out criminal background check requirements for applicants. Keeps information provided for the the background check confidential and allows charging a fee for the background check. Provides that if the Board denies, revokes, or suspends a certification based on information obtained in a criminal history record check, the Board must disclose to the person the information contained in the criminal history record check that is relevant to the Board's actions. Gives the person the right to appear before the Board to appeal the Board's decision; an appearance before the Board constitutes an exhaustion of administrative remedies in accordance with GS Chapter 150B. Sets out fees for: application for certification, application processing, examination, application for specialization, renewal of certification, renewal of specialization, late fee, and duplicate of original certification.

Provides that the Article does not prevent: (1) an individual from conducting activities or services in offering peer-to-peer support; (2) physicians, psychologists, or other licensed professionals or practitioners from engaging in scope-of-practice activities; (3) fee-based pastoral counselors, clergy, family partners peer support, or other qualified professional group members from providing peer support and other related services; or (4) any individual participating in working with or participating in 12-step programs, assistance programs, or other related programs that provide support services.

Allows the Board to seek an injunction against a person violating or seeking to violate the Article. Allows the Board to assess a civil penalty not to exceed $100 for violations of the Article; sets out issues to be considered when fixing the penalty amount. Requires the Board to establish a schedule of civil penalties for violations of this Article. Allows the Board to assess the costs of disciplinary actions against a person found to be in violation of this Article or rules adopted by the Board. Makes violations of the Article a Class 2 misdemeanor. Provides civil immunity to the Board and its officers, employees, and staff, either personally or in their official capacity, for exercising, in good faith, the powers and duties given to the Board under this Article for denying certification or reinstatement of a certification to an applicant or revoking a certification based on information provided in the applicant's criminal history record check.

Effective October 1, 2023.

Requires the Board to adopt temporary rules to implement this act, which will remain in effect until permanent rules that replace the temporary rules become effective. Requires the initial Board appointments to be made on or before October 1, 2021, with the initial terms of the appointees beginning on January 1, 2022.

Deems any individual who possesses a certification as a peer support specialist issued by the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services prior to this act becoming effective, to be in compliance with the act's provisions for the two-year period of that individual's certification. Requires those individuals to comply with the act's provisions when renewing their certifications when this act becomes effective.