Conference report makes the following changes to the 5th edition.

Part I.
Changes the effective date of Part I from October 1, 2023, to February 1, 2024.

Part II.

Deletes Part II of the act concerning the issuance of an internationally-trained physician employee license.

Part III.

Amends GS 93D-1 by amending the definition of the term fitting and selling hearing aids so that it includes authorizing or ordering the use of, or rental of, hearing aids, and no longer includes the rental, prescription, or order for the use of hearing aids.

Amends GS 93D-1.1 by including in the scope of practice of a hearing aid specialist ordering the use of, authorizing, fitting, and selling prescription hearing aids, as defined by the US FDA, without requiring a consumer to first obtain an order or authorization from another healthcare provider (was, prescribing, or ordering the use of, or fitting and selling hearing aids).

Part V.

Amends proposed GS 90-85.26B to vest authority and responsibility for disciplining dispensing optometrists who fail to comply with the provisions of the statute in both the NC Board of Pharmacy and the licensing board (was, licensing board) having jurisdiction over the dispensing optometrist. Adds that the licensing board having jurisdiction over the dispensing optometrist may discipline the optometrist's license to practice optometry.

Changes effective dates so that Section 5.1 becomes effective October 1, 2023, while Section 5.2 and Section 5.3 (concerning dispensing optometrists) of this act become effective March 1, 2024.

Part VII.

Requires the North Carolina Board of Nursing and the North Carolina Department of Health and Human Services (DHHS), Division of Health Service Regulation, to evaluate the federal requirements applicable to the Nurse Aide I education and training program and, to the extent consistent with the applicable federal requirements, develop a plan for the Board of Nursing to assume responsibility for and provide oversight of all nurse aide programs, regardless of nurse aide title, as individuals in these positions collaborate with nurses and other health care providers to deliver care across all health care settings (was, required the development of a plan to relocate the Nurse Aide I education and training program to the Board of Nursing). Requires a report by September 1, 2024, to the specified NCGA committee on the evaluation of the federal requirements applicable to the Nurse Aide I education and training program and, to the extent consistent with the applicable federal requirements, a plan for the Board of Nursing to assume responsibility for it, a transition time line, and recommendations for statutory changes necessary to transition the Nurse Aide I education and training program from the Department to the Board of Nursing, if appropriate.

Part VIII.

Amends proposed GS 131E-88, law enforcement officers required in emergency departments, as follows. Removes from the definition of law enforcement officer an armed security guard with a valid firearm registration permit. Now requires each licensed hospital that has an emergency department to conduct a security risk assessment and develop and implement a security plan with protocols to ensure that at least one law enforcement officer is present at all times, except when temporarily required to leave in connection with the discharge of their duties, in the emergency department or on the same campus as the emergency department (unless the hospital in good faith determines that a different level of security is necessary and appropriate for any of its emergency departments based upon findings in the security risk assessment). Sets out five components that must be included in the security plan. Sets out requirements of the security plan when a hospital determines that a different level of security is necessary and appropriate. Requires the Department of Health and Human Services to have access to all security plans for hospitals with an emergency department and maintain a list of those hospitals with a security plan.

Amends GS 131E-88.2 as follows. Changes the due date of the collection of data from hospitals about assaults, incidents where patient behavioral health and substance use issues resulted in violence, and workplace violence from September 1 to October 1. Now requires DHHS to compile the information from hospitals and share it with the North Carolina Sheriffs' Association, the North Carolina Association of Chiefs of Police, and the North Carolina Emergency Management Association. Requires DHHS to request that these organizations examine the data and make recommendations to decrease the incidences of violence in hospitals and to decrease assaults on hospital personnel. Clarifies that the first data collection must occur on or before September 1, 2025.

Deletes the proposed changes to GS 95-260, GS 95-269, and proposed new GS 95-269A (violation of order issued upon request of a hospital).

Amends GS 14-34.6 to now make it a Class I felony to commit an assault or affray causing physical injury on the following who are discharging (or attempting to discharge) their official duties: hospital employee, medical practice employee, licensed health care provider, or individual under contract to provide services at a hospital or medical practice (was, hospital employee, licensed health care provider, or individual under contract to provide services at a hospital).

Further amends GS 15A-1340.16 by adding as an aggravating factor the defendant committed the offense on the property of a medical practice, defined as a professional corporation organized under or subject to GS Chapter 55B and registered with the North Carolina Medical Board.

Part IX.

Deletes Part IX concerning modernizing and expanding physician-pharmacist collaborative practice.

Part X.

Amends GS 131E-158 by requiring that the flexibilities permitted under (a1)(1) and (2) (changes allowed to ambulance transportation of patients in a state of emergency) not apply to Non-Emergency Medical Transportation (NEMT) services through May 11, 2024 (was, the North Carolina Office of Emergency Medical Services must continue the emergency waiver flexibilities under (a1)(1) and (2) for 12 months following the expiration of the Public Health Emergency). Requires the DHHS, Division of Health Service Regulation, to work with NEMT stakeholders to develop a permanent plan regarding staffing as included in the waiver.

Adds the following new content.

Part XII.

Amends GS 90-292 to include protection of the public from unqualified persons to the State's declared policy concerning licensing audiologists and speech and language pathologists. 

Modifies and adds to the defined terms set out in GS 90-293. Now defines audiologist to mean any person who is qualified by education, training, and clinical experience and is licensed under Article 22 to engage in the practice of audiology (was more generally any person who engages in the practice of audiology). Adds that an audiologist is an independent hearing health care practitioner providing services in hospitals, clinics, schools, private practices, and other settings in which audiologic services are relevant. Expands on the services a person offers that deem the person to be or hold him or herself out to be an audiologist, including hearing aid audiologist and hearing specialist. Adds that an association, company, or trust is included in the defined term person, and that any reference to a licensed person means a natural, individual person. Replaces the definition given for the practice of audiology, now defining the term to mean the application of principles, methods, and procedures not including non-auditory and non-vestibular testing or writing prescriptions for pharmaceutical agents or surgery, and gives a nonexhaustive list of 19 areas of audiology practice. Expands the practice of speech and language pathology to include evaluation, treatment, and instruction related to the development and disorders of communication and cognitive-communication. Makes technical changes. 

Makes organizational and technical changes to GS 90-294 regarding the exclusion of individuals licensed to fit and sell hearing aids under GS Chapter 93D from the scope of the Article 22. Also excludes from the Article the selling of over-the-counter hearing aids. Amends the exclusion of (1) students or trainees who are students or working in a training center program and (2) nurses or other certified technicians trained to perform audiometric screening tests and whose work is supervised by a physician or audiologist, to specify that the exclusion applies if the student, trainee, or nurse is not registered with the Board of Examiners for Speech and Language Pathologists and Audiologists (Board) as an assistant. Makes further technical changes. Specifies that the provisions of Article 22 do not apply to the selling of over-the-counter hearing aids; provides that the sale of an over-the-counter hearing aid is solely a financial transaction and without additional services does not constitute treatment by an audiologist.

Enacts GS 90-294A to authorize licensed audiologists to treat minors by administering nonmedical audiologic services. Specifies that only individuals licensed to practice medicine or working under the supervision of such an individual, or a person licensed under this Article, can make an assessment of a minor for hearing impairment treatment or manage hearing rehabilitative services for a minor for hearing impairment. Authorizes licensed audiologists to provide clinical treatment, home intervention, family support, case management, and other audiologic services to minors. Further authorizes audiologists to participate in the development of individualized educational programs and consult on individual classroom matters. Authorizes audiologists to administer hearing screening programs in school and train and supervise nonaudiologists performing hearing screening in an educational setting. Specifies that over-the-counter hearing aids are not appropriate for individuals under age 18 and do not apply to this statute.

Amends GS 90-295 to remove the specific hour requirements for certain areas in meeting the clinical experience hours required for permanent licensure as a speech and language pathologist; maintains the 400 hour minimum clinical hour requirement. Also amends the licensure requirements to require the applicant to present written evidence of nine months of full-time professional experience in which clinical work (was, bona fide clinical work) has been accomplished in speech and language pathology.

Amends GS 90-298.1 by amending the requirements for a licensed speech and language pathologist or audiologist to register an assistant to also require that the registration fee be remitted to the Board before the assistant can be registered.

Amends GS 90-299 to also require a person registered with the Board to give the Board written notification of the address of where the person engages in practice. Makes conforming changes to the statute's record keeping and notice requirements. Makes language gender neutral.

Amends GS 90-301 to make the grounds for suspension or revocation of a license under the Article also applicable to persons registered under the Article. Makes conforming changes and makes language gender neutral.

Amends GS 90-303 by removing outdated language related to the Board's membership.

Amends GS 90-304 by amending the Board's powers and duties to require providing a list (was, provide an annual list) stating the names of persons currently licensed under the Article; adds the requirement that the list be provided on the Board's website.

Amends GS 90-305 to make the listed fees also applicable to registered individuals.

Amends GS 90-306 by making a clarifying change.

Makes the above changes effective January 1, 2024.

Allows the Board of Examiners for Speech and Language Pathologists and Audiologists to adopt temporary rules to implement the act.

Part XV.

Requires the following of the new Healthcare Common Procedure Coding System (HCPCS) procedure code G0330, which was adopted by DHB as of January 1, 2023, and incorporated into the Medicaid Clinical Coverage Policy 4A: Dental Services: (1) DHB must not reimburse ambulatory surgical centers based solely on the length of the procedure and requires reimbursement, as of July 1, 2023, so that services billed under procedure code G0330 are reimbursed at 95% of the total payment rate listed on the Medicare Part B Hospital Outpatient Prospective Payment System (OPPS), in effect as of January 1, 2023, and requires the rates to be updated annually starting January 1, 2024, so that services are reimbursed at 95% of the Medicare Part B OPPS payment rate, in effect as of January 1, for that procedure code and (2) all standard benefit plans and BH IDD tailored plans must be required to cover procedures billed under procedure code G0330.

Part XVI.

Defines bar under GS 130A-247 to mean establishment with a permit to sell alcoholic beverages pursuant to subdivision (1), (3), (5), or (10) of GS 18B-1001 and that does not prepare or serve food other than beverage garnishes, ice, or food that does not require time or temperature control for safety and that is in an unopened original commercial package, except for food used as a beverage garnish. Makes conforming changes to GS 130A-250-(1). 

Makes conforming changes to the act’s long title.