Requires the Commission for Public Health (Commission) to do the following no later than October 15, 2024. Requires the Commission to begin rulemaking to establish maximum contaminant levels (MCLs), as that term is defined under GS 130A-313 (the North Carolina Clean Water Act), for probable or known carcinogens and other toxic chemicals likely to pose a substantial hazard to public health.  Requires the Commission to establish MCL’s for the following five contaminants: (1) per- and poly-fluoroalkyl substances (PFAS); (2) perfluorooctanoic acid (PFOA); (3) perfluorooctane sulfonate (PFOS); (4) Hexavalent chromium (chromium-6); and (5)1,4-Dioxane. Also requires considering establishing MCLs for any other contaminants for which at least two other states have set MCLs or issued guidance.

Directs the Commission to review certain materials during rulemaking, and annually review these materials thereafter to determine if the MCL’s should be modified. Specifies that the MCL’s must be protective of public health including vulnerable subpopulations such as pregnant and nursing mothers, infants, and children, which state MCLs shall not exceed any MCL or health advisory established by the United States Environmental Protection Agency.

Effective July 1, 2024, appropriates $6 million in recurring funds from the General Fund to the Department of Health and Human Services for 2024-25 to carry out the act's requirements. Allows using the funds to establish up to 37 FTE positions.