North Carolina General Assembly Week in Review

December 10, 2021

Pardon Our Dust

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The General Assembly was not in session this week. In today’s newsletter we provide a brief recap on redistricting with recent newsworthy updates and give a comprehensive rundown of the health-related policies and appropriations from the recently passed biennial budget.

Following the Thanksgiving holiday, COVID cases have continued to rise. As of this morning, in the state of North Carolina, there were 4,153 confirmed cases of the coronavirus, up over 400 cases from last week. There are 1,473 individuals hospitalized, and sadly, 18,955 confirmed deaths – both metrics up by just over 200 from last week. 73% of the total adult population has been vaccinated.

As we all continue to feel the effects of the global pandemic and adjust to a new normal, we want to highlight a few ways our clients across North Carolina have worked to support residents and make this time a little easier for those throughout the state. Read more about what our clients are doing to help by clicking here.

For more information on COVID-19 in North Carolina, click here to visit the Department of Health and Human Services website, and be sure to stay up to date on the latest federal guidelines issued by the Centers for Disease Control and Prevention (CDC) by clicking here.


Congressional and Legislative district lines that passed out of the legislature last month are being litigated in state court. Like a turkey on Thanksgiving, it’s become somewhat of a tradition over the last five decades, under Democrat and Republican-controlled legislatures alike, for district lines in North Carolina to ultimately be settled in the courts.

Over the past seven days, four separate judges have ruled on the Congressional and Legislative maps passed last month by the General Assembly. There are currently several cases challenging separate components of redistricting before the courts, at different levels in the judicial circuit.

On Wednesday, the NC Supreme Court halted candidate filing, which started Monday, and moved the primary date back two months to May 17. The trial court, which will make the first ruling, was given until January 11 to hear the cases. In the coming weeks we will have an in-depth look at the current redistricting cycle and the potential ramifications on the 2022 election and beyond.

2021 Budget – Health Policy

Just hours after the bill made it to his desk last month, Governor Roy Cooper (D) signed SB 105: 2021 Appropriations Act into law. Overall, the budget spends a total of $25.9 billion FY 2021-22 and $27 billion in FY 2022-23, which is almost $1.1 billion more than the previous operating budget and is a 4.7% increase over the last state budget that was enacted in 2017.

The Health and Human Services portion of the budget spends roughly $5.8 billion in FY 2021-22 and $6.3 billion in FY 2022-23, including:

  • Creates the Joint Legislative Committee on Access to Healthcare and Medicaid Expansion which will study various ways to improve access to health care and health insurance for North Carolinians, including, but not limited to, Medicaid Expansion. The committee will be made up of nine Senate members and nine House members and will meet next year during the interim.
  • Extends Medicaid coverage for pregnant women for 12 months postpartum through March 31, 2027.
  • Waives the $100 fee for providers revalidating enrollment or enrolling the North Carolina Medicaid program or the NC Health Choice program for the biennium.
  • Increases the copayments for Medicaid services to $4.00 starting July 1, 2022.
  • Provides $1,000 bonuses to all full-time state employees plus an additional $500 bonus to various employee groups, including employees of DHHS who work in a 24-hour residential or treatment facility.
  • Provides the funding needed to increase NC Pre-K rates for childcare centers by 2% in FY 2021-22 and by an additional 2% in FY 2022-23.
  • $15M for rapid rehousing for individuals and families at risk of homelessness.
  • $3.6M in FY 2021-22 and $5.76M in FY 2022-23 for the House and Community Care Block Grant (HCCBG) to provide in-home and community-based services for older adults and their primary caregivers. This will reduce the HCCBG waitlist by an estimated 1,500 individuals.
  • $2M each year of the biennium for the Key Rental Assistance Program.
  • $7.5M for Camino Community Development Corporation, Inc. for mobile unites to support service delivery.
  • $500,000 to the City of Winston-Salem to create a Hospital-Based Violence Intervention Program in response to the COVID-19 pandemic.
  • $375,232 for the Duke University Hospital-Based Violence Intervention Program in response to the COVID-19 pandemic.
  • $15M to the North Carolina Association of Free & Charitable Clinics to respond to the public health emergency by supporting member clinics.
  • $10M to the Office of Rural Health to establish a competitive grant program to support virtual behavioral health services.
  • $1M to Atrium Health to provide school-based virtual health services in Anson County and Winston-Salem/Forsyth County school districts.
  • $1.5M to fund the NC Statewide Telepsychiatry Program.
  • $1.2M to NC MedAssist to provide additional prescription assistance services.
  • $4M in the first year of the biennium for the Rural Health Loan Assistance Repayment Program to help recruit doctors, physician assistants, dentists, nurse practitioners, and certified nurse midwives to rural areas.
  • $125,000 for Ashe Memorial Hospital.
  • $150,000 for Cabarrus Public Health Interest.
  • $250,000 for Cumberland HealthNET.
  • $250,000 for the Free Clinic of Rockingham County, Inc.
  • $300,000 to Davidson Medical Ministries, Inc.
  • $5M to Atrium Health to support the development of a federally qualified health center in Cleveland County.
  • $500,000 to Healthreach Community Clinic.
  • $575,000 to Local Start Dental, Inc.
  • $200,000 to the North Carolina Dental Society Foundation.
  • $500,000 to The Stedman-Wade Health Services, Inc.
  • $400,000 in FY 2021-22 and $350,000 in FY 2022-23 to fund the development and implementation of a two-year pilot program in Cumberland County to provide health care and job training services to veterans.
  • $700,000 in both years of the biennium to be split equally among North Carolina Senior Games, Inc., Special Olympics North Carolina, Inc., and Cross Trail Outfitters of North Carolina.
  • $1.5M to the North Carolina Medical Society to fund the creation of a continuing education program on PANS and PANDAS.
  • $300,000 to the North Carolina Healthcare Quality Alliance to promote and facilitate the improvement of health care delivery across the state.
  • $100,000 to Meg’s Smile Foundation, Inc.
  • $3.9M in FY 2021-22 and $25.9M in FY 2022-23 to fund an additional 1,000 innovations waiver slots.
  • Transfers $500,000 in FY 2021-22 and $1M in FY 2022-23 from the HCBS Fund to fund at least 114 additional slots in the Community Alternatives Program for Disabled Adults (CAP/DA) Medicaid waiver.
  • Provides $4.3M in FY 2021-22 and $6.5M in FY 2022-23 from the HCBS Fund to add additional slots for Medicaid Home and Community-Based Waiver Programs.
  • $33.9M in FY 2021-22 and $68.1M in FY 2022-23 to fund an increase in direct care worker wages through the HCBS Fund.
  • Increases the Medicaid reimbursement rate for private duty nursing services to $11.25 per 15 minutes ($45/hour).
  • $159.1M in FY 2021-22 and $65.3M in FY 2022-23 to fund the state share of costs associated with the run out of Medicaid and NC Health Choice fee-for-service claims.
  • $133.1M in FY 2021-22 and $119M in FY 2022-23 to fund the transition to Medicaid managed care and the Healthy Opportunities pilot program.
  • $3M to fund an adult care home accreditation pilot program.
  • $12.6M from the State Fiscal Recovery Fund to local management entities/managed care organizations (LMA/MCOs) for temporary funding assistance for intermediate care facilities for individuals with intellectual disabilities (ICF/IID) services.
  • $25M from the State Fiscal Recovery Fund for Forsyth & Mecklenburg Counties crisis behavioral health joint partnerships with local hospital systems, behavioral health crisis centers, emergency services providers, and LME/MCOs.
  • $2.5M from the State Fiscal Recovery Fund to replace the Incident Response Improvement System.
  • $15,077,155 in each year of the biennium to complete the phased-in implementation of the Transitions to Community Living Initiative (TCLI).
  • $1.5M for a behavioral health urgent care pilot program at Dix Crisis Intervention Center.
  • $20M in FY 2021-22 and $30M in FY 2022-23 for technology upgrades and electronic health record system development at state-operated healthcare facilities.
  • $10M in each year of the biennium for group home stabilization and transition.
  • $500,000 to Partners Health Management for Surry County addiction treatment services.
  • $5M in each year of the biennium for Hope Alive.
  • $100,000 in each year of the biennium to Aces for Autism.
  • $250,000 to Hope Restorations.
  • $500,000 to Wilkes Recovery Revolution.
  • $500,000 to GiGi’s Playhouse.
  • Provides the remainder of the $3.1M total funding to Johnston Health Enterprises to fund the construction of mental health treatment beds.
  • Transfers the remainder of the $2.55M in total funding to Good Hope Hospital to construct mental health treatment beds in Harnett County.
  • Provides the rest of the total $8M in funding for Harnett Health System to construct mental health treatment beds at Betsy Johnson Hospital.
  • $36M for local health departments to expand communicable disease surveillance, detection, control, and prevention activities.
  • $150M from the State Fiscal Recovery Fund for lead and asbestos remediation in school and childcare facilities.
  • $3.2M in each year of the biennium to the Human Coalition for a statewide expansion of the Continuum of Care Pilot Project.
  • $1.5 in each year of the biennium to fund the Nurse-Family Partnership.
  • $13M from the North Carolina settlement with Juul Labs, Inc. to establish the Youth Electronic Nicotine Dependence Abatement Fund.
  • $10M in FY 2021-22 and $5M in FY 2022-23 for Child Advocacy Centers.
  • $2M both years of the biennium for the Permanency Innovation Initiative which works to improve permanency outcomes for children living in foster care settings.
  • $600,000 to the Foster Care Transitional Living Initiative Fund for Youth Villages.
  • $300,000 to fund the implementation of a child welfare and behavioral health pilot project.
  • $300,000 to the National Multiple Sclerosis Society to provide home modification services and home modification assistance grants.
  • $400,000 each year of the biennium for the North Carolina Assistive Technology program.
  • $20M for HVAC updates at various state-operated health facilities
  • $1.6M for a New Broughton Hospital Maintenance Facility.
  • $5M to Healing Transitions for the construction of a recovery center and purchase of recovery beds.
  • $21.5M in FY 2021-22 and $53.75M in FY 2022-23 to fund the construction of a new ECU Brody School of Medicine.
  • $17M in FY 2021-22 and $13M in FY 2022-23 to Cabarrus County for a new regional behavioral health crisis service center.
  • $30M to the North Carolina Policy Collaboratory to award research grants to monitor, assess, and address the public health and economic impacts of the COVID-19 pandemic.
  • $40M to be distributed equally among the six North Carolina food banks to meet the increased demand caused by the pandemic.
  • $8.5M for the hardware and infrastructure costs associated with the growth of the HealthConnex system.
  • Allows parents of children temporarily placed into the child welfare system to retain Medicaid eligibility if the parent is making reasonable efforts to comply with the court-order reunification plan.
  • Modifies the Certificate of Need exemption for Legacy Medical Care Facilities to allow a person seeking to operate a Legacy Medical Care Facility to request an additional extension of by time by which the facility must be operational in order to be exempt from CON review.
  • Exempts construction of a new general acute care hospital from Certificate of Need review so long as the county has a total population between 40,000 and 50,000, total land area under 460 square miles, the county contains a portion of a city located in more than one county, and the county is located along the state’s border with another state.

Legislative Meetings

There will be no legislative meetings next week.