S425 - Health and Human Services Omnibus. (SL 2024-34)

Overview: S.L. 2024-34 makes various changes to the laws on health and human services.

Aging and Adult Services. - The act does the following:

• Clarifies the manner of service of the petition and notice of hearing to a disabled adult regarding the provision of adult protective services. (Section 1)

Children and Families. – The act does the following:

• Amends the definition of family child care home to include a child care arrangement where more than two children and less than 11 children, previously 10 children, receive child care in a residence. (Section 2)
• Extends unlicensed kinship care to half-siblings of relative children. (Section 4)
• Clarifies that a first responder to whom an infant can be temporarily surrendered must be on duty. (Section 5)
• Allows application by a director of a county department of social services to the court for limited custody of a surrendered infant upon initiation of notice by publication, instead of waiting for the completion of the notice by publication. (Section 6)
• Updates guidelines for trauma-informed standardized assessments. (Section 7)
• Directs the Division of Child Development and Early Education (DCDEE), Department of Health and Human Services (DHHS), to revise the Quality Rating Improvement System (QRIS) by creating alternative pathways for child care facilities to earn a license of two to five stars and to adopt or amend rules to implement the alternative pathways. The alternative pathways can be focused on (i) program assessment, (ii) classroom and instructional quality, (iii) accreditation, or (iv) any other pathway designated by the North Carolina Child Care Commission. A child care facility is not required to undergo a QRIS assessment by DCDEE until rules implementing the new QRIS pathways become effective. (Section 8)
• Amends the 2023 Appropriations Act by providing that the State portion of the funding for the Tri-Share Child Care pilot program does not revert at the end of the 2023-2025 fiscal biennium and remains available for costs associated with the Tri-Share Child Care pilot program. The North Carolina Partnership for Children must design the Tri-Share Child Care pilot program, establish the program infrastructure, and recruit participating child care providers and employers. (Section 15)

Medicaid. - The act does the following:

• Extends the temporary authority of the federally facilitated marketplace to make North Carolina Medicaid eligibility determinations until June 30, 2025. (Section 9)
• Extends the managed care exemption for justice-involved individuals so that prison inmates, who are currently exempt from enrolling in prepaid health plans, will remain exempt for up to a year after release from prison. The same exemption will apply to inmates in jails and other carceral settings who have had their Medicaid eligibility suspended. (Section 12)

Mental Health, Developmental Disabilities, and Substance Use Services. - The act does the following:

• Encourages DHHS and local management entity/managed care organizations (LME/MCOs) to enter into intergovernmental agreements with the Eastern Band of Cherokee Indians to facilitate the use of tribal health facilities for the voluntary admission or involuntary commitment of North Carolina residents to those facilities and requires reporting by February 1, 2025, on any proposed legislative changes to further facilitate this use of tribal health facilities. (Section 14)
• Requires the area director of Trillium Health Resources (Trillium) to submit to the Secretary of DHHS a new alternative board structure for Trillium. The Secretary can approve the new alternative board structure and appoint the initial board members without each county in Trillium's catchment area adopting a resolution approving the board structure or appointing the board members, notwithstanding statutory requirements. (Section 16)

Hospitals and Healthcare Facilities. - The act does the following:

• Amends references to the East Carolina University Regional Behavioral Health Facility to be consistent in the 2023 Appropriations Act. (Section 10)
• Amends the Hospital Violence Act to create an exemption until June 1, 2025, from the requirement to have a law enforcement officer present in the emergency department for hospitals that submit a security risk assessment, along with other specified criteria, to DHHS by October 1, 2024. (Section 11)
• Grants the authority to establish a campus law enforcement agency within the Board of Directors of the University of North Carolina Health Care System (Board) and updates the powers of the Board to include the authority to engage legal counsel, including private counsel, for any matter the Board deems necessary; and creates G.S. 131E-14.3 within Article 2 of Chapter 131E of the General Statutes to allow the lease or sale of hospital facilities to certain political subdivisions. (Section 13)

Public Health. – The act does the following:

• Amends the minimum education and experience qualifications required for a local health director to include a bachelor's degree in a field related to public health and at least seven years of experience in health programs that include three years of supervisory experience. (Section 3)

General Health Provisions. - The act does the following:

• Makes various changes to the Review Panel of the North Carolina Medical Board, including setting term limits. (Section 17)

This act has various effective dates. Please see the full summary for more detail.