This bill allocates $6.5 million in one-time funding to North Carolina's Department of Health and Human Services to cover increased administrative costs within the Medicaid program. The money will be distributed to county departments of social services to help them manage expenses resulting from recent federal changes. The legislation allows these funds to be used without requiring additional state reporting that would normally be needed for such financial transfers. Effective retroactively from July 1, 2025, the act aims to ensure counties have the necessary resources to handle their Medicaid administrative duties.
HB 1183, titled 'Defend NC,' prohibits North Carolina law enforcement agencies and officers from assisting U.S. Immigration and Customs Enforcement in arrests or serving removal warrants. The bill also directs state agencies to explore alternatives for health and education funding lost due to federal cuts and mandates a study to potentially create a new state health research institute. Additionally, it temporarily exempts certain tariff-affected goods from sales tax in 2026 and includes general statements of intent to protect Medicaid eligibility and uphold federal promises to North Carolinians.
This bill aims to improve support for people with intellectual and developmental disabilities in North Carolina through three main changes. It mandates a minimum wage increase of $18 per hour for direct care workers by raising Medicaid reimbursement rates for providers and facilities, with funds appropriated starting in fiscal year 2026-2027. Additionally, the legislation adds at least 1,000 slots to the state's Medicaid waiver program and requires the creation of a ten-year plan to address unmet service needs. Finally, it seeks to remove income and asset limits for the state's Medicaid buy-in program for workers with disabilities, allowing more individuals to qualify for coverage regardless of their earnings or savings.
This bill expands North Carolina Medicaid coverage to include doula services during pregnancy and the postpartum period while establishing a licensing system for certified professional midwives and birth centers. To support these changes, the state will seek approval from the federal government to cover doula care, create a new council to oversee midwife licensing, and appropriate funds to reimburse doulas and assist the workforce. The legislation defines specific skills doulas must possess, such as newborn care and cultural awareness, and sets up a regulatory framework that distinguishes licensed midwives from other healthcare providers like nurses and physicians.
HB 1138, known as the Aging With Dignity Act, aims to improve long-term care for older North Carolinians by prioritizing home-based services over institutional care for Medicaid beneficiaries aged 55 and older. The bill mandates that institutional placement be the exception rather than the rule, requiring documented medical justification and regular reassessments to ensure individuals remain in the most integrated setting possible. It also establishes a requirement for periodic medication reviews to prevent adverse drug interactions and reduce hospitalizations, while integrating behavioral health services into geriatric care plans. Additionally, the legislation appropriates funds for strategic investments in the state's aging infrastructure and reestablishes a study commission to address the needs of the growing senior population.
This bill expands sales tax exemptions in North Carolina for specific nonprofit organizations and adds a new exemption for diapers and incontinence underpads prescribed by Medicaid providers. It clarifies which types of nonprofits, such as hospitals and certain 501(c)(3) groups, qualify for tax-free purchases of goods and services needed for their operations, while explicitly excluding certain utility services and liquor. The legislation also establishes a formal application process requiring nonprofits to obtain an exemption number from the state and imposes liability for back taxes if the exemption number is misused. Additionally, the bill modifies ownership rules for property used by charities and sets annual dollar limits on the total tax exemptions and refunds available to eligible entities.
This bill directs the North Carolina Department of Health and Human Services to add 1,000 slots to the state's Medicaid Innovations Waiver, which provides alternative care options for individuals with disabilities. To support this expansion, the legislation appropriates $36.2 million in recurring funds from the state's General Fund starting in the 2026-2027 fiscal year. The changes are scheduled to take effect on July 1, 2026, allowing more eligible residents to access services under the waiver program.
SB 704, the "Ronnie Long No Cap Act," removes the $750,000 cap on compensation for exonerees in North Carolina, replacing it with $50,000 per year of wrongful imprisonment. It also requires the state to seek federal approval for Medicaid coverage without income or asset limits for exonerees and mandates the Department of Adult Correction to provide tailored transition services (including housing and employment support) with a $25,000 per person spending limit. The bill directly affects individuals exonerated after wrongful convictions, such as Ronnie Long (44 years incarcerated), by expanding financial compensation, healthcare access, and reintegration support. These provisions apply to exonerees released after the bill's effective date, with compensation retroactive for living individuals.
HB 491 prepares North Carolina's Medicaid program to implement work requirements if authorized by the federal Centers for Medicare and Medicaid Services (CMS). It requires the state's Division of Health Benefits to negotiate with CMS, notify oversight committees within 30 days of starting talks, and submit detailed reports after CMS approves any work requirements plan. The bill does not enact work requirements itself but establishes procedures for future implementation, including timelines for reporting funding needs. This would directly affect current Medicaid recipients if CMS approves work requirements, though the bill is procedural and conditional on federal approval. The legislation is currently in committee review and has not yet become law.
HB 933 increases Medicaid rates to ensure direct care workers for people with intellectual or developmental disabilities earn at least $18 per hour, affecting home/community providers, group homes, and waiver programs like NC Innovations. It adds 1,000 slots to the NC Innovations waiver program (with $36 million in annual state funding) and requires a 10-year plan to address unmet service needs. The bill also removes income and resource limits for Medicaid eligibility under the Health Coverage for Workers with Disabilities program. These changes take effect July 1, 2025, with $183 million in annual state funding supporting the wage increases and $36 million for new waiver slots.
