HB 1045, known as the Fair Wages in Health Care Act, establishes minimum hourly wages for five specific direct care occupations in North Carolina: home care aides, direct support professionals, certified nursing assistants, psychiatric aides, and licensed practical nurses. The bill sets wage floors ranging from $18 to $24 per hour depending on the role, with protections against employers using different job titles to avoid paying the required rates. To help healthcare providers meet these new costs, the Department of Health and Human Services must adjust reimbursement rates for publicly funded programs and update contracts with managed care organizations. The law takes effect on October 1, 2027, and applies to all employers in the state, regardless of whether they are public or private entities.
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 North Carolina legislation aims to reduce healthcare expenses and boost competition by adding a low-cost plan option to the state's insurance marketplace. It establishes a purchasing consortium for public entities to negotiate better rates and allocates funds for chronic disease prevention initiatives. The bill also removes regulatory barriers for rehabilitation facilities and limits hospital consolidation to maintain market diversity. These provisions impact residents seeking coverage, public employers, healthcare providers, and hospital systems within the state.
HB 979 updates North Carolina's system for volunteer advocates supporting nursing home residents. It requires nursing homes to not impede designated volunteer ombudsman representatives who help residents report concerns without fear of retaliation. The bill formalizes that these volunteers must be certified and designated by the State Long-Term Care Ombudsman Program, and establishes new rules for community advisory committees in counties with nursing homes. This directly affects nursing home residents, facilities, and the state's oversight program by strengthening resident advocacy mechanisms.
HB 343 appropriates $380,000 for 2025-26 and $397,000 for 2026-27 to create four full-time ombudsman positions within North Carolina’s Long-Term Care Ombudsman Program. This directly affects residents of nursing homes, adult care homes, and family care homes by enhancing advocacy for their rights and care quality. The bill’s key provision funds staff to move the state’s program toward national standards for resolving facility issues without formal complaints. It becomes effective July 1, 2025, with no advocacy language - only a concrete funding mechanism for expanded protections.
SB 379, the Senior Care Assurance Act, expands healthcare access for North Carolina seniors (65+) by enhancing Medicaid coverage for preventive screenings and chronic care services. It creates two new programs: a $2.5 million annual grant program to fund free health screenings and geriatric care for low-income seniors (at or below the federal poverty level), prioritizing rural and underserved areas, and a $2 million annual program to help seniors purchase telehealth equipment and internet access, with priority for rural seniors. The bill also updates telehealth infrastructure funding to support rural healthcare providers in establishing telehealth services. These provisions directly benefit seniors facing financial or geographic barriers to care, focusing on preventive health and independent aging.
SB 362 appropriates $1 million annually from 2025-2027 to strengthen North Carolina's Long-Term Care Ombudsman Program. It funds $855,000-$893,250 yearly for nine new regional ombudsman positions targeting areas with the greatest need, plus $145,000-$106,750 for operational costs like equipment and transportation. The bill also mandates a study by the Department of Health and Human Services to recommend statutory changes improving the ombudsman program and its volunteer Community Advisory Committees. These changes directly support long-term care residents and their advocates by increasing staffing and program capacity, effective July 1, 2025.
SB 699 would expand Medicaid coverage for personal care services to adults living in licensed adult care homes who earn more than the standard income limit for state assistance but stay below 180-200% of the federal poverty level. It specifically targets individuals who would otherwise qualify for state-funded care but exceed income thresholds, aiming to provide alternatives to nursing home placements. The bill requires North Carolina's health department to request federal approval from CMS within 90 days, ensuring new coverage is fully offset by cost savings and meets all legal requirements. Implementation would only occur if CMS approves the request and all goals in the bill are met.
HB 513 appropriates $1 million annually from the General Fund to fund North Carolina's Long-Term Care Ombudsman Program through fiscal years 2025-2027. It allocates $855,000 yearly to create nine new full-time Regional Ombudsman positions in areas most needing support, as determined by the State Ombudsman, to help meet national staffing standards. The remaining funds cover operational costs like equipment, supplies, and transportation for existing program staff. This directly benefits long-term care residents by expanding access to ombudsman services that address facility concerns and advocate for their rights.
HB 591, the G.U.A.R.D. Act, allows residents of nursing homes and adult care facilities in North Carolina to install and use their own electronic monitoring devices (like cameras or audio recorders) in their rooms at their own expense. The bill requires facilities to provide power, mounting space, and not deny admission or discharge based on a resident's request for monitoring. Recordings from these devices can be used as evidence in court, and facilities face fines or jail time for violating the law. The act directly affects residents and their families by giving them greater control over monitoring their living environment while protecting facility obligations.
