Healthcare (Rural Communities)

This bill creates a new Rural Healthcare Infrastructure Fund in North Carolina to help build, repair, and modernize healthcare facilities in rural areas. The fund will provide money through grants and low-interest loans to support construction and renovation projects, while also replacing an older stabilization program. A state council must first develop and get approval for a detailed plan outlining how the fund will be managed and who can apply before any money is awarded. The bill also updates the duties of the state health council and requires annual reports on how the fund is being used.

This bill creates a new grant program in North Carolina to fund public car and shuttle services in rural counties with low population density. Eligible recipients, such as counties and transit authorities, can use the funds to support commuter travel during peak hours or provide on-demand rides for medical appointments and grocery shopping during off-peak times. To receive funding, applicants must secure a local match of at least 50% and ensure that employers contribute a minimum of 20% for peak-hour commuter services. The program is financed by a $30 million appropriation from the Highway Fund and is scheduled to begin on July 1, 2026.

HB 685, the Rural NC Reinvestment Act, allocates $605 million in nonrecurring state funds for rural North Carolina communities during the 2025-2026 fiscal year. It provides grants for water/sewer infrastructure ($200M), law enforcement/fire equipment ($10M), economic development land ($20M), rural school construction ($200M), broadband expansion ($50M), early childhood education ($100M), and physician placement ($5M). Local governments, schools, emergency services, and healthcare providers in rural areas directly receive these funds, with allocations prioritized based on need, efficiency, and community impact. The bill becomes effective July 1, 2025, focusing on tangible infrastructure and service improvements without creating new regulations.