By Michelle Ries, MPH

During the 2021 North Carolina General Assembly session, the staff of the NCIOM has been monitoring legislation related to recent task force recommendations and other NCIOM work. Below is a listing of selected legislation from the 2021 legislative session and related NCIOM work.

While only one bill listed below passed crossover by the May 13 deadline, NCIOM will continue to watch the General Assembly for additional legislative action on these recommendations.

Task Force on Perinatal System of Care/Task Force on Maternal Health

The recent NCIOM Task Force on Perinatal System of Care, convened in partnership with the Women’s and Children’s Health Section, Division of Public Health, NC Department of Health and Human Services, developed recommendations to ensure that pregnant women and high-risk infants have access to appropriate levels of care through a well-established regional perinatal system of care for the state.

The current NCIOM Task Force on Maternal Health brings together stakeholders and experts from across North Carolina to identify evidence-based solutions for improving maternal health outcomes and to guide and develop a Maternal Health Strategic Plan for the state.

The bills below relate to the Task Force on Perinatal System of Care and the Task Force on Maternal Health.

House Bill 316: Support Maternal Health/Extend Medicaid Coverage (did not pass crossover)

Senate Bill 530 Medicaid for 12 Months Postpartum (did not pass crossover)

These bills would provide NC Medicaid coverage for Medicaid-eligible women for 12 months postpartum (an increase from current coverage of 60 days postpartum).

House Bill 488/Senate Bill 393: Analysis of Doula Support Services and Medicaid Coverage (did not pass crossover)

This bill would require the NC Department of Health and Human Services to conduct a statewide analysis of doula support servers, promote doula services, and provide Medicaid coverage for doula services.

Senate Bill 632: North Carolina Momnibus Act (did not pass crossover)

This bill would: establish the Social Determinants of Maternal Health Task Force within NCDHHS; create the Maternal Mortality Prevention Grant Program to award competitive grants for the prevention of maternal mortality and severe maternal morbidity among Black women; require NCDHHS to create or identify an evidence-based implicit bias training program for health care professionals involved in perinatal care; establish certain specified rights of perinatal care patients; provide appropriations to NCDHHS to support data collection, surveillance, and research on maternal health as a result of the COVID-19 public health emergency; require DHHS to provide the public with evidence-based public health information and education about COVID-19 and pregnancy; and establish the Task Force on Birthing Experience and Safe Maternity Care During a Public Health Emergency within NCDHHS to develop recommendations on respectful maternity care during the COVID-19 public health emergency and other public health emergencies.

For more on legislation related to maternal and infant health, please see previous blog post here.

Task Force on Serious Illness Care

The NCIOM Task Force on Serious Illness Care developed a workable plan to meet the needs of individuals living with serious illness and their caregivers across the state of North Carolina, including recommendations on advance care planning, palliative and hospice care, workforce development, home- and community-based services, and caregiver supports. NCIOM also convened a work group following the completion of the task force, to synthesize additional findings and research to inform legislative action on advance directives. The bills below relate to recommendations from the Task Force on Serious Illness Care.

Senate Bill 666: Updating Requirements for Advance Directives (did pass crossover to House)

This bill would update requirements for completing health care powers of attorney documents, including changing requirements to two qualified witnesses or a notarization (both are currently required), and authorize the Secretary of State to receive electronic filings of advance health care directives.

Senate Bill 680: Remote Notarization Act (did not pass crossover)

This bill would allow for remote notarization of advance health care directives.

Essentials for Childhood/Children’s Social Emotional Health

The Essentials for Childhood initiative focuses on implementation of a public health-centered framework for child maltreatment prevention, including improvements to child and family services, family friendly workplace policies, and economic supports for families. The NCIOM Task Force on the Mental Health, Social, and Emotional Needs of Young Children and Their Families developed recommendations to ensure that there are systems and services in place to meet the mental, social, and emotional health needs of young children ages 0-5 and their families. The bills listed below relate to these initiatives.

Senate Bill 703: Strengthen Child Fatality Prevention System (did not pass crossover)

This bill would create a State Office of Child Fatality Prevention and appropriate funding to support the office; implement a centralized electronic data and information system; change the types of deaths required to be reviewed; combine functions of four current types of review teams into one local team; formalize Child Fatality Task Force functioning and expand reporting; and require DSS to create at least three federally required Citizen Review Panels.

Senate Bill 633/House Bill 505: North Carolina Healthy Pregnancy Act (did not pass crossover)

This bill addresses pregnancy-related discrimination in the workplace and articulates the requirements for a qualified  pregnant person requesting reasonable workplace accommodations and for an employer providing them.

Senate Bill 457/House Bill 596: Healthy Families & Workplaces/Paid Sick Days (did not pass crossover)

This bill would ensure all workers have paid sick days to care for themselves or their families.

House Bill 875: Enact KinCare and Safe Days (did not pass crossover)

This bill would allow employees to use sick days to care for ill family members or if they miss work as the result of stalking, domestic violence,  or sexual violence experienced by themselves or family members.

Senate Bill 576: Recovery Rebate for Working Families Act (did not pass crossover)

This bill would reinstate the Earned Income Tax Credit.

House Bill 574: Revise Child Care Subsidy Rates (did not pass crossover)

This bill would increase child care subsidy rates to the 75th percentile (as recommended by the 2018 Child Care Market Rate Study) for children from birth through 5 years of age in three-, four-, and five-star-rated child care centers and homes.

Task Force on Mental Health and Substance Use

The NCIOM Task Force on Mental Health and Substance Use developed recommendations to increase and improve community-based and evidence-informed prevention, treatment, and recovery services and supports for individuals with mental health and substance use disorders.

Senate Bill 154L: Fully Fund School Social Workers and Psychologists (did not pass crossover)

This bill would appropriate funds each year from FY 2021-2022 to 2030-2031 to the instructional support allotment for the purpose of increasing positions for school social workers and psychologists to meet target ratios (set out in the bill) for each of those 10 years. The appropriation for each year is different, ranging from $50.8 million to $508 million.

Cross-Cutting NCIOM Recommendations

Several recent NCIOM task forces, including the Task Force on Serious Illness Care, the Task Force on Perinatal System of Care, and Healthy NC 2030, have recommended increasing access to affordable health care for uninsured North Carolinians. The bills below aim to close the health insurance coverage gap.

House Bill 470: Medicaid Expansion (did not pass crossover)

Senate Bill 402: Close the Medicaid Coverage Gap (did not pass crossover)

Both bills would expand Medicaid eligibility to 133% of the Federal Poverty Level. The House bill would be paid for using hospital assessment funds; the Senate bill uses American Rescue Plan funds. More on Medicaid eligibility and expansion here.