Written by Erin Bennett
On Monday, May 4, 2020, Governor Roy Cooper signed into law two bills aimed at providing pandemic relief to North Carolinians. Senate Bill 704 and House Bill 1043 cover a wide array of supports addressing education, health services, and economic issues, with the House Bill appropriating funding directly to the Department of Health and Human Services[1] to develop programs to support public health initiatives. The allocations can largely be distilled into three categories—health services and relief efforts, pandemic response infrastructure-building, and changes to Medicaid.
Health Services and Relief Efforts
Most of the funding allocated by HB 1043 is earmarked for relief efforts targeting social determinants of health. The NC DHHS will receive $20 million in flexible funding to distribute as needed to support health care service providers who have been affected by the pandemic. Specifically, this funding can be used to supplement the increased costs borne by local health departments, rural health providers, and the State Lab of Public Health. The money can also be used to help behavioral health and crisis services increase their nursing and community health worker capacity, expand telehealth, cover the cost of infection control support and training for nursing and care homes, and support initiatives to divert individuals with behavioral health crises away from emergency rooms. An additional $20 million is allocated directly to providing one-time payments to LME/MCOs to distribute to Intermediate Care Facilities for Individuals with Intellectual Disabilities, and support programs that divert behavioral health patients and those with opioid use disorder from emergency rooms by providing opioid agonist therapies at treatment centers.
$50 million in funding is directed to supporting rural and underserved communities. This money can be distributed in the form of grants to health providers, targeted hardship financial assistance provided by the state Medicaid system, enhanced telehealth services, critical service transportation support, funding for the Office of Minority Health, and health support for the uninsured. For prescription-specific support, NC DHHS has been given $1.5 million to grant to NC MedAssist, a nonprofit that works to provide indigent and uninsured persons access to prescription drugs.
$6 million is to be divided between the state’s six food banks to provide increased food support[2] services during the pandemic. Food banks are also included in a $19 million allocation intended to provide flexible support to residential special assistance homes, adult and child protective services response efforts, shelters for homeless persons and victims of domestic violence, housing security, and child care supports. This allocation also includes a directive to support NCCARE360 expansion and technical support and a $2.5 subsidiary allotment to Reinvestment Partners to support its Produce Prescription Program.
Upwards of $27 million has been allocated to the NC DHHS Division of Social Services (DSS). Of this funding, $290,000 is earmarked for the NC LINKS program to provide housing and transitional support to foster children. A separate $2.25 million is intended to more broadly support children in foster care by providing a supplemental $100/month payment for each child receiving foster care assistance from April 2020 through June 2020. For other populations that fall within the purview of DSS, $25 million is directed to supporting licensed facilities across the state that receive State-County Special Assistance money as they face increased costs of serving their populations during the pandemic. This will be distributed as a payment of $1325 per resident at each facility from March 10, 2020 to July 30, 2020.[3]
Pandemic Response Infrastructure-Building
HB 1043 also contains line items directed toward shoring up North Carolina’s pandemic response. $25 million has been allocated to NC DHHS to expand testing, contact tracing, and analysis efforts. This money is to be used for capacity building for rapid diagnostic and antibody testing across the state, development of a contact tracing workforce, and improving modelling and analysis of pandemic developments to inform state responsive efforts. The disbursement of this funding is contingent on NC DHHS 1) instating ongoing collection and daily posting of all testing conducted across the state, 2) posting information about any private testing vendor with which the state has contracted, 3) collecting and reporting recovery rates, 4) collecting and reporting hospital discharge data including information about underlying conditions of discharged patients, and 5) collecting and reporting COVID-19 deaths including indication of any underlying comorbidities of decedents.
Medicaid Changes
HB 1043 also makes some notable modifications to the state Medicaid program. First, NC Medicaid has been extended to provide COVID-19 testing for eligible uninsured persons for the duration of the pandemic as long as the federal medical assistance percentage is 100% for the testing service. Second, the bill extends the 5% fee-for-service Medicaid rate increase to providers excluded from the §1135 Medicaid Disaster Plan Amendment Request to the waiver requested by the state after the federal emergency declaration. Third, for the duration of the pandemic, application and recredentialing requirements, criminal background checks, and training requirements have been waived for providers applying for enrollment in NC Medicaid or NC Health Choice. Finally, Disabled Adults Child Passalong eligibility has been streamlined.
[1] Note: This post does not cover funding allocated directly to the Office of State Budget and Management
[2] Food banks are encouraged to use this supplementary funding to buy products from North Carolina growers and producers.
[3] For those residents who are transferred during this time, only the first facility of residence can receive the payment.