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By Rose Hoban

Crossover is the deadline by which legislators must get policy-focused bills passed through one chamber of the General Assembly, lest it die for the rest of the biennium.

This year, the crossover deadline was midnight on April 27, which made for many late nights last week on Jones St.

This year’s session started slowly, with lawmakers taking their time to process bills through committees, where much of the work on amending and crafting bills occurs. But because of the General Assembly’s slow pace in February and March, the latter half of April was often frenetic and even chaotic. In one Rules committee meeting on April 26, 36 bills were debated and voted on in 90 minutes. Some of those bills were complicated, such as the Pharmacy Patient Fair Practices Act. Others in that meeting were controversial, such as the Uniform Voting Hours Act, which would take away county Boards of Elections’ ability to make independent decisions about voting times in their communities.

Many of the health care bills passed last week had a narrow scope. Nonetheless, for those affected by these bills, they are of great importance.

HB 657 Improve Adult Care Home Regulation

This legislation tightens language for adult care home regulation including not issuing an adult care home license to someone whose license has been revoked in the past and studying the effectiveness of the star-rated certificate program. The bill was hashed out between lawmakers and multiple stakeholders.

A number of bills pertaining to adult care homes, such as one to establish mandatory dementia care training and another one to increase personal care service rates, did not survive crossover.

HB 630 Rylan’s Law/ Child Protective Services Observation

This bill adds a requirement that a parent who has been found guilty of abuse, neglect or dependency would need at least two monitored visits with their child before custody could be returned to them.

These “successful visits” must be at least seven days apart and at least an hour long.

The bill is named for Rylan Ott, a 2-year-old from Moore County who wandered away from his parents’ home and drowned in a pond. His former “guardian ad litem,” Pamela Reed, who has testified before legislative committees, has pushed for the law. Reed was in the gallery of the House when the bill cleared that chamber on April 26.

Reed said Moore County social services officials never observed Rylan with his parents, and if they had, they would have noted that his mother, Samantha Bryant, was neglectful. Bryant had previously been charged with neglect. Now she is charged with involuntary manslaughter and neglect.

A trial date has been set for June.

HB 673 DWLR/ Death or Injury by Vehicle

The bill changes state law around someone who is driving a motor vehicle with a license that was revoked due to an “impaired driving” offense. If that driver kills or injures another person while driving with that revoked license, this bill increases the offense to a felony. Currently, that driver could still be charged with “misdemeanor death by vehicle,” a charge which is often the charge in a plea deal.

HB 683 Indian Child Welfare Agreement Form

Right now, when a child who is part of a federally recognized tribe goes up for adoption or foster care placement, social services departments are required to take that child’s Native American culture into account and make attempts to place him or her with another Native American family.

Rep. Charles Graham (D-Lumberton), who is a Lumbee, introduced HB 683 to extend those welfare agreements to children of state-recognized tribes. Lumbees have gained state but not federal recognition.

“North Carolina is one of the few states in this country that recognizes statewide Indian child welfare issues,” Graham said while introducing his bill in the House Health Committee on April 26. “North Carolina has an Indian Child Welfare Act and we’ve done very well in the last two or three years trying to make sure that those children are placed appropriately in the homes of their culture.”

The bill would require that the state Division of Social Services collaborate with the Commission of Indian Affairs to create a standards for establishing agreements with any state recognized Indian tribe around these issues. And the bill would create a process for DHHS to consult with the tribes when considering placement.

“I think that’s been the missing link when we try to get these children placed in appropriate homes, is that consultation part,” Graham said.

HB 774 Require County DSS to Review Placements

HB 776 Adoption Law Changes

Last year, North Carolina’s child welfare system was found to be severely lacking in two reviews of agency processes and outcomes. This year, a number of lawmakers are making tweaks and tightening laws around how children involved in the system are treated.

Photo credit: Hyun Namkoong

HB 774 adds a new subsection to the law on placing children into the custody of another person, such as a foster home, a group home or, say, a relative’s home. This could occur due to a charge of parental neglect or child abuse. Sarah Stevens (R-Mt. Airy), an attorney with extensive family law experience, is managing the bill.

House Bill 776 amends a number of provisions under the laws governing adoptions. The bill makes clarifications for teens who are under 18 and also have children, allowing them some rights over their children.

“Technically, you’re not allowed to really do affidavits or have formal ID until you’re 18,” Stevens explained. “But if you’re younger and you have a child, we treat you as an adult for that purpose.”

“Sometimes you have to appoint a guardian ad litem, or get the parent of the parent of the child to sign something and it leads to a lot of confusion,” she continued. “So we’re saying, if you got pregnant and you’ve got a child, you need to be treated as an adult for certain purposes.”

HB 808 Advisory Council Review of Rare Disease Bills

In 2015, the General Assembly passed House Bill 823, establishing the Advisory Council on Rare Diseases within the School of Medicine at UNC Chapel Hill. The legislation received bipartisan support and passed unanimously through the N.C. House and Senate.

This year, the legislature is revisiting the Advisory Council and asking to require that any bill or resolution around rare diseases, rare disease research or rare disease care be put before the nine-member Council for their input and opinion.

The bill requires the Council to deliver its opinion within two weeks of receiving the proposed bill or resolution.

HB 299 State Health Plan Administrative Changes (agency bill)

This bill makes a number of changes to the North Carolina State Health Plan for Teachers and State Employees, which covers some 650,000 state employees, some retired employees, and their dependents. The bill is a request from the office of North Carolina State Treasurer Dale Folwell.

Photo credit: StockMonkeys.com

A section of the bill which received the most attention would cancel coverage for a beneficiary who lies about their eligibility or their current or prior health status as they’re making a claim for coverage.

“This gives the State Health Plan the ability, as a last resort, to terminate coverage,” said Rep. Josh Dobson (R-Nebo).

The bill also allows for any excess cash balance generated by the plan to cover some of the unfunded liability for retiree health benefits.

“So it gives the State Health Plan greater autonomy, and is more long term in its thinking to shore up some of those long liabilities,” Dobson told the House Insurance Committee on April 11.

The last section of the bill (there are seven provisions in all) gives Board of Trustees members who oversee the plan immunity from civil lawsuits, if the decisions they made about the plan were in good faith.

A companion bill with one other “non controversial” provision passed the Senate Insurance Committee unanimously. The two chambers will have to reconcile their differences in their bills, and eventual passage is highly likely.

SB 160 Handicap Parking Privilege Certification

Currently, physicians are the only practitioners who can sign letters certifying someone’s requirement for a handicap parking pass. Passage of this bill would allow nurse practitioners and physician assistants to also provide that certification.

SB 338 Incapacity to Proceed

When someone with a mental health problem commits a crime, it can take some time for their mental health issues to be stabilized before the court case can proceed. This “incapacity to proceed” can delay the judicial process, sometimes for a long time.

This bill seeks to speed up the process, facilitating the sharing of files about a defendant’s mental health records with clinicians at the program or psychiatric hospital where the defendant is receiving “capacity restoration services.” Those files can also be shared with clinicians chosen by the HHS Secretary.

Currently, the law only allows records to be shared only upon the order of a judge.

SB 383 Behavioral Health Crisis EMS Transports/ Medicaid

At present, Medicaid, the state and federally funded program that covers care for low income children, some of their parents, low income seniors and people with disabilities, only covers ambulance transportation to specific locations, usually hospital emergency rooms.

Image courtesy KOMU News, flickr creative commons

This bill instructs the state Department of Health and Human Services, which administers Medicaid, to devise a program and set reimbursement for ambulances to drop patients with mental health issues at facilities other than emergency departments.

In the bill, lawmakers assert that they want people with mental health issues go straight to behavioral health centers without first passing through a medical facility. ERs have been backed up with mental health patients, leading to long wait times until a bed in a behavioral health facility opens up.

A pilot program in several counties has experimented with having specially trained ambulance crews take patients with mental health crises straight to the behavioral health centers.

This bill would facilitate that process as it spreads to more municipalities.

SB 368 Notice of Medicaid SPA Submissions

When the Department of Health and Human Services requests federal approval for changes to North Carolina’s Medicaid services, the department is already required to give notice to members of the Joint Legislative Oversight Committee on Medicaid and NC Health Choice of what it is asking for within 10 days of the request.

This bill requires DHHS to make the notification at the same time it makes the request to federal regulators. It also requires DHHS to let the General Assembly know when state health leaders decide to not make request.

SB 630 Revise IVC Laws to Improve Behavioral Health

We covered this bill here.

SB 350 Amend Drug Laws/ Ellison v. Treadway

Photo credit: Rose Hoban

The bill sets new penalties for possession of opiate pills, such as oxycodone or Vicodin, in the following quantities:

  • 100-400 pills = Class G felony, minimum term of 35 months, maximum of 51 months and $25,000 fine.
  • 400-600 pills = Class F felony, minimum term of 70 months, maximum of 93 months and $50,000 fine.
  • 600 or more pills = Class D felony, minimum term of 175 months, maximum of 222 months and $200,000 fine.

Possessing, delivering or selling fewer than 100 pills is not considered “trafficking.” However a person possessing that quantity of pills can face prosecution.

HB 835 Create Chain of Survival Task Force

HB 556 Study Early Childhood Education

According to the text of this bill, 23 percent of all deaths in North Carolina are attributable to heart disease. Of those, about 12,000 are from cardiac arrest.

For people who go into cardiac arrest, cardiopulmonary resuscitation can help, but the reality is that the survival rate for people receiving CPR outside of a hospital is disappointingly small. In one large review of dozens of studies,   researchers found that the overall survival rate for patients who go into cardiac arrest outside of a hospital is only about 7.6 percent.

However, survival rates jump when someone in a cardiac arrest has access to an automatic external defibrillator (AED).

HB 835 would create another legislative research committee tasked with identifying means and funding for placing AEDs in state buildings, athletic facilities and public schools. The task force would also come up with ways that state officials can keep track of the AEDs in public buildings, keep them tested and in repair, and find ways to allow for the training courses for lay rescuers.

Another task force approved by the House and now awaiting approval by the Senate is a study committee on early childhood education. The group will study the development and best methods of implementation of a plan for a coordinated system of early care, education and child development services. The bill instructs the group to focus on program outcomes in satisfying the health, safety, developmental and educational needs of all children from birth to 8 years old.

The task force would also look at how to implement a statewide longitudinal evaluation of the educational progress of children from prekindergarten programs through grade three.

Similar longitudinal studies have been done through the Frank Porter Graham Institute at UNC Chapel Hill. The Abecedarian Project studied children over the course of 30 years and found that, in general, children who had preschool services did better than kids who did not have the PreK services. In addition, the children who had preschool services were less likely to be left behind, had better reading scores, and scored higher on intelligence tests.

Correction: The article originally stated that Rylan’s law would affect parents who have been accused of abuse or neglect, however, it only affects parents for whom that abuse and neglect have already been substantiated.

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...