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GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
SESSION LAW 2025-27
HOUSE BILL 576
*H576-v-4*
AN ACT MAKING TECHNI CAL, CONFORMING, AND OTHER MODIFICATIONS TO
LAWS PERTAINING TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.
The General Assembly of North Carolina enacts:
PART I. LAWS PERTAIN ING TO THE DIVISION OF CHILD AND FAMILY
WELL-BEING
DESIGNATE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AS THE
STATE AGENCY RESPONSIBLE FOR MANAGING SCHOOL NURSE FUNDS
SECTION 1.1. G.S. 130A-4.3(b) reads as rewritten:
"(b) The Division of Public Health Department shall ensure that school nurses funded with
State funds (i) do not assist in any instructional or administrative duties associated with a school's
curriculum and (ii) perform all of the following with respect to school health programs:
(1) Serve as the coordinator of the health services program a nd provide nursing
care.
(2) Provide health education to students, staff, and parents.
(3) Identify health and safety concerns in the school environment and promote a
nurturing school environment.
(4) Support healthy food services programs.
(5) Promote healthy physical education, sports policies, and practices.
(6) Provide health counseling, assess mental health needs, provide interventions,
and refer students to appropriate school staff or community agencies.
(7) Promote community involvement in assuring a healthy school and serve as
school liaison to a health advisory committee.
(8) Provide health education and counseling and promote healthy activities and a
healthy environment for school staff.
(9) Be available to assist the county health department durin g a public health
emergency."
PART II. LAWS PERTAINING TO THE DIVISION OF HEALTH BENEFITS
TEMPORARILY EXTEND OPTION TO DECREASE MEDICAID ENROLLMENT
BURDEN ON COUNTY DEPARTMENTS OF SOCIAL SERVICES
SECTION 2.1. Section 1.8(a) of S.L. 2023 -7, as amended by Section 9(a) of S.L.
2024-34, reads as rewritten:
"SECTION 1.8.(a) Notwithstanding G.S. 108A-54(d) and in accordance with
G.S. 143B-24(b), the Department of Health and Human Services (DHHS) is authorized, on a
temporary basis to conclude by June 30, 2025, 2028, to utilize the federally facilitated
marketplace (Marketplace), also known as the federal health benefit exchange, to make Medicaid
eligibility determinations. In accordance with G.S. 108A-54(b), G.S. 108A-54(f), these
Page 2 Session Law 2025-27 House Bill 576
eligibility determinations shall be in compliance with all eligibility categories, resource limits,
and income thresholds set by the General Assembly."
CLARIFY ENROLLMENT IN MEDICAID MANAGED CARE AFTER RELEASE
FROM INCARCERATION
SECTION 2.2.(a) G.S. 108D-40 reads as rewritten:
"§ 108D-40. Populations covered by PHPs.
(a) Capitated PHP contracts shall cover all Medicaid program aid categories except for
the following categories:
…
(9) Recipients who are inmates of prisons. Upon the recipient's release from
prison, the exception und er this subdivision shall continue to apply for a
period that is the shorter of the following: until the first day of the month
following the twelfth month after the recipient's release.
a. The recipient's initial Medicaid eligibility certification period post
release.
b. Three hundred sixty-five days.
(9a) Recipients residing in carceral settings other than prisons and whose Medicaid
eligibility has been suspended. Upon the recipient's release from
incarceration, the exception under this subdivision shall continue to apply for
a period that is the shorter of the following: until the first day of the month
following the twelfth month after the recipient's release.
a. The recipient's initial Medicaid eligibility certification period post
release.
b. Three hundred sixty-five days.
…."
SECTION 2.2.(b) This section is effective when it becomes law and applies to (i)
inmates released on or after that date and (ii) inmates released on or after January 1, 2025, who
are not enrolled with a PHP on the date this act becomes law.
CONFORM NORTH CAROLINA LAW TO FEDERAL REQUIREMENTS FOR
MEDICAID CATEGORICAL RISK LEVELS FOR PROVIDER SCREENINGS
SECTION 2.3.(a) G.S. 108C-3 reads as rewritten:
"§ 108C-3. Medicaid provider screening.
(a) Provider Screening. – The Department shall conduct provider screening of Medicaid
providers in accordance with applicable State or federal law or regulation.
(b) Enrollment Screening. – The Department must screen all initial provider applications
for enrollment in Medicaid, including appli cations for a new practice location, and all
revalidation requests based on Department the Department's assessment of risk and assignment
of the provider to a categorical risk level of "limited," "moderate," or "high." limited, moderate,
or high. If a provider could fit within more than one risk level described in this section, the highest
level of screening is applicable.
(c) Limited Categorical Risk Provider Types. – The All of the following provider types
are hereby designated as "limited" limited categorical risk:
…
(4) Health programs operated by an Indian Health Program (as Program, as
defined in section 4(12) of the Indian Health Care Improvement Act) Act, or
an urban Indian organization (as organization, as defined in section 4(29) of
the Indian Health Care Improvement Act) Act, that receives funding from the
Indian Health Service pursuant to Title V of the Indian Health Care
Improvement Act.
House Bill 576 Session Law 2025-27 Page 3
…
(10) Nursing facilities, including Intermediate Care Facilities for Individuals with
Intellectual Disabilities.Disabilities, that are not skilled nursing facilities.
(10a) Skilled nursing facilities that are limited categorical risk under subsection (k)
of this section.
…
(12) Physician or nonphysician practitioners (including practitioners, including
nurse practitioners, CRNAs, physician assistants, physician extenders,
occupational therapists, speech/language pathologists, chiropractors, and
audiologists), optometrists, audiologists; optometrists; dentists and
orthodontists, orthodontists; and medical groups or clinics.
…
(d) Limited Categorical Risk Screenings. – When the Department designates a provider
as a "limited" limited categorical level of risk, the Department shall conduct such the applicable
screening functions as required by federal law.
(e) Moderate Categorical Risk Provider Types. – The All of the following provider types
are hereby designated as "moderate" moderate categorical risk:
…
(8) Pharmacy Services.services.
…
(11) Revalidating agencies providing durable medical equipment, including, but
not limited to, including orthotics and prosthetics.
…
(15) Skilled nursing facilities that are moderate categorical risk under subsection
(k) of this section.
(f) Moderate Categorical Risk Screenings. – When the Department designates a provider
as a "moderate"' moderate categorical level of risk, the Department shall conduct such the
applicable screening functions as required by federal law and regulation.
(g) High Categorical Risk Provider Types. – The All of the following provider types are
hereby designated as "high" high categorical risk:
(1) Prospective (newly enrolling) Prospective, or newly enrolling, adult care
homes delivering Medicaid-reimbursed services.
…
(4) Prospective (newly enrolling) Prospective, or newly enrolling, agencies
providing durable medical equipment, including, but not limited to, orthotics
and prosthetics.
…
(6) Prospective (newly enrolling) Prospective, or newly enrolling, agencies
providing nonbehavioral health home- or community-based services pursuant
to waivers authorized by the federal Centers for Medicare and Medicaid
Services under 42 U.S.C. § 1396n(c).
(7) Prospective (newly enrolling) Prospective, or newly enrolling, agencies
providing personal care services or in-home care services.
(8) Prospective (newly enrolling) Prospective, or newly enrolling, agencies
providing private duty nursing, home health, or home infusion.
(9) Providers against whom which the Department has imposed a payment
suspension based upon a cre dible allegation of fraud in accordance with 42
C.F.R. § 455.23 within the previous 12 -month period. The Department shall
return the provider to its original risk category not later than 12 months after
the cessation of the payment suspension.
…
Page 4 Session Law 2025-27 House Bill 576
(11) Providers who that have incurred a Medicaid final overpayment, assessment,
or fine to the Department in excess of twenty percent (20%) of the provider's
payments received from Medicaid in the previous 12 -month period. The
Department shall return the provider to its original risk category not later than
12 months after the completion of the provider's repayment of the final
overpayment, assessment, or fine.
…
(13) Skilled nursing facilities that are high categorical risk under subsection (k) of
this section.
(h) High Categorical Risk Screenings. – When the Department designates a provider as
a "high" high categorical level of risk, the Department shall conduct such the applicable screening
functions as required by federal law and regulation.
(i) Dually-Enrolled Providers. – For providers dually enrolled in the federal Medicare
program and Medicaid, the Department may rely on the results of the provider screening
performed by Medicare contractors.
(j) Out-of-State Providers. – For out-of-state providers, the Department may rely on the
results of the provider screening performed by the Medicaid agencies or Children's Health
Insurance Program agencies of other states.
(k) Skilled Nursing Facilities. – The categorial risk level for provider screening of skilled
nursing facilities is the categorical risk level required by federal law or regulation. If federal law
or regulation do es not require a particular categorical risk level, skilled nursing facilities are
limited categorical risk."
SECTION 2.3.(b) G.S. 108C-3, as amended by Section 2.3(a) of this act, reads as
rewritten:
"§ 108C-3. Medicaid provider screening.
…
(c) Limited Categorical Risk Provider Types. – All of the following provider types are
designated as limited categorical risk:
…
(1a) Behavioral health and intellectual and developmental disability provider
agencies that are nationally accredited by an entity approved by the
Secretary.Secretary, unless they meet the description in subdivision (g)(15) of
this section.
…
(16) Portable X-ray suppliers.
…
(e) Moderate Categorical Risk Provider Types. – All of the following provider types are
designated as moderate categorical risk:
…
(5) Hospice organizations.Revalidating hospice organizations, unless they meet
the description in subdivisions (g)(14) and (g)(15) of this section.
…
(10) Revalidating adult care homes delivering Medicaid -reimbursed
services.services, unless they meet the description in subdivision (g)(15 ) of
this section.
(11) Revalidating agencies providing durable medical equipm ent, including
orthotics and prosthetics.prosthetics, unless they meet the description in
subdivision (g)(15) of this section.
(12) Revalidating agencies providing nonbehavioral health home - or
community-based services pursuant to waivers authorized by the federal
Centers for Medicare and Medicaid Services under 42 U.S.C. § 1396n(c). 42
House Bill 576 Session Law 2025-27 Page 5
U.S.C. § 1396n(c), unless they meet the description in subdivision (g)(15) of
this section.
(13) Revalidating agencies providing private duty nursing, home health, personal
care services or in-home care services, or home infusion.infusion, unless they
meet the description in subdivision (g)(15) of this section.
…
(16) Portable X-ray suppliers.
…
(g) High Categorical Risk Provider Types. – All of the following provider types a re
designated as high categorical risk:
…
(14) Prospective, or newly enrolling , hospice organizations and revalidating
hospice organizations undergoing a change in ownership.
(15) The following revalidating providers (i) that are revalidating for the first time
since newly enrolling and (ii) for which fingerprinting requirements, as a
newly enrolling provider, were waived due to a national, state, or local
emergency:
a. Opioid treatment programs that have not been fully and con tinuously
certified by the Substance Abuse and Mental Health Services
Administration since October 23, 2018.
b. Agencies providing durable medical equipment, including orthotics
and prosthetics.
c. Adult care homes delivering Medicaid-reimbursed services.
d. Agencies providing private duty nursing, home health, personal care
services, or in-home care services, or home infusion.
e. Hospice organizations.
…."
SECTION 2.3.(c) Subsection (a) of this section is retroactively effective January 1,
2023. The remainder of this section is retroactively effective January 1, 2024.
CLARIFY MEDICAID SUBROGATION RIGHTS IN MANAGED CARE
ENVIRONMENT
SECTION 2.4.(a) G.S. 108A-57 reads as rewritten:
"§ 108A-57. Subrogation rights; withholding of information a misdemeanor.
(a) As used in this section, the term "beneficiary" means (i) the beneficiary of medical
assistance, including a minor beneficiary, (ii) the medical assistance beneficiary's parent, legal
guardian, or personal representative, (iii) the medical assistance be neficiary's heirs, and (iv) the
administrator or executor of the medical assistance beneficiary's estate.
Notwithstanding any other provisions of the law, to the extent of payments under this Part,
the State shall be subrogated to all rights of recovery, c ontractual or otherwise, of a beneficiary
against any person. Any claim brought by a medical assistance beneficiary against a third party
shall include a claim for all medical assistance payments for health care items or services
furnished to the medical a ssistance beneficiary as a result of the injury or action, hereinafter
referred to as the "Medicaid claim." Any claim brought by a medical assistance beneficiary
against a third party that does not state the Medicaid claim shall be deemed to include the
Medicaid claim. If the beneficiary has claims against more than one third party related to the
same injury, then any amount received in payment of the Medicaid claim related to that injury
shall reduce the total balance of the Medicaid claim applicable to su bsequent recoveries related
to that injury.
The Department may designate one or more PHPs to receive all or a portion of payments due
under this section to the Department for the Medicaid claim by sending a notice of designation
Page 6 Session Law 2025-27 House Bill 576
to (i) the beneficiary who has the claim against the third party and (ii) any PHP designated in the
notice. As used in this section, the term "designated PHP" refers to a PHP designated in the notice
of designation under this subsection.
(a1) If the amount of the Medicaid claim does not exceed one -third of the medical
assistance beneficiary's gross recovery, it is presumed that the gross recovery includes
compensation for the full amount of the Medicaid claim. If the amount of the Medicaid claim
exceeds one -third of the medical assis tance beneficiary's gross recovery, it is presumed that
one-third of the gross recovery represents compensation for the Medicaid claim.
(a2) A medical assistance beneficiary may dispute the presumptions established in
subsection (a1) of this section by app lying to the court in which the medical assistance
beneficiary's claim against the third party is pending, or if there is none, then to a court of
competent jurisdiction in this State, for a determination of the portion of the beneficiary's gross
recovery that represents compensation for the Medicaid claim. An application under this
subsection shall be filed with the court and served on the Department pursuant to the Rules of
Civil Procedure no later than 30 days after the date that the settlement agreement is executed by
all parties and, if required, approved by the court, or in cases in which judgment has been entered,
no later than 30 days after the date of entry of judgment. If a PHP made payments on behalf of a
Medicaid beneficiary that are included in the Medicaid claim, then the application shall also be
served on that PHP within the same time frame in which service is required on the Department.
The court shall hold an evidentiary hearing no sooner than 60 days after the date the action was
filed. All of the following shall apply to the court's determination under this subsection:
(1) The medical assistance beneficiary has the burden of proving by clear and
convincing evidence that the portion of the beneficiary's gross recovery that
represents compens ation for the Medicaid claim is less than the portion
presumed under subsection (a1) of this section.
(2) The presumption arising under subsection (a1) of this section is not rebutted
solely by the fact that the medical assistance beneficiary was not able to
recover the full amount of all claims.
(3) If the beneficiary meets its burden of rebutting the presumption arising under
subsection (a1) of this section, then the court shall determine the portion of
the recovery that represents compensation for the Me dicaid claim and shall
order the beneficiary to pay the amount so determined to the Department
Department, or designated PHP, in accordance with subsection (a5) of this
section. In making this determination, the court may consider any factors that
it deems just and reasonable.
(4) If the beneficiary fails to rebut the presumption arising under subsection (a1)
of this section, then the court shall order the beneficiary to pay the amount
presumed pursuant to subsection (a1) of this section to the Department
Department, or designated PHP, in accordance with subsection (a5) of this
section.
(a3) Notwithstanding the presumption arising pursuant to subsection (a1) of this section,
the medical assistance beneficiary and the Department may reach an agreement on the portion of
the recovery that represents compensation for the Medicaid claim. If such an agreement is
reached after an application has been filed pursuant to subsection (a2) of this section, a stipulation
of dismissal of the application signed by both parties shall be filed with the court.
(a4) Within 30 days of receipt of the proceeds of a settlement or judgment related to a
claim described in subsection (a) of this section, the medical assistance beneficiary or any
attorney retained by the beneficiary shall notify the Department Department, and any designated
PHP, of the receipt of the proceeds.
(a5) The medical assistance beneficiary or any attorney retained by the beneficiary shall,
out of the proceeds obtained by or on behalf of the beneficiary by settle ment with, judgment
House Bill 576 Session Law 2025-27 Page 7
against, or otherwise from a third party by reason of injury or death, distribute to the Department
Department, or designated PHP, the amount due pursuant to this section as follows:
(1) If, upon the expiration of the time for filing an application pursuant subsection
(a2) of this section, no application has been filed, then the amount presumed
pursuant to subsection (a1) of this section, as prorated with the claims of all
others having medical subrogation rights or medical liens against the amount
received or recovered, shall be paid to the Department Department, or
designated PHP, within 30 days of the beneficiary's receipt of the proceeds, in
the absence of an agreement pursuant to subsection (a3) of this section.
(2) If an application has been filed pursuant to subsection (a2) of this section and
no agreement has been reached pursuant to subsection (a3) of this section,
then the Department Department, or designated PHP, shall be paid as follows:
a. If the beneficiary rebuts the presumption arising under subsection (a1)
of this section, then the amount determined by the court pursuant to
subsection (a2) of this section, as prorated with the claims of all others
having medical subrogation rights or medical liens against the amount
received or recovered, shall be paid to the Department Department, or
designated PHP, within 30 days of the entry of the court's order.
b. If the beneficiary fails to rebut the presumption arising under
subsection (a1) of this section, then the amount presumed pursuant to
subsection (a1) of this section, as prorated with the claims of all others
having medical subrogation rights or medical liens against the amount
received or recovered, shall be paid to the Department Department, or
designated PHP, within 30 days of the entry of the court's order.
(3) If an agreement has been reached pursuant to subsection (a3) of this section,
then the agreed amount, as prorated with the claims of all others having
medical subrogation rights or medical liens again st the amount received or
recovered, shall be paid to the Department Department, or designated PHP,
within 30 days of the execution of the agreement by the medical assistance
beneficiary and the Department.
(a6) The United States and the State of North Carolina shall be entitled to shares in each
net recovery by the Department under this section. Their shares shall be promptly paid under this
section and their proportionate parts of such sum shall be determined in accordance with the
matching formulas in use during the period for which assistance was paid to the recipient.
(b) It is a Class 1 misdemeanor for any person seeking or having obtained assistance
under this Part for himself or another to willfully fail to disclose to the county department of
social services or its attorney and to the Department the identity of any person or organization
against whom the recipient of assistance has a right of recovery, contractual or otherwise.
(c) (For contingent repeal, see note) This section applies to the admi nistration of and
claims payments under the NC Health Choice Program established under Part 8 of this Article.
(d) As required to ensure compliance with this section, the Department may apply to the
court in which the medical assistance beneficiary's claim against the third party is pending, or if
there is none, then to a court of competent jurisdiction in this State for enforcement of this
section."
SECTION 2.4.(b) This section is effective when it becomes law and applies to
Medicaid claims brought by medical assistance beneficiaries against third parties on or after that
date.
PART III. LAWS PERTA INING TO THE DIVISIO N OF HEALTH SERVICE
REGULATION
Page 8 Session Law 2025-27 House Bill 576
ALIGN CAPACITY OF MEDICAL FOSTER HOMES OPERATING IN THE STATE
UNDER THE SUPERVISION OF THE UNITED STATES DEP ARTMENT OF
VETERANS AFFAIRS WITH FEDERAL REGULATIONS
SECTION 3.1. G.S. 131D-2.3 reads as rewritten:
"§ 131D-2.3. Exemptions from licensure.
The following are excluded from this Article and are not required to be registered or obtain
licensure under this Article:
(1) Facilities licensed under Chapter 122C or Chapter 131E of the General
Statutes.
(2) Persons subject to rules of the Division of Employment and Independence for
People with Disabilities.
(3) Facilities that care for no more than four three persons, all of whom are under
the supervision of the United States Veterans Administration.
(4) Facilities that make no charges for housing, amenities, or personal care
service, either directly or indirectly.
(5) Institutions that are maintained or operated b y a unit of government and that
were established, maintained, or operated by a unit of government and exempt
from licensure by the Department on September 30, 1995."
AUTHORIZE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO
INSPECT RESIDENCES OR FACILITIES BELIEVED TO BE OPERATING AS
ADULT CARE HOMES WITHOUT A LICENSE AND INCREASE PENALTIES FOR
UNLAWFUL ADULT CARE HOME OPERATIONS
SECTION 3.2.(a) G.S. 131D-2.5(b) reads as rewritten:
"(b) The Department shall charge each registered multiunit assisted housing with services
program a nonrefundable annual registration fee of three hundred fifty dollars ($350.00). Any
individual or corporation that establishes, conducts, manages, or operates a multiunit housing
with services program, subject to registration under this section, that fails to register is guilty of
a Class 3 misdemeanor and, upon conviction shall be punishable only by a fine of not more than
fifty dollars ($50.00) for the first offense and not more than five hundred dollars ($500.00) for
each subsequent offense. Class H felony, including a fine of one thousand dollars ($1,000) per
day for each day the facility is in operation in violation of this Article. Each day of a continuing
violation after conviction shall be considered a separate offense."
SECTION 3.2.(b) G.S. 131D-2.6 reads as rewritten:
"§ 131D-2.6. Legal action by Department.
(a) Notwithstanding the existence or pursuit of any other remedy, the Department may,
in the manner provided by law, maintain an action in the name of the State for injunction or other
process against any person to restrain or prevent the establishment, conduct, management, or
operation of an adult care home without a license. Such action shall be instituted in the superior
court of the county in which any unlicensed activity has occurred or is occurring.
(a1) The Department and county departments of social services may inspect any of the
following as authorized by law:
(1) A residence or facility the Department believes to be operating as an assisted
living residence without an appropriate license or registration.
(2) A registered multiunit assisted housing with services facility to determine if it
is operating as a licensable adult care home facility without a license.
(b) Any individual or corporation that establishes, conducts, manages, or operates a
facility subject to licensure under this section without a license is guilty of a Class 3 misdemeanor
and, upon conviction, shall be punishable only by a fine of not more than fifty dollars ($50.00)
for the first offense and not more than five hundred dollars ($500.00) for each subsequent offense.
an assisted living facility without a license or registration, as required under this Article, is guilty
House Bill 576 Session Law 2025-27 Page 9
of a Class H felony, including a fine of one thousand dollars ($1,000) per day for each day the
facility is in operation in violation of this Article. Each day of a continuing violation afte r
conviction shall be considered a separate offense.
(c) If any person shall hinder the proper performance of duty of the Secretary or the
Secretary's representative in carrying out this section, the Secretary may institute an action in the
superior court of the county in which the hindrance has occurred for injunctive relief against the
continued hindrance, irrespective of all other remedies at law.
(d) Actions under this section shall be in accordance with Article 37 of Chapter 1 of the
General Statutes and Rule 65 of the Rules of Civil Procedure."
SECTION 3.2.(c) This section becomes effective December 1, 2025, and applies to
offenses committed on or after that date.
ALIGN HOSPITAL REPORTING REQUIREMENTS UNDER THE HOSPITAL
VIOLENCE PROTECTION ACT WITH T HE HOSPITAL LICENSE RENEWAL
APPLICATION PROCESS
SECTION 3.3.(a) G.S. 131E-76 is amended by adding a new subdivision to read:
"(1c) Division of Health Service Regulation. – The Division of Health Service
Regulation within the Department of Health and Human Services."
SECTION 3.3.(b) G.S. 131E-88.2 reads as rewritten:
"§ 131E-88.2. Reports.
(a) Annually by October 1, the Department of Health and Human Services, February 28,
each hospital shall report to the Division of Health Service Regulation, shall collect in a manner
and format requested by the Department , the following data from hospitals for the preceding
calendar year: for the prior federal fiscal year ending September 30: (i) the number of assaults
occurring in the hospital or on hospital grounds that required the involvement of law
enforcement, whether the assaults involved hospital personnel, and how those assaults were
pursued by the hospital and processed by the judicial system, (ii) the number and impact of
incidences where patient behavioral health and substance use issues resulted in violence in the
hospital and the number that occurred specifically in the emergency department, and (iii) the
number of workplace violence incidences occurring at the hospital that were reported as required
by accrediting agencies, the Occupational Safety and Health Administration, and other entities.
(b) The Department of Health and Human Services shall compile the information
required by subsection (a) of this section and shall share that data with the North Car olina
Sheriffs' Association, the North Carolina Association of Chiefs of Police, and the North Carolina
Emergency Management Association. The Department shall request these organizations examine
the data and make recommendations to the Department to decrease the incidences of violence in
hospitals and to decrease assaults on hospital personnel.
(c) The Department shall compile the information required by subsections (a) and (b) of
this section and report findings and recommendations to the Joint Legislative Oversight
Committee on Health and Human Services annually by December 1.May 1."
REPEAL NC NEW ORGANIZATIONAL VISION AWARD PROGRAM
SECTION 3.4. Part 6 of Article 6 of Chapter 131E of the General Statutes is
repealed.
DESIGNATE THE NC OFFICE OF EMERGENCY MEDICAL SERVICES AS THE
ENTITY RESPONSIBLE FOR APPROVING INDIVIDUALS TO ADMINISTER
EPINEPHRINE
SECTION 3.5. G.S. 143-509 reads as rewritten:
"§ 143-509. Powers and duties of Secretary.
Page 10 Session Law 2025-27 House Bill 576
The Secretary of the Department of Health and Human Services has ful l responsibilities for
supervision and direction of the emergency medical services program and, to that end, shall
accomplish all of the following:
…
(9) Promote a means of training individuals to administer life-saving treatment to
persons who suffer a se vere adverse reaction to agents that might cause
anaphylaxis. Individuals, upon successful completion of this training
program, may be approved by the North Carolina Medical Care Commission
Office of Emergenc y Medical Services to administer epinephrine to these
persons, in the absence of the availability of physicians or other practitioners
who are authorized to administer the treatment. This training may also be
offered as part of the emergency medical services training program.
…."
PART IV. LAWS PERTAINING TO THE DIVISION OF PUBLIC HEALTH
REVISE THE COMPOSITION OF LOCAL CHILD FATALITY REVIEW TEAMS TO
SUPPORT GREATER EFFICIENCY
SECTION 4.1.(a) G.S. 7B-1407 reads as rewritten:
"§ 7B-1407. Local Teams; composition and leadership.
…
(b) Each Local Team shall consist of the following persons:
(1) The director of the county department of social services or the director of the
consolidated human services agency and a member of the director's
staff.agency, or the director 's designee, who shall be a memb er of senior
management.
(1a) A staff member of the county department of social services or of the
consolidated human services agency, appointed by the county department of
social services or the consolidated human services agency.
(2) A local law enforcement officer, appointed by the board of county
commissioners.
(3) An attorney from the district attorney's office, appointed by the district
attorney.
(4) The executive director of the local community action agency, as defined by
the Department of H ealth and Human Services, or the executive director's
designee.
(5) The superintendent of each local school administrative unit located in the
county, or the superintendent's designee.
(6) A member of the county board of social services, appointed by the c hair of
that board.
(7) A local mental health professional, appointed by the director of the area
authority established under Chapter 122C of the General Statutes.
(8) The local guardian ad litem coordinator, or the coordinator's designee.
(9) The director of the local department of public health.health, or the director 's
designee, who shall be a member of senior management.
(10) A local health care provider, appointed by the local board of health.
(11) An emergency medical services provider or firefighter, appointed by the board
of county commissioners.
(12) A district court judge, appointed by the chief district court judge in that
district.
(13) A county medical examiner, appointed by the Chief Medical Examiner.
House Bill 576 Session Law 2025-27 Page 11
(14) A representative of a local child care facility or Head Start program, appointed
by the director of the county department of social services.
(15) A parent of a child who died before reaching the child's eighteenth birthday,
to be appointed by the board of county commissioners.
(c) The chair of the Local Team may invite a maximum of five additional individuals to
participate on the Local Team on an ad hoc basis for a specific review if the chair believes the
individual's subject matter expertise or position within an organization will enhance t he ability
of the Local Team to conduct an effective review. The chair may select ad hoc members from
outside of the county or counties served by the Local Team. As a condition of participating in a
specific review, each ad hoc member is required to sign the same confidentiality statement signed
by a Local Team member and is subject to the provisions of G.S. 7B-1413.
…."
SECTION 4.1.(b) This section is effective July 1, 2025, or the date this act becomes
law, whichever is later.
REMOVE ERRONEOUS REFERENCES TO THE COMMISSION FOR PUBLIC
HEALTH FROM STATUTES GOVERNING THE STATEWIDE CHEMICAL
ALCOHOL TESTING PROGRAM ADMINISTERED BY THE FORENSIC TESTS FOR
ALCOHOL BRANCH
SECTION 4.2.(a) G.S. 15A-534.2(d) reads as rewritten:
"(d) In making his a determination about whether a defendant detained under this section
remains impaired, the judicial official may request that the defendant submit to periodic tests to
determine his the defendant 's alcohol concentration. Instruments acceptable for making
preliminary breath tests under G.S. 20-16.3 may be used for this purpose as well as instruments
for making evidentiary chemical analyses. Unless there is evidence that the defendant is still
impaired from a combination of alcohol and some other impairing substance o r condition, a
judicial official must is required to determine that a defendant with an alcohol concentration less
than 0.05 is no longer impaired. The results of any periodic test to determine alcohol
concentration may not be introduced in evidence: into evidence in either of the following
circumstances:
(1) Against the defendant by the State in any criminal, civil, or administrative
proceeding arising out of an offense involving impaired driving; ordriving.
(2) For any purpose in any proceeding if the test was not performed by a method
approved by the Commission for Public Health Department o f Health and
Human Services under G.S. 20-139.1 and by a person licensed to administer
the test by the Department of Health and Human Services.
The fact that a defendant refused to comply with a judicial official's request that he submit to a
chemical analysis may not be admitted into evidence in any criminal action, administrative
proceeding, or a civil action to review a decision reached by an administrative agency in which
the defendant is a party."
SECTION 4.2.(b) G.S. 20-138.7(d) reads as rewritten:
"(d) Alcohol Screening Test. – Notwithstanding any other provision of law, an alcohol
screening test may be administered to a driver suspected of violating subsection ( a) of this
section, and the results of an alcohol screening test or the driver's refusal to submit may be used
by a law enforcement officer, a court, or an administrative agency in determining if alcohol was
present in the driver's body. No alcohol screeni ng tests are valid under this section unless the
device used is one approved by the Commission for Public Health, Department of Health and
Human Services, and the screening test is conducted in accordance with the applicable
regulations of the Commission rules adopted by the Department of Health and Human Services
as to the manner of its use."
Page 12 Session Law 2025-27 House Bill 576
REMOVE REFERENCES TO THE NORTH CAROLINA MEDICAL SOCIETY'S
DEFUNCT CANCER COMMITTEE
SECTION 4.3.(a) G.S. 130A-33.50 reads as rewritten:
"§ 130A -33.50. Advisory Com mittee on Cancer Coordination and Control established;
membership, compensation.
…
(b) The Committee shall have consist of up to 34 members, including the Secretary of the
Department or the Secretary's designee. The members of the Committee shall elect a c hair and
vice-chair from among the Committee membership. The Committee shall meet not more than
twice a year at the call of the chair. Six of the members shall be legislators, three of whom shall
be appointed by the Speaker of the House of Representatives, and three of whom shall be
appointed by the President Pro Tempore of the Senate. Four of the members shall be cancer
survivors, two of whom shall be appointed by the Speaker of the House of Representatives, and
two of whom shall be appointed by the Presid ent Pro Tempore of the Senate. The remainder of
the members shall be appointed by the Governor as follows:
(1) One member from the Department of Environmental Quality;Quality.
(2) Three members, one from each of the following: the Department, the
Department of Public Instruction, and the North Carolina Community College
System;System.
(3) Four members representing the cancer control programs at North Carolina
medical schools, one fr om each of the following: the University of North
Carolina at Chapel Hill School of Medicine, the Bowman Gray School of
Medicine, the Duke University School of Medicine, and the East Carolina
University School of Medicine;Medicine.
(4) One member who is an oncology nurse representing the North Carolina
Nurses Association;Association.
(5) One member representing the Cancer Committee of the North Carolina
Medical Society;Society.
(6) One member representing the Old North State Medical Society;Society.
(7) One member representing the American Cancer Society, North Carolina
Division, Inc.;Division, Inc.
(8) One member representing the North Carolina Hospital
Association;Association.
(9) One member representing the North Carolina Association of Local Health
Directors;Directors.
(10) One member who is a primary care physician licensed to practice medicine in
North Carolina;North Carolina.
(11) One member representing the American College of Surgeons;Surgeons.
(12) One member representing the North Carolina Oncology Society;Society.
(13) One member representing the Association of North Carolina Cancer
Registrars;Registrars.
(14) One member representing the Medical Directors of the North Carolina
Association of Health Plans; andPlans.
(15) Up to four additional members at large.
Except for the Secretary, the members shall be appointed for staggered four -year terms and
until their successors are appointed and qualify. The Governor may remove any member of the
Committee from office in accordance with the provisions of G.S. 143B-13. Members may
succeed themselves for one term and may be appointed again after being off the Committee for
one term.
…."
SECTION 4.3.(b) G.S. 130A-213 reads as rewritten:
House Bill 576 Session Law 2025-27 Page 13
"§ 130A-213. Cancer Committee of the North Carolina Medical Society.Consultation with
the Advisory Committee on Cancer Coordination and Control.
In implementing this Part, the Department shall consult with the Cancer Committee of the
North Carolina Medical Society. The Committee shall consist of at least one physician from each
congressional district. Advisory Committee on Cancer Coordination and Control established by
G.S. 130A-33.50. Any proposed rules or reports affecting the operation of the cancer control
program shall be reviewed by the Committee for comment prior to adoption."
AUTHORIZE LOCAL REGISTRARS AT LOCAL HEALTH DEPARTMENTS TO
REMOVE OUTDATED REFERENCES TO PAPER FORMAT VITAL RECORDS
SECTION 4.4. G.S. 130A-97 reads as rewritten:
"§ 130A-97. Duties of local registrars.
The local registrar shall:shall do all of the following:
(1) Administer and enforce provisions of this Article and the rules, and
immediately report any violation to the State Registrar;Registrar.
(2) Furnish certificate forms and instructions suppli ed by the State Registrar to
persons who require them;them.
(3) Examine each certificate when submitted to determine if it has been completed
in accordance with the provisions of this Article and the rules. If a certificate
is incomplete or unsatisfactory, the responsible person shall be notified and
required to furnish the necessary information. All birth and death certificates
shall be typed or written legibly prepared in permanent black, blue-black, or
blue ink;black ink.
(4) Enter the date on which a certificate is received and sign Sign and date as local
registrar;registrar using the registration method prescribed by the State
Registrar.
(5) Transmit Using the registration method prescribed by the State Registrar ,
transmit to the register of deeds of the county a copy of each certificate
registered within seven days of after receipt of a birth or death certificate. The
copy transmitted transmittal shall include the race of the father and mother if
that information is contained on the State copy of in the State Record of the
certificate of live birth. Copies transmitted may be on blanks furnished by the
State Registrar or may be photocopies made in a manner approved by the
register of deeds. The local registrar may also keep a copy of each certificate
for no more than two years;years.
(6) On the fifth day of each month or more often, if requested, send to the State
Registrar all original certificates registered during the preceding month;
andmonth.
(7) Maintain records, make reports and perform other duties required by the State
Registrar."
ALIGN STATE LAW WITH UPDATED FEDERAL GUIDELINES CONCERNING THE
COMMUNICATION OF MAMMOGRAPHIC INFORMATION TO PATIENTS
SECTION 4.5. G.S. 130A-215.5 reads as rewritten:
"§ 130A-215.5. Communication of mammographic breast density information to patients.
(a) All health care facilities that perform mammography examinations shall include in
the summary of the mammography report, required by federal law to be provided to a patient,
information that identifies the patient's individual breast density classification based on the Breast
Imaging Reporting and Data System established by the American College of Radiology. If the
facility determines that a patient has heterogeneously or extremely dense breasts, the summary
of the mammography report shall include the following notice:
Page 14 Session Law 2025-27 House Bill 576
"Your mammogram indicates that you may have dense breast tissue. Dense breast tissue is
relatively common and is found in more than forty percent (40%) of women. The presence of
dense tissue may make it more difficult to detect abnormalities in the breast and may be
associated with an increased risk of breast cancer. We are providing this information to raise your
awareness of this important factor and to encourage you to talk with your physician about this
and other breast cancer risk factors. Together, you can decide which screening options are right
for you. A report of your results was sent to your physician.provide each patient with a summary
of the mammography report in la nguage understandable by a layperson that incl udes an
assessment of the patient's breast density.
(a1) Each health care facility that provides a mammography report to a patient following
a mammography examination shall include in the report information about breast density based
on the patient's mammogram that is consistent with the federal regulations issued by the United
States Food and Drug Administration pursuant to the Mammography Quality Standards Act , 42
U.S.C. § 263b, et seq., as from time to time amended. If a health care facility determines that a
patient has heterogeneously or extremely dense breasts, the report provided to the patient shall
communicate all of the following information:
(1) Breast tissue can be either dense or not dense.
(2) Dense breast tissue makes it harder to find breast cancer on a mammogram
and also increases the risk of developing breast cancer.
(3) In some people with dense breast tissue, other imaging tests in addition to a
mammogram may help find cancers.
(4) Patients with dense breast tissue should talk to their healthcare provider about
breast density, risks for breast cancer, and their individual situation.
(b) Patients Health care facilities may direct patients who receive diagnostic or screening
mammograms may be directed to informative material about breast density. This informative
material may include the American College of Radiology's most current brochure on the subject
of breast density."
EXTEND THE OPTION FOR NORTH CAROLINIANS TO DONATE A PORTION OF
THEIR TAX REFUNDS TO THE BREAST AND CERVICAL CANCER CONTROL
PROGRAM
SECTION 4.6. G.S. 105-269.8 reads as rewritten:
"§ 105-269.8. Contribution by individual for early detection of breast and cervical cancer.
(a) Contribution. – An individual entitled to a refund of income taxes under Part 2 of
Article 4 of this Chapter may elect to contribute all or part of the refund to be used for early
detection of breast and cervical cancer at the Cancer Prevention and Control Branch of the
Division of Public Health of the Department of Health and Human Services. The Secretary shall
provide appropriate language and space on the individual income tax form in which to make the
election. The Secretary shall include in the income tax instructions an explanation that the
contributions will b e used for early detection of breast and cervical cancer only. The election
becomes irrevocable upon filing the individual's income tax return for the taxable year.
(b) Distribution. – The Secretary shall transmit the contributions made pursuant to this
section to the State Treasurer to be distributed for early detection of breast and cervical cancer.
The State Treasurer shall distribute the contributions to the Cancer Prevention and Control
Branch of the Division of Public Health of the Department of Health and Human Services. Funds
distributed pursuant to this section shall be used only for early detection of breast and cervical
cancer and shall be used in accordance with North Carolina's Breast and Cervical Cancer Control
Program's policies and procedures.
(c) Sunset. – This section expires for taxable years beginning on or after January 1,
2026.January 1, 2030."
House Bill 576 Session Law 2025-27 Page 15
PART V. LAWS PERTAINING TO THE DIVISION OF SOCIAL SERVICES
AUTHORIZE MAGISTRATES TO ACCEPT FOR FILING PETITIONS FOR ADULT
PROTECTIVE SERVICES EMERGENCY ORDERS AFTER BUSINESS HOURS AND
TO HEAR EX PARTE MOTIONS REGARDING THESE PETITIONS WHEN A
DISTRICT COURT JUDGE IS UNAVAILABLE
SECTION 5.1.(a) Article 6 of Chapter 108A of the General Statutes is amended by
adding the following new sections to read:
"§ 108A-106.1. Immediate need for petition for emergenc y services when clerk 's office is
closed.
(a) When the office of the clerk is closed, a magistrate shall accept for filing a petition
for an order authorizing the provision of emergency services to a disabled adult and shall note
the date of the filing.
(b) The authority of the magistrate under this section is limited to emergency situations
in which a petition is filed under G.S. 108A-106 seeking an order ex parte for the provision of
emergency services to a disabled adult. Any magistrate who accepts a petition for filing under
this section shall deliver the petition to the clerk's office for processing as soon as that office is
open for business.
"§ 108A-106.2. Ex parte emergency orders by authorized magistrate.
(a) The chief district court judge may authorize one or more magistrates to hear ex parte
motions for the provision of emergency services to disabled adults and issue a show-cause notice
in the order as required by G.S. 108A-106(d). A magistrate may proceed with hearing a motion
ex parte and issuing a show-cause notice under this subsection only if, p rior to the hearing, the
magistrate determines that at the time the party is seeking emergency services ex parte the district
court is not in session and a district court judge is not and will not be available to hear the motion.
(b) An authorized magistrate that issues an ex parte order under this section shall deliver
the signed order to the clerk's office for processing as soon as that office is open for business.
(c) All authorizations for ex parte orders for emergency services may be made by
telephone when other means of communication are impractical. A copy of the petition for an
order authorizing the provision of emergency services shall be provided to the district court judge
or the authorized magistrate by any appropriate method, including hand delivery, fa csimile, or
electronic means. All written orders pursuant to telep honic communication shall bear the name
and the title of the director, the name and the title of the district court judge or authorized
magistrate issuing the ex parte order, the hour and date of the telephonic authorization, and the
signature and the title of the clerk or magistrate receiving the authorization and entering the order
and who accepted the petition for filing."
SECTION 5.1.(b) This section becomes effective November 1, 2025, and applies to
petitions filed under G.S. 108A-106 seeking an order ex parte for the provision of emergency
services filed on or after this date.
ALIGN STATE LAW WITH THE FEDERAL PROHIBITION ON CONDITIONAL
EMPLOYMENT OF APPLICANTS OF CHILD CARE INSTITUTIONS PRIOR TO
OBTAINING CRIMINAL HISTORY RECORD CHECK RESULTS
SECTION 5.2. G.S. 108A-150(g) reads as rewritten:
"(g) Conditional Employment. – A child care institution may shall not employ an applicant
conditionally prior to obtaining the results of a criminal history record check regarding the
applicant if both of the following requirements are met:applicant.
(1) The child care institution shall not employ an applicant prior to obtaining the
applicant's consent for a criminal history record check as required in
subsection (b) of this section or the completed fingerprint cards as required in
G.S. 143B-1209.53.
Page 16 Session Law 2025-27 House Bill 576
(2) The child care institution shall submit the request for a criminal history record
check not later than five business days after the individual begins conditional
employment."
ALIGN DISSEMINATION OF BACKGROUND CHECK INFORMATION FOR
PROSPECTIVE ADOPTIVE AND FOSTER CARE PARENTS WITH FEDERAL
POLICY, LAW, AND STANDARDS
SECTION 5.3.(a) G.S. 48-3-309(e) reads as rewritten:
"(e) The Department shall notify the prospective adoptive parent's supervising county
department of social services of the results of the criminal history check. In accordance with the
federal and State law regulating the dissemination of the contents of the criminal history file, the
Department shall not release or disclose any portion of an indiv idual's criminal history to the
prospective adoptive parent or any other individual required to be checked. the Department may
provide the prospective adoptive parent or any other individual required to submit to a criminal
history record check pursuant to subsection (a) of this section a copy of that applicant's criminal
history information for the purpose of reviewing or challenging the accuracy of the criminal
history. The Department, however, Department shall ensure that the prospective adoptive parent
or any other individual required to be checked pursuant to subsection (a) of this section is notified
of the individual's right to review the criminal history information, the procedure for completing
or challenging the accuracy of the criminal history, and the prospective adoptive parent's right to
contest the preplacement assessment of the county department of social services. Public child
placing agencies, including supervising county departments of socia l services, are required to
have an employee on staff that is trained and certified to receive criminal history record
information to the extent required by federal policy, law, and standards.
A prospective adoptive parent who disagrees with the preplacement assessment of the county
department of social services may request a review of the assessment pursuant to
G.S. 48-3-308(a)."
SECTION 5.3.(b) G.S. 131D-10.3A(f) reads as rewritten:
"(f) The Department shall notify in writing the foster parent and any pe rson applying to
be licensed as a foster parent, and that individual's supervising agency parent of the determination
by the Department of whether the foster parent or prospective foster parent is qualified to provide
foster care based on the criminal history of all individuals required to be checked. In accordance
with the law regulating the dissemination of the contents of the criminal history file furnished by
the Federal Bureau of Investigation, the Department shall not release nor disclose any portion of
an individual's criminal history to the foster parent or any other individual required to be checked.
checked pursuant to subsection (a) of this section. The Department may provide the foster parent,
prospective foster parent, or any other individual required to be checked pursuant to subsection
(a) of this section with a copy of that applicant's criminal history information for the purpose of
reviewing or challenging the accuracy of the criminal history. The Department shall also notify
the each individual required to be checked pursuant to subsection (a) of this section of the
individual's right to review the criminal history information, the procedure for completing or
challenging the accuracy of the criminal history, and the foster parent's or prospective foster
parent's right to contest the Department's determination. Public child placing agencies, including
supervising county departments of social services, are required to have an employee on staff that
is trained and certified to receive criminal history record information to the extent required by
federal policy, law and standards.
A foster parent or prospective foster parent who disagrees with the Department's decision
may request a hearing pursuant to Chapter 150B of the General Statutes, the Administrative
Procedure Act."
House Bill 576 Session Law 2025-27 Page 17
PART VI. LAWS PERTAI NING TO THE DIVISION OF STATE -OPERATED
HEALTHCARE FACILITIES
SUPPORT IMPLEMENTATION OF CAPACITY RESTORATION PILOT PROGRAMS
SECTION 6.1.(a) Part 6 of Article 5 of Chapter 122C of the General Statutes is
amended by adding a new section to read:
"§ 122C-256. Capacity restoration pilot programs.
(a) The following definitions apply in this section:
(1) CBCRP. – Community-based capacity restoration program.
(2) DCCRP. – Detention center capacity restoration program.
(b) Community-Based Capacity Restoration Program. – The Department or an
LME/MCO may contract for three or more CBCRP s. CBCRPs may be county -based or
regionally based. If regionally based, a CBCRP shall align with the State-operated psychiatric
hospital within closest proximity. The Department may consult with one or more LME/MCOs
for the purposes of contracting for CBCRPs under this subsection.
(c) Detention Center Capacity Restoration Program. – The Department or an LME/MCO,
in consultation and with the consent of relevant sheriffs, may contract for up to three DCCRPs.
DCCRPs may be county-based or regionally based. All county sheriffs choosing to participate in
a regional program must enter into an operational agreement with the sheriff hosting the regional
program prior to referring defendants to the program. A regionally based DCCRP shall align with
the State-operated psychiatric hospital within closest proximity. The Department may consult
with one or more LME/MCOs for the purposes of contracting for DCCRPs under this
subsection."
SECTION 6.1.(b) The Department of Health and Human Services (DHHS) and the
Administrative Office of the Courts, in collaboration with the North Carolina Sheriff's
Association, Indigent Defense Services, the Conference of District Attorneys, and other
stakeholders as dee med necessary, shall study relevant statutes and practices, and propose
legislative changes to create a permanent process and procedure for capacity restoration that does
not require involuntary commitment pursuant to Part 7 of Article 5 of Chapter 122C of the
General Statutes. DHHS and the Administrative Office of the Courts shall submit a report to the
Joint Legislative Oversight Committee on Health and Human Services with the proposed
legislative changes by January 1, 2026.
Page 18 Session Law 2025-27 House Bill 576
PART VII. EFFECTIVE DATE
SECTION 7.1. Except as otherwise provided, this act is effective when it becomes
law.
In the General Assembly read three times and ratified this the 26th day of June, 2025.
s/ Ralph Hise
Presiding Officer of the Senate
s/ Diane Wheatley
Presiding Officer of the House of Representatives
s/ Josh Stein
Governor
Approved 3:05 p.m. this 27th day of June, 2025