On April 30, 2020, the House passed HB 1043 – Pandemic Response Act. 

The House and Senate Appropriations Chairs are currently conferencing to decide which provisions from the House and Senate bills will be included in the final bill. A final bill is expected to be voted on by Friday.

Health Policy 

Increase Personal Protection Equipment (PPE)

The bill directs the Division of Public Health, the Division of Health Service Regulation, and the NC Division of Emergency Management to develop a plan for creating and maintaining a strategic stockpile of PPE.

The plan would be required to include who should have access to the stockpile, ways to increase production within the state, potential stockpile locations, recommendations of the amount and kinds of items to stockpile, an inventory mechanism, and a 5 year budget.

Health Provider Support

Dentists

The bill allows the NC Board of Dental Examiners to waive statutory requirements in an emergency. (The NC Medical Board and the NC Board of Nursing do have this authority currently.)

The bill allows dentists to administer COVID-19 tests.

Pharmacists

The bill allows the State Health Director to authorize immunizing pharmacists to administer the COVID-19 vaccine by a statewide order if one is approved by the CDC at a time when the NC General Assembly is not in session. It would be a requirement that the Director develop a written standard screening questionnaire and safety procedures for written protocols for the vaccine to the Joint Legislative Oversight Committee, the NC Medical Board, the NC Board of Nursing and the NC Board of Pharmacy within 10 days  of approving the petition. If this order moves forward, it would expire upon the adjournment of the next session.

The bill also allows pharmacists to use a government issued ID to identify patients picking up prescriptions.

Quality Improvement Plans

This bill would prohibit the enforcement of any administrative rule that would enforce quality improvement meetings between a PA or NP who had been practicing prior to February 2020. This would expire 60 days after the Executive Order is rescinded or December 31, 2020 (whichever is earlier).

Workforce Study

The bill directs the NC Area Health Education Center to study the issues impacting health delivery and the health workforce during a pandemic.

NCDHHS Flexibility

HealthConnex

The bill extends the deadline for providers to connect to HealthConnex from June 2020, to October 2021 to begin submitting demographic and clinical data in order to remain eligible for state funds.

Medicaid Coverage

The bill authorizes DHHS to provide Medicaid coverage for COVID-19 testing for the uninsured during the pandemic as allowed under the Families First Coronavirus Response Act.

The bill authorizes DHHS to provide Medicaid coverage to individuals with 200% FPL as described int he 1115 waiver DHHS submitted for federal approval. Coverage includes the prevention, testing, and treatment of COVID-19.

The bill requires DHHS to follow all federal laws necessary to receive enhanced Medicaid funding under the Families First Act.

Telehealth

Involuntary Commitment 

The bill allows for the first and second examinations for involuntary commitment to be conducted via telehealth if the commitment examiner is reasonably certain that a different result would not have been reached in a face to face examination.

The bill would require all insurers and the State Health Plan to  do the following

  • provide coverage for telephonic care and e-visits
  • provider coverage for provider to provider consultations
  • cover telehealth and virtual health services without prior authorization
  • cover physical therapy, occupational therapy, and speech therapy delivered via telehealth
  • Reimburse providers the same rate for telehealth services as they do for in person services

Medicaid and Medicare

The NCGA urges CMS to provider coverage for health care provided through audio only communication.

Liability Protections

This provision states that any health facility, health provider, or entity that holds legal responsibility for a health professional shall have immunity from any civil liability for any harm or damages alleged to have been sustained as a result of an act or omission in the course of providing health services.

Health Funding 

Behavioral Health and Crisis Services

  • $25 million in nonrecrruing funds to support public health efforts, local health departments, and rural health providers
  • $25 million in nonrecurring funds to support behavioral health services

Medicaid

  • $40 million in nonrecurring funds for coverage of additional costs related to the Medicaid program
  • 5% rate increase for all fee for service Medicaid rates for all providers
  • Authorization to provide Medicaid coverage for COVID-19 testing for the uninsured
  • Authorization to provide Medicaid coverage for to individuals with incomes up to 200% of the federal poverty level
  • Authorization to implement temporary Medicaid provider enrollment relief

Personal Protection Equipment

  • $50 million in nonrecurring funds to purchase PPE and other supplies and equipment

Testing

  • $25 milion in nonrecurring finds to expand public and private testing

Food, Safety, and Child Care

  • $6 million in nonrecurring funds to allocate equally among each of the 6 food banks
  • $2.5 million in nonrecurring funds to the Reinvestment Partners (non-profit organization) which provides funding to eligible Food and Nutrition Services Recipient enrolled by the recipient’s health care provider
  • $2.25 million in nonrecurring funds to assist in serving children in foster care to be used for monthly supplemental payments

Rural and Underserved Communities

  • $25 million in nonrecurring funds to support rural and underserved communities for items not addressed by federal funds
  • $75 million in nonrecurring funds to support rural hospitals
  • $1.4 million in nonrecurring funds to support the 67 free and charitable clinics
  • $1.5 million in nonrecurring funds to NC MedAssist to offset increased costs for services for the uninsured

Other Relief

  • $25 million in nonrecurring funds for NC Teaching Hospitals
  • $100 million to the NC Policy Collaboratory
  • $25 million to the Duke Human Vaccine Institute
  • $25 million to the UNC Gillings School of Public Health
  • $25 million to ECU Brody School of Medicine
  • $25 million to Wake Forest School of Medicine
  • $10 million to Campbell University Osteopathic School of Medicine

Economic Support

  • Would allow employer to initiate an unemployment claim for employees when unemployment is the result of a disaster
  • Appropriates $75 million to the Golden Leaf Foundation to provide emergency loan funding for small businesses