Governor’s Budget Proposal

The Governor released his budget proposal to the NCGA on March 24, 2021.

Here is a link to a general overview of all of the budget allocations.

Here is a link to the presentation made to the NCGA Joint Appropriations Committee by the State Budget Director.

Highlights from provisions related to Health and Human Services include:

Division of Aging and Adult Services

  • Provides $2M in recurring funds in FY 2021-22 and $2M in recurring funds in FY 2022-23 to support aging and adult services by increasing the state’s supplement in the Home and Community Care Block, which funds services for older adults and their caregivers across the state.
  • Provides $3,585,000 in recurring funds in FY 2021-22 and $3,585,000 in recurring funds in FY 2022-23 to increase the state’s investment in nutrition services for older adults.
  • Provides $6,250,000 in recurring funds in FY 2021-22 and $6,250,000 in recurring funds in FY 2022-23to support Key Rental Assistance, which provides supportive house programs for people who are low income and/or disables and in need of affordable housing.
  • Provides $1,500,000 in recurring funds in FY 2021-22 and $1,500,000 in recurring funds in FY 2022-23 to establish an Adult Protective Services Essential Services Fund to provide services such as caregiver support, housing improvements, transportation, and adult day/health care to individuals ages 18 and over.

Division of Social Services

  • Provides $1,550,000 in recurring funds in FY 2021-22 and $21,550,000 in recurring funds in FY 2022-23 to fund 15 new positions to provide support, training, and technical assistance to counties under the regional support model and to staff a Child Protective Services technical hotline.
  • Provides $6M in nonrecurring funds in FY 2021-22 and $6M in nonrecurring funds in FY 2022-23 to help the state and counties with the estimated federal revenue loss resulting from the reduced reimbursement for children in congregate care settings received under the Family First Prevention Services Act.
  • Provides $8.5M in recurring funds in FY 2021-22 and $10M in recurring funds in FY 2022-23 to address critical staffing shortages identified for local social services for Adult Protective Services and Child Protective Services.
  • Provides $190K in recurring funds in FY 2021-22, $190K in recurring funds in FY 2022-23, and $950K in nonrecurring funds in FY 2021-22 to replace the county reimbursement system to reduce county resource time and reporting effort to allow workers to spend more time serving families.

Division of Vocational Rehabilitation

  • Provides $1M in nonrecurring funds in FY 2021-22 to design a supply of adaptive equipment and assistive technologies available to people with disabilities to enable them to live, work, and be educated in their communities.

Division of Central Management and Support

  • Provides $600K in recurring funds in FY 2021-22, $600K in recurring funds in FY 2022-23, and $400K in nonrecurring funds in FY 2021-22 to establish a new Housing Coordination Office to coordinate housing programs and services across divisions and to coordinate with external partners on statewide housing issues.
  • Provides $600K in recurring funds in FY 2021-22 and $600K in recurring funds in FY 2022-23 to support new positions in the Healthy Opportunities Office.
  • Provides $3,155,000 in recurring funds in FY 2021-22 and $3,155,000 in recurring funds in FY 2022-23 to fund operations, maintenance, and development for critical information technology projects including security applications, independent assessments, and NC FAST Child Welfare System enhancements.
  • Provides $35,036,952 in recurring funds in FY 2021-22 and $35,675,431 in recurring funds in FY 2022-23 to fund operations and maintenance, training, and additional technical assistance for NC FAST Child Welfare System enhancements.
  • Provides funding to modernize NC FAST through cloud-based computing solutions and development of a document management system to enhance program integrity.
  • Authorizes the use of receipts for the NC FAST Child Welfare System.
  • Authorizes the use of receipts for NC FAST Infrastructure Modernization

Division of Child Development and Early Education

  • Incrementally increases the NC Pre-K slot reimbursement rates by investing lottery receipts of $22.75M in FY 2021-22 and $27.55M in FY 2022-23.
  • Incrementally expands slot allocation in the second year of the biennium by investing $9.75M in lottery receipts.
  • Provides $10M in recurring funds in FY 2021-22 and $26M in recurring funds in FY 2022-23 to provide funding for and expand statewide participation in the Child Care WAGE$ program which provides educational attainment-based salary supplements for early childhood educators.
  • Invests $20M in lottery receipts to Smart Start to expand statewide access.
  • Provides $10M in recurring funds in FY 2021-22 and $10M in recurring funds in FY 2022-23 to fund approximately 1,700 additional slots for child care subsidy payments for children from low-income working families.
  • Provides $500K in recurring funds in FY 2021-22 and $1M in recurring funds in FY 2022-23 to fund an initiative to decrease the impact of implicit bias on children of color and children with disabilities.

Division of Public Health

  • Provides $845K in recurring funds in FY 2021-22 and $845K in recurring funds in FY 2022-23 to expand the Office of Minority Health and Health Disparities to increase efforts to eliminate health disparities among racial and ethnic minorities and other underserved populations in NC.
  • Provides $8,150,000 in recurring funds in FY 2021-22 and $10,250,000 in recurring funds in FY 2022-23 to increase funding for individualized early intervention services and supports to families with children birth to age 3 with developmental delays and established medical conditions currently eligible for the NC Infant Toddler Program.

Division of Health Benefits

  • Provides a recommendation to expand Medicaid eligibility beginning October 1, 2021 to provide healthcare access for more than 600,000 North Carolinians, prevent rural hospital closure, reduce the number of uninsured veterans, help respond to the opioid epidemic, and secure NC’s share of federal resources of over $5 billion in direct investment. The American Rescue Plan of 2021 provides an additional $1.7 billion in federal funds through Medicaid expansion over two years, of which $400M would support health initiatives designed to increase mental health and telehealth access and programs to support workforce development and Medicaid beneficiary transitions to employer or other private coverage options.
  • Provides in $255,944,748 recurring funds in FY 2021-22, $614,222,759 in recurring funds in FY 2022-23, and $187,566,506 in nonrecurring funds in FY 2021-22 to provide funds to reflect changes in the federal medical assistance percentage, as well as changes in enrollment, utilization, costs, rates, and services association with the Medicaid program.
  • Provides in $26,611,829 recurring funds in FY 2021-22 and $30,741,972 in recurring funds in FY 2022-23 to support the transition and implementation of Medicaid Transformation.
  • Provides $150M in nonrecurring funds for FY 2021-22 for the runout of Medicaid and NC Health Choice fee-for-service claims associated with beneficiaries who have moved to managed care.
  • Provides $64M nonrecurring funds in FY 2021-22 and $64M in nonrecurring funds in FY 2022-23 for implementation of Tailored Plan Care Management provided by a Tailored Plan, Advanced Medical Home, or Care Management Agency.
  • Provides $600K in recurring funds in FY 2021-22 and $600K in recurring funds in FY 2022-23 to support Healthy Opportunities Pilot initiatives to test the impact of health outcomes and health care costs of integrating and financing evidence-based non-medical services into the delivery of Medicaid in up to three pilot regions.
  • Provides $10,998,549 in recurring funds in FY 2021-22 and $10,998,549 in recurring funds in FY 2022-23 to support the increased contractual costs for NC Tracks operations and maintenance functions.
  • Provides $314,080 in recurring funds in FY 2021-22 and $314,080 in recurring funds in FY 2022-23 to support recurring operations and maintenance costs for the electronic vendor verification system to support services requiring an in-home visit by providers.
  • Provides $10,093,200 recurring funds in FY 2021-22 and $13, 457,600 in recurring funds in FY 2022-23 to fund an additional 520 slots for the NC Innovations waiver, which provides individualized services in the home and community to individuals who qualify for institutional level care due to intellectual or developmental disabilities.
  • Provides $1M in recurring funds in FY 2021-22 and $1M in recurring funds in FY 2022-23 to fund an additional 114 slots for the Community Alternatives Program for Disabled Adults waiver, which provides individualized services in the home and community for Medicaid beneficiaries who are medically fragile and at risk for institutionalization.
  • Provides $680,610 in recurring funds in FY 2021-22 and $680,610 in recurring funds in FY 2022-23 to increase funding for the Transition to Community Living Initiative, which supports adults with mental illness in transitioning from institutions to community care settings.
  • Provides $4.25M in recurring funds in FY 2021-22 and $4.25M in recurring funds in FY 2022-23 to fund additional assessment services for the individuals served through the Community Alternatives Program for Children.
  • Provides $20M in recurring funds in FY 2021-22 and $25M in recurring funds in FY 2022-23 to fund the beginning phase of a multi-year initiative to stabilize the long-term care workforce by increasing wages to support recruitment and retention of highly qualified direct care workers.

Division of Mental Health/Developmental Disabilities/Substance Abuse Services

  • Provides $15,077,155 in recurring funds in FY 2021-22 and $15,077,155 in recurring funds in FY 2022-23 to fund the completion of the phased-in implementation of the Transitions to Community Living Initiative and expand the number of individuals transitioning into housing slots, increase the number of referrals to supported employment, and serve more individuals in Assertive Community Treatment.
  • Provides $4,604,182 in recurring funds in FY 2021-22 and $$,604,182 in recurring funds in FY 2022-23 to expand funding for Mental Health First Aid training to identify mental health and substance use disorders and connect individuals with resources and supports.
  • Provides $1.95M in recurring funds in FY 2021-22 and $1.95M in recurring funds in FY 2022-23 to support Mobile Crisis Management services to decrease wait times, enhance family engagement, and provide stabilization services up to four weeks post-acute crisis event to better connect children to behavioral health services.
  • Provides $10.9M in recurring funds in FY 2021-22 and $20M in recurring funds in FY 2022-23 for technology upgrades and electronical health record system development at State Psychiatric Hospitals, Drug and Alcohol Treatment Centers, and other state-operated health care facilities to enhance services and patient safety.

Other pertinent provisions include:

Department of Public Instruction

  • Provides $1.5M in recurring funds for FY 2021-22 and $6M in recurring funds for FY 2022-23 to establish a pilot grant program designed to support high poverty schools that adopt a community schools or other evidence-based model to address barriers to learning. Funding would provide for up to 97 new full-time positions.
  • Provides $3.9M in recurring funds for FY 2022-23 to reduce the co-pays for students eligible for reduced price lunches in schools participating in the National School Lunch Program.
  • Provides $250K in recurring funds for FY 2021-22 and $250K in recurring funds for FY 2022-23 to expand the NC Preschool Pyramid PreK/Kindergarten Social Emotional Learning model to low-performing and/or underfunded LEAs.
  • Provides $5,150,000 in recurring funds for FY 2022-23 to address a shortfall in program funding for the E-Rate program, which helps provides public school classrooms with wireless access through fiber-based broadband internet.

 UNC System Office

  • Provides $500,000 for FY 2021-22 to provide advance planning funds for a new Institute for Health Disparities at Winston Salem Statue University.
  • Provides $4.6M in recurring funds for FY 2021-22 and $4.6M in recurring funds for FY 2022-23 to support the UNC Mountain Area Health Education Center.

NC Housing Finance Agency

  • Increases the annual appropriation ($7,660,000 in recurring funds for FY 2021-22 and $7,660,00 in recurring funds for FY 2022-23) for the Housing Trust Fund, the State’s most flexible source of money for affordable housing.

Department of Military and Veterans Affairs

  • Provides $100K in recurring funds for FY 2021-22 and $100K in recurring funds for FY 2022-23 to create a suicide prevention program for active duty military and veteran in the State.

Department of Administration

  • Provides $775K in recurring funds for FY 2021-22, $775K in recurring funds for FY 2022-23, and $2M in nonrecurring funds for FY 2021-22 to provides grant funds for eligible domestic violence agencies, the NC Coalition Against Domestic Violence, eligible sexual assault agencies, and the NC Coalition Against Sexual Assault.
  • Provides $500K in recurring funds for FY 2021-22, $500K in recurring funds for FY 2022-23, and $175K in nonrecurring funds for FY 2021-22 to fund the Small Business Enterprise Program and the implementation of additional recommendations from the Disparity Study to help the State address the disproportionate impact of COVID-19 on communities of color.

Department of Information Technology

  • Invests settlement funds from the Dish Network lawsuit in a distance-learning package that supports subscription payments for schools that have issued students hot spots and other devises using CARES Act funds but were prohibited from using those funds for monthly fees, classroom technology upgrades, digital literacy and equity projects, and other innovative solutions designed to increase student internet connectivity.

Department of Public Safety

  • Provides $1,309,211 in recurring funds in FY 2021-22, 1,871,711 in recurring funds in FY 2022-23, $299,562 in nonrecurring funds in FY 2021-22 and $5K in nonrecurring funds in FY 2022-23 to fund additional re-entry probation and parole officers to provide transition planning to offenders for release from custody and one Parole Case Analyst to perform an evidence-based risk assessment on post-release/supervision cases to ensure offenders are matched with appropriate community resources.
  • Provides $1M in nonrecurring funds in FY 2021-22 to fund community violence prevention grants, which will be awarded to community and healthcare organizations that approach violence as a public health issue.

Department of Environmental Quality

  • Provides $24M in nonrecurring funds in FY 2021-22 and $6M in nonrecurring funds in FY 2022-23 to local governments statewide to achieve their sustainability goals through planning and implementation of clean energy and clean transportation projects that equitably advance energy efficiency, renewable energy, vehicle electrification and related priorities.
  • Provides $15M in nonrecurring funds in FY 2021-22 and $5M in nonrecurring funds in FY 2022-23 to fund a grant program for school districts to implement energy efficiency and clean energy projects to provide a healthier, safer, and more cost-effective learning environment.
  • Provides $15M in nonrecurring funds in FY 2021-22 and $9M in nonrecurring funds in FY 2022-23 to expand access to clean energy and energy improvements in low-income households.

Capital Improvements

  • Authorizes $229,000,000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to construct a new Administrative Complex for DHHS on Blue Ridge Road in Raleigh.
  • Authorizes$60,275,0000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund major renovations at the J. Iverson Riddle Development Center.
  • Authorizes $20,808,0000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund major renovations at the Black Mountain Neuro-medical Center.
  • Authorizes $50,904,000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund major renovations at the Murdoch Developmental Center.
  • Authorizes $23,833,800 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund major renovations at the O’Berry Neuro-medical Center.
  • Authorizes $187,000,000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund the construction of a new School of Medicine to replace the existing Brody School of Medicine at East Carolina University.
  • Authorizes $67,500,000 in nonrecurring funds in General Obligation Bonds, subject to a vote of the people, to fund the construction of a new School of Health Services to expand health services education in rural NC at UNC-Pembroke.
  • Provides $14,100,000 in nonrecurring funds for major renovations of the facilities at the Longleaf Nero-medical Center.
  • Provides $6,697,300 in nonrecurring planning funds for the renovation of facilities at the J. Iverson Riddle Development Center.
  • Provides $2,312,000 in nonrecurring planning funds for the renovation of facilities at the Black Mountain Neuro-medical Center.
  • Provides $5,656,000 in nonrecurring planning funds for renovations of the facilities at the Murdoch Development Center
  • Provides $2,648,000 in nonrecurring planning funds for the renovation of facilities at the O’Berry Neuro-medical Center.
  • Provides $4,492,000 in nonrecurring funding for building upgrades for the dorms at the Julian Keith Alcohol and Drug Abuse Treatment Center.
  • Provides $9,000,000 in nonrecurring funds to expand TROSA into the Triad area to provide substance abuse disorder treatment and counseling, and to help participants learn work skills and find employment.
  • Provides $28,000,000 in nonrecurring funds for the planning and initial construction of a new School of Medicine to replace the existing Brody School of Medicine at ECU.
 
 

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