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| A summary of news from Raleigh that affects Duke University, Duke Health, and Duke LifePoint Healthcare. September 3, 2021
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In This Issue...
- State Budget Negotiations Continue
- Governor Cooper Signs CON Threshold Bill
- Two Patient Visitation Policy Bills Head to Governor Cooper
- Redistricting Public Hearings Begin Next Week
- Court Rules that Transgender State Employees Can Sue for Health Care Discrimination
- Session Resources
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State Budget Negotiations Continue
Republican budget writers have spent the last several weeks negotiating differences between the House and Senate's version of the state budget, but are unlikely to have a budget finalized before the end of September and have made little progress according to Senate leader Phil Berger. The legislature typically aims to pass a new state budget by the end of the fiscal year on June 30th, but lawmakers are months behind schedule this year with the Senate passing its version of the budget in June and the House passing its version in August. The two chambers have sticking points on several major spending provisions, including differences in the amount of tax cuts, state employee pay raises, and funding for state capital projects. The House also included many more policy provisions in their version of the budget than the Senate did. Republican leaders from both chambers have met with Democratic Governor Roy Cooper to include him in the negotiation process with hopes of reaching a compromise for the budget to become law this year given that the Governor vetoed the budget in 2019.
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Governor Signs CON Threshold Bill
Governor Cooper signed a bill this week amending the state's Certificate of Need (CON) regulations. The new law increases the price threshold for when new equipment or facilities would require a CON and indexes price increases to inflation each year. The law also ensures that providers use a CON within a certain amount of time after receiving it, known as a "shot-clock" provision. Projects costing more than $50 million would have to begin within four years, and projects costing $50 million or less would have to start within two years. At the request of hospitals, a provision was added to clarify that a timeline for a project can be extended if there are extenuating circumstances that delay the initiation of a project. The NC Senate has pushed CON reform for years, and while hospitals have typically been opposed to such measures, bill sponsors worked with the NC Healthcare Association this session to negotiate parts of the legislation.
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Two Patient Visitation Policy Bills Head to Governor Cooper
The legislature gave final approval to two patient visitation policy bills this week that now await Governor Cooper's signature. Several patient visitation policy bills were introduced at the legislature this session in response to healthcare facilities limiting visitation during the height of the COVID-19 pandemic. One bill on Governor Cooper's desk requires hospitals to allow clergy members to visit admitted patients, despite any disaster declarations or the use of the hospital as a temporary emergency shelter. Another bill provides visitation rights for patients in nursing homes, combination homes and adult care homes, and would allow each resident to receive a visit at least twice per month from one preapproved visitor or alternate visitor. It is unknown whether or not Governor Cooper will sign these bills into law. The No Patient Left Alone Act is also nearing passage at the legislature, which would ensure visitation rights for patients in most healthcare facilities during a declared disaster or emergency. A final version is likely to be voted on in the next week or two.
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Redistricting Public Hearings Begin Next Week
This week the House and Senate Redistricting Committees released a schedule for public hearing sessions across the state for members of the public to weigh in on the redistricting process. Beginning next week and running through the end of the month, public hearings will take place in Caldwell, Forsyth, Pasquotank, Durham, Nash, Alamance, Pitt, Jackson, Mecklenburg, Iredell, Robeson, New Hanover and Cumberland counties. The public may sign up on-line to speak at public hearings, and may also sign up to speak on site starting one hour prior to the start of the hearing. Legislators are also still allowing public comments to be submitted online through the NC General Assembly's website. House and Senate Redistricting Committees were supposed to vote on a final public hearing schedule this week, but the schedule was finalized and released without committee approval. After the public hearings, lawmakers will work on an expedited timeline to approve legislative district maps in time for the state and congressional candidate filing deadline in December.
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Court Rules that Transgender State Employees Can Sue NC for Health Care Discrimination
Transgender people enrolled in the North Carolina State Health Plan can proceed with a lawsuit against the state for banning the use of state health insurance to pay for transition care, treatment and surgery, according to a court ruling this week. In 2018, State Treasurer Dale Folwell excluded the coverage of such health care services from the State Health Plan's insurance policies. Shortly thereafter, a group of state employees filed a lawsuit accusing the State Health Plan of discrimination against them or their children for not covering gender-affirming care. Attorneys for the state previously argued that the state had sovereign immunity from the lawsuit, but judges ruled that the immunity was waived when North Carolina used federal funds on the state’s health plan but did not uphold certain requirements of the Affordable Care Act. The Affordable Care Act prohibits any health program or activity that receives federal funds from discriminating against individuals on any grounds prohibited by various federal laws, including Title IX dealing with gender discrimination. The judges also said that gender-affirming care is medically necessary and should therefore be covered by the State Health Plan. In response to the court's decision this week, Treasurer Folwell has called for the U.S. Supreme Court to overturn this ruling.
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Session Resources
The North Carolina General Assembly is in full swing with its legislative session this year. Duke State Relations provides many resources on our website for you to stay up-to-date about legislative activity, including our blog, a list of bills we monitor, and general information about the North Carolina General Assembly and the legislative process. Please contact us if you are interested in becoming involved with advocacy efforts, or if there is a particular legislative issue that you'd like to learn more about.
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