GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 H D HOUSE BILL DRH40438-MGa-15B Short Title: Taxpayer Accountability/Pregnancy Centers. (Public) Sponsors: Representative Cervania. Referred to: *DRH40438 -MGa-15B* A BILL TO BE ENTITLED 1 AN ACT ENHANCING TAXPAYER ACCOUNTABILITY BY REQUIRING THE 2 ESTABLISHMENT OF A COMPETITIVE GRANT PROCESS , PERFORMANCE 3 STANDARDS, AND ADDITIONAL REPORTING REQUIREMENTS FOR 4 PREGNANCY CENTERS. 5 The General Assembly of North Carolina enacts: 6 SECTION 1. Funds appropriated from the General Fund to the Department of Health 7 and Human Services, Division of Public Health, for each year of the 2025-2027 fiscal biennium 8 for Carolina Pregnancy Care Fellowship (CPCF), a nonprofit corporation, are subject to the 9 following requirements: 10 (1) The CPCF shall establish a competitive grant process for awarding the grants 11 authorized by subdivisions (a)(1) through (a)(3) of Section 9H.11 of S.L. 12 2023-134. The plan for administering the competitive grant process shall 13 include all of the following: 14 a. A request for application (RFA) process to allow pregnancy centers 15 located in this State to apply for and receive a grant authorized by this 16 section on a competitive basis. The RFA application shall include at 17 least all of the following components: 18 1. An explanation of the applicant's operations and staff, 19 including all of the following: 20 I. The hours of operation. 21 II. The full name, official position, credentials, specialties, 22 and salaries of all staff and volunteers. 23 III. Required qualifications, trainings, and credentials for 24 all employees, volunteers, contractors, and consultants. 25 IV. An explanation of the application process for 26 employees, volunteers, and consultants, including 27 whether the application requires a disclosure about 28 religious beliefs and if any answer or failure to answer 29 will disqualify an applicant. 30 V. What vendors and materials are used for training 31 employees, consultants, and volunteers. 32 VI. Whether licensed health care providers are required to 33 be on-site during operating hours and, if so, an 34 explanation of the requirement and what arrangements 35 are made if the requirement cannot be met. 36 H.B. 861 Apr 9, 2025 HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025 Page 2 DRH40438-MGa-15B VII. Whether any employees, contractors, or volunteers are 1 unlicensed health care providers. 2 VIII. Whether ultrasounds are performed on-site and, if so, 3 the qualifications of those performing and interpreting 4 the ultrasounds. 5 IX. Whether testing for sexually transmitted diseases is 6 performed on-site and, if so, the names and 7 qualifications of those performing such testing. 8 2. The specific activities, services, and programs provided by the 9 applicant during any part of the year. 10 3. A description of all medical equipment, the purposes of the 11 equipment, and funding sources for all of the equipment. 12 4. An explanation of the applicant's best practices with respect to 13 the use of medical equipment and the provision of any medical 14 testing, medical procedures, or counseling services. 15 5. A description of the applicant's advertising and marketing 16 practices. 17 b. A plan to evaluate the effectiveness, including measurable impact or 18 outcomes, of the activities, services, and programs for which the grant 19 funds are being requested. 20 c. A plan to monitor compliance with applicable law and the grant 21 agreement, with respect to the grantee's expenditure of grant funds. 22 d. A plan to detect fraud and abuse by grantees. 23 (2) No later than July 1 of each year, beginning July 1, 2026, the CPCF shall 24 announce the recipients of the competitive grant awards and allocate funds to 25 the grantees for the respective grant period pursuant to the amounts designated 26 under subsection (a) of this section. After awards have been granted, the CPCF 27 shall submit a report to the Department of Health and Human Services, the 28 Joint Legislative Commission on Governmental Operations, the Joint 29 Legislative Oversight Committee on Health and Human Services, and the 30 Fiscal Research Division on the grant awards that includes at least all of the 31 following information: 32 a. The identity and a brief description of each grantee and each activity, 33 service, and program offered by the grantee. 34 b. The amount of funding awarded to each grantee. 35 c. The number of persons served by each grantee, broken down by 36 activity, service, and program. 37 d. The number of persons served by the Circle of Care Program. 38 e. A copy of each grantee's RFA application. 39 (3) The CPCF may not use more than ten percent (10%) of the total amount of 40 funds allocated by this section for the 2023-2025 fiscal biennium and not more 41 than fifteen percent (15%) of the total amount of funds allocated by this 42 section for subsequent fiscal years for administrative purposes. 43 (4) Funds allocated to CPCF shall be used for nonsectarian, nonreligious purposes 44 only. 45 (5) Annually on July 1, beginning July 1, 2026, the CPCF shall report to the 46 Department of Health and Human Services, the Joint Legislative Commission 47 on Governmental Operations, the Joint Legislative Oversight Committee on 48 Health and Human Services, and the Fiscal Research Division on the use of 49 funds allocated under this section. The report shall include at least all of the 50 following information for the preceding fiscal year: 51 General Assembly Of North Carolina Session 2025 DRH40438-MGa-15B Page 3 a. A description of any monitoring activities undertaken by the CPCF to 1 ensure that grant funds awarded under the competitive grant process 2 authorized by this section are being spent for the purposes for which 3 they were requested. 4 b. A description of any technical assistance provided by the CPCF to 5 grant applicants or grantees. 6 c. A detailed breakdown of the funds expended by the CPCF for 7 administrative purposes related to the competitive grant process 8 authorized by this section. 9 (6) Annually on July 1, beginning July 1, 2026, each pregnancy center awarded 10 grant funds pursuant to the competitive grant process authorized by this 11 section shall report to the Department of Health and Human Services, the Joint 12 Legislative Commission on Governmental Operations, the Joint Legislative 13 Oversight Committee on Health and Human Services, and the Fiscal Research 14 Division on its use of the grant funds. The report shall include at least all of 15 the following information for the preceding fiscal year: 16 a. A report of its activities and services, broken down by funding source, 17 that includes the number of clients served by each pregnancy center 18 by county of residence and the following age categories: 19 1. Less than 16 years old. 20 2. 16 years old through 20 years old. 21 3. 21 years old through 25 years old. 22 4. 26 years old through 30 years old. 23 5. 31 years old through 35 years old. 24 6. 36 years old through 40 years old. 25 7. 41 years old through 45 years old. 26 8. 46 years old and older. 27 b. The number of visits by client for each of the previously defined age 28 categories, broken down by type of visit. 29 c. The number of services, supports, and referrals provided to clients for 30 each of the previously defined age categories, broken down by type of 31 service, support, or referral provided, including pregnancy counseling, 32 pregnancy testing, ultrasounds, and testing for sexually transmitted 33 diseases. 34 d. The number of service requests received by the pregnancy center. 35 e. The race and ethnicity data associated with clients receiving services. 36 f. The number of clients that fall under each of the following income 37 ranges: 38 1. Less than $20,000. 39 2. $20,000 to $34,999. 40 3. $35,000 to $49,999. 41 4. $50,000 to $74,999. 42 5. $75,000 to $99,999. 43 6. Over $100,000. 44 g. The total number of unduplicated clients served by the pregnancy 45 center and the total number of unduplicated new clients served during 46 the fiscal year. 47 SECTION 2. Chapter 131E of the General Statutes is amended by adding a new 48 section to read: 49 "ยง 131E-269.5. Pregnancy centers; performance standards; recovery of State funds for 50 noncompliance. 51 General Assembly Of North Carolina Session 2025 Page 4 DRH40438-MGa-15B (a) As used in this section, the term "pregnancy center" means any nonprofit organization 1 other than a hospital, ambulatory surgical facility, or clinic that performs abortions, that holds 2 itself out as a facility that provides care for pregnant women, including pregnancy counseling 3 services, pregnancy testing, and other nonmedical pregnancy services. 4 (b) The Department shall adopt rules establishing performance standards for pregnancy 5 centers operating in this State. The rules shall, at a minimum, establish a monitoring mechanism 6 and reporting requirements to facilitate the Department periodically assessing whether pregnancy 7 centers are adhering to the established performance standards. The reporting requirements shall, 8 at a minimum, require pregnancy centers to annually report to the Department at least all of the 9 following information for the preceding five-year period: 10 (1) All contracts and agreements entered into with the State of North Carolina or 11 Carolina Pregnancy Care Fellowship (CPCF), a nonprofit organization, during 12 the preceding five-year period. 13 (2) A list of all monetary transactions between the pregnancy center and State of 14 North Carolina or CPCF. 15 (3) Itemized annual expenditures for all of the following: 16 a. Individual employees, with a breakdown of the number of full-time 17 and part-time staff, the number of hours worked by each full-time and 18 part-time staff member, and the salaries and wages paid to each staff 19 member. 20 b. Administrative supplies and materials, with an explanation of the 21 purposes for these items. 22 c. All supplies and materials provided to individuals served by the 23 pregnancy center, including: 24 1. Pregnancy tests. 25 2. Diapers. 26 3. Medicines. 27 4. Baby food. 28 5. Baby formula. 29 d. Marketing and promotional materials, including all of the following: 30 1. Flyers. 31 2. Print advertisements. 32 3. Broadcast advertisements. 33 4. Digital and social media advertisements. 34 5. Promotions for fundraisers. 35 e. Educational materials for clients or patients, including pamphlets and 36 audiovisual seminars. 37 f. Travel expenses. 38 g. Medical equipment, including ultrasound machines. 39 h. Events sponsored by the pregnancy center. 40 i. Medical training and medical equipment training offered by the 41 pregnancy center. 42 j. Contracted services, including staffing services, event services, 43 information technology services, and cleaning services. 44 k. Rent or mortgage and utilities. 45 (4) Documentation of applications for employment and applications for 46 volunteers. 47 (5) Copies of Internal Revenue Service Form 990. 48 (c) The Department shall take appropriate administrative action to recover any amount 49 of grant funds or State appropriations disbursed to a pregnancy center for any fiscal year in which 50 the Department determines that the pregnancy center is out of compliance with the performance 51 General Assembly Of North Carolina Session 2025 DRH40438-MGa-15B Page 5 standards adopted under this section. A pregnancy center aggrieved by a final determination of 1 the Department pursuant to this subsection may appeal the decision as provided under Article 3 2 of Chapter 150B of the General Statutes." 3 SECTION 3. This act becomes effective July 1, 2025. 4