GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 522
Short Title: Thrive at Midlife Act. (Public)
Sponsors: Senator Theodros (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 26, 2025
*S522 -v-1*
A BILL TO BE ENTITLED 1
AN ACT EXPANDING ACC ESS TO AFFORDABLE, COMPREHENSIVE HEALTHC ARE 2
FOR WOMEN IN MIDLIFE THROUGH IMPROVED HE ALTH INSURANCE AND 3
MEDICAID COVERAGE; P ROGRAMS TO EXPAND AC CESS TO ESSENTIAL 4
MIDLIFE HEALTHCARE S ERVICES; TAX CREDITS FOR INDIVIDUALS AND 5
BUSINESSES FOR MIDLIFE HEALTHCARE EXPENS ES; EXPANDED ACCESS TO 6
PROVIDERS TRAINED IN ESSENTIAL MIDLIFE H EALTHCARE SERVICES; 7
PUBLIC AWARENESS AND OUTREACH; BETTER DA TA COLLECTION AND 8
OVERSIGHT; ESTABLISHMENT OF A MIDLIFE HEALTH ADVISORY COUNC IL; 9
AND APPROPRIATING FUNDS FOR THESE PURPOSES. 10
Whereas, women in midlife (ages 40-65) face unique healthcare challenges, including 11
menopause-related conditions, increased risk of chronic diseases, and barriers to affordable 12
healthcare access; and 13
Whereas, improving access to midlife healthcare services will enhance quality of life, 14
reduce long-term healthcare costs, and promote preventive care for women in North Carolina; 15
and 16
Whereas, it is the policy of the State of North Carolina to promote public health and 17
equitable healthcare access; Now, therefore, 18
The General Assembly of North Carolina enacts: 19
20
PART I. TITLE 21
SECTION 1.1. This act shall be known as "The Thrive at Midlife Act." 22
23
PART II. DEFINITIONS 24
SECTION 2.1. The following definitions apply in this act: 25
(1) Essential midlife healthcare services. – Includes, but is not limited to, all of 26
the following: 27
a. Menopause-related care and hormone therapy. 28
b. Osteoporosis screenings. 29
c. Cardiovascular disease prevention. 30
d. Diabetes screenings and management. 31
e. Mammograms and cervical cancer screenings. 32
f. Mental health and wellness programs. 33
g. Telehealth services for midlife-specific conditions. 34
(2) Midlife women. – Individuals assigned female at birth or who identify as 35
women and who are at least 40 but less than 65 years of age. 36 General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 522-First Edition
1
PART III. EXPANDED COVERAGE REQUIREMENTS 2
3
INSURANCE MANDATES 4
SECTION 3.1.(a) Article 3 of Chapter 58 of the General Statutes is amended by 5
adding a new section to read: 6
"§ 58-3-305. Coverage required for essential midlife healthcare services. 7
(a) All health benefit plans shall include coverage for essential midlife healthcare 8
services for individuals who either (i) were assigned female at birth or (ii) identify as a woman 9
and who are at least 40 years of age but less than 65 years of age. 10
(b) Essential midlife healthcare services required to be covered under this section include 11
all of the following: 12
(1) Menopause-related care and hormone therapy. 13
(2) Osteoporosis screenings. 14
(3) Cardiovascular disease prevention. 15
(4) Diabetes screening and management. 16
(5) Mammograms and cervical cancer screenings. 17
(6) Mental health and wellness programs. 18
(7) Telehealth services for midlife-specific conditions. 19
(c) Any cost-sharing requirements, including copayments and deductibles, for essential 20
midlife healthcare services shall not exceed those established for preventative services under the 21
Patient Protection and Affordable Care Act, P.L. 111-148, as amended, or other applicable 22
federal law." 23
SECTION 3.1.(b) The Department of Health and Human Services, Division of 24
Health Benefits, shall ensure coverage for essential midlife healthcare services, as described in 25
G.S. 58-3-305(b), for Medicaid recipients who either (i) were assigned female at birth or (ii) 26
identify as a woman and who are at least 40 years of age but less than 65 years of age. 27
SECTION 3.1.(c) Subsection (a) of this section is effective October 1, 2025, and 28
applies to insurance contracts issued, renewed, or amended on or after that date. The remainder 29
of this section is effective when it becomes law. 30
31
MIDLIFE HEALTH ACCESS PROGRAM 32
SECTION 3.2.(a) Effective July 1, 2025, there is appropriated from the General 33
Fund to the Department of Health and Human Services, Division of Central Management and 34
Support, Office of Rural Health (ORH), the sum of ten million dollars ($10,000,000) in recurring 35
funds for each year of the 2025-2027 fiscal biennium to establish a Midlife Health Access Grant 36
Program (Program). The purpose of the Program is to provide directed grants on a competitive 37
basis to federally qualified health centers, rural health clinics, community-based nonprofit 38
organizations, and other safety-net providers that are capable of providing essential midlife 39
healthcare services to midlife women who are uninsured regardless of their ability to pay. 40
SECTION 3.2.(b) The ORH shall develop application materials and selection 41
criteria for the Program. The selection criteria shall take into consideration the availability of 42
other funds available to the grantee and the incidence of poverty in the area served by the grantee. 43
The ORH shall make the final decision about awarding grants under this Program, subject to the 44
following requirements and limitations: 45
(1) The ORH shall give priority to applicants located in rural and underserved 46
areas of the State. 47
(2) The maximum amount of a grant award under the Program is one hundred 48
thousand dollars ($100,000) per grantee. 49
SECTION 3.2.(c) The ORH may use up to five percent (5%) of these allocated funds 50
to pay for administrative costs associated with establishing and administering the Program. 51 General Assembly Of North Carolina Session 2025
Senate Bill 522-First Edition Page 3
SECTION 3.2.(d) Annually by April 1, beginning April 1, 2027, the ORH shall 1
report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal 2
Research Division on the Program authorized by this section. The report shall include at least all 3
of the following information regarding the preceding fiscal year: 4
(1) A detailed breakdown of expenditures for the Program. 5
(2) The identity and a brief description of each grantee and the amount of funding 6
awarded to each grantee. 7
(3) The number of people served by each grantee. 8
(4) Any other information the Department deems relevant in evaluating the 9
success of the Program. 10
11
PART IV. FINANCIAL RELIEF MEASURES 12
13
MIDLIFE HEALTHCARE INDIVIDUAL TAX CREDIT AND BUSINESS TAX CREDIT 14
SECTION 4.1.(a) Article 4 of Chapter 105 of the General Statutes is amended by 15
adding two new sections to read: 16
"§ 105-153.12. Midlife healthcare individual tax credit. 17
(a) Definitions. – The following definitions apply in this section: 18
(1) FDA. – The United States Food and Drug Administration. 19
(2) Expenses for midlife healthcare. – Expenses for any of the following: 20
a. Menopause-related treatments, including hormone therapy, 21
prescription medications, and medically recommended non-hormonal 22
alternatives. 23
b. Preventative health screenings, including mammograms, cervical 24
cancer screenings, osteoporosis screenings, and cardiovascular risk 25
assessments. 26
c. Chronic disease management, including treatment of diabetes, 27
hypertension, cholesterol issues, and other midlife-onset chronic 28
conditions. 29
d. Mental health services, including therapy or counseling related to 30
midlife hormonal changes, menopause-induced anxiety, and 31
depression. 32
e. Telehealth visits conducted for a treatment, screening, or service under 33
sub-subdivisions a. through d. of this subdivision. 34
(3) Expenses for menopause treatment. – Expenses for any FDA-approved 35
therapy, medication, or intervention prescribed by a licensed physician for 36
managing menopause symptoms, including the following: 37
a. Hormone replacement therapy. 38
b. Non-hormonal prescription treatments. 39
c. Prescription vaginal estrogen treatments. 40
(4) Expenses for prescription medications. – Expenses for FDA-approved 41
prescription medications that directly address midlife health concerns, 42
including osteoporosis, cardiovascular health, menopause, and diabetes. 43
(5) Out-of-pocket expenses. – The total of the following expenses that are not 44
reimbursed by health insurance: 45
a. Expenses for midlife healthcare. 46
b. Expenses for menopause treatment. 47
c. Expenses for prescription medications. 48
(b) Credit. – A taxpayer who has out-of-pocket expenses is allowed a credit against the 49
tax imposed by this Part equal to a percentage of the taxpayer's out-of-pocket expenses listed in 50 General Assembly Of North Carolina Session 2025
Page 4 Senate Bill 522-First Edition
the table below and based upon the taxpayer's filing status and adjusted gross income, as 1
calculated under the Code: 2
Filing Status AGI Credit Amount 3
Married, filing jointly Up to $100,000 100% 4
Over $100,000 5
Up to $200,000 50% 6
Over $200,000 0% 7
8
Head of Household Up to $100,000 100% 9
Over $100,000 10
Up to $200,000 50% 11
Over $200,000 0% 12
13
Single Up to $100,000 100% 14
Over $100,000 0% 15
16
Married, filing separately Up to $100,000 100% 17
Over $100,000 0%. 18
(c) Credit Refundable. – If the credit allowed by this section exceeds the amount of tax 19
imposed by this Part for the taxable year reduced by the sum of all credits allowable, the Secretary 20
must refund the excess to the taxpayer. The refundable excess is governed by the provisions 21
governing a refund of an overpayment by the taxpayer of the tax imposed by this Part. In 22
computing the amount of tax against which multiple credits are allowed, nonrefundable credits 23
are subtracted before refundable credits. 24
"§ 105-153.13. Midlife healthcare business tax credit. 25
(a) Definitions. – The definitions in G.S. 105-153.12 and the following definitions apply 26
in this section: 27
(1) Eligible business. – A business with a physical presence in the State that has 28
out-of-pocket expenses. 29
(2) Out-of-pocket expenses. – As defined in G.S. 105-153.12 and paid by an 30
eligible business on behalf of a qualifying employee. 31
(3) Qualifying employee. – An individual employed (i) for consideration for at 32
least 35 hours a week and whose wages are subject to withholding under 33
Article 4A of Chapter 105 of the General Statutes and (ii) by an eligible 34
business. 35
(b) Credit. – A taxpayer who is an eligible business and has out-of-pocket expenses is 36
allowed a credit against the tax imposed by this Part equal to ten percent (10%) of the taxpayer's 37
total out-of-pocket expenses. 38
(c) Credit Refundable. – If the credit allowed by this section exceeds the amount of tax 39
imposed by this Part for the taxable year reduced by the sum of all credits allowable, the Secretary 40
must refund the excess to the taxpayer. The refundable excess is governed by the provisions 41
governing a refund of an overpayment by the taxpayer of the tax imposed by this Part. In 42
computing the amount of tax against which multiple credits are allowed, nonrefundable credits 43
are subtracted before refundable credits. 44
(d) Aggregate Limitation. – The total amount of credits allowed pursuant to this section 45
may not exceed in the aggregate five million dollars ($5,000,000) for all taxpayers for any one 46
calendar year. 47
(e) Application. – An eligible business seeking to claim a tax credit provided for under 48
this section shall submit an application to the Department of Revenue for tentative approval for 49
the tax credit in the year for which the tax credit is claimed or allowed. Applications shall be 50
accepted on a first come, first served basis. The Department of Revenue shall provide for the 51 General Assembly Of North Carolina Session 2025
Senate Bill 522-First Edition Page 5
manner in which the application is to be submitted and the information required in the application 1
which shall include, at a minimum, proof of the applicant business's out-of-pocket expenses. The 2
Department of Revenue shall review the application and tentatively shall approve the application 3
upon determining that it meets the requirements of this section by January 31 of the year after 4
the application was submitted. If the credit amounts on the tax credit applications filed with the 5
Department of Revenue exceed the maximum aggregate limit of tax credits, then the tax credit 6
must be allocated among the eligible business entities who filed a timely application on a first 7
come, first served basis based upon the amounts otherwise allowed by this section. Once the tax 8
credit application has been approved and the amount has been communicated to the applicant, 9
the eligible business then may apply the amount of the approved tax credit to its tax liability for 10
the tax year of which the approved application applies. 11
(f) Report. – By March 31 of each year, the Department of Revenue shall report to the 12
Joint Legislative Committee on Governmental Operations by county, the number of eligible 13
business tax credit applications the Department has received, the number of tax credit 14
applications approved, and the tax credits approved. This report must be made available in a 15
conspicuous place on the Department's website." 16
SECTION 4.1.(b) This section is effective for taxes imposed for taxable years 17
beginning on or after January 1, 2025. 18
19
THRIVE AT MIDLIFE GRANT PROGRAM FOR SMALL BUSINESS 20
SECTION 4.2.(a) Creation; Administration. – The Thrive at Midlife Grant Program 21
(Program) is established and shall be administered by the Department of Health and Human 22
Services in accordance with this section. 23
SECTION 4.2.(b) Purpose. – The purpose of the program is to promote access to 24
and support for midlife healthcare by providing financial assistance in the form of grants to 25
eligible businesses who have out-of-pocket expenses. 26
SECTION 4.2.(c) Definitions. – The following definitions apply in this section: 27
(1) Department. – The Department of Health and Human Services. 28
(2) Eligible business. – A business with a physical presence in the State that (i) 29
has its headquarters located in this State, (ii) employs 50 or fewer people in 30
this State, (iii) has out-of-pocket expenses during the taxable year in which it 31
applies for grant funding under this section, and (iv) submits proof of its 32
out-of-pocket expenses on a form and in a manner approved by the 33
Department. 34
(3) Expenses for menopause treatment. – Expenses for any FDA approved 35
therapy, medication, or intervention prescribed by a licensed physician for 36
managing menopause symptoms, including the following: 37
a. Hormone replacement therapy. 38
b. Non-hormonal prescription treatments. 39
c. Prescription vaginal estrogen treatments. 40
(4) Expenses for midlife healthcare. – Expenses for any of the following: 41
a. Menopause related treatments, including hormone therapy, 42
prescription medications, and medically recommended non-hormonal 43
alternatives. 44
b. Preventative health screenings, including mammograms, cervical 45
cancer screenings, osteoporosis screenings, and cardiovascular risk 46
assessments. 47
c. Chronic disease management, including treatment of diabetes, 48
hypertension, cholesterol issues, and other midlife onset chronic 49
conditions. 50 General Assembly Of North Carolina Session 2025
Page 6 Senate Bill 522-First Edition
d. Mental health services, including therapy or counseling related to 1
midlife hormonal changes, menopause induced anxiety, and 2
depression. 3
e. Telehealth visits conducted for a treatment, screening, or service under 4
sub-subdivisions a. through d. of this subdivision. 5
(5) Expenses for prescription medications. – Expenses for FDA approved 6
prescription medications that directly address midlife health concerns, 7
including osteoporosis, cardiovascular health, menopause, and diabetes. 8
(6) FDA. – The United States Food and Drug Administration. 9
(7) Out-of-pocket expenses. – The total of the following: 10
a. Expenses for midlife healthcare. 11
b. Expenses for menopause treatment. 12
c. Expenses for prescription medications. 13
(8) Program. – The Thrive at Midlife Grant Program created by this section. 14
SECTION 4.2.(d) Eligibility. – Eligible businesses are eligible to apply for a grant 15
from the program. 16
SECTION 4.2.(e) Application; Limitations. – An eligible business must apply to the 17
Department for a grant during the time frame and on a form prescribed by the Department and 18
must include any supporting documentation required by the Department. Grants shall be awarded 19
on a first come, first served basis. The grant amount to an eligible business may not exceed two 20
thousand five hundred dollars ($2,500) per year. The total of all grants awarded under the 21
program may not exceed the total amount of funds appropriated to and otherwise available under 22
the program. The Department shall verify that the applicant is an eligible business prior to 23
awarding any grant funds under the program. 24
SECTION 4.2.(f) Administration. – The Department may use up to three percent 25
(3%) of funds appropriated to or otherwise available under the program for administrative 26
purposes. 27
SECTION 4.2.(g) Audits. – The Department, in consultation with the Department 28
of Revenue, shall conduct random audits of eligible businesses that receive grant funding under 29
the program. The timing, form, and manner of the audits required by this subsection are in the 30
discretion of the Department but shall be conducted in such a manner as to reasonably ensure 31
that grant funds are used by eligible businesses for purposes consistent with this section. 32
SECTION 4.2.(h) There is appropriated from the General Fund to the Department 33
of Health and Human Services the sum of one million dollars ($1,000,000) in nonrecurring funds 34
for the 2025-2026 fiscal year to be used by the Department for purposes consistent with Section 35
5.2 of this act. 36
SECTION 4.2.(i) This section becomes effective July 1, 2025. 37
38
PART V. EXPANDED ACC ESS TO PROVIDERS TRAINED IN MIDLIFE HEALTH 39
40
SPECIALIZED TRAINING/MIDLIFE HEALTH FELLOWSHIP PROGRAMS 41
SECTION 5.1.(a) G.S. 116-11 is amended by adding the following new subdivision 42
to read: 43
"(13c) The Board of Governors shall require each school of medicine affiliated with 44
a constituent institution of The University of North Carolina to separately 45
establish a midlife health fellowship program. The programs shall meet at 46
least the following criteria: 47
a. Provide educational opportunities for healthcare providers in 48
menopause and chronic disease care. 49
b. Ensure that educational opportunities provided pursuant to 50
sub-subdivision a. of this subdivision comply with requirements 51 General Assembly Of North Carolina Session 2025
Senate Bill 522-First Edition Page 7
necessary for attendees to receive appropriate credit for continuing 1
medical education." 2
SECTION 5.1.(b) No later than July 1, 2026, each school of medicine affiliated with 3
a constituent institution of The University of North Carolina, including the School of Medicine 4
of the University of North Carolina at Chapel Hill and the Brody School of Medicine of East 5
Carolina University, shall establish a midlife health fellowship program in accordance with 6
G.S. 116-11(13c), as enacted by this act. 7
8
EXPANSION OF ACCESS TO MIDLIFE HEALTH PROVIDERS THROUGH 9
TELEHEALTH SERVICES 10
SECTION 5.2. Effective July 1, 2025, Section 9B.7A(b) of S.L. 2023-134 reads as 11
rewritten: 12
"SECTION 9B.7A.(b) The ORH shall establish a telehealth infrastructure grant program to 13
award grants on a competitive basis to rural healthcare providers to be used to purchase 14
equipment, high-speed internet access, and any other infrastructure necessary to establish 15
telehealth services, defined as the use of two-way, real-time interactive audio and video where 16
the healthcare provider and the patient can hear and see each other. In awarding grants under this 17
program, the ORH is subject to the following requirements and limitations: 18
(1) Priority shall be given to independent practices that provide essential midlife 19
healthcare services to individuals assigned female at birth or who identify as 20
women and who are at least 40 but less than 65 years of age; independent 21
primary care practices and practices; and independent obstetrics and 22
gynecology practices. As used in this subdivision, the term "essential midlife 23
healthcare services" includes one or more of the following: 24
a. Menopause-related care and hormone therapy. 25
b. Osteoporosis screenings. 26
c. Cardiovascular disease prevention. 27
d. Diabetes screenings and management. 28
e. Mammograms and cervical cancer screenings. 29
f. Mental health and wellness programs. 30
g. Telehealth services for midlife-specific conditions. 31
(2) The maximum amount of a grant award is two hundred fifty thousand dollars 32
($250,000) per grantee." 33
34
REGIONAL MIDLIFE HEALTH HUBS PILOT PROGRAM 35
SECTION 5.3.(a) Not later than October 1, 2025, the ORH shall establish and 36
administer a Regional Midlife Health Hubs Pilot Program (Pilot Program). The purpose of the 37
Pilot Program is to evaluate the effectiveness of utilizing a community hub accessible in person, 38
through the World Wide Web, or through any other means of electronic access, to refer midlife 39
women to community-based, essential midlife healthcare services. The Pilot Program shall 40
operate in the five North Carolina counties with the highest healthcare disparities among midlife 41
women. Each participating county shall establish a Regional Midlife Health Hub responsible for 42
implementing and administering the Pilot Program on behalf of the residents of that county. The 43
Pilot Program authorized by this subsection shall terminate upon the filing of the report required 44
by subsection (d) of this section. 45
SECTION 5.3.(b) Effective July 1, 2025, there is appropriated from the General 46
Fund to the Department of Health and Human Services, Division of Central Management, Office 47
of Rural Health (ORH), the sum of two million six hundred twenty-five thousand dollars 48
($2,625,000) in nonrecurring funds for each year of the 2025-2027 fiscal biennium to fund 49
establishment and operation of the Pilot Program authorized by subsection (a) of this section. 50
Funds appropriated pursuant to this subsection shall be allocated equally among the five Regional 51 General Assembly Of North Carolina Session 2025
Page 8 Senate Bill 522-First Edition
Midlife Health Hubs responsible for implementing and administering the Pilot Program on behalf 1
of the residents of their respective counties. 2
SECTION 5.3.(c) Each Regional Midlife Health Hub may use up to five percent 3
(5%) of its allocated funds for each year of the 2025-2027 fiscal biennium to pay for 4
administrative costs associated with designing, implementing, and administering a community 5
hub to serve the residents of that county. 6
SECTION 5.3.(d) By February 1, 2028, the Department of Health and Human 7
Services shall conduct a comprehensive evaluation of the Pilot Program authorized by subsection 8
(a) of this section and submit a report of its findings and recommendations to the Joint Legislative 9
Oversight Committee on Health and Human Services and the Fiscal Research Division. The 10
report shall include, at a minimum, all of the following information for each Regional Midlife 11
Health Hub: 12
(1) A detailed breakdown of expenditures for the Pilot Program. 13
(2) A description of the design and operation of each Regional Midlife Health 14
Hub. 15
(3) The number of people served by each Regional Midlife Health Hub. 16
(4) Any other information the Department deems relevant to determining the 17
success of the Pilot Program. 18
19
PART VI. PUBLIC AWARENESS AND OUTREACH 20
21
STATEWIDE AWARENESS CAMPAIGN 22
SECTION 6.1. Effective July 1, 2025, there is appropriated from the General Fund 23
to the Department of Health and Human Services the sum of five hundred thousand dollars 24
($500,000) in nonrecurring funds for the 2025-2026 fiscal year to launch a statewide educational 25
and public awareness campaign on health challenges for midlife women and available resources 26
and services to address these challenges. The campaign shall include outreach initiatives 27
conducted through digital media, social media, radio, and television, with materials distributed 28
to the public in English and Spanish. 29
30
COMMUNITY PARTNERSHIPS 31
SECTION 6.2.(a) Effective July 1, 2025, there is appropriated from the General 32
Fund to the Department of Health and Human Services the sum of two million dollars 33
($2,000,000) in nonrecurring funds for each year of the 2025-2027 fiscal biennium to provide 34
grants on a competitive basis to local, nonprofit, and faith-based organizations that partner with 35
the Department of Health and Human Services to conduct culturally competent outreach and 36
education about health challenges for midlife women and available resources and services to 37
address these challenges. 38
SECTION 6.2.(b) Annually by April 1, 2027, and April 1, 2028, the ORH shall 39
report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal 40
Research Division on use of the funds appropriated by this section. The report shall include at 41
least all of the following information regarding the preceding fiscal year: 42
(1) A detailed breakdown of expenditures. 43
(2) The identity and a brief description of each grantee and the amount of funding 44
awarded to each grantee. 45
(3) A description of the outreach and education performed by each grantee, the 46
audience of people receiving such outreach and education, and the geographic 47
location where the outreach and education was performed. 48
49
PART VII. DATA COLLECTION & OVERSIGHT 50
51 General Assembly Of North Carolina Session 2025
Senate Bill 522-First Edition Page 9
ANNUAL REPORTING 1
SECTION 7.1. Annually by February 1, beginning February 1, 2027, the Department 2
of Health and Human Services shall compile an annual Midlife Health Report identifying gaps 3
in health insurance coverage for essential midlife healthcare services and evaluating healthcare 4
disparities among midlife women residing in the State. The report shall be submitted to the Joint 5
Legislative Oversight Committee on Health and Human Services and the Fiscal Research 6
Division and made publicly available on the Department's website. 7
8
MIDLIFE HEALTH ADVISORY COUNCIL 9
SECTION 7.2.(a) Article 1B of Chapter 130A of the General Statutes is amended 10
by adding new sections to read: 11
"§ 130A-33.45. Midlife Health Advisory Council; creation; duties; composition. 12
(a) There is established the Midlife Health Advisory Council in the Department. The 13
Council shall have the following duties and responsibilities: 14
(1) To make recommendations to the Governor and the Secretary aimed at 15
improving the health status of midlife women, defined as individuals residing 16
in North Carolina who were assigned female at birth or identify as women and 17
who are at least 40 but less than 65 years of age. 18
(2) To identify and examine the limitations and problems associated with existing 19
laws, regulations, programs, and services related to the health status of midlife 20
women. 21
(3) To examine the financing and access to health services for midlife women. 22
(4) To identify and review health promotion and disease prevention strategies 23
relating to the leading causes of death and disability among midlife women. 24
(5) To advise the Governor and the Secretary upon any matter which the 25
Governor or Secretary may refer to it. 26
"§ 130A-33.46. Midlife Health Advisory Council; members; selection; quorum; 27
compensation. 28
(a) The Midlife Health Advisory Council in the Department shall consist of 9 members, 29
to be appointed as follows: 30
(1) Five members shall be appointed by the Governor. Members appointed by the 31
Governor shall be representatives of the following groups: healthcare 32
professionals, public health experts, community advocates, and midlife 33
women with lived experience. 34
(2) Two members shall be appointed by the Speaker of the House of 35
Representatives, one of whom shall be a member of the House of 36
Representatives, and one of whom shall be a public member or a 37
representative of any of the groups specified in subdivision (1) of this 38
subsection. 39
(3) Two members shall be appointed by the President Pro Tempore of the Senate, 40
one of whom shall be a member of the Senate, and one of whom shall be a 41
public member or a representative of any of the groups specified in 42
subdivision (1) of this subsection. 43
(4) Of the members appointed by the Governor, two shall serve initial terms of 44
one year, two shall serve initial terms of two years, and one shall serve an 45
initial term of three years. Thereafter, the Governor's appointees shall serve 46
terms of four years. 47
(5) Of the nonlegislative members appointed by the Speaker of the House of 48
Representatives, one shall serve an initial term of two years. Thereafter, 49
nonlegislative members appointed by the Speaker of the House of 50
Representatives shall serve terms of four years. Of the nonlegislative members 51 General Assembly Of North Carolina Session 2025
Page 10 Senate Bill 522-First Edition
appointed by the President Pro Tempore of the Senate, one shall serve an 1
initial term of two years. Thereafter, nonlegislative members appointed by the 2
President Pro Tempore of the Senate shall serve terms of four years. 3
Legislative members of the Council shall serve two-year terms. 4
(b) The Chairperson of the Council shall be elected by the Council from among its 5
membership. 6
(c) The majority of the Council shall constitute a quorum for the transaction of business. 7
(d) Members of the Council shall receive per diem and necessary travel and subsistence 8
expenses in accordance with the provisions of G.S. 138-5 or G.S. 138-6, or travel and subsistence 9
expenses in accordance with the provisions of G.S. 120-3.1, as applicable. 10
(e) All clerical support and other services required by the Council shall be provided by 11
the Department." 12
SECTION 7.2.(b) There is appropriated from the General Fund to the Department 13
of Health and Human Services the sum of two hundred fifty thousand dollars ($250,000) in 14
recurring funds for each year of the 2025-2027 fiscal biennium to be allocated to cover the 15
operating expenses of the Midlife Health Advisory Council authorized by subsection (a) of this 16
section. 17
18
PART VIII. SEVERABILITY 19
SECTION 8.1. If any section or provision of this act is declared unconstitutional or 20
invalid by the courts, it does not affect the validity of this act as a whole or any part other than 21
the part declared to be unconstitutional or invalid. 22
23
PART IX. EFFECTIVE DATE 24
SECTION 9.1. Except as otherwise provided, this act is effective when it becomes 25
law. 26