North Carolina 2025-2026 Regular Session

North Carolina Senate Bill S522 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		GENERAL ASSEMBLY OF NORTH CAROLINA
2	2		SESSION 2025
3		-	S 1
4		-	SENATE BILL 522
	3	+	S D
	4	+	SENATE BILL DRS45209-MGxfa-73A
	5	+
5	6
6	7
7	8		Short Title: Thrive at Midlife Act. (Public)
8	9		Sponsors: Senator Theodros (Primary Sponsor).
9		-	Referred to: ~~Rules and Operations of the Senate~~
10		-	~~March 26, 2025~~
11		-	~~S522 -v-1~~
	10	+	Referred to:
	11	+
	12	+	DRS45209 -MGxfa -73A
12	13		A BILL TO BE ENTITLED 1
13	14		AN ACT EXPANDING ACCESS TO AFFORDABLE, COMPREHENSIVE HEALTHCARE 2
14	15		FOR WOMEN IN MIDLIFE THROUGH IMPROVED HEALTH INSURANCE AND 3
15	16		MEDICAID COVERAGE; PROGRAMS TO EXPAND ACCESS TO ESSENTIAL 4
16	17		MIDLIFE HEALTHCARE SERVICES; TAX CREDITS FOR INDIVIDUALS AND 5
17	18		BUSINESSES FOR MIDLIFE HEALTHCARE EXPENSES; EXPANDED ACCESS TO 6
18	19		PROVIDERS TRAINED IN ESSENTIAL MIDLIFE HEALTHCARE SERVICES; 7
19	20		PUBLIC AWARENESS AND OUTREACH; BETTER DATA COLLECTION AND 8
20	21		OVERSIGHT; ESTABLISHMENT OF A MIDLIFE HEALTH ADVISORY COUNCIL ; 9
21	22		AND APPROPRIATING FUNDS FOR THESE PURPOSES . 10
22	23		Whereas, women in midlife (ages 40-65) face unique healthcare challenges, including 11
23	24		menopause-related conditions, increased risk of chronic diseases, and barriers to affordable 12
24	25		healthcare access; and 13
25	26		Whereas, improving access to midlife healthcare services will enhance quality of life, 14
26	27		reduce long-term healthcare costs, and promote preventive care for women in North Carolina; 15
27	28		and 16
28	29		Whereas, it is the policy of the State of North Carolina to promote public health and 17
29	30		equitable healthcare access; Now, therefore, 18
30	31		The General Assembly of North Carolina enacts: 19
31	32		20
32	33		PART I. TITLE 21
33	34		SECTION 1.1. This act shall be known as "The Thrive at Midlife Act." 22
34	35		23
35	36		PART II. DEFINITIONS 24
36	37		SECTION 2.1. The following definitions apply in this act: 25
37	38		(1) Essential midlife healthcare services. – Includes, but is not limited to, all of 26
38	39		the following: 27
39	40		a. Menopause-related care and hormone therapy. 28
40	41		b. Osteoporosis screenings. 29
41	42		c. Cardiovascular disease prevention. 30
42	43		d. Diabetes screenings and management. 31
43	44		e. Mammograms and cervical cancer screenings. 32
44	45		f. Mental health and wellness programs. 33
45	46		g. Telehealth services for midlife-specific conditions. 34
46	47		(2) Midlife women. – Individuals assigned female at birth or who identify as 35
47		-	women and who are at least 40 but less than 65 years of age. 36 General Assembly Of North Carolina Session 2025
48		-	Page 2 Senate Bill 522-First Edition
	48	+	women and who are at least 40 but less than 65 years of age. 36
	49	+	FILED SENATE
	50	+	Mar 25, 2025
	51	+	S.B. 522
	52	+	PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
	53	+	Page 2 DRS45209-MGxfa-73A
49	54		1
50	55		PART III. EXPANDED COVERAGE REQUIREMENTS 2
51	56		3
52	57		INSURANCE MANDATES 4
53	58		SECTION 3.1.(a) Article 3 of Chapter 58 of the General Statutes is amended by 5
54	59		adding a new section to read: 6
55	60		"§ 58-3-305. Coverage required for essential midlife healthcare services. 7
56	61		(a) All health benefit plans shall include coverage for essential midlife healthcare 8
57	62		services for individuals who either (i) were assigned female at birth or (ii) identify as a woman 9
58	63		and who are at least 40 years of age but less than 65 years of age. 10
59	64		(b) Essential midlife healthcare services required to be covered under this section include 11
60	65		all of the following: 12
61	66		(1) Menopause-related care and hormone therapy. 13
62	67		(2) Osteoporosis screenings. 14
63	68		(3) Cardiovascular disease prevention. 15
64	69		(4) Diabetes screening and management. 16
65	70		(5) Mammograms and cervical cancer screenings. 17
66	71		(6) Mental health and wellness programs. 18
67	72		(7) Telehealth services for midlife-specific conditions. 19
68	73		(c) Any cost-sharing requirements, including copayments and deductibles, for essential 20
69	74		midlife healthcare services shall not exceed those established for preventative services under the 21
70	75		Patient Protection and Affordable Care Act, P.L. 111-148, as amended, or other applicable 22
71	76		federal law." 23
72	77		SECTION 3.1.(b) The Department of Health and Human Services, Division of 24
73	78		Health Benefits, shall ensure coverage for essential midlife healthcare services, as described in 25
74	79		G.S. 58-3-305(b), for Medicaid recipients who either (i) were assigned female at birth or (ii) 26
75	80		identify as a woman and who are at least 40 years of age but less than 65 years of age. 27
76	81		SECTION 3.1.(c) Subsection (a) of this section is effective October 1, 2025, and 28
77	82		applies to insurance contracts issued, renewed, or amended on or after that date. The remainder 29
78	83		of this section is effective when it becomes law. 30
79	84		31
80	85		MIDLIFE HEALTH ACCESS PROGRAM 32
81	86		SECTION 3.2.(a) Effective July 1, 2025, there is appropriated from the General 33
82	87		Fund to the Department of Health and Human Services, Division of Central Management and 34
83	88		Support, Office of Rural Health (ORH), the sum of ten million dollars ($10,000,000) in recurring 35
84	89		funds for each year of the 2025-2027 fiscal biennium to establish a Midlife Health Access Grant 36
85	90		Program (Program). The purpose of the Program is to provide directed grants on a competitive 37
86	91		basis to federally qualified health centers, rural health clinics, community-based nonprofit 38
87	92		organizations, and other safety-net providers that are capable of providing essential midlife 39
88	93		healthcare services to midlife women who are uninsured regardless of their ability to pay. 40
89	94		SECTION 3.2.(b) The ORH shall develop application materials and selection 41
90	95		criteria for the Program. The selection criteria shall take into consideration the availability of 42
91	96		other funds available to the grantee and the incidence of poverty in the area served by the grantee. 43
92	97		The ORH shall make the final decision about awarding grants under this Program, subject to the 44
93	98		following requirements and limitations: 45
94	99		(1) The ORH shall give priority to applicants located in rural and underserved 46
95	100		areas of the State. 47
96	101		(2) The maximum amount of a grant award under the Program is one hundred 48
97	102		thousand dollars ($100,000) per grantee. 49
98	103		SECTION 3.2.(c) The ORH may use up to five percent (5%) of these allocated funds 50
99	104		to pay for administrative costs associated with establishing and administering the Program. 51 General Assembly Of North Carolina Session 2025
100		-	~~Senate Bill 522-First Edition~~ Page 3
	105	+	DRS45209-MGxfa-73A Page 3
101	106		SECTION 3.2.(d) Annually by April 1, beginning April 1, 2027, the ORH shall 1
102	107		report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal 2
103	108		Research Division on the Program authorized by this section. The report shall include at least all 3
104	109		of the following information regarding the preceding fiscal year: 4
105	110		(1) A detailed breakdown of expenditures for the Program. 5
106	111		(2) The identity and a brief description of each grantee and the amount of funding 6
107	112		awarded to each grantee. 7
108	113		(3) The number of people served by each grantee. 8
109	114		(4) Any other information the Department deems relevant in evaluating the 9
110	115		success of the Program. 10
111	116		11
112	117		PART IV. FINANCIAL RELIEF MEASURES 12
113	118		13
114	119		MIDLIFE HEALTHCARE INDIVIDUAL TAX CREDIT AND BUSINESS TAX CREDIT 14
115	120		SECTION 4.1.(a) Article 4 of Chapter 105 of the General Statutes is amended by 15
116	121		adding two new sections to read: 16
117	122		"§ 105-153.12. Midlife healthcare individual tax credit. 17
118	123		(a) Definitions. – The following definitions apply in this section: 18
119	124		(1) FDA. – The United States Food and Drug Administration. 19
120	125		(2) Expenses for midlife healthcare. – Expenses for any of the following: 20
121	126		a. Menopause-related treatments, including hormone therapy, 21
122	127		prescription medications, and medically recommended non-hormonal 22
123	128		alternatives. 23
124	129		b. Preventative health screenings, including mammograms, cervical 24
125	130		cancer screenings, osteoporosis screenings, and cardiovascular risk 25
126	131		assessments. 26
127	132		c. Chronic disease management, including treatment of diabetes, 27
128	133		hypertension, cholesterol issues, and other midlife-onset chronic 28
129	134		conditions. 29
130	135		d. Mental health services, including therapy or counseling related to 30
131	136		midlife hormonal changes, menopause-induced anxiety, and 31
132	137		depression. 32
133	138		e. Telehealth visits conducted for a treatment, screening, or service under 33
134	139		sub-subdivisions a. through d. of this subdivision. 34
135	140		(3) Expenses for menopause treatment. – Expenses for any FDA-approved 35
136	141		therapy, medication, or intervention prescribed by a licensed physician for 36
137	142		managing menopause symptoms, including the following: 37
138	143		a. Hormone replacement therapy. 38
139	144		b. Non-hormonal prescription treatments. 39
140	145		c. Prescription vaginal estrogen treatments. 40
141	146		(4) Expenses for prescription medications. – Expenses for FDA-approved 41
142	147		prescription medications that directly address midlife health concerns, 42
143	148		including osteoporosis, cardiovascular health, menopause, and diabetes. 43
144	149		(5) Out-of-pocket expenses. – The total of the following expenses that are not 44
145	150		reimbursed by health insurance: 45
146	151		a. Expenses for midlife healthcare. 46
147	152		b. Expenses for menopause treatment. 47
148	153		c. Expenses for prescription medications. 48
149	154		(b) Credit. – A taxpayer who has out-of-pocket expenses is allowed a credit against the 49
150	155		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
151		-	Page 4 ~~Senate Bill 522-First Edition~~
	156	+	Page 4 DRS45209-MGxfa-73A
152	157		the table below and based upon the taxpayer's filing status and adjusted gross income, as 1
153	158		calculated under the Code: 2
154	159		Filing Status AGI Credit Amount 3
155	160		Married, filing jointly Up to $100,000 100% 4
156	161		Over $100,000 5
157	162		Up to $200,000 50% 6
158	163		Over $200,000 0% 7
159	164		8
160	165		Head of Household Up to $100,000 100% 9
161	166		Over $100,000 10
162	167		Up to $200,000 50% 11
163	168		Over $200,000 0% 12
164	169		13
165	170		Single Up to $100,000 100% 14
166	171		Over $100,000 0% 15
167	172		16
168	173		Married, filing separately Up to $100,000 100% 17
169	174		Over $100,000 0%. 18
170	175		(c) Credit Refundable. – If the credit allowed by this section exceeds the amount of tax 19
171	176		imposed by this Part for the taxable year reduced by the sum of all credits allowable, the Secretary 20
172	177		must refund the excess to the taxpayer. The refundable excess is governed by the provisions 21
173	178		governing a refund of an overpayment by the taxpayer of the tax imposed by this Part. In 22
174	179		computing the amount of tax against which multiple credits are allowed, nonrefundable credits 23
175	180		are subtracted before refundable credits. 24
176	181		"§ 105-153.13. Midlife healthcare business tax credit. 25
177	182		(a) Definitions. – The definitions in G.S. 105-153.12 and the following definitions apply 26
178	183		in this section: 27
179	184		(1) Eligible business. – A business with a physical presence in the State that has 28
180	185		out-of-pocket expenses. 29
181	186		(2) Out-of-pocket expenses. – As defined in G.S. 105-153.12 and paid by an 30
182	187		eligible business on behalf of a qualifying employee. 31
183	188		(3) Qualifying employee. – An individual employed (i) for consideration for at 32
184	189		least 35 hours a week and whose wages are subject to withholding under 33
185	190		Article 4A of Chapter 105 of the General Statutes and (ii) by an eligible 34
186	191		business. 35
187	192		(b) Credit. – A taxpayer who is an eligible business and has out-of-pocket expenses is 36
188	193		allowed a credit against the tax imposed by this Part equal to ten percent (10%) of the taxpayer's 37
189	194		total out-of-pocket expenses. 38
190	195		(c) Credit Refundable. – If the credit allowed by this section exceeds the amount of tax 39
191	196		imposed by this Part for the taxable year reduced by the sum of all credits allowable, the Secretary 40
192	197		must refund the excess to the taxpayer. The refundable excess is governed by the provisions 41
193	198		governing a refund of an overpayment by the taxpayer of the tax imposed by this Part. In 42
194	199		computing the amount of tax against which multiple credits are allowed, nonrefundable credits 43
195	200		are subtracted before refundable credits. 44
196	201		(d) Aggregate Limitation. – The total amount of credits allowed pursuant to this section 45
197	202		may not exceed in the aggregate five million dollars ($5,000,000) for all taxpayers for any one 46
198	203		calendar year. 47
199	204		(e) Application. – An eligible business seeking to claim a tax credit provided for under 48
200	205		this section shall submit an application to the Department of Revenue for tentative approval for 49
201	206		the tax credit in the year for which the tax credit is claimed or allowed. Applications shall be 50
202	207		accepted on a first come, first served basis. The Department of Revenue shall provide for the 51 General Assembly Of North Carolina Session 2025
203		-	~~Senate Bill 522-First Edition~~ Page 5
	208	+	DRS45209-MGxfa-73A Page 5
204	209		manner in which the application is to be submitted and the information required in the application 1
205	210		which shall include, at a minimum, proof of the applicant business's out-of-pocket expenses. The 2
206	211		Department of Revenue shall review the application and tentatively shall approve the application 3
207	212		upon determining that it meets the requirements of this section by January 31 of the year after 4
208	213		the application was submitted. If the credit amounts on the tax credit applications filed with the 5
209	214		Department of Revenue exceed the maximum aggregate limit of tax credits, then the tax credit 6
210	215		must be allocated among the eligible business entities who filed a timely application on a first 7
211	216		come, first served basis based upon the amounts otherwise allowed by this section. Once the tax 8
212	217		credit application has been approved and the amount has been communicated to the applicant, 9
213	218		the eligible business then may apply the amount of the approved tax credit to its tax liability for 10
214	219		the tax year of which the approved application applies. 11
215	220		(f) Report. – By March 31 of each year, the Department of Revenue shall report to the 12
216	221		Joint Legislative Committee on Governmental Operations by county, the number of eligible 13
217	222		business tax credit applications the Department has received, the number of tax credit 14
218	223		applications approved, and the tax credits approved. This report must be made available in a 15
219	224		conspicuous place on the Department's website." 16
220	225		SECTION 4.1.(b) This section is effective for taxes imposed for taxable years 17
221	226		beginning on or after January 1, 2025. 18
222	227		19
223	228		THRIVE AT MIDLIFE GRANT PROGRAM FOR SMALL BUSINESS 20
224	229		SECTION 4.2.(a) Creation; Administration. – The Thrive at Midlife Grant Program 21
225	230		(Program) is established and shall be administered by the Department of Health and Human 22
226	231		Services in accordance with this section. 23
227	232		SECTION 4.2.(b) Purpose. – The purpose of the program is to promote access to 24
228	233		and support for midlife healthcare by providing financial assistance in the form of grants to 25
229	234		eligible businesses who have out-of-pocket expenses. 26
230	235		SECTION 4.2.(c) Definitions. – The following definitions apply in this section: 27
231	236		(1) Department. – The Department of Health and Human Services. 28
232	237		(2) Eligible business. – A business with a physical presence in the State that (i) 29
233	238		has its headquarters located in this State, (ii) employs 50 or fewer people in 30
234	239		this State, (iii) has out-of-pocket expenses during the taxable year in which it 31
235	240		applies for grant funding under this section, and (iv) submits proof of its 32
236	241		out-of-pocket expenses on a form and in a manner approved by the 33
237	242		Department. 34
238	243		(3) Expenses for menopause treatment. – Expenses for any FDA approved 35
239	244		therapy, medication, or intervention prescribed by a licensed physician for 36
240	245		managing menopause symptoms, including the following: 37
241	246		a. Hormone replacement therapy. 38
242	247		b. Non-hormonal prescription treatments. 39
243	248		c. Prescription vaginal estrogen treatments. 40
244	249		(4) Expenses for midlife healthcare. – Expenses for any of the following: 41
245	250		a. Menopause related treatments, including hormone therapy, 42
246	251		prescription medications, and medically recommended non-hormonal 43
247	252		alternatives. 44
248	253		b. Preventative health screenings, including mammograms, cervical 45
249	254		cancer screenings, osteoporosis screenings, and cardiovascular risk 46
250	255		assessments. 47
251	256		c. Chronic disease management, including treatment of diabetes, 48
252	257		hypertension, cholesterol issues, and other midlife onset chronic 49
253	258		conditions. 50 General Assembly Of North Carolina Session 2025
254		-	Page 6 ~~Senate Bill 522-First Edition~~
	259	+	Page 6 DRS45209-MGxfa-73A
255	260		d. Mental health services, including therapy or counseling related to 1
256	261		midlife hormonal changes, menopause induced anxiety, and 2
257	262		depression. 3
258	263		e. Telehealth visits conducted for a treatment, screening, or service under 4
259	264		sub-subdivisions a. through d. of this subdivision. 5
260	265		(5) Expenses for prescription medications. – Expenses for FDA approved 6
261	266		prescription medications that directly address midlife health concerns, 7
262	267		including osteoporosis, cardiovascular health, menopause, and diabetes. 8
263	268		(6) FDA. – The United States Food and Drug Administration. 9
264	269		(7) Out-of-pocket expenses. – The total of the following: 10
265	270		a. Expenses for midlife healthcare. 11
266	271		b. Expenses for menopause treatment. 12
267	272		c. Expenses for prescription medications. 13
268	273		(8) Program. – The Thrive at Midlife Grant Program created by this section. 14
269	274		SECTION 4.2.(d) Eligibility. – Eligible businesses are eligible to apply for a grant 15
270	275		from the program. 16
271	276		SECTION 4.2.(e) Application; Limitations. – An eligible business must apply to the 17
272	277		Department for a grant during the time frame and on a form prescribed by the Department and 18
273	278		must include any supporting documentation required by the Department. Grants shall be awarded 19
274	279		on a first come, first served basis. The grant amount to an eligible business may not exceed two 20
275	280		thousand five hundred dollars ($2,500) per year. The total of all grants awarded under the 21
276	281		program may not exceed the total amount of funds appropriated to and otherwise available under 22
277	282		the program. The Department shall verify that the applicant is an eligible business prior to 23
278	283		awarding any grant funds under the program. 24
279	284		SECTION 4.2.(f) Administration. – The Department may use up to three percent 25
280	285		(3%) of funds appropriated to or otherwise available under the program for administrative 26
281	286		purposes. 27
282	287		SECTION 4.2.(g) Audits. – The Department, in consultation with the Department 28
283	288		of Revenue, shall conduct random audits of eligible businesses that receive grant funding under 29
284	289		the program. The timing, form, and manner of the audits required by this subsection are in the 30
285	290		discretion of the Department but shall be conducted in such a manner as to reasonably ensure 31
286	291		that grant funds are used by eligible businesses for purposes consistent with this section. 32
287	292		SECTION 4.2.(h) There is appropriated from the General Fund to the Department 33
288	293		of Health and Human Services the sum of one million dollars ($1,000,000) in nonrecurring funds 34
289	294		for the 2025-2026 fiscal year to be used by the Department for purposes consistent with Section 35
290	295		5.2 of this act. 36
291	296		SECTION 4.2.(i) This section becomes effective July 1, 2025. 37
292	297		38
293	298		PART V. EXPANDED ACCESS TO PROVIDERS TRAINED IN MIDLIFE HEALTH 39
294	299		40
295	300		SPECIALIZED TRAINING/MIDLIFE HEALTH FELLOWSHIP PROGRAMS 41
296	301		SECTION 5.1.(a) G.S. 116-11 is amended by adding the following new subdivision 42
297	302		to read: 43
298	303		"(13c) The Board of Governors shall require each school of medicine affiliated with 44
299	304		a constituent institution of The University of North Carolina to separately 45
300	305		establish a midlife health fellowship program. The programs shall meet at 46
301	306		least the following criteria: 47
302	307		a. Provide educational opportunities for healthcare providers in 48
303	308		menopause and chronic disease care. 49
304	309		b. Ensure that educational opportunities provided pursuant to 50
305	310		sub-subdivision a. of this subdivision comply with requirements 51 General Assembly Of North Carolina Session 2025
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	311	+	DRS45209-MGxfa-73A Page 7
307	312		necessary for attendees to receive appropriate credit for continuing 1
308	313		medical education." 2
309	314		SECTION 5.1.(b) No later than July 1, 2026, each school of medicine affiliated with 3
310	315		a constituent institution of The University of North Carolina, including the School of Medicine 4
311	316		of the University of North Carolina at Chapel Hill and the Brody School of Medicine of East 5
312	317		Carolina University, shall establish a midlife health fellowship program in accordance with 6
313	318		G.S. 116-11(13c), as enacted by this act. 7
314	319		8
315	320		EXPANSION OF ACCESS TO MIDLIFE HEALTH PROVIDERS THROUGH 9
316	321		TELEHEALTH SERVICES 10
317	322		SECTION 5.2. Effective July 1, 2025, Section 9B.7A(b) of S.L. 2023-134 reads as 11
318	323		rewritten: 12
319	324		"SECTION 9B.7A.(b) The ORH shall establish a telehealth infrastructure grant program to 13
320	325		award grants on a competitive basis to rural healthcare providers to be used to purchase 14
321	326		equipment, high-speed internet access, and any other infrastructure necessary to establish 15
322	327		telehealth services, defined as the use of two-way, real-time interactive audio and video where 16
323	328		the healthcare provider and the patient can hear and see each other. In awarding grants under this 17
324	329		program, the ORH is subject to the following requirements and limitations: 18
325	330		(1) Priority shall be given to independent practices that provide essential midlife 19
326	331		healthcare services to individuals assigned female at birth or who identify as 20
327	332		women and who are at least 40 but less than 65 years of age; independent 21
328	333		primary care practices and practices; and independent obstetrics and 22
329	334		gynecology practices. As used in this subdivision, the term "essential midlife 23
330	335		healthcare services" includes one or more of the following: 24
331	336		a. Menopause-related care and hormone therapy. 25
332	337		b. Osteoporosis screenings. 26
333	338		c. Cardiovascular disease prevention. 27
334	339		d. Diabetes screenings and management. 28
335	340		e. Mammograms and cervical cancer screenings. 29
336	341		f. Mental health and wellness programs. 30
337	342		g. Telehealth services for midlife-specific conditions. 31
338	343		(2) The maximum amount of a grant award is two hundred fifty thousand dollars 32
339	344		($250,000) per grantee." 33
340	345		34
341	346		REGIONAL MIDLIFE HEALTH HUBS PILOT PROGRAM 35
342	347		SECTION 5.3.(a) Not later than October 1, 2025, the ORH shall establish and 36
343	348		administer a Regional Midlife Health Hubs Pilot Program (Pilot Program). The purpose of the 37
344	349		Pilot Program is to evaluate the effectiveness of utilizing a community hub accessible in person, 38
345	350		through the World Wide Web, or through any other means of electronic access, to refer midlife 39
346	351		women to community-based, essential midlife healthcare services. The Pilot Program shall 40
347	352		operate in the five North Carolina counties with the highest healthcare disparities among midlife 41
348	353		women. Each participating county shall establish a Regional Midlife Health Hub responsible for 42
349	354		implementing and administering the Pilot Program on behalf of the residents of that county. The 43
350	355		Pilot Program authorized by this subsection shall terminate upon the filing of the report required 44
351	356		by subsection (d) of this section. 45
352	357		SECTION 5.3.(b) Effective July 1, 2025, there is appropriated from the General 46
353	358		Fund to the Department of Health and Human Services, Division of Central Management, Office 47
354	359		of Rural Health (ORH), the sum of two million six hundred twenty-five thousand dollars 48
355	360		($2,625,000) in nonrecurring funds for each year of the 2025-2027 fiscal biennium to fund 49
356	361		establishment and operation of the Pilot Program authorized by subsection (a) of this section. 50
357	362		Funds appropriated pursuant to this subsection shall be allocated equally among the five Regional 51 General Assembly Of North Carolina Session 2025
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359	364		Midlife Health Hubs responsible for implementing and administering the Pilot Program on behalf 1
360	365		of the residents of their respective counties. 2
361	366		SECTION 5.3.(c) Each Regional Midlife Health Hub may use up to five percent 3
362	367		(5%) of its allocated funds for each year of the 2025-2027 fiscal biennium to pay for 4
363	368		administrative costs associated with designing, implementing, and administering a community 5
364	369		hub to serve the residents of that county. 6
365	370		SECTION 5.3.(d) By February 1, 2028, the Department of Health and Human 7
366	371		Services shall conduct a comprehensive evaluation of the Pilot Program authorized by subsection 8
367	372		(a) of this section and submit a report of its findings and recommendations to the Joint Legislative 9
368	373		Oversight Committee on Health and Human Services and the Fiscal Research Division. The 10
369	374		report shall include, at a minimum, all of the following information for each Regional Midlife 11
370	375		Health Hub: 12
371	376		(1) A detailed breakdown of expenditures for the Pilot Program. 13
372	377		(2) A description of the design and operation of each Regional Midlife Health 14
373	378		Hub. 15
374	379		(3) The number of people served by each Regional Midlife Health Hub. 16
375	380		(4) Any other information the Department deems relevant to determining the 17
376	381		success of the Pilot Program. 18
377	382		19
378	383		PART VI. PUBLIC AWARENESS AND OUTREACH 20
379	384		21
380	385		STATEWIDE AWARENESS CAMPAIGN 22
381	386		SECTION 6.1. Effective July 1, 2025, there is appropriated from the General Fund 23
382	387		to the Department of Health and Human Services the sum of five hundred thousand dollars 24
383	388		($500,000) in nonrecurring funds for the 2025-2026 fiscal year to launch a statewide educational 25
384	389		and public awareness campaign on health challenges for midlife women and available resources 26
385	390		and services to address these challenges. The campaign shall include outreach initiatives 27
386	391		conducted through digital media, social media, radio, and television, with materials distributed 28
387	392		to the public in English and Spanish. 29
388	393		30
389	394		COMMUNITY PARTNERSHIPS 31
390	395		SECTION 6.2.(a) Effective July 1, 2025, there is appropriated from the General 32
391	396		Fund to the Department of Health and Human Services the sum of two million dollars 33
392	397		($2,000,000) in nonrecurring funds for each year of the 2025-2027 fiscal biennium to provide 34
393	398		grants on a competitive basis to local, nonprofit, and faith-based organizations that partner with 35
394	399		the Department of Health and Human Services to conduct culturally competent outreach and 36
395	400		education about health challenges for midlife women and available resources and services to 37
396	401		address these challenges. 38
397	402		SECTION 6.2.(b) Annually by April 1, 2027, and April 1, 2028, the ORH shall 39
398	403		report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal 40
399	404		Research Division on use of the funds appropriated by this section. The report shall include at 41
400	405		least all of the following information regarding the preceding fiscal year: 42
401	406		(1) A detailed breakdown of expenditures. 43
402	407		(2) The identity and a brief description of each grantee and the amount of funding 44
403	408		awarded to each grantee. 45
404	409		(3) A description of the outreach and education performed by each grantee, the 46
405	410		audience of people receiving such outreach and education, and the geographic 47
406	411		location where the outreach and education was performed. 48
407	412		49
408	413		PART VII. DATA COLLECTION & OVERSIGHT 50
409	414		51 General Assembly Of North Carolina Session 2025
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411	416		ANNUAL REPORTING 1
412	417		SECTION 7.1. Annually by February 1, beginning February 1, 2027, the Department 2
413	418		of Health and Human Services shall compile an annual Midlife Health Report identifying gaps 3
414	419		in health insurance coverage for essential midlife healthcare services and evaluating healthcare 4
415	420		disparities among midlife women residing in the State. The report shall be submitted to the Joint 5
416	421		Legislative Oversight Committee on Health and Human Services and the Fiscal Research 6
417	422		Division and made publicly available on the Department's website. 7
418	423		8
419	424		MIDLIFE HEALTH ADVISORY COUNCIL 9
420	425		SECTION 7.2.(a) Article 1B of Chapter 130A of the General Statutes is amended 10
421	426		by adding new sections to read: 11
422	427		"§ 130A-33.45. Midlife Health Advisory Council; creation; duties; composition. 12
423	428		(a) There is established the Midlife Health Advisory Council in the Department. The 13
424	429		Council shall have the following duties and responsibilities: 14
425	430		(1) To make recommendations to the Governor and the Secretary aimed at 15
426	431		improving the health status of midlife women, defined as individuals residing 16
427	432		in North Carolina who were assigned female at birth or identify as women and 17
428	433		who are at least 40 but less than 65 years of age. 18
429	434		(2) To identify and examine the limitations and problems associated with existing 19
430	435		laws, regulations, programs, and services related to the health status of midlife 20
431	436		women. 21
432	437		(3) To examine the financing and access to health services for midlife women. 22
433	438		(4) To identify and review health promotion and disease prevention strategies 23
434	439		relating to the leading causes of death and disability among midlife women. 24
435	440		(5) To advise the Governor and the Secretary upon any matter which the 25
436	441		Governor or Secretary may refer to it. 26
437	442		"§ 130A-33.46. Midlife Health Advisory Council; members; selection; quorum; 27
438	443		compensation. 28
439	444		(a) The Midlife Health Advisory Council in the Department shall consist of 9 members, 29
440	445		to be appointed as follows: 30
441	446		(1) Five members shall be appointed by the Governor. Members appointed by the 31
442	447		Governor shall be representatives of the following groups: healthcare 32
443	448		professionals, public health experts, community advocates, and midlife 33
444	449		women with lived experience. 34
445	450		(2) Two members shall be appointed by the Speaker of the House of 35
446	451		Representatives, one of whom shall be a member of the House of 36
447	452		Representatives, and one of whom shall be a public member or a 37
448	453		representative of any of the groups specified in subdivision (1) of this 38
449	454		subsection. 39
450	455		(3) Two members shall be appointed by the President Pro Tempore of the Senate, 40
451	456		one of whom shall be a member of the Senate, and one of whom shall be a 41
452	457		public member or a representative of any of the groups specified in 42
453	458		subdivision (1) of this subsection. 43
454	459		(4) Of the members appointed by the Governor, two shall serve initial terms of 44
455	460		one year, two shall serve initial terms of two years, and one shall serve an 45
456	461		initial term of three years. Thereafter, the Governor's appointees shall serve 46
457	462		terms of four years. 47
458	463		(5) Of the nonlegislative members appointed by the Speaker of the House of 48
459	464		Representatives, one shall serve an initial term of two years. Thereafter, 49
460	465		nonlegislative members appointed by the Speaker of the House of 50
461	466		Representatives shall serve terms of four years. Of the nonlegislative members 51 General Assembly Of North Carolina Session 2025
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	467	+	Page 10 DRS45209-MGxfa-73A
463	468		appointed by the President Pro Tempore of the Senate, one shall serve an 1
464	469		initial term of two years. Thereafter, nonlegislative members appointed by the 2
465	470		President Pro Tempore of the Senate shall serve terms of four years. 3
466	471		Legislative members of the Council shall serve two-year terms. 4
467	472		(b) The Chairperson of the Council shall be elected by the Council from among its 5
468	473		membership. 6
469	474		(c) The majority of the Council shall constitute a quorum for the transaction of business. 7
470	475		(d) Members of the Council shall receive per diem and necessary travel and subsistence 8
471	476		expenses in accordance with the provisions of G.S. 138-5 or G.S. 138-6, or travel and subsistence 9
472	477		expenses in accordance with the provisions of G.S. 120-3.1, as applicable. 10
473	478		(e) All clerical support and other services required by the Council shall be provided by 11
474	479		the Department." 12
475	480		SECTION 7.2.(b) There is appropriated from the General Fund to the Department 13
476	481		of Health and Human Services the sum of two hundred fifty thousand dollars ($250,000) in 14
477	482		recurring funds for each year of the 2025-2027 fiscal biennium to be allocated to cover the 15
478	483		operating expenses of the Midlife Health Advisory Council authorized by subsection (a) of this 16
479	484		section. 17
480	485		18
481	486		PART VIII. SEVERABILITY 19
482	487		SECTION 8.1. If any section or provision of this act is declared unconstitutional or 20
483	488		invalid by the courts, it does not affect the validity of this act as a whole or any part other than 21
484	489		the part declared to be unconstitutional or invalid. 22
485	490		23
486	491		PART IX. EFFECTIVE DATE 24
487	492		SECTION 9.1. Except as otherwise provided, this act is effective when it becomes 25
488	493		law. 26