GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 523
Short Title: Universal Basic Therapy Act. (Public)
Sponsors: Senators Theodros and Batch (Primary Sponsors).
Referred to: Rules and Operations of the Senate
March 26, 2025
*S523 -v-1*
A BILL TO BE ENTITLED 1
AN ACT TO ESTABLISH A PILOT VOUCHER SYST EM FOR MENTAL HEALTH 2
SERVICES, TO EXPAND ACCESS TO CARE, AND TO EVALUATE THE 3
EFFECTIVENESS OF TAR GETED MENTAL HEALTH SUPPORT IN NORTH 4
CAROLINA. 5
Whereas, mental health services remain financially inaccessible for many North 6
Carolinians, particularly in underserved areas; and 7
Whereas, expanding access to counseling, therapy, and psychiatric care will improve 8
public health outcomes and reduce long-term healthcare costs; and 9
Whereas, a structured pilot project will allow for data-driven assessment before 10
broader implementation; and 11
Whereas, the North Carolina Constitution, Article XI, Section 4, mandates the State's 12
responsibility to provide for the welfare of its citizens, including mental health support; Now, 13
therefore, 14
The General Assembly of North Carolina enacts: 15
SECTION 1. This act shall be known and may be cited as the "Mind Care for All 16
Act." 17
SECTION 2. For the purposes of this act, the following definitions apply: 18
(1) Approved providers. – Includes licensed counselors, therapists, psychiatrists, 19
and community mental health centers certified by the Department of Health 20
and Human Services (DHHS). 21
(2) Mental health voucher. – A State-funded certificate that eligible individuals 22
can use to access mental health services from approved providers. 23
(3) Pilot counties. – The select counties chosen for the initial implementation of 24
this act. 25
SECTION 3. By October 1, 2026, the Department of Health and Human Services, 26
Division of Mental Health, Developmental Disabilities, and Substance Use Services 27
(DMH/DD/SUS), shall establish a Mental Health Voucher System pilot project in five counties. 28
DMH/DD/SUS shall select the five pilot counties based on mental health service shortages and 29
rates of untreated mental illness. 30
SECTION 4.(a) The Department of Health and Human Services, Division of Mental 31
Health, Developmental Disabilities, and Substance Use Services, shall reallocate the sum of ten 32
million dollars ($10,000,000) in nonrecurring funds for the 2025-2026 fiscal year from 33
single-stream funding currently allocated to the five pilot counties to be used to support the pilot 34
project created by this act. These funds shall not revert at the end of the fiscal year but shall 35
remain available until expended. 36 General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 523-First Edition
SECTION 4.(b) There is appropriated from the General Fund to the Department of 1
Health and Human Services, Division of Mental Health, Developmental Disabilities, and 2
Substance Use Services, the sum of ten million dollars ($10,000,000) in nonrecurring funds for 3
the 2025-2026 fiscal year to be used to support the pilot project created by this act. These funds 4
shall not revert at the end of the fiscal year but shall remain available until expended. 5
SECTION 4.(c) The Department of Health and Human Services, Division of Mental 6
Health, Developmental Disabilities, and Substance Use Services, shall use the sum of five million 7
dollars ($5,000,000) in nonrecurring funds for the 2025-2026 fiscal year from federal mental 8
health block grants to support the pilot project created by this act. These funds shall not revert at 9
the end of the fiscal year but shall remain available until expended. 10
SECTION 4.(d) Additionally, it is the intent of the General Assembly to create a 11
public-private partnership fund to encourage nonprofit and healthcare industry contributions. 12
SECTION 5. Individuals earning below two hundred fifty percent (250%) of the 13
federal poverty level that demonstrate a mental health need, as determined by a primary care 14
provider or mental health screening, may qualify for the pilot project mental health voucher. 15
Veterans, uninsured individuals, young adults aged 18 to 26, law enforcement officers, and 16
teachers shall be given priority consideration. 17
SECTION 6. The pilot project mental health vouchers shall cover therapy sessions, 18
psychiatric evaluations, medication management, and crisis intervention. Each mental health 19
voucher recipient shall be eligible to receive up to 10 free mental health visits with an approved 20
provider annually, with options for renewal based on clinical need. 21
SECTION 7. DMH/DD/SUS shall recruit and certify mental health providers willing 22
to accept mental health vouchers in pilot counties and shall provide incentives, including State 23
reimbursement bonuses, to encourage provider participation. The pilot project shall allow mental 24
health voucher recipients to use telehealth platforms to connect with approved providers, and 25
DMH/DD/SUS shall provide grants to community health centers to enhance telehealth 26
infrastructure. 27
SECTION 8. DHHS shall collect quarterly reports from participating providers and 28
submit an annual report to the General Assembly and the Independent Review Commission on 29
Mental Health Access, established under Section 9 of this act. This report shall include all of the 30
following: 31
(1) Mental health voucher utilization rates. 32
(2) Patient satisfaction metrics. 33
(3) Symptom improvement metrics. 34
(4) Emergency psychiatric hospitalization rates. 35
SECTION 9.(a) An Independent Review Commission on Mental Health Access 36
(Commission) shall be established to oversee the pilot project evaluation. The Commission shall 37
consist of seven members, as follows: 38
(1) Two mental health policy experts appointed by the Governor. 39
(2) Two representatives from DHHS appointed by the Secretary of the 40
Department of Health and Human Services. 41
(3) One representative from the House of Representatives appointed by the 42
Speaker of the House. 43
(4) One representative from the Senate appointed by the President Pro Tempore 44
of the Senate. 45
(5) One mental health provider participating in the pilot project appointed by the 46
Governor. 47
SECTION 9.(b) The Commission shall conduct a project evaluation based on the 48
annual reports from DHHS required in Section 8 of this act. If the Commission determines that 49
the pilot project demonstrates positive health outcomes and cost-effectiveness, DHHS shall 50 General Assembly Of North Carolina Session 2025
Senate Bill 523-First Edition Page 3
submit a plan to expand the voucher system statewide within five years. This plan shall prioritize 1
rural and high-need urban areas. 2
SECTION 10. DHHS shall establish a Statewide Mental Health Access Oversight 3
Panel to ensure transparency and accountability. The Panel shall conduct public hearings and 4
publish annual project updates. These reports shall be made publicly available on the DHHS 5
website. A feedback portal shall be created for public input on the pilot project effectiveness. 6
SECTION 11. DHHS shall adopt the necessary rules and regulations to implement 7
the provisions of this act. 8
SECTION 12. If any provision of this act is found to be invalid or unconstitutional, 9
the remaining provisions shall remain in effect. 10
SECTION 13. This act is effective July 1, 2025. 11