GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1989

S	1 

SENATE BILL 1396*

Short Title:  Reduce Infant Mortality.	(Public)
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Sponsors: Senators Ezzell, Walker; Allran, Barker, Carpenter, Cochrane, Conder, Daniel, Goldston, Guy, Hardin, Harris, Hunt of Durham, Johnson of Cabarrus, Kaplan, Lee, Martin of Guilford, Marvin, Plyler, Rauch, Richardson, Smith, Soles, Speed, Tally, Ward, Wilson, and Winner.
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Referred to:  Appropriations.
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May 25, 1990

A BILL TO BE ENTITLED
AN ACT TO APPROPRIATE FUNDS TO DEVELOP STATE INITIATIVES FOR ADDRESSING AND REDUCING INFANT MORTALITY IN NORTH CAROLINA.
The General Assembly of North Carolina enacts:
Section 1.  (a) The Department of Human Resources shall provide Medicaid coverage to the extent permitted by federal law, for pregnant women and for children up to the age of one year, whose family income is equal to or less than one hundred eighty-five percent (185%) of the federal poverty guidelines as revised annually by the United States Department of Health and Human Services.  Services provided to pregnant women under this section shall continue through the pregnancy but shall include only services related to the pregnancy and to those other conditions determined by the Department of Human Resources as conditions that complicate pregnancy. In order to reduce county administrative costs and to expedite the provision of medical services to children and pregnant women eligible under this section, no resource test shall be applied.
(b) There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $3,027,219 for the 1990-91 fiscal year to provide the State share of the increased coverage authorized by this section.
Sec. 2. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $300,000 for the 1990-91 fiscal year to expand the Rural Obstetrical Care Incentive Program established under Section 39.3 of Chapter 1100, 1987 Session Laws, Regular Session 1988.  The Rural Obstetrical Care Incentive Program will be used to assist with the cost of  malpractice insurance for family physicians, obstetricians, and certified nurse midwives who agree to provide prenatal and obstetrical services in medically underserved areas of the State.  Physicians and certified nurse midwives covered under the Rural Obstetrical Care Incentive Program are required to participate in an obstetrical care coverage plan developed by their local health department or community, migrant, or rural health center, and must agree to provide services to pregnant women regardless of their ability to pay for the services.
Sec. 3. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $400,000 for the 1990-91 fiscal year to employ, effective January 1, 1991, four teams of certified nurse midwives to serve in critically underserved counties in the eastern and western portions of North Carolina.
Sec. 4. There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $2,000,000 for the 1990-91 fiscal year, for the State share of increasing physician reimbursement for maternity care services.
Sec. 5. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $500,000 for the 1990-91 fiscal year to provide one-time start-up grants to enable local health departments or community, rural, or migrant health centers to employ additional maternity care workers.
Sec. 6. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $900,000 for the 1990-91 fiscal year to provide for expansion of genetic health care services through medical genetics centers.
Sec. 7. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $175,000 for the 1990-91 fiscal year to provide a toll-free hotline for pregnant women, and to conduct an educational awareness campaign through television, radio, and news media, to alert health care patients, physicians, and the general public to the urgency of providing early, continuous, and good quality prenatal care to all women of childbearing age.
Sec. 8. There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, the sum of $350,000 for targeted infant mortality grants.  The infant mortality grants shall be awarded to urban and rural counties with high infant mortality rates and large numbers of infant deaths and shall be used to conduct community-wide efforts to reduce infant mortality.
Sec. 9. (a) There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $1,000,000 to help counties pay for the cost of Medicaid transportation services.
(b) The Division of Medical Assistance shall develop a statewide plan to inform Medicaid recipients about the availability of transportation, to determine the extent to which each local department of social services provides Medicaid transportation when requested, and to ensure that each local department provides Medicaid transportation.  In gathering this information and designing the plan, the Division shall consult with other public and private agencies that work with Medicaid patients who need transportation services.
Sec. 10. (a) The Department of Human Resources, Division of Medical Assistance, shall provide Medicaid coverage to the extent permitted under federal law, for case management services for Medicaid-eligible children under the age of five years who are considered to be at risk for special health problems.
(b) There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $1,484,344 for the 1990-91 fiscal year to provide the State share of the increased coverage for case management services mandated by this section.
Sec. 11. There is appropriated from the General Fund to the Children's Home Society of North Carolina, Inc., the sum of $100,000 for the 1990-91 fiscal year as a grant-in-aid to provide assistance for infant adoption and prenatal counseling services.
Sec. 12. There is appropriated from the General Fund to the North Carolina Coalition on Adolescent Pregnancy Prevention the sum of $75,000 for the 1990-91 fiscal year as a grant-in-aid to provide technical assistance in reducing the high incidence of infant mortality resulting from low birthweight babies born to adolescents.
Sec. 13. The Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, shall report to the Joint Legislative Commission on Governmental Operations in December 1990 about the feasibility of setting up a nurse midwifery education program in North Carolina.
Sec. 14. The Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, shall conduct a needs assessment in each county to determine the availability of prenatal care and necessary supportive services to pregnant women.  The assessment shall include the availability of women, infants, and children nutritional supplements, and maternity care coordination.  The assessment shall also determine the extent to which the lack of such services impacts on low birthweight and infant mortality in the county.  The Department shall report its findings to the Joint Legislative Commission on Governmental Operations on March 15, 1991.
Sec. 15. This act shall become effective July 1, 1990.