GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1991

H	1 

HOUSE BILL 1184*

Short Title:  Infant Mortality Funds.	(Public)
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Sponsors: Representatives Diamont; Anderson, Barnes, Barnhill, Beall, Beard, Bowman, Brubaker, Church, Colton, J. W. Crawford, N. J. Crawford, DeVane, Easterling, Esposito, Ethridge, Fitch, Flaherty, Fletcher, Foster, Gottovi, Gray, Green, Hardaway, Judy Hunt, H. Hunter, R. Hunter, Jeralds, Jones, Jordan, Lewis, Luebke, Lutz, McAllister, McLaughlin, Mercer, Michaux, Miller, Nesbitt, Payne, Redwine, Rhyne, Rogers, Smith, Stamey, Thompson, Wainwright, Wicker, and Wilmoth.
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Referred to:  Appropriations.
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May 9, 1991

A BILL TO BE ENTITLED
AN ACT TO APPROPRIATE FUNDS TO VARIOUS STATE AND NON-STATE ENTITIES TO ADDRESS THE INFANT MORTALITY PROBLEM.
The General Assembly of North Carolina enacts:
Section 1. (a) The Department of Human Resources, Division of Medical Assistance, shall provide medical coverage for nutritional counseling, psycho-social counseling, outpatient and residential substance abuse treatment services, and predelivery and postpartum home visits by maternity care coordinators and public health nurses, for Medicaid eligible pregnant women.
(b) There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $1,664,400 for the 1991-92 fiscal year and the sum of $2,164,005 for the 1992-93 fiscal year to provide the State share of the increased coverage for services mandated by this section.
Sec. 2.  There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $1,000,000 for the 1991-92 fiscal year and the sum of $1,000,000 for the l992-93 fiscal year to provide assistance to counties in paying for the cost of Medicaid eligibility workers to take Medicaid applications for pregnant women and children in public health departments, community, migrant, and rural health centers, and hospital inpatient and outpatient clinics where prenatal care or children's health services are delivered.
Sec. 3.  There is appropriated from the General Fund to the Department of Human Resources, Division of Mental Health, Mental Retardation, and Substance Abuse Services, the sum of $1,420,000 for the 1991-92 fiscal year and the sum of $1,420,000 for the 1992-93 fiscal year to set up three regional residential and outpatient treatment programs for pregnant women who abuse drugs or alcohol, and to continue support for the residential and outpatient treatment center located in Robeson County, North Carolina.  The programs shall be located in either a public health department or a community, migrant, or rural health center that provides prenatal services, and shall include but not be  limited to case management services, transportation, day care, prevention, residential placement, outpatient services, and money for household start-up costs.
Sec. 4.  There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of $500,000 for the 1991-92 fiscal year and the sum of $500,000 for the 1992-93 fiscal year to help counties pay for the cost of Medicaid transportation services for pregnant women and children.  Funds appropriated under this section shall be used to supplement and not to supplant county and federal funds already used for this purpose.
Sec. 5.  There is appropriated from the General Fund to the Department of Human Resources, Office of Rural Health, the sum of $60,000 for the 1991-92 fiscal year and the sum of $60,000 for the 1992-93 fiscal year to provide technical assistance to maternity care coordinators in community, migrant, or rural  health centers, and to expand efforts to recruit doctors and nurse midwives in medically underserved areas.
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 $500,000 for the 1991-92 fiscal year and the sum of $500,000 for the 1992-93 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.  General surgeons who provide cesarean section backup to family physicians in counties where there are no obstetricians or where there are no obstetricians willing or able to provide such backup are also eligible for the program.  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. 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 $750,000 for the 1991-92 fiscal year and the sum of $750,000 for the 1992-93 fiscal year to expand general women's preventive health through local health departments.  Funds appropriated under this section shall be used to supplement and not to supplant existing funds available for this purpose.
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 $1,000,000 for the 1991-92 fiscal year and the sum of $1,000,000 for the 1992-93 fiscal year to provide nutritional supplements under the Women, Infants and Children program.
Sec. 9.  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 $1,000,000 for the 1991-92 fiscal year and the sum of $1,000,000 for the 1992-93 fiscal year to expand case management services for non-Medicaid eligible children under the age of 5 years who are considered to be at risk for special health problems.
Sec. 10.  There is appropriated from the General Fund to the Department of Environment, Health, and Natural Resources, State Public Health Laboratory, the sum of $142,757 for the 1991-92 fiscal year and the sum of $150,000 for the 1992-93 fiscal year to provide timely newborn screening to detect problems to prevent death or the onset of retardation.
Sec. 11.  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 $250,000 for the 1991-92 fiscal year and the sum of $250,000 for the 1992-93 fiscal year to pay for maternity care coordination services for non-Medicaid eligible pregnant women in public health departments or community, migrant, or rural health centers.
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 1991-92 fiscal year and the sum of $75,000 for the 1992-93 fiscal year as a grant-in-aid to provide technical assistance to local adolescent pregnancy prevention projects in reducing the high incidence of infant mortality resulting from low-birthweight babies born to adolescents.
Sec. 13.  There is appropriated from the General Fund to Bowman Gray School of Medicine at Wake Forest University the sum of $60,000 for the 1991-92 fiscal year and the sum of $60,000 for the 1992-93 fiscal year as a grant-in-aid to coordinate neonatal intensive care placements.
Sec. 14.  There is appropriated from the General Fund to the Board of Governors of The University of North Carolina the sum of $95,000 for the 1991-92 fiscal year and the sum of $95,000 for the 1992-93 fiscal year to hire additional clinical faculty to establish a nurse midwifery education program.  The program shall offer multiple track options for participating nurses; the multiple tracks shall take into consideration the varying degrees of preparation, and the only professional prerequisite shall be that applicants be licensed as registered nurses in the State of North Carolina, regardless of their educational preparation.
Sec. 15.  The Department of Insurance, in conjunction with the Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health, and the Department of Human Resources, Division of Medical Assistance, shall conduct a study to determine the extent to which there are women who lack health insurance covering prenatal care and delivery services; and to determine the gaps in private and self-funded health insurance coverage.  Not later than March 1, 1992, the Department of Insurance shall report to the Joint Legislative Commission on Governmental Operations and to the Fiscal Research Division on the progress of this study.
Sec. 16.  This act becomes effective July 1, 1991.