GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1993

S	1 

SENATE BILL 1029

Short Title:  Infant Mortality Funds.	(Public)
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Sponsors: Senators Walker; Allran, Ballance, Carpenter, Cochrane, Codington, Cooper, Edwards, Forrester, Gulley, Gunter, Harris, Hartsell, Hoyle, Kerr, Lee, Marshall, Martin of Pitt, Martin of Guilford, Perdue, Richardson, Seymour, Simpson, Smith, Soles, Speed, Tally, Ward, Warren, Winner of Buncombe, and Winner of Mecklenburg.
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Referred to:  Appropriations.
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May 4, 1993

A BILL TO BE ENTITLED
AN ACT TO APPROPRIATE FUNDS FOR INFANT MORTALITY AND CHILD HEALTH INITIATIVES.
The General Assembly of North Carolina enacts:
Section 1.  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 one million three hundred ninety-two thousand eight hundred eighty-nine dollars ($1,392,889) for the 1993-94 fiscal year and the sum of one million three hundred ninety-two thousand eight hundred eighty-nine dollars ($1,392,889) for the 1994-95 fiscal year to replace lost federal maternal and child health funds.  The funds appropriated under this section shall be used for maternal and child health programs provided by local health departments, high-risk clinics, professional education and training, consultation, and technical assistance.
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 one million dollars ($1,000,000) for the 1993-94 fiscal year and the sum of one million dollars ($1,000,000) for the 1994-95 fiscal year to expand general women's preventive health services through local health departments.  Funds appropriated under this section shall be used to supplement and not supplant existing funds available for this purpose.
Sec. 3.  (a)	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 seven hundred fifty thousand dollars ($750,000) for the 1993-94 fiscal year and the sum of one million five hundred thousand dollars ($1,500,000) for the 1994-95 fiscal year to expand the existing Comprehensive Adolescent Health Projects.  Ten additional grants will be available to be awarded each year of the biennium.  To receive funding, each project must arrange for or provide preventive and primary medical care and mental health services, including but not limited to:  preventive services to delay early sexual involvement, treatment of minor problems and injuries, referrals and follow-up treatments for serious illnesses and injuries, referrals for alcohol and other drug abuse, sexually transmitted diseases, and immunizations.  The Comprehensive Adolescent Health Care Projects shall be developed with the participation of the public schools, local health departments, area mental health programs, community migrant and rural health centers, private physicians, and other appropriate community programs.
(b)	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 fifty thousand dollars ($50,000) for the 1993-94 fiscal year and the sum of fifty thousand dollars ($50,000) for the 1994-95 fiscal year to contract with the University of North Carolina Center on Early Adolescence to provide technical assistance to and evaluate existing adolescent health care clinics and to assist other counties in developing adolescent health care services.
Sec. 3.1. 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 two hundred fifty thousand dollars ($250,000) for the 1993-94 fiscal year and the sum of two hundred fifty thousand dollars ($250,000) for the 1994-95 fiscal year to provide an ongoing source of funding for 12 local project agencies, 20 full-time maternal outreach workers, and one consultant position for the Baby Love program in fiscal year 1993-94, and to fund an additional 12 local project agencies, 20 full-time maternal outreach workers, and a second consultant for the Baby Love program in fiscal year 1994-95.
Sec. 4.  There is appropriated from the General Fund to the N.C. Coalition on Adolescent Pregnancy the sum of two hundred fifty thousand dollars ($250,000) for the 1993-94 fiscal year and the sum of two hundred fifty thousand dollars ($250,000) for the 1994-95 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 birth-weight babies born to adolescents; to conduct research and data collection about effective pregnancy prevention initiatives; to provide services, training programs, and resources to school systems in developing effective family life education curricula; and to conduct a statewide media campaign to reduce pregnancy and promote healthy behavior, aimed at children between ages 10 and 14, including Medicaid eligible children.
Sec. 5.  (a)	Effective October 1, 1993, the Department of Human Resources, Division of Medical Assistance, shall provide medical coverage for parenting education for all Medicaid eligible families with children from birth to three years of age.
(b) There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of three hundred seventy-eight thousand dollars ($378,000) for the 1993-94 fiscal year and the sum of five hundred four thousand dollars ($504,000) for the 1994-95 fiscal year to provide the State share of the increased coverage for services mandated by this section.
Sec. 6. There is appropriated from the General Fund to the Department of Human Resources, Division of Medical Assistance, the sum of seventy-five thousand dollars ($75,000) for the 1993-94 fiscal year and the sum of one hundred thousand dollars ($100,000) for the 1994-95 fiscal year to develop public education materials and a toll-free hotline to inform Medicaid eligible families with children about the Healthy Children and Teens program, and about the availability of providers who accept Medicaid.
Sec. 7. (a) There is appropriated from the General Fund to the Department of Human Resources the sum of six hundred thirty-three thousand seven hundred nine dollars ($633,709) for the 1993-94 fiscal year and the sum of six hundred thirty-three thousand seven hundred nine dollars ($633,709) for the 1994-95 fiscal year to be used to expand the Adolescent Parenting Program in the Division of Social Services.  The funds shall be used to provide the following:
(1)	Expansion funds of $10,000 each to existing adolescent parenting programs in Caldwell, Cleveland, Craven, Cumberland, Durham, Forsyth, Franklin, Gaston, Onslow, Orange, Pasquotank, Pender, Rutherford, Stanly, Union, and Vance;
(2)	Eleven additional grants for local adolescent parenting programs;
(3)	Support services such as day care, transportation, and family planning to participants in the program who are not eligible for AFDC;
(4)	In-home parenting services designed to reduce child abuse and neglect;
(5)	Purchase of resource materials and curricula that are used in the training session with the teenage parents; and
(6)	Expanded State-level oversight, including an interdepartmental advisory group.
(b)	The Department of Human Resources shall:
(1)	Require applicants to conduct an analysis of current programs within a county to avoid duplication of efforts;
(2)	Direct local programs to undertake an annual evaluation of the outcome and impact of the program;
(3)	Assure that the county matches State funds;
(4)	Allow nonprofit organizations within a county to be eligible to apply for an Adolescent Parenting Program;
(5)	Expand State-level oversight by establishing an interdepartmental advisory group; and
(6)	Provide opportunities for male involvement in adolescent pregnancy prevention and promote teen parenting responsibilities for young, single fathers ages 15-23.  These opportunities shall include the following:  vocational training, job placement, assistance in completing a high school education or its equivalent, individual counseling, and parenting skills classes.
Sec. 8.  There is appropriated from the General Fund to the Governor's Commission on the Reduction of Infant Mortality the sum of one hundred thousand dollars ($100,000) for the 1993-94 fiscal year to contract with outside evaluators to determine the extent to which the public and private health, social services and mental health, developmental disabilities, and substance abuse services systems in each county meet the health needs of pregnant women, and infants up to age one, and of children ages one to five.  The study shall include, but not be limited to:  an examination of the percentage of pregnant women in each county that receive early and continuous prenatal care; the extent to which eligible pregnant women, infants, and children are receiving nutritional supplements, case management, and other necessary health, social, mental health, and other support services, and the extent to which children are receiving age appropriate immunizations.  The study shall determine what barriers, if any, exist in each county which prevent pregnant women, infants, and children under the age of five from receiving timely and necessary health services.  The Governor's Commission on the Reduction of Infant Mortality shall report its findings to the General Assembly on or before May 15, 1994.
Sec. 9. (a) The Department of Environment, Health, and Natural Resources shall prepare a plan to ensure that local health departments are providing or arranging for the services necessary to meet the health care needs of pregnant women, infants, and children under age five.  The plan shall include a description of rules, policies, and procedures, and any changes in State law, necessary to:
(1)	Identify counties in which excessive infant and child morbidity and mortality exist;
(2)	Provide local health departments in these identified counties with assistance in developing and implementing improvement plans; and
(3)	Ensure that these local health departments meet appropriate improvement goals.
In order to ensure that improvement goals are met, the Department's plan shall include a compliance system.  The compliance system may include:  heightened technical assistance; targeting of additional resources; withholding of federal or State funds; administrative changes, including formation of district health departments where appropriate; the appointment of caretaker administrators or public health boards; or any other measure necessary to ensure that the health care needs of pregnant women, infants, and children under age five are being met.
(b)	The Department of Environment, Health, and Natural Resources, Division of Maternal and Child Health shall submit this report to the General Assembly no later than May 15, 1994.
Sec. 10. This act becomes effective July 1, 1993.