The Pulse

First look at the Health and Human Services Budget in the joint budget agreement

By: - June 28, 2016 2:07 pm

The joint budget relies on two particular sources of dollars for narrow expansions to targeted programs and services that promote the health and well-being of North Carolinians through Health and Human Services. The first is the $318 million reduction in Medicaid that   is largely due to projections that suggested the demand for Medicaid services would grow even beyond what has been experienced in recessionary periods, as NC Health News reports.  The second is an increased use of federal funds through available block grants to expand access to programs like child care, which limits the state commitment to fund these programs.

Here are a few of the key items in the HHS budget:


  • Provides $1.5 million to support Alzheimer’s patients and their families by creating additional slots for the Community Alternative Program for Disabled Adults.
  • Provides $2.26 million to increase RN rates for Community Alternatives Program for Children services to the rate that is in effect for private duty nurses.
  • Provides $2.6 million for an Innovations Waiver to serve 250 North Carolinians with intellectual or development disabilities through community alternatives programming in their homes.

Health Choice

  • Creates a non-recurring appropriation of $1 million for the Health Choice program which provides health insurance coverage to children in low-income households

Early Education

  • Budgets TANF federal funds on a non-recurring basis to the NC Pre-K program and increases the state investment in NC Pre-K by $1.3 million to serve an additional 260 children. More than 6,500 children will remain on the waiting list.
  • Relies more on federal block grants to fund the NC child care subsidy program, which frees up $6.4 million state dollars and increases child care subsidy access for 260 children.
  • Provides $3.45 million to increase the child care subsidy market rate for children ages 3 to 5 in Tier 1 and 2 counties, which are the most economically-distressed counties in the state.
  • Deploys Child Care Development Block Grant for quality enhancements focused on background checks and fraud prevention ($664,435).

Social Services

  • Provides a one-time $8.4 million appropriation and a recurring $167,083 appropriation to implement the Program Improvement Plan for child welfare. The goal of the plan is to enhance children’s safety while keeping families together and reducing the likelihood of children entering into foster care.
  • Provide $600,000 to promote food and nutrition service outreach to help ensure that older adults who are Medicaid/Medicare (dual eligibles) receive the benefits for which they’re eligible.
  • Provides $60,000 to fund three additional positions to ensure timely review of child fatalities.
  • Provides $1 million for the Children’s Angel Watch Program, which is a foster care program for children who are age 0-6 (with siblings up to age 10) who are not in the custody of the Department of Social Services and whose families are temporarily unable to care for them because of a crisis.
  • Provides $3.75 million to increase the State-County Special Assistance rate for Adult Care Homes.
  • Creates a one-time $300,000 grant to create jobs for people who are chronically unemployed and fund staff time to focus on business development leadership and technical support for advanced manufacturing.
  • Makes small state appropriations for specific non-profit organizations: Boys& Girls Club of Asheboro, Wilmington, Burlington, South Davidson Family Resource Center and Children’s Home of Lexington and Thomasville.  Also funds Child Advocacy Centers.

Public Health

  • Takes $1.9 million in grant funding away from the Office of Minority Health and places it into a program that supports community-based diabetes awareness, per the recommendations of a continuation review.
  • Provides a one-time $1 million appropriation to the State Public Health Laboratory to partially offset increased newborn screening costs and decreased Medicaid receipts.
  • Provides a one-time $1.25 million appropriation the Children’s Developmental Services Agencies to partially offset the anticipated decrease in FY 2016-17 Medicaid receipts.
  • Provides a one-time $14.8 million appropriation to support the local health departments as they adjust to new Medicaid reimbursement rates.
  • Provides a one-time $250,000 appropriation funds for You Quit Two Quit, a smoking prevention and cessation program for pregnant and postpartum women, and mothers.
  • Establishes 2 receipt-supported (i.e. non-General Fund) positions to support efforts to reduce infant mortality.
  • Provides $400,000 in one-time money to expand the Nurse Family Partnership program in the state.
  • Provides funding to develop infrastructure to detect, prevent, control and respond to Zika virus.
  • Provides small state appropriations to Best Start Program in Union County, Salem Pregnancy Care Center and New Hope Pregnancy Center.

Mental Health

  • Provides a one-time $10 million appropriation and a $10 million recurring appropriation to a reserve fund to implement the recommendations of the Governor’s Task Force on Mental Health and Substance Use.


  • Provides $7.7 million to support the establishment of a residency program at Cape Fear Valley Hospital that is affiliated with Campbell University Medical School.
  • Provides $200,000 in one-time money for a pharmacy program NC MedAssist, which helps uninsured North Carolinians access to prescription drugs
  • Provides $550,000 to increase funding for Project CARE to support caregivers of people with Alzheimer’s disease.
  • Funds two positions for the No Wrong Door Initiative that seeks to ensure older adults have access to support.
  • Makes no changes to services for people who are blind and/or deaf and hard of hearing.

Public investments in Health and Human Services of the state budget provide protections for the health and well-being of North Carolina families, children and seniors.  By strengthening healthy outcomes and ensuring access to high quality health services, North Carolina policymakers can improve the quality of life of all North Carolinians and build healthy communities that support thriving economies.

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