AN ACT appropriating funds to the department of health and human services, division of public health, office of rural health, to establish and administer a grant program to enable federally qualified health centers and federally qualified health center look‑alikes to hire community health workers dedicated to addressing and reducing disparities in maternal and infant health outcomes.

The General Assembly of North Carolina enacts:

SECTION 1.(a)  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Central Management and Support, Office of Rural Health (ORH), the sum of three million seven hundred fifty thousand dollars ($3,750,000) in nonrecurring funds for the 2023‑2024 fiscal year and the sum of three million seven hundred fifty thousand dollars ($3,750,000) in nonrecurring funds for the 2024‑2025 fiscal year to be used to establish and administer a grant program that awards grants to federally qualified health centers (FQHCs) and federally qualified health center look‑alikes (FQHC look‑alikes) to hire and deploy community health workers to rural, medically underserved, and low‑wealth areas of the State for the purpose of addressing and reducing racial and ethnic disparities in maternal and infant health outcomes.

SECTION 1.(b)  In establishing and administering the grant program authorized by this section, the ORH is subject to the following requirements and limitations:

(1)        The ORH shall consult with the Office of Minority Health and Health Disparities and the North Carolina Community Health Worker Association in establishing an application process and eligibility requirements for the grant program.

(2)        The ORH shall use these funds to award grants to up to 15 FQHCs and FQHC look‑alikes.

(3)        The ORH shall give priority to FQHCs and FQHC look‑alikes located in low‑wealth areas of the State that (i) are medically underserved, (ii) have historically marginalized populations, (iii) have been disproportionately impacted by high rates of infant or maternal death, and (iv) are at higher risk of maternal‑infant mortality.

(4)        No single grant award in any fiscal year shall exceed four hundred fifty thousand dollars ($450,000).

SECTION 1.(c)  FQHCs and FQHC look‑alikes that are recipients of grants awarded under this section shall use their grant funds to hire community health workers, preferably from the communities being served, with knowledge of, and experience conducting community outreach into, rural or urban communities experiencing high maternal death rates, high infant mortality rates, or both, among minority populations, to perform the following functions:

(1)        To conduct community outreach and provide education to pregnant women at high risk of (i) pregnancy‑related death within a year after giving birth or (ii) fetal, perinatal, or infant death. In conducting this outreach, the community health workers shall make efforts to identify Medicaid members who either are not engaged in maternal or pediatric health care services available under the Medicaid program or are underutilizing these Medicaid services.

(2)        To disseminate printed information about high‑risk maternal death; high‑risk fetal, perinatal, and infant death; and the availability of services and resources for pregnant women to lower these risks.

(3)        To provide information about how to access the following services:

a.         Doula services.

b.         Prenatal care services available through FQHCs and FQHC look‑alikes.

c.         Maternal and pediatric health care services available to Medicaid beneficiaries.

d.         Prenatal and postpartum care for women with substance use disorders.

SECTION 1.(d)  The ORH may use up to two hundred fifty thousand dollars ($250,000) of the funds allocated by this section for each year of the 2023‑2025 fiscal biennium for administrative purposes related to this grant program.

SECTION 1.(e)  By December 15, 2024, the ORH shall report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division on the grant program authorized by this section. The report shall include at least all of the following:

(1)        The identity and a brief description of each grantee and the amount of grant funds awarded to each.

(2)        The number of community health workers hired by each grantee and for each worker:

a.         The number of women served and the racial and ethnic demographics of those served.

b.         The number of communities served and the location of each.

c.         The types of services provided by each community health worker.

(3)        Preliminary information regarding the impact of using community health workers on the maternal and infant health of the women served.

(4)        Any other information requested by the Office of Rural Health as necessary for evaluating the success of this grant program.

SECTION 2.  This act becomes effective July 1, 2023.