Part I.
Declares the General Assembly’s intent to increase the hourly wage of direct care workers in the state to a minimum of $18 per hour. Requires the Department of Health and Human Services (DHHS), Division of Health Benefits (DHB), to provide a Medicaid rate increase to all of the following:

Home and community-based providers enrolled in the Medicaid program. 
Intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), including ICF/IID-level group homes.
Providers who provide services to Medicaid beneficiaries receiving services through the North Carolina Innovations waiver program, the Community Alternatives Program for Children, or the Community Alternatives Program for Disabled Adults, and who are either (i) enrolled in the Medicaid program or (ii) approved financial managers or financial support agencies billing for personal care service or waiver service hours provided by direct care workers hired by employers of record or managing employers under consumer-directed or self-directed options in accordance with any of the listed Medicaid Clinical Coverage Policies in the act. 

Requires DHB to determine the definition of direct care worker to be applied, the amount of rate increases, how a provider or facility will use the increased rate and demonstrate compliance, including required documentation. Provides that any rate increase provided will be effective on the date approved by the Centers for Medicare and Medicaid Services (CMMS). Upon implementation of an applicable rate increase required by this section, DHB must adjust the per member per month (PMPM) capitation amount paid to LME/MCOs accordingly. All LME/MCOs will be required to implement the increase, and it shall also apply to BH IDD tailored plans. 
Appropriates $183 million (the State’s match for the $335 million in recurring federal funds) in recurring funds for each year of the 2025-27 biennium from the General Fund to DHB to implement the above wage increase. Appropriates the federal funds to DHB for the same purpose. Effective July 1, 2025.
Part II.
Effective July 1, 2025, requires DHB to amend the NC innovations waiver to increase the number of slots under the waiver by a minimum of 1,000, made available upon approval by CMMS. Appropriates $36 million (the State’s match for the $65 million in recurring federal funds) in recurring funds for each year of the 2025-27 biennium from the General Fund to DHB to implement the above slots increase. Appropriates the federal funds to DHB for the same purpose. Effective July 1, 2025.
Requires DHB to convene a workgroup of relevant stakeholders to develop a plan to satisfy the registry of unmet needs for the waiver within the next ten years. Requires DHB to submit a report containing the ten-year plan to the specified NCGA Committee by February 1, 2026. 
Part III.
Removes income limits from the eligibility requirements for the Medicaid buy-in for workers with disabilities in GS 108A-66.1. Makes technical and conforming changes. Prevents DHB from considering income disregarded under the State Medical Assistance Plan's financial methodology, including the $65 disregard, impairment-related work expenses, student earned-income exclusions, and other SSI program work incentive income disregards in determining an individual’s counting income. Requires DHB to submit the necessary documentation to CMMS for approval to remove the unearned income limit and the resource limit from the eligibility requirements for the Health Coverage for Workers with Disabilities Medicaid eligibility category by no later than 90 days after the act becomes law. Provides for notice to the Revisor of Statutes upon approval by CMMS. Effective on the date approved by CMMS for the removal of the unearned income and resource limits for Health Coverage for Workers with Disabilities program eligibility.
Appropriates $165,000 in recurring funds from the General Fund to DHB for each year of the 2025-27 biennium to provide a State match for the $301,000 in recurring funds for that time. Appropriates those federal funds to DHB. Effective July 1, 2025.
Part IV.
Requires DHB to study the feasibility of adding coverage of a new Medicaid service, entitled "Community Activities and Employment Transitions" (CAET), that provides individualized services and supports for individuals age 16 or older with intellectual or other developmental disabilities and that meets the three specified criteria established in the subsection. Directs DHB to consider the feasibility of adding the coverage in any of the following ways: (i) by adding an "in-lieu-of" service offered through the 1115 waiver for Medicaid transformation, (ii) by adding or amending a 1915(i) home and community-based State Plan amendment to include the service, or (iii) by adding the service to any existing Medicaid waiver in this state. Requires DHB to collaborate with listed stakeholders. Requires the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services (Commission) to also collaborate with those stakeholders to review any relevant rules. Allows the Commission to amend any relevant rules and, if necessary, to adopt additional rules to account for the numerous community-based activities and employment services that may be provided to Medicaid beneficiaries as part of a new CAET service. Allows DHB to submit any State Plan waivers or amendments or request any other approval from CMMS necessary to implement any new CAET service. Specifies that coverage of the new service cannot begin until on or after January 1, 2026. Requires DHB to submit a report on the CAET service to the specified NCGA committee by April 1, 2026. Effective July 1, 2025, appropriates $2 million from the General Fund to DHB for 2025-26 to be used to support the feasibility study and for drafting requests for the authorities or supports needed to implement any proposed new CAET service.  
Part V.
Requires Division of Mental Health, Developmental Disabilities, and Substance Use Services (DHM) to develop a State Rental Assistance Program (SRAP), modeled after the Transitions to Community Living Program, to provide vouchers to assist individuals with intellectual and developmental disabilities to transition to integrated housing as required by the 2024 consent order entered in Samantha R., et al. v. State of North Carolina, et al., 17 CVS 6357-910 (Wake County Superior Court). Effective July 1, 2025, appropriates $100,000 in recurring funds to DHM for each year of the 2025-27 biennium to support the SRAP.
Requires DHM to convene a workgroup of relevant stakeholders to develop a five-year plan for monthly housing rental subsidies to be provided to individuals with intellectual or other developmental disabilities for use in integrated settings. Specifies that the plan must create 200 new monthly housing rental subsidies to be provided to individuals with intellectual or other developmental disabilities each year over the course of five years, resulting in the creation of a total of 1,000 monthly housing rental subsidies by the end of the five-year period. Directs that by no later than October 1, 2025, DHM must submit a report containing the five-year plan to the specified NCGA committees. 
Part VI.
Appropriates $4,755,071 from the General Fund to the DHHS Division of Employment and Independence for People with Disabilities (DEIPD) in recurring funds for each year of the 2025-27 biennium to increase pay to address the vacancy rate in DEIPD, raise rates for Community Rehabilitation Programs, and sustain the vocational rehabilitation workforce to ensure individuals with disabilities can access paid employment services. Specifies that the funds provide a State match for the $17,569,207 in recurring federal funds, which are appropriated to DEIPD for the same purpose. Appropriates $995,163 from the General Fund to the DHHS Division of Services for the Blind (DSB) in recurring funds for each year of the 2025-27 biennium to increase pay to address the vacancy rate in DSB, raise rates for Community Rehabilitation Programs, and sustain the vocational rehabilitation workforce to ensure individuals with disabilities can access paid employment services. Specifies that the funds provide a State match for the $3,676,959 in recurring federal funds, which are appropriated to DSB for the same purpose. Effective July 1, 2025. 
Part VII.
Amends GS 115C-391.1 to ban school personnel from physically restraining a student in a prone position. Requires a public school unit to request confirmation that parents have received the school’s policy on seclusion and restraint. Amends the GS 115C-391.1(j) notice, consent, reporting, and documentation provisions as follows. Requires school personnel to promptly notify the principal or designee of any use of mechanical restraint (currently, just prohibits uses of mechanical restraint), any use of physical restraint (currently, any use of physical restraint resulting in observable physical injury to a student), any use of seclusion (currently, any prohibited use of seclusion or seclusion that exceeds 10 minutes or the amount of time specified on their behavior intervention plan), and adds notification if the seclusion or restraint was used in a prohibited manner, caused observable physical injury to a student, or exceeded 10 minutes or the amount of time specified on a student's behavior intervention plan. Changes the time limit to promptly notify by the end of the school day when the incident occurred (currently, end of the workday when the incident occurred but in no event later than the end of the following workday). Requires teachers to take at least one credit on the use of seclusion and restraint, including State policies, safe techniques, and trauma-informed practices as part of the licensure renewal. Applies beginning with the 2025-26 school year. 
Part VIII.
Requires the data on the numbers of students who have dropped out of school, been subjected to corporal punishment, been suspended, been expelled, been reassigned for disciplinary purposes, or been provided alternative education services that the State Board of Education (Board) is required to annually report to the General Assembly under GS 115C-12 to also be available to the public on an electronic dashboard established and maintained by the Board. Applies beginning with the 2025-26 school year.
Part IX.
Appropriates $25 million from the General Fund to the University of North Carolina Board of Governors in recurring funds for each year of the 2025-27 biennium to increase pay to be allocated to the State Education Assistance Authority for the North Carolina Personal Education Student Accounts for Children with Disabilities Program (Accounts) in accordance with Article 41 of GS Chapter 115C. Increases the appropriations to the Accounts by $25 million from fiscal year 2027-28 through fiscal year 2032-33 so that the appropriation for the Accounts after fiscal year 2032-33 is $107,643,166. Effective July 1, 2025.
Part X.
Directs DPI to establish a grant program for local school administrative units to apply for funds from the Special State Reserve Fund (SSRF) for children with disabilities for the purpose of covering the extraordinary costs of certain students with disabilities, including costs associated with the placement of students in private schools with approved nonpublic education programs providing special education in accordance with a student's individualized education program (IEP), starting with the 2025-26 school year. Directs that funds administered pursuant to this act are to supplement and not supplant existing federal, State, and local funding for children with disabilities. Provides for an application process for local school administrative units and eligibility requirements, including that the total cost of the services equals or exceeds four times the State average per pupil expenditure for children with disabilities in the prior fiscal year. Provides for reimbursement of 75% of the extraordinary costs (defined). Provides for oversight by DPI, as described, to ensure that if a student covered by grant funds is placed in a private school that has an approved nonpublic education program providing special education in accordance with a student's IEP, the school is approved by DPI as adhering to State and federal laws governing education services for students with disabilities and State and federal laws governing seclusion and restraint of students. Appropriates $1 million from the General Fund to the State Special Reserve Fund in recurring funds for the 2025-26 school year for DPI to implement the above grant program. Requires DPI to submit a report to the specified NCGA committees and division on the amount of grant applications, as described, by March 15, 2026.
Expands the matters in GS 115C-107.5 upon which the Board has to report to the specified NCGA committee pertaining to the educational performance of children with disabilities to include a summary analysis of the listed data monitored and collected by DPI. Directs the Board to submit the data beginning with the report submitted on October 15, 2026.
Effective July 1, 2025.
Part XI.
Requires the Department of Transportation (DOT) to create an office within DOT to be known as the Office of Accessible Transportation and Mobility (Office).  Specifies the Office’s purpose, and requires all appropriate State and local agencies to coordinate with the Office. Requires the Office to consult with stakeholders. Requires DOT to submit a report on the Office’s mission and scope of responsibilities and include a five-year plan to guide the Office’s work to the specified NCGA committees by no later than March 31, 2026.

Statutes affected:
Filed: 108A-66.1, 115C-391.1, 115C-270.30, 115C-12, 115C-600, 115C-107.5