After weeks of waiting and disputes over expanded gambling in the state, the North Carolina Senate finally approved the 2023-2024 state budget early Friday morning. Governor Roy Cooper has stated he intends to allow the budget to become law without his direct signature, essentially because the budget includes the expansion of Medicaid.

The Medicaid expansion program will give health insurance to over 600,000 additional North Carolinians, using $1.4 billion in federal funds set aside for this purpose. At this time, the launch of the Medicaid expansion program is planned for December 1, 2023.

Among the $30 billion outlined in the spending plan is hundreds of millions of dollars earmarked for mental health and substance use investment, in what some lawmakers called a “historic” investment in health care.

Concerning mental health issues, the budget includes:

  • $20 million in bonuses and incentive pay for workers in state psychiatric hospitals. This is on top of the promised 4% raise for most state workers in 2023.
  • Increased rates paid to mental health and substance abuse services providers, to the sum of $130 million over the next 2 years.
  • $80 million in support services for families with children with mental health needs.
  • $10 million for 350 new slots in the Innovation Waiver program, which provides community-based care for people with intellectual and developmental disabilities.
  • The construction of a $50 million regional children’s behavioral health hospital, to be built somewhere in the Triangle area. UNC Health and ECU are collaborating on this project, along with multiple other clinics and healthcare facilities.

The Department of Health and Human Services (DHHS) was also given more direct control over state-funded mental health agencies. Policies included in the spending plan will allow people who are dissatisfied with the service they receive from their local agency to switch providers, a concession that has not existed before.

Overall, the 2023-2024 budget marks a considerable increase in mental health infrastructure investment, one that we hope continues into future years.

For more information:

“State budget heavy on health care spending,” North Carolina Health News

“‘Most significant budget’ in NC to become law after Senate vote, Cooper decision,” WRAL News