reglab/statecodes huggingface dataset:
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 1 - General Provisions. › § 108D-3 - Conflicts; severability.

§ 108D-3. Conflicts; severability.
(a) To the extent that this Chapter conflicts with the Social Security Act or 42 C.F.R. Parts 438 and 457, federal law prevails, except when the applicability of federal law or rules have been waived by agreement between the State and the U.S. Department of Health and Human Services.
(b) To the extent that this Chapter conflicts with any other provision of State law that is contrary to the principles of managed care that will ensure successful containment of costs for health care services, this Chapter prevails and applies.
(c) If any section, term, or provision of this Chapter is adjudged invalid for any reason, these judgments shall not affect, impair, or invalidate any other section, term, or provision of this Chapter, but the remaining sections, terms, and provisions shall be and remain in full force and effect. (2013-397, s. 1; 2019-81, s. 1(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 1A - Disenrollment from Prepaid Health Plans. › § 108D-5.1 - General provisions.

§ 108D-5.1. General provisions.
(a) Nothing in this Article shall be construed to limit or prevent the Department from disenrolling, from a PHP, an enrollee who (i) is no longer eligible to receive services through the Medicaid program or (ii) becomes a member of a population of beneficiaries that is not required to enroll in a PHP under State law.
(b) Nothing in this Article shall be construed to exclude a Medicaid beneficiary who is otherwise required by State law to enroll in a PHP from enrolling in a PHP, or to prevent a beneficiary who is otherwise exempted from enrollment in a PHP from disenrolling from a PHP and receiving services through the fee-for-service program. (2019-81, s. 1(a); 2022-74, s. 9D.15(z); 2023-11, s. 3.2(h).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 1A - Disenrollment from Prepaid Health Plans. › § 108D-5.5 - PHP requests for disenrollment.

§ 108D-5.5. PHP requests for disenrollment.
(a) In General. – A PHP requesting disenrollment of an enrollee from the PHP shall submit a written request for disenrollment to the enrollment broker.
(b) Limitations on PHP Requests for Disenrollment. – A PHP shall not request disenrollment of an enrollee from the PHP for any reason prohibited by 42 C.F.R. § 438.56(b)(2). A PHP may request disenrollment of an enrollee only when both of the following criteria are met:
(1) The enrollee's behavior seriously hinders the PHP's ability to care for the enrollee or other enrollees of the PHP.
(2) The PHP has documented efforts to resolve the issues that form the basis of the request for disenrollment of the enrollee. (2019-81, s. 1(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 1A - Disenrollment from Prepaid Health Plans. › § 108D-5.7 - Notices.

§ 108D-5.7. Notices.
(a) Notices of Resolution. – For each disenrollment request by an enrollee or a PHP, the Department shall issue a written notice of resolution approving or denying the request by mail to the enrollee before the first day of the second month following the month in which the enrollee or PHP requested disenrollment. For expedited enrollee requests for disenrollment made under G.S. 108D-5.3(d), the Department shall issue the written notice of resolution approving or denying the expedited request within three calendar days of receipt of the request. In the same mailing as the notice, the Department shall also provide the enrollee with an appeal request form that includes all of the following:
(1) A statement that, in order to request an appeal, the enrollee must file the form with OAH no later than 30 days after the mailing date of the notice of resolution, and the form may be filed by either (i) sending the form by mail or fax to the address or fax number listed on the form or (ii) calling the telephone number on the form and providing the information requested on the form.
(2) The enrollee's name, address, telephone number, and Medicaid identification number.
(3) A preprinted statement that indicates that the enrollee would like to appeal the specific adverse disenrollment determination identified in the notice of resolution.
(4) A statement informing the enrollee of the right to be represented at the contested case hearing by a lawyer, a relative, a friend, or other spokesperson.
(5) A space for the enrollee's signature and date.
(b) Notices Pertaining to Expedited Enrollee Requests for Disenrollment. – If the Department determines that an enrollee's request for disenrollment does not meet the criteria for an expedited request, the Department shall do the following:
(1) No later than three calendar days after receiving the enrollee's request for disenrollment, make reasonable efforts to give the enrollee and all other affected parties oral notice of the denial and follow up with a written notice of the denial. The denial is not appealable.
(2) Issue the notice of resolution within the time limits established for standard disenrollment requests under subsection (a) of this section. (2019-81, s. 1(a); 2021-62, ss. 2.1(d), 2.2(e); 2022-74, s. 9D.15(z).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 1A - Disenrollment from Prepaid Health Plans. › § 108D-5.9 - Appeals of adverse disenrollment determinations.

§ 108D-5.9. Appeals of adverse disenrollment determinations.
(a) Appeals. – An enrollee, or the enrollee's authorized representative, who is dissatisfied with an adverse disenrollment determination may request a hearing to appeal the determination by filing the appeal request form provided under G.S. 108D-5.7(a) with the Office of Administrative Hearings within 30 calendar days of the date on the notice of resolution. The form may be filed by either (i) sending the form by mail or fax to the address or fax number listed on the form or (ii) calling the telephone number on the form and providing the information requested on the form. A request for a hearing to appeal an adverse disenrollment determination of the Department under this section is a contested case subject to the provisions of Article 3 of Chapter 150B of the General Statutes. The appeal shall be conducted in accordance with the procedures in Part 6A of Article 2 of Chapter 108A of the General Statutes.
(b) Parties. – The Department shall be the respondent for purposes of appeals under this section. (2019-81, s. 1(a); 2021-62, s. 2.1(e).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 2 - Enrollee Grievances and Appeals. › § 108D-11 - Managed care entity grievance and appeal procedures, generally.

§ 108D-11. Managed care entity grievance and appeal procedures, generally.
(a) Each managed care entity shall establish and maintain internal grievance and appeal procedures that (i) comply with the Social Security Act and 42 C.F.R. Part 438, Subpart F, and (ii) afford enrollees and their authorized representatives constitutional rights to due process and a fair hearing.
(b) An enrollee, or the enrollee's authorized representative, may file grievances and managed care entity level appeals orally or in writing.
(c) A managed care entity shall not attempt to influence, limit, or interfere with an enrollee's right or decision to file a grievance, request for a managed care entity level appeal, or a contested case hearing. However, nothing in this Chapter shall be construed to prevent a managed care entity from doing any of the following:
(1) Offering an enrollee alternative services.
(2) Engaging in clinical or educational discussions with enrollees or providers.
(3) Engaging in informal attempts to resolve enrollee concerns prior to the issuance of a notice of grievance disposition or notice of resolution.
(d) A managed care entity shall not take punitive action against a provider for any of the following:
(1) Filing a grievance on behalf of an enrollee or supporting an enrollee's grievance.
(2) Requesting a managed care entity level appeal on behalf of an enrollee or supporting an enrollee's request for a managed care entity level appeal.
(3) Requesting an expedited managed care entity level appeal on behalf of an enrollee or supporting an enrollee's request for a managed care entity level expedited appeal.
(4) Requesting a contested case hearing on behalf of an enrollee or supporting an enrollee's request for a contested case hearing.
(e) The appeal procedures set forth in this Article shall not apply to instances in which the sole basis for the managed care entity's decision is a provision in the State Plan or in federal or State law requiring an automatic change adversely affecting some or all beneficiaries. (2013-397, s. 1; 2019-81, s. 1(a); 2021-62, s. 2.1(f).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 2 - Enrollee Grievances and Appeals. › § 108D-12 - Managed care entity grievances.

§ 108D-12. Managed care entity grievances.
(a) Filing of Grievance. – An enrollee, or the enrollee's authorized representative, has the right to file a grievance with a managed care entity at any time to express dissatisfaction about any matter other than an adverse benefit determination. Upon receipt of a grievance, a managed care entity shall cause a written acknowledgment of receipt of the grievance to be sent by mail.
(b) Notice of Grievance Disposition. – The managed care entity shall resolve the grievance and cause a notice of grievance resolution to be sent by mail to the enrollee and all other affected parties as expeditiously as the enrollee's health condition requires, but no later than 30 days after receipt of the grievance, provided that the managed care entity may extend such time frame to the extent permitted under 42 C.F.R. § 438.408(c).
(c) Right to Appeal. – There is no right to appeal the resolution of a grievance to OAH or any other forum. (2013-397, s. 1; 2019-81, s. 1(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 2 - Enrollee Grievances and Appeals. › § 108D-13 - Standard managed care entity level appeals.

§ 108D-13. Standard managed care entity level appeals.
(a) Notice of Adverse Benefit Determination. – A managed care entity shall provide an enrollee with a written notice of an adverse benefit determination by mail as required under 42 C.F.R. § 438.404. The notice will employ a standardized form included as a provision in the contract between the managed care entity and the Department.
(b) Request for Appeal. – An enrollee, or the enrollee's authorized representative, has the right to file a request for a managed care entity level appeal of a notice of adverse benefit determination no later than 60 days after the mailing date of the notice of adverse benefit determination. Upon receipt of a request for a managed care entity level appeal, a managed care entity shall acknowledge receipt of the request for appeal in writing by mail.
(c) Continuation of Benefits. – A managed care entity shall continue the benefits of a Medicaid enrollee during the pendency of a managed care entity level appeal to the same extent required under 42 C.F.R. § 438.420.
(d) Notice of Resolution. – The managed care entity shall resolve the appeal as expeditiously as the enrollee's health condition requires, but no later than 30 days after receiving the request for appeal, provided that the managed care entity may extend such time frame as permitted under 42 C.F.R. § 438.408. The managed care entity shall provide the enrollee and all other affected parties with a written notice of resolution by mail within this 30-day period.
(e) Right to Request Contested Case Hearing. – An enrollee, or the enrollee's authorized representative, may file a request for a contested case hearing under G.S. 108D-15 as long as (i) the enrollee, or the enrollee's authorized representative, has exhausted the appeal procedures described in this section or G.S. 108D-14 or (ii) the enrollee has been deemed, under 42 C.F.R. § 438.408(c)(3), to have exhausted the managed care entity level appeals process.
(f) Request Form for Contested Case Hearing. – In the same mailing as the notice of resolution, the managed care entity shall also provide the enrollee with an appeal request form for a contested case hearing that meets the requirements of G.S. 108D-15(f). (2013-397, s. 1; 2019-81, s. 1(a); 2022-74, s. 9D.15(t).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 2 - Enrollee Grievances and Appeals. › § 108D-15.1 - Expedited contested case hearings on disputed adverse benefit determinations.

§ 108D-15.1. Expedited contested case hearings on disputed adverse benefit determinations.
In accordance with 42 C.F.R. § 431.224, an enrollee, or an enrollee's authorized representative, may request that an appeal under G.S. 108D-15(d) be expedited if the time otherwise permitted for a hearing could jeopardize the enrollee's life, health, or ability to attain, maintain, or regain maximum function. With regard to a request for an expedited appeal, all of the following apply:
(1) The enrollee shall submit any additional documentation from a licensed health care professional with relevant excerpts from the enrollee's medical record that was not already provided with regard to the adverse benefit determination to demonstrate the need for an expedited appeal.
(2) The Department shall determine if the enrollee's request meets the criteria for an expedited appeal.
(3) If the Department determines that the enrollee's request does not meet the criteria for an expedited appeal, then (i) the Department shall make reasonable efforts to give the enrollee, or the enrollee's authorized representative, oral notice of the denial as expeditiously as possible and shall follow up with a written notice of denial and (ii) the enrollee's appeal shall not be subject to the expedited time frame in subdivision (4) of this subsection. The denial is not appealable.
(4) If the Department determines that the enrollee's request meets the criteria for an expedited appeal, then (i) the mediation procedure under G.S. 108D-15(i) shall not apply to the appeal request and (ii) the decision required under G.S. 108D-16 shall be made as expeditiously as possible. (2021-62, s. 2.2(i).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 2 - Enrollee Grievances and Appeals. › § 108D-16 - Notice of final decision and right to seek judicial review.

§ 108D-16. Notice of final decision and right to seek judicial review.
The administrative law judge assigned to conduct a contested case hearing under G.S. 108D-15 shall hear and decide the case without unnecessary delay. The judge shall prepare a written decision that includes findings of fact and conclusions of law and send it to the parties in accordance with G.S. 150B-37. The written decision shall notify the parties of the final decision and of the right of the enrollee and the managed care entity to seek judicial review of the decision under Article 4 of Chapter 150B of the General Statutes. (2013-397, s. 1; 2019-81, s. 1(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 3 - Managed Care Entity Provider Networks. › § 108D-21 - LME/MCO provider networks.

§ 108D-21. LME/MCO provider networks.
Each LME/MCO operating the combined 1915(b) and (c) waivers shall develop and maintain a closed network of providers to furnish mental health, intellectual or developmental disabilities, and substance abuse services to its enrollees. A closed network is the network of providers that have contracted with the local management entity/managed care organization operating the combined 1915(b) and (c) waivers. (2019-81, s. 1(a); 2022-74, s. 9D.13(d).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 3 - Managed Care Entity Provider Networks. › § 108D-22 - PHP provider networks.

§ 108D-22. PHP provider networks.
(a) Except as provided in G.S. 108D-23, each PHP shall develop and maintain a provider network that meets access to care requirements for its enrollees. A PHP may not exclude providers from their networks except for failure to meet objective quality standards or refusal to accept network rates. Notwithstanding the previous sentence, a PHP must include all providers in its geographical coverage area that are designated essential providers by the Department in accordance with subdivision (b) of this section, unless the Department approves an alternative arrangement for securing the types of services offered by the essential providers.
(b) The Department shall designate Medicaid providers as essential providers if, within a region defined by a reasonable access standard, the provider either (i) offers services that are not available from any other provider in the region or (ii) provides a substantial share of the total units of a particular service utilized by Medicaid beneficiaries within the region during the last three years and the combined capacity of other service providers in the region is insufficient to meet the total needs of the Medicaid enrollees. The Department shall not classify physicians and other practitioners as essential providers. At a minimum, providers in the following categories shall be designated essential providers:
(1) Federally qualified health centers.
(2) Rural health centers.
(3) Free clinics.
(4) Local health departments.
(5) State Veterans Homes. (2019-81, s. 1(a); 2022-74, s. 9D.15(z).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 3 - Managed Care Entity Provider Networks. › § 108D-23 - BH IDD tailored plan networks.

§ 108D-23. BH IDD tailored plan networks.
Each entity operating a BH IDD tailored plan shall develop and maintain a closed network of providers only for the provision of behavioral health, intellectual and developmental disability, and traumatic brain injury services. A closed network is the network of providers that have contracted with the entity operating a BH IDD tailored plan to furnish these services to enrollees. A closed network must include all essential providers, as designated in accordance with G.S. 108D-22(b), that (i) are located within the region for which the entity holds a BH IDD tailored plan contract and (ii) provide any covered behavioral health, intellectual and developmental disability, or traumatic brain injury service in that region. (2019-81, s. 1(a); 2021-62, s. 4.7(b); 2022-74, s. 9D.13(e).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-30 - Intent and Goals.

§ 108D-30. Intent and Goals.
It is the intent of the General Assembly to transform the State's current Medicaid program in order to provide budget predictability for the taxpayers of this State while ensuring quality care to those in need. The new Medicaid program shall be designed to achieve the following goals:
(1) Ensure budget predictability through shared risk and accountability.
(2) Ensure balanced quality, patient satisfaction, and financial measures.
(3) Ensure efficient and cost-effective administrative systems and structures.
(4) Ensure a sustainable delivery system. (2015-245, s. 1; 2019-81, s. 14(a); 2022-74, s. 9D.15(z); 2023-11, s. 3.2(e).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-35 - Services covered by PHPs.

§ 108D-35. Services covered by PHPs.
(a) Capitated PHP contracts shall cover all Medicaid services, including physical health services, prescription drugs, long-term services and supports, and behavioral health services, except as otherwise provided in this section.
(b) The capitated contracts required by this section shall not cover any of the following:
(1) Medicaid services covered by the local management entities/managed care organizations (LME/MCOs) under the combined 1915(b) and (c) waivers shall not be covered under a standard benefit plan, except that all capitated PHP contracts shall cover the following services:
a. Inpatient behavioral health services.
b. Outpatient behavioral health emergency room services.
c. Outpatient behavioral health services provided by direct-enrolled providers.
d. Mobile crisis management services.
e. Facility-based crisis services for children and adolescents.
f. Professional treatment services in a facility-based crisis program.
g. Outpatient opioid treatment services.
h. Ambulatory detoxification services.
i. Nonhospital medical detoxification services.
j. Partial hospitalization.
k. Medically supervised or alcohol and drug abuse treatment center detoxification crisis stabilization.
l. Research-based intensive behavioral health treatment.
m. Diagnostic assessment services.
n. Early and Periodic Screening, Diagnosis, and Treatment services.
o. Peer support services.
p. Behavioral health urgent care services.
In accordance with this subdivision, 1915(b)(3) services shall not be covered under a standard benefit plan.
(2) Dental services.
(3) Services provided through the Program of All-Inclusive Care for the Elderly (PACE).
(4) Services documented in an individualized education program, as defined in G.S. 115C-106.3, or other document described in the Medicaid State Plan, and provided or billed by a local education agency, as defined in G.S. 115C-106.3.
(5) Services documented in an individualized family service plan under the Individuals with Disabilities Education Act, 20 U.S.C. § 1436, that are provided and billed by a Children's Developmental Services Agency or by a provider contracted with a Children's Developmental Services Agency to provide those services.
(6) Services for Medicaid program applicants during the period of time prior to eligibility determination.
(7) The fabrication of eyeglasses, including complete eyeglasses, eyeglass lenses, and ophthalmic frames. (2015-245, s. 4; 2016-121, s. 2(b); 2017-57, s. 11H.17(a); 2017-186, s. 4; 2018-48, s. 1; 2019-81, ss. 12, 14(a); 2021-62, ss. 3.2, 4.9(a); 2021-180, s. 9F.11(c); 2022-74, s. 9D.15(w).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-45 - Number and nature of capitated PHP contracts.

§ 108D-45. Number and nature of capitated PHP contracts.
The number and nature of the contracts required under G.S. 108D-65(3) shall be as follows:
(1) Four contracts between the Division of Health Benefits and PHPs to provide coverage to Medicaid recipients statewide.
(2) Up to 12 contracts between the Division of Health Benefits and PLEs for coverage of regions specified by the Division of Health Benefits pursuant to G.S. 108D-65(2). Regional contracts shall be in addition to the four statewide contracts required under subdivision (1) of this section. Each regional contract shall provide coverage throughout the entire region for the Medicaid services required by G.S. 108D-35. A PLE may bid for more than one regional contract, provided that the regions are contiguous.
(3) The limitations on the number of contracts established in this section shall not apply to BH IDD tailored plans described in G.S. 108D-60.
(4) Initial capitated PHP contracts may be awarded on staggered terms of three to five years in duration to ensure against gaps in coverage that may result from termination of a contract by the PHP or the State. (2015-245, s. 4; 2016-121, s. 2(b); 2018-48, s. 1; 2019-81, s. 14(a); 2022-74, s. 9D.15(z).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-50 - Defined measures and goals.

§ 108D-50. Defined measures and goals.
The new delivery system and capitated PHP contracts shall be built on defined measures and goals for risk-adjusted health outcomes, quality of care, patient satisfaction, access, and cost. Each component shall be subject to specific accountability measures, including penalties. The Division of Health Benefits may use organizations such as National Committee for Quality Assurance (NCQA), Physician Consortium for Performance Improvement (PCPI), or any others necessary to develop effective measures for outcomes and quality. (2015-245, s. 4; 2019-81, s. 14(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-55 - Administrative functions.

§ 108D-55. Administrative functions.
PHPs shall be responsible for all administrative functions for recipients enrolled in their plan, including, but not limited to, claims processing, care and case management, grievances and appeals, and other necessary administrative services. (2015-245, s. 4; 2019-81, s. 14(a).)
2023 North Carolina General Statutes › Chapter 108D - Medicaid and NC Health Choice Managed Care Programs › Article 4 - Prepaid Health Plans. › § 108D-70 - Advanced Medical Homes.

§ 108D-70. Advanced Medical Homes.
PHPs shall be required to implement an Advanced Medical Home care management program but shall not be required to contract with any particular entity as an Advanced Medical Home. A PHP may contract with any entity to serve as an Advanced Medical Home or may create its own Advanced Medical Home care management program. (2018-49, s. 7; 2019-81, s. 14(a).)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 1A - Exhibition of Children. › § 110-20.1 - Exhibition of certain children prohibited.

§ 110-20.1. Exhibition of certain children prohibited.
(a) Except to the extent otherwise provided in subsection (d) of this section, it is unlawful to exhibit publicly for any purpose, or to exhibit privately for the purpose of entertainment, or solely or primarily for the satisfaction of the curiosity of any observer, any child under the age of 18 years who has a mental illness or intellectual disability or who presents the appearance of having any deformity or unnatural physical formation or development, whether or not the exhibiting of the child is in return for a monetary or other consideration.
(b) It is unlawful to employ, use, have custody of, or in any way be associated with any child described in subsection (a) of this section for the purpose of an exhibition prohibited by subsection (a) of this section, or for one who has the care, custody, or control of the child as a parent, relative, guardian, employer, or otherwise, to neglect or refuse to restrain the child from participating in the exhibition.
(c) It is unlawful to procure or arrange for, or participate in procuring or arranging for, anything made unlawful by subsections (a) and (b) of this section.
(d) This section does not apply to the transmission of an image by television by a duly licensed television station, or to any exhibition by a federal, State, county, or municipal government, or political subdivision or agency thereof, or to any exhibition by any corporation, unincorporated association, or other organization organized and operated exclusively for religious, charitable, or educational purposes, no part of the net earnings of which inures to the benefit of any private shareholder or individual.
(e) Any violation of this Article is a Class 3 misdemeanor. Each day during which any violation of this Article continues after notice to the violator, from any county social services director, to cease and desist from any violation of this section is a separate and distinct offense. Any act or omission prohibited by this Article is, with respect to each child, a separate and distinct offense. (1969, c. 457, s. 1; c. 982; 1993, c. 539, s. 821; 1994, Ex. Sess., c. 24, s. 14(c); 2018-47, s. 8.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 3 - Control over Child-Caring Facilities. › § 110-45 - Institution has authority of parent or guardian.

§ 110-45. Institution has authority of parent or guardian.
Every indigent child which may be placed in any orphanage, children's home, or child-placing institution in this State, which shall be an institution existing under and by virtue of the laws of this State, shall be under the control of the authorities of such institution so long as, under the rules and regulations of such institution, the child is entitled to remain in the same. The authority of the institution shall be the same as that of a parent or guardian before the child was placed in the institution; but such authority shall extend only to the person of the child. (1917, c. 133, s. 1; C.S., s. 5063.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 3 - Control over Child-Caring Facilities. › § 110-46 - Regulations of institution not abrogated.

§ 110-46. Regulations of institution not abrogated.
Nothing in this Article shall be construed in any way to abrogate any of the rules and regulations of such institutions insofar as the rules and regulations have for their purpose the welfare and protection of the institutions. (1917, c. 133, s. 2; C.S., s. 5064.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 3 - Control over Child-Caring Facilities. › § 110-47 - Enticing a child from institution.

§ 110-47. Enticing a child from institution.
It is unlawful for any person to entice or attempt to entice, persuade, harbor, or conceal, or in any manner induce any indigent child to leave any of the institutions hereinbefore mentioned without the knowledge or consent of the authorities of such institutions. But this Article shall not interfere with a mother's right to her child in case she becomes able to sustain her child; and the county commissioners in the county in which she resides shall in case of doubt have authority to recommend to the institution concerning the child. (1917, c. 133, s. 3; C.S., s. 5065.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 3 - Control over Child-Caring Facilities. › § 110-48 - Violation a misdemeanor.

§ 110-48. Violation a misdemeanor.
Any person violating any of the provisions of G.S. 110-45, 110-46 and 110-47 shall be guilty of a Class 1 misdemeanor. (1917, c. 133, s. 4; C.S., s. 5066; 1993, c. 539, s. 822; 1994, Ex. Sess., c. 24, s. 14(c).)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-85 - Legislative intent and purpose.

§ 110-85. Legislative intent and purpose.
Recognizing the importance of the early years of life to a child's development, the General Assembly hereby declares its intent with respect to the early care and education of children:
(1) The State should protect children in child care facilities by ensuring that these facilities provide a physically safe and healthy environment where the developmental needs of these children are met and where these children are cared for by qualified persons of good moral character.
(2) Repealed by Session Laws 1997-506, s. 2, effective September 16, 1997.
(3) Achieving this level of protection and early education requires the following elements: mandatory licensing of child care facilities; promotion of higher quality child care through the development of enhanced standards which operators may comply with on a voluntary basis; and a program of education to help operators improve their programs and to deepen public understanding of child care needs and issues. (1971, c. 803, s. 1; 1987, c. 788, s. 1; 1997-506, ss. 1, 2.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-88.1 - Commission may not interfere with religious training offered in religious-sponsored child care facilities.

§ 110-88.1. Commission may not interfere with religious training offered in religious-sponsored child care facilities.
Nothing in this Article shall be interpreted to allow the State to determine the training or curriculum offered in any religious-sponsored child care facility as defined in G.S. 110-106(a). (1999-130, s. 6.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-92 - Duties of State and local agencies.

§ 110-92. Duties of State and local agencies.
When requested by an operator of a child care center or by the Secretary, it shall be the duty of local and district health departments to visit and inspect a child care center to determine whether the center complies with the health and sanitation standards required by this Article and with the minimum sanitation standards adopted as rules by the Commission for Public Health as authorized by G.S. 110-91(1), and to submit written reports on these visits or inspections to the Department on forms approved and provided by the Department of Environmental Quality.
When requested by an operator of a child care center or by the Secretary, it shall be the duty of the building inspector, fire prevention inspector, or fireman employed by local government, or any fireman having jurisdiction, or other officials or personnel of local government to visit and inspect a child care center for the purposes specified in this Article, including plans for evacuation of the premises and protection of children in case of fire, and to report on these visits or inspections in writing to the Secretary so that these reports may serve as the basis for action or decisions by the Secretary or Department as authorized by this Article. (1971, c. 803, s. 1; 1973, c. 476, ss. 128, 138; 1975, c. 879, s. 15; 1985, c. 757, s. 155(j); 1987, c. 543, s. 4; 1989, c. 727, s. 31; 1989 (Reg. Sess., 1990), c. 1024, s. 21; 1991, c. 273, s. 6; 1997-443, s. 11A.45; 1997-506, s. 9; 2007-182, s. 2; 2015-241, s. 14.30(u).)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-93 - Application for a license.

§ 110-93. Application for a license.
(a) Each person who seeks to operate a child care facility shall apply to the Department for a license. The application shall be in the form required by the Department. Each applicant seeking a license shall be responsible for supplying with the application the necessary supporting data and reports to show conformity with rules adopted by the Commission for Public Health pursuant to G.S. 110-91(1) and with the standards established or authorized by this Article, including any required reports from the local and district health departments, local building inspectors, local firemen, voluntary firemen, and others, on forms which shall be provided by the Department.
(b) If an applicant conforms to the rules adopted by the Commission for Public Health pursuant to G.S. 110-91(1) and with the standards established or authorized by this Article as shown in the application and other supporting data, the Secretary shall issue a license that shall remain valid until the Secretary notifies the licensee otherwise pursuant to G.S. 150B-3 or other provisions of this Article, subject to suspension or revocation for cause as provided in this Article. If the applicant fails to conform to the required rules and standards, the Secretary may issue a provisional license under the policies of the Commission. The Department shall notify the applicant in writing by registered or certified mail the reasons the Department issued a provisional license.
(c) Repealed by Session Laws 1997-506, s. 10, effective September 16, 1997.
(d) Repealed by Session Laws 1977, c. 929, s. 1. (1971, c. 803, s. 1; 1975, c. 879, s. 15; 1977, c. 4, s. 4; c. 929, s. 1; 1985, c. 757, s. 155(k), (l); 1987, c. 543, ss. 5, 6; c. 788, s. 7; 1991, c. 273, s. 7; 1997-443, s. 11A.118(a); 1997-506, s. 10; 1999-130, s. 3; 2007-182, s. 2.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-94 - Administrative Procedure Act.

§ 110-94. Administrative Procedure Act.
The provisions of Chapter 150B of the General Statutes shall be applicable to the Commission, to the rules the Commission adopts, and to child care contested cases. However, a child care operator shall have 30 days to file a petition for a contested case pursuant to G.S. 150B-23. The contested case hearing shall be scheduled to be held within 120 days of the date the petition for a hearing is received, pursuant to G.S. 150B-23(a), in any contested case resulting from administrative action taken by the Secretary to revoke a license or Letter of Compliance or from administrative action taken in a situation in which child abuse or neglect in a child care facility has been substantiated. A request for continuance of a hearing shall be granted upon a showing of good cause by either party. (1971, c. 803, s. 1; 1975, c. 879, s. 15; 1977, c. 929, s. 2; 1985, c. 757, s. 155(m); 1987, c. 788, s. 8; 1989, c. 429; 1991, c. 273, s. 8; 1997-506, s. 11.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-98 - Mandatory compliance.

§ 110-98. Mandatory compliance.
It shall be unlawful for any person to:
(1) Offer or provide child care without complying with the provisions of this Article; or
(2) Advertise without disclosing the child care facility's identifying number that is on the license or the letter of compliance. (1971, c. 803, s. 1; 1985, c. 757, s. 156(ee); 1987, c. 788, s. 9; 1997-506, s. 12.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-98.1 - Prima facie evidence of existence of child care.

§ 110-98.1. Prima facie evidence of existence of child care.
A child care arrangement providing child care for more than two children for more than four hours per day on two or more consecutive days shall be prima facie evidence of the existence of a child care facility. (1977, c. 4, s. 6; 1987, c. 788, s. 10; 1997-506, s. 13.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-98.5 - Care for school-age children during state of emergency.

§ 110-98.5. Care for school-age children during state of emergency.
Notwithstanding any provision of law or rule to the contrary, when remote or virtual learning is required due to a declared state of emergency issued under G.S. 166A-19.20, the following shall apply:
(1) A community-based organization is authorized to provide care for school-age children at a remote learning facility, provided the community-based organization is registered with the Department through a process consistent with the registration process the Department uses for licensed child care facilities. For purposes of this subdivision, the following definitions shall apply:
a. Community-based organizations. – Organizations of demonstrated effectiveness that are representative of a community or significant segments of a community that provide educational or related services to individuals in the community, such as parks and recreation programs, YMCAs, YWCAs, and Boys and Girls Clubs.
b. Remote learning facility. – A building or space used to house school-age children during the school year for the purpose of facilitating online or remote learning.
(2) When providing care to school-age children pursuant to this section, the limitations regarding the maximum amount of screen time for children three years of age and older shall not apply.
(3) Care provided to school-age children pursuant to this section is not considered child care as defined under G.S. 110-86. (2020-97, s. 3.7A(a).)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-99 - Possession and display of license.

§ 110-99. Possession and display of license.
(a) It shall be unlawful for a child care facility to operate without a current license authorized for issuance under G.S. 110-88.
(a1) Each child care facility shall display its current license in a prominent place at all times so that the public may be on notice that the facility is licensed and may observe any rating which may appear on the license. Any license issued to a child care facility under this Article shall remain the property of the State and may be removed by persons employed or designated by the Secretary in the event that the license is revoked or suspended, or in the event that the rating is changed.
(b) A person who provides only drop-in or short-term child care as described in G.S. 110-86(2)d. and G.S. 110-86(2)d1., excluding drop-in or short-term child care provided in churches, shall register with the Department that the person is providing only drop-in or short-term child care. Any person providing only drop-in or short-term child care as described in G.S. 110-86(2)d. and G.S. 110-86(2)d1., excluding drop-in or short-term child care provided in churches, shall display in a prominent place at all times a notice that the child care arrangement is not required to be licensed and regulated by the Department and is not licensed and regulated by the Department. (1971, c. 803, s. 1; 1997-506, s. 14; 1999-130, s. 4; 2003-192, s. 2; 2005-416, s. 2.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-101.1 - Corporal punishment banned in certain "nonlicensed" homes.

§ 110-101.1. Corporal punishment banned in certain "nonlicensed" homes.
The use of corporal punishment as a form of discipline is prohibited in those child care homes that are not required to be licensed under this Article but that receive State or federal subsidies for child care unless this care is provided to children by their parents, stepparents, grandparents, aunts, uncles, step-grandparents, or great-grandparents. Care provided children by their parents, stepparents, grandparents, aunts, uncles, step-grandparents, or great-grandparents is not subject to this section. Religious sponsored nonlicensed homes are also exempt from this section. (1993, c. 268, s. 1; 1997-506, s. 17.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-102 - Information for parents.

§ 110-102. Information for parents.
The Secretary shall provide to each operator of a child care facility a summary of this Article for the parents, guardian, or full-time custodian of each child receiving child care in the facility to be distributed by the operator. Operators of child care facilities shall provide a copy of the summary to each child's parent, guardian, or full-time custodian before the child is enrolled in the child care facility. The child's parent, guardian, or full-time custodian shall sign a statement attesting that he or she received a copy of the summary before the child's enrollment. The summary shall include the name and address of the Secretary and the address of the Commission. The summary shall explain how parents may obtain information on individual child care facilities maintained in public files by the Division of Child Development. The summary shall also include a statement regarding the mandatory duty prescribed in G.S. 7B-301 of any person suspecting child abuse or neglect has taken place in child care, or elsewhere, to report to the county Department of Social Services. The statement shall include the definitions of child abuse and neglect described in the Juvenile Code in G.S. 7B-101 and of child abuse described in the Criminal Code in G.S. 14-318.2 and G.S. 14-318.4. The statement shall stress that this reporting law does not require that the person reporting reveal the person's identity.
The summary of this Article shall be posted with the facility's license in accordance with G.S. 110-99. Religious-sponsored programs operating pursuant to G.S. 110-106 shall post the summary in a prominent place at all times so that it is easily reviewed by parents. (1971, c. 803, s. 1; 1975, c. 879, s. 15; 1977, c. 1011, s. 3; 1985, c. 757, ss. 155(o), 156(v); 1997-443, s. 11A.118(a); 1997-506, s. 18; 1998-202, s. 13(w); 2003-196, s. 1.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-102.1 - Reporting of missing or deceased children.

§ 110-102.1. Reporting of missing or deceased children.
(a) Notwithstanding G.S. 14-318.5, operators and staff, as defined in G.S. 110-86(7), and G.S. 110-91(8), or any adult present with the approval of the care provider in a child care facility as defined in G.S. 110-86(3) and G.S. 110-106, upon learning that a child which has been placed in their care or presence is missing, shall immediately report the missing child to law enforcement. For purposes of this Article, a child is anyone under the age of 16.
(b) If a child dies while in child care, or of injuries sustained in child care, a report of the death must be made by the child care operator to the Secretary within 24 hours of the child's death or on the next working day. (1985, c. 392; 1987, c. 788, s. 12; 1997-506, s. 19; 2013-52, s. 4.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-102.1A - Unauthorized administration of medication.

§ 110-102.1A. Unauthorized administration of medication.
(a) It is unlawful for an employee, owner, household member, volunteer, or operator of a licensed or unlicensed child care facility as defined in G.S. 110-86, including child care facilities operated by public schools and nonpublic schools as defined in G.S. 110-86(2)(f), to willfully administer, without written authorization, prescription or over-the-counter medication to a child attending the child care facility. For the purposes of this section, written authorization shall include the child's name, date or dates for which the authorization is applicable, dosage instructions, and signature of the child's parent or guardian. For the purposes of this section, a child care facility operated by a public school does not include kindergarten through twelfth grade classes.
(b) In the event of an emergency medical condition and the child's parent or guardian is unavailable, it shall not be unlawful to administer medication to a child attending the child care facility without written authorization as required under subsection (a) of this section if the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. For purposes of this subsection, the following definitions apply:
(1) A bona fide medical care provider means an individual who is licensed, certified, or otherwise authorized to prescribe the medication.
(2) An emergency medical condition means circumstances where a prudent layperson acting reasonably would have believed that an emergency medical condition existed.
(c) A violation of this section that results in serious injury to the child shall be punished as a Class F felony.
(d) Any other violation of this section where medication is administered willfully shall be punished as a Class A1 misdemeanor. (2003-406, s. 2.)
2023 North Carolina General Statutes › Chapter 110 - Child Welfare › Article 7 - Child Care Facilities. › § 110-102.2 - Administrative penalties.

§ 110-102.2. Administrative penalties.
For failure to comply with this Article, the Secretary may:
(1) Issue a written warning and a request for compliance;
(2) Issue an official written reprimand;
(3) Place a licensee upon probation until his compliance with this Article has been verified by the Commission or its agent;
(4) Order suspension of a license for a specified length of time not to exceed one year;
(5) Permanently revoke a license issued under this Article.
The issuance of an administrative penalty may be appealed as provided in G.S. 110-90(5) and G.S. 110-90(9). (1985, c. 757, s. 156(ff); 1987, c. 788, s. 13; c. 827, s. 235.)