Let’s start with the big headline: North Carolina has a state budget, for the first time since 2018. This in itself is very good news, because the state budget ensures continued operations for so many vital programs that serve kids and families — from public schools to public health, and so much more. While the budget falls far short in many areas, it does represent good faith negotiation and compromise on the part of our leaders, and that too is something for which we can be grateful.  

Read NC Child’s full breakdown of the state budget here.  

This session yielded a mixed bag for NC Child’s multi-issue agenda. Let’s take a look at the accomplishments, and the to-do list — because we still have a lot left to do for our kids and families. 

Parents & caregivers still waiting on health coverage — but there is progress

You are probably just as disappointed as I am that North Carolina legislators decided not to expand Medicaid this legislative session. But do not give up hope. We came closer than ever before this year, and legislative leaders have announced a study committee to take up the issue in 2022.  

Congress is now discussing closing the “coverage gap” through Build Back Better. But the federal solutions aren’t nearly as strong as Medicaid expansion. North Carolinians deserve comprehensive services and coverage, just like people in 38 other states.  

Parents, early childhood teachers, and others who can’t get the health care they need have never stopped speaking up to legislators, the Governor, and the press. They aren’t giving up — and neither will we, until every parent and caregiver has the health coverage they need. 

There is some good news on health coverage though. Legislators took two big steps that will improve coverage for parents and caregivers who currently rely on Medicaid: 

• The budget included language that will extend postpartum Medicaid coverage from six weeks to 1 year. This is a big step in the fight against maternal and infant death, especially the huge disparities faced by Black families.  
• Parents who temporarily lose custody of their children will now be able to keep their Medicaid coverage. This is vital to help parents get the care and treatment they need to reunite their families and provide for their children.  

One thing the General Assembly didn’t do that we asked for: Merge the NC Health Choice program with NC Medicaid. This step would help ensure continuous, quality coverage for enrolled children — particularly those with special health care needs.  

Short-term investments in early childhood education

The pandemic has driven home how absolutely essential child care is to families, and to our nation’s economy. NC Child and partners advocated strongly with Congress for a robust child care relief package in the American Rescue Plan, and our state received over $1 billion in short-term relief for the child care sector. We’re grateful to have been able to help provide input into the design of NC DHHS’ child care stabilization grants. And we’re so glad that legislators allocated these relief funds quickly so that they could get out to providers and families who need them. 

However, we really did not see any sustainable investment in early childhood in terms of state allocations of recurring funding. We and partners asked legislators to address the stagnant rate for child care subsidy reimbursements — vital for the child care providers who serve families eligible for subsidy — but they did not. Other investments in child care and early education were all essentially flat (read more in our budget summary).  

We have a long way to go until every child in our state gets the chance to attend high-quality early education programs. Sustainable investment from our state’s leaders is imperative to meet this goal.  

Environmental health is a bright spot

NC Child was proud to lead efforts to update the Childhood Lead Poisoning Prevention law this year. HB 272 was signed into law in July, and will reduce lead exposure for more than 30,000 young children, particularly in child care settings.  

Early in 2021, we worked with NC DHHS to ensure that they would allow child care providers to use some portion of their federal relief funding to fix water faucets and fountains in their child care centers when they test positive for lead. We are thrilled that the legislature allocated $150 million in American Rescue Plan funds to test and clean up lead in child care centers and public schools across the state.  

Other important successes to note

Legislators passed several other bills advocated by NC Child and our partners this session:  

• SB35 raised the age of marriage in North Carolina from 14 years of age to 16, with a maximum 4-year age difference for adults seeking to marry 16- and 17 year-olds.  
• SB207 raised the age to charge juveniles with a crime from 6 to 10 years old (with some specific carve-outs for 9 and 10 year-olds). The legislation implemented several other Juvenile Justice Advisory Committee policy recommendations as well.  
• HB608, Dignity for Women Who are Incarcerated, provided reasonable accommodations for pregnant inmates. The legislation prohibits shackling of inmates when in labor, and requires that they receive the necessary postpartum care.  
• HB769 provided a “bill of rights” for foster parents.  

Lots of work still to do

Children’s mental health is in a dire state, with the need for suicide prevention and intervention at an all-time high. While the legislature did use some short-term funding for mental health through American Rescue Plan funds, they missed the chance to allocate the state recurring funds needed to truly address the dramatic shortage of school nurses and other trained professionals who support students in crisis.  

Another bright spot: We are incredibly proud of Child Advocacy Network members in Guilford county, who successfully advocated for county commissioners to include $1 million in the county budget to cover 15 additional school nurse positions.   

In 2022, in addition to the priorities already covered above, we will continue pushing for more of the unfinished business on our list: 

• Re-establish the Earned Income Tax Credit in NC, to provide direct cash assistance to families who would most benefit.  
• Ban corporal punishment in NC public schools. Thanks to years of advocacy, no school districts still use this brutal practice — and we still want to see it out of state law.  

Our commitment is unwavering to fight for the day that all children can thrive in this state regardless of race or socioeconomic status. And we are dedicated to making sure the voices of those we serve is heard in future legislative sessions.