Governor Cooper Proposed FY 2023-2025 Budget Includes Significant Behavioral Health Funding

Today, Governor Roy Cooper released his recommended budget for FY 2023-2025, which he has named First in Opportunity.

The budget includes an average 18% teacher raise over the biennium, a $1 billion plan to support mental health, the largest investment in state employee compensation in 50 years and critical funding for child care, job training, and economic development. First in Opportunity is a responsible, balanced budget that does not raise taxes for North Carolinians while maintaining almost $7 billion in reserves in case of a potential downturn.

As indicated in Governor Cooper’s “Roadmap for $1 Billion on Behavioral Health and Resilience Investments” released last week, the Governor’s proposed budget for FY 2023-2025 seeks significant funding and investments in behavioral health.

The budget includes the following:

Prioritizing North Carolinians’ Mental Health:

Invests $1.4 billion to provide critical mental health services across the state. Investments will support the expansion of evidence-based behavioral health programs statewide, address the behavioral health workforce shortage, and ensure that youth and adults can access the care they need to thrive. Funds will also support community-based services and mental health initiatives for K-12 and higher education students.

Department of Health and Human Services

IHOPE (Improving Health Outcomes for People Everywhere) Fund

Leverages $1 billion of the state’s American Rescue Plan Medicaid Expansion bonus dollars to improve behavioral health and draw down federal receipts where possible. Funds will be used to expand access to care, increase the number of providers, and improve critical infrastructure.

Behavioral Health Rates – Invests $75 million per year over the next three years in state funding, $225 million total, to increase rates for inpatient and community behavioral health services. Funding will be used to draw down federal match and ensure that Medicaid reimbursement rates reflect the actual cost of providing care.

Behavioral Health Crisis System – Provides $200 million to expand access to critical supports including mobile crisis and non-emergency department crisis treatment, as well as community-based supportive housing. Funds will also support a statewide involuntary commitment transportation program.

Community and School-Based Behavioral Health Investments – Invests $175 million for startup costs for primary care practices to adopt the evidence-based Collaborative Care model and support the expansion of Certified Community Behavioral Health Clinics. Funding will also expand youth behavioral health supports in schools and extend mental health education to the public. Funds will also support a targeted clinical loan forgiveness program, and specialty treatment training for behavioral health providers.

Psychiatric Facility Capacity Improvement – Invests $100 million to increase step-down funding and placements for state psychiatric hospital patients. Funds will also be used to raise salaries and offer loan forgiveness to the state facility workforce, as well as invest in critical infrastructure.

Department of Public Safety

Local Mental Health Support for First Responders - Includes $700,000 to expand the Responder Assistance Initiative (RAI) to local first responders. RAI will provide a common entry point to connect first responders with peer support, consultation, and comprehensive behavioral health resources.

Juvenile Justice Residential Crisis Unit - Provides $4 million recurring and $100,000 nonrecurring for operating and start-up costs for a crisis unit serving juvenile justice youth with mental and physical health concerns at the C.A. Dillon Detention Center. This unit addresses an increase in behavioral and physical health concerns since the implementation of Raise the Age.

Department of Public Instruction

Funding for Instructional Support Personnel will support school nurse and social worker positions in high-need schools, an internship program for school psychologists, master’s pay for social workers, and increases in the allotment to school districts for school counselors, nurses, social workers, and psychologists.

Instructional Support Personnel – Provides $134.3 million in FY 2023-24 and $267 million in FY 2024-25 for Specialized Instructional Support Personnel (SISP), including school counselors, nurses, social workers, and psychologists, to support student mental and physical health. Funds provided for SISP will support the programs described below, as well as increases in the SISP position allotment that allows school districts to flexibly hire SISP staff to best meet student needs.

School Nurse and Social Worker Positions - Provides $108 million in FY 2023-24 and $116.6 million in FY 2024-25 to hire a school nurse or social worker in every Tier 1 and Tier 2 county school that does not currently employ one. The program will ensure that every school building has a nurse or social worker onsite to meet students’ mental and physical health needs.

School Psychologist Internship Program - Invests $5.4 million in FY 2023-24 and $5.8 million in FY 2024-25 to fund 115 year-long school psychologist internship positions at a starting teacher salary. The program will provide stipends for students in school psychology preparation programs to conduct their required third-year internships in public schools, growing a pipeline of qualified school psychologists in currently underserved school districts.

Social Worker Pay Increases - Provides $7.5 million each year for school districts to pay social workers on the master’s degree salary schedule. Competitive salaries for school social workers will help districts recruit and retain qualified candidates to fill critical vacancies.

Read more about the Governor’s behavioral health funding recommendations here.

Read full budget recommendations here.

Please note that these are RECOMMENDATIONS. The North Carolina House and Senate both draft their own budgets then a conference committee is formed to finalize a budget that may or may not include the Governor’s recommendations. NASW-NC WILL advocate for these additions in the final budget. Once finalized by the House and the Senate and signed by the Governor, the budget should take effect July 1, 2023.