Over the past several weeks, the Center has encouraged Nonprofit Policy Update readers to complete a brief survey about potential 2023 nonprofit sector legislation. We greatly appreciate those readers who took the time to share their input. Your responses are already helping us develop support among legislators for policy solutions that would help nonprofits. 

Thus far, the policy issues of greatest interest to respondents are:

1. Expanding Medicaid (see the next item for the latest developments on this issue);
2. Exempting nonprofits from paying sales tax on purchases instead of having to seek semiannual refunds of the sales tax they pay;
3. Modernizing the NC Nonprofit Corporation Act;
4. Establishing a state tax credit for charitable donations by non-itemizers;  
5. Reforming the state’s charitable solicitation licensing law to address common challenges that nonprofits face;
6. Clarifying that nonprofits do not need to charge sales tax on fundraising events that include entertainment; and
7. Addressing a wide variety of challenges that nonprofits experience with state grants and contracts.

Survey respondents also identified a variety of other state-level policy solutions or policy challenges that could affect nonprofits this year, including changes to healthcare laws that could provide new options for nonprofits to provide health coverage for their employees, and reinvestment of unspent COVID-19 relief funds into the work of charitable nonprofits. 

Over the past several weeks, the Center has been talking with legislators from both parties and both chambers about introducing legislation to address each of these issues. We’ll keep you posted as bills are filed and there are opportunities for your nonprofit to take action. In the meantime, don’t hesitate to reach out with other suggestions for nonprofit legislative priorities for 2023, either by completing the survey or emailing us.

A bill (H.B. 76) filed in the NC House of Representatives on Wednesday would enact Medicaid expansion in North Carolina, providing health coverage for about 600,000 North Carolinians in the health coverage gap who have incomes that are too high to qualify for Medicaid but too low to receive health care subsidies under the Affordable Care Act marketplace.  

The bill also would enable North Carolina to participate in the Healthcare Access and Stabilization Program (HASP), a federal program that would help provide better financial stability for many nonprofit hospitals. The bill also would develop a program to improve access to workforce development services for North Carolinians enrolled in the state’s Medicaid program.

Notably, the bill makes no changes to the state’s Certificate of Need (CON) laws that limit the ability of health care providers to offer a variety of health-related services. Hospitals and health systems – many of which are 501(c)(3) nonprofits – have been concerned that major changes to CON laws could significantly reduce their revenue, potentially causing some hospitals to close. Last year, leadership in the NC Senate included CON changes in its version of Medicaid expansion legislation. A separate bill (S.48) filed in the Senate last week would repeal North Carolina’s Certificate of Need (CON) law.

As we explained in a Care4Carolina blog post last summer, the Center strongly supports Medicaid expansion because it would support the work of charitable nonprofits by:

1. Complementing the work of many nonprofits that provide services to North Carolinians who don’t currently have adequate health coverage;
2. Providing health coverage for some employees of nonprofits that don’t offer group health plans and whose salaries leave them in the health care coverage gap; and 
3. Providing payment for some types of Medicaid-eligible services that nonprofits currently provide to clients for free.

The House is expected to move quickly to pass Medicaid expansion. The bill has its first committee hearing next Tuesday morning, and it could have two additional committee hearings later that day. The House will likely vote on the bill, which has strong bipartisan support, by the end of next week. 

The Center will keep you posted when there is a need for nonprofits to take action to support Medicaid expansion.

In response to a recent Center survey, many Nonprofit Policy Update readers told us they would like to get to know their state legislators better. One great way to develop (or strengthen) your relationship with your state senator and representatives is to come to Raleigh to meet with them at their office in the NC General Assembly. While the Center is not planning a nonprofit lobby day at the NC General Assembly this year, we are always happy to provide one-on-one coaching, encouragement, and advocacy tips to nonprofit leaders who are coming to Raleigh to meet with state legislators. Let us know if you are interested in coming to Raleigh to meet with your legislators sometime this winter or spring – or if you already have a trip scheduled – and we can work with you both before and during your visit to ensure that you have a successful advocacy experience. Scheduling tip: Legislators are typically in Raleigh from Monday evenings through mid-day on Thursdays during most of the legislative session, so it’s often best to plan for meetings on a Tuesday, Wednesday, or Thursday.

Is there a policy change you wish you could convince your state or local lawmakers to make? If so, we have a new program for you. The Center is launching the NC Nonprofit Public Policy Advocacy Academy to empower participating organizations with the concepts, skills, and coaching they need to develop effective public policy advocacy programs. This three-month program will help a small group of nonprofit leaders:

1. Develop their own organization-specific policy advocacy campaign strategy; 
2. Reach at least one milestone on the path toward achieving their desired policy goal; and
3. Develop the confidence and skills to continue their campaigns. 

The Center is currently accepting applications from individuals at nonprofits based in and serving people in North Carolina. Check out the NC Nonprofit Public Policy Advocacy Academy resource page for more information and to apply. Note: While we are reviewing applications on a rolling basis, we strongly encourage interested organizations to apply quickly to ensure consideration before space fills up.

The Center is currently hosting Nonprofit Policy Conversations around the state to bring together nonprofit leaders and local elected officials (mostly state legislators) to discuss public policy issues that are important to charitable nonprofits and the people and communities they serve. At each Conversation, the Center provides a briefing on 2023 state legislative priorities, nonprofit sector trends, and potential public policy solutions and challenges for nonprofits in 2023 and beyond. The Conversations also will include discussions about state and federal public policy issues of particular interest to local nonprofits.

The Center has already hosted events in Asheville, Charlotte, Winston-Salem, Burlington, and the event in Wilmington this afternoon. We and local partners will host upcoming events in Concord (February 24), Raleigh (March 6), and Fayetteville (March 27) – register now. While we request a registration fee in support of these events, please let us know if this is a barrier as we can assist if asked.

During the COVID-19 pandemic, Congress created a temporary exemption (known as continuous coverage) from annual Medicaid recertification rules that normally require Medicaid recipients to provide verification of their income, family size, and other information to ensure they remain qualified. The Medicaid continuous coverage provision ends on April 1, and the NC Department of Health and Human Services (DHHS) will then begin the process of recertifying Medicaid beneficiaries in North Carolina. As many as 300,000 North Carolinians could lose their Medicaid benefits if they don’t recertify. Many of these North Carolinians may have begun participation in Medicaid during the pandemic and may be unfamiliar with the recertification process.

In the coming months, DHHS will be relying on nonprofits that provide services to North Carolinians who receive Medicaid benefits to help notify their clients about the return of the recertification requirements. DHHS has developed a toolkit with additional information and resources that may be helpful for nonprofits in sharing appropriate messaging with the people they serve. The DHHS toolkit is available in English and Spanish.

The Biden Administration recently announced that the President will end the declared COVID-19 public health and national emergencies on May 11. The announcement of an event months from now is designed to allow the public and people in all levels of governments time to prepare. Among other things, the end of the public health emergency may mean that people have to start paying for COVID-19 testing and treatment, and it could affect employer-sponsored health insurance, COBRA, and flexible spending accounts.

A bill (S.83) filed in the NC Senate on Wednesday would prohibit the use of the TikTok and WeChat apps on state-owned devices and during participation in state-funded programs. The bill was triggered by security concerns surrounding the Chinese-owned apps. If this bill becomes law, nonprofits with state grants and contracts would need to ensure that their staff, volunteers, and clients don’t use these apps while participating in state-funded programs. Last month, Governor Roy Cooper issued an executive order prohibiting the use of TikTok and WeChat on state-owned devices. Unlike the Senate bill, Governor Cooper’s executive order does not limit the use of the apps by nonprofits and their clients during the provision of state-funded programs.

Last month, NC Child published an excellent legislative advocacy guide, which includes useful information on the legislative process, advocacy tips, and resources for tracking what’s happening at the General Assembly. NC Child also published a blog post with six tips for legislative advocates for children in North Carolina. While both resources are targeted for nonprofits advocating for children, most of the information can be helpful for any nonprofit advocating at the General Assembly this year.

A bill (S.89) filed in the NC Senate yesterday would prohibit nonprofits from providing funding to the State Board of Elections or to county election boards. Governor Cooper vetoed an identical bill (S.725) in December 2021. In the past, legislators have expressed concern that some organizations – including nonpartisan 501(c)(3) nonprofits – could provide funding to local elections boards to bolster support in communities with strong partisan leanings.

Last Friday, the NC Supreme Court granted a petition to rehear a case challenging a 2018 law that requires North Carolinians to show photo identification when voting in elections. The Supreme Court struck down the law in a December decision, with all four Democratic justices voting to strike down the law, and all three Republican justices voting to uphold the law. The court now has a 5-2 Republican majority. Many nonprofit organizations have expressed concerns that the voter ID law could make voting more difficult for many people served by nonprofits, particularly seniors, people with disabilities, and low-income citizens. The Supreme Court is scheduled to rehear the case on March 13.

A bill (H.B. 61) filed in the NC House of Representatives on Tuesday would end at-will employment in North Carolina by adding an implied covenant of good faith and fair dealing to every employment contract in North Carolina. Translation from legalese: If this law were to pass, nonprofits and other employers would only be able to fire employees for just cause. Because North Carolina is currently an at-will employment state, nonprofits and other employers can terminate workers with or without cause. The bill has only Democratic sponsors, so the Republican-controlled House is very unlikely to consider it this session.

The Center provides Nonprofit Policy Update as a weekly benefit to its nonprofit members. However, to help all North Carolina nonprofits respond to continuing challenges from the COVID-19 pandemic, we're temporarily providing this newsletter to non-member nonprofits. Become a member to continue receiving these updates along with many other valuable benefits.