March 17, 2021
The legislature’s Fiscal Research Division updated the Joint Committee on HHS Appropriations on the State’s Division of Health Service Regulation today, and gave an overview of the Division’s budget.
The Division of Health Service Regulation (DHSR) at the NC Department of Health and Human Services oversees licensure and regulates the construction and operation of health care facilities. This includes health care facilities planning and issuing Certificates of Need. DHSR also conducts jail inspections, establishes curricula and competency testing of Nurse Aids and Medication Aides, maintains the Nurse Aid Registry, and assists with radiation protection in facilities. The Office of Emergency Medical Services is housed within DHSR, which fosters statewide emergency medical services (EMS) and administers the Hospital Preparedness Program. For fiscal year 2021-22, the Division will have $76.2 million in budget requirements. The Licensure, Certification, and Inspections area receives the most funding within the Division, followed by Preparedness and Planning, Service Support, and Jails and Detention Centers Inspections.
During the COVID-19 pandemic response, routine survey work at DHSR was temporarily suspended, allowing the Division’s staff and resources to focus on COVID-19 response, including infection control, prevention surveys and complaint investigations. Key activities at DHSR included planning for hospital surges and healthcare capacity during the peak of the pandemic, along with moving around resources and services where needed. The Division also created temporary solutions for supplemental bridge staffing for nursing homes and adult care homes that experienced staffing shortages. DHSR’s Office of Emergency and Medical Services helped operate the state warehouse for Personal Protective Equipment (PPE), and administered the distribution of PPE for frontline healthcare workers across the state. DHSR estimates a total of $2.1 million in staff time was directed toward pandemic response over the last year, with over $400,000 in overtime incurred.
Another function of DHSR is overseeing the Healthcare Preparedness Program (HPP). This program is a federal cooperative agreement to promote a consistent national focus to improve patient outcomes during emergencies and enable rapid recovery. There are eight regional coalitions across the state, including the Mountain Area Healthcare Preparedness Coalition, Triad Healthcare Preparedness Coalition, Metrolina Healthcare Preparedness Coalition, Duke Healthcare Preparedness Coalition, Mid Carolina Regional Healthcare Coalition, CapRAC Healthcare Preparedness Coalition, Eastern Healthcare Preparedness Coalition, and Southeastern Healthcare Preparedness Coalition. The HPP existed before the pandemic, and the Division receives funds for this program on an ongoing basis. The State received an additional $3.4 million in federal funding last year for COVID-19 response. The HPP regional coalitions had emergency plans in place for a pandemic, but the only real experience they had in responding to a pandemic was during the Ebola outbreak several years ago. Although DHSR was able to quickly pivot to respond to COVID-19, the Division said no one was prepared for the virus to evolve the way that it has.