North Carolina HB 1044: Justice in Mental Health Act.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 1044

Short Title: Justice in Mental Health Act. (Public)
Sponsors: Representatives Price, Belk, Prather, and Morey (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Rules, Calendar, and Operations of the House
April 27, 2026
*H1044-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO BUILD ADDITIONAL CAPACITY IN STATE PSYCHIATRIC HOSPITALS, 2
TO ESTABLISH REHABILITATIVE DISPOSITION AND COMMUNITY SAFETY 3
PROGRAMS, TO INCREASE THE LIMIT ON SAFEKEEPER BEDS AND 4
APPROPRIATE FUNDS TO USE FOR COSTS RELATED TO THE ADDITIONAL 5
SAFEKEEPER BEDS, AND TO APPROPRIATE FUNDS FOR GUIDANCE FOR 6
JUDGES ON IDENTIFYING BEHAVIORAL HEALTH RISKS AMONG 7
COURT-INVOLVED INDIVIDUALS. 8
Whereas, the General Assembly finds that timely access to appropriate behavioral 9
health evaluation, stabilization, and treatment is essential to protecting public safety and 10
promoting the orderly administration of justice; and 11
Whereas, the General Assembly finds that insufficient capacity in State psychiatric 12
hospitals, workforce shortages, and gaps in community-based treatment services contribute to 13
prolonged detention, delayed case resolution, and avoidable strain on courts, jails, and law 14
enforcement; and 15
Whereas, the General Assembly finds that stronger coordination between courts and 16
behavioral health providers, together with rehabilitation pathways and treatment-oriented 17
interventions, can reduce unnecessary confinement, and improve outcomes for court-involved 18
individuals while preserving public safety and civil liberties; and 19
Whereas, the General Assembly further finds that prolonged waits for behavioral 20
health evaluation and treatment can cause individuals to remain in local confinement for extended 21
periods, exceeding 300 days in some cases, and that even a modest reduction in such wait times 22
can conservatively save counties tens of millions of dollars statewide over time in detention, 23
staffing, transportation, and related costs, thereby reducing upward pressure on property tax 24
payers who fund local public safety operations; Now, therefore, 25
The General Assembly of North Carolina enacts: 26
27
CLOSING GAPS IN THE MENTAL HEALTH-JUDICIAL NEXUS 28
SECTION 1.(a) By no later than January 1, 2027, the Administrative Office of the 29
Courts (AOC), in coordination with the Department of Health and Human Servives, Division of 30
Mental Health, Developmental Disabilities, and Substance Use Services (DMH/DD/SUS), shall 31
develop and disseminate enhanced guidance materials, and develop optional continuing 32
educational modules, for judges, magistrates, clerks, and other court personnel regarding the 33
identification of behavioral health risk indicators among court-involved individuals. These 34
guidance materials shall include all of the following: 35

General Assembly Of North Carolina Session 2025
Page 2 House Bill 1044-First Edition
(1) Evidence-informed indicators of escalating behavioral health crises. 1
(2) Risk patterns associated with untreated serious mental illness, substance use 2
disorders, or co-occurring conditions. 3
(3) Indicators associated with impaired reality testing, loss of impulse control, or 4
acute psychiatric decompression. 5
(4) Appropriate referral pathways for rehabilitative disposition, crisis response, 6
or involuntary commitment where authorized by law. 7
(5) Best practices for balancing public safety, civil liberties, and clinical 8
appropriateness. 9
SECTION 1.(b) Nothing in subsection (a) of this section shall be construed to alter 10
the evidentiary standards required for involuntary commitment, detention, or criminal 11
adjudication. 12
SECTION 1.(c) By no later than January 1, 2027, the AOC and DMH/DD/SUS shall 13
jointly develop a statewide framework to strengthen rehabilitative disposition pathways between 14
district courts, superior courts, and community-based behavioral health providers. The 15
framework shall include all of the following: 16
(1) Standardized referral protocols for pretrial rehabilitative disposition into 17
treatment programs. 18
(2) Mechanisms for real-time communication between courts and local 19
management entities/managed care organizations (LME/MCOs). 20
(3) Expansion of mental health treatment courts where the AOC and 21
DMH/DD/SUS deem it feasible. 22
(4) Guidance on coordinating with jail administrators to identify individuals 23
appropriate for rehabilitative disposition. 24
(5) Data-sharing agreements consistent with the Health Insurance Portability and 25
Accountability Act of 1996 (HIPAA) and State privacy laws. 26
SECTION 1.(d) G.S. 122C-3(11) reads as rewritten: 27
"(11) Dangerous to self or others. 28
... 29
b. Dangerous to others. – Within the relevant past, the individual has 30
inflicted or attempted to inflict or threatened to inflict serious bodily 31
harm on another, or has acted in such a way as to