North Carolina HB 1090: Funds/State Agencies for Loss of Receipts.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 2
HOUSE BILL 1090
Committee Substitute Favorable 5/12/26

Short Title: RURAL Care Act. (Public)
Sponsors:
Referred to:
April 30, 2026
*H1090-v-2*
A BILL TO BE ENTITLED 1
AN ACT TO ENACT THE REVITALIZING, UPLIFTING REGIONS & ACCESS LOCAL 2
(RURAL) CARE ACT TO PROVIDE FOR THE CREATION OF A RURAL 3
HEALTHCARE INFRASTRUCTURE FUND AND A RURAL HEALTHCARE 4
INFRASTRUCTURE PROGRAM TO BE ADMINISTERED BY THE NEWLY 5
CREATED NORTH CAROLINA RURAL HEALTHCARE INFRASTRUCTURE 6
COUNCIL; TO DIRECT THE NORTH CAROLINA RURAL HEALTHCARE 7
INFRASTRUCTURE COUNCIL TO DEVELOP A PLAN FOR THE ESTABLISHMENT 8
AND ADMINISTRATION OF THE RURAL HEALTHCARE INFRASTRUCTURE 9
PROGRAM; AND TO REPEAL THE RURAL HEALTH CARE STABILIZATION 10
PROGRAM. 11
The General Assembly of North Carolina enacts: 12
13
PART I. RURAL HEALTHCARE INFRASTRUCTURE FUND 14
SECTION 1.1.(a) Chapter 131E of the General Statutes is amended by adding a new 15
Article to read: 16
"Article 4A. 17
"Rural Healthcare Infrastructure Fund." 18
SECTION 1.1.(b) G.S. 131A-32 is recodified as G.S. 131E-74 in Article 4A of 19
Chapter 131E of the General Statutes, as enacted by subsection (a) of this section, and reads as 20
rewritten: 21
"§ 131E-74. The Rural Health Care Stabilization Healthcare Infrastructure Fund. 22
(a) Legislative Intent. – The General Assembly recognizes the need to establish and 23
maintain a sufficient funding source to address the ongoing capital and healthcare infrastructure 24
needs of the rural areas of the State. The General Assembly further recognizes the need to protect 25
the State's substantial improvements in existing healthcare facilities while providing a stable 26
funding source to pay for new facilities to meet the needs of a growing rural population. 27
(b) Creation and Source of Funds. – The Rural Health Care Stabilization Healthcare 28
Infrastructure Fund is created as a nonreverting special fund in the Office of State Budget and 29
Management. Department of Health and Human Services to provide financial assistance in the 30
form of grants and loans at below market interest rates with structured repayment terms to support 31
the construction, renovation, or modernization of healthcare facilities located in rural areas of the 32
State. The Fund shall operate as a revolving fund consisting of funds appropriated to, or otherwise 33
received by, the Rural Health Care Stabilization Healthcare Infrastructure Program and all funds 34
received as repayment of the principal of or interest on a loan made from the Fund. The North 35
Carolina Rural Healthcare Infrastructure Council shall administer the Fund. The State Treasurer 36

General Assembly Of North Carolina Session 2025
Page 2 House Bill 1090-Second Edition
is the custodian of the Fund and shall invest its assets in accordance with G.S. 147-69.2 and 1
G.S. 147-69.3. Moneys in the Fund shall only be used for loans made pursuant to this Article. 2
(c) Use of Funds. – Monies in the Fund shall first be used to meet the debt service 3
obligations supported by the General Fund. In addition to meeting the debt service obligations 4
supported by the General Fund, the North Carolina Rural Healthcare Infrastructure Council may 5
allocate money from the Fund to provide financial assistance for the following purposes: 6
(1) New capital projects for facilities licensed under this Chapter or Chapter 122C 7
of the General Statutes that are located in rural areas of the State. 8
(2) Repair and renovation projects for existing facilities licensed under this 9
Chapter or Chapter 122C of the General Statutes that are located in rural areas 10
of the State. 11
(3) Other healthcare infrastructure projects located in rural areas of the State 12
determined by the North Carolina Rural Healthcare Infrastructure Council to 13
be consistent with the intent of the General Assembly, as specified in 14
subsection (a) of this section. 15
(4) Administrative costs incurred by the North Carolina Rural Healthcare 16
Infrastructure Council for administering the Fund, provided that such costs 17
shall not exceed one hundred thousand dollars ($100,000) in any fiscal year. 18
(d) Unexpended Funds. – Funds appropriated for a project that are unspent and 19
unencumbered upon completion of the project shall revert to the Fund. For the purposes of this 20
subsection, a project includes any allocation from the Fund for a purpose specified in subsection 21
(c) of this section. 22
(e) Report. – Annually on March 1, the North Carolina Rural Healthcare Infrastructure 23
Council shall report to the Joint Legislative Oversight Committee on Health and Human Services 24
and the Fiscal Research Division on the use of funds allocated from the Fund. The report shall 25
include at least all of the following information for the preceding fiscal year: 26
(1) Amounts credited to the Fund. 27
(2) Amounts expended from the Fund and the purposes of the expenditures, 28
including, at a minimum: 29
a. A descrip