Cooper details mental health plan; GOP sets budget limits

North Carolina Gov. Roy Cooper unveiled on Wednesday a $1 billion plan to address the state's mental health and substance abuse needs, which have spiked amid increasing overdose deaths and spiraling rates of suicide among young people.

The Democratic governor's office said his initiatives, which will be outlined in his upcoming state budget proposal, include more behavioral health services for those in schools and in jails. He also wants to spend more on in-patient treatment and supplemental services like mobile crisis units to help people facing psychiatric episodes.

Cooper also wants to raise Medicaid reimbursement rates to providers of mental health services because he said they haven't been updated in a decade.

Drug overdose deaths in North Carolina surged by 72% over the past two years — exceeding 4,000 in 2021 — while youth suicides have doubled in the past decade, according to a summary of the proposal.

“This plan tackles the ongoing mental health crisis in a direct and meaningful way by investing in the whole-person health of North Carolinians,” Cooper said in the release about the proposal, which he hinted at during his State of the State address this week.

Plan details were released the same day that Republican lawmakers announced that they’ve agreed on some key budget spending figures. The offices of House Speaker Tim Moore and Senate leader Phil Berger confirmed that the two-year budget they plan to pass would grow by over 10%, or nearly $3 billion, compared to what is being spent this fiscal year.

The consensus on spending limits is a positive indicator that the legislature will fashion a final budget bill and send it to Cooper before the next fiscal year begins July 1.

A summary of Cooper's mental health proposal also points to a one-time $1.8 billion financial sweetener from the federal government over two years if the state expands Medicaid to hundreds of thousands of low-income adults as a way to boost investment.

Republican legislative leaders last week announced a deal on a Medicaid expansion measure that could reach Cooper's desk in the coming days. The state has wide latitude in how that $1.8 billion can be spent. One key legislator said efforts to earmark about half of that money for mental health services are afoot.

Much of Cooper's spending requests would be used to raise Medicaid rates, expand community-level behavioral health clinics and develop more programs that allow people within the criminal justice system to get mental health treatment or avoid jail. Other recommended spending addresses child welfare services, housing support, telehealth options and electronic health records.

Republicans are already building their own budget. The House aims to approve its spending plan by early April.

The spending agreement by the two chambers outlines a final budget of about $29.7 billion in the coming fiscal year, or 6.5% above the current fiscal year's budget of $27.9 billion. The amount would grow to $30.8 billion during the 2024-25 fiscal year, or another 3.75% increase.

Rep. Jason Saine, a Lincoln County Republican and a top House budget writer, said he was comfortable with the spending level increase, pointing to the state's flush coffers and population growth, and to inflation. Next year’s percentage increase is largely in line with the spending increase between the 2021-22 fiscal year and the current year.

“We’re not breaking the bank because we’re paying for our growth,” Saine said. “We’re being very reasonable about what we’re doing and kind of keeping things when all things are said and done on an even keel.”

Cooper’s budget office and the General Assembly’s staff economists estimated last month that state coffers would collect $3.25 billion, or nearly 11% more than anticipated when the current state budget law was enacted last summer.