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It's 505 and welcome in to a Tuesday edition of the Carolina Journal News Hour on Charlotte's FM News Talk 107.9 FM, WBT. I'm Nick Craig. Good morning to you. We start off with some concerning information coming out of the North Carolina General Assembly via North Carolina's Medicaid program. According to details out of a recent meeting, spending on autism therapy in North Carolina's Medicaid program is projected to exceed a billion dollars within the next two years.
This is prompting state lawmakers in a meeting last week to raise alarms and press health officials to explain these rapidly rising costs. The meeting took place a couple of weeks ago, March the 10th, as members of the Joint Legislative Oversight Committee on Health and Human Services and Medicaid, where lawmakers reviewed new data showing the rapid spending that has been applied to applied behavioral health analysis, known as ABA and related therapies, is climbing rapidly. The North Carolina Department of Health and Human Services data from DHHS shows that ABA spending will surge by roughly 425% from $121.7 million in 2022 to a projected $1.1 billion by 2027. This rapid escalation threatens to overwhelm the state's Medicaid budget and become one of its largest fiscal expenditures. Medicaid data presented to state lawmakers also shows spending surged 347% between 2022 and 2025 as the number of children receiving services grew from just over 3,800 to more than 13,000.
At the same time, the intensity of care increased with the average patient hours rising from 47.5 hours to more than 54 hours per month. Lawmakers say that these spending Trends are raising urgent questions about how North Carolina will manage both fiscal policy and policy challenges posed by this unprecedented growth. State Senator Ralph Heiss, who is the Republican from Mitchell County, said during the meeting: Nothing here can answer the question of where this growth rate is coming from. DHHS officials say that there are several factors that are contributing to this rapid spike that we've seen over the last couple of years: a 15% Medicaid reimbursement rate, which increased in 2024, a growing number of providers entering the market, and increased demand as more families seek diagnosis and treatment.
Now, this is a relatively new situation in North Carolina as the state only began covering autism therapy under Medicaid in 2019, making it a relatively new and rapidly expanding benefit. Despite these expectations, Explanations, the department's reports indicate that these factors do not fully account for this rapid surge. The Department of Health and Human Service report also found that providers may sometimes use therapy when less intensive options are available, and that the increase in the number of new patients receiving treatment far outpaces the rate of new autism diagnosis. According to State Senator Jim Bergen, who is the Republican from Harnett County, he said, I am extremely concerned about the dollar versus the service that individuals are actually getting, with providers acknowledging that there is a variation in quality. According to Matt Feiler, who is the CEO of Mozak Pediatric Therapy, told the committee, there is a lot of variation in the quality of providers.
This ABA therapy that we're talking about this morning is intensive, and it's individualized treatment designed to help children with autism. develop communication, behavioral, and daily living skills. Sessions often include teaching children to follow directions, practice everyday tasks, and build communication abilities. Because treatment is individualized, the definition is broad and very difficult to standardize. Registered behavioral technicians who are hourly employees who complete 40 hours of training and are required to have a high school diploma typically deliver therapy and provide direct care, while more highly trained behavioral analysis designs and supervised treatment plans could also be provided.
Despite heightened scrutiny of spending and services, both families and providers emphasize that the therapy can, in fact, be transformative, particularly when delivered early, with more than 70% of children receiving services being age six or younger. North Carolina's experience reflects a broader national pattern. According to the Centers for Medicare and Medicaid Services, ABA therapy has been one of the fastest growing Medicaid expenses nationwide. Recent federal policy changes require states to cover autism-related services under the Medicaid program. In response to the national spending spike, the United States Department of Health and Human Services Office of the Inspector General has decided to launch a state-by-state investigation into Medicaid Autism Therapy billing focusing on improper payments and documentation failures.
So far, audits in Maine, Wisconsin, Indiana, and Colorado have uncovered widespread problems. In each state that was reviewed, auditors examined samples of ABA claims and found errors, including auditors finding payments. Despite missing documentation, some providers billing for therapy sessions when children were asleep or watching videos, and the price per hour of treatment drastically increasing when covered by Medicaid. Reflecting these federal concerns at the state level, State Auditor Dave Bollock and his office have launched a detailed review of North Carolina's autism therapy spending, with State Auditor Dave Bollock saying, that was one area that we did identify that we really needed to take a closer look at. We're not asleep at the wheel.
We're looking at it in a very tough manner. Bollock said that the investigation is part of a broader effort to identify unusual spending patterns across state government, saying the first thing that we did was scan across our government to look for spikes that would clearly be obvious that our team would need to go in and take a look at immediately. Our teams have identified an area that has spiked. In North Carolina, and that is the provision of ABA services in the autism arena. That has been a tremendous spike in the amount of money that Medicaid spends in these particular areas.
Our team has begun a detailed look at that. In response to these trends and the core financial concerns, DHHS has proposed reforms to strengthen oversight, enhance accountability, and preserve access to medically necessary autism therapy. Those proposals include strengthening individualized treatment requirements, increasing documentation and utilization review, enhancing credential standards, aligning services more closely with clinical guidelines. The Carolina Journal previously reported that the state is also facing an ongoing lawsuit over some of these Medicaid reimbursement rates for autism services. That lawsuit was filed by families.
Of more than 20 children with autism after the governor proposed reimbursement cuts of up to 10% for applied behavioral analysis therapy, or ABA, which we've been discussing this morning. Reductions steeper than those applied under other Medicaid services. Parents argue that the cuts unfairly singled out children with autism and could disrupt medically necessary treatment, particularly for those relying on intensive long-term care. A Wake County Superior Court judge issued a preliminary injunction blocking those cuts, finding that families were likely to succeed in their claims if it were to continue moving through the judicial system. In his order, the judge warned that the reduction could result in a denial of care, delayed access to services, and an increased risk of isolation of the affected children.
The dispute stems from a broader budget conflict as the governor. Proposed to implement the cuts amid a Medicaid funding shortfall after lawmakers failed to reach a budget agreement back in July of 2025.
Some of the numbers from this report coming from the North Carolina Department of Health and Human Services are truly eye-popping as it relates to this applied behavioral health analysis. As I mentioned, spending will surge 425% from $121 million in 2022. To a projected more than $1 billion by 2027. At the same time, lawmakers have also been provided information showing some of those surges in the amount of children receiving the therapy from about 3,800 to more than 13,000, all at the same time. While lawmakers and health officials note that the rate of spending is not lined up with the rate of new diagnoses of autism here across the state of North Carolina, this is one of the many concerns that lawmakers have as it relates to Medicaid spending in the state of North Carolina.
Back just a couple of years ago, the Republican-led General Assembly, alongside Democrat Governor Roy Cooper, expanded Medicaid services across the state. And with that, many voiced some of the concerns as it would relate to ballooning spending in recent years. And it would appear that one of those areas, at least as of right now, is autism therapy. Covered through the program, a couple of different angles that we're watching on this: what will lawmakers do in Raleigh, plus this ongoing audit, not only from the federal government, but from state auditor Dave Bollick. This is something that will have a real implication, not only for the families using the services, but for the state budget and taxpayers as a whole.
We'll keep an eye on the details over on our website, CarolinaJournal.com, and of course, bring you the latest as soon as we get it right here on the Carolina Journal News Hour. The Bleacher Report app is your destination for sports. Right now, the NBA is heating up, March Madness is here, and MLB is almost back. Every day there's a new headline, a new highlight, a new moment you've got to see for yourself. That's why I stay locked in with the Bleacher Report app.
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I'm the host of a news show from Washington Post Opinion called Reasonably Optimistic. and it's an antidote to the pessimism that's riddling America right now. Every Wednesday, I'm going to talk to people who see a path forward. It does seem to me that there is some awakening of a desire to act together, to solve problems where they are. You know, I am a believer in America, and it's worth fighting for.
Join me Wednesdays on YouTube or wherever you get your podcasts. It's 521. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk, 107.9 FM. WBT, I'm Nick Craig. A good Tuesday morning to you.
Over the last 10 or 15 years, for those that follow law enforcement closely, there's been a lot more discussion over body camera and body cam footage. We've seen this used in high-profile court cases all across the United States, as well as some here in North Carolina. There's an interesting legal challenge that goes back a couple of years in the state as it relates to body cam footage. That case ran its way all the way up to the United States Supreme Court to walk us through some details this morning. Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal.
news hour. Mitch, this is not the first time we've talked about should we, should we not be releasing body camera footage over the last couple of months. What's the latest on this story you're tracking back that goes all the way back to 2023? Yes, and the case started in the fall of 2023 when a woman named Charlotte Shimudi, and I may be pronouncing it incorrectly. I apologize if so, but that's the way the name looks.
Anyway, she was arrested for resisting a public officer in Mooresville and was charged in North Carolina district court. And as part of her defense against this charge, she wanted to get access to the body cam footage that would have been related to the incident or to her arrest or to her being taken to jail. And so she had a subpoena that was issued to get this body cam footage. And the district court judge, not too long after the subpoena was issued in December of 2023, issued a ruling in, I believe it was January of 2024 that said the Mooresville police needed to turn over this body cam footage.
Well, Mooresville appealed that ruling. Saying that that did not comply with the law about accessing body cam footage. The case got to the State Court of Appeals in 2024 and in late 2024 and in October of 2024, the appeals court. Upheld the trial court ruling and said this footage needs to be turned over. But then the case went to the North Carolina Supreme Court, which had a very different view.
One year later, in October 2025, the state Supreme Court split 5-2. And the five Republicans on the court all said that, wait a minute, there is now a new process that's in place for those who want to get access to body cam footage. This was a law that was put in place by the General Assembly in 2016 that said that you have to go through this other procedure to try to get the body cam footage. You can't just use a subpoena. In fact, this new procedure has supplanted a subpoena.
And the reason is that the General Assembly Whether it was wise or not, it was the choice of the General Assembly to do this, wanted to make sure that courts weren't turning over or weren't allowing information, sensitive information to be turned over without there being a real adequate check in place. And that was the General Assembly's choice to do that. And so that is the procedure that any criminal defendant would have to go through. They don't go through a normal subpoena. They would have to go to Superior Court and actually get a separate order to get the body cam footage.
Well, that was what the state Supreme Court ruled in October of 2025. But the plaintiff in this case said that that was a wrong ruling and wanted the U.S. Supreme Court to step in and say that this was a violation of Sixth Amendment rights, something called compulsory process clause of the Sixth Amendment, that you are allowed to have witnesses and that you're allowed. To compel witness testimony, and that has been seen by courts to extend beyond witnesses, but actually also extend to materials. And so, the body cam footage would be material that would help with the defense.
The Supreme Court decided not too long after that petition, just within a matter of a couple of months, not to take the case. And this is not strange. The Supreme Court rejects. Almost all of the petitions that are made for what is called a writ of certioriari, and that is the writ or the order that would allow the Supreme Court to take the case. The Supreme Court said no, didn't offer any commentary or opinion about why.
This case was listed among dozens of others that the Supreme Court turned down. But that basically ends the legal case for the plaintiff. The state Supreme Court acted, said that you have to go through this other process, can't just have a subpoena. The U.S. Supreme Court declined to step in and overrule the North Carolina Supreme Court.
So that now is the law of the state. If a criminal defendant wants to access this body cam footage, he or she cannot just issue a subpoena to get it. They have to go through this process that was spelled out in a state law in 2016. You know, Mitch, it is kind of interesting when you look at, of course, all of the various states across the country that have all their different rules and laws as it relates to this kind of footage being released. If you spend some time perusing the internet, you'll see that there is a lot of body camera footage from certain states or certain jurisdictions where there's not a lot, maybe from other areas.
And obviously, that has a lot to do with how easy and/or hard it is to get some of this footage out. Do we know if the plaintiff in this case tried to go through this process that the General Assembly laid out in 2016, then passed into law, and then presumably was either signed by the governor or veto overridden by the General Assembly? We don't know from the court record if that happened.
Now, it's possible that this happened after the initial attempt to get the subpoena issued because this has now, as you've mentioned, been playing out over the span of more than a couple of years. What happened was the charge was made in district court. The appeal or the order shortly after the subpoena was for the police to turn over the body cam footage. And that was the law of the case for the next year. The State Court of Appeals said the same thing in October of 2024.
It was only after the appeal to the state Supreme Court where you saw some idea that perhaps this was not going to... be able to happen. And I'm guessing that she doesn't have the body cam footage because she would have then made the case moot.
So it's entirely possible that she's gone through the other process. If she hasn't gone through that process yet, and if the case is still active, then she would likely now try to go through the other process to get the footage. It is a little bit more extensive. And Justice Richard Dietz of the North Carolina Supreme Court, in his opinion, basically admitted that this is going to be more time consuming and cumbersome for the criminal defendants. For their lawyers and also for the courts, but that is the process the General Assembly spelled out, and it was a reasonable process, and it's not one that the courts could second guess.
So, my guess is now that the U.S. Supreme Court has ruled against Charlotte Chimudi: that if her case is still active and if she still wants the body cam footage, that she will now have to go back and follow the process that was spelled out in that state law because she's not going to be able to get the footage through a subpoena. Yeah, and I guess maybe one of the other ways that this could be dealt with, not only in this case, but others, would be lobbying the North Carolina General Assembly, maybe to change some of those laws or rewrite them in a way that would make it more accessible for some of those individuals to get access to that. But obviously, that's a completely different process that would play out and would be very far down the road, presumably, as it relates to legislation. Mitch, it's a great story this morning.
Appreciate the information and the update. You can read continued coverage over on our website, CarolinaJournal.com. Mitch Cokei from the John Locke Foundation joins us on the Carolina Journal News Hour. It's 5:36. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk, 107.9 FM, WBT.
I'm Nick Craig. Good Tuesday morning to you. Two weeks ago, right here on the Carolina Journal News Hour, we brought you an update on an ongoing legal battle that has been taking place in the state of North Carolina as it relates to a ballot selfie. If you're not familiar with what that is, well, it's pretty self-explanatory. It is a selfie that you take with your ballot.
That is prohibited in North Carolina state law. A Libertarian candidate and voter in the Raleigh area had taken this challenge to court. We saw a ruling back a couple of weeks ago, and now that ruling is being appealed to walks through those details this morning, Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour. Mitch, before we get to the appeal, can you briefly walk us through what that March 9th ruling said? Sure.
This was a ruling from U.S. District Judge Louise Flanagan, who basically upheld North Carolina's series of laws that together ban ballot selfies. There isn't just one law that says you cannot take a ballot selfie. In fact, there's no reference to ballot selfie anywhere in the state laws. Basically, five different laws that ban taking photos of a completed ballot inside a voto enclosure.
All of those laws together basically make up the state's ballot selfie ban. And what happened was a Libertarian voter who also at the time was a candidate for state senate went into a voting booth in the primary season in the 2024 election cycle, took a photo of herself with her completed ballot, posted it on social media, and then got a warning from the Wake County Board of Elections saying you should take that down. It's against you. Against the law to do this. That was what prompted her to file suit.
She got help from the Foundation for Individual Rights and Expression, or FIRE, to file this suit. FIRE is against ballot selfie bans across the country, and so was interested in helping the plaintiff, Susan Hogarth, in her case. She went to court and in the federal district court, Judge Flanagan basically allowed Susan Hogarth to keep the ballot selfie from the primary season up and also issued an injunction that allowed her to post a ballot selfie for the general election in 2024 while this process played out. But eventually, after going through all of the court documents, looking at the arguments both for and against these various laws, Judge Flanagan came out with the ruling in early March that said, no, these laws are legitimate. They serve the government interest of trying to promote vote buying and coercion of voters, and that this is a reasonable way to do that.
Now, the fact that Susan Hogarth and Fire are appealing now a couple of weeks later going to the fourth U.S. Circuit Court of Appeals shouldn't surprise us. This is the type of thing that was likely to go to appeal anyway. If Hogarth had won at the trial court level, I could see state officials appealing the ruling to the Fourth Circuit. And since Hogarth lost, And the idea is that FHIR, working along with her, are trying to challenge these rules pretty much anywhere they're in place across the country.
It's no surprise that they would like to take this to a higher tribunal to see if the fourth U.S. Circuit Court of Appeals will buy the same arguments from the state, or if they agree with Hogarth and Fire, that a ballot selfie is part of First Amendment expression and should be allowed to proceed.
So the fact that this is going. To an appeal before the Fourth Circuit in Richmond shouldn't surprise us too much. It was probably likely going to go there anyway. And my guess is. Whichever side loses it, the Fourth Circuit will probably try to take the case to the Supreme Court.
And of course, it's anybody's guess whether the Supreme Court would take it because they take only a small fraction of the cases that are appealed to the Supreme Court. But this is the type of thing that I think the state obviously would like to want to protect its rules. On the other side, Susan Hogarth, the candidate and libertarian voter, and Fire, the group that she's working with, would like to get these ballot selfies allowed across the country and certainly to as great an extent as possible. And if that can be throughout the Fourth Circuit, They'll be happy with that as well. You know, Mitch, this has always been an interesting story as we've watched it play out over the last couple of years here with the variety of different avenues and pathways in which it's gone through the legal system.
The argument, of course, to have the ability to do this under your First Amendment rights. But then, as you noted, and as state officials have noted, as this lawsuit has played out, making sure that buying votes and vote coercion is not taking place here in North Carolina is also a pretty serious risk as well.
So, it's kind of an interesting, really kind of tightrope that you're almost walking as this process continues to play out. It really is interesting, and there are compelling arguments for both sides. I think most of us, if we haven't really thought about it, probably think the ballot selfie is okay. That, you know, what's the problem with you taking a picture of yourself with your ballot?
Now, a lot of us. Wouldn't want that. I mean, there's a secret ballot for a reason. You don't want necessarily people to know the way that you vote. But for some people, they definitely do want people to know the way they vote.
They say, Hey, this is my candidate, or these are my group of candidates, this is my group of candidates, and I want people to know that I voted for those folks. And that is their expression of their acting on their civic duty, choosing their candidates, especially if you are a committed libertarian like Susan Hogarth. You might want to tell people, Hey, I voted for these libertarians up and down the ballot, and I think you should too. And that's part of their argument. But if you think about it beyond just that surface level, you might say, Oh, you know, there is the potential of problems with the vote buying and the coercion.
The real question legally would be. If that is a compelling government interest trying to stop vote buying or trying to stop coercion of voters, is this the best way to go about it? Because Having these laws in place butts up against that very fundamental First Amendment right of free expression. And I think one of the things that helped convince Judge Flanagan, based on the way that she wrote about this, is that this is not a ruling that's taking, this ruling is not about something that's taking place in the open air, in a public forum, where people really don't expect privacy. This is taking place in a voting enclosure when there are all kinds of rules limiting what can and can take place in a polling place.
And as we've talked about before, even within several yards or several hundred yards of a polling place, there are things you can and can't do. And so it's a much more restricted area than if someone said, well, you can't show this piece of paper, the equivalent of the ballot selfie, while you're walking around in a public park or while you're walking down a sidewalk. That would probably be a harder sell for a judge than something. that is setting a rule that takes place in a polling place or in a voting booth. Yeah, and to the credit of election officials, not here, not just at the state board of elections, but all across the entire state of North Carolina, all 100 county board of elections, Mitch, they do train their staff very carefully on what those rules are, what those buffer zones look like to make sure that active electioneering and other sorts of activities that could sway voters.
For example, there's been a lot of debate and discussion about providing people with snacks and food and things like that right outside of voting locations as well. It is a very different situation than the public square, for lack of a better term. That's true. And one of the things that we saw during the course of this case was I don't believe that Susan Hogarth had any problem at the polling place when she cast her primary ballot. It really only cropped up after she posted the image on social media.
But then, even though she had an injunction in place helping her for the general election, she did run into some issues when she went to the polls in the fall of 2024 when an election official saw her about to take the photo and said, hey, you're not really supposed to do that. And then there was a discussion that took a little while. She said, you know, I have a court order saying I can do this. And after a bit of discussion back and forth, she was allowed to take the photo, was allowed to post it. But as you alluded to, this is the case of election officials trying to make sure that they're adhering to the rules that have been set down in state law and by the state board of elections.
And so I think it will be interesting to see once this is ultimately resolved. Is it resolved more in the favor of the First Amendment and your right to post the selfie, or is it resolved more in the area of election integrity, protecting the election process, and saying that we don't want to have vote buying and coercion? They are two very interesting and important concepts that are butting up against each other on this ballot selfie issue. And the courts have yet to have a final ruling. But at this point, the ruling is in favor of the laws and against the voter who would like to post the selfie.
Mitch, real quick, walk through this appeal process that's going to play out now.
So it goes to the Fourth U.S. Circuit Court of Appeals at last report. It didn't even have a case number yet.
So this is not something that's going to happen very quickly. And in fact, because we're in the middle of an election cycle now, I'm guessing that the Fourth Circuit is not going to have a ruling that would necessarily have an impact for the rest of the 2026 election cycle. Perhaps they will, but this is likely something that's going to take a matter of months. We'll, of course, keep a very close eye on those details. You can not only read the most recent update about this appeal, but the lengthy legal battle that this has been over on our website, CarolinaJournal.com.
We appreciate the information this morning. Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour. Good morning again. It's 5:53. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk 107.9 WBT.
We've got some business news we're tracking across the state this morning. Back on March the 19th, Governor Josh Stein announced the grand opening of the new PSA Airlines headquarters. That is listed over at Charlotte International Airport as this follows the company's move from Dayton, Ohio. Governor Stein said during a press release, North Carolina is first in flight and the future of flight. PSA Airlines' decision to move its headquarters to Charlotte is a testament to North Carolina's top-tier workforce and strong aviation industry.
This investment will create good-paying jobs locally and keep our state connected to the world. PSA's new Charlotte headquarters is anticipated to generate more than $10 million in state and local taxes. Tax revenue annually, in addition to supporting more than $228 million in economic output. This is according to a study from NC State's Institute for Transportation Research and Education. The report reads, these 400 well-paying jobs can be expected to support an additional 470 jobs with employers and community businesses across the state.
With 24% of these additional jobs and 11% of local government tax revenue outside of Mecklenburg County. According to the PSA Airlines president and CEO Deion Flannery, he said in a press release: Charlotte is an aviation-rich talent market, and we're very excited to be here, and we're already realizing the vast potential it offers. Our headquarters here represents more than a new home. It's a long-term investment in our people, the community, and in the economic growth we're helping drive for North Carolina. Today's event allows us to celebrate the people and partners who have made this headquarters possible and with whom we'll continue to partner to generate win-win outcomes not only in the Queen City, but across the state.
The headquarters consolidates PSA's management, support staff, and operational teams, including its integrated operations center, into a single facility. Located near the American Airlines hub at Charlotte Douglas International, it strengthens coordination and collaboration while improving efficiency and reliability across its network. According to the chief operating officer of PSA Airlines Chris McCartney, he said the Charlotte headquarters enhances how we will manage the airline's daily operation. Housing our IOC, crew resources, maintenance teams, and dispatch leadership together under one roof will help improve reliability and optimize operations, which of course benefits our customers. PSA Airlines did offer all of its previous Dayton-based employees the option to relocate, with about 40% choosing to do so, with more than 35,000 applications being received for the remaining 250 job openings in Charlotte.
There are more than 400 aerospace companies that have made North Carolina home, including Jet Zero, a startup aviation company that was announced by Governor Stein last year. Jet Zero plans to invest more than $4.7 billion in Greensboro to build the first commercial airplane manufacturing facility at the Piedmont Triad International Airport. Jet Zero's announcement was the largest job announcement. In state history, with the project being part of a job development investment grant, a JDIG grant. Additionally, GE Aerospace recently announced that it would invest some $160 million across four facilities in Asheville, Durham, Wilmington, and West Jefferson, creating hundreds of new jobs across the state.
You can read some additional quotes from Governor Josh Stein as well as other high-ranking officials over at PSA Airlines. Those details over on our website this morning, CarolinaJournal.com. Look for the story with the headline: PSA Airlines opens new HQ in Charlotte. That's going to do it for a Tuesday edition of the Carolina Journal News Hour. WBT News is next.
Followed by Good Morning, BT. We're back with you tomorrow morning, 5 to 6, right here on Charlotte's FM News Talk 107.9 WBT. At Verbo, we understand that even the best of plans sometimes need a little support, so we've planned for the plot twists. Every booking is automatically backed by our Verbo care guarantee, giving you confidence from the very start. Whenever you need help, it's ready, before your stay, through the moments in between, and after your trip.
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