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Call 1-800GRANGER, clickgranger.com, or just stop by. Granger for the ones who get it done. It's 505 and welcome in to a Monday 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. A recent New York Times investigation into autism therapy clinics has put another national spotlight on the same Medicaid spending and oversight concerns that North Carolina lawmakers and state auditor Dave Bollock have been raising now for months.
The New York Times story published back just a couple of weeks ago focused heavily on a company called Complete Kids, a North Carolina-based autism therapy clinic chain, and described young children spending long days in clinics while Medicare covers much of the costs. More than 80% of Complete Kids patients are covered by Medicare. Medicaid and the company collected about $130 million from the program since 2019, according to the New York Times. The investigation reported the rapid growth of applied behavioral analysis or ABA therapy that has raised concerns about overbilling, long treatment hours, private equity investment, and whether some providers are prescribing more care than children might actually need. ABA therapy is widely used for children with autism, and many families say, in fact, it helped their children improve communication, behavior, and daily living skills.
This report from the New York Times lands months after scrutiny in Raleigh with state auditor Dave Bollock recently saying that his office is examining the surge in Medicaid-funded autism therapy costs, pointing to a rise from roughly $1.4 million in total billings to more than $660 million annually over a five-year period. A spokesperson for the Office of the State Auditor recently said, the state auditor's office is in the middle of a large-scale review of ABA therapy in North Carolina that will look at potential fraud, lax oversight, and everything in between. With over 3 million North Carolinians enrolled in Medicaid, it is important to examine these costs on behalf of taxpayers who fund the program. Data presented to lawmakers at a March Joint Legislative Oversight Committee on Health and Human Services and Medicaid showed spending on autism therapy services surging by a whopping 347% from 2022 to 2025. During that period, the number of children receiving services grew from just over 3,800 to more than 13,000 in that same time period, 2022 to 2025.
The New York Times investigation adds a ground-level Look at what that growth can mean inside of clinics. At the Complete Kids Clinic in Concord, reporters described preschool-aged children working one-on-one with therapists in small cubicles. In one of the scenes reported by The Times, a six-year-old girl fell asleep after hours of therapy and was awakened after seven minutes under the company's nap policy. Complete Kids told the New York Times that the rule is meant to prevent fraud because clinics can bill insurers or Medicaid only when children are awake and receiving services. The investigation also raised questions about whether the industry's financial incentives are encouraging excessive treatment hours.
Current and former workers told the New York Times that some clinics, and listen to this, recommend 20, 30, or even 40 hours of therapy per week.
Some said clinics encourage families to keep their children out of school so that they could attend more therapy. One former executive said that therapy hours were sometimes based on a child's availability rather than actual clinical needs. North Carolina's 2026 Medicaid budget agreement includes provisions to begin starting and to address some of these concerns under the agreement. Any ABA service plan involving more than Than 16 hours per week of therapy must be approved by a Medicaid prepaid health plan or the Department of Health and Human Services, with those plans being updated and reapproved each and every month. The budget language also requires what are called licensed qualified autism service providers or LQASPs to develop individualized service plans for each Medicaid beneficiary.
Those plans must include involvement from parents, guardians, or caretakers. The agreement limits telehealth as well as paraprofessionals are no longer able to provide ABA services through telehealth and patient assessments conducted by licensed autism providers must be conducted live and in person. Licensed providers may still use telehealth to observe and direct paraprofessionals, but remote supervision cannot make up more than 50% of the provider's service for an individual Medicaid recipient. The rule also focuses on paraprofessionals who often provide the direct therapy. The New York Times reported that Medicaid often pays about $70 per hour now.
And $83 in North Carolina for therapy, largely delivered by workers with high school diplomas who earn around $20 an hour. That is obviously a huge gap between what the actual provider is making versus what the Medicaid program is paying out. Under the budget agreement, at least 10% of all services provided by paraprofessionals must involve observation and direction by an LQASP. For beneficiaries receiving more than 200 hours of services from a provider over six months, providers must document that the LQASP service equals at least 10% of the paraprofessional hours unless additional services are medically necessary. And if so, that must be justified by the provider.
The New York Times also reported that autism clinics operate with less state oversight than child care centers, even though young children may spend long days there, as I mentioned just a couple of minutes ago, some even 40-plus hours a week. The New York Times said it found 12 police reports of child abuse at complete kids' facilities since 2013. At least two resulted in criminal charges against employees, and another is the subject of a lawsuit. suit that is currently ongoing filed by a parent. North Carolina Medicaid opened an investigation into complete kids after the Times shared its findings.
Melanie Bush, North Carolina's Medicaid director, told the New York Times in their investigative piece that the program was prepared to take, quote, swift and appropriate action, including the possible suspension of Medicaid payments or termination from programs if warranted. The budget agreement also includes enforcement language allowing the Department of Health and Human Services to recoup payments for a first or second occurrence of noncompliance. For a third instance of material and systematic noncompliance, the department would have the ability to suspend a provider's eligibility to bill Medicaid for one or two years, depending on the legitimacy of the concern and all of the obvious. The pertinent information for each of these cases. This has again grown into a much larger discussion, not only here across North Carolina, but across the nation in recent years, as ABA therapy spending has really spun out of control in many states.
Looking here at North Carolina, just $1.4 million in total billing just a couple of years ago to now more than $660 million over a relatively short five-year period of time. As state lawmakers do continue in Raleigh, we are expecting them back this week as we continue through the legislative short session. There are a lot of discussions as we still await the full state budget, what spending is going to look like. And lawmakers, we've heard this recently from Governor Josh Stein as well, concerned. About some of these rising Medicaid costs and what this means for the future financial stability here of North Carolina.
At the same time, the auditor's office conducting what they are describing as a large-scale review of this ABA autism therapy here in the state of North Carolina. We will be keeping a very close eye on this, not only from the auditor's office, but other news reports, information from DHHS, state lawmakers, a lot of different individuals involved in kind of getting to the bottom of exactly what is going on here. We'll be keeping you up to date with those details over on our website, CarolinaJournal.com, and right here on the Carolina Journal News Hour. It's 521. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk 107.9 FM.
WBT, I'm Nick Craig. Good morning to you. A wide-ranging K-12 education bill making its way through the North Carolina Senate would now commission a study on open enrollment. That is a policy that lets students attend public schools outside of their assigned attendance zone, aka their address. The move comes as a year years after similar state House measures died in the North Carolina Senate.
The legislation, Senate Bill 1006, known as the K-12 Innovation and Transformation Act, cleared the Senate's Higher Education Committee on June the 3rd. A successful adopted amendment from Senator Brad Overkash, the Republican from Gaston County, directs the North Carolina Collaboratory. to study open enrollment policies in school districts across the state. The amendment instructs the collaboratory to, quote, look at what type of proposed policies that we could explore to allow students to extend schools just based on their assigned school, all still within the same school system. That is what Overcash told the committee.
The move marks renewed Senate interest in an idea that the chamber had previously let stall. Going back to the most recent legislative session in May of 2025, the North Carolina House passed House Bill 981, which would have created a committee to study the policy, but the Senate at the time never took up the legislation. Representative Mike Sheetzelt, the Republican from Wake County, said during debate on the bill last year during the legislative long session, we don't want children's educational offerings to be severely curtailed. By a zip code or neighborhood in which they live. North Carolina has no statewide policy on open enrollment and ranks last among 50 states on those policies.
This is according to a Reason of Foundation study. Roughly 45 to 50 North Carolina districts allow some student transfers, while a small number, including Union and Winston-Salem Forsyth County schools, offer more comprehensive options. Dr. Bob Lubke, the director of the Center for Effective Education at the John Locke Foundation, said calling for a study on open enrollment is a positive step. And I applaud the Senate's actions in including the provision in the Education Omnibus Bill.
Open enrollment can offer real benefits to students and schools alike, and I'm hopeful the study will provide a good framework for legislation that will expand educational opportunities for students and also aid schools. A recent Carolina Journal poll found that 79% of likely voters support an open enrollment approach for public education. Very similar to a lot of the other numbers that we follow here, that we have followed in our most recent Carolina Journal polling, some very strong support for a variety of different school choice measures, whether that is things like the Opportunity Scholarship Program, or in this case, some discussions about Open enrollment, which would give families and their children more flexibility as it relates to what school they are attending. As lawmakers continue to debate a litany of policies in Raleigh, we'll be keeping an eye on this right here on the Carolina Journal News Hour. On that education topic, the same Overcash amendment looking at open enrollment carried a second provision that requires every public school unit to adopt what is called a release time policy.
That policy would permit a one-hour weekly excused absence for off-campus religious instruction offered by a private organization. Overcash said it would allow our students in public schools to have a one-hour excused absence to engage in religious instruction given by a private entity off-campus. He pointed to a 1952 United States Supreme Court ruling, which upheld public school release programs for students during the days. For off-campus religious instruction, and noted currently that 39 states permit said practice. Overcash continued by saying that these programs are important to help build the moral and religious character of our students.
He added that participation would be voluntary, require parental approval, and law would require that there is no cost to the district itself. In some other education topics as well, AI tutoring and teacher pay, two amendments are bundled into this sweeping K through 12 education measure approved, sponsored by Senator Michael Lee, the Republican from New Hanover County. Senate Bill 1006 carries tens of millions of dollars. in both recurring and one-time spending. One of the measures there includes a state-funded artificial intelligence tutoring program, competency-based high school pilots, a $43 million increase for advanced teacher roles in terms of paying for that, a teacher apprenticeship initiative, and new limits on district overspending.
Senator Lee said that he was advancing the package even though much of it carries budget implications, saying we're currently in the conference process on the budget, and so we wanted to make sure that we had committee time to dedicate to some of these really important issues for workforce development and education. Democrats praised the bill's larger initiatives, but pressed Lee on how some of the money would be spent, according to one back and forth with a member from Durham County, questioned why the bill steers funding to named companies rather than using the competitive bid process. According to Representative Chitler, they said, quote, I have some questions and concerns about the allocations to specific organizations versus specific requests for proposal processes that might be more standard, pointing to roughly $10 million for the Khan Academy's artificial intelligence platform. Why would we forego a comprehensive process? Was the back and forth debate.
She also questioned that technology and the funding model and asked whether ChatGPT would be the underlying platform, saying learning off of our students and potentially monetizing learning, or would this be something like a closed model? And why the bill commits recurring money to what resembles a pilot program. With the lawmaker continuing by saying, I'm struggling to find the evidence that shows that this is a better investment, say $10 million in instructional assistance. State Senator Lee said that the program is completely Closed with no backflow or information, and that and that the state had named Cotton Academy in its bill precisely because of the data protections that it had vetted. Noting that this is something we're pushing onto the districts, this is allowing our LEAs the ability to compete.
That measure is now heading to the Senate Appropriations Committee. As kind of all over the map, there, this is a very wide-ranging K-12-12 education bill, looking at a variety of different topics and issues, looking at some significant funding for school programs as well. All of this while we continue to watch the ongoing discussion in Raleigh as it relates to a full state budget, presumably sometime in the month of June, another week of jam-packed meetings, looking at the House calendar for Tuesday. Once again, dozens of meetings taking place for a variety of committees. Similar situation on Wednesday as well.
We'll be Keeping an eye on this. Not only will I be doing that, but the rest of our Carolina Journal team keeping an eye on those details and all of the movements in Raleigh over the next couple of weeks. Continuing coverage of that over on our website, CarolinaJournal.com, and right here on the Carolina Journal NewsHour. 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 Monday morning to you. One of the long-running legal stories that we've been keeping an eye here on the Carolina Journal News Hour and over on our website, CarolinaJournal.com, deals with bars that were shut down during the COVID-19 pandemic. If you wind back the clock, going back almost six years now, you will remember a lot of discussion taking place across the state of North Carolina from many bar and restaurant owners.
Some of those bar owners, in particular, have taken the state of North Carolina to court to walk us through the latest. Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour. Mitch, hard to think. Six years ago, these conversations were brand new. Everybody was trying to figure everything out.
What's the latest you're tracking in the court system? You might remember, Nick, that a couple of different lawsuits were filed against then-Governor Roy Cooper over his COVID-era shutdowns. And the claims from these bar owners and their bars as the plaintiffs was that the bars were being treated unfairly compared to other businesses that were being allowed to reopen. When COVID happened, almost all businesses were shut down. But fairly early on in the government's regime on this, they started allowing businesses to reopen, but forced private bars to remain closed for a much longer time period than many other businesses, including some of their competitors.
So there were a couple of different lawsuits challenging these shutdowns and saying that Governor Cooper and his administration were violating these bar owners' rights to get the fruits of their own labors, running their legal businesses. And in August of 2025, the state Supreme Court, in party line votes, 5-2, with the five Republicans on one side and the majority and the two Democrats on the other side said that, yes, these bar owners could move forward with their lawsuits challenging the shutdowns as violating their state constitutional rights.
So the cases are back before a trial court. And in one of the cases, led by the North Carolina Bar and Tavern Association, we're seeing some movement in getting to an actual resolution of the dispute at the trial court level. We talked a little while ago about the fact that the plaintiffs' lawyers in this case had gone to the judge who's overseeing this case, Judge Superior Court Judge Edwin Wilson, and said, look, there are a number of these plaintiffs. It was in the neighborhood of 25 to 30 if you lump bar owners and their bars together. We haven't been able to contact them since 2024.
And so we would like the court to say that we no longer represent these plaintiffs. Since we can't reach them, we can't talk to them about legal strategies.
So please just allow us to stop representing them. Judge agreed to that. And then, at the same time, on the other side of the court dispute, Governor Josh Stein's lawyers, since Stein has taken over as the defendant in this case, once he took office as governor, they've said, Well, we should dismiss those plaintiffs from the case. They're not represented by anyone. They haven't taken part in this case for a couple of years, so they should just be dismissed from the case.
And a hearing that took place this week before Judge Wilson dealt with that issue of whether those plaintiffs, now that they're not represented by any lawyer, should also be dismissed from this case. And he basically agreed. He didn't take any final action. He said the party should come up with an order, send it to him by Tuesday, and then he'll sign off on it. He also didn't take any action on another request that's come from Stein's lawyers, and that is to disqualify or dismiss from the case the North Carolina Bar and Tavern Association itself.
Now he was the lead plaintiff in this case, but now Stein's lawyers are saying. The association itself can't get any relief based on what has come out from the state Supreme Court. They were seeking an injunction at the time, but they can't get any damages. It would be the actual bar owners and the bars themselves that could get damages, not the Bar and Tavern Association.
So that issue was not addressed in this latest hearing, but could be in a hearing that's now scheduled for June 9th. And that's the next big date in this case is that probably all other things are going to be resolved before it could go forward to discovery and motions to get rid of the case and potentially to even go to a trial. We also learned during the course of this latest hearing about how many plaintiffs are really left. The plaintiffs' lawyers described it as 60 groupings. And when they meant groupings, they're talking about grouping of an individual person who's the bar owner and one or more bars that the person owns.
So about 60 real plaintiffs, if you lump them. The bar owners and their bars together. That's how many are still pursuing this case. And that's how many could potentially collect damages from the state if they ultimately prevail. Mitch, you were very clear to use the word bar consistently in our discussion.
And this is relevant for our audience that maybe doesn't remember exactly what was going on six years ago when these discussions were first coming to light. Restaurants that served alcohol were able to reopen. I say relatively in the time scale, but relatively quickly, they were allowed to continue to operate. But bars in particular, of which there is no food being served, those are the ones that were hit with these very lengthy shutdowns that went well beyond what we saw from any other lockdown or shutdown here in the state of North Carolina. Yes, and it was not just the fact that you had a distinction between restaurants and bars.
Restaurants that had a bar could open their bar. And country clubs that had a bar could open their bar. It was basically standalone private bars that had no other business. Those were the ones that remained closed during the entirety of this shutdown. And that was part of the reason of the suit.
They're saying, look, if you're shutting us down because there's some sort of health impact, why is there a health impact from our bar and not? a very similar bar that's attached to a restaurant or to some other establishment. What makes us different? And they basically said that the government couldn't come up with any adequate excuse. And so that was one of the reasons why it was unfair and perhaps unconstitutional to shut down these bars, these standalone bars, while allowing bars in restaurants and in other areas to reopen.
There was also Accusations made in the course of the suit that the governor was taking economics into account and the idea of allowing breweries and businesses that have been seen as contributing to the economy more than a bar, allowing them to reopen for economic reasons, but forcing the bars to remain closed. All of that would take place as a court case moved forward. But the main thing at this point is that it's not really going to move forward until you know exactly who the plaintiffs are who are going to be taking part in this and what the defense is going to be from Governor Stein and the State Justice Department lawyers who are representing him. Mitch, one of the most disturbing things in this entire scenario is the fact that while these bars were shut down, they still owed the state of North Carolina, had to go through the process of getting their ABC certification renewed, which I'll note is a lengthy and relatively expensive situation.
Meanwhile, the door is essentially barred shut, not allowed to operate. And so I would imagine as this case continues to roll out, that some of that will come up in this discussion from these bar owners. On one hand, the state says, pony up for your ABC license or you won't be able to serve alcohol. And on the other hand, the state says, well, you can't serve alcohol anyway, but if you allow your license to lapse, there's a lot of big issues with that as well. Yeah, I'm sure that that is going to be playing a major role as this case moves forward.
And then, of course, I don't know how much this is going to play a role, but there's a potential that this case could even play some sort of role in our marque election matchup. Because remember that the Democrats candidate for U.S. Senate is former Governor Roy Cooper, and it was Governor Cooper and his administration that was responsible for all of this. Governor Stein is being forced to deal with this case now, and he played some role in local state government at the time as the Attorney General, but he did not make any of those decisions. It was Governor Roy Cooper at the time who was ultimately responsible for these shutdown decisions.
And it's possible that as this election matchup moves forward, that those who are trying to elect Michael Watley might say, hey, look at this case and remember that Governor Roy Cooper was shutting down businesses and hurting the economy and keeping us all away from our jobs. And potentially, even though it's now been six years since all of that happened, some people might remember that and say, hmm, this could affect what I think about when I go to the polls. Yeah, I guess from a political standpoint, maybe a little bit of a guerrilla marketing campaign, Mitch, in these very fruitful bars and restaurants across the state of North Carolina that are packed with people after work each and every weekday. Real quick, one more time, this June the 9th court date that we've got on the calendar, what exactly is going to go on there? We'll probably see at that meeting, which has been billed as a status conference.
They'll kind of finalize who are the plaintiffs in this case. My guess is there will be a ruling on whether the Bar and Tavern Association can continue as a plaintiff or not. And then after that, probably a schedule of what's going to take place with any discovery, future hearings, maybe setting a trial date out in the future in case they can't come up with some sort of settlement.
So it's basically a status conference that'll set the stage for what moves forward with the rest of the case.
Well, cool. We'll be keeping our eye on that. We know that you'll keep us up to date not only here on the Carolina Journal News Hour, but we do have continuing coverage of this over on our website, CarolinaJournal.com. We appreciate the update this morning. Mitch Coke from the John Locke Foundation joins us on the Carolina Journal News Hour.
Good morning again. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk 107.9 FM, WBT, Governor Josh Stein recently signed an executive order aimed at strengthening North Carolina's military communities by coordinating efforts in improving communication and dissemination of information to military and their families. He talked about the importance of recognizing service members during Military Appreciation Month at a press conference, noting in part, North Carolina is home to the fourth largest military presence in the nation, including the most populated Army base in the world and the largest East Coast base for the Marines. We're also home to more than 90,000 active duty military personnel, more than 40,000 National Guard and Reserve members, and more than 600,000 military veterans and nearly 150 military family members. Servicemen and women who choose a career that separates them from their families and can put them directly in harm's way, and they do it because they are patriots who love this country and value what it stands for.
End quote there from Governor Stein. He added that the state owes them a profound gratitude and is committed to becoming the best state in the nation for veterans and military family members. The executive order, the governor said, builds on the modernization of two prior orders, one from 2012, the other from 2013, by recognizing the central role of the state's Department of Military and Veterans Affairs, known as the NCDMVA. In coordination with state support of service members, under the order, each cabinet agency will designate a military affairs coordinator, including a council of state agencies. This military affairs coordinator and each agency will have two main jobs.
Being knowledgeable about their agency's work that could impact service members and their families. As well as coordinating with the NC DMVA and other agencies about shared efforts to support service members, that group will convene each agency's military affairs coordinator regularly to develop strategies for tackling gaps in state service to the military and their families. Secretary of the NC Military and Veteran Affairs Jocelyn Millette stressed the importance of the military's presence in North Carolina as it is the second largest sector of North Carolina's economy and touches every aspect of the state's communities, including health care, education, housing, and workforce development. She said during the press conference, we cannot be one of the most military-friendly states based on the population and number of installation alone. It takes intentional coordination and collaboration at all levels and within all sectors to ensure that we are supporting our service members and their families.
Families, as well as the installations that they call home in the surrounding communities, who ensure their readiness because they deserve it, because our national security depends on it. You can read more on this executive order from Governor Josh Stein's, from Democrat Governor Josh Stein. We've got a full copy linked up to it over on our website this morning, CarolinaJournal.com. Head on over to our website and look for the story with the headline: Stein Signs Executive Order on NC Military Communities. That's going to do it for a Monday edition.
WBT News is next, followed by Good Morning BT. We're back for you tomorrow, 5 to 6, right here on Charlotte's FM News Talk, 107.9 FM, WBT. Yeah.
