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HB 1044

Justice in Mental Health Act.

2025-2026 Session Introduced by Eric Ager and 34 co-sponsors

Expands court-linked behavioral health treatment, adds funds for community care and safekeeping expansion, and strengthens guidelines to shorten delays while boosting safety and ci

Passed 1st Reading
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Bill Summary · HB 1044

Summary of HB 1044 (Justice in Mental Health Act) – North Carolina, 2025 Session

Note: This summary reflects the bill text as introduced April 23, 2026. It outlines the bill’s main goals, substantive provisions, affected parties, and timing.

General purpose and intent

  • The bill aims to reduce delays in behavioral health evaluation, stabilization, and treatment for court-involved individuals; expand treatment capacity; create rehabilitative disposition pathways; and increase safe capacity within the state’s jail and prison system associated with safekeeping/mental health needs.
  • It seeks to improve public safety and court efficiency while preserving civil liberties by promoting treatment-oriented solutions over prolonged confinement.

Key provisions and changes

1) Closing gaps between courts and behavioral health systems (Section 1)

  • By Jan 1, 2027, the Administrative Office of the Courts (AOC), in coordination with the DMH/DD/SUS, must:

    • Develop and distribute enhanced guidance materials for judges, magistrates, clerks, and court staff on identifying behavioral health risk indicators among court-involved individuals. Contents include escalation indicators, patterns of untreated mental illness/substance use, indicators of impaired reality testing, referral pathways for rehabilitative disposition or involuntary commitment, and best practices balancing safety and civil liberties.
    • Jointly develop a statewide rehabilitative disposition framework to link district and superior courts with community-based providers. Features include standardized pretrial treatment referrals, real-time court-LME/MCO communication, expansion of mental health treatment courts, coordination with jail administrators, and HIPAA/compliant data-sharing.

  • Note: Subsection (d) modifies criteria for “dangerous to self or others” in statute 122C-3(11), clarifying how dangerousness is established and allowing consideration of patterns of behavior and loss of volitional control without lowering evidentiary standards. A primer on dangerousness is not intended to alter existing legal burdens.

  • Funding and implementation: The bill appropriates funds to implement these provisions (detailed below) and requires reporting on progress and outcomes starting December 1, 2027.

2) Rehabilitative disposition and community safety programs (Section 2)

  • The 2026–2027 fiscal year onward: $224 million (recurring) to DMH/DD/SUS to build/expand behavioral health treatment capacity and court-support initiatives, including:
    • Crisis response and clinical stabilization capacity (mobile crisis units, crisis receiving/short-term stabilization).
    • Community-based assessment, treatment, and recovery services (outpatient, intensive outpatient, medication management, peer support, care coordination, continuity of care).
    • Judicially Managed Accountable Recovery Courts (JMARCs) and related court-linked clinical services.
    • Other evidence-based behavioral health initiatives to reduce court delays and improve safety outcomes.

3) State psychiatric hospital beds and staffing (Section 3)

  • Funding to DMH/DD/SUS: $320,400,000 (recurring) starting 2026–2027 to hire/contract staff for state psychiatric hospital operations.
  • One-time funding to OSBM: $118,000,000 (nonrecurring) in 2026–2027 to expand bed capacity, with a condition that DMH/DD/SUS must certify bed occupancy within 90 days before release of funds; funds non-reverting until expended.
  • Additional recurring funding to support expanded capacity: $35,600,000 (to DMH/DD/SUS) beginning 2026–2027 for ongoing staffing.
  • Uses allowed: workforce stability and retention measures (preceptors, onboarding, training, supervision, employee assistance, safety improvements). Note: Bonuses prohibited except as part of an approved retention plan.

4) Increase limit on safekeepers; funding for safekeeping expansion (Section 4)

  • The cap on county prisoners in safekeeping or for medical/mental health treatment in the state system increases from 200 to 500 (subject to secretary approval).
  • Funding to DAC: $90,000,000 (nonrecurring) in 2026–2027 for nonrecurring costs of expanding safekeeping capacity; from 2026–2027 onward, $16,000,000 (recurring) to cover ongoing operational costs associated with the expanded safekeeping capacity.

5) Reporting and oversight (Section 5)

  • By July 1, 2027, and annually thereafter: DHHS-DMH/DD/SUS, in coordination with AOC, must report on:
    • Costs and savings related to Sections 2 and 3.
    • Reductions in case loads and detentions, impacts on recidivism.
    • Barriers requiring legislative action.
  • An updated framework status report is due by December 1, 2027, and annually thereafter, covering:
    • Number of court-involved individuals diverted to treatment.
    • Changes in pretrial detention rates for individuals with serious mental illness.
    • Impacts on recidivism.
    • Identified barriers and needed legislative action.

6) Effective dates (Section 6)

  • The act becomes effective when it becomes law, with various components phased in as noted (e.g., certain parts effective July 1, 2026; specific dangerousness-related changes effective December 1, 2026).

Who is affected

  • Court system participants (judges, magistrates, clerks, and other court personnel) who assess behavioral health risk and determine disposition.
  • DMH/DD/SUS and the Administrative Office of the Courts, departments responsible for mental health services, and jail/corrections systems.
  • Individuals who are court-involved and may require rehabilitative disposition or treatment services.
  • State psychiatric hospitals, state budget and administrative offices (OSBM), and local sheriffs/jails managing safekeeping warrants.
  • Local governments funding safekeeping beds and related detention costs.

Key timeline highlights

  • By Jan 1, 2027: Enhanced guidance and rehabilitative disposition framework developed and disseminated.
  • December 1, 2027: Required annual/periodic reporting on framework implementation and outcomes.
  • 2026–2027 fiscal year: Major funding starts for behavioral health capacity and safekeeping expansion.
  • July 1, 2026 (effective date for some sections): general effective date for certain provisions; December 1, 2026: new dangerousness standards apply to determinations made on or after that date.

Potential impacts

  • Short-term: Increased investment in behavioral health capacity, staff, and data-sharing infrastructure; expanded safekeeping capacity.
  • Medium-term: More court-referred treatment options, faster access to evaluation/treatment, and potential reductions in pretrial detention for individuals with behavioral health needs.
  • Long-term: Potential reductions in court delays, improved public safety outcomes, and measurable changes in recidivism, with ongoing reporting to oversight committees.

Compiled from official sources — confirm details with the bill’s official record.

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