AN ACT to provide an appropriation for defraying the expenses of various divisions of the department of health and human services; to create and enact a new section to chapter 6-09 of the North Dakota Century Code, relating to an extraordinary medical needs housing loan fund; to amend and reenact sections 50-06-06.6, 50-06-42, 50-24.5-02.3, and 50-33-05, and subsection 1 of 50-36-03 of the North Dakota Century Code and subsection 6 of the new section to chapter 54-07 of the North Dakota Century Code created in section 1 of Senate Bill No. 2176, as approved by the sixty-ninth legislative assembly, relating to leases of department of health and human services property, substance use disorder treatment program, basic care payment rates, state of residence for child care assistance, opioid settlement advisory committee, and children's cabinet; to provide for a transfer; to authorize a line of credit; to provide legislative intent; to provide for a legislative management study; to provide an application; to provide an exemption; to provide for a report; and to provide an effective date.
HB 1012 is the Department of Health and Human Services appropriations bill for the 2025-27 biennium. It provides funding for the department’s major divisions, including behavioral health, human services, medical services, public health, business operations, and salaries and wages, with a total appropriation of about $5.79 billion from all funds and about $2.22 billion from the general fund. The bill also sets out detailed one-time funding items for technology, housing, child care, behavioral health facilities, guardianship services, crisis services, and other targeted programs.
Beyond the budget, the bill makes several policy changes and creates new programs. It establishes an extraordinary medical needs housing loan fund administered by the Bank of North Dakota, authorizes a child welfare technology line of credit, and directs new grants for behavioral health facilities in the northeast and northwest regions. It also adjusts statutes governing department property leases, substance use disorder treatment vouchers, basic care payment rates, and child care assistance residency rules, while adding reporting requirements, transfer authority, and studies on topics such as maternal health, disability services, truancy, dementia coordination, and long-term structured residences.
The bill substantially affects North Dakota’s health and human services funding structure and related statutes. It appropriates operating and grant funding across the department, continues or exempts several prior appropriations, authorizes transfers between line items, and creates continuing appropriations and financing tools for specific projects. Statutory changes include revised rules for leasing DHHS property, expanded and modified substance use disorder voucher funding, a permanent $5-per-day basic care rate increase through June 30, 2027, a residency limitation for child care assistance, and changes to the opioid settlement advisory committee and children’s cabinet provisions. It also creates a new loan program for housing serving individuals with extraordinary medical needs and directs multiple reporting and study obligations to the department and legislative management.
The overall sentiment appears broadly supportive but divided, consistent with a large omnibus appropriations bill that combines core agency funding with many policy directives and targeted projects. The bill passed both chambers, but not unanimously, with notable opposition in the House and some dissent in the Senate, indicating that while the majority supported the department’s budget and key initiatives, a substantial minority had concerns about the scope, spending levels, and policy provisions. The final votes suggest the bill was ultimately accepted as necessary to fund essential health and human services operations and selected priorities.
The main points of contention likely centered on the bill’s size, the level of general fund spending, and the inclusion of numerous one-time grants and policy riders in a single appropriations measure. Specific areas that may have drawn scrutiny include the behavioral health facility grants, the extraordinary medical needs housing loan fund, the child care provider support payments, the basic care rate increase, the medical assistance expansion program reimbursement rules, and the moratorium on new intermediate care facility beds. There may also have been differing views on the bill’s use of special funds, its transfer authority, and the degree of legislative control versus agency flexibility in administering large portions of the appropriation.