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.
HB1012 is the North Dakota Department of Health and Human Services (HHS) appropriations bill for the 2025-27 biennium. It funds HHS operations across salaries and wages, business operations, behavioral health, human services, medical services, and public health, with a grand total appropriation of about $5.79 billion from all funds and about $2.22 billion from the general fund. The bill also includes a number of one-time funding items and targeted grants, such as child care provider support, behavioral health facility grants, guardianship services, housing for individuals with extraordinary medical needs, juvenile justice diversion services, and several public health and crisis-response initiatives.
Beyond appropriations, the bill makes several policy and statutory changes. It creates an extraordinary medical needs housing loan fund administered by the Bank of North Dakota, authorizing low-interest loans for housing construction projects serving individuals with disabilities and extraordinary medical needs. It also amends laws governing HHS property leases, the substance use disorder treatment voucher system, basic care payment rates, and child care assistance residency rules, and it updates membership and staffing provisions for certain advisory bodies, including the opioid settlement advisory committee and the children’s cabinet. The bill further authorizes a line of credit for a child welfare technology project and allows transfers of appropriation authority within HHS under specified reporting requirements.
The bill’s impact on state law is broad because it not only funds agency operations but also directs how certain programs must be administered. It sets conditions for grants, reporting, and matching funds; establishes a moratorium on new intermediate care facility beds; continues or exempts several unspent appropriations; and requires studies or reports on topics such as long-term structured residences, disability services, maternal health access, truancy, dementia coordination, and behavioral health facility expansion. It also includes specific reimbursement and rate provisions affecting Medicaid expansion, managed care, nursing facilities, basic care, and substance use treatment providers.
Overall, the sentiment reflected in the bill’s passage is supportive and pragmatic, with strong legislative backing for maintaining HHS operations and funding priority services. The recorded votes show clear approval in both chambers, suggesting broad agreement on the need for the appropriations and related policy measures. The bill’s structure also indicates a focus on targeted investments in behavioral health, child care, disability services, and rural health infrastructure.
Notable points of contention are likely centered on the size of the HHS budget, the use of one-time funding, and the policy conditions attached to certain programs. Areas that may draw debate include the Medicaid expansion reimbursement limits, the child care residency restriction, the moratorium on new intermediate care facility beds, the use of grant funds without standard procurement procedures, and the balance between state control and provider flexibility in behavioral health and long-term care. The bill also reflects competing priorities between ongoing operating costs and new initiatives such as housing, facility grants, and workforce-related supports.
HB1012 substantially appropriates and reallocates state and federal funds for HHS programs and amends multiple sections of the North Dakota Century Code affecting leases, substance use disorder vouchers, basic care rates, child care assistance eligibility, and advisory committee composition. It creates a continuing loan fund for extraordinary medical needs housing, authorizes a Bank of North Dakota line of credit for child welfare technology, and imposes reporting, transfer, and program administration requirements on HHS and related entities. The bill affects HHS, the Bank of North Dakota, child care providers, behavioral health and substance use treatment providers, basic care facilities, Medicaid expansion managed care, and disability and housing-related service providers.
The overall sentiment appears favorable and bipartisan, with the bill passing both chambers by comfortable margins. The vote totals suggest broad support for the HHS budget and the bill’s mix of operational funding, one-time grants, and policy directives. The bill’s contents indicate a legislative preference for targeted investments in behavioral health, child care, housing, and disability services, while also maintaining oversight through reporting and study requirements.
Likely points of contention include the scale of the HHS appropriation, the use of one-time funding for recurring service needs, and the bill’s detailed policy conditions on providers and grant recipients. Specific issues that may have drawn concern are the Medicaid expansion reimbursement cap, the restriction limiting child care assistance to in-state residents, the moratorium on new intermediate care facility beds, and the ability to award certain grants outside normal procurement rules. Stakeholders most likely to disagree include provider groups, child care advocates, disability advocates, and legislators concerned about fiscal restraint or administrative flexibility.