AN ACT to amend and reenact section 50-24.1-47 of the North Dakota Century Code, relating to the family paid caregiver service pilot project and the cross-disability advisory council; and to provide an appropriation.
SB2305 expands and continues North Dakota’s family paid caregiver service pilot project, which allows the Department of Health and Human Services to make payments to a legally responsible individual who provides extraordinary care to an eligible person enrolled in certain Medicaid 1915(c) waivers. The bill clarifies that the pilot is intended to cover care beyond ordinary household responsibilities when that care is necessary to protect health and welfare and help avoid institutionalization. It also directs the department to use assessments to determine eligibility and the level of care authorized, and it ties payment levels to the family caregiving rate used in the aged and disabled waiver.
The bill also requires the department to manage the pilot within the limits of legislative appropriation, adopt rules for administration, and prevent duplicate payment for care already covered by other Medicaid waiver or state plan services. Participants must annually attest that they will not seek reimbursement for the same extraordinary care on days when other paid waiver services are provided. Decisions under the program may be appealed under the state administrative procedures chapter, but denials or reductions caused by a lack of available funding are not appealable. The bill further requires periodic reporting to the Legislative Management on the pilot’s impact, usage, and costs, and it gives the cross-disability advisory council a formal role in planning, implementation, and assessment design for the pilot and future children’s cross-disability waiver efforts.
SB2305 amends North Dakota Century Code section 50-24.1-47 to refine the legal framework for the family paid caregiver service pilot project and to appropriate $7.3 million in general fund money for the 2025-2027 biennium. It affects the Department of Health and Human Services’ authority to administer caregiver payments, sets standards for eligibility and payment, limits duplication with other Medicaid-funded services, and establishes reporting and advisory requirements. The bill primarily impacts Medicaid waiver participants, family caregivers who are legally responsible individuals, and the department responsible for administering long-term care and disability services.
The bill appears to have broad bipartisan support and little visible opposition. It passed the Senate unanimously and the House by a strong margin, indicating general agreement that the pilot project should be funded and continued. The absence of recorded committee debate in the provided materials suggests the measure was not highly controversial in the legislative process.
The main policy issues embedded in the bill are administrative and fiscal rather than partisan. Potential points of concern include the size of the $7.3 million appropriation, the restriction that payments cannot duplicate other Medicaid services, and the limitation that funding shortfalls are not appealable. Another possible area of interest is the role of the cross-disability advisory council in shaping the assessment method and future waiver design, which reflects a desire for stakeholder input but could raise questions about program implementation and eligibility standards. No specific opposition is shown in the votes or available discussion materials.