A BILL for an Act to create and enact a new section to chapter 50-06 of the North Dakota Century Code, relating to long-term care services for patients with ventilator or psychiatric needs.

69th Legislative Assembly (2025-26) Introduced by Sean Cleary and 4 co-sponsors

Creates four ND regional long-term care districts with in-state providers for ventilator or psychiatric needs, funding incentives, and out-of-state fallback if needed.

Second reading, failed to pass, yeas 5 nays 41

Purpose and intent

SB 2316 would direct the state to organize and expand access to long‑term care (LTC) for individuals who require ventilator support or have significant psychiatric care needs. The intent is to establish regional service capacity within North Dakota, reduce out‑of‑state placements where possible, and provide a funding mechanism to help in‑state facilities care for these higher‑acuity residents.

Key provisions

Creates a new statutory section in NDCC chapter 50‑06 titled “Long‑term care services for patients with ventilator or psychiatric needs.”

Service regions and contracting:

The Department (state department responsible for LTC services) must establish four service regions across the state for providing long‑term care to people with ventilator or psychiatric needs.
The Department shall contract with a provider in each region to deliver those services.

Out‑of‑state care if no in‑state contract:

If the Department cannot contract with an in‑state entity to provide required services, the state shall pay the costs of providing care at a certified long‑term care facility located in another state.

Interstate collaboration:

The Department may collaborate with neighboring states to ensure services are available to patients.

Additional funding to in‑state facilities:

A long‑term care facility that provides documentation that a resident has ventilator or psychiatric needs and was receiving services at an out‑of‑state facility in the prior year becomes eligible to receive additional funding equal to the additional cost of care at that out‑of‑state facility.

Who would be affected

Individuals in North Dakota who require long‑term ventilator support or ongoing psychiatric long‑term care — potentially improved access to in‑state services.

Long‑term care providers in North Dakota — opportunities to contract for regional provider roles and to receive additional funding when admitting certain high‑acuity residents.

State Department administering LTC services — new duties for regional planning, contracting, interstate coordination, and payment/oversight.

State budget — potential increased expenditures for contracting, additional funding to facilities, or out‑of‑state placement costs if in‑state capacity is lacking.

Procedural status and timeline

Introduced: March 11, 2025.

Sponsors: Senators Mathern, Cleary, Lee; Representatives Hendrix, D. Johnston.

Status (as provided): Second reading — failed to pass (yeas 5, nays 41).

If enacted, implementation would require the Department to establish regions, solicit/award provider contracts, and set up procedures for documentation and payment to facilities.

Potential impacts and considerations

Benefits: could reduce the need for out‑of‑state placements, improve continuity of care, and build in‑state capacity for high‑acuity LTC patients.

Challenges: recruiting qualified providers in each region, negotiating contracts, verifying clinical capability (ventilator/psychiatric care), and securing sufficient state funding for contract support and the additional per‑resident payments.

Fiscal: the bill could increase state costs; actual fiscal impact would depend on contracting terms, number of eligible residents, and whether in‑state providers are found.

Bill