Summary — SB 2305 (North Dakota) — Family Paid Caregiver Service Pilot Project; appropriation
Status & key dates
- Introduced: March 11, 2025.
- Passed both chambers (Senate 47–0; House 84–6).
- Signed by Governor April 15, 2025; filed with Secretary of State April 17, 2025.
- Enacting language amends North Dakota Century Code §50‑24.1‑47 and provides a one‑time appropriation for FY2026–FY2027.
Purpose
- To create and fund a family paid caregiver service pilot project administered by the Department of Health and Human Services (DHHS) that allows payment to legally responsible family members who provide “extraordinary care” to eligible Medicaid 1915(c) waiver participants (excluding the HCBS aged & disabled waiver).
Key provisions
- Establishment and administration: DHHS shall establish, manage, and operate the family paid caregiver service pilot project and may adopt rules governing the program, eligibility, and exclusions.
- Eligible caregivers and recipients: Payments are made to a “legally responsible individual” who provides extraordinary care to an eligible participant in Medicaid 1915(c) waivers (the aged & disabled waiver is excluded).
- Definition — extraordinary care: Care that (a) exceeds the household tasks a legally responsible person would ordinarily perform for someone without extraordinary medical/behavioral needs, and (b) is necessary to ensure health/welfare and avoid institutionalization.
- Assessment requirement: DHHS must utilize an assessment (evidence‑based where the program is offered through a Medicaid‑approved waiver) to determine level/need for extraordinary care, considering age, activities of daily living, medical needs, and social‑emotional needs. The cross‑disability advisory council will provide input on assessment development and ongoing implementation.
- Payment limits and coordination with Medicaid: Payments must not duplicate services paid through Medicaid 1915(c) waivers or the Medicaid state plan. Caregivers must annually attest they will not seek reimbursement under the pilot for days when other 1915(c) waiver services are paid.
- Payment rate: Payments must be commensurate with the rate for family caregiving in the HCBS aged & disabled waiver (aligned with self‑directed support professional hourly wage/rate language in different drafts).
- Appeals: Applicants may appeal DHHS application decisions under chapter 28‑32. However, denial, reduction, revocation, or termination due to unavailability of pilot funding for the biennium is not appealable.
Fiscal impact / appropriation
- One‑time appropriation of $7,300,000 from the general fund to DHHS for establishing and issuing pilot payments for the biennium July 1, 2025 – June 30, 2027. (Earlier drafts showed $9,000,000; enrolled/second engrossed versions use $7,300,000.)
Who is affected
- Legally responsible family caregivers of Medicaid 1915(c) waiver participants (except those in the aged & disabled waiver).
- Medicaid program administration (DHHS) — rulemaking, assessments, program oversight.
- The cross‑disability advisory council — consultative role.
- State budget — one‑time $7.3M appropriation for the 2025–27 biennium.
Other notes
- Language across drafts refers both to a “pilot project” and to a “program”; final enrolled text treats it as a pilot project with rulemaking and reporting responsibilities.
- The statute contains a “contingent expiration date” note in the header (no date specified in the provided text).
