25.0909.02001
Title.03000
Adopted by the Human Services
Committee
Sixty-ninth
February 4, 2025
Legislative Assembly
of North Dakota
Introduced by
Senators Hogan, Cleary, Lee, Weston
Representative Dobervich
A BILL for an Act to amend and reenact section 50-24.1-47 of the North Dakota Century Code,
relating to the family paid caregiver service programpilot project and the cross-disability
advisory council; and to provide an appropriation.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. AMENDMENT. Section 50-24.1-47 of the North Dakota Century Code is
amended and reenacted as follows:
50-24.1-47. Family paid caregiver service pilot projectservices program - Report.
(Contingent expiration date - See note)
1.The department shall establish manage and operate the family caregiver service pilot
project to assist in making paymentssubmit an amendment to all current Medicaid
1915(c) waivers and those to be developed to provide payment for family caregiver
services. The payment must be made make payments to a legally responsible
individual who provides extraordinary care to an eligible individual who is a participant
in the Medicaid 1915(c) waivers, excluding the home and community-based services
aged and disabled waiver.
2.The family paid caregiver service pilot project mayprogram must include funding for
extraordinary care, which means care:
a.Exceeding the range of activities a legally responsible individual would ordinarily
perform in the household on behalf of an individual without extraordinary medical
or behavioral needs; and
Page No. 1 25.0909.02001
SENATE BILL NO. 2305
PROPOSED AMENDMENTS TO
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b.Is necessary to assure the health and welfare and avoid institutionalization of the
individual in need of care.
3.The department may adopt rules addressing management of the family paid caregiver
service pilot project and establish the eligibility requirements and exclusions for the
family caregiver service pilot project. The department shall manage and operate the
family paid caregiver pilot project in accordance with the adopted rules and within the
limits of legislative appropriation for the family paid caregiver pilot project. The
department shall utilize an assessment of an eligible individual to determine the need
for extraordinary care which must consider the unique needs and circumstances of
applicants including age, activities of daily living, medical needs, and social emotional
needs. The department may not make payments to a legally responsible individual
which duplicatelevel of care authorized and to determine the best interests of the
individual in need of care. The pilot project may not provide a payment for any care
that is otherwise compensated through a service or assistance provided, administered,
or supervised by the department, including Medicaid 1915(c) waiver or the Medicaid
state plan. A legally responsible individual shall attest on an annual basis that the
legally responsible individual agrees not to seek reimbursement for extraordinary care
through the family paid caregiver service pilot project on days when other 1915(c)
waiver services are paid by the department.
4.A decision on an application which is issued by the department under this section may
be appealed as provided under chapter 28-32. An individual may not appeal a denial,
a revocation, a reduction in payment, or the termination of the family caregiver service
pilot project administered by the department due to the unavailability of funding
received for the purpose of issuing payments as part of the family caregiver service
pilot project for the biennium.
5.The department shall provide the legislative management with periodic reports on the
impact, usage, and costs associated with the family caregiver service pilot projectA
payment under this section to a legally responsible individual must be commensurate
with the current self - directed support professional hourly wage rate for family
caregi v ing in the home and community-based services aged and disabled waiver .
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4. When a family paid caregiver service program is available through a Medicaid-
approved home and community - based services waiver, the department shall use an
assessment to determine the level of care authorized which must consider the unique
needs and circumstances of all applicants including age, activities of daily living,
medical needs, and social emotional needs. The assessment must be evidence-
based. The family paid caregiver service program may not provide a payment for any
care that is otherwise compensated through a Medicaid 1915(c) waiver or the
Medicaid state plan.
5. A decision on an application which is issued by the department under this section may
be appealed as provided under chapter 28 - 32. An individual may not appeal a denial,
a revocation, a reduction in payment, or the termination of the family paid caregiver
service program administered by the department due to the unavailability of funding
received for the purpose of issuing payments as part of the family paid caregiver
service program.
6.The cross-disability advisory council under section 50 - 06 - 46 shall participate with and
provide feedback to the department on the planning, design, and ongoing
implementation of the family paid caregiver service program pilot project and future
centers for Medicare and Medicaid services children's cross-disability 1 915(c) waiver .
The council shall provide input into the development of the assessment method used
to determine the level of care authorized for an individual need for extraordinary care .
SECTION 2. APPROPRIATION - DEPARTMENT OF HEALTH AND HUMAN SERVICES -
ONE-TIME FUNDING - FAMILY CAREGIVER SERVICE PILOT PROJECT. There is
appropriated out of any moneys in the general fund in the state treasury, not otherwise
appropriated, the sum of $9,000,000, or so much of the sum as may be necessary, to the
department of health and human services for the purpose of establishing and issuing payments
as part of the family paid caregiver service pilot project, for the biennium beginning July 1, 2025,
and ending June 30, 2027.
Page No. 3 25.0909.02001
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