[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6386608,"mediaKeyId","2117895-fb58fc2b7378e26789ceb87597423593","parentId",2117895,"title","Hearing on resident-rights bill surfaces privacy, liability and operational questions; Department seeks more stakeholder work","audioSeconds",4004,"startMs",4059000,"endMs",8063000,"viewUrl","/Search/View?dp=1&key=2117895-fb58fc2b7378e26789ceb87597423593&start=4059&end=8063","thumbnailUrl","https://assets.pipeline.soar.com/2117895-fb58fc2b7378e26789ceb87597423593/thumbnail_4059000.jpg","articleUrl","/articles/6386608/North-Dakota/Hearing-on-resident-rights-bill-surfaces-privacy-liability-and-operational-questions-Department-seeks-more-stakeholder-work","mediaUrl","https://secure.pipeline.soar.com/6386608-6ed0573dc7ea93e4866e77f1f38c63e0/orig.mp4?Expires=1771168604&Signature=SBHKERnnoWMk6Z89dI6GGmXTZw1JdKRGlAH3yHlKH~bve2BEmodrIpKaysZps7~JKhndQLnZWtP3xlI3bsFnKo211mH5BytR24O2lDEWn8H3ODlDSjpc8uFLx4ApR4oVQDg8lwhqM65547FpZzGiR3NJWaG6ku5SsnF80SXzbu2WUJ5MvN9505jBk7OTjyReL0Va7DyaNaLn02ThWlpxTRwRCVbKYRssA2cgWAyMIZ1YWckHTbybRrPUi1SIqKxBHs3neYDNgSGPIw5HCTMyVmVC30gAbOp-mdweWaKSNKhZ5NLjXeUOQon0gfSY2pwJowWV79Qfyx0j~TMRrZPgWg__&Key-Pair-Id=KUT5TJCACFTXG","author","Senate Human Services, ND","date","2025-01-14T00:00:00Z","article","The Senate Human Services Committee opened a public hearing on Senate Bill 2070, a Department of Health and Human Services request bill that would revise the statutory resident-rights chapter for long-term care facilities to reflect new technology and clarify transfer, discharge and billing procedures.

Carla Bachman, the State Long Term Care Ombudsman, presented the changes as an effort to update statutory language, protect resident privacy and reduce recurring complaints the ombudsman's office receives about transfers and discharge notices. The bill would rename and expand definitions (for example, distinguishing \"authorized electronic recording\" from \"technology device\" and \"virtual visitation\"), shorten the window for the initial oral statement of resident rights from 30 to 14 days, set more detailed content requirements for transfer and discharge notices, require facilities to make copies of transfer/discharge notices to the ombudsman's office, strengthen anti-retaliation language, and add timeframes for payout of resident personal funds and refunds.

Bachman said stakeholder meetings were held with providers, residents and families and that the Department had revised several provisions after feedback, but she also acknowledged remaining drafting issues and invited further technical conversations.

The hearing drew substantive comment from the field. Marina Spahr, director of the Medicaid Fraud Control Unit in the attorney general's office, supported the bill's goals but urged removal or narrowing of proposed criminal and civil liability waivers she described on page 10, lines 29'31 of the draft. Spahr said a broad waiver could impede investigation of abuse, neglect or financial exploitation and recommended either deleting the waiver or adding language explicitly excluding the AG's investigative authority (for example, language similar to NDCC 32-40-808, as cited in testimony).

Nikki Wagner, president of the North Dakota Long Term Care Association, said association members had participated in drafting discussions but continued to have substantive concerns. Wagner's written and oral testimony listed operational concerns for assisted living and basic care: (1) shortening the oral explanation window to 14 days could overwhelm new residents and conflict with resident-centered orientation processes; (2) language about \"full access to the community\" and certain care-plan expectations could impose obligations that fit skilled nursing facilities but not assisted living or basic care; (3) the right to choose any attending physician may be impractical in rural areas with limited transportation and physician availability; (4) requiring written notice when admission is denied for inability to verify a payment source may be administratively burdensome and could embarrass private-pay prospective residents; and (5) some provisions mirror federal skilled nursing regulations (Appendix PP) that do not neatly map onto assisted-living operations. Wagner urged more time for collaboration between providers, the ombudsman and the department before the committee acts.

Other discussion focused on electronic monitoring and recording. Bachman said the intent was to protect residents by distinguishing devices used for communication/visitation (for example, tablets used for video calls) from devices used to record activity in a resident's private room. The attorney general's office recommended clarifying whether family-owned monitoring devices and facility-owned monitoring systems are both permitted and whether recording should be allowed for virtual-monitoring devices; the AG's office also asked for narrower liability language. Providers asked whether the bill unintentionally would import skilled-nursing regulatory standards into assisted living and basic care; they requested specific wording changes and asked for more time to reach agreement.

Committee members responded by asking the ombudsman to share her annual report and by encouraging the parties to pursue technical fixes. Committee members emphasized that while they support stronger resident protections, many provisions present operational challenges across different levels of care and would benefit from additional stakeholder drafting. The ombudsman and provider representatives said they would continue to meet and attempt to narrow disagreements.

No committee vote was taken; senators asked the parties to reconvene and bring recommended language back to the committee.","mediaType","Video","parentTitle","Senate Human Services Jan 14, 2025","oneSentenceSummary","Senate Bill 2070 would revise and broaden resident rights for long-term care facilities, adding new definitions for \"authorized electronic monitoring\" and requirements on transfers, billing and pharmacy choice; witnesses urged more consensus work to resolve privacy, liability and assisted-living implementation concerns.","taxTitle","Human Services, Senate, Legislative, North Dakota","taxId",28905,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6386611,"Committee moves bill to remove prior authorization for children on five or more psychotropics and to add trigger for discriminatory rebate offers",8693,2213000,10906000,"/Search/View?dp=1&key=2117895-fb58fc2b7378e26789ceb87597423593&start=2213&end=10906","https://assets.pipeline.soar.com/2117895-fb58fc2b7378e26789ceb87597423593/thumbnail_2213000.jpg","/articles/6386611/North-Dakota/Committee-moves-bill-to-remove-prior-authorization-for-children-on-five-or-more-psychotropics-and-to-add-trigger-for-discriminatory-rebate-offers","https://secure.pipeline.soar.com/6386611-2fc80d76c55ef55671f4d5cc3c6de374/orig.mp4?Expires=1771168604&Signature=TNk6F5LnlMYerRX01DvuTdARgoTiGQIsb0oPehzh7hX8OC6WpGRPV8PRE9Lc~vfY~tm5Ry11Da58vPPwTqkWVv3Tlkjx4e6JoDH0ZUYzRsRA-YEJHDE-PK710l~PVG9SDEP0ZQY0flBQniZ35W2GAGLLHHDoaRjGEHyrEP523xhp5gx4r0YMbVChPPFXJgoZLa1GW1ZovK4jj9kQEhYdqTRxvTt6kDblN4D0k8kn0RiglyyHwNRguh76-sBFEVIypVva249IjR3DApSxMgbmIyv4fHJr7TymOH35d5oABo7~-0IfEogYyJ0suKYYZdFqUrBZeq8Ucn9vNpThI85iMg__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Human Services Committee on Monday advanced Senate Bill 2076 after hearing technical explanation from the Department of Health and Human Services and emotional testimony from caregivers.

The bill has two distinct components. First, the Department seeks to remove an existing statutory requirement to prior authorize psychotropic medications for children who are on five or more concurrent psychotropic prescriptions. That requirement was enacted in 2019 with an administrative estimate that only about a dozen children would be affected. Department witnesses said that, after programming and policy changes and after carving pharmacy out of managed care, the number of children meeting that threshold rose to about 78, later to roughly 120, and currently hovers near 100 depending on seasonal variation. \"It's nowhere close to 12,\" Department pharmacy director Dr. Bridal Joyce told the committee, and the department proposed removing the automatic prior-authorization requirement because implementing statewide prior authorization for a much larger caseload would be disruptive.

Second, the bill would add narrowly written language that lets the department trigger prior authorization for specific medication categories if manufacturers make discriminatory supplemental-rebate offers that would otherwise favor out-of-state pricing. Dr. Joyce explained that the state participates in a multistate rebate pool and has seen offers that would give other states materially larger supplemental rebates because North Dakota statute excludes specified drug classes from prior authorization. Those offers, she testified, can lead manufacturers to offer lower net prices to states without the exclusion. The proposed trigger would allow the department, when presented with a discriminatory supplemental-rebate offer, to impose prior authorization on the affected category so the state can secure comparable pricing. Joyce described the proposal as a protective, limited response to market tactics: \"We don't want to remove the exclusions. We need to respond to discriminatory offers.\"

Parents and other witnesses opposed the idea of prior authorization; several described difficult experiences with Medicaid coverage and the risk that delays in psychotropic medication could harm people in crisis. Chrisanna Peterson, a Bismarck parent whose adult son receives disability services and Medicaid, testified that prior authorization processes can be slow and disruptive for people in urgent need and asked the committee to oppose any measure that would gate medications for vulnerable people.

Committee members debated the trade-offs. Senators expressed concern about North Dakota's high ranking on several quality measures: the department reported the state remains near the top nationally for children receiving high numbers of psychotropics and for long-stay nursing home residents receiving at least one antipsychotic. Members asked for more data on prescribing patterns by provider type and on foster-care and Medicaid subpopulations. Dr. Joyce said the department already produces data and direct physician outreach and described ongoing efforts to send individualized letters to prescribers showing their prescribing rates compared with peers.

On the supplemental-rebate topic, witnesses described schematic examples of pricing and rebate percentages and explained how a discriminatory supplemental offer can materially change net costs. Dr. Joyce said the proposed trigger would apply only when a manufacturer explicitly conditions a superior supplemental-rebate offer on a state's ability to prior authorize an excluded category.

Senator Rohrs moved a \"do pass\" recommendation; Senator Hogan seconded. The committee called the roll and recorded a unanimous recommendation to advance the bill: Chair Lee (yes), Senator Weston (yes), Senator Rohrs (yes), Senator Hogan (yes), Senator Van Oosten (yes), Senator Clements (yes). Senator Rohrs volunteered to carry the bill.

The hearing included both technical policy discussion and personal testimony about care access. The department and advocates agreed to continue data collection and follow-up with committee members on provider-level prescribing breakdowns and foster-care data. The committee advanced the bill to the next stage with unanimous support from the members present.","Senate Bill 2076 would remove a statutory requirement to prior-authorize psychotropic medications for children on five or more concurrent prescriptions and would add a narrowly defined trigger allowing the state to activate prior authorization for a drug class when manufacturers offer discriminatory supplemental rebates.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6386621,"Senate Human Services Committee advances bill updating dementia care services program",1476,637000,2113000,"/Search/View?dp=1&key=2117895-fb58fc2b7378e26789ceb87597423593&start=637&end=2113","https://assets.pipeline.soar.com/2117895-fb58fc2b7378e26789ceb87597423593/thumbnail_637000.jpg","/articles/6386621/North-Dakota/Senate-Human-Services-Committee-advances-bill-updating-dementia-care-services-program","https://secure.pipeline.soar.com/6386621-2ae6b2a24500b00c44f5e7f40b2bd01f/orig.mp4?Expires=1771168604&Signature=TfuF34B9bH6Dz0wG8TDkbk7CAqd~zbsdK8GAGaIgwn7iK817sEHoaQ3Sat5BCTW4S9Do8mcA8yZoor1Fn79YP-GCaKi0v9G-NsKnfRUikUzYQEAIgBWgiyW~tHbEf5YFtckmgLDkkep45jLNlzdhgAh4sF3wLuvDS7AMay~yU28Ga3V9hMux1OzmmsPVEKbz7E-A9gz14dRxMSl1KDUXFhjNHOOEQbs4s6lln6OmE61doOFvfPiq1H2ZzJznh7TQXPZWSOiukqpTvdMNceLqH1FOnvFZrBK-OO2aQrxbC55jEpGt~VjzvTxEChyCxdU5VlS0vsEL3aybciU2Z-IbzQ__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Human Services Committee on Monday advanced Senate Bill 2140, a Department of Health and Human Services-requested update to the state's dementia care services authorizing statute.

Supporters, including the Alzheimer's Association and state adult and aging services staff, told the committee the bill revises definitions and program language that date to 2009 to reflect current diagnostic tools, biomarker testing and the growing understanding that Alzheimer's disease exists on a continuum rather than appearing only in late stages.

Melanie Gaby, North Dakota policy director for the Alzheimer's Association, told the committee the changes are technical and do not alter the program's purpose. \"We now have the ability to accurately diagnose Alzheimer's disease through a combination of standard cognitive exams, biomarker testing, and amyloid PET scans,\" Gaby said. \"This understanding is the reason we propose removing the definition of dementia and replacing it with a definition of who our clients are.\" She said the goal is to bring the statute into alignment with research and ensure services remain available to families and professionals.

Scott Bernstein, executive director of Guardian and Protective Services, described the association's long partnership with the state and said the bill preserves a government-nonprofit model that delivers training and direct consultation to families, memory-care staff and health professionals. Nancy Nicholas Meyer, director of Adult and Aging Services at the Department of Health and Human Services, told the committee the Alzheimer's Association performed an average of 631 care consultations per month in state fiscal year 2023 and delivered professional and public training reaching an average of 107 participants per month. Meyer said the department and the Alzheimer's Association agree the proposed language changes \"are positive and align with the current needs for this program\" and that no fiscal note accompanies the bill.

Desiree Sorensen, director of the Mountrail-McKenzie Human Service Zone, described how human service zones and qualified service providers rely on dementia training and resources to respond when people with dementia display concerning behaviors in the community. She said timely training for direct care providers and local partners such as law enforcement and EMS is critical.

Committee members asked technical questions about definitions and examples. Senators and witnesses discussed the difference between dementia (an umbrella of symptoms) and specific causes such as Alzheimer's disease, Lewy body dementia or frontotemporal disorders; Gaby, who holds a doctorate and a policy role with the Alzheimer's Association, provided scientific context and examples.

Senator Rohrs moved a \"do pass\" recommendation; Senator Weston seconded. The committee called the roll: Chair Lee (yes), Senator Weston (yes), Senator Rohrs (yes), Senator Hogan (yes), Senator Van Oosten (yes) and Senator Clements (no). The committee recorded five votes in favor, one opposed; the bill was forwarded from committee with a favorable recommendation. Senator Clements volunteered to carry the bill.

The bill updates statutory language that currently authorizes the dementia care services program and clarifies program clients and services. Supporters emphasized the change is primarily technical: to update definitions and incorporate modern diagnostic and treatment realities while maintaining the existing statewide partnership between the state and the Alzheimer's Association.

No formal opposition testimony was offered at the hearing; the committee record includes additional written testimony in support, including from the Center for Rural Health.

The committee set no further changes on the record; sponsors and witnesses indicated willingness to answer follow-up questions and to provide materials posted with committee documents.

The advance of SB2140 sends the bill to the next step in the legislative process with the committee's endorsement.","The committee heard support testimony and unanimously advanced Senate Bill 2140 to update statutory language that authorizes North Dakota's dementia care services program, with supporters saying the changes align the law with modern diagnostics and care.","actionData","errors"]

Article not found

Hearing on resident-rights bill surfaces privacy, liability and operational questions; Department seeks more stakeholder work

Committee moves bill to remove prior authorization for children on five or more psychotropics and to add trigger for discriminatory rebate offers

Senate Human Services Committee advances bill updating dementia care services program