[{"_1":2,"_112":-5,"_113":-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",[32,76,88,100],{"_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",6571609,"mediaKeyId","3156919-ebfac4f5d79da1a753e4c3993f469b7e","parentId",3156919,"title","Committee debates language giving Medicaid rate-adjustment authority to department; staff seek clarity on legislative oversight","audioSeconds",763,"startMs",2734000,"endMs",3497000,"viewUrl","/Search/View?dp=1&key=3156919-ebfac4f5d79da1a753e4c3993f469b7e&start=2734&end=3497","thumbnailUrl","https://assets.pipeline.soar.com/3156919-ebfac4f5d79da1a753e4c3993f469b7e/thumbnail_2734000.jpg","articleUrl","/articles/6571609/North-Dakota/Committee-debates-language-giving-Medicaid-rate-adjustment-authority-to-department-staff-seek-clarity-on-legislative-oversight","mediaUrl","https://secure.pipeline.soar.com/6571609-d82375cdbbd32365f310e697269243d3/orig.mp4?Expires=1770960912&Signature=Gkx8lBVuvgIeE2qTdxaHurIjCclZ-ka73jNELMdMAfU935Cs44Pavso7yyetxdPujWjHgUUyM0J0oT8V9nfkZzcWI31fVnrNX6KDBo-MgdYJ0y5w0~4lthAGoc2IX0AODz-IHOikR~RlcDYkGWy-AT5-a~XX7j586Hi~C1Q4Pv61Y8LwLmbGTjwpkEAmx~mODCGeqhd4z6ilmjbiCGcHI1BQTTCVCc9eDvaHWFCDoSjs0KJwmnJ7Bx4FFoHpkX3JJl5Yfl50p-oX0-vZkH72T8JoUaFK-Vhy93mFjnoUJnsD1rBt-6xE1P~wTrEQ-Zjyp6lVPUcQ~2ne8boD3qjBLg__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota Legislature","date","2025-04-30T00:00:00Z","article","The conference committee discussed proposed language in HB1012 (section 31) that would state legislative intent for the Department of Health and Human Services to review Medicaid utilization and, if needed, implement adjustments to keep the program cost effective.

Sarah Acre, executive director of the Division of Medical Assistance, told the committee the department seeks authority to manage Medicaid efficiently in the face of federal uncertainty and utilization changes. “I think in terms of what we're hearing from, DC these days, there's still a lot of uncertainty... I think we're getting a little tight, in terms of our preparations. And so wanna make sure that we are doing our best to control costs,” Acre said, adding that changes requiring administrative rules, state-plan amendments or other formal actions would continue to follow existing public-comment and tribal-consultation processes.

Committee members raised concerns about the breadth of language that would allow the department to \"implement any adjustments the department determines appropriate,\" saying it could be interpreted as granting broad authority to change amounts, duration or covered services without prior legislative review. Senator Plurio said striking that phrase would be appropriate because otherwise \"we're abdicating some of our responsibility\" and constituents would ask why cuts occurred without legislative action.

Several conferees suggested a middle path: keep department authority to manage utilization but require interim oversight, for example by reporting proposed adjustments to a legislative budget or budget section before implementation. The committee did not adopt final language at this meeting; members agreed to reconvene at 1:00 p.m. after consulting counsel and checking current Century Code delegation language.

Donna (staff) and other committee members said the language in question is legislative intent rather than a change to Century Code; the committee asked staff to confirm whether the current statutory delegation exists and to bring legal counsel for the 1:00 p.m. meeting. \"If we remove the language that would also be satisfactory. We just default to normal operating practices,\" one staff member said. The committee agreed to hold the issue for further legal review and a later decision.","mediaType","Video","parentTitle","HB 1012 Conference Committee Apr 30, 2025","oneSentenceSummary","Conferees debated proposed HB1012 language that would authorize the Department of Health and Human Services to review Medicaid utilization and, as necessary, implement adjustments to control costs amid federal uncertainty.","taxTitle","House of Representatives, Legislative, North Dakota","taxId",28308,"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},6571614,"Conference committee adopts modified early childhood package, including infant/toddler fund and working-parent subsidy increase",1293,1116000,2409000,"/Search/View?dp=1&key=3156919-ebfac4f5d79da1a753e4c3993f469b7e&start=1116&end=2409","https://assets.pipeline.soar.com/3156919-ebfac4f5d79da1a753e4c3993f469b7e/thumbnail_1116000.jpg","/articles/6571614/North-Dakota/Conference-committee-adopts-modified-early-childhood-package-including-infanttoddler-fund-and-working-parent-subsidy-increase","https://secure.pipeline.soar.com/6571614-8a05e88ff036c9cd40b297ec0ed6abce/orig.mp4?Expires=1770960912&Signature=TdnXETpXT-MwkZhyfyPFz2w181rgtVPgjqrF9rsf3-edh-bcyuF5RnQnaEUSdlnICmNboIIqU~Sv9Xwm83Zoz6jiwoDyQUVBPnQatevZ7kvDUaaS-x7wqO7~sHi8wqkB8l7wYsF5k~7IzbuPY7KyZMiHvFR53Xp79vGewDQbPvnd0LAOwSz14VeUIdd4ZH5VDn29ry1j9qpvaTHJQyyQ94mz3vurCzNYY6PtRwsNOVMNpH-W1dPXtIy86He0AOXDqSyOyutp-dsO4oJ0O8kzm9hhT5rsPV8ijdrLhwNWNPxPKpMReqzjPvNvTcTLBCsBHgyq~ERZUQ~jMjAT4XSXxQ__&Key-Pair-Id=KUT5TJCACFTXG","The conference committee on House Bill 1012 approved a modified early childhood funding package that adjusts several programs and adds a new infant- and toddler-focused provider reimbursement fund.

Senator Cleary outlined the Senate’s proposal to prioritize services for children ages 0–3 and described the new infant and toddler provider fund included in the Senate version of HB1012. “Essentially, what this does is provides a monthly reimbursement at a level of $200 per infant and a hundred and $15 per toddler,” Cleary said, explaining the fund is intended to help providers cover the higher staffing ratios and costs for infants and toddlers.

The package approved by the committee makes the following changes (as stated in committee discussion):
- An infant and toddler provider fund (Senate language) with adjusted funding of $11,000,000 (down from $13.5 million in the Senate proposal). The fund is intended to reimburse providers monthly for infants at $200 and toddlers at $115 to reduce losses providers incur serving 0–3-year-olds.
- Waterford funding reduced and designated as one-time funding at $1,500,000, with the committee directing the Department of Human Services to target the program to families lacking preschool access.
- Best-in-class program funding reduced to a $2,000,000 increase above a $12,000,000 base (for a total of $14,000,000 in committee discussion).
- Childcare grants, resources and shared services increased to $3,000,000 (committee agreed to raise the House’s reduced amount slightly).
- Quality rating bonuses retained at the House level (the committee kept the House-recommended $1.5 million for bonuses but discussed moving funding if necessary to avoid double-paying providers receiving both bonuses and the new provider fund).
- The working-parent subsidy (a subsidy, not a tax credit) will receive $2,200,000 in carryover funding to preserve current participants; committee discussion noted this would preserve the program at current utilization levels while the committee considers improvements.

Jessica Thomas of the Department of Human Services told the committee there were 278 participating families as of February and that maintaining current participation at the $300-per-family-per-month match would cost “right around $2,000,000” for the next biennium.

Representative Ms. Cotton urged the committee not to reduce child-care funding, saying, “North Dakotans property tax, housing, childcare. I mean, I can't go home and go backwards on childcare.” Several conferees expressed a desire to stay within the governor’s recommended total for childcare while better targeting funds to infants and toddlers.

Senator Davidson moved the revised package with the Waterford program funded as one-time and an added $2.2 million to the working-parent subsidy; Senator Cleary seconded. The committee took a roll-call vote: Chairman Nelson voted no, Representative O’Brien, Representative Mitscog, Chairman Dever, Senator Cleary and Senator Davidson voted yes. The motion passed 5-1.

Committee members agreed to revisit administrative details (for example, whether Waterford administration should move to the Department of Public Instruction) and to monitor program execution; they also asked departments to provide targeting and utilization data during follow-ups.","The committee approved a negotiated early childhood package that creates an infant and toddler provider fund, reduces Waterford funding to one-time, funds childcare grants and quality bonuses at adjusted levels, and adds $2.2 million carryover for the working-parent subsidy. The motion passed 5-1.",{"_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},6571619,"Committee rejects proposed higher provider inflator; motion to set inflator at 2% fails",176,847000,1023000,"/Search/View?dp=1&key=3156919-ebfac4f5d79da1a753e4c3993f469b7e&start=847&end=1023","https://assets.pipeline.soar.com/3156919-ebfac4f5d79da1a753e4c3993f469b7e/thumbnail_847000.jpg","/articles/6571619/North-Dakota/Committee-rejects-proposed-higher-provider-inflator-motion-to-set-inflator-at-2-fails","https://secure.pipeline.soar.com/6571619-c60f020a89a225e412f83a1d4e378cd1/orig.mp4?Expires=1770960912&Signature=EB4lqjO5mmsJiUCGUJxtR~~yqHMM4bz0rcce-mORKxIg~fuD7yqTAJw~T3w-tyslI-E~n3~QyYNq~YVcdJfXxGL1I77fN7nAN6qBKvrY8StNH2rC0bZXbz5J3dn5aGR9KULwigAdvyTyflrHp3PFlFK92sWb1gT3h1gz0aVtccD7KMzXXfkdmKfF-QDORUJVtisoBfFK0k3eYrs8jVxsUo6dbiRpO0ApIi~0x71gLRhFiG4naY36an3BOH1Hg-ui33jvdImi4L~yfDwCTBg7D~A6sE3Ze1Ea4k~I4Bo4xCTdeLvJeu-NvrZxIj3hEC7RVBQGVXU0zvKWu4rtkEi8cQ__&Key-Pair-Id=KUT5TJCACFTXG","The conference committee debated increases to provider reimbursement inflators and rejected a motion to adopt a higher inflator.

At the start of the inflator discussion Senator Cleary moved to “move the inflator to 2 and 2.” The motion was seconded and committee members discussed budget impacts and workforce considerations. One member summarized the fiscal effect: “It's state, yeah general fund is 2.5. Federal is 2.5. So it's about a near a dollars 5,000,000 total but 2.5 general fund which is what we're most concerned with in this exercise.”

Supporters argued that inflator increases were necessary to stabilize provider workforces; opponents said other targeted investments would be preferable. After a roll-call vote the motion failed, with Chairman Nelson, Representative O’Brien, Representative Mitscog, and Chairman Dever voting yes and Senator Cleary and Senator Davidson voting no. A committee member announced, “No. That motion fails.”

The committee then moved on to other budget items without adopting the proposed inflator increase.","A motion to set the provider inflator to 2% general fund/2% federal fund failed after committee debate about workforce impacts and program targeting.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6571624,"Conference committee accepts Senate position to remove state hospital funding and steering committee from HB1012",398,412000,810000,"/Search/View?dp=1&key=3156919-ebfac4f5d79da1a753e4c3993f469b7e&start=412&end=810","https://assets.pipeline.soar.com/3156919-ebfac4f5d79da1a753e4c3993f469b7e/thumbnail_412000.jpg","/articles/6571624/North-Dakota/Conference-committee-accepts-Senate-position-to-remove-state-hospital-funding-and-steering-committee-from-HB1012","https://secure.pipeline.soar.com/6571624-f473ca0779db7c7d1c314ea1e03390b1/orig.mp4?Expires=1770960912&Signature=MCyMF2ZhiEQk1zTB3PCVw8JW7e57t6qnKT--gAWr2EKdY-7ZvKjdp8ivj8w9KbixI8-lPY2ICbWCYWeWTEu~dzbpzGSa-RRXxyMSFgvhA-K5Tro8rD94QTjLUBzfq53xNBih-NB~KUCxFNprlK~9q1gH1daMpXQKzoCWjmx2cz0ffB8GbtJ4HckzpDWhrx01q~9uulaZEDoMWzy2j~nZgeD~-BKXnOHYkSbcUymljmlPA~YcNGRWgf5JaGFKIr-s4TEwirQKq0dvZf4QknLJcuQhdIwSnkwwKbCc4fe3Ums73roK3iMrtSoFbmSJ~Parou79tiEzct9tEImqgpqjLg__&Key-Pair-Id=KUT5TJCACFTXG","The Conference Committee on House Bill 1012 voted unanimously to accept the Senate’s position to remove direct state hospital construction funding and to eliminate a steering committee provision from HB1012.

Committee Chairman Nelson called the roll and Representative O'Brien moved that the committee “accept the senate's position to reduce the state hospital funding where that would be at 0 and then remove section 21 which is the steering committee.” The motion was seconded by Senator Davidson and passed 6-0 with votes recorded from Chairman Nelson, Representative O’Brien, Representative Mitscog, Chairman Dever, Senator Cleary and Senator Davidson.

Representative O’Brien told the committee the state hospital item has been moved to House Bill 1015, the Office of Management and Budget bill, and summarized the Senate proposal: “it's a $200,000,000 appropriation from SIF, a hundred million dollar line of bridal. And then it would remove the steering committee, which would go underneath the office of management and budget.” He added the OMB would oversee construction administration and that the steering committee language would be included in HB1015 under OMB oversight, with seats for the Department of Health and Human Services, OMB, the governor’s office and legislative appointees from both chambers.

Representative O’Brien said the House’s original position had been larger: “the HR position on the state hospital it was $300,000,000,” but described the current approach as intended to get construction started this summer and to provide oversight through the OMB-established steering committee in the other bill.

The committee did not adopt any amendment that kept funding or the steering committee language in HB1012; the formal action removes those items from HB1012 and moves them to HB1015 as described.

The committee proceeded to other budget items after the vote and did not take further action on the state hospital language in this meeting.","The conference committee on House Bill 1012 voted 6-0 to accept the Senate position that removes state hospital construction funding and eliminates a steering committee, moving construction appropriations and oversight language into House Bill 1015 under the Office of Management and Budget.","actionData","errors"]

Article not found

Committee debates language giving Medicaid rate-adjustment authority to department; staff seek clarity on legislative oversight

Conference committee adopts modified early childhood package, including infant/toddler fund and working-parent subsidy increase

Committee rejects proposed higher provider inflator; motion to set inflator at 2% fails

Conference committee accepts Senate position to remove state hospital funding and steering committee from HB1012