The North Dakota Legislature met January 21 – 23, for a Special Session primarily to address the Rural Health Transformation Program (RHTP).
Appropriation for RHTP passes:
North Dakota was awarded $198.9 million for the first year of the RHTP, which required the Legislature to appropriate ND HHS to spend. Since the funds are tied to specific distribution timelines as determined by the Center for Medicaid and Medicare Services (CMS), the legislature was required to act outside the normal biennial legislative session. The legislature passed the appropriation for a total of $397.8, which included an appropriation for ND HHS to spend the same amount for the second year of the RHTP as an estimate since the legislature won’t meet again until January 2027.
The appropriation bill also includes authority for the Bank of North Dakota to provide $40 million in bridge loans for RHTP grant applications where organizations need gap funding until reimbursement is available from the RHTP.
RHTP Policy Related Bills:
Fifty percent of the funding for RHTP was distributed equally among all approved states that applied. Another 50% of the funding was awarded based on a variety of factors that included policy recommendations to enhance access and quality of care in rural communities.
An interim legislative committee on RHTP reviewed the policy recommendations and selected four policy actions that North Dakota had not already adopted to consider during the special session. Passing the policies has the potential to increase future funding ND receives from RHTP.
The four RHTP policy bills all passed and included:
- Require participation in the Presidential Physical Fitness Test in physical education curriculum in elementary, middle, and high schools in ND. The test was included in North Dakota’s physical education requirements in the past but is not currently. The current Presidential administration seeks to reinstate the standard nationally.
- Require physicians to obtain 1 hour of nutrition focused continuing education every renewal cycle (every other year).
- Join North Dakota to the Physicians Assistant (PA) licensure compact. The compact has already been adopted by 18 other states as of the time of this article. Physician Assistants with licenses in compact states will be granted privilege to practice in North Dakota.
- Expand pharmacists’ prescriptive authority and allow for therapeutic substitutions. This bill includes a limited expansion of a pharmacist’s ability to prescribe certain allowable medications and devices at a pharmacy. This will also allow pharmacists to order laboratory tests and offer therapeutic substitutions (different that generic substitutions) with certain exclusions.
Non-RHTP Related Policy Bills
While the scope of the special session was focused on RHTP, legislators used the opportunity to propose other bills for consideration. Legislative Management was directed to review 19 proposed bills and selected seven for consideration during the special session.
- Two bills related to providing free school lunches were defeated. A bill that would have required public school districts to offer one school breakfast and one school lunch each school day at no cost by establishing a school meals fund in the department of public instruction passed the House but was defeated by two votes in the Senate. A second bill would have established a small fund for grants to schools that applied to help offset the costs of providing school meals at no cost to students whose household income did not exceed 300% of the federal poverty level failed in the House and did not make it to the Senate.
- Passed a $5 million appropriation to the Medical Facility Infrastructure Loan Fund administered by the Bank of ND to keep the hospital in Elgin, ND from closing.
- Passed a property tax credit correction bill so the primary residence property tax credit applies after any other exemptions or credits (ie 5% early payment discount) to maximize the property tax savings for homeowners.
- Passed one time funding for Information Technology department to complete digital accessibility compliance upgrades and the Public Service Commission to support federal lawsuit intervention efforts.
- Passed a bill allowing the sale of a small parcel of land on the Ray Richards Golf Course owned and operated by the University of ND in Grand Forks, which was donated to the University by a family endowment. The Department of Transportation will purchase 6.5 acres of the golf course for a traffic project. UND requested to use up to $4 million from the sale to spend on capitol improvements for the Golf Course.
- Passed a resolution to recognize and congratulate the YMCA on it’s 175th anniversary.
If you have any questions about the topics or logistics of the session, please reach out to Kim Kuhlmann, External Affairs Manager in ND.
CHAD will continue to monitor, analyze, and provide assistance with the RHTP process for our members.
Sign up to receive updates directly from the ND HHS Rural Health Transformation Program webpage.
