All Roll Calls
Yes: 136 • No: 2
North DakotaHB 16232025 Special SessionHouseWALLET
AN ACT to provide an appropriation to the department of health and human services for federal rural health transformation program grant funds; to provide an appropriation to the Bank of North Dakota to administer a loan program; to provide for a transfer; to amend and reenact section 6-09-47 of the North Dakota Century Code, relating to a rural health loan program under the medical facility infrastructure loan fund; to provide an exemption; to provide for a legislative management report; to provide for application; to provide a report; and to provide an effective date.
Sponsored By: Legislative Management
Became Law
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
$398 million for rural health projects
The law provides $397,873,940 in federal funds to the state health department for rural health transformation projects. The money is available from the law’s effective date through June 30, 2027. The budget office may shift this funding between this act and certain DHHs lines in House Bill 1012 at the department’s request and must notify the Legislative Council. Transfers to the salaries and wages block grant are not limited by House Bill 1012’s usual cap. If DHHS awards funds to another state agency, the budget office may raise that agency’s federal‑fund authority by the same amount and must notify the Legislative Council. Grant agreements must state the funding ends when the federal program ends, and DHHS may require process and outcome measures from grantees.
Short-term gap loans for rural clinics
Clinics and health providers approved for a federal Rural Health Transformation grant can get short‑term gap loans. The Bank of North Dakota runs the program, with interest up to 2% and terms up to 3 years. Applicants must show DHHS/CMS grant approval and financial need. Up to $40 million of the Bank’s earnings moves into the loan fund through June 30, 2027, and that money may be used only for this program. The Bank also gets $600,000 and four staff to administer it. Principal payments replenish transferred Bank profits, and interest goes back into the fund.
Low-interest construction loans for medical facilities
The state offers low‑interest construction loans to medical facilities through a revolving fund run by the Bank of North Dakota. Eligible applicants are facility governing boards with projects of at least $1,000,000 that will be used for 30 years, and they must show need and long‑term viability. Loans are capped at the smaller of $15,000,000 or 75% of project cost, carry a 2% rate, and can run up to 25 years. Construction must finish within 24 months of loan approval or the borrower may forfeit the loan. The Bank may charge an annual service fee, the fund is audited, and repayments flow back into the fund.
Easier buying for grant-funded projects
Projects paid with this law’s rural health funds get streamlined purchasing. Agencies can use an alternate process to hire architects, engineers, and similar consultants for funded public improvements. Equipment and supplies bought with these funds may be transferred if allowed by the federal program. Eligible entities may use cooperative purchasing if it follows federal program rules. Buying routine items like training materials, memberships, or online access is allowed under simpler terms when no personal data is shared and security is not affected.
Sponsors & Cosponsors
Sponsor
Legislative Management
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 1/23/2026
Second reading, passed, yeas 46 nays 0
Yes: 46 • No: 0
House vote • 1/22/2026
Second reading, passed, yeas 90 nays 2
Yes: 90 • No: 2
Actions Timeline
Filed with Secretary Of State 01/23
1/28/2026HouseSigned by Governor 01/23
1/23/2026HouseSent to Governor
1/23/2026HouseSigned by Speaker
1/23/2026HouseSigned by President
1/23/2026SenateReturned to House
1/23/2026HouseSecond reading, passed, yeas 46 nays 0
1/23/2026SenateEngrossment placed on calendar 14 0 2
1/22/2026SenateIntroduced, first reading, referred Joint Appropriations Committee
1/22/2026SenateReceived from House
1/22/2026SenateSecond reading, passed, yeas 90 nays 2
1/22/2026HouseAmendment adopted, placed on calendar
1/22/2026HouseReported back amended, do pass, amendment placed on calendar 22 0 1
1/21/2026HouseCommittee Hearing 10:30
1/21/2026HouseIntroduced, first reading, referred Joint Appropriations Committee
1/21/2026House
Bill Text
Adopted by the House Joint Appropriations Committee
Enrollment
FIRST ENGROSSMENT
INTRODUCED
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