Appropriations committee caps PRTF therapeutic-leave payments at $500 per day; department to authorize days

The House Appropriations Committee — Human Resources Division voted 6 to 2 to set a $500 daily payment for therapeutic leave days under Senate Bill 2,399 and directed the Department of Health and Human Services to authorize how many leave days a given individual may use.

The vote came after hours of committee questions about how Medicaid PRTF (psychiatric residential treatment facility) per diem rates are calculated and how paying for therapeutic leave days would affect facility reimbursement and the state fiscal note. Committee members discussed alternatives including a flat fee, a percentage of the Medicaid average, tiered rates tied to occupancy, or leaving the bill unchanged. Sarah Acre, Executive Director of the Division of Medical Services at the North Dakota Department of Health and Human Services, told the committee the fiscal note was drafted assuming the full Medicaid rate would be paid for therapeutic leave days under the bill as introduced.

The committee’s action reduces the fiscal exposure compared with paying full rates. Acre said the fiscal note for the 2025-27 biennium included roughly $1,000,053.69 in general funds and $2,774,653.00 in federal funds for…