Appropriations committee recommends 'do not pass' on provider accreditation grant bill, 3-2

The Senate Appropriations Committee voted 3-2 to recommend a "do not pass" recommendation on Senate Bill 2192, a bill that would have authorized state reimbursement to community providers for accreditation costs. The motion passed after committee debate about federal compliance, program scope and whether accreditation should be mandatory or optional.

Angela Denias, executive director of the North Dakota Association of Community Providers, told the committee that accreditation "should not be mandatory, but instead an optional additional service" and asked that if accreditation is required the state fund it rather than imposing an unfunded mandate on small providers.

Sarah Acre, Executive Director of the Division of Medical Services at the Department of Health and Human Services, gave a brief history of state funding for accreditation and testified the department was neutral in policy committee. Acre said the department historically paid accreditation costs for certain intellectual and developmental disability (IDD) providers in 2019 and partially in 2021, but has not included that funding in more recent biennial budgets. She noted accreditation helps meet federal regulatory expectations in ways the department’s own oversight does not always cover.

Committee members questioned the placeholder appropriation ($240,000 as introduced) and whether it would cover all providers; staff and witnesses said the real total to reimburse every affected provider would be higher (testimony suggested roughly $450,000 would be more adequate) and that accreditation cycles vary (most accreditations occur on a three‑ or four‑year schedule). Estimates for per‑provider accreditation costs mentioned figures around $30,000, but witnesses said costs vary widely by accrediting body and scope.

Motion and vote: Senator Davison made a motion for a do‑not‑pass recommendation on SB 2192; Senator Mangrum seconded. The clerk recorded the roll-call votes as follows: Senator Clary — Nay; Senator Davidson — Aye; Chairman Deaver — Aye; Senator Grama — Yes; Senator Matherne — No. The committee chair announced the motion passed on a split 3–2 vote and that the bill will proceed to the full appropriations committee with the committee’s recommendation.

Background: Witnesses listed several accrediting bodies used by providers, including the Commission on Accreditation of Rehabilitation Facilities (CARF), the Joint Commission, the Council on Accreditation, the National Association for Dual Diagnosis and the Council on Quality and Leadership (CQL). Providers said accreditation is a continuous‑improvement process that can prove valuable to consumers and payors, but smaller providers struggle to absorb multi‑thousand‑dollar costs without state support or a rate review to include accreditation costs in reimbursement rates.

The committee’s do‑not‑pass recommendation sends the bill to the full appropriations process with opposition from the committee; sponsors and provider groups may continue discussions in the House and conference process.