The Legislative Tribal‑State Relations Committee voted to instruct legislative staff to draft legislation seeking a state‑supported IMD (institutions for mental disease) waiver to expand Medicaid reimbursement for tribal residential addiction‑treatment facilities.

The motion directs Legislative Council staff to prepare bill language for the committee’s review and to work with the vice chair and tribal health leaders on that draft. Committee members took a roll‑call vote; the motion carried.

The IMD exclusion is a federal Medicaid rule that has historically limited federal reimbursement for residential mental‑health and addiction‑treatment facilities that have more than 16 beds. Tribal leaders from the MHA Nation told the committee the limit prevents the nation from operating larger, locally based residential programs that could keep relatives in state for treatment instead of flying them to out‑of‑state facilities.

Justin Shook, executive director of Good Road Recovery Center, described the operational impact: without a waiver, tribal treatment providers struggle to sustain larger residential programs because Medicaid reimbursement for beds beyond 16 is not available under current rules. Dr. Joy Fralick said an IMD waiver would let the tribe expand from 16 beds to a larger capacity and could allow the facility to serve other tribes and nontribal residents in the region.

Committee members discussed legislative next steps. A committee member offered to work with Legislative Council staff to draft language; another member seconded the request. The committee chair asked for a roll call; members recorded support and the motion was declared carried. Committee leadership said they will place the draft on a future interim meeting agenda and invite tribal health leaders to review the proposed bill language before the committee acts further.

The committee’s vote does not itself change federal Medicaid rules; it directs state legislative staff to prepare bill language and signals state legislators’ interest in pursuing a change that requires state and federal administrative action (and federal approval for an IMD waiver). Tribal witnesses requested parallel actions at the executive level and federal engagement to secure federal waiver approval.