A new bill filed by State Rep. Cynthia Ball in the North Carolina House aims to shift Medicaid-funded long-term care for older adults toward home and community-based settings, according to the North Carolina State House.
The bill, filed as HB 1138 on April 29 during the 2025 regular session, was formally listed with the short title: ‘Aging With Dignity Act.’
The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.
In essence, this bill establishes a statewide presumption that Medicaid-funded long-term care for adults 55 and older be provided in home- and community-based settings when appropriate, with required assessments for institutional placement. It mandates regular medication and behavioral health reviews, screening for social isolation, and integration of geriatric behavioral health services. It appropriates $120 million for a housing-first integrated senior housing pilot, $3.5 million annually to expand the long-term care ombudsman program, and $10 million annually for a geriatric workforce pipeline. It creates a Medicaid family caregiver stipend pilot, reestablishes an Aging Study Commission, and generally takes effect July 1, 2026.
Of the four sponsors of this bill, Ball proposed the most bills (23) during the 2025 regular session.
Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.
You can read more about the bills and other measures here.
Ball graduated from the University of North Carolina at Greensboro with a BA and again from Virginia Commonwealth University.
Ball, a Democrat, was elected to the North Carolina State House in 2017 to represent the state’s 49th House district, replacing previous state representative Gary Pendleton.
| Authors | Bill Number | Date Filed | Title |
|---|---|---|---|
| Cynthia Ball, Dante Pittman, Garland E. Pierce, and Gloristine Brown | HB 1138 | 04/29/2026 | Aging With Dignity Act. |
| Cynthia Ball, Donny Lambeth, Erin Paré, and Ray Pickett | HB 1124 | 04/29/2026 | Interstate Compact for School Psychologists. |
| Cynthia Ball, Julie von Haefen, Lindsey Prather, and Zack Hawkins | HB 1017 | 04/21/2026 | Sound Basic Education for Every Child. |
| Cynthia Ball, Julie von Haefen, Lindsey Prather, and Monika Johnson-Hostler | HB 941 | 04/10/2025 | Expand & Enhance the Teaching Fellows Program. |
| Cynthia Ball, Bryan Cohn, Dante Pittman, and Frances Jackson, PhD | HB 943 | 04/10/2025 | Turning High-Achieving Students into Teachers. |
| Cynthia Ball, Gloristine Brown, Julia Greenfield, and Mike Colvin | HB 979 | 04/10/2025 | Update Volunteer System/LTC Ombudsman Program. |
| Cynthia Ball, Tim Longest, Vernetta Alston, and Zack Hawkins | HB 823 | 04/08/2025 | County Service Districts/Research & URSD. |
| Cynthia Ball, Julie von Haefen, Lindsey Prather, and Phil Rubin | HB 815 | 04/07/2025 | Voucher School Accountability Act. |
| Cynthia Ball, Cecil Brockman, Lindsey Prather, and Phil Rubin | HB 816 | 04/07/2025 | Voucher School Transparency Act. |
| Cynthia Ball, Brandon Lofton, Dante Pittman, and Garland E. Pierce | HB 786 | 04/03/2025 | Working Families Act. |
| Cynthia Ball, Allison A. Dahle, Amber M. Baker, and Phil Rubin | HB 691 | 04/02/2025 | Voter Protection and Reliance Act. |
| Cynthia Ball, Brandon Lofton, Carla D. Cunningham, and Cecil Brockman | HB 715 | 04/02/2025 | Universal Pre-K. |
| Cynthia Ball, Julie von Haefen, Mary Belk, and Pricey Harrison | HB 686 | 04/01/2025 | Safe Cosmetics Act. |
| Cynthia Ball, Amber M. Baker, Donny Lambeth, and Erin Paré | HB 588 | 03/31/2025 | School Psychologist Omnibus. |
| Cynthia Ball, Brandon Lofton, Phil Rubin, and Rodney D. Pierce | HB 608 | 03/31/2025 | Protect Health and Gov’t Personnel Info. |
| Cynthia Ball, Julie von Haefen, Lindsey Prather, and Rodney D. Pierce | HB 531 | 03/26/2025 | Addressing NC’s Teacher Crisis/NTSP. |
| Cynthia Ball, Becky Carney, Carla D. Cunningham, and Mary Belk | HB 495 | 03/24/2025 | Accessing Midwives Act. |
| Cynthia Ball, Carla D. Cunningham, Donna McDowell White, and Donny Lambeth | HB 464 | 03/19/2025 | Healthy Students – A Nurse in Every School. |
| Cynthia Ball, Allison A. Dahle, Maria Cervania, and Monika Johnson-Hostler | HB 429 | 03/18/2025 | Turtle Rescue Team Special Registration Plate. |
| Cynthia Ball, Amos L. Quick, III, Julie von Haefen, and Lindsey Prather | HB 445 | 03/18/2025 | Fairness & Transparency in Education Salaries. |
| Cynthia Ball, Julie von Haefen, Lindsey Prather, and Zack Hawkins | HB 420 | 03/17/2025 | Sound Basic Education for Every Child. |
| Cynthia Ball, Marcia Morey, Mary Belk, and Pricey Harrison | HB 293 | 03/05/2025 | Marine Life Stewardship Act. |
