Rep. Pierce files long-term care bill in North Carolina House

A new bill filed by State Rep. Garland E. Pierce in the North Carolina House aims to prioritize home- and community-based care for adults 55 and older receiving Medicaid, 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, Cynthia 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.

Pierce graduated from Fayetteville State University with a BS.

Pierce, a Democrat, was elected to the North Carolina State House in 2005 to represent the state’s 48th House district, replacing previous state representative Donald Bonner.