The proposed bill aims to enhance the framework for adult foster care in North Dakota by introducing new requirements for substitute caregivers and respite care providers, as well as allowing the use of electronic monitoring devices by adult foster care providers. Specifically, it defines "substitute caregiver" and "respite care provider," stipulating that the Department of Human Services cannot limit their services to less than 220 days within a 24-month period or 110 days within a 12-month period. Additionally, it clarifies that days of care provided for less than 12 hours will not count towards these limits, ensuring that private pay adult foster care providers have adequate support.

Furthermore, the bill permits adult foster care providers to employ temporary assistants for residents with physical limitations and allows the use of electronic monitoring devices, with the requirement that such use must be approved in writing by the resident or their legal representative if incapacitated. The bill also mandates a legislative management study during the 2025-26 interim to evaluate the licensing of foster homes for adults, focusing on barriers to service access, regulatory challenges, and funding limitations, with input from various stakeholders.