SB 2403

               Sixty-ninth Legislative Assembly of North Dakota
         In Special Session Commencing Wednesday, January 21, 2026
                                        SENATE BILL NO. 2403
                                           (Senator Schaible)
                                      (Representatives Holle, Rohr)
AN ACT to amend and reenact section 6-09-47 of the North Dakota Century Code, relating to a medical
     facility emergency operating loan program under the medical facility infrastructure loan fund; to
     provide an appropriation; to provide a transfer; to provide an effective date; and to provide an
     expiration date.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
    SECTION 1. AMENDMENT. Section 6-09-47 of the North Dakota Century Code is amended and
reenacted as follows:
   6-09-47. Medical facility infrastructure loan fund - Medical facility infrastructure loan
program - Medical facility emergency operating loan program - Continuing appropriation - Audit
and costs of administration.
    1.   The Bank of North Dakota shall administer a medical facility infrastructure loan program to
         provide loans to medical facilities to conduct construction that improves the health care
         infrastructure in the state or improves access to existing nonprofit health care providers in the
         state. The construction project may include land purchases and may include purchase, lease,
         erection, or improvement of any structure or facility to the extent the governing board of the
         health care facility has the authority to authorize such activity.
    2.   In order to be eligible under thisthe medical facility infrastructure loan program, the applicant
         must be the governing board of the health care facility which shall submit an application to the
         Bank. The application must:
         a.   Detail the proposed construction project, which must be a project of at least one million
              dollars and which is expected to be utilized for at least thirty years;
         b.   Demonstrate the need and long-term viability of the construction project; and
         c.   Include financial information as the Bank may determine appropriate to determine
              eligibility, such as whether there are alternative financing methods.
    3.   A medical facility infrastructure loan provided under this section:
         a.   May not exceed the lesser of fifteen million dollars or seventy-five percent of the actual
              cost of the project;
         b.   Must have an interest rate equal to two percent; and
         c.   Must provide a repayment schedule of no longer than twenty-five years.
    4.   A recipient of a medical facility infrastructure loan under this section shall complete the
         financed construction project within twenty-four months of approval of the loan. Failure to
         comply with this subsection may result in forfeiture of the entire loan received under this
         section.
    5.   The Bank shall administer a medical facility emergency operating loan program to provide
         emergency operating loans to local nonprofit hospitals located in cities with a population of
         fewer than two thousand five hundred according to the most recent decennial census.
                                        S. B. NO. 2403 - PAGE 2
         a.   To be eligible for an emergency operating loan under this subsection, the governing
              board of a health care facility shall:
              (1)   Submit an application to the Bank by March 31, 2026;
              (2)   Provide financial information as requested by the Bank to determine eligibility,
                    including information on alternative financing and other funding sources; and
              (3)   Provide an updated operating plan and cash flow projections indicating the
                    feasibility of future operations after restructuring and sufficient financial resources to
                    address any operating deficit and to repay the loan.
         b.   A medical facility emergency operating loan under this subsection:
              (1)   May not exceed five million dollars per qualified applicant;
              (2)   Must have an annual interest rate that does not exceed two percent; and
              (3)   Must have a maximum term that does not exceed eleven years, unless a shorter
                    term is required based on an analysis by the Bank, with the first year of the loan
                    eligible for interest-only payments.
    6.   The medical facility infrastructure loan fund is a special fund in the state treasury. This fund is
         a revolving fund. All moneys transferred into the medical facility infrastructure fund, interest on
         moneys in the fund, and collections of principal and interest on loans from the fund are
         appropriated to the Bank on a continuing basis for the purpose of providing loans under this
         section.
  6.7.   Funds in the medical facility infrastructureMoneys in the fund may be used for loans as
         provided under this section and to pay the costs of administration of the fund. Annually, the
         Bank may deduct a service fee for administering the medical facility infrastructure fund
         maintained under this section.
  7.8.   The medical facility infrastructure fund must be audited in accordance with section 6-09-29.
         The cost of the audit and any other actual costs incurred by the Bank on behalf of the fund
         must be paid from the fund.
  8.9.   The Bank shall deposit loan repayment fundsrepayments in the medical facility infrastructure
         fund.
    SECTION 2. APPROPRIATION - TRANSFER - GENERAL FUND TO MEDICAL FACILITY
INFRASTRUCTURE LOAN FUND - MEDICAL FACILITY OPERATING LOAN - ONE-TIME FUNDING.
There is appropriated out of any moneys in the general fund in the state treasury, not otherwise
appropriated, the sum of $5,000,000, which the office of management and budget shall transfer to the
medical facility infrastructure loan fund for a medical facility operating loan program, during the period
beginning with the effective date of this Act and ending June 30, 2027. The appropriation under this
section is considered a one-time funding item.
    SECTION 3. EFFECTIVE DATE. This Act becomes effective immediately upon its filing with the
secretary of state.
     SECTION 4. EXPIRATION DATE. Section 1 of this Act is effective through June 30, 2037, and after
that date is ineffective.
                                         S. B. NO. 2403 - PAGE 3
                        ____________________________  ____________________________
                        President of the Senate  Speaker of the House
                        ____________________________  ____________________________
                        Secretary of the Senate  Chief Clerk of the House
This certifies that the within bill originated in the Senate of the Sixty-ninth Legislative Assembly of North
Dakota and is known on the records of that body as Senate Bill No. 2403.
Senate Vote:      Yeas 46  Nays 0  Absent 1
House Vote:       Yeas 80  Nays 12  Absent 2
                                                                      ____________________________
                                                                      Secretary of the Senate
Received by the Governor at ________M. on _____________________________________, 2026.
Approved at ________M. on __________________________________________________, 2026.
                                                                      ____________________________
                                                                      Governor
Filed in this office this ___________day of _______________________________________, 2026,
at ________ o’clock ________M.
                                                                      ____________________________
                                                                      Secretary of State