Rep. Garland E. Pierce has filed a bill in the North Carolina House designed to prioritize home and community-based Medicaid care for adults ages 55 and up, as indicated by the North Carolina State House.
The proposal, submitted as HB 1138 on April 29 for the 2025 regular session, carries the short title: ‘Aging With Dignity Act.’
Below is our summary, referencing the actual bill text and including clarifications of its provisions where needed.
Broadly, the bill sets a statewide standard for offering Medicaid-funded long-term care to adults 55 and older in home and community settings when feasible, with institutionalization assessed as required. Regular medication and behavioral health reviews, screenings for social isolation, and the integration of geriatric behavioral health care would be prioritized. In addition, the measure proposes $120 million for a pilot program with integrated senior housing, allocates $3.5 million per year to expand the long-term care ombudsman program, and dedicates $10 million per year to develop a geriatric workforce pipeline. The bill also outlines a Medicaid caregiver stipend pilot, the revival of an Aging Study Commission, and is generally set to go into effect July 1, 2026.
Among the legislation’s four sponsors, Cynthia Ball introduced the highest number of bills, with 23 submitted during the 2025 regular session.
North Carolina’s legislative process for bills involves a step-by-step path before any measure becomes law. Lawmakers begin by filing a bill, after which it is sent to a committee for analysis. The measure must receive three readings in each chamber, and any alterations by one chamber after the other has passed it require both chambers to approve the revised version. Once the legislature passes an identical bill in both chambers, it is sent to the governor, who has 10 days (or up to 30 if the legislature is out of session) to sign it, veto it, or take no action, allowing it to become law.
Additional details about North Carolina bills and legislative actions can be found here.
Pierce holds a Bachelor of Science degree from Fayetteville State University.
A Democrat, Pierce was first elected to the North Carolina State House in 2005, representing the 48th House district after Donald Bonner.
| Authors | Bill Number | Date Filed | Title |
|---|---|---|---|
| Garland E. Pierce, Cynthia Ball, Dante Pittman, and Gloristine Brown | HB 1138 | 04/29/2026 | Aging With Dignity Act. |
| Garland E. Pierce, Lindsey Prather, Sarah Crawford, and Zack Hawkins | HB 1141 | 04/29/2026 | Protecting Medicaid & Autism Services. |
| Garland E. Pierce, Amos L. Quick, III, Frances Jackson, PhD, and Renée A. Price | HB 1053 | 04/27/2026 | Additional Funding for School Supplies. |
| Garland E. Pierce, B. Ray Jeffers, Dante Pittman, and Eric Ager | HB 1057 | 04/27/2026 | Affordable Food Act. |
| Garland E. Pierce, Diane Wheatley, Donna McDowell White, and Maria Cervania | HB 974 | 04/10/2025 | DHHS Study/Hospice Patient Complaints. |
| Garland E. Pierce, Brandon Lofton, Cynthia Ball, and Dante Pittman | HB 786 | 04/03/2025 | Working Families Act. |
| Garland E. Pierce, Abe Jones, and Zack Hawkins | HB 726 | 04/02/2025 | Youth Mentoring & Academic Enhancement Comm. |
| Garland E. Pierce | HB 642 | 04/01/2025 | Funds/Scotland Cty. Wastewater Improvements. |
| Garland E. Pierce, Carolyn G. Logan, Kanika Brown, and Renée A. Price | HB 662 | 04/01/2025 | Support the State Highway Patrol. |
| Garland E. Pierce, Diane Wheatley, Grant L. Campbell, MD, and Phil Shepard | HB 663 | 04/01/2025 | Living Donor Protection Act. |
| Garland E. Pierce | HB 417 | 03/17/2025 | Funds for Hoke County Park. |
| Garland E. Pierce, Abe Jones, Hugh Blackwell, and Marcia Morey | HB 335 | 03/06/2025 | Expand Emergency Judge Eligibility. |
| Garland E. Pierce | HB 311 | 03/05/2025 | Funds for the Town of Gibson. |
| Garland E. Pierce, Carolyn G. Logan, Gloristine Brown, and Jordan Lopez | HB 316 | 03/05/2025 | Child Care Act. |
| Garland E. Pierce, Donna McDowell White, and Robert T. Reives, II | HB 280 | 03/04/2025 | Support for the Senior Tar Heel Legislature. |
| Garland E. Pierce | HB 285 | 03/04/2025 | Funds for Laurinburg-Maxton Airport. |
| Garland E. Pierce | HB 260 | 03/03/2025 | Reallocate Raeford Sewer Infrastructure Funds. |
| Garland E. Pierce | HB 262 | 03/03/2025 | Designate Chief R. Malloy Overpass. |
| Garland E. Pierce | HB 257 | 02/27/2025 | Funds for Scotland & Hoke Projects. |
| Garland E. Pierce, Julie von Haefen, Rodney D. Pierce, and Sarah Crawford | HB 179 | 02/24/2025 | Labor Org. Membership Dues Tax Deductible. |
