State Rep. Cynthia Ball has introduced legislation in the North Carolina House that would move Medicaid-funded long-term care for adults 55 and older primarily to home and community-based settings, as referenced by the North Carolina State House.
The proposal, House Bill 1138, was filed on April 29 during the 2025 regular session with the formal short title: ‘Aging With Dignity Act.’
The following is our summary, referencing the actual bill text and where needed, providing interpretation to clarify specific sections.
Essentially, this bill creates a presumption that adults 55 and older receiving Medicaid-funded long-term care should do so in home and community-based environments whenever feasible, with mandatory assessments preceding any institutional placement. It calls for periodic reviews of medications and behavioral health, screenings for social isolation, and the incorporation of geriatric behavioral health services. Funding allocations include $120 million for a housing-first pilot program for integrated senior housing, $3.5 million per year to enhance the long-term care ombudsman program, and $10 million annually to develop the geriatric workforce pipeline. Other provisions establish a Medicaid family caregiver stipend pilot and reconstitute an Aging Study Commission. Most measures would begin July 1, 2026.
Among the bill’s four sponsors, Ball introduced the highest number of bills—23—in the 2025 regular session.
In North Carolina, bills undergo a multi-step process before becoming law. Legislation is filed by a member and assigned to a committee for evaluation. Each bill must be read three times in both chambers. Any amendments made in one chamber after passage by the other require agreement on the updated version by both. Once aligned, the legislation is sent to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or allow the bill to become law without a signature.
You can find more details about related bills and other legislative actions here.
Ball holds a BA from the University of North Carolina at Greensboro, as well as a degree from Virginia Commonwealth University.
A Democrat, Ball was first elected in 2017 to represent North Carolina’s 49th House district, taking the seat previously held by 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. |
