AN ACT to amend and reenact subsection 3 of section 50-24.1-40 of the North Dakota Century Code, relating to the tribal health care coordination fund.

Created a new Tribal Health Care Coordination Fund in the state treasury with continuing appropriations to the department for distribution to tribal governments

Requires tribes to use distributed funds for ten essential public health services and community health representative programs, with capital construction limited to 50% through June 30, 2025, then 35% thereafter

Mandates annual reports to the department detailing fund usage and biennial independent audits by certified public accountants, with tribes able to use fund money to pay for audits

Establishes enforcement mechanisms where the department can withhold distributions if tribes fail to file timely reports or audits, and must recover improperly used funds

Distribution amounts are proportional to federal funding received from care coordination agreement requests originating within each tribal nation