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HB 1138, known as the Aging With Dignity Act, aims to improve long-term care for older North Carolinians by prioritizing home-based services over institutional care for Medicaid beneficiaries aged 55 and older. The bill mandates that institutional placement be the exception rather than the rule, requiring documented medical justification and regular reassessments to ensure individuals remain in the most integrated setting possible. It also establishes a requirement for periodic medication reviews to prevent adverse drug interactions and reduce hospitalizations, while integrating behavioral health services into geriatric care plans. Additionally, the legislation appropriates funds for strategic investments in the state's aging infrastructure and reestablishes a study commission to address the needs of the growing senior population.