[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6349532,"mediaKeyId","2238398-21fdb4c212d8658af06e94f13fff41dd","parentId",2238398,"title","Blind-services advocate urges increased state support for Older Individuals Who Are Blind program","audioSeconds",186,"startMs",5294000,"endMs",5480000,"viewUrl","/Search/View?dp=1&key=2238398-21fdb4c212d8658af06e94f13fff41dd&start=5294&end=5480","thumbnailUrl","https://assets.pipeline.soar.com/2238398-21fdb4c212d8658af06e94f13fff41dd/thumbnail_5294000.jpg","articleUrl","/articles/6349532/North-Dakota/Blind-services-advocate-urges-increased-state-support-for-Older-Individuals-Who-Are-Blind-program","mediaUrl","https://secure.pipeline.soar.com/6349532-58da8189da31f53ed6cd13b70cb36df3/orig.mp4?Expires=1776853895&Signature=GplTuoBUmimFRtkWDqnWHBuhnogMm1vFnEzLwl8o2TI9~VyVXab-3SgXC91pAkrCl-6atSniErqySigQGogBhU-vpKiSVhAR4Lb4eZg7--YngI7aX9zSOuPzeoQ1kIF4RQUPH8crLs7iQ2NWavDbNOACt4Zm4UxKBUQshmo6zVbQ-kMKZgb3tc4usAvjQ1GfLUH30booqzm9RqEvshLzYTksUTWUD50uTpA7m2xtF4lnyet2PnXV3UQeJqWAP7IK-9wREejuuVGacTLTwm9pct8HEe9V3mAJWTxiBX-0DvslqVfJaEjLpkyGbGpUDx2nqcAiJUxR32YfBTlRtDFCZQ__&Key-Pair-Id=KUT5TJCACFTXG","author","State of North Dakota","date","2025-02-04T00:00:00Z","article","Alan Peterson, representing himself and the North Dakota Association of the Blind, told the Human Services Policy and Appropriations Committee that the Older Individuals Who Are Blind (OIB) program serves hundreds of seniors statewide but lacks adequate state funding to meet demand.

Peterson, who identified himself as blind and as a volunteer advocate with the association, said the OIB program is designed for people age 55 and older and focuses on independent-living skills, assistive-technology devices, home adaptations and training that allow people to remain in their homes rather than move to congregate care. He told the committee that about 700\u0000to\u0000750 unduplicated older individuals were served in the prior year and that the federal grant supports roughly 90 percent of OIB program funding while about 10 percent of costs fall to the state.

Peterson said the OIB state funding allocation has not been meaningfully increased in decades (he cited 1987 as the last significant state increase) and asked the committee to consider a state increase to cover adaptive devices and other services that federal grant dollars do not fully support.

Committee members asked whether additional state funding would jeopardize federal dollars; Peterson said increases in state funding for OIB would augment services and are not a matching requirement that would be matched by the federal grant in the way some other programs are accounted.

Ending: Committee members thanked Peterson and asked staff to review the program numbers; Peterson said he would be available to answer follow-up questions.

","mediaType","Video","parentTitle","House Appropriations - Human Resources Division Feb 4, 2025","oneSentenceSummary","An advocate for blind and vision-impaired North Dakotans told the Human Services Policy and Appropriations Committee that the Older Individuals Who Are Blind (OIB) program needs additional state funding to provide assistive devices and home adaptations so older people can stay in their homes.","taxTitle","Appropriations - Human Resources Division, House of Representatives, Legislative, North Dakota","taxId",28888,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6349537,"Interim VR director warns of flat federal grants, seeks $8 million technology appropriation and flexibility",4445,4355000,8800000,"/Search/View?dp=1&key=2238398-21fdb4c212d8658af06e94f13fff41dd&start=4355&end=8800","https://assets.pipeline.soar.com/2238398-21fdb4c212d8658af06e94f13fff41dd/thumbnail_4355000.jpg","/articles/6349537/North-Dakota/Interim-VR-director-warns-of-flat-federal-grants-seeks-8-million-technology-appropriation-and-flexibility","https://secure.pipeline.soar.com/6349537-c201cab59bd8959777d2ee128c0cfd5d/orig.mp4?Expires=1776853895&Signature=fecI3ECskbZC-uSbkt3M5Fs2KpONE2RcuGqR2pxrDWQdPrpWWtWb~YclE5NDImGh04PgGR6CIIVzHd0Kduxh8UgiDPOevatzjXVX7YeuNeCIffd74WaGePhwYNBqWzp1AUxAkchjz-lZB0IG750eB5tiThkqGdUUdTQQtZEnOCokHly4Tq-LnC5XkpgDt1xCcxCc1HGRBHKSZD5hxyatWAoSK41hqqgrxXfBnv9GL1nA2oXNNY5pknff9Z4abVwFnlKbNzZKY20b3l6h1-Rvq5~2xr-8gCe0E3Hi2qMmAg-5M51p8HqooHblezRHNvMAX~Lk19R64wSNq6xkXc5SuA__&Key-Pair-Id=KUT5TJCACFTXG","Interim Vocational Rehabilitation director Jim Fleming told the Human Services Policy and Appropriations Committee that North Dakota's VR program ranks at or near the top nationally on several federal performance measures but faces growing caseload pressure and a federal grant structure that can leave the program constrained without legislative flexibility.

Fleming described VR's mission and services: employer outreach and retention, supported and customized employment, pre-employment transition services (Pre-ETS) for students (services in 71 schools), older-individuals-who-are-blind (OIB) services, Randolph-Sheppard vending operations for blind vendor concessions, and community-based supports. He said North Dakota alternates with Utah among the highest employment rates for working-age people with disabilities and that the program has strong performance in credential attainment and post-exit employment.

Fleming emphasized funding constraints. The primary VR grant functions as a federal-state matching program (reported as roughly 78.7 percent federal / 21.3 percent state). Fleming said the federal minimum allotment is effectively consumed by regular operating expenditures; drawing additional reallotment federal dollars requires an appropriation vehicle. The governor's budget includes $8 million for a VR technology system: Fleming said that money could be used for a major replacement or to expand the existing AWARE case-management system, and that vendors often require assurance of full funding before bidding on large contracts. He told the committee the department would likely phase a large project over several grant years to avoid maintenance-of-effort issues.

Fleming asked lawmakers to consider the volatility of federal funding under continuing resolutions and recommended exploring a state-level mechanism to stabilize VR funding over several years (a sinking/bridge fund) so the program could draw down federal reallotments when available without risking future state maintenance-of-effort obligations.

Staffing and workload: Fleming said VR had 87 authorized positions with 78 filled at the time of testimony and several vacancy and recruitment challenges. He said case counts have grown about 39 percent in three years while staffing did not increase, and the program has a significant number of employees near retirement. He described a push toward specialization (for example, statewide employer-relations specialists) and some remote or itinerant counselor models to improve reach.

Fleming described program-specific asks and items on the horizon: system modernization (the $8M request), use of Social Security reimbursements to offset some OIB costs, improving supported-employment capacity and employer relations, and a department-sponsored bill (House Bill 1066) to raise the wage rate for Community Service Employment Program (CSEP) participants assigned to the Department of Human Services. Fleming said HB1066 passed the policy committee on a 12-1 due-pass vote; the bill would set an interim higher rate (example number in bill text: $12/hour) for CSEP participants working for DHS and then allow the department to set a rate by rule.

Fleming and committee staff discussed the grant accounting mechanics, carryover rules, and timing. April Herring of the finance office clarified aspects of \"other\" funds in the budget presentation (fees, vending revenues, Randolph-Sheppard receipts).

Ending: Fleming said VR's performance is strong but the combination of flat federal grants, rising caseloads and provider-price pressures creates the need for legislative discussion on the proposed technology appropriation and whether some form of state-level stabilization or targeted additional appropriations are needed.

","Interim VR director Jim Fleming told lawmakers the state-run vocational rehabilitation program ranks among the nation's best on several measures but faces strained capacity because federal grant funding has been flat while caseloads climbed; Fleming asked for an $8 million technology appropriation and urged lawmakers to consider mechanisms to stabilize grant funding.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6349541,"Child support officials cite improved collection rates, seek extension of IT appropriation",3433,207000,3640000,"/Search/View?dp=1&key=2238398-21fdb4c212d8658af06e94f13fff41dd&start=207&end=3640","https://assets.pipeline.soar.com/2238398-21fdb4c212d8658af06e94f13fff41dd/thumbnail_207000.jpg","/articles/6349541/North-Dakota/Child-support-officials-cite-improved-collection-rates-seek-extension-of-IT-appropriation","https://secure.pipeline.soar.com/6349541-c07616e446edf69c05a23ac6180851cb/orig.mp4?Expires=1776853895&Signature=dAXiRVKvm7FQ~97wbOvwvyk9gbTrlosMWOtDGGKA~OIgubroNZw88ServXWAcnYv6pGDmSXSojgnvBo0wrmsL4D~o2DgtGSgZcLbEKtd4azwzecwU4cM7XdsUKUOoaocpSvig-pDNIEeSy1uesn95JZaOc3wE8dMEwYYWorDuG3Q~hqUlC6TdA-LDW38Y7QvRXECpteu3cO6Inlr9hIRbNM2ZWMv833n8lrISbEAjEd0Bd7yXroEz1uIC8c2Lm8b7lARZgrXIEDL2o4V1R7bEs5NiXclfz3Z8aMGvVR5x2E-OWRc776M~RL-0abAIqcnv6Ja0Jmljr8hvr7s1ST09g__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Human Services\u0000child support section told the Human Services Policy and Appropriations Committee on [date not specified] that it has raised paternity and collection rates and is asking the legislature to extend an existing IT-system appropriation carried on the books from the prior biennium.

The department's interim director of the child support section, Jim Fleming, told committee members the program now serves about 50,800 full-service child support cases and an additional roughly 20,000 limited-service cases. Fleming said the office has about 61.2 full-time equivalent staff and that collections in the most recent reporting year were in the neighborhood of $190 million. He said current-support compliance is ‘‘almost 80 percent’’ and that the state holds about $254 million in arrears.

Fleming described several policy and operational changes he credited for performance gains. The section moved periodic reviews from the federal minimum of every three years to every 18 months to keep orders aligned with pay changes; expanded partnerships with employers to increase new-hire reporting and the use of automatic withdrawals; and developed a program connecting payers to job services, a workforce program now recognized by federal child-support guidance for federal financial participation.

Fleming also described enforcement tools the section uses selectively: tax-refund intercepts, license suspensions (about 1,200 currently suspended) and involuntary payments from gaming and vehicle trade-ins when state checks or prize redemptions meet federal reporting thresholds. He said license suspensions are used to bring parents to the negotiating table and that the section offers arrears-interest suspension when a payer signs and maintains an agreed payment plan.

The section described new referral strategies with foster-care staff. Fleming said that when reunification is the goal, child-support referrals can be deferred so child-support actions do not undercut reunification efforts; if reunification fails, referrals may be reactivated. He said the change is guided by research (University of Wisconsin study cited) and recent federal guidance allowing certain TANF and foster-care referral exceptions.

On technology and budgeting, Fleming said planning is under way for a full replacement or major modernization of the child-support case-management system. He told the committee the project estimate from previous planning was about $60 million, with a 34 percent state share identified previously as coming from the Community Health Trust Fund; the department will ask the legislature to extend that authorization another biennium so the project can continue. Fleming said a planning contract is in place and an RFP for system modernization is possible this year, with vendor timelines ranging from two to four years.

Fleming said the section's operating budget will be lower overall than in prior biennia due to reductions in rent and other space-related costs after increased use of telework and a remote call center; he also described using experienced retirees as temporary staff during critical IT modernization work. Fleming said the child-support program remains heavily federally matched (the program stated typical federal reimbursements around 66 percent) and that additional state general fund dollars yield a large federal match.

Committee members asked about evaluation of the foster-care referral strategy and about the proposed system modernization funding. Fleming said the foster-care referral approach is still ramping up and that effectiveness in North Dakota was guided by out-of-state study; he said the system modernization funding is in the existing appropriation and that the unspent Community Health Trust Fund dollars were identified earlier but not yet expended.

The section also described tribal partnerships, including work with three tribal programs and Standing Rock; a tribal offset consortium that had been briefly interrupted by an IRS decision this summer was restarted after congressional and press attention, Fleming said.

The presentation closed with Fleming acknowledging high program performance and asking the committee for continued legislative support for operating and IT modernization funds.

Ending: The committee recessed to floor session; no formal committee action or vote on the child-support operating budget or the IT appropriation extension was recorded during the portion of the transcript covering the child-support presentation.

","The Department of Human Services' child support section told lawmakers it has raised paternity and payment rates and will ask the legislature to extend a previously authorized IT appropriation while continuing operations funded largely through federal matching.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6349527,"Care model pilot for behaviorally complex long-term care residents sought; proponents cite ER and hospital savings",2725,9366000,12091000,"/Search/View?dp=1&key=2238398-21fdb4c212d8658af06e94f13fff41dd&start=9366&end=12091","https://assets.pipeline.soar.com/2238398-21fdb4c212d8658af06e94f13fff41dd/thumbnail_9366000.jpg","/articles/6349527/North-Dakota/Care-model-pilot-for-behaviorally-complex-long-term-care-residents-sought-proponents-cite-ER-and-hospital-savings","https://secure.pipeline.soar.com/6349527-6bc2bf3865f4c9ee004df65741e8fab2/orig.mp4?Expires=1776853895&Signature=NMicpJFv~19CeBzwysdZW9G0iI0sS0fp~94ra~ZmaH6aJ8Zp5QIOgZOJKW7lxKZviWVWBvJkTcUDjaboOkydSxh0H6dmZWDS1nXqCloQZZTDT7ItPUnmH27sQhwl4M-GAr1q8zcnFo2nsMNYj~9SpaenJEJ7JgtgcN8G~BwSfwinQwDIZxxoW97Pga8EVd3PBikHPtyJTJgpRYsQwjCGMzfLcmltKwUNZKNseDIBJmL-oe2xlL-8j7uDMf-i1Yu~Vdz2yFippSESw8~qHUxnkB4KY8FOBP~DggjC8OO0uwI2fILlqvmdbXgEQ3bW0E2r00CQDygHUrP5dBjgWwSHxg__&Key-Pair-Id=KUT5TJCACFTXG","The North Dakota Long-Term Care Association asked the Human Services Policy and Appropriations Committee to fund a $3 million, two-year pilot to deliver behavioral-health training, on-site non-billable supports and clinical wraparound services to nursing homes and basic-care facilities treating residents with severe behavioral health needs.

Nikki Wagner, president of the association, introduced the proposal and said facilities face growing difficulty caring for residents who present severe agitation, aggression or self-harm risk. Wagner said staffing policies, regulatory risks (for example, restraints, psychotropic oversight and resident-safety citations) and limited access to inpatient psychiatric beds leave nursing homes unable to stabilize a subset of high-need residents.

Dr. Christy Kovacs, chief clinical officer of Behavioral Health Solutions, outlined a model deployed in other states. The proposed approach combines:

- Targeted staff training (de-escalation, trauma-informed practices, psychiatric and dementia care).
- Creation of individualized behavior-support and crisis plans and training caregivers on those plans.
- Deployment of paraprofessional supports and one-on-one psychosocial activities (behavioral health technicians, dementia-certified activity professionals) to reduce staff burden and provide therapeutic engagement.
- Clinical wraparound billed where possible (Medicare Part B) including psychiatric assessment, medication management, psychotherapy, cognitive assessment and peer support; monthly gradual-dose-reduction reviews for psychotropic medications.

Dr. Kovacs said other states use different rate structures; Nevada's behavioral-complex program offers supplemental daily payments that range roughly between $111 and $326 per resident day depending on intensity, she said. Behavioral Health Solutions presented Nevada results showing fewer ER visits for participants (a 72 percent reduction in ER visits for people on the Nevada program compared with controls cited by the vendor) and fewer out-of-state placements; the vendor also reported reductions in antipsychotic use where nonpharmacologic interventions were employed.

Wagner and Dr. Kovacs proposed a targeted pilot of about 50 residents for North Dakota, at an estimated $100 per resident per day under the requested $3 million biennial funding. They described a 90-day ramp-up to credential staff, onboard facilities and begin training and said the pilot would emphasize data collection to evaluate cost-savings and clinical outcomes before any statewide expansion.

Committee members asked about applicability to dementia patients, antipsychotic use and measurable cost savings. Dr. Kovacs said the model covers a broad diagnostic range (neurocognitive disorders such as Alzheimer's with associated behaviors, primary psychiatric disorders, substance-use related behavioral psychiatric presentations) and that the clinical aim is to reduce severity and frequency of behaviors through staff training and individualized plans; she said some patients will still require medication but that measured reductions in psychotropic use may follow successful nonpharmacologic interventions.

Ending: Committee members expressed interest and asked for more data and implementation details; no appropriation or committee vote was recorded in the transcript excerpt.

","The North Dakota Long-Term Care Association and a behavioral-health vendor proposed a biennial $3 million pilot to provide training, on-site nonbillable supports and clinical wraparound services to nursing homes caring for residents with severe behavioral needs. Supporters cited out-of-state experience showing fewer ER transfers and shorter acute","actionData","errors"]

Article not found

Blind-services advocate urges increased state support for Older Individuals Who Are Blind program

Interim VR director warns of flat federal grants, seeks $8 million technology appropriation and flexibility

Child support officials cite improved collection rates, seek extension of IT appropriation

Care model pilot for behaviorally complex long-term care residents sought; proponents cite ER and hospital savings