[{"_1":2,"_100":-5,"_101":-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],{"_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",6278641,"mediaKeyId","2639313-3288abb1b510576083f227a4bc5929e6","parentId",2639313,"title","Health department proposes host‑home pilot, ICF moratorium and waiver changes in developmental‑disability budget","audioSeconds",1663,"startMs",6588925,"endMs",8252639,"viewUrl","/Search/View?dp=1&key=2639313-3288abb1b510576083f227a4bc5929e6&start=6588&end=8252","thumbnailUrl","https://assets.pipeline.soar.com/2639313-3288abb1b510576083f227a4bc5929e6/thumbnail_6588925.jpg","articleUrl","/articles/6278641/North-Dakota/Health-department-proposes-hosthome-pilot-ICF-moratorium-and-waiver-changes-in-developmentaldisability-budget","mediaUrl","https://secure.pipeline.soar.com/6278641-dce3c2c9561f2df7d93b4b9df7f19ae9/orig.mp4?Expires=1771075919&Signature=eD4ABPkHJ4JjFP7xgvpdpptVqlX8Cxz9DXYoW3EjZTCuuewmhsjoVFeOPVTmMUig5bzZ14pw8DU47A4phAzIU5IzbGHJxqk2DZn0LPjekZH29-0gPda7HzhXzQOzuZ2pcIG0qIr3j~n9RZTiWTe0bTzD70M01Xi05~LvATPWRnGbpa15BJ5-lSvQCyt6QlkBo2SYn2G9VsgkgMW6rhRcMhF~7G3tHEeJbaGz0z~-308RGevO2m2-jOHQ1wropNXyqxY1UrWY0aHzNtAbCfDhJgtt-cVJGETkb7RJHSYQnIhX6kMzmdeXpttUjlavfWSeu85Xc0urrjUs1GzCWjIFOg__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota State Legislature","date","2025-03-14T00:00:00Z","article","Tina (presenter name recorded; last name not specified), speaking for the Department of Health and Human Services’ Developmental Disabilities (DD) section, told the Senate Appropriations Committee that the DD budget request totals about $810.6 million and accounts for roughly 12.9% of the state's HHS budget. She presented program data, proposed policy changes and several budget items the department is seeking for the 2025‑27 biennium.

The department reported growth in demand for DD services: a 35.5% increase in referrals from 2021 to 2024, and a 10% growth in licensed providers. Tina said the intermediate care facility (ICF) licensed capacity is 451 beds while average monthly bed usage for July 2023–June 2024 was about 389 beds. The department supported a House amendment that would pause adding any new licensed ICF beds between July 1, 2025, and June 30, 2027, and described that as a planning step to “level set” capacity and explore repurposing open beds for short‑term crisis placements rather than expanding institutional capacity.

To fill gaps for youth with high needs, the department proposed a host‑home pilot for therapeutic, family‑style residences. The pilot would establish 20 host homes serving about 20 youth (birth through 21) with therapeutic supports; the department intends to use ARPA funds for a pilot procurement and asked for ongoing appropriations to operate the model if successful. The department said it is pursuing a procurement with a vendor known to provide therapeutic foster‑care services to implement the pilot.

The department also proposed several waiver and program changes: conversion of the outdated ICAP assessment to the SIS‑C (a strengths‑based support‑needs assessment), increased annual limits for waiver equipment and supplies (raised to $5,000) and an increase in the environmental modification cap to $40,000 per five years. Tina said those changes took effect in April 2024 and are intended to expand assistive technology and home modification options that help people remain in community settings.

Tina described the department’s outlier policy that allows enhanced staffing authorizations when an individual’s medical or behavioral needs exceed standard service authorizations. She presented a case study of a young man with complex needs who required dozens of placement attempts and outlier funding to stabilize—a use case the department said underlines the need for host homes and crisis options.

The presentation included an item the House added to HB1012: a one‑time general fund payment to the Anne Carlson Center for Health and Disabilities; the department said the House amount was intended to offset recent shortfalls but that the payment is one‑time rather than ongoing. Department fiscal staff confirmed that one‑time payments for prior services are not eligible for federal FMAP matches.

Committee members pressed department staff on eligibility definitions, how the department decides to add service options within existing waivers, and whether the state is adding ICF beds. Tina said the department plans to explore repurposing licensed beds for crisis placements but does not intend for the moratorium to remove existing licensed capacity from providers that intend to fill them.

Ending: The DD section asked the committee for follow‑up time to continue the discussion; the department offered to provide procurement documents and additional cost estimates for the host‑home pilot and for conversion to SIS‑C.","mediaType","Video","parentTitle","Senate Appropriations - Human Resources Division Friday, Mar 14, 2025 9:00 AM - 11:58 AM","oneSentenceSummary","Department of Health and Human Services presented an $810.6 million developmental disabilities budget that includes a proposed moratorium on new licensed ICF capacity, a 20‑host‑home pilot for youth, changes to assessment tools and higher caps for assistive technology and environmental modifications in waivers.","taxTitle","Appropriations - Human Resources Division, Senate, Legislative, North Dakota","taxId",28901,"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},6278646,"Alzheimer's Association urges continued funding for state dementia care services",59,3859655,3918789,"/Search/View?dp=1&key=2639313-3288abb1b510576083f227a4bc5929e6&start=3859&end=3918","https://assets.pipeline.soar.com/2639313-3288abb1b510576083f227a4bc5929e6/thumbnail_3859655.jpg","/articles/6278646/North-Dakota/Alzheimers-Association-urges-continued-funding-for-state-dementia-care-services","https://secure.pipeline.soar.com/6278646-bf593908ec26352f3214ec1463a0d38c/orig.mp4?Expires=1771075919&Signature=bcYv5aHwmQp1hMyZuPHGnV64WYd58XFQHsxeH697boDjr0lFfXCzlQNagQOpQ-O0BFOKq86LvromyV~SwwgIr44PAD~T2KfHjCVw9gDZhC~1kk3YnKxDbv6yR8aMewAjxHeIF67UYbcih4Lc9y9a4LFcFtql0wzh8poOuivda7lb-5DbAqGeGpk8BrtCQUMsZsUFh-amdTz5OeMwG9Q5wRDnWf~Xv8DvTNN55n0a9KM0pQDY-Cl6hOVZnrUh3S~vwd8pjxzRfvfMbbYbDzZtDp5v6DoOo9pWaSm7~vHMJD3Pxkj~2mk1kGFTrYyTYMctn5TVUw9aUCXaWUjz-c--cA__&Key-Pair-Id=KUT5TJCACFTXG","Joan Danks, North Dakota manager for the Minnesota‑North Dakota chapter of the Alzheimer's Association, told the Senate Appropriations Committee that the association supports the Adult and Aging Services budget proposals and the dementia care services contract included in House Bill 1012. Melanie Gaby, policy director and lobbyist for the association, introduced Danks and said the organizations partner with the state on referrals and training.

Danks summarized the association’s services for people living with dementia and their caregivers, saying the association provides care consultations, public education and on‑demand training for qualified service providers. “We partner with them in so many ways beyond the dementia care services contract,” Danks said.

The association requested continued level funding for the dementia care services program and said the program complements the department’s ADRL intake and caregiver supports. No formal action was taken by the committee during the hearing; the association’s remarks were recorded as testimony in support of the department’s budget request.","Alzheimer's Association representatives told the committee they support the adult and aging services budget request and urged continued funding for the state's dementia care services contract included in House Bill 1012.",{"_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},6278650,"Officials tell appropriations panel they need new funds to meet DOJ settlement, expand home‑and‑community supports",4395,412025,4807825,"/Search/View?dp=1&key=2639313-3288abb1b510576083f227a4bc5929e6&start=412&end=4807","https://assets.pipeline.soar.com/2639313-3288abb1b510576083f227a4bc5929e6/thumbnail_412025.jpg","/articles/6278650/North-Dakota/Officials-tell-appropriations-panel-they-need-new-funds-to-meet-DOJ-settlement-expand-homeandcommunity-supports","https://secure.pipeline.soar.com/6278650-5f883e545cc99c58263c1663c7d8a56e/orig.mp4?Expires=1771075919&Signature=XQil0Eou6-O~6~HHycauOiNCzEHyrb1gxIhgc7-evJ0fWlJD1U2eQV5CNQ3tGxtcz6SrRehiO79ZyMur-aTZ~ko8PKP69lLqcGRU7Km3zLt-9QvW~6fsUi8xacazIarVayoeyL9Xl9x0YMT1TAKmlemdcN2qaiYpf5Ty~x7Xdhdbu3Hx5OyI-nNjIA8PGMZDYOvwNUlEoWbUnpuZI9AGTEglTn-pIf4nuI634ddBQ2B8J8993RONxezGSPkcZZQgN9C~HN33ibVAF9Nhd1WuPt1cfm57tvCw~-b0ZplsVlo~kc~ICfmrJR2r1eNxCADCSuzJa6KNK6aqSrBkEJ6r~Q__&Key-Pair-Id=KUT5TJCACFTXG","Nancy Nicholas Meyer, director of Adult and Aging Services in the North Dakota Department of Human Services, told the Senate Appropriations Committee on Oct. 12 that the division needs additional money to meet benchmarks set in a Department of Justice settlement and to expand home‑and‑community‑based services that keep older people out of institutions.

Meyer summarized several specific requests and program details, saying the division serves about 3,500 people in state or federally funded home‑and‑community‑based services and that the Older Americans Act programs reached roughly 35,000 recipients last year. “The Aging and Disability Resource Link is really the place to start,” Meyer said, describing ADRL as the single intake and referral point for aging services.

Why it matters: aging officials said community‑based care is less expensive than institutional care and is central to complying with the DOJ settlement aimed at expanding integrated community options. Committee members were also asked to approve ongoing and one‑time funding for programs that case managers and providers say are already strained.

Meyer outlined the division’s top budget requests: $5.2 million to continue transition and diversion supports that help people move from institutions or basic care back to community housing; $300,000 in general fund rental assistance to supplement federal programs for people who are not eligible for other rental supports; and $718,522 to maintain adult protective services contracts in three regions. Meyer said the rental assistance average is about $600 per person per month and that small amounts of rental help often make a transition possible.

Meyer described operational capacity and demand: the ADRL has six staff who answered more than 12,000 calls in 2024 with an average wait time of about one minute; the division has 73 HCBS case managers and four basic‑care case managers; the division receives approximately 150 referrals per month and roughly 80 become active cases. Senior nutrition programs delivered about 1.4 million meals to 19,000 consumers; the division reported about $3 million in voluntary meal contributions that are reinvested in providers.

On assistive technology and telecommunications, Meyer said the department contracts with North Dakota Assistive and administers a telecommunications equipment distribution program funded by a surcharge on phone bills; that program has roughly $300,000 in biennial funds and has served several hundred people. “If we gave them more money, they could spend it,” Meyer said of ND Assistive, adding demand routinely outstrips current funding.

Meyer also briefed the committee on diversion programs that use flexible federal funds such as Money Follows the Person to help people leave institutional care. She said those flexible dollars and the proposed transition/diversion funding have allowed the state to meet benchmarks in the DOJ settlement by providing rental assistance, furniture and short‑term services that prevent or shorten institutional stays.

Committee members asked operational questions about provider capacity, whether ADRL intake covers Medicaid eligibility (Meyer said ADRL screens and refers but Medicaid eligibility determinations remain with the Medicaid unit), and how the division coordinates with veteran services if VA benefits change. Donna Ockland, speaking for the department later in the hearing, told the committee the House had approved the executive budget requests related to the DOJ settlement as submitted.

The department emphasized these were budget requests for the legislature to consider; the committee did not take a formal vote on the funding items during the hearing. Meyer closed by reiterating that ADRL functions as the unified intake point for aging services and that expanding housing, case management and assistive technology supports are central to the department’s strategy for keeping people in community settings.

Ending: Meyer concluded her testimony by noting continued outreach and public input sessions on the budget and encouraging coordination among state partners and local providers moving forward.","Department of Human Services officials asked the Senate Appropriations Committee for funding to meet Department of Justice settlement benchmarks and expand services that keep older North Dakotans in the community, including rental assistance, transition/diversion supports and funding for adult protective services.","actionData","errors"]

Article not found

Health department proposes host‑home pilot, ICF moratorium and waiver changes in developmental‑disability budget

Alzheimer's Association urges continued funding for state dementia care services

Officials tell appropriations panel they need new funds to meet DOJ settlement, expand home‑and‑community supports