[{"_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",6092819,"mediaKeyId","2852094-cccafbaed5bc1cb8afff9b5916a05e15","parentId",2852094,"title","Lawmakers debate SUD voucher expansion, jail mental‑health payments and youth crisis pilots as HHS requests multiple program increases","audioSeconds",2253,"startMs",7737000,"endMs",9990000,"viewUrl","/Search/View?dp=1&key=2852094-cccafbaed5bc1cb8afff9b5916a05e15&start=7737&end=9990","thumbnailUrl","https://assets.pipeline.soar.com/2852094-cccafbaed5bc1cb8afff9b5916a05e15/thumbnail_7737000.jpg","articleUrl","/articles/6092819/North-Dakota/Lawmakers-debate-SUD-voucher-expansion-jail-mentalhealth-payments-and-youth-crisis-pilots-as-HHS-requests-multiple-program-increases","mediaUrl","https://secure.pipeline.soar.com/6092819-c2aaeba6cab35154713b68346f7cbfe6/orig.mp4?Expires=1770757081&Signature=QG5fzKrvlcxnddj7MPt84P2AtwR9XYAZ6ZFif4Xmi7C22hVwH-QJk0kHFOu3t3Xb~Phj9615unx7j-sEtgeuov~NCHUxxULXJBImrcS8P0aVT-1fN4AFdZpSBsHHxEYqfmmHvSJh8BHSB6lWXYkXcWfnee302XiCQLvPRLccT6pYJfrXBNO9URux1zEz4HxQl~M17D8MEtYjxHLnQx3-NNx09IVpZIAEHjmba6eg0TlczeV1F25ejvodPPy16b8PipSLmsCDIfuItoJhc~synXauK8oyb1dtwa~JvNvhjV6R~n5vWiCzZMkBqMNM~HI~OKUGvg0CrHCrivrRr4jBMA__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota Legislature","date","2025-04-02T00:00:00Z","article","Bismarck — The Appropriations — Human Resources Division debated several behavioral‑health program requests Friday, including expansions to the state’s substance‑use disorder (SUD) voucher program, a proposal to reimburse medical expenses at institutions for mental disease (IMDs), pilot funding for jail‑based mental‑health services, and a proposed youth crisis stabilization pilot.

SUD voucher expansion and IMD medical expenses

Department testimony said utilization of the SUD voucher program has grown and that an additional $2.5 million of general fund support would keep reimbursement rates aligned with Medicaid and meet increasing demand. The department described how the voucher program reimburses treatment providers and said earlier biennia had seen the program run out of funds mid‑biennium.

On IMD medical expenses, the House had not included funding. The Senate discussion flagged a $500,000 request that would reimburse certain medical costs incurred while a person is in a facility larger than 16 beds, because Medicaid reimbursement pauses for individuals in IMDs. The department said the program would reimburse provider purchases (for example, medications or urgent care needs) on a receipt basis, subject to administrative rules and later rulemaking and delayed implementation.

“The intent of the delayed implementation was that the Department would need to draft rules. What’s reimbursable? How did…what’s that process like?,” a committee member said; department staff said rules and reimbursement criteria would be developed before funds would be available.

Jail mental‑health services

Lawmakers also discussed a proposal to allow voucher‑style reimbursement for mental‑health services delivered in county jails where many detainees are held for extended periods. The original idea stemmed from a locality that used COVID funding to provide on‑site mental‑health care in a county jail and reported positive outcomes.

Committee discussion focused on (a) whether the proposal duplicates existing county investments, (b) the administrative burden of creating a new payment stream and provider requirements, and (c) whether a pilot or phased approach is preferable. The department said expanding the voucher program to add mental‑health providers would require statutory and administrative changes because current voucher providers are licensed addiction treatment providers.

Youth crisis stabilization and children’s services

The department had proposed a $6 million youth crisis stabilization pilot (split 50/50 general fund and federal), which the House declined. Committee members argued for a single pilot instead of two full pilots, and several senators linked the proposal to separate pending legislation to expand youth residential services. One lawmaker said stabilizing a child for 24–48 hours can avoid court escalation and reduce longer‑term costs.

Other program lines and conference recommendations

The committee also reviewed funding for juvenile residential treatment (QRTP), a voluntary treatment pilot for custody youth, and program cost‑to‑continue lines. Members generally supported continuing existing programs (Free Through Recovery and Community Connect) but expressed concern about unchecked expansion without clearer ceilings or utilization data. Several senators asked the department to provide utilization and outcomes data before final decisions.

Where the committee landed

Lawmakers signaled mixed priorities: some members supported keeping the SUD voucher increase and the IMD medical expense funding (with narrow rules), others favored piloting jail‑based mental‑health reimbursement rather than a statewide roll‑out, and several urged a single youth crisis pilot tied to planned residential expansions. No formal appropriations were adopted at the hearing; committee members asked the department to return with specific fiscal and operational details for each proposed program.","mediaType","Video","parentTitle","Senate Appropriations - Human Resources Division Apr 2, 2025","oneSentenceSummary","Lawmakers debated multiple behavioral‑health program requests — a $2.5 million SUD voucher expansion, $500,000 for IMD medical expenses, a proposed jail mental‑health reimbursement stream, and a youth crisis stabilization pilot — and asked HHS for more detail before committing funds.","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},6092824,"HHS outlines $9.4M in COVID behavioral‑health awards ending; $6.2M unspent, contracts re‑prioritized",367,5131000,5498000,"/Search/View?dp=1&key=2852094-cccafbaed5bc1cb8afff9b5916a05e15&start=5131&end=5498","https://assets.pipeline.soar.com/2852094-cccafbaed5bc1cb8afff9b5916a05e15/thumbnail_5131000.jpg","/articles/6092824/North-Dakota/HHS-outlines-94M-in-COVID-behavioralhealth-awards-ending-62M-unspent-contracts-reprioritized","https://secure.pipeline.soar.com/6092824-6b5abe2c0d5a093935424e23c4e68717/orig.mp4?Expires=1770757081&Signature=X0uJkvv381ytDvcnSTThs5MZgx6Z1tFwlO38rssWWL6UGLjEYjdjuzLUs9qIXEepqLlX5pWUCpEYqOtkSpYr0QVo0fEYqKDoZsPMC-RFY2z~EHGashgQ~9cbN9UiPWnk1T22a2bozIAWKfQOGb0ixcivbHN9B4t-GMLMZKdGlkbTMJO2~Bc7W1lV1wuRIpC5oc5XAl2IDoNEfhSn5aeq7Fz1xzg6ENPQ2zVL-a-r1DOIp9ZSFuzwucIG~fsLn1AX-VkNIB4L6xKopkEmQzJeC2xnu9mT7Hejsvr2XSXZQmxyyjySgleq1TFBDeuEUPeMsO7WmX3W91Xh-yy0D64Dmw__&Key-Pair-Id=KUT5TJCACFTXG","Bismarck — Pam Segnus, the department’s executive director for behavioral health, briefed the appropriations subcommittee on federal COVID‑era grants that support behavioral health and said roughly $9.4 million in awards tied to the federal pandemic response are scheduled to expire by Sept. 30, 2025.

Segnus told lawmakers the department had drawn approximately $3.1 million of the total awards and had about $6.2 million remaining when the grants were slated to terminate. The department categorized prior draws and obligations as: 33% expended (reimbursements and direct purchases), 23% obligated through external contracts, and the remainder either intentionally turned back or canceled.

Segnus presented a breakdown of contracts affected and said some contracts were in the procurement pipeline (entered but not signed) and were therefore canceled without finalized agreements, while others were terminated after formal contract execution. She said the department prioritized continuity for services where termination would abruptly stop care — for example, withdrawal‑management providers that operate 24‑7 social detox services.

“The obligated in blue… are obligated and contract canceled or terminated, and that was 43% of this total pie,” Segnus said in the hearing’s slide‑by‑slide discussion. She told the committee the department has found replacement funding for $344,000 of obligated contracts and is working with Medicaid and other federal partners to minimize service disruptions.

Examples and use of funds

Segnus identified canceled or unfinalized contracts that included workforce‑recruitment tools (a virtual‑reality recruiter demonstration) and a contract for mental‑health support to staff who respond to critical incidents. She said one small $250,000 award was intentionally turned back because it was specific to PPE and items the state did not need.

She also read a list of continuing contracts through Sept. 30, 2025, and said sustainability plans are in place for services that can be transitioned to billable codes or other federal funding streams. “We are working with providers to make sure that they know how to bill for services. Medicaid has reached out and said, ‘what are some things we can do to assist to make sure that when something’s billable that that’s happening?’” Segnus told the committee.

Lawmakers’ questions and department response

Committee members asked what “canceled but in progress” means; Segnus explained those were agreements that had been scoped and entered into the contracting pipeline but not fully executed. Senators also asked whether terminating contracts creates obligations or penalties; Segnus said contracts generally include appropriation or funding contingency language and that unresolved invoices for services performed remain a priority for federal drawdown attempts.

Senators asked about the mental‑health support contract for staff, described in the hearing as payment for specialized support to behavioral health clinicians who respond to traumatic incidents; Segnus said the department is exploring other federal block‑grant sources and re‑prioritizing existing funds to preserve critical workforce supports.

Next steps

Segnus said the department is reviewing other federal and state sources (including the Substance Abuse Prevention and Treatment Block Grant and opioid settlement funds) to sustain prioritized services and will provide the committee additional detail on which services will continue, transition to Medicare/Medicaid billing, or end when federal COVID funds expire.","Behavioral health grants funded with federal COVID dollars total about $9.4 million; the department reported $3.1 million drawn and $6.2 million remaining at termination and described which contracts were canceled, which were converted to other funding, and how it prioritized ongoing services.",{"_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},6092826,"HHS requests 103 FTEs and expanded authority to stand up four CCBHCs, cites $20 million needed",5771,1075000,6846000,"/Search/View?dp=1&key=2852094-cccafbaed5bc1cb8afff9b5916a05e15&start=1075&end=6846","https://assets.pipeline.soar.com/2852094-cccafbaed5bc1cb8afff9b5916a05e15/thumbnail_1075000.jpg","/articles/6092826/North-Dakota/HHS-requests-103-FTEs-and-expanded-authority-to-stand-up-four-CCBHCs-cites-20-million-needed","https://secure.pipeline.soar.com/6092826-08037417cf6d922aab69f8bb278814bb/orig.mp4?Expires=1770757081&Signature=X1lXVYe0TYlji2jSj3vFfKQvC3~A51F8Z4vB4tSKWAjooIUXNAI1wxo66zloPRos7pu3OC0-D4iMrmZy5lZTxWdHy9qotd76B1vCSVH1NgYZDe0NkARPWYZ5P5l~4Up5KaeSGDnFQghju~ESQmxl1FdgIgqtYPFp0JVz2IHhvoB3GOdcbmx5E7NLiP3p2b~wilqCw6xF1duesEfVEhF9sF4up9GD0BB0K8SdIOZV9OpWQCxZfCK8WkfNAtHBL1Itc9wb9VKM~6D-sDBFfpRFl87DnVQJbjbm3mLLBueDOu6TTA4UrB2FrCslCepIitLJR62J-zfoHiA6wd77dNhabg__&Key-Pair-Id=KUT5TJCACFTXG","Bismarck — Department of Health and Human Services officials told the Appropriations — Human Resources Division on Friday that the state will need 103 new full‑time equivalent positions and expanded spending authority to stand up four Certified Community Behavioral Health Clinics (CCBHCs) planned for Williston, Dickinson, Minot and Fargo.

The department’s presenter, identified in the hearing as Donna, said Pam Sangness’s team calculated staffing needs and “in order to stand up the 4 CCBHCs and to continue to be current on all the services without turning people away, we will need 103 FTE.” Donna added, “So every million dollars that we have will get us 5 FTE for a full 24 months.”

The request to add roughly 103 FTEs prompted discussion about cost and funding sources. Donna said a rough funding estimate to staff the 103 positions for a 24‑month biennium is about $20,000,000 of authority in the FTE block grant, and she told the committee: “So the request of a hundred additional FTE, we will likely need around $20,000,000 give or take in order to make sure that those 4 CCBHCs are up and running.”

Why it matters

Committee members pressed staff about how much of the positions will be billable and when revenue will begin to offset salary costs. Donna and Deputy Commissioner Sarah Stolt said many services are billable to commercial insurers and Medicaid once rate setting and billing codes are established, but that establishing Medicaid reimbursement for new CCBHC service codes typically requires a full year of documented costs before rates are set.

“Because we’re a governmental entity, we need a full year to establish what the actual costs are… and that’s why it takes a year to get the revenues,” Donna said, repeating a point Sarah Stolt later described to the committee as a federal requirement for governmental entities.

How lawmakers could provide authority

Several senators and staff discussed two mechanical approaches: (1) raise the department’s overall FTE block grant authority by the requested amount, or (2) add a separate, earmarked line in the block grant specifically for the CCBHC positions while keeping broader underfunding elsewhere.

Donna said either approach could work but emphasized that the legislature should record an approved FTE count if it wants the department to treat it as an explicit authorization: “If you were wanting to fund a new initiative… you could have a separate line just like that mechanically, and then the money would go in the FTE block grant for the department to manage as a whole.” She noted the department could stagger hires and that not all 103 FTEs would need to be on payroll the entire biennium.

Concerns and clarifications

Lawmakers asked for a spreadsheet with timing and revenue assumptions; Donna agreed to provide one for the committee. Committee staff (Keith) later noted bill language governing the block grant already allows the department to move FTEs up and down, but implementing a separate pool would require additional bill language.

Senators also sought clarity on partnerships with private providers. Pam Sangness, the departmental executive director for behavioral health, told the committee CCBHCs will partner with private providers to avoid unnecessary duplication and to coordinate care across regions. She said private pay, private insurance and Medicaid clients can be served: “They cannot turn anyone down. So whether they’re private pay, have private health insurance, have Medicaid, or don’t have any insurance, the CCBHC can serve all of those populations.”

Ending and next steps

The department promised to supply a staffing and authority spreadsheet and to return with Pam and other staff later the same day to answer follow‑up questions. Committee members discussed placing the 103 FTEs on a separate line or adding the dollars to the block grant; no formal vote or final appropriation was taken during the hearing.

The subcommittee also flagged reporting requirements: Donna pointed to proposed quarterly reports the department would produce so lawmakers can track how the FTE block grant and any earmarked CCBHC authority are used.","Department of Health and Human Services told the appropriations subcommittee it needs 103 new full‑time positions and roughly $20 million of authority to staff four Certified Community Behavioral Health Clinics (CCBHCs); lawmakers discussed alternatives including a separate line in the FTE block grant and quarterly reporting requirements.","actionData","errors"]

Article not found

Lawmakers debate SUD voucher expansion, jail mental‑health payments and youth crisis pilots as HHS requests multiple program increases

HHS outlines $9.4M in COVID behavioral‑health awards ending; $6.2M unspent, contracts re‑prioritized

HHS requests 103 FTEs and expanded authority to stand up four CCBHCs, cites $20 million needed