[{"_1":2,"_99":-5,"_100":-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",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":44,"_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":73},"mediaId",6135878,"mediaKeyId","5670518-e2e128db7e1433b9fb6efa6dd657c363","parentId",5670518,"title","Tribal leaders urge managed‑care option for Medicaid to address health disparities","audioSeconds",0,"startMs",4763000,"endMs","viewUrl","/Search/View?dp=1&key=5670518-e2e128db7e1433b9fb6efa6dd657c363&start=4763&end=4763","thumbnailUrl","https://assets.pipeline.soar.com/5670518-e2e128db7e1433b9fb6efa6dd657c363/thumbnail_4763000.jpg","articleUrl","/articles/6135878/North-Dakota/Tribal-leaders-urge-managedcare-option-for-Medicaid-to-address-health-disparities","mediaUrl","https://secure.pipeline.soar.com/6135878-eec868aa4a45c39e088d5f561bf7c475/orig.mp4?Expires=1771051204&Signature=U3PHmc~R1t8Pw~p6vXRzuT75wJrruaAblEvXkYrCfmznj0bJpUZgbOn~BMU-jtQCuODwfrNgH1Xz7HIuiByno3osB2-IXy67R42RSOr-2-mjJXS7TQsPJcdxArvOofjZUbCKixtzWEL-SYiFhB0ALBIZhuUX1hWONcI3sctCavHQ-xmSA4aDl6wxDxRK~pNroCbHrstF~-lKrsZAS45e7rRLPA2XbfwKbRWh0iC8JUmloHwxpyDfvZviDZMmd~6vHVzjMcVG33Cwks1y7hjSIxF5kfbVrVV5CliYAOKf06fxEF4UbWV8tdZI~zClDqKvEixeLrvprftrZNzTi8gI3g__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota Legislature","date","2025-08-19T00:00:00Z","article","Committee members and tribal leaders discussed shifting Medicaid services for tribal members to a tribe‑managed, capitated model to improve access to behavioral health and address social determinants of health.

\"We've been engaged with South Dakota Department of Social Services on, taking a look at managed care,\" Chairman Renville told the committee, describing work that tribal leaders and South Dakota officials have done to explore a tribal‑run managed‑care arrangement. He said the goal is to \"shift the focus from...a reactive model, which is more expensive,\" toward earlier intervention and better management of mental‑health and substance‑use disorders.

Renville said the tribes in North Dakota support the effort and that the model appears feasible for the state. He told the committee he has scheduled a meeting with Secretary Althoff on Aug. 28 and invited North Dakota counterparts to participate. In broad terms he described a \"rule of thumb\" capitation figure of about $1,000 per member per month and cited an informal population estimate of roughly 30,000 Native American Medicaid members in North Dakota as context for feasibility discussions. He also estimated a realistic negotiation and implementation timeline of about 18 months, with an expedited target of next summer.

Committee members and agency staff raised related workforce and telemedicine issues. Director Hawk of the governor's office said the governor’s workforce subcabinet is discussing housing and childcare as workforce bottlenecks and that the governor's office intends to stand up a tribal‑state relations subcabinet to address cross‑cutting issues including behavioral health.

Several lawmakers noted the potential budgetary effect of a capitated model: in a managed‑care arrangement some costs become federally matched and pre‑negotiated, which could reduce the state’s variable costs for care delivered in urban settings where Indian Health Service (IHS) facilities are absent. No formal action was taken; the chairman invited committee members to attend further meetings and to follow up with legislative staff and tribal leaders.

Why it matters: The discussion could lead to a significant administrative change in how Medicaid services are organized for enrolled tribal members. Proponents say a tribal‑managed, capitated model may improve care delivery, address social determinants of health and stabilize state budget exposure; opponents or fiscal analysts will need detailed modeling and formal agreements before any transition.","mediaType","Video","parentTitle","Tribal and State Relations Committee Aug 19, 2025","oneSentenceSummary","Tribal leaders and committee members discussed a tribal‑managed Medicaid model (capitated managed care) as a tool to improve behavioral health and chronic‑disease outcomes and to stabilize state budgeting; chairman and tribal leader described meetings with South Dakota and upcoming talks with state health officials.","taxTitle","Legislative, North Dakota","taxId",28306,"location","North Dakota","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_46":81,"_48":82,"_50":83,"_52":84,"_54":55,"_56":57,"_58":85,"_60":61,"_62":63,"_64":86,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6135883,"North Dakota Native Tourism Alliance pitches cultural tourism, reports rising economic impact",866,1614000,2480000,"/Search/View?dp=1&key=5670518-e2e128db7e1433b9fb6efa6dd657c363&start=1614&end=2480","https://assets.pipeline.soar.com/5670518-e2e128db7e1433b9fb6efa6dd657c363/thumbnail_1614000.jpg","/articles/6135883/North-Dakota/North-Dakota-Native-Tourism-Alliance-pitches-cultural-tourism-reports-rising-economic-impact","https://secure.pipeline.soar.com/6135883-f55237d7032c876776053811814218fd/orig.mp4?Expires=1771051204&Signature=PoJCAbrCAsfZYKHYZlWkx0HSQd54JdDgXi4MRws-h9Ns0QSfU8bPVbbPubac78s56ODNJiksAVz5GYA0gFakKK03AalbrTVyOX6JAQrkzbpZgpGwJyBRFcZX37UAiDo5hrerIFwyULVeQ2kqEtvOdozTTARRuwCGO2r3wtCKenPHUnul9Hk2PPPgqR8fv8hzRU-GTa6hzcnHO8qkV0vlT3rskZZcprav1xVvcFBSUjXjBhx8xaDvoGzRukZ~Pd1NYf1ErYfatC0swhUc4B~XvD~zNogzshi1EqRpnGGCFimc53kQBWxu4WPlqcyHHOMPGn2hrDCwPy6gChMLcCPa3Q__&Key-Pair-Id=KUT5TJCACFTXG","Representatives of the North Dakota Native Tourism Alliance told the Tribal and State Relations Committee that tribal‑led cultural tourism is growing and that tribes want to retain more visitor spending locally.

\"My name is Les Thomas. I'm an enrolled member of Turtle Mountain Band of Chippewa, and presently I am the board president of North Dakota Native Tourism Alliance,\" Les Thomas said, introducing the alliance and its purpose \"to preserve, protect, promote, and respect and educate the world about our history and our cultures.\" He told the committee that the alliance recorded a $3,300,000,000 economic impact in 2023 and preliminary figures of $3.4 billion for 2024.

Stacy Lecamp, introduced herself as the Executive Director of the alliance and described how the group organizes regional tours so visitors spend nights and dollars on tribal lands. \"We start developing these what we call regional... within 1 tribal base, wherever that tribal nation is at, what is the surrounding area around it? What can they see if they're gonna go from A, B to C? But making sure they're staying at our tribal nations,\" Lecamp said.

Tamara St. John, tribal historian and a board member for tribal tourism, said the work is an expression of tribal sovereignty and helps tribes tell their histories \"with our own voices.\" She also noted partnerships with the State Historical Society and university preservation programs and referenced work on NAGPRA protocols and collections.

Alliance speakers described a calendar of international interest — groups from Norway, Sweden, Italy, the U.K. and France — and said the alliance is coordinating with state tourism offices to place tribal experiences on itineraries tied to larger events. The group said it is planning outreach connected to America250 activities and to statewide festivals such as the HoosFest and the United Tribes Powwow.

The presenters listed concrete tourism‑development items already in place in tribal communities, including an indoor water park and equestrian facility in Turtle Mountain and interpretive centers and cultural events at other tribal sites. They said booking for international tours typically begins in October and stressed the importance of on‑reservation lodging, tour products and local entrepreneurs for capturing visitor spending.

Why it matters: Committee members and state staff heard that tribal‑led tourism is already a significant economic sector and that tribes want partnership with state marketing efforts to increase visitor stays on tribal lands. The alliance requested continued collaboration on event calendars, marketing and logistics; committee members signaled support for partnership and further meetings.","Leaders of the North Dakota Native Tourism Alliance told the Tribal and State Relations Committee that tribal‑led cultural tourism is expanding, reporting a $3.3 billion economic impact in 2023 and $3.4 billion in 2024 and outlining plans for international and regional tours and events tied to America250 activities.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_46":93,"_48":94,"_50":95,"_52":96,"_54":55,"_56":57,"_58":97,"_60":61,"_62":63,"_64":98,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6135888,"Legislative staff outlines committee charge, tribal-state study topics",716,1027000,1743000,"/Search/View?dp=1&key=5670518-e2e128db7e1433b9fb6efa6dd657c363&start=1027&end=1743","https://assets.pipeline.soar.com/5670518-e2e128db7e1433b9fb6efa6dd657c363/thumbnail_1027000.jpg","/articles/6135888/North-Dakota/Legislative-staff-outlines-committee-charge-tribal-state-study-topics","https://secure.pipeline.soar.com/6135888-0c025389cc2cae039106c57598f12fa7/orig.mp4?Expires=1771051204&Signature=oWigrdmKc2fnjSlgURXm2YgSad7oM~jgeY1qko~s0mPcrlmYg~TcS3dA8ku~bsFOvLuFuemAQvq6Iyu8-Q8jlMTmvtmQnqZXDQSEO5vgiBggig2fYu-~66sxoJg40sq0r70vuaWLDNOGmby1MiMQKUqHYEiEub~ThQLtZLVjy8fq-oFkejM4o8QpUSS9Ss~z1k30Q8FpbP7d94OMipAhGwYdvp41S3sRyMQDzHXim2-EVKPJ2hhVin8drFSx0tr8CLM6wkb1k2G7sgvk7i3imUXkIHVxVsw0gZyDqROjHl-nCQ5aJrsbLefQ-WyLvcgd8k0bcKFvf52sRi4GuBSikg__&Key-Pair-Id=KUT5TJCACFTXG","Legislative Council staff opened the Tribal and State Relations Committee meeting with a summary of interim rules and the committee’s study assignments.

“The meetings and the meeting dates and times are selected by the chairman. The meetings are governed by the rules of the assembly. If there's an area that is unclear or is not addressed by our normal rules, Mason's manual of legislative procedure applies,” a Legislative Council staff member said while outlining committee procedure and reporting requirements.

The committee was given three memoranda for its work this interim: a tribal background memo (LC number 279066010.00) setting out the committee’s statutory charge under North Dakota Century Code §54‑35‑23; a listing of existing intergovernmental tax agreements (cigarette/tobacco, motor‑fuel, oil and gas, and sales and use tax agreements); and a study directive on taxation of land owned by tribal members (LC number 2709067010.00), which the staff said derives from Section 1 of House Bill 1563.

The background material reviewed federal case law and statutory frameworks that limit state taxing authority over tribal trust lands and summarized differences between trust land and fee land. The staff presentation noted federal principles discussed in the materials, including the Indian Reorganization Act of 1934 and court precedent that states generally lack authority to tax reservation lands absent express Congressional authorization. The staff also cited a North Dakota Century Code provision (transcribed in the meeting as 57‑02‑08.4) that staff said codifies some related state interpretations.

Committee members were told the study may\"include an analysis of federal law, judicial decisions, state property tax exemptions related to property of native Americans, and the interaction between tribal sovereignty and state law,\" and that testimony could be taken from tribal tax departments, the state tax commission, and tribal schools and other stakeholders.

Chairman Renville said he intends for the committee to meet across the state and to hear directly from every federally recognized tribe in North Dakota during the interim. The meeting concluded without substantive committee votes on policy; the committee adjourned by voice vote.

Why it matters: The memos set the legal and factual scope for the committee’s interim work on tribal–state relations and on whether and how state taxation applies to land owned by enrolled tribal members within reservation boundaries. The outcomes of the study could inform future legislation, intergovernmental agreements or administrative guidance.","Legislative Council staff reviewed interim rules and background memos directing the Tribal and State Relations Committee to study tribal–state relations and the taxation of land owned by tribal members.","actionData","errors"]

Article not found

Tribal leaders urge managed‑care option for Medicaid to address health disparities

North Dakota Native Tourism Alliance pitches cultural tourism, reports rising economic impact

Legislative staff outlines committee charge, tribal-state study topics