State aging services director outlines rising demand, housing and transition requests tied to DOJ settlement

Nancy Nicholas Meyer, director of Adult and Aging Services, told the Senate Appropriations Committee’s Human Resources Division that the agency is seeing sharply rising demand for home- and community-based services and requested targeted funding to support transitions, housing assistance and adult protective services.

Meyer said the agency serves roughly 3,500 people in state- and federally funded home- and community-based services and that referrals are running at about 150 new referrals a month, with roughly 80 of those converting to active cases. She identified several funding requests in the agency’s decision package: $300,000 in general funds for state rental-assistance to meet Department of Justice settlement benchmarks, $5.2 million to continue transition and diversion supports, and $718,522 to sustain adult protective services contracts in three regions.

Why it matters: The agency’s requests are tied to an ongoing settlement with the U.S. Department of Justice that requires the state to expand community options and reduce unnecessary institutional placements. Meyer told lawmakers that housing remains the top barrier to transitioning people from institutional settings to integrated community homes.

Key points from the testimony - Intake and navigation: The Aging and Disability Resource Link (ADRL) now serves as the state’s intake system for aging and long-term services; Meyer said ADRL staff manage calls from 8 a.m. to 6 p.m., average phone wait time is about one minute, and ADRL handled roughly 12,000 calls in 2024. The ADRL determines potential eligibility and refers callers to case managers or options counselors as needed. - Workforce and caseloads: The division employs about 44 staff; the largest group is HCBS case managers (73 case managers were cited for field casework, plus four basic care case managers). Meyer said staff are busy: the agency receives 150 referrals monthly and 80 become cases. - Nutrition and preventive services: The Older Americans Act-funded senior nutrition program provided about 1.4 million meals to 19,000 consumers; providers operate 205 senior nutrition sites statewide and the program mixes federal, state and local funding and participant contributions. The agency also funds evidence-based fall-prevention and caregiver training programs and piloted a CAPABLE-style program that paired occupational therapy, nursing and home modification supports. - Assistive technology and telecommunications: Meyer said the agency administers a telecommunications-equipment distribution program supported by a portion of phone-fee revenue; ND Assistive receives approximately $300,000 biennially for assistive-technology distribution and specialized equipment (amplified phones, photo-dial phones, specialized answering machines) to help people remain connected and safer at home. - Adult protective services: Reports to the APS system have risen; the agency marked 5,978 reports and 1,522 investigations in the cited period. Meyer said much of the APS work is voluntary outreach when adults decline services. To maintain investigative capacity, the agency is requesting $718,522 to continue contracts with three providers operating in higher-demand regions. - Housing and Money Follows the Person (MFP): Meyer said that housing is the primary barrier to transitions from institutional settings and that the agency uses an average rental-assistance amount of about $600 to help people access private housing while they receive community supports. The agency requested $300,000 in general funds to support individuals who do not qualify for federal rental assistance but need a small subsidy to move from institutions into community housing; the agency said previous allocations were spent and carryover balances are exhausted. - Transition and diversion program: The agency asked for $5.2 million to continue flexible transition/diversion supports that help people move from hospitals, skilled nursing facilities, basic care or ICFs into community settings; Meyer said these flexible funds pay for furniture, short-term housing supports and other one-time needs to effect transitions.

Committee questions and clarifications Committee members asked whether the ADRL concept could be better marketed (several members noted the public may not recognize the ADRL name), how the state coordinates with veteran services when federal veteran supports change, and whether the assistive-technology program could absorb additional funds (Meyer said the ND Assistive program typically spends its allocation and could use more resources). Committee members also pressed on whether the House funding levels meet the DOJ settlement requirements; agency staff and the Fiscal Office said the executive request matched the settlement goals and that the House had approved the executive settlement requests in committee as presented.

Nut graph: Meyer framed the requests as part of a larger effort to preserve community living for older adults and people with disabilities, arguing that modest, flexible investments (rental assistance, one-time transition supports, targeted APS contracts) prevent costlier institutional care and help the state meet DOJ settlement benchmarks.

Ending: The committee heard extensive Q&A and signaled it would continue to consider adult-and-aging budget items alongside a broad slate of long-term-care and developmental-disabilities appropriations; members urged clearer public messaging on ADRL and said they would return to unresolved items in later hearings.