ND committee hears researchers and parents on ACEs, home visiting and federal match opportunity

A North Dakota legislative interim committee heard a presentation on the population‑level effects of adverse childhood experiences and a separate briefing on evidence‑based home visiting, with advocates pressing lawmakers to consider funding and outreach to expand services.

Dr. Ramona Danielson, a public‑health researcher at North Dakota State University, told the Protection and Victim Services Committee that ACEs are not an individual diagnostic tool but a population measure correlated with higher lifetime risk of chronic illness, mental‑health disorders and greater interaction with public systems. “Higher exposure to ACEs is associated with increased chronic illness across the life course,” she said, warning that precise dollar estimates of economic impact are difficult because most studies rely on observational data and causal attribution is complex.

Why it matters: Committee members said they wanted clearer data to guide budget decisions. Danielson said North Dakota BRFSS data show about 17% of adults reported four or more ACEs and that those with high ACE scores tend to appear disproportionately in systems such as corrections and child welfare. She emphasized evidence‑based protective interventions while cautioning that converting life‑course impacts into a single cost figure requires many assumptions.

Following Danielson’s remarks, two home‑visiting program leaders described how long‑term, relationship‑based visits support parents and children. Allison Mahoney of Families Flourish North Dakota and Missy Barranco of Aspire ND said home visiting is voluntary, typically begins prenatally or shortly after birth and lasts two to four years; programs commonly use nurses, social workers or trained paraprofessionals and focus on parent–child interaction, screening and referrals. A parent who participated in Healthy Families described weekly home visits that led to developmental referrals for her child and ongoing postpartum support.

Funding and scale: Presenters said 12 organizations operate one or more models statewide; Healthy Families reported offering services in all 53 counties but having served families in 39 to date. They described a blended funding model: Title IV‑E (Families First) and other federal/state grants, Medicaid targeted case management for eligible parents, philanthropy and local fundraising. They highlighted a federal home‑visiting opportunity — the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program — that uses a 3:1 federal match ladder; presenters said North Dakota has become eligible for increased match funds and could access up to about $1.5 million in federal dollars with a $500,000 non‑federal match, but noted MIECHV targets high‑risk populations and sustainability and supplantation rules constrain how money can be used.

Questions from legislators ranged from how families are referred (hospitals at birth, pregnancy navigators, WIC, human services, self‑referral) to gaps in public awareness and the difficulty of recruiting and paying staff. Presenters said many visits are not fully covered by reimbursement rates and organizations rely on supplemental philanthropy to sustain services.

Next steps: Committee members requested follow‑up materials and said they were interested in exploring agency budget requests and bill drafts that could help secure matching funds and stabilize program funding. The committee approved its prior meeting minutes by voice vote before the presentations began.