North Dakota

In February 2007, North Dakota Comprehensive Employment Systems produced a report that summarizes the current state of long-term care in North Dakota including funding sources, expenditures, and the potential outcomes of change is not initiated. The report goes on to cite recommendations for change.

Need an overview of the basic components of the nation’s largest health coverage program? Medicaid covers 55 million low-income individuals and is the dominant source of long-term care financing. Examine the structure of the program, who it covers, what services it provides, and spending. Because Medicaid is jointly financed by the federal and state governments programs vary across states. Tables examining the state-to-state variation in eligibility, enrollment, and spending are included.

Thirteen states and the District of Columbia will get more than $547 million in grants over five years to build Medicaid long-term care programs that will help keep people at home and out of institutions. This “Money Follows the Person” initiative was included in the Deficit Reduction Act of 2005 (DRA), currently being implemented by CMS. The press release lists the states and the amount of money committed over the next five years.

This report summarizes the research findings of a 2006 questionnaire disseminated to gather information about choice and access to continuum of care services. The survey gained information from consumers regarding services they are using, services needed, and barriers encountered. Data was gathered regarding how consumers learn about available services and suggestions to guide the development of a single point of entry (SPE) system, also called an Aging and Disability Resource Center (ADRC).

This report describes the hospital discharge planner (HDP) survey conducted in the beginning of 2006. The HDP questionnaires were disseminated to gather information about the awareness of choice and access to continuum of care services for the elderly and people with disabilities as well as to gather ideas about how to optimize choice and improve access to these services. Review the results and read about the barriers faced by discharge planners.

Interviews were conducted to identify current perceptions, patterns, themes, and suggestions for improving the choice and self-direction, quality and access to long term care supports. This research also identified ways to develop a mechanism to balance state resources for services, and to identify elements for the design and structure of a single point of entry mechanism. Groups included: consumers of HCBS, elderly and younger nursing home residents, family members of consumers, and providers.

This paper explores and analyzes selected state approaches to engage nursing facility operators to be part of systems change activities that offer individuals additional, less restrictive choices to live more independently with appropriate supports. The strategies described offer other states lessons learned that may be replicated as part of a broader approach to meet changing and growing demand for home and community-based services. Efforts in IN, IA, MI, MN, NE, ND, NY, and WI are described.

The Compendium contains basic information about each of the Real Choice Systems Change Grant awards in FY03–FY04 plus the Family to Family and Systems Transformation Grantees awarded in FY05 and FY06. The Compendium will help Grantees identify others with similar goals and activities. Learn more about how the grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. The sixth edition replaces all previous editions.

A new database showcases the efforts of many of the TA providers serving CMS’ grantees. The database allows users to see the wide range of activities that support and enrich the grantees under the New Freedom Initiative. The database contains important information regarding existing and upcoming research products, conferences, and significant meetings as well as a wide variety of toolkits, surveys, and policy briefs, intended to be of interested to the disability and long-term care community.

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.