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Agency reports progress toward community-based services for people with disabilities

November 20, 2002

Bismarck, N.D. - The North Dakota Department of Human Services issued an update on the state's progress in developing a wide array of services for people with disabilities and long-term illnesses. The agency has produced several fact sheets, titled "Olmstead Updates," which describe trends in public services for people with disabilities. The documents focus on the following department services: mental health, substance abuse, developmental disabilities, and long-term care.

"It has been two years since the department held public dialogues on the United States Supreme Court's Olmstead decision, which encourages consumer-focused, community-based services for people with disabilities of all ages," said agency executive director, Carol K. Olson. "We wanted to let people know that as a state, we continue to make progress. However, because of the state's rural nature we do face challenges assuring access in some regions of North Dakota."

Olson said North Dakota is doing a good job of serving people in communities. "North Dakota is ahead of many other states that still rely too heavily on institutions to serve people with disabilities. In 1979, about 1,000 adults and children resided at the Grafton State School and San Haven. In the 20 years since the successful lawsuit filed by the ARC of North Dakota, the situation has changed dramatically. Today about 147 people reside at the Developmental Center each month. Thousands of people with developmental disabilities are living, working, and leading more meaningful lives in communities across the state. In fact, North Dakota leads the nation in per capita fiscal effort in this area."

Department records show a similar shift in mental health and substance abuse services. That delivery system has been transformed from an institution-centered system that provided care to over 2,500 people at the State Hospital in 1950 to one that provides an array of treatment and support services. In 2001, the State Hospital's average daily census was about 160, while the number of people receiving treatment and related services at the regional human service centers totaled 25,124.

While the updates point out positives, they also mention challenges. For example, in 2001, North Dakota had more nursing home residents per 1,000 persons age 65 and older than any other state in the nation. The state is committing almost $299 million of its current budget for Medicaid nursing home care to serve about 3,700 people per month. The state's aging population and reductions in the federal government's Medicaid matching rate for North Dakota assure that this budget area will receive prominent attention in the future.

Olson said it is important to sustain services for people who need nursing home care, but that the state also needs to do a better job of assuring that people have a wider array of options as they age and their abilities change. Nursing homes consume 21 cents of every dollar in the state's human services budget, and home and community-based long-term care services consume 3 cents.

"We know that we still have an institutional-bias in Medicaid funding for long-term care. We also know that some people who qualify for nursing home care can be cared for in their homes through community-based long-term care services. They can receive quality services at a fraction of the cost, because Medicaid isn't paying for bricks and mortar, meals, administration, or other ancillary services," Olson said.

Olson said that services for people with disabilities will continue to adapt to changing expectations and standards. "The input from consumers and families regarding services and program decisions is vital, and we need to continue to work together with consumers, families, advocates and providers to assure quality, efficient, and effective services," she said.

"Olmstead Update" fact sheets are available on the department's Web site in the Resources area (PDF files), or by contacting the Department of Human Services at (701) 328-1814.


Heather Steffl, Public Information Specialist, North Dakota Department of Human Services, (701) 328-4933


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