BUDGET COMMITTEE ON HUMAN SERVICES

The Budget Committee on Human Services was assigned responsibilities in four areas. Senate Concurrent Resolution No. 4001 provided for a study of human service centers, including the delivery of services and the cost versus benefit of those services, the possibility of combining service centers and the administrative costs of the centers related to the programs and clients served, third-party reimbursements, and human service center competition with private providers.

Section 14 of Senate Bill No. 2012 provided for a study of the administrative costs of human service programs, including costs incurred by the central office of the Department of Human Services, human service centers, and county social services and a review of the effects of the 1997 "swap" legislation on state and county human services program costs.

Senate Bill No. 2086 provided that the Legislative Council receive reports from the Department of Human Services regarding its progress in developing a fee-for-service payment system for developmental disabilities treatment or care centers and to receive certification from the department by October 1, 2004, on whether the department and developmental disabilities services providers have reached an agreement on a new fee-for-service payment system.

Section 5 of House Bill No. 1014 provided that the Legislative Council receive a report from the Children's Services Coordinating Committee at least twice during the 2003-04 interim on the amount of "refinancing" funds generated and the uses of the funds for the 2003-05 biennium.

Committee members were Representatives Clara Sue Price (Chairman), Jeff Delzer, William R. Devlin, Gary Kreidt, Vonnie Pietsch, Louise Potter, Robin Weisz, and Alon Wieland and Senators Bill L. Bowman, Richard Brown, Tom Fischer, Joel C. Heitkamp, Aaron Krauter, Judy Lee, Harvey Tallackson, and Russell T. Thane.

The committee submitted this report to the Legislative Council at the biennial meeting of the Council in November 2004. The Council accepted the report for submission to the 59th Legislative Assembly.

HUMAN SERVICE CENTER STUDY

Senate Concurrent Resolution No. 4001 provided that the Legislative Council study the delivery of services and cost versus benefit of those services provided by the eight human service centers, to consider the possibility of combining human service centers and the administrative costs of the centers related to the programs and clients served, and to study third-party reimbursement and human service center competition with private providers.

Background

The Department of Human Services operates eight regional human service centers--Northwest Human Service Center in Williston, North Central Human Service Center in Minot, Lake Region Human Service Center in Devils Lake, Northeast Human Service Center in Grand Forks, Southeast Human Service Center in Fargo, South Central Human Service Center in Jamestown, West Central Human Service Center in Bismarck, and Badlands Human Service Center in Dickinson.

The committee reviewed the history of the human service centers and learned they were established in 1982. Previously, services were offered through area social service centers, the regional vocational rehabilitation offices, and mental health and retardation centers. The centers were developed to coordinate and avoid duplication of services and to enhance a comprehensive approach to serving clients.

2003-05 Budget

The following schedule provides the 2003-05 biennium appropriation and the authorized full-time equivalent (FTE) positions for each human service center:

2003-05 Biennium
Human Service Center	General Fund	Other Funds	Total	FTE
Northwest Human Service Center	$3,630,039	$3,645,640	$7,275,679	51.00
North Central Human Service Center	7,841,196	6,723,674	14,564,870	114.78
Lake Region Human Service Center	4,637,960	3,782,973	8,420,933	63.00
Northeast Human Service Center	7,996,363	11,444,820	19,441,183	136.90
Southeast Human Service Center	9,509,320	11,215,222	20,724,542	184.20
South Central Human Service Center	5,627,107	5,731,868	11,358,975	86.00
West Central Human Service Center	8,463,209	9,121,635	17,584,844	120.00
Badlands Human Service Center	4,365,904	4,558,723	8,924,627	78.00
Mental health contingency	250,000		250,000	0.00
Total	$52,321,098	$56,224,555	$108,545,653	833.88

The committee reviewed information on changes made to the original legislative appropriations and authorized FTE positions for each human service center during the 2003-05 biennium and on the status of each human service center's 2003-05 biennium budget. The committee learned that to assist with providing for undesignated general fund reductions made by the Legislative Assembly, the human service centers were asked to make budget reductions where possible. The centers identified certain administrative and other reductions that reduced total general fund budgets for the centers from $52.1 million to $51.7 million. The committee learned for the first year of the biennium, the human service centers spent a total of $51.1 million of $109 million available for the biennium, or 47 percent, leaving $57.9 million, or 53 percent, available for the second year of the biennium. Regarding the general fund share of the human service center budgets, a total of $29.3 million was spent the first year, or 57 percent of the $51.7 million available, leaving $22.4 million, or 43 percent, available for the second year of the biennium. The department has not yet allocated the $250,000 general fund appropriation for the mental health contingency pool.

Human Service Center Core Services

The committee reviewed the department's strategic planning process. In the development of the department's strategic plan in 2002, program purpose statements were developed, which clearly identified the reason for each program's existence. The department's strategic plan includes achievement expectations for each program. As part of the planning process, the department has created guiding principles based upon input from regional stakeholder input meetings. These principles provide the basis for creation of the human service center core services. The department's five guiding principles are:

• The Department of Human Services has the responsibility to serve our state's most vulnerable people.
• Planning, evaluating, budgeting, and best practices regarding services delivery and allocation of resources are data-driven, evidence-based, and results-oriented.
• Essential core services are based on individual needs with full consumer involvement and are aimed at optimizing self-sufficiency and independence.
• Local and natural support systems will be fully engaged and partnerships generated to maximize resources and efficiency.
• Services will be designed to accommodate specific regional needs with resources allocated in a cost-effective manner to create alternative solutions to reach rural and urban populations.

The department regularly reviews the results of program measures, obtains feedback from stakeholders, evaluates department progress, and uses the information to adjust the department's plans.

The committee reviewed the core services of the human service centers, including:

Aging services

• Aging services administration.
• Vulnerable adult protective services.
• Long-term care ombudsman program.
• Adult family foster care licensure.

Developmental disabilities

• Case management.
• Day supports (Southeast).
• Extended services (Northwest and Badlands).
• Infant development (Northwest, Northeast, Southeast, and South Central).

Vocational rehabilitation

• Assessment for eligibility and rehabilitation needs.
• Counseling and guidance.
• Information and referral.
• Job-related services.
• Vision services.
• Supported employment services (Badlands and Northwest).
• Rehabilitation technology services (Badlands and West Central).
• Business services, including Americans with Disabilities Act consultation and assessment.

Child welfare services

• Program supervision - Regional representatives and child care licensing specialists.
• Parental capacity evaluation.
• Foster parent support services.
• Acute/clinical services as deemed clinically appropriate.

Children's mental health

• Level I criteria

  Care coordination.
  Acute/clinical services as deemed appropriate.

• Level II criteria

  Care coordination.
  Case aide services.
  Crisis residential/safe beds.
  Flexible funding.
  Acute clinical services as deemed appropriate.

Serious mental illness (extended care coordination)

• Care coordination.
• Case aide services.
• Needs-based array of residential services.
• Community support services.
• Medical management.
• Acute/clinical services as deemed clinically appropriate.

Acute clinical services

• Core populations

  Self-harm/suicide.
  Child abuse and neglect.
  Foster care/subsidized adoption.
  Acute psychiatric.

• Services

  Psychological evaluation and testing.
  Psychiatric evaluation.
  Clinical evaluation.
  Individual therapy.
  Group therapy.
  Family therapy.
  Clinical case management.
  Medication management.
  Crisis residential.
  Short-term hospital.
  Laboratory and clinical screening.

Substance abuse services

• Care coordination/case aide.
• Evaluation.
• Social and medical detoxification services.
• Needs-based array of primary treatment services

  Low-intensity outpatient.
  Intensive outpatient.
  Day treatment.

• Needs-validated residential services.
• Medication/medical monitoring/management.

Crisis/emergency response services

• 24 hours a day 7 days a week crisis call response from a designated, trained center employee.
• Regional intervention services

  Screening.
  Gatekeeping/referral.

Client Waiting Lists - Human Service Centers

The committee reviewed client waiting lists at the human service centers and learned waiting lists vary depending on the type of service. For crisis situations, human service centers respond immediately. For non-emergency service needs, waiting lists may vary from no waiting time to two months. The department's maximum standard for waiting times is 10 days. The committee learned the Southeast Human Service Center has the most concern with excessive waiting times for services.

Shared Human Service Center Services

The committee learned the human service centers have begun sharing administrative and program services, including:

Director

• Lake Region and South Central Human Service Centers.
• Northeast and Southeast Human Service Centers.
• West Central and Badlands Human Service Centers.
• Northwest and North Central Human Service Centers.

Business manager

• Northwest and North Central Human Service Centers.

Child care licensing regional representative

• Southeast and South Central Human Service Centers.
• West Central and Badlands Human Service Centers.

Long-term care ombudsman

• Northwest and North Central Human Service Centers.
• Lake Region and Northeast Human Service Centers.
• Southeast and South Central Human Service Centers (Aging services employee).

Adult protective services

• Northwest and North Central Human Service Centers.

Vision specialist

• Northwest and North Central Human Service Centers.

Developmental disabilities regional program administrator

• West Central and Badlands Human Service Centers.

County Social Services

The committee reviewed the role and responsibilities of county social services. The committee received information on programs administered by county social services, including:

Economic assistance

• Temporary assistance for needy families (TANF).
• Medicaid.
• Food stamps.
• Low-income home energy assistance program (LIHEAP).
• Child care assistance program.
• Child support program.
• Basic care payments.
• County general assistance program.

Counties have just under 300 eligibility workers in 51 county social services offices responsible for determining eligibility and authorizing benefits for clients receiving economic assistance. Counties are the primary resource for low-income individuals and families in need of public benefits and human service centers and private providers are the major referral sources.

Child welfare - County social services provide direct service of these programs with oversight from the regional human service center.

• Child protective services.
• Foster care services.
• Family preservation/support services.
• Regulatory functions.

Home and community-based services

• Case management.
• Homemaker.
• Personal care.
• Respite care.
• Chore services.
• Emergency response system.
• Family home care.
• Adult foster care.
• Adult day care.
• Information and referral.

Access to home and community-based services is available through county social services case management. Counties coordinate referrals, complete assessments, determine eligibility, develop service plans, and authorize payments for in-home care services. The majority of counties also directly provide in-home care services to county residents.

Client Waiting Lists - County Social Services

Regarding waiting lists for county social services, the committee learned the majority of county-administered programs have externally federal- or state-established timelines that counties must meet. Therefore, there are no client waiting lists for county social services.

Shared County Social Services

The committee received information on shared county social services. The committee learned 27 counties share a county social services director, 29 counties share child protective services and child abuse and neglect services, and 18 counties share adult protective services. Counties are continuing to expand the sharing of social services. The committee learned that nine counties in the northeastern part of the state have developed a joint powers agreement to share social services and reduce costs and that Towner, Benson, and Ramsey Counties have entered into a full contractual arrangement for sharing social services.

Private Providers and Cooperative Efforts

The committee received a listing of other organizations and private providers that offer services similar to the services offered by the human service centers by region and reviewed cooperative efforts of the human service centers, county social services, and private providers. The committee learned the number and types of private providers vary by region and the human service centers, county social services, and private providers coordinate efforts to meet the human services needs in each region. Human service centers, county social services, and private providers may serve the same families but may be providing different types of services.

Human Service Center Contracts

The committee received information on Department of Human Services contracts by type of service and by human service center for the 1997-99 through 2003-05 bienniums. The committee learned the department's total contracts have increased from $18.79 million for the 1997-99 biennium to a projected $19.25 million for the 2003-05 biennium.

Human Service Centers - Third-Party Revenue

The committee reviewed a schedule of the department's projected third-party revenue collections at the human service centers for the 2003-05 biennium. Revenue collections are projected to total $28.9 million during the 2003-05 biennium, which is approximately 27 percent of the centers' 2003-05 biennium budgets. Of the total collections, $24.2 million is from Medicaid, $3.5 million from private insurance, and $1.2 million from individuals. Medicaid collections comprise approximately 83 percent of the human service centers' third-party collections. The rates charged by the human service centers are based on actual costs incurred by the human service centers.

Human Service Center Facilities

The committee reviewed the facilities of each human service center, including floor plans, square footage, and costs. The following schedule compares the facility information for the human service centers:

Human Service Center Facilities
Center	Owned/Leased	Square Feet	Annual Cost Per Square Foot	Total Annual Cost
Northwest	Leased	23,365	$8.50	$198,603
North Central	Leased	41,182	9.34	384,640
Lake Region	Leased	18,236	9.67	176,342
Northeast	Leased	40,040	12.05	482,482
Southeast	Owned	50,000	8.60	430,000
South Central	Leased	29,917	10.95	327,591
West Central	Leased	38,879	13.54	526,272
Badlands	Leased	23,725	7.61	180,653
Total		265,344	$10.20	$2,706,583

Human Service Center Reporting Format

The committee considered options for human service centers to provide a consistent and comparative reporting format to legislative committees and budget tour groups. The intent of this format is to provide a consistent and comprehensive reporting basis for major human service center programs to allow for an understanding of services provided and clients served and to facilitate comparisons among human service centers. This format is not intended to preclude legislators or legislative committees from requesting other data or the human service centers from providing additional information.

The committee received information from each of the human service centers in the proposed reporting format. The appendix at the end of this report summarizes the information for fiscal year 2003.

Impact of Methamphetamine Addiction

The committee received information on the impact of methamphetamine addiction on the treatment programs of human service centers. The committee learned that methamphetamine addiction has had a significant effect on the treatment services provided by the human service centers and on the child welfare system in the state.

The committee received information on the communications between the Department of Corrections and Rehabilitation and the human service centers regarding the provision of services for individuals released from the corrections system for methamphetamine-related offenses. The committee learned that 30 days prior to an inmate's release, the Department of Corrections and Rehabilitation social workers refer the inmate to a human service center to allow time for information to be exchanged and appointments scheduled to meet the treatment needs of the individual to be released.

The committee received information on the physical, mental, and cognitive effects of methamphetamine use and the difficulty in treating individuals who have used methamphetamine. The committee learned longer term treatment is necessary due to the longer term effects of methamphetamine addiction compared to other drugs.

The committee reviewed the impact of methamphetamine addiction on children and families. The committee learned the number of children in foster care has been increasing and that approximately 15 percent of foster care cases are the result of methamphetamine manufacturing, use, or selling. The committee learned the increase of children in foster care has substantially increased the caseload of child welfare workers. The department is seeking to address these concerns by analyzing child welfare worker and supervisor caseloads, involving relatives to provide care for children rather than placing the children in foster care, recruiting additional foster care families, and exploring the possibility of performance-based contracting with residential foster care providers.

The committee received information on the seizure and disposition of assets of drug offenders. The committee learned North Dakota Century Code (NDCC) Section 54-12-14 provides the statutory provisions related to the asset forfeiture fund and the uses of money in the fund. The Attorney General is authorized to seize cash and other assets, such as cars, boats, airplanes, guns, drugs, etc., from individuals involved in criminal activities. The Attorney General may spend the proceeds from seized and forfeited assets for drug enforcement purposes, such as drug buys, purchasing equipment, overtime costs, or matching federal drug enforcement grants. When the Attorney General's office is involved in a drug enforcement activity that results in seized and forfeited assets, the agency must share the proceeds of the assets seized with other law enforcement agencies involved in the enforcement effort. The committee learned if money in the fund were to be used for substance abuse treatment costs or for the cost of cleanup of methamphetamine labs, a legislative change to NDCC Section 54-12-14 would be required.

Other Reports and Testimony

The committee heard other reports and testimony, including:

• Information on human service center funding, FTE positions, and clients.
• Demographic information by county and human service region, including information on population categories, trends, and projections.
• The need for more alcohol and drug education in schools to reduce the use of methamphetamine and other drugs and alcohol.
• Concerns of the elderly in the state which include:

  Having enough money to pay bills.
  Accessing health care systems.
  Being able to stay safely at home.

Recommendations

The committee recommends legislative committees and Budget Section tour groups request information from each human service center in the following format, reflecting information for the current and two previous bienniums:

Human Service Center (In Total)

• Funding by funding source, with explanations of any changes from legislative appropriations.
• FTE positions, with explanations of any changes from legislatively authorized levels.
• Major sources of federal and special/other funds.
• Unduplicated number of clients served annually.
• Number of clients served annually - One-time visit only. (This data will be reported beginning with fiscal year 2005.)
• Status of current biennium budget.

Major Program Reporting

Administration

• Summary of services.
• Funding by funding source.
• FTE positions.
• Major sources of federal and special/other funds.
• Administrative costs as a percentage of budget.
• Administrative costs per client served.

Child welfare

• Summary of services.
• Funding by funding source.
• FTE positions.
• Major sources of federal and special/other funds.
• Average number of children in foster care per year.
• Average number of children in foster care placed out of state.
• Number of child abuse and neglect reports per year.
• Percentage of incidence of repeat maltreatment.
• Average time spent in foster care.
• Percentage of foster care reentries within 12 months of previous discharge.

Disability services

• Summary of services.
• Funding by funding source.
• FTE positions.
• Major sources of federal and special/other funds.
• Number of Developmental Center residents from region.
• Unduplicated number of clients served annually

  Developmental disabilities.
  Vocational rehabilitation.

• Percentage of clients employed

  Developmental disabilities.
  Vocational rehabilitation.

• Average annual earned income of clients - Vocational rehabilitation.
• Average caseload per caseworker

  Developmental disabilities.
  Vocational rehabilitation.

Older adult services

• Summary of services.
• Funding by funding source.
• FTE positions.
• Major sources of federal and special/other funds.
• Dollar amount of contracts, number of service sites, and number of individuals served under the Older Americans Act.
• Dollar amount of contracts and number of individuals served

  Vulnerable adult services.
  National Family Caregiver support program.

Mental health and substance abuse services

• Summary of services.
• Funding by funding source.
• FTE positions.
• Major sources of federal and special/other funds.
• Contracts with providers by type of service and funding with explanations of major funding changes between bienniums.
• For mental health services

  Unduplicated number of clients served

  Individuals with serious mental illness.
  Individuals with acute mental illness.
  Children with serious emotional disorders.

  Average caseload per caseworker
  

  Individuals with serious mental illness.
  Individuals with acute mental illness.
  Children with serious emotional disorders.

  Number of State Hospital admissions from region by year.
  Number of clients in extended employment.
  Average annual earned income of clients in extended employment.

• For substance abuse services

  Unduplicated number of clients served.
  Average caseload per caseworker.
  Number of State Hospital admissions from region by year.
  Number of clients with multiple admissions for services

  Two or three.
  Four or five.
  More than five.

Statewide or Unique Programs

• Summary of services.
• Funding by funding source.
• FTE positions.
• Unduplicated number of clients served.
  

HUMAN SERVICES PROGRAM ADMINISTRATIVE COSTS

Section 14 of Senate Bill No. 2012 provided that the Legislative Council study the administrative costs of human services programs. The study is to include administrative costs incurred by the central office of the Department of Human Services, human service centers, and county social services. In addition, the study is to include a review of the effects of the 1997 "swap" legislation on state and county human services program costs.

Department of Human Services Administrative Costs

The committee reviewed the administrative costs and FTE positions with administrative responsibilities at the department's central office, State Hospital, Developmental Center, and human service centers. Departmentwide 410.2 FTE positions and $95.3 million, or 6.23 percent, of the department's 2003-05 biennium budget are identified as administrative.

County Administrative Costs

The committee reviewed the administrative and other costs of county social services programs. The committee learned:

• County administrative costs of economic assistance programs totaled $21.7 million statewide in state fiscal year 2002.
• The total number of county eligibility staff for economic assistance programs increased by 6.9 percent from 1997 to 2003 and during this same time period, program expectations have increased resulting in additional workload for county staff. Less time is allowed for assessing food stamp cases, increased emphasis is placed on case management for TANF cases, and significantly more time is spent monitoring assets for elderly individuals on medical assistance.
• Counties have attempted to reduce administrative costs and county social services costs by sharing services. Counties have collaborated with one or more counties to jointly administer a number of economic assistance programs, including Health Tracks - 13 counties, TANF eligibility - 16 counties, foster care eligibility - 11 counties, economic assistance supervision - 15 counties. In addition, 23 counties have full-time directors, 4 have part-time directors, and 26 have shared directors. Of the shared directors, one serves a four-county area, three serve a three-county area, and eight serve a two-county area. Of the 23 full-time director positions, 3 have full-time administrative responsibility. Directors in 33 counties provide some type of direct client services, 28 provide social services, and 17 provide economic assistance services.
• In addition to the county administrative costs of economic assistance programs, counties are responsible for costs relating to child welfare, home and community-based services, child support enforcement, and general assistance. County representatives expressed concern regarding the additional funding that is needed to provide county social services.
• Funding for social services programs of the counties has increased from $38.4 million in calendar year 2000 to $46.9 million in calendar year 2002.
• State aid distribution fund allocations to cities and counties increased from $51.5 million in the 1995-97 biennium to an anticipated $69.4 million in the 2003-05 biennium.
• Counites' share of the social services block grant has decreased from $2.2 million in calendar year 1998 to $1.5 million in calendar year 2003.

"Swap" Analysis

The committee reviewed the "swap" agreement, which as approved by the 55th Legislative Assembly (1997) required counties, effective January 1, 1998, to assume financial responsibility for the costs of administering certain economic assistance programs and required the state to assume complete financial responsibility for grant programs, including TANF, basic care assistance, child care assistance, and medical assistance. In addition, the state agreed to provide additional support for administrative costs of counties with Indian land. Statutory provisions relating to these programs are contained in NDCC Title 50.

The schedule below presents legislative appropriations for TANF, basic care assistance, child care assistance, medical assistance, and grants to Indian counties since the 1997-99 biennium:

	1997-99	1999-2001	2001-03	2003-05
TANF
General fund	$5,700,000	$5,500,000	$3,950,382	$3,950,382
Special funds	4,000,000	6,397,947	10,525,123	12,215,691
Federal funds	31,200,000	13,110,930	11,150,551	13,341,867
Total	$40,900,000	$25,008,877	$25,626,056	$29,507,940
Child care assistance
General fund				$5,726,109
Special funds	$3,528,016	$3,675,262	$4,013,314
Federal funds	14,749,420	12,832,634	17,233,719	21,335,096
Total	$18,277,436	$16,507,896	$21,247,033	$27,061,205
Basic care assistance
General fund	$1,654,727			$747,857
Special funds	4,473,987	$7,690,647	$2,783,072	2,284,362
Federal funds			6,081,186	5,363,506
Total	$6,128,714	$7,690,647	$8,864,258	$8,395,725
Medical assistance1
General fund	$180,467,562	$195,469,683	$217,096,629	$259,872,239
Special funds	7,206,368	8,035,112	36,388,8272	12,584,800
Federal funds	422,301,922	471,880,515	550,022,159	596,320,683
Total	$609,975,852	$675,385,310	$803,507,6152	$868,777,722
Grants to Indian counties
General fund		$121,766	$456,993	$649,559
Special funds	$1,059,000	1,654,654	2,068,007	1,964,607
Total	$1,059,000	$1,776,420	$2,525,000	$2,614,166
Total
General fund	$187,822,289	$201,091,449	$221,504,004	$270,946,146
Special funds	20,267,371	27,453,622	55,778,343	29,049,460
Federal funds	468,251,342	497,824,079	584,487,615	636,361,152
Total	$676,341,002	$726,369,150	$861,769,962	$936,356,758
1Includes nursing facilities, intergovernmental transfer payments, and developmental disabilities services grants, but excludes Healthy Steps. 2Includes the $16.3 million special funds deficiency appropriation approved by the 2003 Legislative Assembly.

The committee received information on the grant costs of economic assistance programs included in the "swap" agreement by funding source for each biennium since 1995-97 and welfare reform-related computer systems costs paid by the Department of Human Services since the 1995-97 biennium. The following schedule prepared by the Department of Human Services shows the effects of the "swap" agreement on the county and state share of funding for economic assistance programs:

Economic Assistance Grants - "Previously" the County Share
	Actual Expenditures for 1999-2001 Biennium	Actual Expenditures for 2001-03 Biennium	Estimated Expenditures for 2003-05 Biennium
Traditional Medicaid	$19,018,277	$23,046,095	$26,966,119
Developmental disabilities	3,237,525	3,602,696	4,446,576
Basic care	1,835,862	456,552	428,040
TANF	1,132,032	1,326,077	1,329,506
Job opportunities and basic skills	335,878	636,532	704,321
State Hospital	292,355	311,836	233,474
Child care	833,904	1,178,536	1,259,306
Total additional grants costs assumed by the state	$26,685,833	$30,558,324	$35,367,342

County Administrative Cost - "Previously" State Reimbursement
	Reimbursement for 1999-2001 Biennium	Reimbursement for 2001-03 Biennium	Estimated Reimbursement for 2003-05 Biennium
Federal funds for economic assistance programs	$24,286,907	$25,218,052	$25,954,276
State funds for IV-D regional units	1,526,632	1,653,300	1,712,074
Total additional administrative costs assumed by county	$25,813,539	$26,871,352	$27,666,350

Overall Effect on Counties and State
	Reimbursement for 1999-2001 Biennium	Reimbursement for 2001-03 Biennium	Estimated Reimbursement for 2003-05 Biennium
Grant costs in excess of administrative reimbursement	$872,295	$3,686,972	$7,700,992
Additional funds for countywide cost allocation plan fee	232,880	71,828
Additional computer costs in excess of fiscal year 1995 costs inflated at consumer price index	893,828	1,648,387	1,675,766
Additional Indian county funds provided in excess of $440,000	1,336,421	2,040,976	2,309,176
Avoided county expenditures and corresponding additional state costs	$3,335,424	$7,448,163	$11,685,934

Temporary Assistance for Needy Families

The committee received information on the status of the TANF program reauthorization by Congress, changes made by the Department of Human Services to the TANF educational provisions, the status of TANF program expenditures, and TANF pilot projects. During the 2003-05 biennium, the TANF program has been repeatedly temporarily extended by Congress pursuant to a continuing resolution.

The committee learned the Department of Human Services changed its TANF education policy in 2003 in anticipation of federal changes to the program. All three versions of the TANF reauthorization being considered by Congress limit educational opportunities. The change being considered allows only 4 months of education to qualify as work participation rather than 12 months under the current program. The department had been approving education activities for a full year; however, because the department anticipated TANF would be reauthorized in 2003, the department did not approve TANF recipients for a full year of education with the expectation that it would have to rescind the approval because of new TANF provisions. Instead, the department adopted a policy on educational limitations which is common to all three versions of the reauthorization. Although reauthorization has been delayed, the department does not believe more flexibility will be provided for TANF education. Current department policies are consistent with what the department anticipates will be the final rules for education under the reauthorized TANF program. The department has been flexible in applying the education rules for Job Corps and vocational rehabilitation clients who have been allowed to continue their education; however, the department will not be able to continue this practice under reauthorization unless changes are made in the federal legislation.

Through June 2004 the department has spent $13 million for TANF benefits, which is $1.6 million less than anticipated expenditures of $14.6 million. Actual expenditures were less than estimated due to the number of TANF cases being an average of 88 per month fewer than estimated and average monthly payments averaging from $13 to $52 per month per case less than estimated.

The committee received information on the Cass County TANF pilot project. The Cass County pilot project included five major components--employment, education, mental health, case management, and sanctions. The focus of the Cass County pilot project is on employment and self-sufficiency. Each client has a support team consisting of staff from Job Service North Dakota, the human service center, and county social services to address specific areas of the plan. The committee learned that the pilot project has resulted in positive outcomes for the clients involved.

The committee received information on the Williams County TANF pilot project. The primary goal of the project is to help clients achieve self-sufficiency, allowing them to exit the program as soon as possible. The pilot project addresses employment, education, sanctions, case management, and mental health. The pilot project utilizes a mentor who works closely with the TANF client to eliminate any barriers to obtaining self-sufficiency. The committee learned many positive outcomes have resulted from the pilot project.

Administration of Children's Health Insurance Program

The committee received information on the administrative functions and administrative costs of the children's health insurance program. Federal law limits the amount states can claim for administrative costs for the children's health insurance program to no more than 10 percent of the cost of providing medical services to eligible children for each federal fiscal year of operation. For the 2003 federal fiscal year, the administrative expenditure limit was $719,141 and the department spent $79,677 for administrative expenses during that year.

The committee reviewed the positive and negative effects of transferring the eligibility determination function from the state to the counties. A positive effect would be the eligibility process would be more seamless since the counties already determine eligibility for the Medicaid program. A negative effect would be that many more people would be involved in the eligibility determination process across the state.

Child Support Enforcement

The committee received information on the administrative functions and costs of child support enforcement programs.

Child Support Enforcement Organizational Structure

The committee learned a number of entities are involved in the administration of child support in North Dakota, including the Department of Human Services, regional child support enforcement units, county social services boards, and the courts. Three regional child support enforcement units in the state are under the authority of state's attorney's offices, four units are under the authority of county social services boards, and one unit's director reports to the county social services board while the staff reports to the state's attorney's office.

The Department of Human Services was appropriated $6.8 million, of which $400,000 is from the general fund, for the 2003-05 biennium for its child support program. These amounts exclude child support collections paid to families and $1.8 million of federal incentive payments to counties. The department is authorized 38 FTE positions for child support enforcement. In addition, $1.4 million is funded in the Information Technology Division of the Department of Human Services for computer system costs of the regional child support enforcement units.

Regional child support enforcement units employ approximately 120 employees and the units spent approximately $5 million in calendar year 2003, approximately $900,000 of which is from federal child support incentive funds and the remainder is from property taxes. Costs for each regional child support enforcement unit are allocated to individual counties based on a formula developed by the counties of each region.

The committee reviewed other states' child support enforcement systems. Information was provided on the child support enforcement systems in Iowa, Maine, and South Dakota as those states are similar in size to North Dakota and have consistent, high-performance child support enforcement records. In overall rankings for child support enforcement programs, South Dakota is ranked first, North Dakota third, Iowa seventh, and Maine 13th.

The committee reviewed organizational charts for the three states' child support delivery systems and a comparison of a number of components of each system's structure, including outlying offices, caseloads, staffing, customer service, paternity establishment, review and adjustment, enforcement, funding, and performance measures. While North Dakota has a state-supervised and county-operated program, Iowa, Maine, and South Dakota each have a state-administered child support enforcement program.

The Department of Human Services supports changing the structure of the North Dakota child support enforcement program to provide for state administration and suggested this could be accomplished by:

• Removing county responsibility for the program effective January 1, 2006.
• Retaining offices in the cities where they are now located.
• Authorizing the transfer of the regional child support enforcement unit staff to the Department of Human Services.
• Maintaining budgeted 2004 county funding contributions in the future.
• Authorizing a continuing appropriation for funding from the tribes if the tribes choose to apply for available child support enforcement federal funding.

Lake Region Child Support Enforcement Unit

The committee learned the 58th Legislative Assembly (2003) provided $215,000 of general fund support for the Lake Region Child Support Enforcement Unit. A section was included in Senate Bill No. 2012 providing that the 59th Legislative Assembly (2005) consider removing the general fund support if the unit's performance does not improve during the 2003-05 biennium. The committee received information on the status of the unit's performance and the Department of Human Services plan for addressing this issue in its 2005-07 budget request. The committee learned that in federal fiscal year 2002, the performance of the unit was eighth among the eight regions in the state and although it did show some performance improvement, it continued in eighth place in federal fiscal year 2003. The committee learned the Department of Human Services is planning to include the $215,000 of general fund support for the unit in its 2005-07 budget request.

The Lake Region Child Support Enforcement Unit area includes seven counties and two Indian reservations. Because of the high unemployment rate on the Indian reservations, many noncustodial parents living in these areas are unemployed; therefore, it is difficult for the unit to collect the related child support payments.

Representatives of the Lake Region Child Support Enforcement Unit testified on the importance of continuing the $215,000 general fund appropriation for the unit due to lack of available county funding in the region. The committee was informed that Benson and Rolette Counties have lost taxable land due to flooding and as a result of tribal governments purchasing land.

The committee heard testimony that an income-withholding order can be issued from a state district court but may not result in any support collections when the employer of the noncustodial parent is a tribal entity and will not honor income-withholding orders issued in state district courts. The committee learned state district courts lack jurisdiction on Indian reservations. Thirty-four percent of the Lake Region Child Support Enforcement Unit's cases are in "lack of jurisdiction," meaning the noncustodial parents are living on an Indian reservation. In 80 percent of the unit's cases, one of the parents is Native American.

The committee reviewed the performance of the Lake Region Child Support Enforcement Unit and learned even if the "lack of jurisdiction" cases are removed, the unit's performance is still ranked eighth in the state.

The committee reviewed issues relating to the recognition of child support enforcement orders on Indian reservations and found:

• Tribal entities will honor income-withholding orders if issued from a tribal court,
• The tribes have informed the child support enforcement unit that attorneys for the unit may pursue cases in tribal court if the attorneys are licensed by the tribal court,
• The unit has attempted to license its attorneys in tribal court but have not received clear direction from the tribes on the process involved, and
• Many regional child support enforcement offices no longer attempt to file state court orders in tribal courts due to past failed experiences and the time involved in traveling to the tribal courts for a hearing.

State Jurisdiction on Indian Reservations

The committee reviewed state jurisdiction on Indian reservations. Congress enacted Public Law 280 in 1953, which gave six "mandatory" states civil and criminal jurisdiction over all or part of Indian country within those states. Public Law 280 also authorized another group of states, which included North Dakota, to voluntarily opt to assume criminal and civil jurisdiction over Indian country. The second group of eight states was empowered to assume such jurisdiction by amending their state constitutions and state statutes. In 1963 the North Dakota Legislative Assembly passed legislation (NDCC Chapter 27-19) requiring tribal acceptance of jurisdiction before the state can assume jurisdiction in certain matters. Under this law, determining the parentage of children, termination of parental rights, commitments by district courts, guardianship, marriage contracts, obligations of support of spouse, children, or other dependents are examples of the types of cases which the state courts could decide if the tribes agreed. In addition to the statutory provision regarding the consent of tribes before the state can assume jurisdiction, in 1968 Congress enacted similar provisions to limit the further extension of Public Law 280. The 1968 provisions require tribal consent, by majority vote of the adult members, before any of the option states could assume jurisdiction over any areas of Indian country. Since the enactment of this amendment, no tribe has voted to consent to state court jurisdiction. In addition, Public Law 280 was amended to provide that states that had previously opted to exercise jurisdiction over Indian country could retrocede or disclaim such jurisdiction subject to acceptance by the federal government.

Considerations and Options

The committee learned the federal government has made federal funding available to Indian tribes for developing their child support programs. The federal regulations require Indian tribes to accept child support-withholding orders from other jurisdictions in order to be eligible to receive the federal funds. Currently the Sisseton-Wahpeton Reservation has established its own child support program.

Representatives of Ramsey County provided testimony suggesting a committee should be established to review the child support collection process in the state and the committee include representatives of state agencies, regional child support enforcement units, counties, legislative branch, judicial branch, and Indian tribes.

The Supreme Court's Committee on Tribal and State Court Affairs includes representatives of both state and tribal courts. The purpose of the committee is to expand tribal and state court judges' knowledge of the respective judicial systems and to identify and discuss issues regarding court practices, procedures, and administration which are of common concern to members of tribal and state judicial systems. Procedures are to be in place in tribal courts relating to recognizing state court orders. Procedurally, a petitioning process to the court is required, a hearing held, and then, if appropriate, the order will be issued.

The committee considered a bill draft amending NDCC Section 54-58-03 to require the Governor to receive legislative approval before entering, renewing, amending, or extending any tribal-state gaming compacts and the committee:

• Reviewed potential constitutional concerns with the bill draft and learned that constitutionality would be determined by the interpretation of the court; however, there have been cases in other states in which a state law was found to be unconstitutional when the state legislature was not involved in approving tribal-state gaming compacts.
• Learned that under the bill draft, a tribal-state gaming compact negotiated by the Governor would not go into effect until approved by the Legislative Assembly during either a regular or special session. Federal law requires states to negotiate in good faith with the Indian tribes and if it is determined that a state is not negotiating in good faith, the federal Department of Interior may approve gaming compacts in that state.
• Received information on the approval process for Indian tribes relating to tribal-state gaming compacts. Each of the five Indian tribes has a negotiating team and the chairman of each team negotiates on behalf of each tribe.
• Learned the current compact was negotiated in 1999 and is effective for 10 years with a possible five-year extension.
• Received testimony from representatives of the North Dakota Indian Gaming Commission indicating the bill draft is not necessary because in past negotiations, legislative input has been provided.

Committee member comments on the bill draft included:

1. It is important for the Legislative Assembly to be involved in determining provisions of gaming compacts because the Legislative Assembly is the policymaking branch of government and should have a role in the gaming compact process.
2. Provisions in the bill draft are necessary to maintain the balance of power between the executive and legislative branches.
3. The time is appropriate for the Legislative Assembly to consider making this change because there is no urgent issue that could influence the basic decision of legislative involvement in the tribal-state gaming compacts.
4. The majority and minority leaders from both houses were involved in previous negotiations.
5. The purpose of the bill draft is to increase communications between state agencies, the Governor, Indian tribes, and members of the Legislative Assembly, and to enhance the understanding of tribal-state gaming compacts.
6. Involvement of so many people in the gaming compact approval process could result in delays.
7. The Indian gaming industry in North Dakota could be negatively impacted by the process.

The committee discussed the child support enforcement issue and received testimony from other interested persons and makes the following observations:

1. The location of Indian reservations within a regional child support unit's area results in a larger caseload for the unit.
2. Because the counties are required to provide social services to persons on an Indian reservation, while the reservation does not contribute to the county's tax base, an unfair tax burden is placed on other taxpayers.
3. The funding of social services for persons on reservations should be the responsibility of the state or federal government, not the county.
4. The state Child Support Enforcement Division should enter into a cooperative agreement with the tribes to address the jurisdictional issues with the reservations.
5. Discussions between state and tribal leaders need to occur to improve the child support collection process.
6. The lack of child support collections on Indian reservations is an enforcement problem.
7. When child support is not collected, limited state funding available for other children and families in need is further reduced.
8. Improvements can be made on jurisdictional issues with Indian reservations by increasing the level of communication between the entities involved.

Other Reports

The committee received other reports, including a report comparing the number of Medicaid-eligible persons and the number of Medicaid-eligible persons actually receiving services during each of the last five fiscal years. The number of Medicaid-eligible individuals has increased from 41,953 in fiscal year 1999 to 53,134 in fiscal year 2003.

Recommendations

The committee recommends House Concurrent Resolution No. 3001 to provide for a Legislative Council study of the legal and enforcement issues relating to child support collections on Indian reservations, including issues relating to state and tribal jurisdictions, recognition of income-withholding orders, and logistics involved in transferring funds collected to custodial parents.

The committee recommends Senate Bill No. 2025 to require the Governor to obtain legislative approval before entering, renewing, amending, or extending any tribal-state gaming compact.

DEVELOPMENTAL DISABILITIES SERVICES PAYMENT SYSTEM

Senate Bill No. 2086 provided that the Department of Human Services report to the Legislative Council during the 2003-04 interim regarding its progress in developing a fee-for-service payment system for treatment or care centers and by October 1, 2004, the department is to certify to the Legislative Council whether the department and developmental disabilities services providers have reached an agreement on a new fee-for-service payment system.

Background

The 57th Legislative Assembly (2001) approved Senate Bill No. 2307, which provided that the Department of Human Services, in cooperation with developmental disabilities services providers, prepare a joint recommendation for consideration by the 58th Legislative Assembly regarding a new statewide developmental disabilities services provider reimbursement system. The 2001-02 interim Budget Committee on Human Services received quarterly reports from the Department of Human Services regarding the progress of the workgroup organized to develop the recommendation. The 2001-02 workgroup consisted of representatives of the Department of Human Services, developmental disabilities services providers, and legislators. Although a consensus of all developmental disabilities services providers was not reached, a strong majority expressed support that the department, in cooperation with the developmental disabilities services industry, develop a bill to implement a prospective fee-for-service payment system in lieu of the current retrospective system. The prospective fee-for-service model would have been based on allowable costs and would have been provider-specific. A prospective system establishes the reimbursement rate prior to the provision of services. Each provider's rate is unique based on each provider's historic costs. The initial rate is adjusted each year by inflationary increases until periodically rebased as determined by the Legislative Assembly. The targeted implementation date of the new payment system was to be July 1, 2005, and the payment system was to be budget-neutral as compared to the current system.

The Department of Human Services introduced 2003 Senate Bill No. 2086 to implement a fee-for-service ratesetting system effective July 1, 2005. As passed by the 58th Legislative Assembly, the bill created a workgroup consisting of one voting member appointed by the Governor, three voting members from the Department of Human Services, and three voting members from the North Dakota Association of Community Facilities. The bill:

1. Provided that the department implement a fee-for-service payment system by July 1, 2005. The fee-for-service payment system must require each developmental disabilities services provider to be responsible for its own operating costs and that the fee paid represents payment in full for the services provided.
2. Established a trust fund with up to two-tenths of 1 percent of the general fund appropriation provided for developmental disabilities grants for the 2005-07 biennium to be used for:
   1. Reasonably unforeseeable costs experienced by developmental disabilities providers.
   2. One-time improvements needed to comply with the Life Safety Code.
   3. Additional costs associated with providing services to individuals with extraordinary needs.
3. Required the department to report to an interim Legislative Council committee regarding its progress in developing a fee-for-service payment system and to certify to the Legislative Council by October 1, 2004, whether the department and developmental disabilities providers reached an agreement on the new payment system.

The committee learned that the 58th Legislative Assembly appropriated a total of $190.6 million for developmental disabilities services grants for the 2003-05 biennium, of which $61.9 million is from the general fund and $128.7 million is from federal funds. In total, the funding provided for developmental disabilities services grants is an increase of $17.1 million compared to the 2001-03 biennium appropriation of $164.2 million. The Legislative Assembly provided funding for increasing the average wage for employees of developmental disabilities services providers by 87 cents per hour and for increasing the allowable fringe benefits percentage from 30 to 33 percent of salary.

The 2003-05 biennium budget anticipates serving an average of 2,189 developmental disabilities clients in day and residential services for each year of the 2003-05 biennium and 1,337 clients in family support programs for each year of the 2003-05 biennium. The Department of Human Services contracts with private providers for many developmental disabilities services, including residential, family support, day support, extended employment, and infant development.

Workgroup Recommendations

The committee learned a workgroup was formed, as required by Senate Bill No. 2086, consisting of three representatives of developmental disabilities services providers, three representatives of the Department of Human Services, and one member appointed by the Governor.

The committee received reports from the workgroup. The committee learned the workgroup did not recommend changing from a retrospective payment system to a prospective or "fee-for-service" payment system but did recommend:

1. Allowable and nonallowable costs for developmental disabilities services providers contained in North Dakota Administrative Code Chapter 75-04-05 be changed. The changes are budget-neutral and have been submitted to the Department of Human Services for consideration and final approval by the Administrative Rules Committee.
2. Additional funding for individualized supported living arrangements be provided. Members of the workgroup representing the Department of Human Services abstained from voting on this recommendation because it is not budget-neutral.
3. The final ratesetting process be completed within a two-year cycle. This recommendation will result in each provider's budget being based on an audited fiscal year that ended two years previously.
4. The provider penalty for filing a late cost report be reduced from 10 to 1 percent and the Department of Human Services be encouraged to strictly enforce the penalty provision.
5. The concept of the money following the client be expanded within the Department of Human Services budget when individuals are moved from the Developmental Center to community settings.
6. Regular meetings of representatives of the Department of Human Services, Governor's office, and developmental disabilities services providers be continued to discuss reimbursement issues and other issues that arise.

Committee Recommendations

The committee received the workgroup's report but did not make any recommendations.

CHILDREN'S SERVICES COORDINATING COMMITTEE REPORTS

Section 5 of 2003 House Bill No. 1014 provided that the Children's Services Coordinating Committee report to an interim Legislative Council committee at least twice during the 2003-04 interim on the amount of "refinancing" funds generated and the uses of the funds for the 2003-05 biennium.

2003 Legislative Assembly Action

The 2003 Legislative Assembly appropriated $2,794,000 of funds generated by "refinancing." The schedule below lists the estimated amounts allocated for various purposes:

	Estimated Amount
Department of Human Services	$279,400
Children's Services Coordinating Committee - Administration	139,700
Grants to regional and tribal committees for collaboration and administration	977,900
Grants to participating entities	1,397,000
Total	$2,794,000

"Refinancing" is a system administered through the Department of Human Services allowing federal reimbursement of eligible administrative costs of local schools, juvenile courts, and public health organizations to be claimed under the federal IV-E foster care and Medicaid programs. The local organizations participating in the system complete time studies to document the amount of time spent with children eligible for the federal reimbursement. These time studies are submitted to the relevant regional or tribal children's services coordinating committee, reviewed by the state Children's Services Coordinating Committee, and submitted for federal administrative cost reimbursement by the Department of Human Services. The federal reimbursements are received by the Department of Human Services. The department retains its percentage allocation (10 percent) and transfers the remaining funds to the state Children's Services Coordinating Committee, which retains its percentage (5 percent) and distributes the remaining funds to the children's services coordinating committee of the region or tribe that generated the funds. Each regional or tribal committee distributes the percentage allocation of funds to each of the organizations that generated the federal reimbursements (50 percent) and uses the remaining funds (35 percent) for its administrative and operating costs and for other purposes based on the allocations approved by the Legislative Assembly. The percentage allocations of these funds for the 2003-05 biennium compared to the 2001-03 biennium are listed below:

	2001-03 Biennium	2003-05 Biennium
Department of Human Services	10.0%	10.0%
Children's Services Coordinating Committee - Administration	1.7%	5.0%
Children's Services Coordinating Committee - Grants
Participating entities generating federal funds	20.0%	50.0%
Statewide grants	10.2%	0.0%
Regional and tribal children's services coordinating committees for administrative costs	16.2%	0.0%
Regional and tribal children's services coordinating committees for collaboration efforts	1.8%	0.0%
Regional and tribal children's services coordinating committees for administrative costs and collaboration efforts	0.0%	35.0%
Regional and tribal children's services coordinating committees for grants to providers	40.1%	0.0%
Total	100.0%	100.0%

The estimated funding to be available from "refinancing" for the 2003-05 biennium compared to the 2001-03 biennium is substantially reduced due to a federal policy change relating to the allowable uses of federal IV-E foster care funds. The change became effective on July 1, 2002, and allows federal IV-E foster care funding to be claimed only if the child being served is in foster care or is a "candidate" for foster care. Previously, these funds could be claimed for a child in foster care or for a child who was "at risk" of being placed in foster care. The 57th Legislative Assembly anticipated "refinancing" would generate $8.3 million for the 2001-03 biennium while the 58th Legislative Assembly anticipated "refinancing" to generate only $2.8 million for the 2003-05 biennium.

2003-05 "Refinancing" Funds Status

The committee received information on the status of "refinancing" funds generated and the uses of the funds for the 2003-05 biennium to date. Through June 30, 2004, the Children's Services Coordinating Committee generated $1,281,201 from "refinancing" activities. Of this amount, $128,120 was distributed to the Department of Human Services, $64,060 to the Children's Services Coordinating Committee, $640,601 to participating agencies, and $448,420 to local children's services coordinating committees.

During the first year of the biennium, the local children's services coordinating committees spent $1,048,187, of which $606,381 were grants and $441,806 were for operating expenses of the committees. Of the $441,806 spent on operating expenses, $71,847, or 16 percent, related to grants administration; $48,541, or 11 percent, related to "refinancing" administration; $112,806, or 26 percent, related to board or committee administrative costs; and $208,612, or 47 percent, related to collaboration leadership. The total amount spent by the local children's services coordinating committees exceeded the amounts generated due to the timelag between when the funds are generated and received.

Discontinuation of "Refinancing"

The committee learned a federal departmental appeals board decision involving the State of Missouri and its use of federal IV-E foster care dollars has resulted in a substantial negative effect on North Dakota's ability to claim federal IV-E dollars under the "refinancing" system. The appeals board decision results in a negative effect to North Dakota because the appeals board concluded that agencies claiming federal IV-E dollars need to be supervised by the Department of Human Services or be involved in the placement and care of children.

Under North Dakota's "refinancing" system, agencies, including juvenile courts, schools, and public health units, claim administrative reimbursement under the federal IV-E program but are not supervised by the Department of Human Services nor are they responsible for the placement and care of children; therefore, based on the appeals board decision, the Department of Human Services believes the activities of these agencies are nonreimbursable under federal IV-E foster care. As a result, the Department of Human Services discontinued the "refinancing" initiative with the Children's Services Coordinating Committee effective June 30, 2004.

The committee learned that the Children's Services Coordinating Committee hopes to continue to meet quarterly; however, the state office will be closing at a yet-to-be-determined date. The Department of Human Services and the Department of Corrections and Rehabilitation will provide the necessary support services to maintain the committee.

The Children's Services Coordinating Committee plans to introduce a bill in the 59th Legislative Assembly to continue the state committee and local committees without state funding.

The future plans for the regional children's services coordinating committees are:

• Region I, Williston - Will continue operating through June 30, 2005.
• Region II, Minot - Will continue operating through June 30, 2005; however, if no other funding is identified, its operations will end. The committee will continue to meet quarterly.
• Region III, Devils Lake - The committee will continue to operate through June 30, 2005; however, staff support will end as of October 2004.
• Region IV, Grand Forks - Has discussed continuing as a regional board beyond July 1, 2005; however, staff time will be reduced significantly and eventually eliminated due to loss of funding.
• Region V, Fargo - Plans to continue its current structure and staff.
• Region VI, Jamestown - Will continue to operate with present staff while funds are available and may consider operating after funds are depleted.
• Region VII, Bismarck - Seeking other grants; however, if none are received, the office will close by June 30, 2005.
• Region VIII, Dickinson - Will retain a .4 FTE staff person for at least one year to continue coordination and collaboration of services.
• Tribal children's services coordinating committees - The state committee is unaware of any tribal committees that are still operating.

The committee received other testimony regarding the negative effect the loss of "refinancing" funds will have on the provision of children's services across the state.

Recommendations

The committee received the reports of the Children's Services Coordinating Committee but did not make any recommendations.

BUDGET TOURS

During the interim, the Budget Committee on Human Services functioned as a budget tour group of the Budget Section and visited the West Central Human Service Center, Lake Region Human Service Center, North Central Human Service Center, School for the Deaf, and State Fair. The committee also heard budget reports from the Badlands Human Service Center, South Central Human Service Center, and Northwest Human Service Center.

The committee learned about facility programs, major improvement needs, and problems the institutions and facilities may be encountering during the interim. The tour group minutes are available in the Legislative Council office and will be submitted in report form to the Appropriations Committees during the 2005 legislative session.

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