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Home & Community-Based Services: State-Only Funded Programs in North Dakota

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Service Payments for the Elderly & disabled (SPED)²⁶

Administrative Agency: Dept of Human Services

Population Served: Elderly, physically disabled.

Annual Expenditure: $6,381,000 FY03

Funding Source: 95% General revenue, 5 % county funds

Number of People Served: 2007 FY03

Eligibility Criteria: Assets less than $50,000. Impairments in 4 ADLs/5 IADLs which have lasted/are expected to last at least 3 mths. Under 18s screened for nursing facility level of care, must be ineligible for waivers, living in community & capable of directing own care or have a legally responsible person. People with mental illness & MR/DD not covered.

Further Information:

Program Name: Expanded SPED²⁶

Administrative Agency: Dept of Human Services

Population Served: Elderly, physically disabled adults.

Annual Expenditure: $535,900 FY03

Funding Source: General revenue

Number of People Served: 233 FY03

Eligibility Criteria: Recipients eligible for Medicaid & SSI, nursing home level of care, able to toilet, transfer, eat independently but impaired in 3 of 4 activities; meal preparation, housework, laundry, or taking medication (health, welfare, or safety needs otherwise requiring care in an institution).

Further Information:

Program Name: Family Home Care³

Administrative Agency: Dept of Human Services

Population Served: Adults (18+)

Annual Expenditure: $779,728 FY03

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: 3 or more ADLs

Further Information: Cost control Respite cap $550/month, families can be paid to provide respite care.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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