Remarks as prepared for delivery
Good afternoon and thank you for joining us. Today, we are pleased to announce that the Department of Justice and the State of North Dakota have reached a comprehensive settlement agreement to ensure compliance with the Americans with Disabilities Act. The agreement commits North Dakota to expand services for individuals with disabilities so, when appropriate, they will be able to choose to remain in their own homes, near family and friends, while receiving the services they need, instead of entering or remaining in nursing facilities to receive care.
I thank Governor Doug Burgum and the North Dakota legislature for their commitment to improve the lives of people with disabilities. I also thank the Executive Director of the North Dakota Department of Human Services, Christopher Jones. We appreciate the collaborative approach that the State displayed in working to resolve the issues that we identified during our investigation.
Several years ago, the Department of Justice notified North Dakota that it was investigating complaints that the State fails to provide adults with physical disabilities the services that they need to remain in their own homes and live in their communities, leaving them no choice but to live in nursing facilities. In response, the state cooperated fully with our investigation, including our requests for information. The parties have now agreed to enter into a pre-suit, comprehensive settlement agreement to resolve the Department’s investigation of the state’s alleged violations of the Americans with Disabilities Act.
The agreement commits the State to prevent unnecessary segregation by providing community-based services to two groups of people with physical disabilities: those in nursing facilities who choose, and are appropriate, to receive services at home, and those who are at serious risk of being forced into nursing facilities unnecessarily. These changes will not only benefit people with disabilities, but also their families, friends, and communities throughout the Peace Garden State.
But what do these changes mean? For one North Dakotan in his 20s, this agreement means freedom to live life on his own terms. This young man, who I will call John, has a mobility disability and needs assistance with bathing, dressing, and other activities. Like so many Americans, he dreams of completing his education, supporting himself, and living in his own apartment. But under North Dakota’s current system, John must rely on his parents for care that otherwise would only be available to him in a nursing facility. John and his parents worry that, in the future, when his parents are inevitably unable to assist him, John will be forced to enter a nursing facility, rather than continue to live independently in his own home in the community.
The settlement agreement will expand choices for John and other people with physical disabilities. The agreement requires the state to transform its long-term care system so that people with disabilities can remain with their families and communities, while still receiving the care that they need. The state will provide more than 2,500 people with individualized services. These services include help with deciding where to live, identifying and arranging for community-based services, and finding accessible housing. They also include services provided at home, including home health aides to help with daily activities such as bathing and dressing.
Finally, the agreement includes several provisions designed to ensure that North Dakota develops high-quality long-term care services that are available throughout the state. The state will hire a subject matter expert to advise the state on how to implement the agreement and to issue public reports. The state will improve its data collection and quality assurance systems to recognize where gaps in services exist, as well as monitor the health and safety of people who choose to receive community-based services. And the state will develop a plan detailing how it will complete the reforms in the agreement and engage with stakeholders about the plan.
Enabling people in nursing facilities, who choose and are appropriate for community-based care, to transition to the community is especially urgent during the COVID-19 pandemic, given the high risk of virus transmission in congregate settings. And, according to a recent report commissioned by the Centers for Medicare and Medicaid Services, serving an individual with community-based services is generally more cost-effective than serving that same person in an institutional setting.
On behalf of our team, I want to say thank you to the individuals with disabilities, families, advocates, and other community members who shared their stories and gave us suggestions on how to improve North Dakota’s long-term care system. Going forward, we will need your ongoing support and engagement to make sure that the reforms in this agreement are successful. Thank you also to the providers of community-based services and nursing-facility services in North Dakota who shared their experiences and their vision for a better system. Your participation in implementing the coming reforms will be essential.
The agreement is a great victory for both the people of North Dakota and its government. With the leadership in this State and the engagement of the community, we believe that North Dakota will serve as a model of how a state can ensure that people with disabilities receive services necessary to remain in their homes and communities, when appropriate. In light of the level of commitment and cooperation shown, we believe that North Dakota will achieve all of the reforms in the agreement, and more importantly, improve the lives of people like John and his family. We look forward to working with North Dakota to create that change.
At this time, I will invite U.S. Attorney Drew Wrigley to offer remarks. Drew Wrigley and his office have worked closely with the Civil Rights Division on the investigation and the negotiations that produced the settlement agreement.
 This individual gave the Department of Justice permission to share his story under a pseudonym.
 Debra J. Lipson, Measures of State Long-Term Services and Supports Rebalancing, HCBS Quality Measures Issue Brief (Nov. 2019) at 2, https://www.medicaid.gov/medicaid/quality-of-care/downloads/hcbs-quality-measures-brief-3-rebalancing.pdf.
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