[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6380129,"mediaKeyId","2133225-9b238c359ff4d67cad2b9a6928a6fe0b","parentId",2133225,"title","State health officials ask for $1.86 million increase to cover UND autopsy work as forensic pathologist shortage continues","audioSeconds",316,"startMs",1038000,"endMs",1354000,"viewUrl","/Search/View?dp=1&key=2133225-9b238c359ff4d67cad2b9a6928a6fe0b&start=1038&end=1354","thumbnailUrl","https://assets.pipeline.soar.com/2133225-9b238c359ff4d67cad2b9a6928a6fe0b/thumbnail_1038000.jpg","articleUrl","/articles/6380129/North-Dakota/State-health-officials-ask-for-186-million-increase-to-cover-UND-autopsy-work-as-forensic-pathologist-shortage-continues","mediaUrl","https://secure.pipeline.soar.com/6380129-af8b396e5bd49bf70c90ad94bc986c34/orig.mp4?Expires=1770440209&Signature=lYxaaTkTfrTo6jYmYtHhxQ~O93oR4wf6n-W-cCYImZZwdbirJcQHZ9eIq8H6AmhHeOMtTJYMfkO6HwfWkDAK60eEfeaigfUT6CRiNogtNubm-2qfHsJ0jlCmS8RaUfdcrb5TRIys9xudA3LRa~J~ioOSo22soXNS8j5qAn92oQXOYwxj8DXqe4Yx6exd9P-mZzLaO362gN70JVifODHTZULqZBzx0vtWe9iWdl~aXn7UWDydRIANROjmzts~uOhUxViGhU75TpFxA~YnUrLOHxG3HYKgXkqMNH79EiXdnFl-oGc4lBcSo5ShyCAMIQDPlPmFcExogMo2bAJuQYmjMw__&Key-Pair-Id=KUT5TJCACFTXG","author","House Appropriations - Human Resources Division, ND","date","2025-01-20T00:00:00Z","article","The House Appropriations Committee's Human Resources Subcommittee heard testimony about the Department of Health and Human Services' forensic examiner operations, including a request to raise the contract with the University of North Dakota School of Medicine and Department of Pathology by $1.86 million to support autopsy services used in eastern North Dakota.

Why it matters: The forensic examiner's office determines cause and manner of death for nonnatural deaths and supports county coroners and law enforcement. Committee members were told the state is balancing a multi‑location service model — a Bismarck office and a long‑standing UND contract for eastern counties — while a national shortage of forensic pathologists limits hiring options.

“We've had a contract for several years with UND to cover the eastern part of North Dakota,” said Kirby Krueger, director of Disease Control and Forensic Pathology, describing the referral process and recent case counts. Krueger told the committee UND completed 372 autopsies in 2024 while the Bismarck office completed fewer cases and referred some western cases to UND because the Bismarck pathologist is available only two days a week.

Krueger said the forensic examiner supervisor position in Bismarck has been vacant since April; the agency contracted a search firm and described nationwide difficulty filling forensic pathology posts. Adrian Nightstep, office manager for the forensic examiner's office, told the panel autopsy reports are completed within about four to six weeks once toxicology results arrive, and that toxicology testing is routed first to the crime lab for qualitative screening and then, if needed, to an outside lab for quantitative analysis.

Committee members pressed details about the autopsy contract and recent facility upgrades. Krueger described HVAC and security work at the autopsy suite this year to correct condensation and safety problems: the HVAC replacement cost about $43,000 and security upgrades (cameras and badge entry) about $50,000. He said the department used previously authorized emergency flexible funds (an exemption in the department's budget created last biennium) to replace the HVAC promptly; the department indicated it would provide exact accounting for those emergency expenditures on request.

Officials also told the committee the contract increase reflects UND's documented costs for pathologists, staffing and supplies so the university will not continue to absorb expense increases. The forensic examiner office seeks a separate capital request to implement an electronic records system for case files; that equipment request was shown at about $278,000 in the section's decision packages.

Ending: Lawmakers were shown the numerical case load and a cost breakdown that the department said justified the additional autopsy contract funds. The committee asked for supplementary budget detail and pledged follow‑up questions about the vending of costs between the Bismarck office and UND while the state continues recruiting for a permanent forensic pathologist.","mediaType","Video","parentTitle","House Appropriations - Human Resources Division Jan 20, 2025","oneSentenceSummary","The House Appropriations subcommittee heard that the state relies on a long‑standing autopsy contract with the University of North Dakota and is requesting a $1.86 million increase to that contract amid a nationwide shortage of forensic pathologists and a vacant forensic examiner position in Bismarck.","taxTitle","Appropriations - Human Resources Division, House of Representatives, Legislative, North Dakota","taxId",28888,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6380114,"Healthy and Safe Communities section seeks $2 million for maternal services, highlights WIC, loan‑repayment and domestic‑violence proposals",1522,6477000,7999000,"/Search/View?dp=1&key=2133225-9b238c359ff4d67cad2b9a6928a6fe0b&start=6477&end=7999","https://assets.pipeline.soar.com/2133225-9b238c359ff4d67cad2b9a6928a6fe0b/thumbnail_6477000.jpg","/articles/6380114/North-Dakota/Healthy-and-Safe-Communities-section-seeks-2-million-for-maternal-services-highlights-WIC-loanrepayment-and-domesticviolence-proposals","https://secure.pipeline.soar.com/6380114-752c3a73105399e7dee20ac10fadce45/orig.mp4?Expires=1770440209&Signature=GdnKJdEZUFynzvj0c07xOFAQWoWHYdeTSUdIbkrrUBZ0JqgqwgYQOwZYQ1LnOh-HQ0SO457~NrxxNOQWb6EswDMIvFg5Zyg2fk6YOq3dbIWb1fegLmpEUqrloT1AVQwOIMqJFW1ZYLOEiw1m-1c9BB8dYwMXi6zSbk3QDijpgQelTA67q6gJWbzSGgaXkbDdWCRgU8XzfarcySJs7tXxEa2yb8TxqlN51aakerpClUpTlzLi1yY7kfScRs6DqrYF9WXZMZT376xrzWV-uirl3fAndvx8aj4ZIFpIjq7iHd0xOPYGhwwYPUWwWc5~-FkBcrzKr3~7dLYkTcgPoVazhA__&Key-Pair-Id=KUT5TJCACFTXG","Kim Mertz, director of the Healthy and Safe Communities section, presented program updates and budget requests to the House Appropriations Human Resources Subcommittee, including a $2 million general‑fund proposal to expand maternal and postpartum services and a $2.25 million request from the Community Health Trust Fund to strengthen domestic violence and sexual assault services statewide.

Why it matters: Maternal and child health indicators and social‑service supports are central to early‑life outcomes. Lawmakers asked for data on prenatal care access, breastfeeding disparities and program capacity while the department explained how targeted state investments would be used.

Mertz said the department's maternal and child health performance measures show weaknesses: 80 percent of women received adequate prenatal care (defined as care within the first four months), but other measures — including rising preterm birth and lower breastfeeding initiation among American Indian mothers — remain concerns. The department's executive budget includes $2 million in general funds for maternal and child health services for preconception, prenatal and postpartum support, chronic‑disease prevention, screening and stronger community services.

WIC and newborn screening: WIC served roughly 16,000 participants (2023 data), including about half of newborns in the state, Mertz said, and the agency is applying for federal infrastructure funding to modernize WIC data systems. Newborn screening processes were described as long‑standing (since 1964) and the program now screens for 34 conditions; the department recently applied for a grant (PROPEL) to strengthen data infrastructure and long‑term follow‑up.

Loan repayment and workforce: Natalie Young, director of the primary care office, summarized state and federal loan‑repayment programs under the North Dakota Health Service Corps. She told the committee the Century Code (state) awards are structured over five years and require employer matching contributions for several professions: physicians receive $100,000 (employer match 50%, total $150,000), psychologists $60,000 (employer match 25%), advanced practice providers $20,000 (employer match 10%) and registered nurses $20,000 (employer match 10%). Federal two‑year awards were described separately and can provide up to $50,000 for certain occupations; the department said it currently does not maintain a waiting list for eligible applicants.

Domestic violence and sexual assault: Deanna Askew described services to victims and crisis centers (19 centers statewide) and testified that in 2023 the programs served thousands of victims and impacted more than 4,200 children who witnessed incidents. The department proposed $2.25 million from the Community Health Trust Fund for staffing, transitional housing, mobile advocacy, transportation and prevention services for local providers.

Tobacco and youth nicotine prevention: Neil Sharvat, director of the Tobacco Prevention and Control Program, noted sustained progress in cigarette smoking rates but emphasized youth vaping remains a concern. He told lawmakers roughly one in three high‑school students has ever vaped and about one in five currently vape, and he outlined workforce training and nicotine‑treatment specialist expansion efforts.

Ending: Committee members asked for further cost breakdowns for proposed general‑fund and trust‑fund requests, lists of grantees and more details about program implementation timelines. Staff said they would provide the requested breakdowns and additional grant detail.","The section director described a $2 million general‑fund request to expand maternal and postpartum services, a $2.25 million Community Health Trust Fund decision package for domestic violence and sexual assault programs, WIC and newborn screening updates, and the state loan‑repayment programs thatRecruit and retain clinicians in shortage areas.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6380119,"Health officials report sharp syphilis rise, describe rare human rabies investigation and virus sequencing work",1521,2708000,4229000,"/Search/View?dp=1&key=2133225-9b238c359ff4d67cad2b9a6928a6fe0b&start=2708&end=4229","https://assets.pipeline.soar.com/2133225-9b238c359ff4d67cad2b9a6928a6fe0b/thumbnail_2708000.jpg","/articles/6380119/North-Dakota/Health-officials-report-sharp-syphilis-rise-describe-rare-human-rabies-investigation-and-virus-sequencing-work","https://secure.pipeline.soar.com/6380119-710c0ad2143c7000915c8b404a2f35e7/orig.mp4?Expires=1770440209&Signature=XgMs098-22-PbsLq3i97CCMCY3loErbQxf0LDcVlUui2T94NS9w5jFa0~lzPfx9x1TPGeHP-79IW3X6YP1lPWJH9uopadSHe0afm4EWuRQXxLrkW4dScq0hCNLARgnG7sYC4MntAqrUX1-7SuW2~dIgzIulJNmPHnLBeE9ZtYAzGfgvK-2IX9UZMyaPyULqw2rbMajnDleYC4W-akhQac38GrYEvmwEs5J0R197v-pmK3Fh1FfdiqGjm2rlrWilAAnKVhHmW0w-dOVI-~ywCw1SGYPxVjRadTf9f6erweKTqYiCz5KnTusf3QjgAESilGCEWX3OxAK6x-vGt9hDEGA__&Key-Pair-Id=KUT5TJCACFTXG","The Human Resources Subcommittee heard detailed accounts of surveillance and outbreak work from the Department of Health and Human Services, including a substantial increase in syphilis cases, a rare human rabies investigation that required prophylaxis for exposed healthcare workers and expanded laboratory sequencing to track enteric outbreaks.

Why it matters: Rapid rises in sexually transmitted infections and the reappearance of rare but fatal diseases are public‑health priorities that can drive prevention funding and clinical outreach. Committee members examined how field investigators, partner clinics and laboratory capacity work together to identify cases and protect contacts.

Kirby Krueger explained that reported syphilis cases rose to 343 in 2024, a 60 percent increase from 214 cases in 2023. He said partner services (case interviews and partner notification) yielded about 20 percent of detected new cases and that the department identified 16 pregnant women with syphilis in 2024; 14 were treated before delivery, but two were late or had no prenatal care and two infants met the clinical case definition for congenital syphilis and received treatment.

Krueger also described an investigation of a non‑North Dakota resident who died of human rabies after receiving some healthcare in the state. He said the diagnosis was confirmed postmortem and that about 24 individuals were recommended to receive rabies post‑exposure prophylaxis after the exposure assessment and clinical review. Krueger told the committee that human‑to‑human transmission of rabies is rare and usually involves organ‑transplant cases; this hospital incident required detailed tracing and coordination with the treating facility.

On laboratory work and foodborne surveillance, Krueger and staff explained that the department seeks DNA sequencing for enteric pathogens (salmonella, campylobacter, E. coli O157) through a reference laboratory to match strains across cases. That sequencing can take weeks; public notification depends on whether sequencing shows a national link or local cluster. The subcommittee also heard about the state's infection‑prevention outreach (ICARS voluntary assessments) and antimicrobial‑stewardship awards to facilities that have formal stewardship programs.

Ending: Lawmakers sought clarification on hospital protocols for suspected rabies patients and asked for follow‑up on which facilities participate in voluntary infection‑control assessments. Department staff said they would provide facility participation lists and additional details to the committee.","Witnesses described a 60% year‑over‑year increase in reported syphilis cases, steps taken to prevent congenital syphilis and an unusual human rabies case that prompted roughly two dozen post‑exposure prophylaxis recommendations; officials also outlined DNA sequencing used in foodborne outbreak work and hospital infection control programs.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6380124,"Lawmakers hear that kindergarten vaccination rates have fallen as state seeks funds to buy RSV and hepatitis B doses for birthing hospitals",477,1436000,1913000,"/Search/View?dp=1&key=2133225-9b238c359ff4d67cad2b9a6928a6fe0b&start=1436&end=1913","https://assets.pipeline.soar.com/2133225-9b238c359ff4d67cad2b9a6928a6fe0b/thumbnail_1436000.jpg","/articles/6380124/North-Dakota/Lawmakers-hear-that-kindergarten-vaccination-rates-have-fallen-as-state-seeks-funds-to-buy-RSV-and-hepatitis-B-doses-for-birthing-hospitals","https://secure.pipeline.soar.com/6380124-83101e69854ae7d04b48257cb8fe8afe/orig.mp4?Expires=1770440209&Signature=LSI5ny9Mb42biPh6jw808X-R5zrGmSrsG~JB1fwd6SnyskvmPRsrz9U-X3kQRJzWbbDAlmstGXautmZcvfya6gkc4rVhpZY-zSX8hAW~OZyZfzWM0cgD8CRJYsbg6V4J0QA5L-dF57f-E3adUYvo2ooWBInxhvoAHWdO8XdU4Jqq4IsxadPGQIjzyCDxzND2w5d28XhBp0gCmrzIPlAfeCDGcRB~3VwHogbUvuA9d4VHcUEXL6R887lG7Pyl2W424AtDW03~JF3im8c2oUwzDM5qkMMEBLehGkAEm1IBaCcoo6pzH7aHcK9LKgl8oKQcnVKq7L7MxTdxHudW5hJrQQ__&Key-Pair-Id=KUT5TJCACFTXG","Health and Human Services officials told the House Appropriations Committee Human Resources Subcommittee that kindergarten immunization coverage in North Dakota has been slipping and philosophical and moral exemptions are increasing, prompting a mix of operational and budget requests aimed at boosting protection for young children.

Why it matters: Declining routine childhood vaccine coverage raises the risk of outbreaks of highly contagious diseases such as measles and polio. Committee members heard proposals to expand access to RSV protection for newborns and to help birthing hospitals supply hepatitis B vaccine to infants before discharge.

“This first year that we had the immunization coverage available for infants — either the monoclonal antibody or vaccinating the mom during pregnancy — we estimate that we had close to 55 percent coverage,” Kirby Krueger, director of Disease Control and Forensic Pathology, said of the initial RSV protection rollout. He said 2024 preliminary estimates showed greater than 70 percent protection for the highest‑risk infants.

Molly Howell, immunization director for HHS, told the committee kindergarten coverage for core childhood vaccines has declined in recent years and that exemption rates — particularly philosophical/moral exemptions — have increased, eroding herd immunity in places. Howell noted measles requires roughly 95 percent coverage to prevent outbreaks and polio experts recommend at least 80 percent coverage.

The department's executive decision package requests about $2.2 million from the public health operating fund (Fund 370) to coordinate immunization access at birthing hospitals, which would include purchase and distribution of hepatitis B vaccine and RSV monoclonal antibody (nirsevimab) doses for infants at discharge. Stephanie Rasmussen of the agency finance office confirmed that the proposed immunization access funding would be paid from Fund 370.

HHS staff also described a recent modernization of the state immunization information system. Krueger said the North Dakota Immunization Information System (NDIS) modernization went live Nov. 18, 2024; the department reported 75 interoperable connections, impacted vaccination sites and more than 700,000 immunization records served in the last biennium. The department asked for continued IT and modernization funding to support NDIS and related interoperability work.

Other public‑health details presented to the committee included increases in pertussis (preliminary 151 cases in 2024, with 13 infants and eight infant hospitalizations) and a 2024 infant Hemophilus influenzae type b meningitis case in an unvaccinated infant. The witnesses emphasized the role of provider outreach, school record enforcement and reminder/recall systems in improving routine vaccination coverage.

Ending: Committee members asked for follow‑up data at county and school district levels and requested that the department provide more detail on the proposed Fund 370 purchase plan and on how the immunization access package would be administered at birthing hospitals.","Health officials told the appropriations subcommittee kindergarten immunization coverage has declined and exemption rates have risen; the department proposed a decision package to buy hepatitis B and RSV monoclonal antibody doses for birthing hospitals using public health operating funds and discussed immunization system modernization.","actionData","errors"]

Article not found

State health officials ask for $1.86 million increase to cover UND autopsy work as forensic pathologist shortage continues

Healthy and Safe Communities section seeks $2 million for maternal services, highlights WIC, loan‑repayment and domestic‑violence proposals

Health officials report sharp syphilis rise, describe rare human rabies investigation and virus sequencing work

Lawmakers hear that kindergarten vaccination rates have fallen as state seeks funds to buy RSV and hepatitis B doses for birthing hospitals