The North Dakota Senate Appropriations Committee convened on March 18, 2025, to discuss critical updates regarding the Human Resources Division, particularly focusing on services for children with disabilities. A significant portion of the meeting centered on the proposed cross disability waiver, aimed at improving access to home and community-based services for children aged 3 to 21 with mild to moderate support needs.

The discussion highlighted the case of a child named Eve, who was born prematurely and diagnosed with Down syndrome. Eve's family initially benefited from early intervention services and Medicaid support, but after she turned three and transitioned to Part B services, they noticed a regression in her developmental progress. This prompted them to seek further assistance from the regional developmental disabilities unit.

The committee emphasized the need to modernize the system to ensure equitable access to essential services. Plans for the 2025-2027 biennium include designing a new level of care for both the children's cross disability waiver and the developmental disability waiver. A key proposal is to align eligibility criteria for children aged 3 to 5 with those under Part B of the Individuals with Disabilities Education Act. This change could have allowed Eve to continue receiving necessary services and maintain Medicaid access.

Another focal point of the meeting was the redesign of the developmental disability level of care. The state intends to update its eligibility definition to reflect contemporary standards, incorporating social functioning as a critical component. This shift aims to better serve individuals with disabilities and promote their independence in community settings.

The anticipated implementation of the new service delivery system is set for July 2028. Committee members discussed the importance of ensuring adequate funding and consistent service rates across various waivers to avoid disparities in service provision. The committee's deliberations will continue as they work towards finalizing these significant changes in support of children with disabilities in North Dakota.