The North Dakota Legislative Task Force on Government Efficiency convened on July 30, 2025, to discuss significant advancements in behavioral health services and Medicaid management, highlighting the state's commitment to outcome-based funding and cost-effective care.

Pam Segnus, Executive Director of Behavioral Health with the Department of Health and Human Services, presented the "Free Through Recovery" program, which has been pivotal since its inception in 2016. This initiative aims to provide individuals with behavioral health services in their communities, thereby preventing the need for incarceration and promoting family stability. Segnus emphasized that the program is designed to support individuals in achieving personal recovery goals, such as maintaining housing and reunifying with children. Notably, 69% of participants have met three out of four key outcomes, demonstrating the program's effectiveness.

The task force also explored the financial implications of this program, revealing that it costs approximately $4.15 per month per participant, significantly less than the $4,500 monthly cost of incarceration. This cost-effective approach not only alleviates the burden on the justice system but also supports individuals in leading productive lives within their communities.

In addition to behavioral health, Sarah Acre, Executive Director of Medical Services, shared insights on Medicaid management. Acre highlighted North Dakota's success in controlling pharmacy costs while ensuring access to necessary medications. The state has managed to keep its per capita spending lower than the national average, despite an increase in total reimbursements to pharmacies. This achievement is attributed to strategic decisions, such as directing participants to lower-cost drugs and negotiating supplemental rebate agreements.

The discussions underscored the importance of evaluating Medicaid expenditures, particularly in light of recent federal legislation that may impact funding. Task force members expressed a desire for deeper analysis of reimbursement rates and service utilization to ensure that North Dakota continues to provide high-quality care while managing costs effectively.

As the meeting concluded, the task force recognized the need for ongoing evaluation of state programs to ensure they meet the evolving needs of the population while remaining fiscally responsible. The commitment to outcome-based funding and efficient service delivery stands as a testament to North Dakota's proactive approach in addressing behavioral health and Medicaid challenges.