DEPARTMENT OF JUSTICE Settlement Agreement WITH North Dakota
fact sheet

Purpose and Background

• In response to complaints from adults with physical disabilities receiving services in North Dakota’s long-term care system, the U.S. Department of Justice (DOJ) investigated the State’s compliance with Title II of the Americans with Disabilities Act (ADA), which requires public entities to administer services to individuals with disabilities in the most integrated setting appropriate to their needs. 
• North Dakota agreed to enter into a pre-suit settlement agreement to resolve DOJ’s investigation.

Target Populations

• Adults with physical disabilities who currently reside in a nursing facility but who are appropriate for and do not oppose receiving services in the community (Nursing Facility Target Population); and
• Adults with physical disabilities who are at serious risk of entering nursing facilities unnecessarily (At-Risk Target Population).

 
Implementation Plan: To maximize the State’s autonomy and flexibility, the State will develop a plan, tailored to its service system, to implement the agreement.

Goals of the Proposed Settlement: Require North Dakota to address unnecessary segregation and provide community services by:

• Implementing individualized assessments through person centered planning to identify supports and services necessary to meet the individual’s needs in the most integrated setting. §§ III.M; VIII.
• Preventing or ending unnecessary segregation in nursing facilities by diverting and transitioning individuals who can and wish to receive services in the community.  §§ III.D, X, XI.E.
• Providing adults with physical disabilities necessary community-based services, e.g., durable medical equipment, home modifications, nursing visits, transportation to medical appointments, personal care services by a home health aide, and supervision services, by building capacity in its existing community-based service system (§§ IX, XIII); providing case management (§§ III.A, VII) and housing specialist assistance (§§ III.E, XII); and implementing health and safety measures (§ XVI).

Interim and Final Benchmarks

• The State will provide person centered plans (§§ VIII.I.3 and 4), permanent support housing slots (§§ III.L, XII.B), transitions to the community and diversions from nursing facilities (§ XI.E), and informational visits (§ XIV.A) to identified target population members throughout the agreement.

Oversight, Enforcement, and Termination

• The parties selected a subject matter expert who will review the State’s progress and provide recommendations.  Every six months, the expert will issue a public report on the State’s progress.  § V.
• If the Department of Justice believes that the State is violating the agreement, it may ask the Subject Matter Expert to act as a mediator.  If both sides do not agree or the State does not fix the problem, the United States may bring a civil lawsuit in federal court.  § XVII.
• This Agreement will end eight years after the date it is signed, if the Parties agree that the State has met the Agreement’s requirements for a year.  § XVII.H.
• The Department of Justice and North Dakota may agree to end the agreement early if the State meets all requirements.  § XVII.I.