AGP Executive Report

Leadership in Medicaid and autism services: North Dakota HHS named Stephanie Bates as executive director of the Medical Services Division, overseeing Medicaid, CHIP, autism services and other programs. SNAP rules open for public comment: The state’s Healthy Choice Waiver would restrict SNAP purchases of most candy, energy drinks and sweetened beverages; comments are due by Oct. 15 after a federal request delayed implementation to Nov. 1. Measles exposure watch: Health officials reported possible exposure on an Amtrak Empire Builder passenger who used the restroom at the Minot station; people who may be exposed should monitor for symptoms for 21 days and coordinate with providers. Food safety alert: A Chilean frozen berry recall expanded after an E. coli outbreak; affected Great Value and Trader Joe’s frozen organic berry lots were shipped to stores including North Dakota—check freezers. Youth nicotine shift: Fargo Cass Public Health says teen vaping is down, but smokeless tobacco use among high schoolers more than doubled from 2023 to 2025, with nicotine pouches likely a driver. Care access and local health staffing: Essentia Health St. Joseph’s-Baxter Clinic welcomed family medicine specialist Dr. Kayla Fussy. Rural emergency funding: Rugby Ambulance is seeking a mill levy increase to sustain EMS as costs rise and the service has run at a deficit.

Rural Workforce & Access: A CNN look at Hettinger, ND shows how immigrant workers are filling critical hospital roles, including ultrasound technician Marichu Castillo Villamiel, highlighting the strain and payoff of staffing small-town care. Food Safety: A Chilean supplier expanded recalls of frozen organic berries sold at Walmart and Trader Joe’s after an E. coli outbreak sickened 17 people and hospitalized six; North Dakota shoppers are urged to check freezers for affected lots. Public Health Alerts: North Dakota health officials reported possible measles exposure for people who were on an Amtrak Empire Builder passenger route and at the Minot station during a specific window; unvaccinated exposed residents may need to quarantine and everyone should watch for symptoms. Nutrition Policy: North Dakota opened a public comment period on proposed SNAP restrictions that would limit purchases of certain sugary drinks and candies, with implementation delayed to Nov. 1. Local EMS Funding: Rugby’s ambulance service is seeking a mill levy increase to cover rising costs and sustain emergency care as the service has run deficits for years. Community Health Support: Women’s Way is helping North Dakotans get breast cancer screenings, offering free or no-cost support for eligible people.

SNAP Policy Update: North Dakota opened a public comment period on planned Healthy Choice Waiver changes that would restrict what people can buy with SNAP benefits, including most candies, energy drinks and sweetened beverages; comments run through Oct. 15. Public Health Alert: State health officials say a measles-positive passenger on Amtrak’s Empire Builder traveled through Minot and used the station restroom around 9:30 a.m. Sept. 24, creating a potential exposure for passengers and anyone at the station from 9:06 to 9:51 a.m.; unvaccinated people should quarantine and monitor for 21 days. Youth Nicotine Trend: Fargo Cass Public Health reports teen vaping is down, but smokeless tobacco use among high school students more than doubled from 3% in 2023 to 7% in 2025, with nicotine pouches likely a driver. Rural EMS Funding: Rugby Ambulance Service is seeking a mill levy increase to sustain emergency care as costs rise and the service has operated at a financial loss for more than a decade. Healthcare Access (Medicare): Aetna announced its 2027 Medicare plan lineup, highlighting $0 copays for key services and targeted support for people with chronic conditions.

Measles Alert: North Dakota health officials are tracking a possible measles exposure after an Amtrak Empire Builder passenger traveled from Chicago to Minot (Sept. 23–24) and used the restroom at the Minot station around 9:30 a.m.; people on the train or at the station during the stop (about 9:06–9:51 a.m.) should monitor for symptoms for 21 days, and unvaccinated people should quarantine. Tobacco Use Shift: North Dakota teen vaping is down, but smokeless tobacco use among high schoolers more than doubled from 3% (2023) to 7% (2025), with nicotine pouches like Zyn suspected to be a driver. Cancer Screening Access: Women’s Way is helping Fargo-area women get breast cancer screenings, covering costs and barriers like co-pays, deductibles, reminders, and transportation. Child Safety Trial: A civil negligence case against the Anne Carlsen Center over alleged mishandling of a 2019 sexual abuse allegation is set for trial Oct. 5–16. Food Safety: The FDA reports more illnesses tied to recalled sprouts (E. coli and salmonella), with additional cases and hospitalizations reported as the outbreak spreads. Drug Pricing Accountability: Iowa joined a coalition seeking court approval of a $400 million Sandoz generic-drug settlement over alleged anticompetitive price manipulation. Rural Health & Workforce: North Dakota’s rural health grant strategy is moving toward “anchor partners,” and HHS awarded over $12.4 million to North Dakota for community-based care.

Legal Accountability: A Jamestown civil lawsuit over alleged sexual assault at the Anne Carlsen Center is headed to a jury trial Oct. 5–16, after claims that the center failed to supervise and negligently kept a male employee despite prior inappropriate conduct. Regional Health Care Consolidation: Minnesota’s HealthPartners and Essentia Health have approved a plan to combine into a 22-hospital system spanning Minnesota, North Dakota and Wisconsin, with patients and regulators watching for impacts on access and costs. Food Safety: The FDA says more people have been added to an E. coli and Salmonella outbreak tied to alfalfa sprouts from Everything Sprouts LLC, with cases reported in North Dakota and 15 other states. Drug Pricing & Consumer Relief: Multiple state attorneys general are seeking court approval of a $400 million Sandoz settlement over alleged generic-drug price-fixing, while the Trump administration has begun mailing $500 ACA “refund” checks to eligible HealthCare.gov enrollees in 30 states. Public Health Policy: A North Dakota SNAP error-rate story flags rising administrative problems that could cost the state money, as SNAP rules and funding responsibilities shift. Mental Health Access: A counseling compact is expanding across states, allowing licensed counselors to practice across state lines via telehealth and in person.

Drug Pricing Accountability: Multiple state attorneys general, including Oregon and New York, are seeking court approval for a $400 million settlement with Sandoz (with Fougera) over alleged conspiracies to inflate generic drug prices and limit competition—potentially returning about $469 million total to states and eligible consumers. Consumer Health Costs: The Trump administration has begun mailing $500 ACA “refund” checks to about 950,000 people in 30 states that use HealthCare.gov and paid full premiums without subsidies, with eligibility tied to income and marketplace rules. Rural Health in ND: North Dakota is rolling out a new rural hospital network aimed at helping rural facilities survive and thrive, alongside efforts to manage Rural Health grants through “anchor partners.” ND Health & Wellness Research: A University of North Dakota study finds whole fruits may better protect against heart and blood vessel problems than fruit juice, likely due to fiber and polyphenols. ND Agriculture & Health: USDA is investing $30 million to address salinity in North Dakota’s Prairie Pothole Region, supporting soil health and water-quality conservation that can affect long-term local resilience. Local Care Access: HealthPartners and Essentia Health announced plans to combine into a larger 22-hospital system spanning Minnesota, Wisconsin, and North Dakota, with patient and community input requested during review.

SNAP Oversight: North Dakota’s SNAP payment error rate is reported at 12.76%, more than double the national 6% threshold, raising the risk of costly federal paybacks. ACA Refunds: The Trump administration has started mailing $500 “Obamacare” refund checks to nearly 1 million people in 30 states using the federal marketplace, including North Dakota, for those who paid full premiums without assistance. Rural Health Funding: North Dakota will use in-state “anchor partners” to manage Rural Health Transformation grants, aiming to speed up delivery of more than $160 million. Rural Hospitals Network: A new three-year rural hospital collaboration is drawing attention for cutting costs, improving outcomes, and keeping local hospital control. Workforce & Care Access: HHS awarded North Dakota over $12.4 million through Money Follows the Person to help move eligible people from institutions into community-based care. Clinical Safety & Training: The North Dakota Air National Guard and Sanford announced a medical training partnership for nurse practitioners, physician assistants, and registered nurses. Health Equity in Transplant: A new study finds only 60% of liver transplant recipients are vaccinated against hepatitis B, leaving many at risk.

ACA Refund Checks: The Trump administration began mailing $500 rebate checks to nearly 1 million Americans in 30 states who bought coverage through the federal Affordable Care Act marketplace, with recipients receiving letters signed by Trump; North Dakota is on the eligible list, while residents in state-run exchanges (like California and New York) won’t get the payments. Rural Health Funding: North Dakota HHS will use “anchor partners” to manage its Rural Health Transformation Program grants, aiming to speed implementation of more than $160 million tied to rural access, workforce, and technology. Medicaid Leadership: HHS named Stephanie Bates to lead North Dakota’s Medical Services Division, overseeing Medicaid and related health programs. Health System Merger Impact: Minnesota’s HealthPartners and Essentia Health approved a merger plan that would create a large regional nonprofit system spanning Minnesota, Wisconsin, and North Dakota, with ND Essentia clinics set to adopt the HealthPartners name over time. Public Health Money Follows the Person: HHS awarded North Dakota over $12.4 million to help move eligible people from institutional care into community-based settings. Clinical Safety Gap: A new study found only 60% of liver transplant recipients are vaccinated against hepatitis B, highlighting a preventable risk for severe complications.

Major Health Merger: HealthPartners and Essentia Health have approved a definitive affiliation agreement to combine into one nonprofit system under the HealthPartners name, pending regulators, with plans to integrate operations across Minnesota, Wisconsin, and North Dakota (22 hospitals, 135+ clinics, 6,000 clinicians). State Oversight: Minnesota Attorney General Keith Ellison says his office will review the proposed mega-merger under state healthcare, charities, and antitrust laws. Veterans Mental Health Funding: The U.S. Department of Veterans Affairs awarded North Dakota nearly $699,000 to expand veteran mental health and suicide prevention services statewide, marking the first award for ND under the Staff Sergeant Parker Gordon Fox program. Workforce & Access: North Dakota reports 12,435 job openings statewide, including 3,737 in healthcare, as the state moves toward merging workforce programs into a new Department of Workforce Development. Local Health System Costs: Grand Forks County approved switching employee health insurance to NDPERS for Jan. 1, aiming to lower deductibles and keep costs within budget mandates. Nutrition & Chronic Disease: A national report flags North Dakota among states with very high adult obesity rates, while noting a recent drop in obesity in West Virginia and Louisiana. Healthcare Compliance & Transparency: A Fargo psychiatric/addiction hospital settlement over alleged Medicaid billing issues included a provision limiting public disclosure, raising questions about accountability and open records.

County Health Costs: Grand Forks County commissioners approved switching employee health insurance to NDPERS, with estimated 2027 premiums of about $5.3M versus $6.05M under Blue Cross Blue Shield, effective Jan. 1, while some employee representatives questioned how any excess funds will be used. Veteran Mental Health Funding: The U.S. Department of Veterans Affairs awarded nearly $699,000 to North Dakota to expand veteran suicide prevention and mental health services statewide starting next fiscal year. Healthcare System Merger: Minnesota-based Essentia Health and HealthPartners approved a planned nonprofit merger that would operate under the HealthPartners name, pending regulators, with an expected effective date of Jan. 1, 2027; Essentia clinics in North Dakota are included. Rural Health Grants: HHS awarded more than $1.3M to three North Dakota universities for rural health policy work, Head Start projects, and FDA-related research. Medicaid Billing Dispute: Prairie St. John’s Hospital in Fargo agreed to a $5.5M Medicaid billing settlement but negotiated a provision barring the state from publicizing it for months, raising questions about transparency. Workplace Wellness: Blue Cross Blue Shield of North Dakota’s Worksite Wellness Summit highlighted employer support for mental health, sleep, and stress.

Health Policy & Access: A state-by-state Medicaid “report card” and looming federal changes are pushing long-term care planning into the open, with Medicaid’s rules varying widely by state and affecting families when a parent needs round-the-clock support. Mental Health in Aviation: The U.S. Senate passed two bipartisan bills to make it easier for pilots and air traffic controllers to seek mental health care and understand how medications affect medical eligibility, aiming to reduce stigma and long review delays. Drug Pricing Accountability: North Dakota’s AG Alan Wilson is urging consumers to file claims tied to multistate settlements over alleged generic drug price inflation, including a plan preliminarily approved by a federal court. AI Oversight: North Dakota’s Insurance Commissioner ordered an AI company and founder to stop selling securities in the state for allegedly soliciting investments without proper registration. Rural Health & Worksite Wellness: Blue Cross Blue Shield of North Dakota’s Worksite Wellness Summit in Fargo highlighted employer support for mental health, sleep, and resilience. Community Health & Safety: A Safe Haven Baby Box opened in Campbell County, adding another anonymous surrender option for newborns. Clinical Research: A Lancet trial found long-acting injectable HIV treatment helped adolescents maintain viral suppression better than daily pills. Local Health Care News: Essentia Health-St. Joseph’s Medical Center welcomed an orthopedic surgery physician assistant trained at UND. Data Centers & Public Concerns: North Dakotans are asking questions as data center development accelerates faster than local rules, with counties considering moratoriums and ordinances.

Workplace Mental Health: Blue Cross Blue Shield of North Dakota’s Worksite Wellness Summit in Fargo put mental health, sleep and resilience front and center, urging employers to make therapy access easier and more visible. HIV Treatment Update: A Lancet trial found long-acting injectable HIV therapy (cabotegravir–rilpivirine) kept adolescents’ virus suppressed better than daily pills, with fewer viral rebounds by week 96. Maternal & Infant Support: Jamestown Regional Medical Center partnered with The Milk Bank to expand access to pasteurized donor human milk, adding a local Milk Depot for approved donor drop-offs. Child Safety: North Dakota HHS says 3 in 4 car seats were used incorrectly in 2025, highlighting common harness and anchor mistakes and pointing families to certified child passenger safety techs. Rural Health & Policy: The U.S. Interior Department agreed to overhaul wetland rules affecting North Dakota farmland, allowing farmers to redraw old easement maps and manage excess field water while protecting duck habitat. Healthcare Workforce: Essentia Health-St. Joseph’s Medical Center welcomed orthopedic physician assistant Emma Bestul, a UND graduate. Public Health & Safety Tech: Insurance Commissioner Jon Godfread ordered two AI firms to stop doing business in North Dakota over improper investment solicitation. Community Health Access: First responders opened a Safe Haven Baby Box in Campbell County, offering anonymous surrender options for newborns.

AI & Investor Protection: North Dakota Insurance Commissioner Jon Godfread ordered Silverberry Group (now WoundScribe AI) to stop doing business in the state, saying the firms solicited investments without proper registration; the companies can request a hearing. Maternal Health Access: Jamestown Regional Medical Center (JRMC) partnered with The Milk Bank to expand access to pasteurized donor human milk, adding a Milk Depot at its Specialty Clinic for approved donor drop-offs. Child Safety: North Dakota HHS says 3 in 4 car seats checked in 2025 were used incorrectly, urging parents to install and strap seats correctly every trip and to use certified child passenger safety techs. Behavioral Health Infrastructure: A beam-signing ceremony marked a milestone for North Dakota’s new State Hospital, described as a modern, trauma-informed replacement for aging facilities. Rural Mental Health & Suicide Risk: A report highlighted that male farmers and ranchers face much higher suicide risk, pointing to resources like the Farm and Ranch Stress Assistance Network and 988. Policy Watch: The North Dakota Supreme Court upheld the state’s ban on puberty blockers, hormones, and “mutilating gender surgeries” for minors. Health Care Workforce/Access: A federal E-Rate program that helps schools and libraries with connectivity could be cut or changed, raising concerns about impacts on education tech and access.

Child Health & Courts: The North Dakota Supreme Court upheld the state’s ban on puberty blockers, hormones, and “mutilating gender surgeries” for minors, rejecting arguments that the procedures should be treated as a protected right. Maternal & Infant Care: Jamestown Regional Medical Center (JRMC) partnered with The Milk Bank to expand access to pasteurized donor human milk and launched a Milk Depot for approved donors. Public Health Safety: North Dakota HHS says 3 in 4 car seats checked in 2025 were used incorrectly, urging parents to use certified child passenger safety techs and install seats correctly every time. Rural Mental Health: A report highlights higher suicide risk among male farmers and ranchers, pointing to stressors like drought and price swings and directing people to resources including 988. Addiction & Toxicology: A new synthetic opioid, cychlorphine, has been detected in 18 states, linked to dozens of deaths in East Tennessee, raising concerns for broader monitoring. Community Health Access: Chrysalis Health and Curaechoice expanded mental health services for employer plans, including in North Dakota, with no-cost in-person and virtual options. Infectious Disease Watch: A tick study is expanding into North Dakota, asking residents to submit ticks from themselves or pets to track species and possible diseases. Healthcare Workforce: Gov. Kelly Armstrong aligned workforce programs into a single structure and named Katie Ralston Howe as the state’s first workforce commissioner.

Energy & Health Policy: Sen. Kevin Cramer argues the U.S. still lacks enough domestic refining capacity to protect consumers from global supply shocks—an issue that can ripple into healthcare costs via higher prices for essentials. School Connectivity: A federal E-Rate funding shift could reduce support for North Dakota school and library internet and hardware, raising concerns that local districts may have to cover gaps. Mental Health in Aviation: The U.S. Senate passed the John A. Hauser Mental Health in Aviation Act, aimed at updating FAA rules so pilots and air traffic controllers can seek care without career penalties. Behavioral Health Infrastructure: North Dakota’s new State Hospital project reached a construction milestone with a beam-signing ceremony, framed as a major upgrade for trauma-informed behavioral health care. Public Health & Safety: A North Dakota tick study is expanding statewide, asking residents to submit ticks from people or pets; officials warn fall is a peak season. Access to Care: Chrysalis Health and Curaechoice are partnering to expand no-cost mental health services in North Dakota and surrounding states. Legal/Transparency: The ND Attorney General issued a summary opinion saying the ND Department of Health and Human Services complied with open records law. Community Support: “Lend A Hand Up” highlights multiple North Dakota families facing serious illness and injury, including acute kidney/liver failure and stage 3 esophageal cancer.

Mental Health in Aviation: The U.S. Senate passed the John A. Hauser Mental Health in Aviation Act, backed by Sen. John Hoeven and Sen. Tammy Duckworth, aiming to reduce stigma and update FAA rules so pilots and air traffic controllers can seek care without career delays. Public Health & Safety: A North Dakota tick study is expanding, with kits available at Sanford urgent care locations in Fargo and an online dashboard to track tick activity as fall “peak” season approaches. Opioid Alert: A new synthetic opioid, cychlorphine, has been identified in 18 states, tied to dozens of deaths in East Tennessee, prompting renewed concern for substance detection and prevention. Healthcare Access & Costs: Chrysalis Health and Curaechoice are partnering to expand no-cost mental health services for employer plans, including locations in North Dakota. Caregiving Support: A “Lend A Hand Up” roundup highlights several North Dakota families facing serious medical crises, from acute kidney/liver failure to cancer and traumatic brain injury. State Policy/Transparency: North Dakota AG issued a summary opinion saying the Department of Health and Human Services complied with open records law. Nutrition Assistance: SNAP purchase rules are changing in more states, with shoppers urged to recheck local restrictions before buying items like soda and certain prepared desserts.