Audit Finds Failures in North Dakota Agency Operations
A new audit reveals significant oversight gaps and improper payments at the North Dakota Department of Health and Human Services.
Updated on Oct. 29, 2026 in Substance Abuse
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The North Dakota State Auditor's Office issued a report detailing seven areas of procedural failures within the Department of Health and Human Services for the biennium ending June 30, 2025. Findings include millions in questionable spending and widespread errors in program verification data.
Why it matters
The report highlights systemic issues in how the state manages essential health and support services, raising concerns about the accuracy of resource allocation for vulnerable residents. The failures point to a lack of consistent internal oversight for critical social programs.
The audit identified that 95% of receipts for the Free Through Recovery program lacked evidence of financial need, while 92% lacked proof that other resources were exhausted. Additionally, incorrect vendor data affected 67% of reviewed electronic visit verification claims.
The players
North Dakota Department of Health and Human Services
This state agency is responsible for administering health and human services programs across North Dakota.
North Dakota State Auditor's Office
This office is tasked with auditing state agencies to ensure accountability and proper management of taxpayer funds.
The details
The agency paid $4.7 million for electronic visit verification software, yet 34% of home visits lacked digital verification because providers defaulted to manual recording. Furthermore, background checks for in-home providers carried a projected error rate of 41%, and summer food assistance programs incorrectly excluded 5,872 children while covering 1,610 ineligible ones.
Timeline
The audited biennium period occurred between 2023 and 2025.
The biennium being reviewed concluded on June 30, 2025.
Health Landscape
The audit identifies a significant departure from the fiscal accountability standards mandated by the North Dakota Century Code. This failure to maintain internal controls signals a broader challenge in managing large-scale health and human services programs across the state.
Residents relying on state-funded behavioral health or food assistance programs may face ongoing uncertainty regarding service eligibility and delivery. The lack of reliable background checks and verification systems could also impact the quality of care provided by in-home health workers.
The takeaway
Taxpayers and program participants should monitor the agency for updates on how it plans to modernize its electronic verification software and internal tracking procedures. Ensuring these systems are functional is essential to guaranteeing that state support reaches the intended recipients.
Further reading
For additional context on behavioral health oversight and policy in the state, visit the Substance Abuse section.
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