Public Comments Being Accepted on Changes to ND Medicaid Waiver Services That Enable People With Physical Disabilities to Live at Homes and in Their Communities

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BISMARCK, N.D. – The North Dakota Department of Human Services reminds North Dakotans that it is still accepting public comments from adults with physical disabilities, guardians, family members and others about proposed amendments to the state’s Medicaid waiver for in-home and community-based services (HCBS). The waiver pays for services that allow individuals who qualify for nursing home care to live at home and in their communities. The agency continues to accept comments through Sept. 29, at 5 p.m. CT.

Medicaid HCBS waiver services can help delay or prevent institutional care in nursing homes. The department is seeking federal approval to amend the waiver to reflect recent state legislative changes increasing payment rates for some services and to support strategies included in the state’s Department of Justice settlement agreement implementation plan. The strategies are intended to increase access to in-home and community-based support services.

The amendment increases the payment rate for nonmedical transportation to essential community services, family personal care services, and supervision services provided to individuals who need monitoring to assure their health and safety. It also would expand the types of relatives who can provide family personal care services, which is currently limited to a spouse. Other changes remove the requirement that an individual live alone to qualify for formalized training and community support services, and it would allow supervision to be provided to individuals living with family members. In addition, the amendment would allow environmental modifications, like a wheelchair ramp, to be completed on rental property when it’s rented by an eligible individual, and it would allow the state to use the higher rural differential rate to pay for transition support services, supervision and companionship services.

The draft waiver amendment is online at A copy will be provided upon request.

Individuals can submit comments until 5 p.m. CT, on Sept. 29, 2021, by email to or phone to 701-328-8744, 711 (TTY). Comments can also be mailed to the department’s Aging Services Division. See details at

After the public comment period ends, the waiver will be submitted to the federal Centers for Medicare and Medicaid Services for review and approval. It is expected to be effective Jan. 1, 2022.

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