Medicaid Waiver for Home and Community Based Services (Medicaid Waiver)

North Dakota's Medicaid Home and Community Based Services Waiver is an agreement between the Center for Medicare & Medicaid Services (CMS) and the state's Medicaid Agency, the North Dakota Department of Human Services. This waiver helps eligible individuals who would otherwise require nursing home services to remain in their homes or communities. It gives eligible people options, if their needs can be met in their homes.

Covered Services

• Adult Day Care - Provides at least four hours per day of attended care in a group setting
• Adult Family Foster Care - Provides a safe, supervised family living environment, 24-hour per day in a state licensed setting
• Case Management - Assesses needs; helps with care planning, provider selection, referrals and service monitoring
• Chore Service - Includes snow removal and heavy cleaning
• Emergency Response System (Lifeline) - Provides telephone emergency response
• Environmental Modification - (Limited) Modifies the home to enhance the client's independence
• Homemaker Service - Provides house cleaning, laundry, and/or meal preparation services
• Non-Medical Transportation - Transports or escorts client for essential needs such as grocery shopping social security office visit, etc.
• Residential Care - Services provided in a facility in which at least five (5) unrelated adults reside, and in which personal care, therapeutic, social, and recreational programming are provided in conjunction with shelter. This service includes 24-hour on-site response staff to meet scheduled and unpredictable needs and to provide supervision, safety, and security
• Respite Care - Provides temporary relief to full-time caregivers
• Specialized Equipment - Provides special equipment reducing the need for human help
• Supported Employment Services - Provision of intensive, ongoing support to individuals to perform in a work setting with adaptations, supervision, and training relating to the person's disability. This would not include supervisory or training activities provided in a typical business setting. This service is conducted in a work setting, mainly in a work site in which persons without disabilities are employed
• Transitional Living Service - Services that train people to live with greater independence in their own homes. This includes training, supervision, or assistance to the individual with self-care, communication skills, socialization, sensory/motor development, reduction/elimination of maladaptive behavior, community living, and mobility

Eligibility Requirements

To qualify for services under the Medicaid Waiver program, an individual must be:

• A Medicaid recipient (meets Medicaid income and other eligibility requirements), and
• Screened at nursing facility level-of-care, and
• At least 65 years of age OR disabled by Social Security Disability criteria, and
• Capable of directing his/her own care, and
• Living in his or her own home or apartment (not in dormitory or other group housing), and
• Able to have his or her service/care need(s) met within the scope of this waiver

Seeking Services

For information about services in your area, contact your County Social Service Office.

 

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