1915(i) behavioral health services and supports are for qualifying people with certain behavioral health conditions.
What Services and Supports are available through 1915(i)?
All members work with a care coordinator. Care coordinators help the member create a person-centered plan of care. Members work with care coordinators to set goals. They will choose services and supports to help them achieve their goals. This helps members live successfully in their homes and communities.
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Peer Support Help for you from other people who also live with challenges. Ages 18+ | Family Peer Support Help for your family members by connecting them with other families who also support their loved ones. Ages 0-17 | Housing Support Help so you can move into and/or stay in your own home. Ages 17.5+ | Non-Medical Transportation Rides to activities in your community or to non-medical appointments to help you meet your goals. All ages |
Supported Education Help so you can work on your educational goals. Ages 5+ | Supported Employment Help getting and keeping a job in your community. Ages 14+ | Respite Short term help for when your caregiver can't be there. Ages 0-20 | Benefits Planning Help to learn about your benefits and how things change when you get a job in your community. All ages |
Pre-Vocational Training Help for a short time so you can learn work or volunteer skills. Age 17.5+ or has GED/Diploma | Training and Support for Unpaid Caregivers Help for your caregiver to learn ways to support you. All ages | Community Transition Services Money to help move into your own home after living in a group home, treatment center, or nursing home. All ages | |
How does someone qualify for 1915(i)?You must meet ALL criteria to qualify.
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| Age 0+; and | ||
| Currently enrolled in ND Medicaid or Medicaid Expansion; and | ||
| Have a household income at or below 150% of the Federal Poverty Level (revised 4.2024); and | ||
Receive a WHODAS score of 25 or above or a DLA-20 score of 5 or below; and
| Assessments must be completed no more than 90 days before applying for 1915(i). |
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| Lives in and will receive services in a setting meeting the federal home and community-based service (HCBS) setting requirements; and | Home and community-based settings do not include
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| Have a qualifying behavioral health diagnosis (revised 5.21.2024). | Need documentation of diagnosis dated within the last twelve (12) months. | |
| Q: How does 1915(i) eligibility for a foster care youth work? What happens if the youth is adopted? | A: If a child is in foster care or "subsidized adoption" the child remains on their own Medicaid and eligibility is determined based on that child's income. Once a child is adopted, the member's adoptive parents need to notify the Customer Support Center or use the Self-Service Portal (SSP) to update the child's legal name and then the child's parents will need to apply for the child's Medicaid as now the child is part of a new household which means that the parental income will be looked at for Medicaid eligibility. A child's 1915(i) eligibility would not be affected unless the child's Medicaid closes for any reason (i.e. due to no longer meeting eligibility criteria). |
| Q: What if an application is submitted without all the application information? i.e., what if it is missing a diagnosis? | A: Incomplete applications are placed in a pended status. Applications are notified in writing what information is missing, how to get the missing information, and how to submit it. If the missing information is not received within 45 days from the date of the notice the application will be denied and the applicant will be sent a denial letter. |
| Q: What if a 1915(i) application is submitted while a Medicaid application or renewal is being processed? | A: The 1915(i) application will be pended for up to 90 days to allow the application or renewal paperwork to be processed. |
| Q: How long am I eligible for 1915(i)? | A: You are eligible so long as you continue to meet program eligibility criteria in the above table. Your 1915(i) "review" date depends when your Medicaid review date occurs. Most people are determined eligible for a 12-month period. If you become eligible for 1915(i) less than 6 months before your Medicaid review date, then your 1915(i) review date will be 12 months from the date of 1915(i) eligibility. For example, if your Medicaid ends on April 15th and you just became eligible for 1915(i) on February 1st, your 1915(i) is reviewed on February 1st of the following year. If you became eligible for 1915(i) more than 6 months before your Medicaid review date, then your 1915(i) review date would be the same as your Medicaid review date. For example, if your Medicaid review date is August 1st, and you became eligible for 1915(i) on February 1st, then your review date for both programs is August 1st. |
| Q: What does it mean when my 1915(i) eligibility is "suspended"? | A: Suspension can occur for a couple of reasons:
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| Q: What if I want to stop getting 1915(i)? | A: If you want to stop 1915(i) eligibilty, you or your guardian, as applicable, need to contact the Customer Support Center to notify them of the change. Phone: 1.866.614.6005 or 701-328-1000; 711 (TTY) |
North Dakota 1915(i) Medicaid State Plan Amendment
Enrollment Data Dashboards
Providers
Project History
In April 2020, the Department submitted the 1915(i) Medicaid State Plan Amendment Application to the Centers for Medicare & Medicaid Services (CMS) for review. The Application describes who is eligible, the process for enrollment, what services are available, what providers can render services, and how quality will be assured.
The Centers for Medicare and Medicaid Services (CMS) issued its final approval of the 1915i state plan amendment on January 15, 2021.
Public Comment Page Content
Application Draft
Webinars
- March 4, 2020: Application Draft Webinar