Public Notice - Public Comment Medicaid 1915(c) HCBS waiver amendment

Public Comment Sought on Medicaid 1915(c) Home and Community-Based Services (HCBS) Waiver Amendment Application

The North Dakota Department of Health and Human Services’ Adult and Aging Services Section is accepting public comments on an amendment of the states’ Medicaid waiver for home and community-based services. The waiver pays for a variety of in-home community-based support services that allows individuals who otherwise qualify for nursing home care to remain living in their homes and communities. 

The purpose of the amendment is to incorporate administrative language changes that were approved under the NDAC 75-03-23 effective Oct.1, 2022, further define waiver language under the covered waiver services. The amendment would also update internal processes for person-centered planning and long-term services and supports options counseling.

Proposed changes to this waiver:

Incorporate administrative language changes that were approved under the NDAC 75-03-23 effective Oct. 1, 2022, biennium for the qualified service provider enrollment/reenrollment requirements. 

• Remove Child Abuse and Neglect SFN 433 checks.
• Change the waiver so the agency provider would only need to revalidate status every 5 years. Change enrollment to 5 years (60 months) for Agency, 2.5 years (30 months) for individual providers.

Administrative language changes for qualified service providers.

• Include allowing a “relative” as an employee of an agency providing Residential Rehabilitation or Community Supports to be hired by the agency to provide care. Relatives employed by Residential Habilitation Providers and Community Supports cannot be legal spouse and cannot live with the care recipient.

Administrative language changes for covered services.

• Further define vehicle modification under the service of Environmental Modification. Include exceptions are made to go over the cap for Medicaid as a reasonable modification.
• Include the utilization of Non-Medical Transportation to enable waiver participants to gain access to waiver and other essential community services or resources as specified by the service plan to maintain the participant in their home and community. 
• Allow Non-Medical Transportation for Adult Residential Services when Non-Medical Transportation is not included in the Adult Residential Services rate.
• Remove from Supervision that Respite Care cannot be a service combination. Supervision and Respite Care cannot be utilized at the same time.

Language changes for internal processes.

• Reasonable Modifications to exceed funding caps require the prior approval of Program Administration.
• All PCP are reviewed and approved by Adult and Aging Services Staff.
• Long-Term Services and Supports Options Counseling process has been outlined in the waiver.

The draft waiver amendment document is online at www.hhs.nd.gov/medicaid-provider-information/medicaid-waivers. A copy will be provided upon request. 

Comments will be accepted from Dec. 1, 2022, until 5 p.m. CT on Dec. 30, 2022.

Comments will be accepted in the following ways:

Email:  dhshcbs@nd.gov 

Phone: (855) 462-5465 or 711 (TTY) (text telephone) 

Fax: (701) 328-8744

Mail: North Dakota Department of Health and Human Services
        Attn:  Adult and Aging Services Section/HCBS
        1237 W. Divide Ave. Suite 6
        Bismarck, ND 58501

Date Posted: Dec. 1, 2022