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

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

North Dakota Health and Human Services is accepting public comment on an amendment to the state’s Medicaid 1915(c) waiver for home and community-based (HCBS) services. The waiver pays for a variety of HCBS that allow individuals who otherwise qualify for nursing home care to remain living in their homes and communities.

The purpose of the amendment is to implement changes in services and programming to improve access to HCBS and update language changes related to internal processes.

Proposed changes to this waiver:

Changes in services and programming.

• Allow for administratively claiming of certain HCBS case management tasks and allow for a registered nurse with a bachelor’s degree in nursing to provide case management services.
• Change allowable tasks for case management in the waiver and broaden the provider qualifications to improve access to HCBS and promote health equity, health literacy and cultural humility in person-centered planning. The provision of case management would be limited to agency providers and will update the provider qualifications to allow culturally or community-based organizations and tribal entities to provide the service to waiver eligible individuals.
• Update tasks for extended personal care services to include providing a ride and escort to medical appointments because of communication or other impairments. 
• Change the rate methodology for cost-based rates under fee for service waiver programs of emergency response service and adult daycare to be paid at the reasonable and customary rate. Extended personal care and nurse educator to be paid at maximum rate established for the service.

Language changes for internal processes.

• Update language on the states nursing facility level of care process.
• Update qualified service provider enrollment to be completed by the state rather than by a contracted entity.

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

Comments will be accepted from Aug. 28, 2024, until 5 p.m. CT on Sept. 26, 2024.

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: Adult and Aging Services Section/HCBS
        Health and Human Services
        1237 W. Divide Ave. Suite 6
        Bismarck, ND 58501

Date Posted: Aug. 28, 2024