North Dakota Health and Human Services (HHS) is seeking public comment on a five-year renewal to the state’s Medicaid 1915(i) State Plan Amendment. The amendment allows Medicaid to pay for additional in-home and community-based services for qualifying children and adults with mental health conditions, substance use disorders and/or brain injuries. Comments will be accepted through March 28 at noon CT.
As part of the renewal, HHS is proposing language updates to align with behavioral health best practices and implementing improved quality measurements that support Medicaid’s overall quality improvement strategy. There are no proposed changes to Medicaid 1915(i) general provider policies.
“The Medicaid 1915(i) program provides a pathway for qualifying Medicaid members with behavioral health needs to access in-home and community-based services and supports closer to home. This aligns with our agency’s strategic priorities,” said Sarah Aker, HHS Medical Services Division director.
In January 2025, nearly 900 individuals received Medicaid 1915(i) services including housing, educational and employment supports; community transition services; peer support; care coordination; respite care; and other supportive services. There are nearly 500 individual and agency providers enrolled to provide Medicaid 1915(i) services.
“We continue to work on strengthening this program and its impact on the health and well-being of our members,” Aker said.
The draft five-year renewal is available online at hhs.nd.gov/1915i. Copies are available upon request.
Submitting comments
Individuals can submit comments by emailing stanleycody@nd.gov, or calling 701-239-8987, or 711 (TTY) or by fax at 701-328-1544. Comments can also be mailed to North Dakota Health and Human Services, Medical Services Division, Attn: Cody Stanley, 600 E. Blvd. Ave., Dept. 325, Bismarck, ND, 58505-0250.
After the public comment period ends, the Medicaid 1915(i) State Plan Amendment five-year renewal will be submitted to the federal Centers for Medicare and Medicaid Services (CMS) for review and approval. The Medicaid 1915(i) State Plan Amendment is expected to be effective Oct. 1, 2025.
Background
During the 2019 legislative session, North Dakota lawmakers authorized the then-North Dakota Department of Human Services to create a Medicaid 1915(i) State Plan Amendment to address gaps in the state’s behavioral health system. It was approved by CMS in December 2020.
Since then, CMS has approved several changes to the state’s Medicaid 1915(i) State Plan Amendment including lowering of the World Health Organization Disability Assessment Schedule (WHODAS) eligibility score to allow more individuals to qualify for services and streamlining provider enrollment to help build a more robust network of service providers.
To learn more about Medicaid 1915(i) in-home and community-based behavioral health services, visit hhs.nd.gov/1915i.