American Rescue Plan Act Funds for Home & Community-Based Services (ARPA HCBS) Funds

Current initiative underway - Workforce Training Assessment Project

The purpose of this project is to identify and establish innovative workforce training strategies to meet provider needs and improve the quality of life for North Dakotans. HHS held a virtual kickoff meeting on Oct. 4, 2023 to share information about the project and to gather feedback from stakeholders. 

• Meeting recording
• Presentation slides

Through American Rescue Plan Act (ARPA) Section 9817, and in conjunction with the federal Centers for Medicare and Medicaid Services (CMS), North Dakota’s Health and Human Services agency was approved to dispense about $31.7 million through grants and pilot programs through a spending plan submitted to CMS in June of 2021.  

Section 9817 of the American Rescue Plan Act of 2021 (ARP) (Pub. L. 117-2) provides qualifying states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS) provided between April 1, 2021, and March 31, 2022.  

States are in a unique position to accelerate the expansion of home and community-based services (HCBS) by making investments that increase access and support both transitions and diversions from institutional settings. The array of HCBS strategies and approaches will serve older adults, children and adults with physical disabilities, and children and adults with intellectual or developmental disabilities, to include autism spectrum disorder and brain injury.  

The initiatives funded through the spending plan approved by CMS aim to improve the HCBS system in North Dakota attempting to make it more financially sustainable, more readily accessible in both under-served and high need geographies and committed to continuous quality improvement. 

Timeline

CMS Reporting 

CMS requires quarterly fiscal reporting and bi-annual narrative reporting on initiatives and activities. The HCBS spending plan should estimate, by quarter and in total, the amount of funds attributable to the increase in FMAP that the state has claimed and/or anticipates claiming between April 1, 2021, and March 31, 2022, as well as anticipated and/or actual expenditures for the state’s activities to implement, to enhance, expand, or strengthen HCBS under the state Medicaid program between April 1, 2021, and until the state funds equivalent to the funds attributable to the increased FMAP are fully expended.  

To qualify for the FMAP increase, states must submit HCBS spending plans and narratives to CMS on the activities the state has implemented and/or intends to implement to enhance, expand, or strengthen HCBS under the Medicaid program. The HCBS spending narrative is intended to provide information and updates on the state’s required ARP section 9817 activities, the connection between the spending plan and the scope of the activities, and how the state intends to sustain these activities.  

North Dakota’s Spending Plan 

• Original Approved Spending Plan - Coming Soon
• Most Current Approved Spending Plan - April 17, 2023

Current Funding Opportunities

HHS invites enrolled Qualified Service Provider (QSP) agencies and licensed developmental disability (DD) providers to apply for a Transportation Department Grant. This grant aims to enhance accessible transportation services for older adults, adults with a physical disability, and individuals with an intellectual disability in North Dakota, supporting their right to live in the most integrated setting possible. The goal is to ensure individuals can receive necessary care in their chosen setting while maintaining access to the broader community.

This one-time grant will reimburse up to $75,000 for the cost of purchasing a new or used ADA accessible vehicle that will be used to provide one of the qualified services listed below. The grant funds cannot be used for vehicle registration, insurance or other costs. 

QSP agencies who have been operating for a minimum of two years and intend to enroll or are currently enrolled in at least one of the following services are eligible to apply:

• Non-emergency medical transportation (NEMT)
• Non-medical transportation (NMT)
• Residential Habilitation
• Community supports
• Adult residential services

DD licensed providers who have been licensed for a minimum of two years in at least one of the following services are eligible to apply:

• Residential Habilitation
• Day Habilitation
• Small Group Employment
• Prevocational Services
• Independent Habilitation
• Individual Employment Supports

ARPA Transportation Grant Overview
ARPA Grant Application
ARPA Budget Template
ARPA Evaluation Tool

Agencies that previously received an American Rescue Plan Act (ARPA) grant are eligible to apply for this grant.

Grant applications and budgets are currently being accepted and are due no later than April 28, 2025. They can be sent to carechoice@nd.gov

Youth Social Supports & Community Integration Grant

HHS is offering grants to qualifying agencies to facilitate community integration for youth 12 – 21 years of age who are eligible for home and community-based services (HCBS) or program/case management throughout the state.  HHS will award no more than four grants, not to exceed $150,000 each.  These one-time grants will be effective May 19^th, 2025 – August 31, 2025.  Providers interested in expanding community and social integration supports for this population and who can begin the project no later than June 2, 2025, are encouraged to apply.

Grant applications are due May 1, 2025, by 8 a.m. CT and must be sent to tbay@nd.gov.

• Youth Social Supports & Community Integration Grant General Overview
• Attachment A - Youth Social Supports Community Integration Grant Application
• Attachment B - HHS Youth Social Supports Community Integration Grant Budget Template
• Attachment C - Youth Social Supports Community Integration Grant Evaluation Tool

Previous Funding Opportunities

HHS offered agency development grants to support the growth and development of businesses that can deliver high quality in-home and community-based services to qualified North Dakotans to help them live at home and in the community with supportive services if they choose.  

DHHS awarded grants through an application evaluation process in amounts up to $50,000 to assist agencies with their enrollment and/or successful operation as a Medicaid-reimbursable HCBS Agency in North Dakota. Thirty providers accepted community grant awards. 

Agencies could apply for multiple grants, based on their expansion plans (deadline was October 2022). Four of the thirty awarded providers are engaged with multiple grants. 

• Project Overview

Examples of the ways these funds can be utilized by providers who have been awarded: 

• Training and professional development
• Staff recruitment or retention costs, including background checks
• Operating costs (for up to 3 months)
• Outreach and marketing activities
• Promotional materials related to the new or expanded services
• Technology costs to support the work of the new or expanding agency
• Furniture and equipment costs, or simple building renovations needed to establish a new HCBS agency or expand services in an existing agency
• Consulting services to help the agency assess and improve business operations (billing, staffing, operations)
• Other allowable items if approved by the State, funds may not be used for room and board 

Providers who have received notification of award

Additional Resources

• Frequently Asked Questions 
• For questions, please contact NDARPA@mslc.com