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This webpage contains information for North Dakota's Autism Spectrum Disorder Waiver service providers.
IMPORTANT: Autism Waiver service providers must have a Provider Agreement in place with the state before they can be reimbursed for waiver services. An agency wishing to provide waiver services must first enroll as a service provider. Enroll Here.
CONTACT:
Providers with questions should contact Katherine Barchenger, State Autism Coordinator, at (701) 328-4630, toll-free (800) 755-2719, ND Relay TTY (800) 366-6888, or kbarchenger@nd.gov.
Evaluation and Diagnostic Teams:
- Level of Care Determination (SFN 60680) - Use to document in Medicaid Management Information system (MMIS)
- Registration Intake Face Sheet (SFN 60602)
Service Managers:
- Participant Service Plan (PSP) (SFN 600)
- Progress Notes for Service Managers - Complete Monthly) (SFN 918)
- Purchase Request Form for Assistive Technology items (SFN 688)
- Incident Reporting Forms (SFN 60603)
- Transition Plan (for transitioning off of the waiver) (SFN 60615)
Respite Care Providers:
- Progress Notes for Respite Care Providers (SFN 60614)