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

Public comment is sought 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.

• Incorporate rate changes approved in the 2025 ND Legislative Session.
• Update the rate methodology for Adult Residential Care, by rebasing rates according to updated cost reports in 2026 and 2027.
• Update service limits under Family Personal Care, Supervision, Waiver Personal Care to further clarify provider qualifications.
• Update limits under HCBS Care Coordination to avoid duplication of services other waiver services.

Language changes for internal processes.

• Update language to allow for quarterly monitoring visits by state employed case management to be completed via telephone.

Comments will be accepted from July 22, 2025, until 5 p.m. CT on Aug. 21, 2025.

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

View the draft waiver amendment document at www.hhs.nd.gov/waivers. A copy will be provided upon request.
Date posted: July 22, 2025