North Dakota Health and Human Services (HHS) is seeking public comment on an amendment to the state’s Medicaid Traditional Individuals with Intellectual Disabilities/Developmental Disabilities (IID/DD) Home and Community-Based Services (HCBS) waiver dated April 1, 2025. Comments will be accepted from Aug. 29 through Sept. 28.
The waiver offers a range of in-home and community-based services that support people with intellectual and developmental disabilities in the least restrictive setting.
One proposed change to the waiver is the addition of host homes as a new service for youth with developmental disabilities. Host homes will help families during a crisis by providing a licensed family setting where a youth can live temporarily to receive specialized training and support to meet his or her needs. This model helps youth move from crisis to stabilization while staying connected to their biological families and working toward reunification.
The 2025 North Dakota Legislature approved funding for host homes, which supports an HHS strategic priority: advancing the foundations of well-being through access to high-quality services and supports.
The proposed amendment also includes updating language on internal processes and provider compliance with incident reporter requirements.
Public Comment
The waiver amendment application with the proposed changes is available at hhs.nd.gov/waivers. Copies can be mailed upon request.
Comments can be submitted by mail to North Dakota Health and Human Services – Developmental Disabilities Section, Attn: Heidi Zander, 1237 W. Divide Ave., Suite 1A, Bismarck, N.D., 58501, by email to hzander@nd.gov, or by phone at (701) 328-8945, 711 (TTY).
After the public comment period ends, the waiver will be submitted to the federal Centers for Medicare and Medicaid Services (CMS). Based on the CMS timeframes for review and approval, the waiver amendment is expected to be effective on Jan. 1, 2026.
Waivers are agreements between CMS and a state's Medicaid agency and serve specific groups of people. Waivers specify the number of people to be served, eligibility criteria, available services, including any limits on services; and procedures for the evaluation and re-evaluation of level of care.