North Dakota Medicaid Resources

• State Medicaid Website: North Dakota
• North Dakota State Council on Developmental Disabilities Website
• Chapters of the Arc in North Dakota

North Dakota Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 10,600 people with disabilities covered by Medicaid in North Dakota. North Dakota spent $20,194 on each Medicaid recipient with a disability in 2007.

15% of all people covered by Medicaid in North Dakota have a disability, which is the same as the percentage of people covered by Medicaid who have a disability nationally.

The state spends 42% of all the money it spends on Medicaid on services for people with disabilities, which is also the same as the national percentage of Medicaid spending on these services.

Experience Health ND:

This program provides disease management services to adults and children with disabilities who live in the community.

• Health: disease management

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary.

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close enough to a PACE center to be eligible.

• Community: day care, health-related transportation
• Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
• Home: home and environmental modifications, home care
• Social Services: social services

Medically Fragile Children’s waiver:

This waiver allows children to receive home-based care instead of having to live in hospitals or other residential care facilities. In order to be eligible children must have a chronic or permanent medical condition that causes them to rely on intensive long-term medical assistance.

Ages: 3 to 17

• Community: transportation
• Health: dietary supplements, equipment and supplies
• Home: respite, environmental modifications, in-home supports, individual and family counseling
• Social Services: case management

Developmental Disabilities Self-Directed Supports waiver:

This waiver allows people with developmental disabilities to take charge of their own care by choosing and directing their services. It covers payment for normal supportive services.

Ages: 3 and older

Option for Self-Direction: This waiver lets people with disabilities and their families work with Medicaid professionals to direct their own supports.

• Health: behavioral consultation, medical equipment and supplies
• Home: environmental adaptations and modifications, in-home supports, transportation costs for caregivers

Traditional MR/DD HCBS waiver:

This waiver is an alternative to the Self-Directed Supports waiver, for individuals with disabilities who cannot or do not want to direct their own care. This waiver covers the cost of services provided in a home or community setting, to help individuals stay out of residential facilities.

• Community: adult day care, transportation costs
• Health: day habilitation, behavioral consultation, medical equipment and supplies, infant development services
• Home: homemaker services, residential habilitation, home health care and extended services, adult family foster care, environmental supports and modifications, in-home supports, parenting support

North Dakota HCBS waiver for the Elderly and Disabled (Med Waiver):

Like other Elderly and Disabled waivers, this waiver covers older adults or those who are disabled by Social Security standards. This waiver additionally requires that recipients be capable of directing their own care and be living in their own homes (not in dormitory or group housing).

Ages: 60 and older for people with or without disabilities, or younger for adults with permanent disabilities

Level of Care: nursing

Restriction: You must live in your own home, not in a group home, to use this waiver.

• Community: adult day care, non-medical transportation, transitional living services
• Health: personal emergency response systems, specialized medical equipment
• Home: adult family foster care, chore services, home modifications, homemaker services, residential care, respite care
• Social Services: case management
• Work: supported employment

Traumatic Brain Injury waiver:

This program covers people who have a brain or spinal cord injury. Instead of entering a nursing facility, patients can receive services at home.

Ages: 18 and older

Level of Care: nursing

• Community: transitional living services
• Health: personal emergency response systems
• Home: residential and personal care
• Social Services: case management