NDDHS amending Medicaid eligibility, SPED program benefits

Jonathan Alm, NDDHS Legal Advisory Unit, presided over public hearings at the Capitol Building yesterday for proposed amendments to SPED program home- and community-based services, and for Medicaid eligibility. (Brandon L. Summers / The Dickinson Press)

Public hearings were held at the Capitol Building Wednesday on amendments to North Dakota Department of Human Services programs.

Amendments are being made to home- and community-based services under the Special Payments for Elderly and Disabled program, and the Medicaid waiver for aged and disabled program.

The changes are a result of the 2019 human services appropriations bill and House Bill 1099, which expands the definition of adult foster care to include an agency model.

"It will allow us to serve more consumers in the home and community," Nancy Nikolas Maier, NDDHS Director of Aging Services, said. "It expands our service array, which is a really good thing for the people we serve."

For both SPED and Medicaid waivers, NDDHS may provide licensed adult foster care to clients who are 18 or older and would benefit from a family environment.


That has been amended to also include "or a shared living" environment.

For Medicaid waivers, NDDHS has added "residential habilitation" and "community support" services up to 24 hours per day for clients who live alone or with an adult who is unable to provide care and needs formal training or daily support.

The services are designed to assist with and develop self-care, socialization, and adaptive skills that improve a client's ability to reside independently.

NDDHS may also provide companionship services up to 10 hours per month to clients who live alone and could benefit from services to help reduce social isolation.

Amendments are also being made to Medicaid eligibility.

The changes will benefit the roughly 75,000 individuals in North Dakota who are eligible for the program at any given time, Leeann Thiel, NDDHS Assistant Director of Medical Services, said.

"Some of the changes actually increase the eligibility limits for individuals, which will allow more people to be eligible and receive the medical services they need," she said.

Changes focused on the Children's Health Insurance Program, which includes individuals under age 19, and who have income at or below 175% of poverty level.


A plan unit may consist of one individual, a married couple, or family with children under 21 - or, if disabled, under 18 - whose income is considered in determining eligibility for any member of that unit, without regard to whether the members of the unit all physically reside in the same location.

A parent or other caretaker of children under 21 may select the children who will be included in the plan unit.

Other changes were also made under Medicaid eligibility.

To determine medically needy eligibility for pregnant women, children aged to 19, or parent or caretaker relatives, income budgeting will be based on non-MAGI (modified adjusted gross income) methodology, with the exclusion of assets.

Under poverty income level: the income level for pregnant women is equal to 162% of the poverty level applicable to a family of the size involved. The family size is increased for each unborn child when determining the appropriate family size.

No members of the public attended the hearings Wednesday.

The NDDHS, though, will continue to accept written comments on the proposed amendments through Sept. 23.

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