North Dakota Medicaid waiver guide
Learn how North Dakota Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
North Dakota delivers developmental disability services through Health and Human Services, with eight regional human service centers spread across the state acting as your access point. The main program is the Traditional IID/DD Home and Community-Based Services Waiver, which serves people of all ages and offers both provider-managed and participant-directed services as an alternative to institutional placement. Your working contact is a Developmental Disabilities Program Manager — a DDPM — and connecting with one is effectively the first real step.
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People with intellectual disabilities and related conditions who would otherwise need institutional placement
Children with medically fragile needs
The waiver serves individuals with intellectual disabilities and related conditions, of all ages, who would otherwise need institutional placement. North Dakota runs a formal eligibility determination process through its regional human service centers, and Medicaid eligibility is required to fund waiver services. Contact Developmental Disabilities directly for the current eligibility determination materials, which the state publishes alongside its DD services brochure.
The waiver serves people with intellectual disabilities and related conditions. Your regional human service center conducts the eligibility determination.
The waiver exists to provide community alternatives to institutional placement, so you must be found to need that level of care.
North Dakota's waiver serves individuals of all ages — there is no age threshold to reach before applying.
Waiver services are Medicaid-funded, so Medicaid eligibility runs alongside the developmental disability determination.
North Dakota does not publish a standing statewide waiting list for its IID/DD waiver in the way many states do. Access runs through the eight regional human service centers, and the pace is set by the eligibility determination process and by service availability in your region rather than by a queue position.
North Dakota uses a referral process to start. You can make a referral yourself, and the state publishes materials explaining how the eligibility determination process works.
Open linkA Developmental Disabilities Program Manager becomes your working contact. HHS publishes guidance specifically on connecting with a DDPM, which tells you how central this relationship is.
Your regional human service center conducts the determination. Request the current eligibility determination materials — the state publishes them, and knowing the standard in advance helps you assemble the right documentation.
Waiver services are Medicaid-funded. Getting Medicaid in place alongside the DD determination avoids a stall at the funding step.
Open linkNorth Dakota's waiver offers both provider-managed and participant-directed options. Ask your DDPM to walk through both before defaulting to agency services.
Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
North Dakota's waiver explicitly offers both provider-managed and participant-directed services, and self-directing services are a named category in the state's own service listing. Ask your DDPM how self-direction works and what employer responsibilities come with it before deciding.
Approved waiver services are paid by North Dakota Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
In a largely rural state, whether a specific service exists near you can matter as much as whether you qualify for it. Ask your DDPM what is actually available in your region and what the alternatives are.
In residential settings the waiver pays for services, not room and board, which is typically covered by the person's own income such as SSI.
Early intervention is one of North Dakota's named DD service categories, serving young children within the same system rather than through a wholly separate agency.
School districts provide special education under an IEP. DD waiver services are separate from and additional to what school provides.
The waiver serves all ages, so there is no reason to delay a referral until a particular birthday.
Residential and vocational services continue into adulthood. Start planning with your DDPM before school services end so nothing lapses in between.
North Dakota publishes both a rights to appeal and fair hearing process and a separate grievance process, and they are not the same thing — ask which one fits your situation. Deadlines run from the date on your notice. The Protection & Advocacy Project is North Dakota's protection and advocacy agency; requests go through Centralized Intake.
Protection & Advocacy agency for North Dakota
1-800-472-2670Visit site1237 W. Divide Ave., Suite 1A, Bismarck — dhsddreq@nd.gov, TTY 711
701-328-8930Visit siteEight regional human service centers — your local access point
Visit siteHow to start, connecting with a DDPM, and eligibility determination materials
Visit siteFree advocacy — 701-328-2950 locally, panda_intake@nd.gov
1-800-472-2670Visit siteLocal help & referrals — dial 211
Visit siteMake a referral to Developmental Disabilities, then connect with a DDPM — a Developmental Disabilities Program Manager. HHS publishes guidance on both steps, and the DDPM becomes your ongoing working contact through eligibility and service planning.
A Developmental Disabilities Program Manager. They are your case management contact within the system, coordinating the eligibility determination, service planning, and access to providers.
No. North Dakota's IID/DD waiver serves individuals of all ages, offering community alternatives to institutional placement. There is no birthday to wait for before making a referral.
Yes. North Dakota's waiver offers both provider-managed and participant-directed services, and self-directing services appear as a distinct category in the state's own service listing. Ask your DDPM to explain both models.
They are separate processes and North Dakota publishes guidance on each. An appeal and fair hearing challenges a decision about eligibility or services; a grievance raises a complaint about how you were treated or how a service was delivered. Ask which route fits before filing.
The waiver serves individuals with intellectual disabilities and related conditions, of all ages, who would otherwise need institutional placement. North Dakota runs a formal eligibility determination process through its regional human service centers, and Medicaid eligibility is required to fund waiver services. Contact Developmental Disabilities directly for the current eligibility determination materials, which the state publishes alongside its DD services brochure.
make a referral to developmental disabilities, connect with a ddpm, go through the eligibility determination, establish medicaid, then enroll and choose providers. Start with North Dakota Health and Human Services, Developmental Disability Service.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
North Dakota does not publish a standing statewide waiting list for its IID/DD waiver in the way many states do. Access runs through the eight regional human service centers, and the pace is set by the eligibility determination process and by service availability in your region rather than by a queue position.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
North Dakota's DD services overview and regional office access.
North DakotaHow to start, connecting with a DDPM, the eligibility determination process, and appeals and grievances.
North DakotaNorth Dakota's 1915(c) waivers, including the Traditional IID/DD waiver.
North DakotaFree protection and advocacy services, including appeals help.
North DakotaFind waiver providers and services in North Dakota on Waiverly.
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