Changes to Medicaid 1915(i) state plan amendment expands access to behavioral health services for children and adults, streamlines provider enrollment

<< All News Monday, December 27, 2021 - 11:00am

The North Dakota Department of Human Services has received approval by the federal Centers for Medicare and Medicaid Services (CMS) to amend its Medicaid 1915(i) state plan amendment to increase access to in-home and community-based behavioral health services for children and adults and build a more robust network of service providers. 

Implemented in February 2021, the Medicaid 1915(i) state plan amendment allows North Dakota Medicaid to pay for additional in-home and community-based services for qualifying individuals enrolled in Medicaid or Medicaid Expansion with mental health conditions, substance use disorders and/or brain injuries. 

The most significant change to the Medicaid 1915(i) state plan amendment is the lowering of the World Health Organization Disability Assessment Schedule (WHODAS) eligibility score from 50 to 25, which will allow more individuals to qualify for 1915(i) services. The WHODAS is an instrument used to measure an individual’s function and disability in activities of daily living. Also, provider qualifications for prevocational training, supported education and supported employment have changed, so more providers can now enroll to provide these vital services. 

All changes to the Medicaid 1915(i) state plan amendment are effective Jan. 1, 2022. 

“We continue to see significant need for behavioral health services and supports across the state,” said Pamela Sagness, Behavioral Health Division director. “The enhancements will make it easier for more North Dakotans to qualify for the in-home and community-based services to better support their behavioral health needs.” 

The Medicaid 1915(i) state plan amendment addresses gaps in the state’s behavioral health system and is considered to be the most robust program approved by CMS in the country. Services offered include educational, employment and housing supports; community transition services; peer support; care coordination; respite care and other supportive services.   

Group provider development grants
The department is offering development grants to help build a more robust service provider network to provide in-home and community-based services to qualifying individuals through the Medicaid 1915(i) state plan amendment.

A total of $80,000 in grants is available, and providers may request up to $10,000. Interested organizations can learn more online at www.behavioralhealth.nd.gov/1915igrant. The deadline to apply is Dec. 30, 2021. If grant funding remains following the Dec. 30 deadline, the department will continue to accept applications until the total funds are awarded.

“This is a wonderful opportunity for North Dakota providers to bill for new services, expand their workforce through nontraditional behavioral health professionals and improve access to services in underserved areas of the state,” said Caprice Knapp, North Dakota Medicaid executive policy director.

As of Dec. 1, 2021, there are 40 individuals and 25 group providers enrolled in the Medicaid 1915(i) state plan amendment. For a complete list of providers and services by region, visit www.behavioralhealth.nd.gov/1915i-providers

During the 2019 legislative session, North Dakota lawmakers authorized the department to create a Medicaid 1915(i) state plan amendment. After gathering input and stakeholder recommendations from six community meetings around the state and a 30-day public comment period, the department submitted its draft state plan amendment to CMS in April 2020. It was approved in December 2020.

Information about the state’s Medicaid 1915(i) state plan amendment can be found online at www.behavioralhealth.nd.gov/1915i.

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