North Dakota expands eligibility for community-based behavioral health services at home – InForum


FARGO – North Dakota is making it easier to qualify for a program that provides a wide range of home and community support services for people with mental illnesses, substance use disorders or brain injuries.

Eased eligibility requirements open up access to services including education, employment and housing supports, peer support, care coordination and respite care.

North Dakota social services officials touted the program as a major step in providing support to help people with mental illness stay in their homes and communities, where they have the support of their families.

“I think in 10 years or maybe 20 years from now people (will) look back and say that was the turning point” in providing better care for people with behavioral illnesses, said Pamela Sagness, director behavioral health services. for the North Dakota Department of Social Services.

To be eligible for assistance, people must be eligible for Medicaid and meet certain disability criteria.

When the program was first launched early last year, few people were eligible for assistance due to strict eligibility requirements imposed by the federal government. Last summer, the Department of Social Services asked federal officials for permission to relax eligibility requirements.

Federal authorities approved the application, expanding eligibility starting Jan. 1, 2022. Prior to the easing of standards, only 24 applicants qualified out of an estimated population of 11,500 residents eligible for the program.

Under the new eligibility, 44 people have qualified and more approvals are pending, Sagness said. As word of the program spreads, more people will benefit, she said.

Carolotta McCleary, executive director of Mental Health America of North Dakota and head of the North Dakota Mental Health Advocacy Network, applauded the broader eligibility standards.

“It’s extremely helpful for those looking for services,” she said. “That should help open it up a bit. Many more people will find themselves eligible to receive services.

Eligibility has been expanded by lowering the World Health Organization Disability Assessment Schedule eligibility score from 50 to 25. The score is an instrument used to measure a person’s function and disability in activities of daily living.

“The enhancements will make it easier for more North Dakotans to qualify for home and community services to better meet their behavioral health needs,” Sagness said.

Provider qualifications have also changed, allowing more providers to expand their services. A total of $80,000 in grants has been made available, up to $10,000, to help build a “more robust” network of service providers.

“We want to reach people a little earlier,” before their disease progresses and they require more intensive treatment, Sagness said. Ideally, treatment should take place in the person’s community, where family and other supports are available.

“It’s usually what’s best for individuals,” she said. “It’s also financially sound.”

A consultant’s 2018 review found that most of North Dakota’s spending on people with behavioral illnesses was aimed at providing the highest levels of care. The state aims to provide more preventative care and early intervention, Sagness said.

“This is a huge system change,” she said. Lawmakers have approved the new support package but will cut funding elsewhere because people will no longer need the other help, she added.

As of December 1, 40 individual providers and 25 group providers were enrolled in the Medicaid program. A complete list of providers by region is available online at

For more information about the Home and Community Service Delivery Program for the Mentally Ill, go to


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