75-03-23.2-02. Community transition eligibility criteria.

1. To be considered eligible for community transition, an applicant of any age must: a. Be receiving Medicaid and have a significant disability; b. Be receiving Medicaid expansion, have a significant disability, and have a verifiable monthly income at or below one hundred thirty-eight percent of the current monthly poverty level; or

c. Be receiving currently or have been determined eligible by the department for one of the following services, waivers, or programs: (1) Developmental disabilities program management; (2) Developmental disabilities waiver; (3) North Dakota Medicaid state plan personal care; (4) Services payments for the elderly and disabled program; (5) Expanded service payments for the elderly and disabled program; (6) Medicaid waiver for home and community-based services; (7) Children's hospice waiver; (8) Autism spectrum disorder waiver; or (9) Medically fragile children's waiver.

2. To be considered eligible, an applicant must be living in a provider-operated residential facility and be requesting a transition to an eligible community residence.

3. An applicant shall submit an application in the form and manner prescribed by the department.

4. An applicant with presumptive eligibility or a pending Medicaid application is not eligible for community transition.

5. An applicant is not eligible if: a. The applicant qualifies for the money follows the person grant or another federal transition service. b. A referral for the community transition program occurs after a transition to the community occurs. c. The applicant previously has been enrolled in the community transition and diversion program within the past twelve months.

6. An individual is not eligible to reapply if the individual has been denied participation in the community transition program within the past twelve months, unless the individual has had a significant change in condition or living arrangement.

History: Effective January 1, 2026.

General Authority: NDCC 50-06-05.1, 50-06-16

Law Implemented: NDCC 50-06-05.1