COMMUNITY INTEGRATION SERVICES PROVIDER IN NORTH DAKOTA

FOSTERING INDEPENDENCE THROUGH ACTIVE COMMUNITY PARTICIPATION AND SOCIAL ENGAGEMENT

Community Integration Services in North Dakota support individuals with disabilities, chronic conditions, or age-related challenges by enhancing their ability to participate in community life. These services promote social inclusion, independent living, and active participation in local activities. Community Integration Services are authorized under North Dakota Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: North Dakota Department of Human Services (NDDHS)

Role: Administers Medicaid waiver funding for Community Integration Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: North Dakota Medical Services Division (MSD)

Role: Manages Medicaid waiver services and oversees Medicaid provider participation.

Agency: North Dakota Division of Aging Services

Role: Provides oversight for community integration services targeting elderly individuals and adults with disabilities.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Community Integration Services meet quality, safety, and person-centered care standards.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

Community Integration Services aim to improve social, vocational, and independent living skills by connecting individuals to local resources, community programs, and social networks.

Approved providers may deliver:

• Social Skills Development: Teaching communication, relationship-building, and social interaction.

• Community Participation: Facilitating involvement in clubs, recreational activities, and local events.

• Vocational Skill Building: Preparing individuals for community-based employment or volunteer roles.

• Independent Living Training: Enhancing skills like budgeting, using public transportation, and daily decision-making.

• Peer Support Groups: Encouraging social connections through structured group activities.

• Recreational Outings: Organizing visits to parks, community centers, or cultural events.

• Advocacy and Self-Determination: Teaching self-advocacy skills and promoting personal choice.

• Transition Support: Assisting with moving from institutional to community settings.

• Transportation Coordination: Ensuring safe travel to and from community activities.

• Documentation: Maintaining records of participation, progress, and outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the North Dakota Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Community Integration provider via the North Dakota Medicaid Management Information System (MMIS).

• Maintain general liability and professional liability insurance.

• Develop policies for community participation, social engagement, and safety management.

• Ensure staff complete required background checks, health screenings, and training in community integration practices.

4. NORTH DAKOTA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application via the North Dakota MMIS for Community Integration Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, community integration policies, and staff training documentation.

Program Readiness Review:

• NDDHS and MSD evaluate provider readiness, including engagement protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Community Integration Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (North Dakota Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• Community Integration Policy & Procedure Manual including:

  • Social skill development and community engagement protocols

  • Personal safety and client advocacy guidelines

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for activity tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety, transportation, and emergency response protocols

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Community Integration Program Director

Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in community engagement and program management.

Role: Community Support Specialists

Requirements: Experience in social services, community programs, or rehabilitation; background clearance.

Role: Peer Mentors

Requirements: Experience with community involvement and providing peer support; training in social engagement.

Role: Activity Coordinators

Requirements: Experience in planning community events and recreational activities.

All staff must complete:

• Training in social skills development, client safety, and community inclusion

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety, emergency response, and client interaction training

• Documentation and record-keeping best practices

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are available under the following North Dakota Medicaid Waivers:

• Aged and Disabled Waiver

• Technology Dependent Waiver

• Developmental Disabilities Waiver

• Home and Community-Based Services (HCBS) Waiver

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: North Dakota Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

North Dakota Department of Human Services (NDDHS)

Website: https://www.nd.gov/dhs/

North Dakota Medicaid Management Information System (MMIS)

Website: https://www.nd.gov/dhs/services/medicalserv/medicaid/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NORTH DAKOTA COMMUNITY INTEGRATION SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Community Integration Services in North Dakota, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for social engagement and community participation

• Staff credentialing, training program templates, and compliance documentation

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and client outreach strategies

• Quality assurance systems for social integration and compliance monitoring

• Collaboration with community organizations, healthcare providers, and local businesses

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.