1. Program Definition and Services

Adult Day Services in North Dakota provide daytime care and social engagement for adults with disabilities, chronic illnesses, or age-related challenges. The program aims to provide a safe, structured environment that enhances participants' optimal functioning, allows community-based support, and offers temporary relief for primary caregivers. Services include:

• In-Home Personal Care: Individualized assistance with activities of daily living (ADLs) and community support integrated into the day schedule (Social and Recreational Activities, Health Monitoring, Personal Care Assistance, Therapeutic Activities, and Nutritional Support)
• Residential Personal Care: Supervision, monitoring, and program management within the facility layout during operating hours (Memory Care Programs, Behavioral Support, Transportation Coordination, Caregiver Support, and Detailed Service Documentation)

2. Regulations

The program is governed by the following regulations:

• North Dakota Administrative Code, Title 75, Article 75-03 (Chapter 75-03-23 Provision of Home and Community-Based Services Under the Service Payments for Elderly and Disabled Program and the Medicaid Waiver)
• North Dakota Administrative Code, Title 75, Article 75-04 (Developmental Disabilities Operational Rules)
• Mental Hygiene Law (NC General Statutes Chapter 122C)
• Social Services Law (Protection of People with Special Needs)
• Child Protective Services Act (State Central Register Reporting)

3. Licensing or Certification

Providers must be certified as a Qualified Service Provider (QSP) or approved adult day care facility by the North Dakota Department of Health and Human Services and follow all Home and Community-Based Services (HCBS) requirements. Facilities operating within existing basic care or skilled nursing homes must secure specialized departmental clearances under Chapters 33-03-24.1 or 33-07-03.2-25.

4. Responsible State Agency

The Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS), in coordination with the Aging Services and Medical Services Divisions, is responsible for reviewing applications and certifying adult day services providers.

5. Application Process

The application process is conducted through the electronic North Dakota Medicaid Portal (Enterprise MMIS) or the dedicated QSP Enrollment Portal. Providers must submit forms online to initiate the application process.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety, physical plant, and operational rules
• Agency policies and procedures (including nutrition plans for participants attending over a mealtime)
• Staff qualifications, competency verifications, and training records
• Proof of general and professional liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional office or the QSP Hub for detailed information on current processing timeframes.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the North Dakota Secretary of State and secure necessary federal identification numbers (EIN and Type 2 NPI).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Representatives must complete a department-approved Qualified Service Provider Orientation or program orientation prior to initial enrollment.

10. Additional Notes

• Adult Day Care programs must operate on a regularly scheduled basis for 3 or more hours per day, one or more times per week.
• Providers must ensure that nonresidential care settings meet all state accessibility, hygiene, and environmental safety guidelines.
• All direct care staff must conduct mandatory background clearances and fingerprinting screenings covering offenses outlined under ND Century Code.
• Providers must maintain detailed records of daily attendance, face-to-face services, and care logs for Medicaid documentation and billing using mandated electronic systems like Therap.

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