North Dakota HHS lists a Home and Community-Based Services Waiver, effective January 1, 2026, among its current Medicaid 1915(c) waivers. HHS explains that a waiver is essentially an agreement between CMS and the state Medicaid agency spelling out who's served, how many participants are allowed, the eligibility rules, the services offered, and the level-of-care evaluation and reevaluation process. The state describes this particular waiver as serving older adults and people with physical disabilities who want to stay at home but need help with daily living tasks.
To use the community waiver path, a person still has to pass a nursing-home-level-of-care screening even while choosing to receive services in the community rather than a facility. The general long-term-care requirements don't disappear either — the applicant still needs to qualify for a Medicaid coverage group, show a medical need, and meet the applicable financial rules. In other words, home care is an alternative service setting for someone who's already eligible, not a way to skip the application, resource test, client share, or transfer review.