Home Modification and Repairs for Older Adults: Challenges and Opportunities for State Units on Aging: This report by the USC Fall Prevention Center of Excellence and ADvancing States reports on a national survey

NORTH DAKOTA ADULTS AND AGING SERVICES (State Unit on Aging)

State Units on Aging (SUAs) are designated state-level agencies that develop and administer state plans that advocate for and provide assistance, including home modifications or repairs, to older residents, their families, and adults with physical disabilities. SUAs administer funds, including Older Americans Act funds, which may be used to support home modification or repair services through local Area Agencies on Aging and other state and local entities.

Program(s) of the North Dakota State Unit on Aging with home modification or repairs include:

1. The North Dakota Adults and Aging Services Division uses state general funds to help individuals who are not eligible for Medicaid waiver services pay for home modifications.

2. Expanded Service Payments for the Elderly and Disabled (Ex-SPED) Program
Program Description: This program pays for in-home and community-based services for people who would otherwise receive care in a licensed basic care facility. The program covers environmental modification services. It is limited to modifying the home to enhance client independence.
Population Served: North Dakota residents who are Medicaid and Supplemental Security Income (SSI)-eligible, meet certain Activities of Daily Living and Instrumental Activities of Daily Living Requirements, and who would otherwise receive services in a licensed basic care facility.

3. Service Payments for the Elderly and Disabled (SPED) Program 
Program Description: The SPED program provides limited environmental modifications that enhance independence for people who are older or physically disabled and who have difficulty completing tasks that enable them to live independently at home.
Population Served: North Dakota residents with incomes of less than $50,000; inability to pay for services; limitations with four Activity of Daily Living and five Instrumental Activities of Daily Living; capable of managing their own care; and meet other requirements.

NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES: MEDICAID AGENCY

1. Medicaid Waiver for Home and Community-Based Services
   Program Description: This waiver helps eligible individuals who would otherwise require nursing home services to remain in their homes or communities. Environmental modification services are available to modify the recipient’s home to enhance their ability to function as independently as possible in the home.
   Population Served: Medicaid-eligible North Dakota residents at least 65 years of age or residents with a disability by Social Security Disability criteria, living in their own home or apartment, and able to direct their own care.
2. 1915(c) Traditional Intellectual Disabilities and Developmental Disabilities (IDD/DD) Home and Community Based Services Waiver
   Program Description: This waiver provides eligible individuals with environmental modifications, equipment and supplies, in-home supports, and other services.
   Population Served: Medicaid-eligible North Dakota residents with IDD/DD across the lifespan (no age limit) who meet an intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care.

NORTH DAKOTA STATE ASSISTIVE TECHNOLOGY PROGRAM

North Dakota Assistive
The State Assistive Technology Grant Program, funded under the Assistive Technology Act of 2004, supports comprehensive, statewide programs in each state that improve the provision of assistive technology (often home modification-related) to individuals with disabilities of all ages.

NORTH DAKOTA STATE FALL PREVENTION COALITION

North Dakota Falls Prevention Coalition (inactive)
For an up to date list of all state fall prevention coalitions, visit: https://www.ncoa.org/resources/list-of-state-falls-prevention-coalitions/

1. To locate the Area Agency on Aging in your state, please contact Eldercare Locator at https://eldercare.acl.gov/Public/Index.aspx

2. Data Brief: Building Community Capacity to Serve Older Adults: The Role of Area Agencies on Aging in Home Modifications and Repairs
This Data Brief highlights key findings from the 2019 National Survey of Area Agencies on Aging on how Area Agencies on Aging are providing and funding home modification and repair activities. It was developed by the USC Fall Prevention Center of Excellence in partnership with the National Association of Area Agencies on Aging as part of the Administration for Community Living project, “Promoting Aging in Place by Enhancing Access to Home Modifications.”

3. Featured Efforts:

Rebuilding Together of Cass and Clay County
Fargo, North Dakota
Rebuilding Together offers free home repairs and renovation services to low income families in Cass and Clay County with a focus on assisting older adults, veterans, and individuals with disabilities. Rebuilding Together includes several programs: 1) the Green Program which provides eco-friendly repairs and restorations to decrease energy spending; 2) a Handy-Man Program to provide a variety of repairs; 3) a Roof Program to provide roof repairs and replacements; and 4) the Safe at Home program to provide fall prevention and entrance access modifications for older adults and people with disabilities.