Residential and Independent Living Options for Disabled Adults in North Dakota

Housing After High School: The Options

When a young adult with a disability finishes high school in North Dakota, housing becomes an immediate question. Some families assume their child will live at home indefinitely. Others want their child to live as independently as possible but don't know what's available or how it's funded. The reality is that North Dakota has several residential models, each suited to different levels of support need, and most are funded through the Traditional IID/DD HCBS Waiver.

Understanding these options before graduation matters because the enrollment and placement process takes time. Families who start exploring housing during the transition planning years are in a far stronger position than those who scramble after school services end.

Host Homes

In North Dakota's host home model, a licensed provider family welcomes the young adult into their home on a long-term basis. The host home provider is trained and contracted through a licensed service agency, and they receive a stipend funded by the DD waiver to cover room, board, and direct support.

Host homes work well for individuals who benefit from a family-like environment but whose own family can't provide full-time support. The setting is a regular house in a regular neighborhood — not an institutional facility. The young adult participates in household routines, community activities, and daily living alongside the host family.

Host homes are particularly common in rural North Dakota, where larger group residential settings don't exist. The challenge is finding host home providers — recruitment is ongoing, and in some regions the supply of willing and qualified hosts doesn't meet demand.

Residential Habilitation

Residential habilitation provides training and support in daily living skills within a home setting. This can happen in the individual's own apartment, a family home, or a shared living arrangement. Staff come in on a scheduled basis to work on specific goals — cooking, cleaning, budgeting, transportation, personal care — with the aim of building independence over time.

Under the DD waiver, residential habilitation hours are authorized through the Person-Centered Service Plan and funded based on the individual's assessed level of need (determined by the SIS and ICAP evaluations). The service can be delivered by a licensed agency or through self-directed arrangements where the family hires and manages support staff directly.

For young adults who want to live in their own apartment but need regular support, residential habilitation provides the scaffolding. The intensity can be adjusted as the individual's skills develop — starting with daily visits and gradually reducing to weekly check-ins.

Independent Living With Supports

Some young adults with disabilities can live independently with minimal, intermittent support. North Dakota's Centers for Independent Living provide skills training, peer mentoring, and information and referral services to help individuals with disabilities live on their own. These are not residential placements — they're community organizations that provide the tools and connections people need to manage their own housing.

For individuals who qualify for the DD waiver, independent living supports can be combined with other waiver services. Someone might live in their own apartment, receive a few hours of residential habilitation per week, and work with a supported employment job coach — all funded through the waiver.

The key barrier to independent living in North Dakota is affordable, accessible housing. In larger cities like Fargo and Bismarck, the rental market is competitive. In rural areas, options are extremely limited. Families should start researching housing availability and waitlists well before graduation because timing varies by program, location, and provider capacity.

Funding Through the DD Waiver

Most residential services for adults with intellectual and developmental disabilities in North Dakota are funded through the Traditional IID/DD HCBS Waiver. To access these services:

1. The individual must be enrolled in the DD system through their regional Human Service Center
2. They must meet the ICF/IID level of care, verified through the SIS and ICAP assessments
3. They must be eligible for North Dakota Medicaid (applying separately, since the state is a 209(b) state)
4. The residential services must be authorized in the Person-Centered Service Plan

North Dakota has historically maintained a near-zero waitlist for its DD waiver, which means that individuals who meet the eligibility criteria can generally access services without the multi-year waits common in other states. However, "no waitlist" doesn't mean instant access — the enrollment process itself takes months, and finding a provider (or setting up self-directed services) takes additional time.

The Environmental Modification Option

For families where the young adult will continue living at home, the DD waiver can fund environmental modifications to the family home — wheelchair ramps, bathroom accessibility features, safety modifications, and specialized equipment. These modifications must be authorized through the Person-Centered Service Plan and may be funded as a waiver service, subject to program requirements and the approved plan.

This option is practical for families in rural areas where residential placements don't exist or where the young adult and family prefer to live together. The modifications help the individual function more independently within the home while reducing caregiver burden.

Starting the conversation about housing during the IEP transition process gives families time to explore all options and begin the enrollment process. The North Dakota IEP Transition to Adulthood Guide includes worksheets for evaluating residential options and tracking the DD waiver enrollment timeline.

Frequently Asked Questions

Can my adult child stay on the DD waiver and live with me?

Yes. Many families choose this arrangement, especially in rural areas. The DD waiver can fund residential habilitation services, environmental modifications, and family support even when the individual lives with family. The Person-Centered Service Plan authorizes the specific services based on the individual's goals and needs.

What is the difference between a host home and a group home?

A host home is a private residence where a licensed provider family supports one or two individuals. A group home is a licensed residential facility, typically operated by an agency, that serves multiple residents with dedicated staff. Host homes offer a more family-like setting, while group homes provide more structured, shift-based staffing.

How do I find available host homes or residential openings?

Your Developmental Disabilities Program Manager (DDPM) at the regional Human Service Center is the primary resource for connecting with licensed providers in your area. They maintain relationships with provider agencies and host home networks and can help match your child's needs with available placements.

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