# Title 75 — Department of Human Services

## Article 75-04 — Developmental Disabilities

## Chapter 75-04-06 — Eligibility for Intellectual Disabilities - Developmental Disabilities Program Management Services

[Repealed]
Four-Year-Old Children [Repealed]
### § 75-04-06-01. Principles of eligibility.

1. The process of determining an individual's eligibility to receive intellectual disabilities -
developmental disabilities program management services involves the recognition of several
criteria and an understanding of expected outcomes as each criterion is applied. Professional
judgment is applied to determine the applicability of the provision of intellectual disabilities -
developmental disability program management services.
2. The following criteria must be used as the frame of reference for a team of at least three
professionals, led by the developmental disabilities program administrator or the
administrator's designee, for the determination of an individual's eligibility for intellectual
disabilities - developmental disabilities program management services.
History: Effective July 1, 1991; amended effective January 1, 1997; July 1, 2012; April 1, 2018;
January 1, 2025.
General Authority: NDCC 25-01.2-18, 50-06-16
Law Implemented: NDCC 25-01.2-02, 50-06-05.3
### § 75-04-06-02. Criteria for service eligibility - Class member.

Repealed effective January 1, 1997.
### § 75-04-06-02.1. Criteria for service eligibility - Children age three and above.

1. An individual is eligible for intellectual disabilities - developmental disabilities program
management services if the individual has a diagnosis of intellectual disability which is severe
enough to constitute a developmental disability.
a. A diagnosis of the condition of intellectual disability must be made by an appropriately
licensed professional using diagnostic criteria accepted by the American psychiatric
association.
b. Determination of whether the manifestation of the condition is severe enough to
constitute a developmental disability must be done in accordance with the definition of
developmental disability in North Dakota Century Code section 25-01.2-01.
2. An individual is eligible for intellectual disabilities - developmental disabilities program
management services if the individual has a condition of intellectual disability, diagnosed by an
appropriately licensed professional using diagnostic criteria accepted by the American

psychiatric association, which is not severe enough to constitute a developmental disability,
and the individual must be able to benefit from treatment and services purchased through the
developmental disability division on behalf of an individual who meets the criteria of
subsection 1.
3. An individual is eligible for intellectual disabilities - developmental disabilities program
management services if the individual has a condition, other than mental illness, severe
enough to constitute a developmental disability, which results in impairment of general
intellectual functioning or adaptive behavior similar to that of an individual with the condition of
intellectual disability, and the individual must be able to benefit from services and intervention
techniques which are so closely related to those applied to an individual with the condition of
intellectual disability that provision is appropriate. Determination of eligibility for individuals
described in this subsection requires the application of professional judgment in a two-step
process:
a. The team must first determine whether the condition is severe enough to constitute a
developmental disability. North Dakota Century Code section 25-01.2-01 must be applied
in order to determine if a developmental disability is present. The presence of a
developmental disability does not establish eligibility for services through the intellectual
disabilities - developmental disabilities program management services system, but does
require the team to consider all assessment data and apply professional judgment in the
second step.
b. The team must then determine whether services can be provided to an individual
determined to have a condition, other than mental illness, severe enough to constitute a
developmental disability. The team must have a thorough knowledge of the condition and
service needs of the applicant, as well as a thorough knowledge of services that would
be appropriate through the developmental disabilities system. When considering if
intellectual disabilities - developmental disabilities program management is appropriate,
the team must consider factors, including:
(1) Whether the individual would meet criteria appropriately used to determine the need
for services in an intermediate care facility for individuals with intellectual disabilities.
(2) Whether appropriate services are available in the existing developmental disabilities
service delivery system.
(3) Whether a service, which uses intervention techniques designed to apply to an
individual with intellectual disabilities, delivered by staff trained specifically in the
field of intellectual disabilities, would benefit the individual.
(4) Whether a service, designed for an individual with the condition of intellectual
disability, could be furnished to the individual without any significant detriment to the
individual or others receiving the service.
c. If the team concludes, through the application of professional judgment, that an
individual's needs can be met through specific services purchased by the department for
individuals who meet the criteria of subsection 1, an intellectual disabilities -
developmental disabilities program manager may be assigned. Services may be
provided, subject to the limits of legislative appropriation. New services need not be
developed on behalf of the individual.
History: Effective January 1, 1997; amended effective July 1, 2012; April 1, 2018.
General Authority: NDCC 25-01.2-18, 50-06-16
Law Implemented: NDCC 25-01.2-02, 50-06-05.3

### § 75-04-06-03. Criteria for service eligibility - Applicants who are not members of the plaintiff

class.
Repealed effective January 1, 1997.
### § 75-04-06-04. Criteria for service eligibility - Children birth through age two.

1. Service eligibility for children from birth through age two is based on distinct and separate
criteria designed to enable preventive services to be delivered. Young children may have
conditions which could result in substantial functional limitations if early and appropriate
intervention is not provided. The collective professional judgment of the team must be
exercised to determine whether the child has a high-risk condition or has a developmental
delay, and if the child may need early intervention services. If a child, from birth through age
two, has a high-risk condition or has a developmental delay, the child may be included on the
caseload of an intellectual disabilities - developmental disabilities program manager and
considered for those services designed to meet specific needs. Eligibility for continued service
inclusion through intellectual disabilities - developmental disabilities program management
must be redetermined by age three using criteria specified in section 75-04-06-02.1.
2. For purposes of this section:
a. "Developmental delay" means a condition of a child, from birth through age two:
(1) Who is performing twenty-five percent below age norms in two or more of the
following areas:
(a) Cognitive development;
(b) Gross motor development;
(c) Fine motor development;
(d) Sensory processing (hearing, vision, haptic);
(e) Communication development (expressive or receptive);
(f) Social or emotional development; or
(g) Adaptive development; or
(2) Who is performing at fifty percent below age norms in one or more of the following
areas:
(a) Cognitive development;
(b) Physical development, including vision and hearing;
(c) Communication development (expressive and receptive);
(d) Social or emotional development; or
(e) Adaptive development.
b. "High-risk condition" means a condition of a child, from birth through age two:
(1) Who, based on a diagnosed physical or mental condition, has a high probability of
becoming developmentally delayed; or

(2) Who, based on informed clinical opinion which is documented by qualitative and
quantitative evaluation information, has a high probability of developing a
developmental delay.
History: Effective July 1, 1991; amended effective July 1, 1993; January 1,1997; July 1, 2012; April 1,
2018.
General Authority: NDCC 25-01.2-18, 50-06-16
Law Implemented: NDCC 25-01.2-02, 50-06-05.3
### § 75-04-06-05. Service availability.

The extent to which appropriate services other than program management services are available to
an eligible individual is dependent upon legislative appropriations and resources. Eligibility for program
management services does not create an entitlement to services other than program management
services if resources are not available.
History: Effective August 1, 1997; amended effective April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 50-06-16
Law Implemented: NDCC 25-01.2-02
### § 75-04-06-06. Developmental disabilities program management eligibility for three-year-old

and four-year-old children.
Repealed effective July 1, 2014.
### § 75-04-06-07. Denial, reduction, and termination of services by the department - Appeal.

1. An eligible individual or authorized representative may appeal a denial, reduction, or
termination of services under this chapter. An appeal under this section must be made within
thirty days of the date of the notice of the denial, reduction, or termination. An eligible
individual or authorized representative shall submit the request for an appeal and hearing
under North Dakota Century Code chapter 28-32 and chapter 75-01-03 to the appeals
supervisor for the department.
2. An eligible individual or authorized representative may request an informal review within ten
days of the date of the notice. A request for an informal review does not change the time
within which the request for an appeal hearing must be filed.
History: Effective April 1, 2018; amended effective January 1, 2025.
General Authority: NDCC 25-01.2-18
Law Implemented: NDCC 25-01.2-02, 25-01.2-18
### § 75-04-06-08. Developmental disabilities program management caseload and responsibilities.

1. The average caseload of the developmental disabilities program managers must be no more
than sixty eligible individuals per program manager.
2. The developmental disabilities program manager shall complete the following:
a. Review individual rights with eligible individuals and applicants.
b. Conduct service coordination and monitoring for eligible individuals.
c. Authorize appropriate services for eligible individuals.
History: Effective April 1, 2020; amended effective January 1, 2025.
General Authority: NDCC 25-01.2-18

Law Implemented: NDCC 25-01.2-02, 25-01.2-18
