Family members can get paid to care for a senior loved one under some circumstances in North Dakota, though it is not the default arrangement offered under the Medicaid waiver. Seniors who wish to hire a family member as a caregiver should ask a Medicaid worker about self-direction of funds as an option.

What Program Pays for In-Home Care in North Dakota?

North Dakota operates three waiver programs to support seniors at home, including Freedom of choice: Section 1915(b), Home and Community-Based Services (HCBS): Section 1915(c), and Demonstration: Section 1115 waivers. HCBS 1915(c) is the standard program for seniors enrolled in Medicaid who prefer to remain in their homes rather than move into assisted living or nursing home communities. This waiver pays registered agencies to cover the cost of employee caregivers. 

The Section 1915(b) Freedom of Choice waiver, which must be specifically requested as an alternative, is a beneficiary-directed program that permits enrollees to choose their own caregiver, including close family members and friends. Section 1115 waivers are granted on a case-by-case basis for more unique care arrangements specifically approved by the HCBS program.

Can Family Members Get Paid as Caregivers?

Family members can work as caregivers only under a Freedom of Choice waiver, except in the less-common scenario where the senior has a compatible Section 1115 program set up for in-home care. To get qualified as a Freedom of Choice caregiver, the family member must attend an in-person orientation and meet HCBS caregiver qualifications, including a current CPR card and clean criminal background check.

How to Enroll a Family Caregiver in North Dakota

Seniors who participate in Medicaid may be eligible for any of North Dakota’s three waiver programs if they are over 65 and have personal needs that would otherwise only be met by a nursing home level of care. Once a doctor certifies the medical or disability-related need for in-home care services, beneficiaries can apply for an HCBS waiver that covers family caregivers through Medicaid. After a home inspection and assigned allotment of hours, family caregivers can start work and receive payment for their beneficiary-authorized time sheets.