North Dakota pays for certain in-home care services through its state Medicaid program and several other programs and waivers designed to support older and disabled adults living in their own homes. To receive funded in-home care in North Dakota, individuals need to receive or be eligible for Medicaid enrollment.

Individual programs may have additional eligibility criteria. Care needs, functional status and living arrangements can affect whether a person qualifies for North Dakota’s in-home care programs.

Expanded Service Payments for the Elderly and Disabled 

North Dakota’s Expanded Service Payments for the Elderly and Disabled program, or Ex-SPED, covers certain services for people assessed as requiring care in a basic care facility. It pays for services at home and in community settings, although it doesn’t cover people living in institutional or dormitory-style settings. To qualify, an individual must receive or be eligible for Supplemental Security Income and be able to carry out activities of daily living, such as eating or using the bathroom, relatively independently. 

This program is designed to support enrollees in managing essential activities, such as food preparation, housekeeping tasks or medication management. It also pays for services to meet health and welfare needs. Examples of covered services include:

  • Emergency response systems
  • House cleaning
  • Limited home modifications to support independence
  • Meal preparation
  • Laundry services
  • Respite services for caregivers
  • Case management services

Medicaid Waiver for Home and Community-Based Services

The Medicaid Waiver for Home and Community-Based Services in North Dakota pays for in-home services for people who would otherwise need to live in a nursing home. A person may be eligible to enroll if they’re 65 or older or meet the Social Security Disability criteria. The waiver only covers people who can oversee their own care and live in their own homes. 

North Dakota’s Medicaid Waiver covers a broad range of practical, social and health-related services, including:

  • Transportation services
  • Home modifications and specialized equipment to promote independence
  • Temporary respite relief for carers
  • Homemaker services, such as cleaning and laundry
  • Meal preparation
  • Case management services
  • Adult day care

Program of All-Inclusive Care for the Elderly

The Program of All-Inclusive Care for the Elderly, or PACE, pays for services designed to promote the health and independence of adults aged 55 and older. An individual doesn’t need to be a Medicare or Medicaid beneficiary to enroll in PACE, although it’s only available for people who would otherwise require care in a nursing home. A person may not be eligible for PACE if the program can’t safely meet their needs while living at home or if they live outside North Dakota’s PACE areas. 

Generally, PACE covers all necessary medical, social and care services for enrollees. Covered services may vary by area, but they must include the following:

  • Primary care
  • Social services
  • Services to maintain functional status, such as occupational therapy
  • Personal care
  • Recreational therapy
  • Meals and nutritional advice