In North Dakota, Family Personal Care pays a spouse or close relative who lives with the person, once they enroll as a Qualified Service Provider. Family Personal Care is a service of North Dakota's Medicaid Home and Community-Based Services (HCBS) waiver. Under North Dakota Family Personal Care, the provider must give at least three hours of care a day, and the state pays for no more than 10 hours a day.

In This Guide

Who Can Be Paid Through North Dakota Family Personal Care?

Family Personal Care is one of the services of the Medicaid Waiver for Home and Community Based Services, North Dakota's 1915(c) waiver for people 65 and older and adults 18 to 64 with disabilities who meet a nursing facility level of care. Family Personal Care lets the person choose their spouse, or a parent, grandparent, adult child, adult sibling, adult grandchild, adult niece or adult nephew, as the paid provider.

Living together is the deciding rule. North Dakota's HCBS waiver application says, "Payment will only be made to legal spouses or family members who reside in the same home." A North Dakota Family Personal Care provider must also be an enrolled Qualified Service Provider (QSP) who demonstrates competency in family personal care standards.

Your situation Can Family Personal Care pay you?
Spouse living in the same home Yes, as an enrolled QSP
Listed relative living in the same home Yes, as an enrolled QSP
Relative who lives elsewhere No; Family Personal Care pays only family in the same home
Legal guardian who is a listed relative living there Yes, with case manager pre-approval if they hold decision-making authority
Live-in provider who isn't a spouse or listed relative No; the person is served under Medicaid State Plan personal care

The same-home rule and the State Plan route for non-family providers come from the waiver application. The guardian row rests on North Dakota's Family Personal Care chapter, which says "A legally responsible individual would include a Legal Spouse or Guardian." A relative who lives elsewhere may have other paid routes; the North Dakota how-to-get-paid guide covers them.

What Family Personal Care Pays For

Family Personal Care pays for hands-on help with daily activities. The North Dakota waiver lists bathing and hygiene, dressing, incontinence care, toileting, transferring and positioning, mobility, and feeding.

Much of what you do around the house won't count. North Dakota's HCBS waiver states: "Payment will not be made for assistance with the tasks of communication, community integration, housework, laundry, meal preparation, money management, shopping, social appropriateness, and transportation." That can sting when cooking and errands fill half your day, so it helps to know before the plan of care is written.

Three more limits from the waiver application:

  • Monthly cap: Under North Dakota's waiver application, the cost of Family Personal Care "is limited to a maximum monthly cap set by the Department or through legislative action," and the Department there is ND HHS. Ask the case manager for the current cap.
  • State Plan or EPSDT: North Dakota Family Personal Care "is not available to individuals who are eligible to receive such services through the Medicaid State Plan or" Early and Periodic Screening, Diagnostic and Treatment (EPSDT).
  • Services you give up: Family Personal Care recipients aren't eligible for adult residential care, adult foster care, transitional living, residential habilitation, community support and companionship services.

How Many Hours Does North Dakota Family Personal Care Pay?

North Dakota sets a floor and a ceiling on Family Personal Care hours, and each one decides something different for your family.

  • Below the 3-hour floor. When a family member gives less than three hours of care a day under North Dakota Family Personal Care, live-in care moves to Medicaid State Plan personal care (MSP-PC) at its daily rate, as long as the provider is eligible for MSP-PC.
  • Above the 10-hour ceiling. North Dakota caps reimbursable Family Personal Care hours at 10 a day. You can give more care than that, but North Dakota's Family Personal Care chapter says the state "is not obligated to pay because that care is being provided because of their close personal relationship and that they share a household with the eligible individual."

If you're caring around the clock, North Dakota Family Personal Care's 10-hour daily cap means every hour past 10 in a day, overnight checks included, goes unpaid. Describe the whole care load, nights included, during planning so the plan of care reflects what the person actually needs.

In North Dakota, a spouse can't use the MSP-PC fallback, so a spouse who gives under Family Personal Care's 3-hour daily minimum has no State Plan route to pay. For State Plan personal care, North Dakota's administrative code says no payment may be made for personal care services provided by the recipient's spouse, parent of a minor child, or legal guardian.

Within those limits, the number of hours comes from planning, not from you. North Dakota's live-in paid caregiver policy says, "The person-centered planning process will determine the number of hours care will be provided."

What Will You Earn?

Ask the case manager what North Dakota Family Personal Care pays per hour before you plan a budget around it. As an estimate based on home care aide wages, the Bureau of Labor Statistics puts the median wage for home health and personal care aides in North Dakota at $18.96 an hour (May 2025). That figure describes aide wages across the state, so your Family Personal Care pay may be higher or lower.

North Dakota Family Personal Care pay may also be excluded from federal income tax. Under IRS Notice 2014-7, 1915(c) waiver payments for care in the home the provider shares with the person can be excluded from gross income, but not when the provider has a separate home. Our guide to whether waiver payments are taxable covers the details.

If You're a Spouse or Guardian With Decision-Making Authority

North Dakota's waiver treats a spouse or guardian as a legally responsible person, and it allows paying one who meets the QSP qualifications for Family Personal Care. There's one added step when that person also makes decisions for the recipient. North Dakota's HCBS waiver application says, "If the legally responsible person wants to become the provider and has decision making authority over the recipient the case manager must pre-approve the arrangement." The case manager then sends the State Medicaid Agency a narrative explaining why the arrangement is in the person's best interest, and attaches it to the care plan.

It's an extra step, not a bar. The full spouse picture is in getting paid to care for your spouse in North Dakota.

Other Options for Family Who Live Together

  • Waiver Personal Care is closed to live-in relatives. The HHS manual says live-in relatives meeting the family-member definition "are not eligible to provide waiver personal care." Under unusual or unique circumstances, the HCBS Program Administrator can consider another combination of services, in writing, as a potential reasonable modification.
  • MSP-PC daily rate, by choice. Individuals with live-in providers, except spouses or legal guardians, may choose Medicaid State Plan personal care at its daily rate, and a relative already providing MSP-PC doesn't have to move to Family Personal Care.
  • SPED Family Home Care comes second. North Dakota's state-funded Service Payments for the Elderly and Disabled (SPED) program has a Family Home Care service, but if the person receives or would be eligible for Medicaid and meets level of care screening, Family Personal Care must be sought first. If Family Personal Care would be detrimental to the household, the case manager can ask the Program Administrator to consider an exception. See North Dakota SPED Family Home Care for how that program works.

Every program side by side is in North Dakota caregiver programs.

How to Start, Step by Step

1
Step 1

Call ND HHS

The ND HHS Medical Services Division is the contact for Medicaid waivers: 1-800-755-2604 toll-free, or (701) 328-7068.

2
Step 2

Confirm the waiver

The person you care for must qualify for North Dakota Medicaid and the HCBS waiver. The rules are in North Dakota Medicaid HCBS waivers and the application steps in how to apply for North Dakota Medicaid.

3
Step 3

Ask for Family Personal Care by name

Tell the case manager you live in the same home and want to be the provider.

4
Step 4

Enroll as a QSP

You'll need to demonstrate competency in family personal care standards.

5
Step 5

Settle the hours in the plan

Your daily Family Personal Care hours come out of person-centered planning, within North Dakota's 10-hour cap.,

Frequently Asked Questions

Is there a waiting list for Family Personal Care?

North Dakota's January 2026 waiver application reported over 1,150 enrolled QSPs statewide and said, "we do not have a waiting list for waiver services."

Can my brother's wife be paid to care for our mother?

She can. Family Personal Care's relative list includes "the current or former spouse of one of the following relatives," which covers an adult child's spouse, as long as she lives in the same home and enrolls as a QSP.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in North DakotaNorth Dakota's HCBS waiver can pay a spouse or close relative who lives with the care recipient, and VA programs can pay veteran family caregivers. CaregiverHow to Get Paid to Care for Your Spouse in North DakotaNorth Dakota's Medicaid waiver lets a spouse be the paid Family Personal Care provider if you live in the same home. Here is how to qualify, plus VA routes. CaregiverCaregiver Programs in North Dakota: A Complete DirectoryNorth Dakota caregiver programs that pay a spouse or relative, live-in or not: Family Personal Care, SPED, free NFCSP respite, VA stipends and tax rules. MedicaidHow North Dakota Medicaid HCBS Waivers WorkNorth Dakota Medicaid HCBS waivers pay for home and community care instead of a nursing home. See who qualifies, what's covered, and how to apply in 2026. CaregiverAre Medicaid Waiver Payments Taxable?Are Medicaid waiver payments taxable? Usually not, if you live with the person you care for. What IRS Notice 2014-7 excludes, what it misses, how to report it. CaregiverNorth Dakota SPED Family Home Care: Getting Paid to Care for a Relative Without MedicaidYes. North Dakota SPED Family Home Care pays a spouse or listed relative who lives with the person, up to 10 hours a day, via state-funded SPED. Who qualifies.

Find personalized help getting paid through North Dakota Family Personal Care at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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