N.Dakota Service Payments for the Elderly and Disabled (SPED and Ex-SPED) Programs

Page Reviewed / Updated - Mar. 2015

Program Description

The North Dakota Department of Human Services offers a program called Service Payments for the Elderly and Disabled, abbreviated as SPED.  This program has two levels which provide similar services but have differing eligibility requirements.  These levels are referred to as regular SPED and Expanded SPED or Ex-SPED. 

Both programs provide a range of services intended to help individuals remain living at home or in their community.   Although assisted living services are not among the included benefits, adult foster care, which provides a similar level of care to assisted living just in a smaller environment, is included.  Both programs also allow for consumer direction of services.  For clarification purposes, this means that the individuals receiving care services and have the right and the flexibility to choose their own service providers (assuming they meet the ND Department of Human Services standards).  Certain family members, usually the adult children, can be hired as service providers and paid for their caregiving efforts.

 Under these programs, family members can receive payment for caregiving for their loved ones.

In addition to adult foster care and home care, the major benefits of this program include Personal Emergency Response Services (also called Medical Alert services), chore services, respite care and minor changes to the home to preserve the residents independence. 


Eligibility Guidelines

Applicants must be at least 18 years of age and legal residents of North Dakota.  Services are not provided to individuals in Medicaid funded nursing homes, therefore program participants must either live at home or in adult foster care.  

Functionally, applicants must have challenges completing at least four of their activities of daily living without assistance or five instrumental activities of daily living.

Financially, the applicant's monthly income is not considered in fixed terms.  Rather, the applicant must be found to have an inability to paid for their care.  Assets, however, are considered in fixed terms.  In 2015, the applicant is limited to a maximum of $50,000 in assets.  This does not include the value of their home. 


Benefits and Services

The services available are the same whether the beneficiary is approved for SPED or Ex-SPED, however their financial obligations may differ.  Ex-SPED beneficiaries have the complete cost of services paid for, while SPED beneficiaries are charged a service fee.  However the fee for services is minor when comparing to purchasing these same services from private elder care service providers.  Services covered by these programs include:

  • Adult Foster Care
  • Assistance with Household Chores
  • Family Home Care
  • Homemaker
  • Home Modifications (minor changes to improve home access and safety)
  • Personal Care
  • Personal Emergency Response System (PERS)
  • Respite Care


How to Apply / Learn More

These programs are available statewide.  To learn more or begin the application process, there are several paths.  One can contact their local county social service office, visit the Aging and Disability Resource webpage or call the toll-free number at 1-855-462-5465.

 Did You Know?  Every day 1.5 million Americans over 65 receive home care and two-thirds of them are women.