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

Page Reviewed / Updated - May. 2017

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. SPED is intended for individuals who are more functionally impaired than those enrolled in Ex-SPED.

Both programs provide a range of services intended to help senor and disabled 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 more intimate environment, is included. Both programs also allow for consumer direction of services. For clarification purposes, this means that individuals receiving care services 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 an adult child can be hired as service providers and paid for their caregiving efforts. However, this individual must live with the care recipient.

Under these programs, certain 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 modifications to the home to preserve the resident's independence.

 

Eligibility Guidelines

Applicants for SPED and Ex-SPED 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.

Other eligibility requirements for SPED and Ex-SPED vary slightly as follows:

SPED:

  • Functionally, SPED 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 absolute terms. Rather, the applicant must have an inability to pay for their care. That being said, there may be a service fee, also called a cost share for services, which is determined based on one’s income. 
  • Assets, however, are considered in fixed terms. As of 2017, applicants for SPED are limited to a maximum of $50,000 in liquid assets, which includes checking, savings accounts, stocks, etc. When calculating the value of assets, one should not include the value of their home, as this is considered an exempt asset.

Ex-SPED:

  • Functionally, Ex-SPED applicants must meet one of the following requirements:
  • Have challenges completing at least three of four of the following instrumental activities of daily living: housecleaning, laundry, preparing meals, or administering medications. 
  • Needs supervision due to health, safety, or welfare issues. 
  • Must not have significant issues with their activities of daily living. 
  • Is eligible for SSI, but is not required to receive it. 
  • Is eligible for Medicaid, but Medicaid enrollment is not a requirement.

 

Benefits and Services

The services available are the same whether the beneficiary is approved for SPED or Ex-SPED, with the exception of personal care, which is only available for SPED enrollees.

Financial obligations between the programs may differ. Ex-SPED beneficiaries have the complete cost of services covered, while SPED beneficiaries may be charged a service fee. However the fee for services is minor when compared to purchasing these same services from private elder care service providers. Services covered by these programs include:

  • Adult Day Care
  • Adult Foster Care
  • Assistance with Chores (such as removal of snow)
  • Family Home Care (payments to family members for caregiving)
  • Homemaker Services (assistance with in-home, non-care related chores, such as light cleaning and preparation of meals)
  • Home Modifications (minor changes to improve home access and safety, such as installation of grab bars)
  • Personal Care (SPED only – assistance with bathing, toiletry, etc.)
  • Personal Emergency Response System (Medical Alert)
  • Respite Care
  • Transportation Assistance (for non-medical purposes only)
  • Case Management

 

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. One may also find additional information about SPED here or Ex-SPED here.

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