Updated September 4, 2026. Quick answer: yes, through Family Personal Care (FPC), a Qualified Service Provider category under North Dakota’s HCBS Medicaid waivers. Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How North Dakota pays a family caregiver
| Program | Family Personal Care (FPC), a Qualified Service Provider category under North Dakota’s HCBS Medicaid waivers |
|---|---|
| Can a family member be paid? | Yes. “spouse or by one of the following relatives…parent, grandparent, adult child, adult sibling, adult grandchild, adult niece, or adult nephew” |
| Can a spouse be paid? | Yes. “spouse or by one of the following relatives…parent, grandparent, adult child, adult sibling, adult grandchild, adult niece, or adult nephew” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
North Dakota HHS lets an HCBS waiver participant use Family Personal Care, one of its Qualified Service Provider (QSP) categories, in which an eligible relative, explicitly including a spouse, enrolls as a paid QSP through the state’s QSP Enrollment Portal. Because a spouse is also a legally responsible individual with decision-making authority, the case manager must separately approve the arrangement and document why it serves the participant’s best interest. Reimbursable Family Personal Care hours are capped at 10 per day, with a 3-hour daily minimum to qualify.
What this doesn’t answer
Could not extract readable text from the official QSP rate-sheet and billing-code-rate PDFs, so no confirmed current dollar hourly rate for Family Personal Care could be verified this session. A separately named Family Paid Caregiver pilot program found via an HHS news release appears limited to specific children’s and I/DD waivers, and was not confirmed to be the same benefit as the general-population Family Personal Care option described here.
Sources
- North Dakota HHS Service Chapter 525-05, Family Personal Care 525-05-30-32 (revised 07/01/2026), the source of the quoted list of qualified relatives, the three-hour daily minimum, the 10-hour daily reimbursement cap and the case-manager approval requirement
- North Dakota Health and Human Services: HCBS policy manual and program pages
Read September 4, 2026; sources re-read and pinned to the specific policy section September 6, 2026.
Same question, other states: Ohio · Oklahoma.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.