Written by a parent, not a doctor. Nothing here is medical advice.

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North Dakota program

Being paid to care for your own child

A North Dakota pilot pays a parent or other legally responsible adult for extraordinary care at home.

What it is

A North Dakota pilot pays a parent or other legally responsible adult for extraordinary care at home.

This pilot can pay a family member whose daily care goes beyond ordinary parenting. It is separate from ordinary in-home support. Waiver enrollment and the pilot’s own review both matter.

Eligibility rules
  • The caregiver must live with the child and provide extraordinary unpaid care. The child must actively use a qualifying waiver service authorized in the care plan. Ordinary nursing coverage alone does not qualify a parent for payment.
What you get
  • About $166 for each approved day, up to five days a week.
What the help includes
  • The pilot is an exception to ordinary medically fragile in-home support rules requiring workers to live elsewhere.
  • The payable week runs Sunday–Saturday. A day with four or more cumulative hours of listed paid waiver, Medicaid personal-care or private-duty-nursing services is not payable under the pilot. One paid participant per household is allowed.
If you decide to apply
  1. Ask the waiver case manager whether your child is enrolled in a qualifying waiver.
  2. If you decide to pursue the pilot, contact its office with waiver paperwork and a description of daily care.

701-328-8930 — North Dakota Health and Human Services · Official page ↗

After you ask
  • The case manager walks you through the online application, a self-assessment of the care you give and a background check. Places depend on funding, with a waiting list by application date. Approval lasts six months at a time, and you claim each month within 30 days.
Good to know

Funding runs through June 30, 2027. It is a temporary pilot, not a permanent Medicaid payment.

Other details
  • The pilot is funded through June 30, 2027. The case manager confirms whether funding continues afterward. Payments are reported on Form 1099 and may affect other benefits. A tax preparer and each benefits program check the actual payment; it is not automatically tax-free Medicaid waiver income.
Official sources
Ask your social worker

“Could the pilot pay me for the care my child needs, and what responsibilities would come with it? Could you help us check waiver eligibility and whether pursuing it makes sense?”

Why I’m asking: I want to understand whether the care at home could bring some income back into our household.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Call the pilot by name and ask what your child needs to be enrolled in first.

Your social worker

The waiver case manager says whether your child is enrolled and can start the referral.

The care team

Records and letters when the application asks for them.

Who decides
North Dakota Health and Human Services, through the pilot.
Ask the agency
“I live with my child and give their daily care. Can I be paid through the Family Paid Caregiver pilot, and is my child on a waiver?”

How to apply

First step: Call 701-328-8930 and ask for the Family Paid Caregiver pilot by name, and ask what waiver your child would need.

  1. Ask first whether your child can get onto a waiver; this pilot sits behind that.
  2. Call 701-328-8930 and ask for the Family Paid Caregiver pilot by name.
  3. Ask whether there is a wait and how long the funding runs.

Official application / program page ↗

Where it starts: Call the pilot on 701-328-8930 or 800-755-8529.

What to gather

  • Your child’s waiver paperwork, if any
  • A description of the daily care you give

How long: Not published. Ask when you call.

What a yes looks like

An agreement naming you as the paid carer and the daily rate.

What a no looks like, and the next move

Usually because the child is not on a waiver. Ask the waiver office about the medically fragile route.

Watch out

  • Waiver enrollment alone is insufficient: active services, extraordinary-care assessment and pilot approval are required. A day with at least four cumulative paid service hours is not payable.
  • The funding behind it runs to June 30, 2027 and nothing after that is published.

Dates that change this

2027-06-30: The funding behind this pilot runs to June 30, 2027. Nothing has been published about what happens after that, so do not plan a household budget past that date on it.

2026-09-11: How many families are waiting for a place in the pilot was not published. Ask when you call. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

$165.98 per approved day from July 1, 2026, with at most five payable days per Sunday–Saturday week.

  • $165.98 — Daily rate from July 1, 2026

Covers: Payment to a co-resident, legally responsible family carer

What it costs the family: Nothing.

The eligibility facts, as published

Who
a legally responsible individual who lives with and gives daily care to the applicant, including a parent
Coverage
waiver enrollment and active use of a waiver service; extraordinary-care assessment, co-residence and pilot approval are separate requirements
Funding
available to June 30, 2027 under Senate Bill 2305 (2025)

The trap: The general Medically Fragile in-home support page says in-home support workers must live outside the child’s home. This pilot is the exception, so ask for it by its own name rather than asking about in-home support.

Where I read this

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