Area Agencies on Aging in North Dakota

Complete Guide to Area Agencies on Aging in North Dakota (2026)

Last updated: January 06, 2026

If You Need Emergency Help

Call 911 immediately if you or someone you know is in immediate danger, experiencing a medical emergency, or being abused or neglected.

For urgent aging or disability assistance:

• North Dakota Aging and Disability Resource-LINK: 1-855-462-5465 – Statewide information and assistance
• TTY: 711 – For hearing impaired callers
• Adult Protective Services: Contact local Human Service Center – Report elder abuse, neglect, or exploitation
• Crisis Text Line: Text HOME to 741741 – Free, confidential support
• National Suicide Prevention Lifeline: 988 – Mental health crisis support

For immediate food and emergency assistance:

• Contact your local Human Service Center for emergency assistance programs
• North Dakota 211: Dial 2-1-1 – General emergency resources and assistance
• SNAP Hotline: Contact local Human Service Center – Food assistance applications

Key Takeaways

• North Dakota has a unique single-AAA structure – the North Dakota Aging Services Division serves the entire state
• Statewide services are delivered through 8 regional Human Service Centers acting as focal points
• All services are free or low-cost for seniors 60+ and people with disabilities of any age
• No income requirements for basic information and assistance services
• Call 1-855-462-5465 to connect with the Aging and Disability Resource-LINK statewide
• SPED and Ex-SPED programs provide state-funded alternatives to Medicaid for home care
• Home and Community-Based Services (HCBS) waiver helps eligible North Dakotans receive care at home
• Strong emphasis on rural service delivery adapted to North Dakota’s geography and sparse population
• Consumer-directed services allow eligible individuals to hire and manage their own caregivers

What Are Area Agencies on Aging in North Dakota?

North Dakota operates differently from most states when it comes to aging services. Rather than having multiple independent Area Agencies on Aging (AAAs), North Dakota has been designated as a single planning and service area under the federal Older Americans Act. This means the entire state functions as one large AAA, with the North Dakota Aging Services Division serving as both the state agency and the area agency.

This centralized structure allows North Dakota to maintain consistent service standards across the state while adapting to the unique challenges of serving a largely rural population spread across 53 counties. The North Dakota Department of Health and Human Services Aging Services Division coordinates services for the state’s older adults and people with disabilities through a network of regional staff and local providers.

The single-AAA approach is particularly well-suited to North Dakota’s demographics and geography. With a small population (approximately 780,000 people) spread across a large geographic area, this centralized model allows resources to be allocated efficiently while ensuring that even the most remote areas receive services.

North Dakota’s Aging Services Division also functions as the state’s Aging and Disability Resource-LINK (ADRL), providing comprehensive information and assistance to people of all ages with disabilities, not just seniors. This “no wrong door” approach means you can contact the system for help regardless of your age or specific situation.

The eight regional Human Service Centers throughout North Dakota serve as focal points for aging services, providing local access to statewide programs while maintaining the efficiency of the centralized model.

North Dakota’s Regional Human Service Centers

Statewide Aging Services Division Contact:

• Address: 1237 W. Divide Ave., Suite 6, Bismarck, ND 58501
• Phone: (701) 328-4601
• Email: dhshcbs@nd.gov

Note: Always verify current contact information by calling the Aging and Disability Resource-LINK at 1-855-462-5465.

Core Services Provided by North Dakota Aging Services

Information and Assistance Through Aging and Disability Resource-LINK

The Aging and Disability Resource-LINK (ADRL) provides comprehensive information and assistance to help you navigate available services and understand your options. Trained specialists can help with:

• Explanation of programs and services available throughout North Dakota
• Long-term care planning and options counseling
• Eligibility requirements and application assistance for various programs
• Benefits counseling for Medicare, Medicaid, Social Security, and other programs
• Referrals to appropriate agencies and community resources
• Care transitions and discharge planning support
• Assistance connecting with local service providers

ADRL services are available to anyone who contacts the system, regardless of age, income, or disability status.

Nutrition Programs

North Dakota Aging Services coordinates nutrition programs designed to address food insecurity while promoting social engagement and health education throughout the state.

Congregate Meals: Nutritious meals served at senior centers, community centers, churches, and other gathering places in communities across North Dakota. These programs provide more than nutrition – they offer opportunities for socialization, health education, and information about other services. Suggested donations are typically $4-6 for participants 60+, but no one is denied meals for inability to contribute.

Home-Delivered Meals: For seniors who are homebound or have difficulty accessing congregate meal sites, North Dakota coordinates home-delivered meal programs. Volunteers and professional staff deliver meals directly to homes throughout the state, typically 1-5 days per week depending on need and geographic location.

Nutrition Education: Programs include nutrition counseling, cooking demonstrations, and education about managing chronic conditions through diet.

Special Rural Considerations: Due to North Dakota’s geography, meal delivery may involve significant travel distances, and some remote areas may receive frozen meals to ensure consistent nutrition access.

Transportation Services

Transportation is a critical challenge in North Dakota due to vast distances and limited public transit. Aging Services addresses transportation needs through various programs:

Medical Transportation: Priority transportation for medical appointments, dialysis, therapy, and other health-related trips. Services often involve long-distance transportation to regional medical centers, particularly for specialized care.

General Transportation: Scheduled transportation for essential activities like grocery shopping, banking, pharmacy visits, and social activities. Service frequency varies significantly based on geographic location and population density.

Volunteer Driver Programs: Extensive networks of volunteer drivers help bridge transportation gaps, especially for medical appointments requiring travel to Fargo, Bismarck, Grand Forks, or Minot.

Rural Innovation: North Dakota has developed creative transportation solutions including shared ride programs, medical escort services for long trips, and coordination with medical shuttle services.

Reality Check: Due to North Dakota’s geography, transportation often requires advance planning of several days to weeks, especially for specialized medical care. Winter weather can significantly impact service availability.

Legal Assistance

North Dakota Aging Services provides free legal assistance for seniors 60+ in civil matters that affect their health, safety, and economic well-being. Services are coordinated through Legal Services of North Dakota and include:

• Medicare and Medicaid problems and appeals
• Social Security benefit issues and disability claims
• Housing matters (landlord-tenant disputes, mobile home issues, property concerns)
• Consumer protection (scams, fraud, identity theft)
• Estate planning basics (wills, advance directives, powers of attorney)
• Family law issues affecting seniors (guardianship, elder abuse)
• Public benefit applications and appeals
• Agricultural law issues affecting farming families

Legal services are provided through a combination of staff attorneys, contracted legal aid, and volunteer lawyer programs adapted to serve North Dakota’s rural population.

Health Insurance Information and Counseling

North Dakota provides free, unbiased counseling to help Medicare beneficiaries understand their options and resolve problems through trained volunteer counselors. Services include:

• Medicare enrollment assistance and plan comparisons
• Medicare Supplement (Medigap) plan guidance
• Medicare Part D prescription drug plan selection
• Medicare Advantage plan reviews and annual open enrollment help
• Appeals assistance for denied claims and coverage disputes
• Help understanding Medicare statements and bills
• Assistance with Medicare fraud reporting and prevention

Counselors operate throughout North Dakota and receive extensive training to provide completely objective advice with no financial interest in insurance sales.

Case Management and Care Coordination

For individuals with complex needs, North Dakota Aging Services provides case management services to help coordinate multiple services and navigate the healthcare system. Case managers:

• Conduct comprehensive assessments of needs, goals, and preferences
• Develop individualized care plans with input from clients and families
• Connect individuals with appropriate services and benefits
• Monitor situations over time and adjust services as needs change
• Advocate on behalf of clients with service providers and agencies
• Coordinate with healthcare providers, family members, and informal caregivers
• Assist with care transitions between different levels of care

Family Caregiver Support

North Dakota operates comprehensive Family Caregiver Support Programs to assist family members caring for older adults or people with disabilities. Services include:

Information and Education: Training workshops on caregiving techniques, stress management, understanding chronic conditions, navigating healthcare systems, and planning for the future. Special attention is given to supporting caregivers in rural areas.

Support Groups and Counseling: Peer support groups and individual counseling to help caregivers cope with the emotional, physical, and financial challenges of caregiving. Some support groups meet virtually to accommodate geographic distances.

Respite Care: Temporary care services that give family caregivers breaks from their caregiving responsibilities. Options include in-home companions, adult day programs, and short-term residential care.

Supplemental Services: Limited funding for items and services not covered by other programs, such as assistive devices, home modifications, emergency response systems, or caregiver supplies.

North Dakota’s Home and Community-Based Services Programs

North Dakota offers several state-funded and Medicaid programs that help eligible individuals receive care at home instead of in nursing facilities.

Service Payments for the Elderly and Disabled (SPED)

SPED is a state-funded program that provides in-home and community-based services for older adults and people with physical disabilities who need assistance to remain safely in their homes.

Services Include:

• Personal care assistance
• Homemaker and chore services
• Adult day care
• Adult family foster care
• Emergency response systems
• Respite care for family caregivers
• Family home care

Eligibility Requirements:

• Must be 64 years or older (or have a physical disability)
• Must have liquid assets less than $50,000
• Must be impaired in at least 4 activities of daily living OR 5 instrumental activities of daily living
• Must demonstrate inability to pay for services privately
• No Medicaid eligibility required

Consumer Direction: SPED allows participants to hire and manage their own caregivers, including qualified family members.

Expanded Service Payments for the Elderly and Disabled (Ex-SPED)

Ex-SPED provides similar services to SPED but serves individuals who would otherwise require care in a licensed care facility.

Key Differences from SPED:

• No service fees for participants
• Serves individuals who meet institutional level of care criteria
• More comprehensive service package available
• Priority for individuals at immediate risk of nursing home placement

Home and Community-Based Services (HCBS) Medicaid Waiver

North Dakota’s HCBS waiver provides comprehensive services for individuals who require nursing facility level of care but prefer to live in the community.

Services Include:

• Service coordination and case management
• Personal care and home health aide services
• Adult day health programs
• Respite care services
• Environmental modifications and assistive technology
• Home-delivered meals
• Adult family foster care
• Assisted living services (in approved facilities)
• Transportation to medical appointments
• Personal emergency response systems

Eligibility Requirements:

• Must be North Dakota resident
• Must be Medicaid eligible
• Must require nursing facility level of care
• Must be able to live safely in the community with waiver services
• Income limit: $1,174/month for individuals (2025)
• Asset limit: $3,000 for individuals, $6,000 for couples

Waiting List: North Dakota’s HCBS waiver may have a waiting list, but the state reserves slots for emergency situations involving health and safety concerns.

Program of All-Inclusive Care for the Elderly (PACE)

PACE offers comprehensive health care and long-term services for individuals 55+ who require nursing facility level of care but wish to remain in the community.

Services Include:

• Primary and specialty medical care
• Prescription medications
• Home care services
• Adult day health programs
• Transportation to medical appointments
• Social services
• Rehabilitation services

Special Population Services

Rural and Frontier Seniors

North Dakota’s predominantly rural character requires specialized approaches to service delivery:

Rural-Specific Adaptations:

• Mobile service delivery teams bringing services directly to remote communities
• Extensive volunteer driver networks for long-distance medical transportation
• Telehealth and virtual service delivery options
• Coordination with Critical Access Hospitals and rural health clinics
• Seasonal service adaptations for harsh winter weather
• Regional coordination to maximize service efficiency across large territories

Frontier Challenges:

• Some counties have fewer than 2 people per square mile
• Limited broadband access in some areas affects telehealth options
• Provider recruitment and retention challenges
• Weather-related service disruptions
• Higher per-capita service delivery costs

Native American Seniors

North Dakota is home to five federally recognized tribes, and Aging Services works closely with tribal communities:

Tribal-Specific Services:

• Spirit Lake Nation Human Service Center provides culturally appropriate services
• Coordination with tribal aging programs on all reservations
• Cultural considerations in service delivery approaches
• Traditional foods incorporation in nutrition programs where possible
• Collaboration with Indian Health Service programs

Tribal Resources:

• Spirit Lake Tribe: (701) 766-4221
• Three Affiliated Tribes (Mandan, Hidatsa, Arikara): (701) 627-4781
• Turtle Mountain Band of Chippewa: (701) 477-2605
• Standing Rock Sioux Tribe: (701) 854-8500
• Sisseton-Wahpeton Oyate: (701) 256-5851

Veterans and Military Families

North Dakota has a significant veteran population, and Aging Services coordinates with the North Dakota Department of Veterans Affairs:

Veteran-Specific Services:

• Assistance applying for VA benefits and healthcare
• Transportation to VA medical facilities in Fargo and regional centers
• Help with VA pension and disability claims
• Connection to VA home and community-based services
• Support for military spouses and survivors

Key Resources:

• North Dakota Department of Veterans Affairs: (701) 328-8387
• Fargo VA Medical Center: (701) 232-3241
• Veterans Crisis Line: 988 (Press 1)
• County Veterans Service Officers throughout the state

Agricultural and Farming Families

North Dakota’s agricultural economy creates unique needs for aging farmers and ranchers:

Agricultural-Specific Considerations:

• Farm succession planning and estate issues
• Disability benefits for farming-related injuries
• Healthcare access for remote agricultural areas
• Seasonal service delivery considerations
• Assistance with agricultural safety modifications
• Support for farm family caregivers during busy seasons

Seniors with Limited English Proficiency

While North Dakota is predominantly English-speaking, Aging Services provides language assistance:

Language Support:

• Interpretation services available for major languages
• German and Norwegian interpretation reflecting historical immigration patterns
• Native American language considerations for tribal seniors
• Assistance coordinating with refugee resettlement language services

How to Access Services

Step 1: Contact the Aging and Disability Resource-LINK

Call 1-855-462-5465 to reach the statewide Aging and Disability Resource-LINK, or contact your regional Human Service Center directly using the contact information listed above.

Step 2: Initial Information Gathering and Screening

Trained specialists will conduct an initial screening to understand:

• Your current situation and immediate needs
• What type of assistance you’re seeking
• Your location and any accessibility needs
• Basic demographic and insurance information
• Whether you need urgent assistance or ongoing services
• Transportation and communication preferences

This conversation typically takes 15-25 minutes and helps staff determine the best way to assist you.

Step 3: Comprehensive Assessment (If Needed)

For ongoing services, waiver eligibility, or complex situations, you may need a comprehensive assessment. This assessment can be conducted:

• Over the phone for some services
• At your regional Human Service Center
• In your home if you’re homebound or live in a remote area
• Via telehealth technology when appropriate

Assessments evaluate your:

• Physical and cognitive abilities
• Safety and living situation
• Social support system and family involvement
• Financial resources and insurance coverage
• Service preferences and goals
• Transportation needs and geographic considerations

Step 4: Service Planning and Authorization

Based on your assessment, Aging Services staff will:

• Explain available services and programs throughout North Dakota
• Assist with benefit applications (Medicaid, Medicare, SNAP, etc.)
• Develop an individualized service plan with your input
• Make referrals to appropriate providers and agencies
• Help you choose providers when options are available
• Schedule ongoing services and follow-up appointments
• Coordinate with your healthcare team and family

Step 5: Ongoing Support and Care Coordination

North Dakota Aging Services provides continuing support through:

• Regular check-ins with case managers or care coordinators
• Annual reassessments for waiver program participants
• Assistance accessing new services as needs change
• Problem-solving and advocacy when issues arise with providers
• Care plan updates and service adjustments
• Support during care transitions (hospital to home, etc.)

Costs and Financial Assistance

Free Services

These services are available at no cost to participants:

• Information and assistance through ADRL and Human Service Centers
• Health insurance counseling and Medicare assistance
• Legal consultations and basic legal services
• Case management and care coordination
• Family caregiver support and education
• Adult protective services and elder abuse assistance

Low-Cost Services with Suggested Donations

These services typically have suggested donations but participants cannot be denied for inability to pay:

• Congregate meals ($4-6 suggested donation)
• Home-delivered meals ($4-7 suggested donation per meal)
• Transportation services ($3-8 suggested donation per trip depending on distance)

State-Funded Services (SPED/Ex-SPED)

SPED services may have minimal fees based on ability to pay, while Ex-SPED services are provided at no cost to participants. These programs serve as alternatives for individuals who don’t qualify for Medicaid but need assistance.

Insurance and Medicaid Coverage

Many services can be covered through:

• Medicaid HCBS waiver program
• Medicare (for medically necessary services)
• Private insurance plans
• Veterans benefits through VA
• PACE program for comprehensive care
• Other federal and state programs

Financial Reality: North Dakota’s rural geography means higher service delivery costs, which can affect service frequency and availability. However, the state has developed innovative funding approaches to ensure services reach even the most remote areas.

Quality Assurance and Your Rights

Program Standards

North Dakota Aging Services must meet federal and state standards for:

• Staff qualifications and ongoing training requirements
• Service quality and safety protocols
• Financial management and accountability
• Non-discrimination and civil rights compliance
• Confidentiality and privacy protections
• Cultural competency and rural service delivery
• Emergency preparedness and response

Oversight and Monitoring

Aging Services is monitored by:

• North Dakota Department of Health and Human Services
• Federal Administration for Community Living
• Independent auditors and quality assurance teams
• Consumer advisory councils and stakeholder groups
• North Dakota Legislative Assembly

Complaint Process

If you have concerns about Aging Services:

1. Talk to your service provider first – Many issues can be resolved quickly at the direct service level
2. Contact your regional Human Service Center supervisor – Each center has procedures for handling complaints
3. File a complaint with the Aging Services Division Director – Contact (701) 328-4601 for state-level review
4. Contact the Long-Term Care Ombudsman – Call 1-855-462-5465 for nursing home and assisted living complaints
5. File with state agencies – North Dakota Department of Health and Human Services handles serious violations

Your Rights as a Service Recipient

You have the right to:

• Be treated with dignity, respect, and cultural sensitivity
• Receive services without discrimination
• Have your personal information kept confidential
• Participate in decisions about your care and services
• Be informed about available services and eligibility requirements
• File complaints without fear of retaliation
• Receive services that meet professional standards
• Access interpretation services when needed
• Receive services in the least restrictive environment possible

Geographic Service Considerations

Frequently Asked Questions (FAQs)

How does North Dakota’s single-AAA system compare to states with multiple AAAs?

North Dakota’s centralized approach allows for consistent statewide standards and efficient resource allocation across a largely rural state. Unlike states with multiple AAAs that may have varying service levels, North Dakota can ensure equitable access regardless of where you live. However, this means less local control compared to states where each AAA adapts to very specific community needs.

What makes SPED and Ex-SPED programs unique to North Dakota?

SPED and Ex-SPED are state-funded alternatives to Medicaid that allow North Dakota to serve individuals who don’t qualify for Medicaid but still need assistance. These programs offer consumer direction, allowing participants to hire their own caregivers including family members. This is particularly valuable in rural areas where formal providers may be limited.

How does the vast geography of North Dakota affect service delivery?

North Dakota’s 70,000+ square miles and sparse population require creative solutions. Services may involve significant travel times, weather-related delays, and higher costs. The state compensates through volunteer driver programs, mobile service teams, telehealth options, and regional coordination to maximize efficiency while ensuring even remote areas receive services.

Can I hire my family members to provide my care?

Yes, through SPED, Ex-SPED, and HCBS waiver programs, North Dakota allows consumer direction where eligible individuals can hire and manage their own caregivers, including qualified family members (with some restrictions). This is particularly beneficial in rural areas where formal providers may be limited.

What happens during North Dakota’s harsh winters?

North Dakota has developed winter service protocols including emergency stockpiling of supplies, weather contingency plans, priority service lists for vulnerable individuals, coordination with emergency management, and alternative service delivery methods. Some services may be delayed, but emergency needs are prioritized.

Are there waiting lists for services in North Dakota?

Most Older Americans Act services don’t have waiting lists, but the HCBS Medicaid waiver may have limited slots and waiting periods. However, North Dakota reserves emergency slots for individuals in immediate health and safety danger. SPED and Ex-SPED programs typically don’t have waiting lists as they’re state-funded alternatives.

How do services work for farmers and ranchers in remote areas?

North Dakota understands agricultural lifestyles and offers flexible service delivery including mobile teams, seasonal service adjustments, coordination with agricultural extension services, farm-specific safety modifications, and understanding of farming income fluctuations for benefit determinations.

What if I need to travel long distances for medical care?

North Dakota has extensive volunteer driver programs and medical transportation services specifically designed for long-distance trips to regional medical centers. Some programs provide overnight accommodation assistance for medical trips requiring extended stays. Veterans may have access to special VA transportation programs.

Can I receive services if I live on tribal land?

Yes, North Dakota coordinates with all five federally recognized tribes to provide services on reservations. The Spirit Lake Nation has its own Human Service Center, and other tribal areas are served through coordination between state and tribal programs, ensuring culturally appropriate service delivery.

How does North Dakota’s oil boom affect aging services?

The western North Dakota oil development has created both opportunities and challenges. Higher incomes in some areas affect benefit eligibility, housing costs have increased, and rapid population changes stress service systems. However, increased tax revenues have also allowed for enhanced transportation and service infrastructure improvements.

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Disclaimer

Program details, contact information, and services can change without advance notice. While this guide uses the most current available information as of January 2026, we strongly recommend verifying all details directly with the North Dakota Aging and Disability Resource-LINK or your regional Human Service Center before making decisions or applying for services.

This guide is for informational purposes only and does not constitute professional legal, medical, or financial advice. Always consult with qualified professionals for advice specific to your situation.

For the most current information, contact:

• North Dakota Aging and Disability Resource-LINK: 1-855-462-5465
• TTY: 711
• Email: carechoice@nd.gov
• Your regional Human Service Center

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About This Guide

Researched and Compiled by Grants for Seniors

This guide has been carefully researched using publicly available government resources and official program websites. We systematically review federal and state program information to create comprehensive, accurate guides for older Americans seeking grant opportunities.

Our Sources: All information comes from official sources including federal agency websites (HHS, ACL, CMS), North Dakota state government departments, official program documentation, and verified nonprofit organization resources.

Verification Process: Each program listing undergoes thorough online verification by cross-referencing information across multiple official sources, checking current program status, verifying contact information, and confirming eligibility requirements and deadlines.

Information Currency:
• Last Updated: January 2026
• Sources Verified: January 2026
• Next Review: April 2026

Important Note: Government programs can change without advance notice. While this guide uses the most current available information, we strongly recommend verifying all details directly with program administrators before applying.

Found an Error? If you discover outdated information or additional programs that should be included, please contact us at info@grantsforseniors.org.

Disclaimer: This guide is for informational purposes only and does not constitute professional advice. Always confirm program details with official sources before applying.

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This resource is independently researched to help seniors access available financial assistance programs.