TiinaA little help for family caregivers

FOR FAMILY CAREGIVERS

Can you get paid to care for your parent?

Often, yes: if your parent has Medicaid and needs help with everyday tasks, many states will pay a family member to give that help. Here’s how it works, what your parent’s state offers, and who to call.

How it works

  1. Your parent has Medicaid. If they don’t yet, they can apply through the state Medicaid office. There are limits on income and savings.
  2. They need help with everyday tasks, like bathing, dressing, meals or getting around. A nurse or caseworker usually does an assessment to confirm it and decide how many hours of help they get.
  3. Ask for the option that lets your parent choose their caregiver. States call it self-directed, consumer-directed or participant-directed care, or structured family caregiving.
  4. If your parent is approved, and you’re approved as their caregiver, the program pays you. Expect paperwork, a background check and sometimes training. Some programs pay by the hour and others a daily rate, usually through a payroll company the state works with.

Your parent’s state

ALABAMA

Personal Choices (self-directed services for Home and Community-Based Waiver participants)

Your parent can use a self-directed budget to hire someone to help with their care. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

ALASKA

Personal Care Services (PCS), Consumer-Directed PCS Program

Your parent can choose, hire and supervise their own personal care assistant. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

ARIZONA

ALTCS Direct Care Services (family members as paid caregivers)

If your parent is in the Arizona Long Term Care System, an adult child can be a paid direct care worker.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

ARKANSAS

ARChoices in Homecare waiver

Your parent can have a relative paid for ARChoices services, but not a spouse, legal guardian or someone with power of attorney over their care.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

COLORADO

In-Home Support Services (IHSS)

Your parent can choose and supervise their own attendants, including family members, through In-Home Support Services.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

CONNECTICUT

Community First Choice (CFC)

Your parent can hire certain family members and friends as paid staff through Community First Choice. Some family members are excluded.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

DELAWARE

Attendant Services Program (self-directed)

Your parent can choose and manage their own in-home caregiver. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

DISTRICT OF COLUMBIA

Elderly and Persons with Physical Disabilities (EPD) Waiver, Services My Way

If your parent is approved for the EPD Waiver, they can ask for Services My Way so their child or a friend can be paid to provide care.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

FLORIDA

Statewide Medicaid Managed Care Long-Term Care, Participant Direction Option

Your parent can hire a family member, neighbor or friend of their choosing through the Participant Direction Option in long-term care Medicaid.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

GEORGIA

Structured Family Caregiving (Medicaid waiver)

Some Georgia programs, like Structured Family Caregiving, pay a family member who provides care. What's offered varies by area.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

HAWAII

Ask about paid family care

Ask the Area Agency on Aging whether your parent’s Medicaid coverage can pay a family member to help. The other options further down this page may also help.

Who to call: your parent’s local Area Agency on Aging can tell you what help is available. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

IDAHO

Ask about paid family care

Ask the Area Agency on Aging whether your parent’s Medicaid coverage can pay a family member to help. The other options further down this page may also help.

Who to call: your parent’s local Area Agency on Aging can tell you what help is available. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

ILLINOIS

Community Care Program, In-Home Service

Some In-Home Service agencies may hire a family member as your parent's paid aide after a background check and training. Each agency decides.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

INDIANA

Attendant Care (PathWays for Aging and Health & Wellness waivers)

Your parent can have a relative paid for attendant care. Since July 2024 a spouse cannot be paid for it.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

IOWA

Ask about paid family care

Ask the Area Agency on Aging whether your parent’s Medicaid coverage can pay a family member to help. Ask specifically about the Consumer Choices Option, Iowa Medicaid’s self-directed option. The other options further down this page may also help.

Who to call: your parent’s local Area Agency on Aging can tell you what help is available. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

KANSAS

Frail Elderly (FE) Waiver, Attendant Care

Your parent can choose a family member to provide their attendant care, but not a spouse or someone appointed to represent them.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

KENTUCKY

Home and Community Based (HCB) Waiver, Participant Directed Services

Your parent can hire a qualified family member as a paid worker. A spouse can be paid only in special circumstances.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

LOUISIANA

Community Choices Waiver, Self-Direction

Your parent can hire their own paid aide through self-direction. Ask when you call whether an adult child can be paid in this program.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MAINE

MaineCare Consumer Directed Attendant Services (Section 12)

Your parent may be able to hire and direct their own attendant. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MARYLAND

Community First Choice

Your parent can direct their own personal assistance worker. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MASSACHUSETTS

MassHealth Adult Foster Care

Pays a live-in caregiver for your parent. The caregiver can be a family member, other than a spouse or legal guardian.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MINNESOTA

Community First Services and Supports (CFSS)

Your parent can hire and direct their own support workers, and Minnesota law allows paying a spouse in this program. Ask when you call whether an adult child can be paid.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MISSISSIPPI

Elderly and Disabled (E&D) Waiver, paid relatives

Medicaid may pay a relative, other than a spouse or guardian, to help your parent when state criteria are met.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MISSOURI

Consumer Directed Services (CDS)

Your parent can hire anyone they choose, except a legal spouse or guardian, as their paid caregiver.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

MONTANA

Community First Choice Services / Personal Care Services, self-directed

Your parent can hire and manage their own aide, and adult children may be eligible to be paid.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NEBRASKA

Aged and Disabled (AD) Waiver, Personal Care

Your parent can have a relative paid to provide personal care. Rules for a spouse are different.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NEVADA

Self Directed Personal Care Services (Intermediary Services Organization)

Your parent can self-direct their own personal care services. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NEW HAMPSHIRE

Choices for Independence waiver, Participant Directed and Managed Services (PDMS)

Your parent can design their own services and choose their providers. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NEW MEXICO

Community Benefit Personal Care Services, paid family caregivers

Your parent can have a family member or friend paid as their personal care aide, if they qualify for personal care services.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NEW YORK

Consumer Directed Personal Assistance Program (CDPAP)

Your parent can choose a family member to be their paid aide, but not a spouse or their designated representative.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NORTH CAROLINA

Community Alternatives Program for Disabled Adults (CAP/DA), consumer-directed in-home aide

Your parent can hire a family member, including an adult child, as a paid in-home aide.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

NORTH DAKOTA

Family Personal Care (ND Health and Human Services HCBS)

Your parent can have a qualified relative, including an adult child, paid to provide their personal care.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

OHIO

PASSPORT participant direction (Choices Home Care Attendant / Consumer-Directed Personal Care)

Your parent can hire a family member as a paid aide. A spouse or a legal representative relative needs extra approval.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

OKLAHOMA

ADvantage Waiver, Consumer-Directed Personal Assistance Services and Supports (CD-PASS)

Your parent can hire some family members as paid aides, but generally not a spouse, legal guardian, or power of attorney.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

OREGON

Independent Choices Program (Medicaid long-term services and supports)

Your parent can hire who they want, including a spouse or other family members, and pay them from a monthly cash benefit.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

PENNSYLVANIA

Community HealthChoices participant-directed personal assistance (Services My Way, common law employer model)

Your parent can hire a family member or friend as a paid aide.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

RHODE ISLAND

Personal Choice Program (self-directed Medicaid LTSS)

Your parent can choose who provides their care. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

SOUTH CAROLINA

Community Choices Waiver: Attendant Care (Self-Directed)

Your parent can hire their own attendant, who may be a relative within the state's family caregiver limits.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

SOUTH DAKOTA

Structured Family Caregiving (HOPE waiver)

Pays a small stipend to a family member who provides substantial care for your parent, who must qualify for the HOPE waiver.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

TENNESSEE

CHOICES Consumer Direction (TennCare)

Your parent can hire family members, friends or neighbors through Consumer Direction. Some limits apply, so ask what they are when you call.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

TEXAS

Consumer Directed Services (CDS) option in Texas Medicaid programs

Your parent can hire and manage their own paid aides. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

UTAH

Aging Waiver: Personal Attendant Services, self-directed

Your parent can choose a family member or friend to provide their self-directed personal attendant services.

The state’s page about it (PDF)

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

VERMONT

Choices for Care: Flexible Choices (participant or surrogate-directed employees)

Your parent can hire and manage their own paid workers. Ask when you call whether an adult child can be paid in this program.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

VIRGINIA

CCC Plus Waiver: consumer-directed personal care

Your parent can hire an attendant, and approved family members can be paid if they meet the same qualifications as other aides.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

WASHINGTON

Paid Family Caregiver (Individual Provider through Consumer Direct Care Network Washington)

Your parent can have a family member as a paid caregiver if your parent qualifies for Medicaid long-term services and supports.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

WEST VIRGINIA

Aged and Disabled Waiver (ADW) with Personal Options self-direction

Your parent can hire friends or family members as their own employees, but not a spouse, legal guardian or legal representative.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

WISCONSIN

IRIS (Include, Respect, I Self-Direct)

Your parent can choose their own workers, including a family member, and manage them within a budget.

The state’s page about it

Family Care (self-directed supports option)

Your parent can self-direct part of their services and choose a family member as a worker.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

WYOMING

Community Choices Waiver: participant-directed services

Your parent can direct their own paid workers. A relative can be hired only if the state's waiver approval allows it.

The state’s page about it

Who to call: your parent’s local Area Agency on Aging can tell you about this program and help you start. Find it by calling 1-800-677-1116 (call or text) or at eldercare.acl.gov.

What to ask when you call

Have this ready

If your parent isn’t on Medicaid

If your parent is a veteran

If the veteran has a VA disability rating of 70% or higher and needs ongoing personal care, the VA’s Program of Comprehensive Assistance for Family Caregivers may pay an eligible family caregiver a monthly stipend. Call the VA Caregiver Support Line at 1-855-260-3274, weekdays 8 am to 8 pm Eastern.

The VA’s page about it

If they have long-term care insurance

Some policies pay for care at home, and some will pay a family member. Check the policy or call the insurer and ask.

A written caregiver agreement

Your parent can pay you from their own money under a written agreement. An elder law attorney can help you check how the agreement and payments may affect Medicaid eligibility later.

Help that isn’t pay

The Area Agency on Aging can also connect you with respite care, so you can take a break, and with caregiver support programs near your parent.

If your parent has dementia

For people on Original Medicare with a dementia diagnosis, Medicare’s GUIDE program may pay for care planning, a support line and some respite care, so you can take a break.

Programs and rules change, so check with your parent’s state before you decide. This is general information, not legal or financial advice.