States that pay family caregivers
For each state and DC: can an adult child be paid, can a spouse be paid, the main program, the intake phone and the official source we checked.
Adult child can be paid: 34 confirmed yes, 11 reported yes, 0 limited cases. 6 states are not yet confirmed.
How to read this table
How to read this: Yes (confirmed) means we found it in the state's official rule, handbook or program page. Reported yes means an official summary describes it, but we haven't found it in the rule text itself, so confirm with your state. Not yet confirmed means we haven't confirmed the answer on an official source yet. In most states the rules for paying a spouse are different from the rules for paying an adult child, so check both columns.
Table last checked: (each row shows its own date). Rules change. Confirm with your state before you act.
โ Yes r Reported ~ Limited ? Not yet confirmed
The table
| State | Adult child paid? | Spouse paid? | Main program | Intake phone | Official source | Last checked |
|---|---|---|---|---|---|---|
| Alabama | Yes (confirmed) | Not confirmed | Personal Choices (self-directed option) | 1-877-425-2243 | Alabama Medicaid โ Personal Choices | |
| Alaska | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| Arizona | Yes (confirmed) | Limited cases (confirmed) | ALTCS โ Spouse as Paid Caregiver (attendant care) | โ | AHCCCS โ Policy 1320-A Self-Directed Attendant Care | |
| Arkansas | Yes (confirmed) | No (confirmed) | IndependentChoices (self-directed personal care) | โ | Arkansas DHS โ Self-Direction/IndependentChoices | |
| California | Yes (confirmed) | Limited cases (confirmed) | In-Home Supportive Services (IHSS) | โ | CDSS โ Apply for IHSS | |
| Colorado | Yes (confirmed) | Limited cases (confirmed) | Consumer-Directed Attendant Support Services (CDASS) | โ | HCPF โ In-Home Support Services | |
| Connecticut | Yes (confirmed) | No (confirmed) | Connecticut Home Care Program for Elders (CHCPE) | โ | CT DSS โ Connecticut Home Care Program for Elders | |
| Delaware | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| District of Columbia | Yes (confirmed) | No (confirmed) | EPD Waiver โ Services My Way (participant-directed) | โ | DHCF โ EPD Waiver Services | |
| Florida | Yes (confirmed) | Not confirmed | Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) โ Participant Direction Option (PDO) | 800-963-5337 | FL Elder Affairs โ Caregiving | |
| Georgia | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| Hawaii | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| Idaho | Yes (confirmed) | No (confirmed) | Personal Care Services and Aged & Disabled (A&D) Waiver | โ | IDHW โ Long-term care provider enrollment and general information | |
| Illinois | Reported yes | Limited cases (confirmed) | Home Services Program (HSP) | โ | IDHS โ HSP customer handbook | |
| Indiana | Reported yes | Yes (confirmed) | Structured Family Caregiving (SFC) | โ | FSSA โ ATTC and SFC relationship guidance | |
| Iowa | Yes (confirmed) | No (confirmed) | Consumer Choices Option (CCO) | 1-800-338-8366 | Iowa HHS โ Consumer Choice Option | |
| Kansas | Yes (confirmed) | Limited cases (confirmed) | Frail Elderly (FE) waiver โ self-directed Attendant Care Services | โ | KDADS โ Frail Elderly (FE) waiver page and FAQ | |
| Kentucky | Reported yes | Limited cases (confirmed) | Participant Directed Services (PDS) | โ | CHFS โ PDS FAQ (June 2024) | |
| Louisiana | Reported yes | Limited cases (confirmed) | Community Choices Waiver โ self-direction | โ | LDH โ Community Choices Waiver self-direction employer handbook | |
| Maine | Reported yes | Limited cases (confirmed) | MaineCare Section 19 โ Home and Community Benefits for the Elderly and Adults with Disabilities | โ | Maine DHHS โ Section 19 rule adoption notice | |
| Maryland | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| Massachusetts | Yes (confirmed) | No (confirmed) | MassHealth Personal Care Attendant (PCA) program | โ | MassHealth โ 130 CMR 422.000 PCA regulations | |
| Michigan | Yes (confirmed) | No (confirmed) | Home Help Program | โ | MDHHS โ Home Help client handbook (Pub-1733) | |
| Minnesota | Reported yes | Yes (confirmed) | Personal Care Assistance (PCA) / Community First Services and Supports (CFSS) | โ | MN DHS โ bulletin: spouses and parents of minors can be paid PCA/CFSS workers | |
| Mississippi | Yes (confirmed) | No (confirmed) | Elderly and Disabled (E&D) Waiver โ relatives as direct care workers | 800-421-2408 | Miss. Admin. Code Title 23, Part 208 (HCBS E&D Waiver rules) | |
| Missouri | Yes (confirmed) | No (confirmed) | Consumer-Directed Services (CDS) โ Personal Care Assistance | โ | MO DHSS โ Personal Care Assistance (CDS model) | |
| Montana | Yes (confirmed) | Limited cases (confirmed) | Community First Choice / Personal Care โ self-directed | โ | DPHHS โ Accessing Community First Choice Services | |
| Nebraska | Yes (confirmed) | Limited cases (confirmed) | Aged and Disabled (AD) Waiver โ LRI Personal Care | โ | NE DHHS โ LRI Personal Care and Extraordinary Care resource | |
| Nevada | Yes (confirmed) | Reported no | Medicaid Personal Care Services โ self-directed (Intermediary Service Organization) | โ | Nevada Medicaid โ Family Caregivers Technical Bulletin 23-002 | |
| New Hampshire | Yes (confirmed) | No (confirmed) | Choices for Independence (CFI) โ Participant Directed and Managed Services (PDMS) | โ | NH DHHS โ He-E 801 Choices for Independence rule | |
| New Jersey | Yes (confirmed) | Yes (confirmed) | Personal Preference Program (PPP) | โ | NJ DMAHS โ Personal Preference Program | |
| New Mexico | Yes (confirmed) | Reported yes | Community Benefit / Self-Directed Community Benefit (SDCB) | โ | NM HCA โ Family paid caregivers in the Community Benefit (explainer) | |
| New York | Yes (confirmed) | No (confirmed) | Consumer Directed Personal Assistance Program (CDPAP) | 1-833-247-5346 | NY DOH โ CDPAP | |
| North Carolina | Yes (confirmed) | Limited cases (confirmed) | Community Alternatives Program for Disabled Adults (CAP/DA) โ consumer-directed option | โ | NC Medicaid โ CAP/DA | |
| North Dakota | Yes (confirmed) | Yes (confirmed) | Family Personal Care (Qualified Service Provider) | โ | ND HHS โ Family Personal Care policy 525-05-30-32 | |
| Ohio | Yes (confirmed) | Limited cases (confirmed) | PASSPORT Waiver โ Participant Direction (Choices Home Care Attendant Service and Consumer-Directed Personal Care Service) | 1-866-243-5678 | Ohio Admin. Code 5160-44-32 (provider relationships, spouses, parents) | |
| Oklahoma | Reported yes | Limited cases (confirmed) | ADvantage Waiver โ CD-PASS (Consumer-Directed Personal Assistance Services and Supports) | โ | OKDHS โ CD-PASS service option | |
| Oregon | Yes (confirmed) | Reported yes | Medicaid in-home services โ homecare workers | โ | ODHS โ Spousal Pay worker guide | |
| Pennsylvania | Yes (confirmed) | No (confirmed) | Community HealthChoices (CHC) โ participant-directed services | 1-877-550-4227 | PA DHS โ CHC 1915(c) Appendix C (payment to relatives, 2026) | |
| Rhode Island | Reported yes | No (confirmed) | Personal Choice Program | โ | RI EOHHS โ Personal Choice Program | |
| South Carolina | Not yet confirmed | Not yet confirmed | Not yet confirmed | โ | โ | |
| South Dakota | Yes (confirmed) | Reported yes | HOPE Waiver โ Structured Family Caregiving | โ | SD DHS โ Paid Family Caregiver | |
| Tennessee | Yes (confirmed) | Reported no | TennCare CHOICES โ Consumer Direction | โ | TennCare โ CHOICES | |
| Texas | Yes (confirmed) | No (confirmed) | STAR+PLUS / STAR+PLUS HCBS โ Consumer Directed Services (CDS) option | 2-1-1 | TX HHS โ STAR+PLUS Handbook 8200 CDS | |
| Utah | Reported yes | Limited cases (confirmed) | New Choices Waiver โ self-administered services | โ | Utah DHHS โ New Choices Waiver provider manual | |
| Vermont | Reported yes | Limited cases (confirmed) | Choices for Care โ self-directed and Flexible Choices | โ | DAIL โ Choices for Care manual | |
| Virginia | Reported yes | Limited cases (confirmed) | CCC Plus Waiver โ consumer-directed personal care | โ | DMAS โ Legally Responsible Individuals | |
| Washington | Yes (confirmed) | Reported no | Medicaid in-home care โ Individual Provider (IP) | โ | DSHS โ Becoming a Paid Caregiver | |
| West Virginia | Yes (confirmed) | No (confirmed) | Aged and Disabled Waiver โ Personal Options | โ | WV Aged and Disabled Waiver Program | |
| Wisconsin | Yes (confirmed) | Reported yes | IRIS (Include, Respect, I Self-Direct) | โ | WI DHS โ IRIS Program Overview | |
| Wyoming | Yes (confirmed) | Reported yes | Community Choices Waiver โ participant direction | โ | WDH โ Participant-Direction |
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