Updated September 3, 2026. Quick answer: yes, through Self-Directed Attendant Care (SDAC), part of Diamond State Health Plan Plus (DSHP Plus) Long-Term Services and Supports. Most adult family members can be hired and paid to provide the care. Whether a spouse specifically qualifies is not clearly stated in the materials reviewed this session.
How Delaware pays a family caregiver
| Program | Self-Directed Attendant Care (SDAC), part of Diamond State Health Plan Plus (DSHP Plus) Long-Term Services and Supports |
|---|---|
| Can a family member be paid? | Yes. “You can pay a family member or friend to give self-directed care but you cannot pay your Employer Representative to give your care.” |
| Can a spouse be paid? | Not clearly addressed in the materials reviewed this session. |
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
Enrollees in DSHP Plus LTSS talk to their managed-care-plan Case Manager about switching to Self-Directed Attendant Care; the member (or an Employer Representative, who cannot be the paid caregiver) becomes the employer of record for a chosen Attendant Care Employee, and the plan’s vendor runs payroll.
What this doesn’t answer
The only official document located that squarely answers the family-hire question is a state-contracted MCO LTSS member handbook that never uses the word “spouse,” so spousal eligibility specifically is Unclear rather than confirmed either way. Several DHSS pages that formerly answered this directly returned 404 this session, and no current published SDAC hourly rate was found on an official source.
Sources
Read September 3, 2026.
Same question, other states: Florida · Georgia.
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.