Updated September 3, 2026. Quick answer: yes, through Participant Direction Option (PDO), within the Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) Program. Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How Florida pays a family caregiver
| Program | Participant Direction Option (PDO), within the Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) Program |
|---|---|
| Can a family member be paid? | Yes. “Participants may hire any individual of their choosing to provide their PDO services, including neighbors, family members, or friends.” |
| Can a spouse be paid? | Yes. “Providers may include a Consumer’s neighbor, friend, spouse, or relative [s. 409.221 (4)(f), F.S.].” |
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
Request PDO through your managed care plan’s case manager, who screens you, and you (or a Representative, who cannot also be a paid worker) become the employer of your chosen direct service worker with a Fiscal/Employer Agent handling payroll.
What this doesn’t answer
The spousal-eligibility quote comes from a related developmental-disabilities program handbook (CDC+), not the SMMC LTC PDO manual itself, which uses only “family members” and never the word “spouse”, so the spousal answer is carried from an adjacent Florida self-direction program rather than the PDO manual directly. No statewide published hourly rate was found. The official PDO Guidelines template says rates are inserted per participant/plan, confirming they are not published centrally.
Sources
- Florida Administrative Code (flrules.org), rule 59G-13.088: CDC+ Program Handbook
- AHCA: SMMC LTC Participant Direction Option (PDO) Manual, May 2022
- AHCA: SMMC LTC PDO Guidelines template, May 2022
Read September 3, 2026.
Same question, other states: Georgia · Hawaii.
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.