Updated September 4, 2026. Quick answer: yes, through Consumer-Directed Personal Care Service (CD-PCS) and Choices Home Care Attendant Service (C-HCAS). Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How Ohio pays a family caregiver
| Program | Consumer-Directed Personal Care Service (CD-PCS) and Choices Home Care Attendant Service (C-HCAS) |
|---|---|
| Can a family member be paid? | Yes. “There is no other willing and able provider or direct care worker available to provide the HCBS waiver services” |
| Can a spouse be paid? | Yes. “There is no other willing and able provider or direct care worker available to provide the HCBS waiver services” |
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
Ohio Medicaid’s HCBS waivers offer participant-directed options (CD-PCS and C-HCAS) run with a Financial Management Service, letting a participant hire and directly manage a caregiver, including many relatives. A spouse or the parent of a minor child is treated as a legal representative under Ohio Administrative Code 5160–44–32 and can only be the paid direct care worker if there is no other willing and able provider available, the state confirms health and safety needs can still be ensured, and the person works through an agency provider or an FMS, with hours generally capped at 40 per week.
What this doesn’t answer
The Ohio Department of Aging’s individual-provider certification page and a current rate sheet could not be reached (404 errors), so the hourly pay rate is unverified. Confirmation that ordinary, non-legally-responsible relatives can be hired without the extra restrictions came from secondary program-summary pages rather than a primary ODM/ODA page read directly this session, though it is consistent with how OAC 5160–44–32’s restrictions are written to apply only to legal representatives.
Sources
Read September 4, 2026.
Same question, other states: Oklahoma · Oregon.
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.