Updated September 3, 2026. Quick answer: yes, through In-Home Supportive Services (IHSS). Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How California pays a family caregiver
| Program | In-Home Supportive Services (IHSS) |
|---|---|
| Can a family member be paid? | Yes. “If you are approved for IHSS, you must hire someone (your individual provider) to perform the authorized services.” |
| Can a spouse be paid? | Yes. “This determines which program is appropriate, the Personal Care Services Program (PCSP), which prohibits a recipient’s spouse from acting as the provider, or the IHSS Plus Waiver (IPW), which does not.” |
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
Apply through your county IHSS office (form SOC 295); a county social worker assesses need and determines the applicable sub-program, and under the IHSS Plus Waiver/”Able and Available Spouse” rules a spouse may be the paid individual provider, subject to conditions in MPP Section 30-763.41.
What this doesn’t answer
A primary CDSS document listing current statewide or county-specific dollar wage figures was not directly opened this session (the CDSS wage-rates page links to a spreadsheet that wasn’t opened directly), so the rate is carried as unverified rather than the commonly-cited secondary figures. The exact current sub-program label for the spousal exception was not re-confirmed against a newer primary source than a 2009 All-County Letter.
Sources
- California Department of Social Services: All-County Letter No. 09-30 (June 30, 2009), Phase One IHSS Social Worker Training Q&A
- California Department of Social Services: In-Home Supportive Services (IHSS) Program overview page
- California Department of Social Services: County IHSS Wage Rates page
Read September 3, 2026.
Same question, other states: Colorado · Connecticut.
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.