Updated September 3, 2026. Quick answer: yes, through Community First Services and Supports (CFSS) and Consumer Directed Community Supports (CDCS). Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How Minnesota pays a family caregiver
| Program | Community First Services and Supports (CFSS) and Consumer Directed Community Supports (CDCS) |
|---|---|
| Can a family member be paid? | Yes. “A spouse or parent of a minor can be paid to help their spouse or child with tasks beyond what is considered ordinary responsibility.” |
| Can a spouse be paid? | Yes. “Parents of minors, Stepparents of minors, Legal guardians of minors, Spouses [can serve as paid caregivers, effective Oct. 1, 2024]” |
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
$6.22 per 15-minute unit (about $24.88/hour) base rate for CFSS 1:1 personal-assistance services, effective 04/01/2026. “CFSS, Agency, 1:1 | 15 Minutes | T1019 U9 | $6.22 [Rate 04/01/2026]”
How it works
A person applies through their county/tribal nation case manager for a Medical Assistance disability/aging waiver assessment, then chooses either CDCS or CFSS; under the self-directed models the participant is the employer of record and must enroll with a Financial Management Service to handle payroll, with a family worker (including a spouse or parent of a minor, since Oct. 1, 2024) subject to a required background check and semiannual review.
What this doesn’t answer
Persistent anti-scraping protection blocked direct access to the CDCS-specific manual page on paying a spouse/parent of a minor, so the CDCS-specific spousal exception language (as distinct from the PCA/CFSS page independently opened) is not independently confirmed this session. Current enrollment-cap/waitlist status for CDCS, CFSS, or the underlying HCBS waivers was not verified.
Sources
- Minnesota DHS bulletin: spouses and parents of minors as paid PCA/CFSS workers, effective Oct. 1, 2024
- Minnesota DHS DHS-3945-ENG: Long-Term Services and Supports Service Rate Limits, effective 04/01/2026
Read September 3, 2026.
Same question, other states: Mississippi · Missouri.
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.