Updated September 4, 2026. Quick answer: yes, through Consumer-Directed (CD) Services under the CCC Plus, Community Living, and Family and Individual Supports Waivers. Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How Virginia pays a family caregiver
| Program | Consumer-Directed (CD) Services under the CCC Plus, Community Living, and Family and Individual Supports Waivers |
|---|---|
| Can a family member be paid? | Yes. “Consumer-directed (CD) services is a model of service delivery that empowers the member receiving services to employ an attendant to provide care. The member or their designated representative performs all of the employer responsibilities including hiring, training, managing, and if necessary, terminating the attendant.” |
| Can a spouse be paid? | Yes. “Reimbursement may be made to LRIs for up to 40 hours per week.” |
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
$17.97/hour (NOVA region) or $13.88/hour (Rest of State region), effective July 1, 2025. “S5126 | Personal Care | NOVA | $17.97 … S5126 | Personal Care | ROS | $13.88”
How it works
Virginia Medicaid, administered by DMAS, lets a CCC Plus, Community Living, or FIS waiver member self-direct personal care by employing their own attendant, with a Services Facilitator agency helping the member learn employer duties. As of July 1, 2025, DMAS permanently allows a spouse or a parent of a minor (a legally responsible individual, LRI) to be that paid attendant, but only for extraordinary, above-and-beyond ADL care, documented in person-centered planning and capped at 40 hours per week; ordinary IADL help and supervision do not count.
What this doesn’t answer
The DMAS Consumer-Directed Services page itself does not spell out, in so many words, that non-spouse relatives may be hired; that is inferred from the fact that DMAS singles out spouses and parents of minors for special extraordinary-care restrictions, implying other relatives are not subject to that restriction. A separate legislative budget action proposes a further personal care rate increase effective July 1, 2026, which was not yet confirmed as finalized in the source reviewed.
Sources
- Virginia DMAS: Legally Responsible Individuals (LRIs) program page
- Virginia DMAS: Consumer Directed Services program page
- Virginia DMAS Medicaid Expansion Site (MES): Personal Care Rate Updates Effective July 1, 2025 bulletin
Read September 4, 2026.
Same question, other states: Washington · West Virginia.
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.