Paying family caregivers

Programs that let family members be paid to give care, often through Medicaid self-directed services.

3 states and 6 rows on record · updated Oct 15, 2026

Where it stands

Each state is shaded by the furthest stage of any row in this topic.

Federal: in effect or in use.

When it happened

One dot per dated event, or per row date where no events are recorded, shaded by stage. Every row has a date.

State by state

Federal first, then states A to Z. Open a line for its rows and sources.

Jurisdiction	Status	Key detail	Date
JurisdictionFederal	StatusIn effect or in use	Key detail CMS Medicaid HCBS authorities guidanceShow details and sources CMS Medicaid HCBS authorities guidanceActive, Implementation Jul 4, 2026 CMS's HCBS authorities page explains that states have several Medicaid HCBS options, including 1915(c) waivers, 1915(i) state plan HCBS, 1915(j) self-directed personal assistance services, and 1915(k) Community First Choice. CMS's HCBS quality page connects those authorities to quality measurement and quality-improvement work. Who it affects: Medicaid HCBS beneficiaries, family caregivers, disabled people, older adults, state Medicaid agencies Why it matters: A caregiver-facing corpus needs one federal guidance anchor that distinguishes the Medicaid authorities behind state waiver, self-direction, and community-first-choice pathways without turning the row into eligibility advice. CMS Medicaid HCBS authorities CMS HCBS quality Last reviewed Jul 4, 2026	DateImplementationJul 4, 2026
JurisdictionNew Jersey	StatusIn effect or in use	Key detail New Jersey MLTSS and PPP home-community guidance2 rows on record. Show all and sources New Jersey MLTSS and PPP home-community guidanceActive, Implementation Jul 4, 2026 DMAHS describes MLTSS as expanding home- and community-based services and coordinating long-term services and supports through NJ FamilyCare managed care, while the PPP page describes self-directed services that can let qualifying members choose workers, including trusted individuals such as friends, relatives, or neighbors. Who it affects: NJ FamilyCare members, older adults, disabled people, family caregivers, authorized representatives Why it matters: This is the official guidance bridge between New Jersey's managed long-term-care model and self-directed personal care, but it should not be used as a stand-alone eligibility determination. NJ DMAHS Managed Long Term Services and Supports NJ DMAHS Personal Preference Program NJ DMAHS MLTSS application guidance Last reviewed Jul 4, 2026 New Jersey Personal Preference Program fiscal-intermediary transitionImplementing, Implementation Jan 7, 2026 DMAHS posted PPP fiscal-intermediary transition resources; January 2026 materials describe Horizon NJ Health member transition from PPL to Palco and PPP reimbursement-rate changes effective January 1, 2026. Who it affects: NJ FamilyCare members, PPP participants, authorized representatives, family caregivers, self-directed workers Why it matters: Fiscal-intermediary changes can disrupt enrollment, payroll, timesheets, and worker continuity even when a member's underlying personal-care need has not changed. NJ DMAHS PPP FIT community resources NJ PPP FI Transition Community Workgroup PDF Last reviewed Jun 18, 2026	DateImplementationJul 4, 2026
JurisdictionNew York	StatusIn effect or in use	Key detail New York home-care consumer and LHCSA guidance2 rows on record. Show all and sources New York home-care consumer and LHCSA guidanceActive, Implementation Jul 4, 2026 NYSDOH consumer and Health Profiles pages explain home-care agency types, complaints and questions, and licensed home care services agencies. The CDPAP page separately anchors the consumer-directed pathway for Medicaid personal assistance. Who it affects: home-care clients, family caregivers, older adults, disabled people, home-care agencies Why it matters: Caregivers need a clear map of agency home care, certified home health, and consumer-directed personal assistance before comparing programs, workers, and complaint routes. NYSDOH home care information for consumers NYS Health Profiles licensed home care services agencies NYSDOH Consumer Directed Personal Assistance Program Last reviewed Jul 4, 2026 New York CDPAP single fiscal intermediary implementationImplementing, Implementation Sep 1, 2025 CDPAP administrative rules and transition materials changed the pathway for consumer-directed home care and personal assistant enrollment. Who it affects: Medicaid home-care consumers, personal assistants, family caregivers Why it matters: A registration, payroll, or documentation failure can disrupt care at home even when the underlying service need has not changed. Related programs: Consumer Directed Personal Assistance Program (CDPAP) NY Department of Health CDPAP Last reviewed Jun 17, 2026	DateImplementationJul 4, 2026
JurisdictionPennsylvania	StatusIn effect or in use	Key detail Pennsylvania Caregiver Support ProgramShow details and sources Pennsylvania Caregiver Support ProgramEffective, Implementation Jan 1, 2026 Pennsylvania maintains a statewide caregiver-support pathway through the Department of Aging and local aging network partners. Who it affects: family caregivers, older adults, people with disabilities, kinship caregivers, area agencies on aging Why it matters: Caregivers need to know when respite, supplies, counseling, training, or reimbursement-style supports exist outside Medicaid eligibility alone. Pennsylvania Department of Aging Caregiver Support Program Last reviewed Jun 18, 2026	DateImplementationJan 1, 2026