Get Paid to Care for Your Elderly Parent in Kentucky
Kentucky's Consumer Directed Option (CDO), also called Participant-Directed Services, lets HCB waiver members hire their own non-medical caregivers, including adult children and even spouses. Public Partnerships (PPL) handles payroll and tax withholding. Note: the HCB waiver currently has a waiting list.
This guide covers what Kentucky family caregivers need to know: the program structure, pay rates, who can be paid, eligibility, how to apply, and other programs that may supplement your income.
Kentucky pays family caregivers $13–$18 per hour through the Consumer Directed Option (Participant-Directed Services) option within the Home and Community Based (HCB) waiver. Your parent must meet a nursing-facility level of care but prefer to remain at home.
Kentucky's Main Program: Consumer Directed Option (Participant-Directed Services)
Consumer Directed Option (Participant-Directed Services) is a self-directed option within Kentucky's Home and Community Based (HCB) waiver, which provides home and community-based care for seniors and adults with disabilities who meet a nursing-facility level of need. Under self-direction, your parent (or you as their authorized representative) can hire, train, schedule, and supervise the personal-care attendant — and that attendant can be you, an adult child.
What the Program Pays For
Authorized self-directed services typically include:
- Personal care: bathing, grooming, dressing, oral hygiene
- Toileting assistance and incontinence care
- Mobility help: transferring, positioning, ambulation support
- Meal preparation and feeding assistance
- Light housekeeping directly related to health and safety
- Medication reminders (not administration, which requires a nurse)
- Supervision for individuals with cognitive impairment, including dementia
Pay Rates Across Kentucky
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Louisville / Lexington Metro | $14–$18/hr | Member negotiates pay within HCB service-rate caps |
| Northern Kentucky | $14–$17/hr | FMS withholds payroll taxes from the budgeted rate |
| Eastern / Appalachian Kentucky | $13–$16/hr | Rates trend toward the state minimum wage |
Rates are set within the participant's approved plan-of-care budget and the state's limits; the figures above are typical ranges, not guarantees.
Who Can Be Paid
Friends and relatives including adult children — and, under the CDO, even spouses — can be hired and paid to provide care. Always confirm the current rules with Kentucky Department for Medicaid Services (DMS) before you count on a specific arrangement.
Eligibility Requirements
Your Parent Must:
- Be enrolled in full Kentucky Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing-facility level of care
- Be enrolled in the Home and Community Based (HCB) waiver (or its self-directed option)
- Live in Kentucky in a community setting (not a nursing home)
- Be able to direct their own care, or have a legal/authorized representative who can
You (the Caregiver) Must:
- Be 18 years of age or older
- Meet the program's relationship rules (see above)
- Pass a criminal background check and registry search
- Complete any required caregiver orientation and training
- Be legally authorized to work in the United States
- Submit timesheets through PPL (Public Partnerships LLC)
How to Apply: Step-by-Step
- Apply for Kentucky Medicaid. Apply online at kynect.ky.gov/benefits or call 1-877-315-0589. Your parent must meet income and asset limits.
- Request a long-term-services assessment. Contact your local Medicaid or aging office to request a comprehensive functional assessment that determines whether your parent qualifies for the Home and Community Based (HCB) waiver.
- Enroll in the waiver. Once deemed eligible, your parent is enrolled in the Home and Community Based (HCB) waiver and assigned a case manager or care coordinator.
- Request the self-directed (CDO) option. During care planning, ask specifically for the consumer/self-directed service model and state that you, the adult child, want to be the hired caregiver.
- Enroll with PPL (Public Partnerships LLC). Complete enrollment paperwork — W-4, I-9, and background authorization — so payroll, tax withholding, and timesheets are handled for you.
- Complete orientation. Finish any state-required caregiver orientation covering personal-care techniques, emergency procedures, and reporting.
- Begin care and submit timesheets. Provide care per the authorized plan and submit electronic timesheets; payroll is processed on a regular cycle with taxes withheld.
Check Your Parent's Eligibility
Our free Benefits Checker helps identify whether your parent qualifies for Kentucky's caregiver-pay programs and other benefits.
Check Eligibility NowOther Programs That May Pay Kentucky Family Caregivers
VA Veteran-Directed Care & PCAFC
If your parent is a veteran enrolled in VA healthcare, the Veteran-Directed Care program provides a monthly budget that can pay family caregivers, and the Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for eligible primary caregivers. Contact the caregiver support coordinator at your parent's VA medical center or call 1-855-260-3274.
Personal Care Agreement (Private Pay)
If your parent does not qualify for Medicaid, a formal written Personal Care Agreement lets them pay you from their own funds at fair-market rates. Drafted with an elder-law attorney, it must be prospective and reasonable — and it keeps payments from being treated as "gifts" during the Medicaid 5-year look-back.
State Respite & Caregiver Support
Through the National Family Caregiver Support Program, Kentucky's Area Agencies on Aging fund respite, training, and counseling. These rarely pay ongoing wages but reduce your out-of-pocket costs. Find your local agency through the Eldercare Locator (1-800-677-1116) or 1-877-925-0037.
Tax Implications for Family Caregivers
- W-2 wages: The financial management agency issues you a W-2; federal income tax, Social Security, and Medicare are withheld.
- IRS Notice 2014-7: If you live in the same home as your parent (the Medicaid waiver participant), your self-directed wages may be excludable from federal gross income. Consult a CPA before filing — see IRS guidance on Medicaid waiver payments.
- Earned Income Tax Credit: These wages count as earned income and may qualify you for the EITC.
Maintain daily logs of services provided — date, time in, time out, and a brief description. Medicaid audits self-directed arrangements, and accurate records protect both you and your parent.
What Kentucky Caregivers Are Actually Earning
At 30 hours per week and about $15 per hour, you would earn roughly $1,950 per month. At 40 hours per week and $18 per hour, earnings reach about $3,120 per month — around $37,440 per year before taxes.
For comparison, a nursing home costs far more per year, and agency home care runs roughly $30–$40 per hour. A self-directed arrangement lets your parent receive care from someone they trust, while you earn income that partially replaces what you may have given up to provide care.
Contact Information
- Kentucky Department for Medicaid Services (DMS): www.chfs.ky.gov/agencies/dms/dca/Pages/hcb-waiver.aspx | 1-877-315-0589
- Apply for Medicaid: kynect.ky.gov/benefits
- State aging services: www.chfs.ky.gov/agencies/dail/Pages/default.aspx | 1-877-925-0037
- Eldercare Locator (find local help): eldercare.acl.gov | 1-800-677-1116
- Medicaid (federal): medicaid.gov
Frequently Asked Questions
Pay is negotiated within the HCB waiver's service-rate caps and processed through the financial management agency; take-home pay commonly falls around $13 to $18 per hour after payroll taxes.
The Consumer Directed Option (CDO), or Participant-Directed Services, is a self-directed feature of Kentucky's HCB waiver that lets the member hire, manage, and pay their own caregivers, including family members, for non-medical care.
Yes. Under the Consumer Directed Option, friends and relatives including adult children and spouses can be hired and paid to provide care.
The Home and Community Based (HCB) waiver, through its Consumer Directed Option (Participant-Directed Services), allows family caregivers to be paid.
First establish Medicaid eligibility through kynect, then apply for the HCB waiver through an Aging and Disability Resource Center; for HCB questions call DMS at 1-877-315-0589. An HCB waiting list currently exists.
Yes. A parent with dementia who qualifies for the HCB waiver at a nursing-facility level of care can use the Consumer Directed Option to hire and pay an adult child as caregiver.
Related Guides
- How to Get Paid to Care for Your Parent (National Overview)
- How to Apply for Medicaid for an Elderly Parent
- Caregiver Tax Deductions 2026
- VA Benefits for Elderly Parents
- Power of Attorney for an Elderly Parent
- Medicaid Spend-Down Rules
This guide is general information, not legal or financial advice. Program names, pay rates, and eligibility rules change and vary by county — confirm details with Kentucky Department for Medicaid Services (DMS). Sources: www.chfs.ky.gov · kynect.ky.gov.