Get Paid to Care for Your Elderly Parent in Virginia
Virginia families who step up to care for an aging parent at home may be leaving real money on the table. The state's Consumer-Directed Services (CDS) program, part of the Commonwealth Coordinated Care Plus (CCC Plus) Medicaid waiver, allows your parent to hire you as their paid caregiver instead of using a home care agency.
This guide covers everything Virginia family caregivers need to know: the program structure, pay rates, eligibility requirements, how to apply, and additional programs that may supplement your income.
Virginia pays family caregivers $11–$15 per hour through the Consumer-Directed Services option within the CCC Plus Medicaid waiver. Your parent must require a nursing facility level of care but prefer to remain at home. Spouses are generally excluded from serving as paid caregivers.
Virginia's Main Program: Consumer-Directed Services (CDS)
Consumer-Directed Services is embedded within Virginia's CCC Plus waiver, which provides home and community-based care for seniors and adults with disabilities who meet a nursing facility level of need. Under CDS, your parent becomes the employer of record, meaning they (or you as their representative) have the authority to hire, train, schedule, and if necessary dismiss their personal care attendant.
This is distinct from the standard CCC Plus model where a managed care organization assigns an agency caregiver. With CDS, your parent has control, and you, an adult child, can be the person they hire.
What CDS Pays For
Authorized services under Consumer-Directed Services include:
- Personal care assistance: 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)
- Respite care (temporary relief for the primary caregiver)
- Supervision for individuals with cognitive impairment
Pay Rates Across Virginia
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Northern Virginia (NOVA) | $13–$15/hr | Higher cost-of-living area |
| Richmond Metro Area | $12–$14/hr | Mid-range rates |
| Rural Southwest / Southside | $11–$13/hr | Lower cost areas |
Eligibility Requirements
Your Parent Must:
- Be enrolled in full Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing facility level of care
- Be enrolled in the CCC Plus waiver
- Reside in Virginia and live 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
- Not be the participant's spouse
- Pass a criminal background check and registry search
- Complete required caregiver orientation and training
- Be legally authorized to work in the United States
- Submit timesheets through the fiscal agent portal
Virginia's CDS program generally excludes spouses from being paid caregivers. However, adult children, including step-children and children-in-law in some circumstances, are typically allowed. Always confirm current policy with the Virginia Department of Medical Assistance Services (DMAS).
How to Apply: Step-by-Step
- Apply for Virginia Medicaid (Medicaid for Aged, Blind, and Disabled). Apply online at commonhelp.virginia.gov or at your local Department of Social Services. Your parent must meet income and asset limits.
- Request a Long Term Services and Supports (LTSS) assessment. Contact your local Department of Social Services or the CCC Plus managed care plan to request a comprehensive clinical assessment. This assessment determines whether your parent qualifies for the CCC Plus waiver.
- Enroll in the CCC Plus waiver. Once deemed eligible, your parent will be enrolled in CCC Plus and assigned to a managed care organization (Anthem HealthKeepers Plus, Magellan Complete Care, Molina Complete Care, or United Healthcare). You can request enrollment with a specific plan.
- Request the Consumer-Directed Services option. During care planning, your parent's care coordinator at the MCO will review available service delivery options. Ask specifically for Consumer-Directed Services and state that you (the adult child) want to be the hired attendant.
- Enroll with the fiscal agent. Virginia contracts with Public Partnerships LLC (PPL) as the fiscal management service. You and your parent will complete enrollment paperwork, including your W-4, I-9, and background authorization, through PPL.
- Complete caregiver orientation. Virginia requires CDS personal care attendants to complete a state-approved orientation. Training covers personal care techniques, emergency procedures, and reporting requirements.
- Begin care and submit timesheets. Once approved, you provide care per the authorized plan. You submit electronic timesheets through PPL's portal. Payroll is processed bi-weekly with taxes withheld automatically.
If your parent has dementia or cognitive impairment that prevents them from managing the CDS arrangement, you can serve as their Employer of Record as an authorized representative. You'll manage scheduling, training, and timesheet approvals on their behalf.
Other Virginia Programs That Pay Family Caregivers
Virginia Lifespan Respite Care Program
While not a direct wage program, Virginia's Lifespan Respite Care program provides vouchers that reimburse family caregivers for respite services, including paying other family members to provide temporary relief. Grants of up to $500 per caregiver are available on a first-come, first-served basis each year. Contact the Virginia Caregiver Coalition at 1-800-552-4464.
VA Veteran-Directed Care
If your parent is a Virginia veteran enrolled in VA healthcare, the Veteran-Directed Care program provides a monthly budget that can be used to pay family caregivers. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for primary caregivers of eligible post-9/11 veterans. Contact the caregiver support coordinator at your parent's VA medical center.
Personal Care Agreement (Private Pay)
If your parent does not qualify for Medicaid or the CCC Plus waiver, a formal written Personal Care Agreement allows them to pay you from their own funds at fair market rates. This agreement must be prospective (for future services), specify a reasonable hourly rate, and be drafted with the assistance of a Virginia elder law attorney. This arrangement is also important for Medicaid planning, payments under a formal agreement are not considered "gifts" during the 5-year lookback period.
Virginia Division for Aging Services (VDAS) Programs
VDAS funds programs through local Area Agencies on Aging that provide caregiver support including training, counseling, and limited respite funding. These programs do not pay ongoing wages but can reduce your out-of-pocket caregiving costs. Call 1-800-552-3402 or visit vda.virginia.gov.
Check Your Parent's Eligibility
Our free Benefits Checker helps identify whether your parent qualifies for Virginia's Consumer-Directed Services and other caregiver pay programs.
Check Eligibility NowTax Implications for Virginia Family Caregivers
Federal Tax Treatment
- W-2 wages: PPL issues you a W-2 for your CDS earnings. Federal income tax, Social Security, and Medicare taxes are withheld.
- IRS Notice 2014-7: If you live in the same home as your parent (the Medicaid waiver participant), your CDS wages may be excluded from federal gross income. This is a significant potential benefit, consult a CPA before filing.
- Earned Income Tax Credit: CDS wages count as earned income, which may qualify you for the EITC.
Virginia State Taxes
- Virginia follows the federal Difficulty of Care exclusion for in-home caregivers who reside with the care recipient, which can reduce or eliminate Virginia income tax on CDS wages.
- If you pay self-employment taxes under a private Caregiver Agreement, Virginia allows deductions for self-employment health insurance premiums.
Maintain daily logs of services provided, including date, time in, time out, and a brief description. Virginia Medicaid audits CDS arrangements, and accurate records protect both you and your parent.
What Virginia Caregivers Are Actually Earning
At 30 hours per week and $13 per hour, you would earn approximately $1,690 per month, or just over $20,000 per year. At 40 hours per week and $15 per hour, earnings reach $2,400 per month, roughly $28,800 annually before taxes.
For comparison, a nursing home in Virginia costs $90,000–$140,000 per year. Community-based home care through an agency runs $25–$35 per hour. The CDS program lets your parent receive comparable care from someone they trust, while you earn an income that partially replaces what you may have given up to provide care.
Contact Information
- Virginia DMAS (Medicaid): dmas.virginia.gov | 1-804-786-7933
- CommonHelp (Medicaid application): commonhelp.virginia.gov
- Public Partnerships LLC (Fiscal Agent): publicpartnerships.com
- Virginia Division for Aging Services: 1-800-552-3402
- Eldercare Locator (local AAA): eldercare.acl.gov
Frequently Asked Questions
Virginia's Consumer-Directed Services program pays family caregivers between $11 and $15 per hour. The exact rate varies by locality and is set based on the participant's approved hours and service plan.
Consumer-Directed Services (CDS) is a Virginia Medicaid waiver option that allows eligible individuals to hire, train, and supervise their own caregivers, including family members, instead of using a home care agency. The participant or their authorized representative acts as the employer of record.
In most cases, spouses are excluded from being paid caregivers under Virginia's Consumer-Directed Services program. Adult children, siblings, and other non-spousal relatives are generally eligible. Verify current rules with the Virginia Department of Medical Assistance Services.
Consumer-Directed Services is available through Virginia's Commonwealth Coordinated Care Plus (CCC Plus) waiver, which covers home and community-based services for individuals who require a nursing facility level of care. The CCC Plus waiver is the primary pathway for family caregivers to get paid in Virginia.
You start by applying for Virginia Medicaid through Cover Virginia, then request a Long Term Services and Supports assessment through your local Department of Social Services. Once enrolled in CCC Plus, you request the consumer-directed option through your managed care plan and complete enrollment with a fiscal agent such as Public Partnerships LLC (PPL).
Virginia uses Public Partnerships LLC (PPL) as its fiscal agent for Consumer-Directed Services. PPL handles payroll processing, tax withholding, workers' compensation, and timesheet management so the participant does not have to manage these tasks directly.
Virginia has historically maintained waiting lists for some Medicaid waiver slots. However, individuals with urgent or critical needs may receive priority. Contact the Virginia Department of Medical Assistance Services or your local Medicaid office to check current enrollment status.
Yes. Virginia's Consumer-Directed Services program covers supervision and personal care for individuals with cognitive impairment, including dementia. If your parent cannot direct their own care, an authorized representative, such as you as their adult child, can manage the CDS arrangement on their behalf.