Get Paid to Care for Your Elderly Parent in West Virginia
West Virginia's Aged and Disabled Waiver (ADW) includes a Personal Options self-direction model that lets a participant hire and pay their own caregivers, including an adult child, from a monthly Medicaid budget. Payroll and employer taxes are managed by the fiscal agent Palco.
This guide covers what West Virginia 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.
West Virginia pays family caregivers $12–$20 per hour through the Aged & Disabled Waiver – Personal Options self-direction option within the Aged and Disabled Waiver (1915(c) HCBS Medicaid waiver). Your parent must meet a nursing-facility level of care but prefer to remain at home.
West Virginia's Main Program: Aged & Disabled Waiver – Personal Options self-direction
Aged & Disabled Waiver – Personal Options self-direction is a self-directed option within West Virginia's Aged and Disabled Waiver (1915(c) HCBS Medicaid 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 West Virginia
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Statewide (Personal Options) | $12–$20/hr | Participant sets the worker's wage from a monthly budget; must be at least state minimum wage |
| Charleston / Kanawha Valley | $13–$20/hr | Apply via Bureau of Senior Services at 1-866-767-1575 |
| Rural / Appalachian counties | $12–$18/hr | Palco handles payroll, taxes, and background checks for hired relatives |
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
Spouses and legal guardians cannot be paid; adult children and other relatives (including ex-spouses) may be hired through Personal Options. Always confirm the current rules with West Virginia Bureau for Medical Services (BMS) before you count on a specific arrangement.
Eligibility Requirements
Your Parent Must:
- Be enrolled in full West Virginia Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing-facility level of care
- Be enrolled in the Aged and Disabled Waiver (1915(c) HCBS Medicaid waiver) (or its self-directed option)
- Live in West Virginia 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 Palco
How to Apply: Step-by-Step
- Apply for West Virginia Medicaid. Apply online at adwprogram.wv.gov or call 1-304-356-4913. 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 Aged and Disabled Waiver (1915(c) HCBS Medicaid waiver).
- Enroll in the waiver. Once deemed eligible, your parent is enrolled in the Aged and Disabled Waiver (1915(c) HCBS Medicaid waiver) and assigned a case manager or care coordinator.
- Request the self-directed (ADW) 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 Palco. 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 West Virginia's caregiver-pay programs and other benefits.
Check Eligibility NowOther Programs That May Pay West Virginia 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, West Virginia'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 1-866-767-1575.
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 West Virginia Caregivers Are Actually Earning
At 30 hours per week and about $16 per hour, you would earn roughly $2,080 per month. At 40 hours per week and $20 per hour, earnings reach about $3,466 per month — around $41,600 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
- West Virginia Bureau for Medical Services (BMS): bms.wv.gov/chapter-501-aged-and-disabled-waiver | 1-304-356-4913
- Apply for Medicaid: adwprogram.wv.gov
- State aging services: dhhr.wv.gov/bms/Programs/WaiverPrograms/Pages/default.aspx | 1-866-767-1575
- Eldercare Locator (find local help): eldercare.acl.gov | 1-800-677-1116
- Medicaid (federal): medicaid.gov
Frequently Asked Questions
Under the Aged and Disabled Waiver's Personal Options program, family caregivers are typically paid about $12–$20 per hour. The participant sets the wage from an approved monthly Medicaid budget, and it must be at least the state minimum wage.
The Aged and Disabled Waiver (ADW) is a West Virginia Medicaid program providing in-home long-term care to people 18 and older who would otherwise need nursing-home care. Its Personal Options option lets participants self-direct services and hire their own attendants.
No, a spouse (and a legal guardian) cannot be paid to provide care under ADW Personal Options. However, adult children and other relatives, including ex-spouses, may be hired and paid as attendant-care workers.
The Aged and Disabled Waiver (ADW), through its Personal Options self-direction feature, lets family caregivers be paid. It is administered by the West Virginia Bureau for Medical Services with payroll handled by Palco.
Contact the Bureau of Senior Services / ADW program at 1-866-767-1575, or call the Aged & Disabled Waiver line at 1-304-356-4913. The applicant must meet nursing-home medical criteria and West Virginia Medicaid financial limits.
Yes. If your parent qualifies for the Aged and Disabled Waiver at a nursing-home level of care, an adult child can be hired and paid through Personal Options to provide care, including dementia care. Caregivers must complete training and a background check.
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 West Virginia Bureau for Medical Services (BMS). Sources: adwprogram.wv.gov · bms.wv.gov.