How to Become a Paid Caregiver for a Family Member in CT

To become a paid caregiver for a family member in Connecticut, you enroll your relative in a Medicaid-funded program that allows self-directed hiring, pass a background check, complete any required training, and get onboarded as their employee through a fiscal intermediary that runs the payroll. The wage for personal care attendants serving Medicaid clients is $23 per hour as of January 1, 2026, up from $18.25 under the previous contract. Which program you use depends on your family member’s age, disability, and finances, and whether you can be paid at all depends on how you’re related to them.

Which Program Fits Your Family Member

Connecticut runs paid family caregiving through the Department of Social Services and, for people with developmental disabilities, the Department of Developmental Services. There is no single door. Match the person you’ll be caring for to the right program first, because eligibility and caregiver rules differ across them.

Connecticut Home Care Program for Elders

CHCPE serves residents aged 65 and older who are at risk of nursing home placement. It includes both state-funded and Medicaid waiver components. Adult Family Living, offered under CHCPE, pays a family caregiver who shares a home with an elderly relative to provide daily care, with an intermediary agency supervising the arrangement and providing training.¹

Community First Choice

Community First Choice is a self-directed Medicaid option for people who meet an institutional level of care. Instead of assigning a provider, CFC gives the participant a budget based on their assessed needs and lets them decide how to spend it, including hiring a family member. The participant or their representative acts as the employer.²

Personal Care Attendant Waiver

The PCA Waiver serves adults aged 18 to 64 with long-term physical disabilities who need hands-on help with at least two activities of daily living. It has a waiting list, so apply early.³

Acquired Brain Injury Waiver

The ABI Waiver covers adults aged 18 to 64 with an acquired brain injury. Participants direct their own care and act as the employer for household employees, including family members.⁴

DDS Waiver Programs

If your family member is a client of the Department of Developmental Services, DDS Medicaid waiver programs can pay family caregivers, including relatives who would be excluded elsewhere.⁵

Eligibility for Your Family Member

Every program requires the care recipient to demonstrate a functional need serious enough to justify institutional care, meaning hands-on help with activities of daily living like bathing, dressing, eating, or toileting. A DSS social worker or Access Agency care manager conducts the assessment, and for CFC that same assessment sets the participant’s care budget.²

Financial limits depend on the program. The state-funded CHCPE tier has no income limit and an asset ceiling of $48,798 for an individual, which is workable for many moderate-income seniors. The Medicaid waiver tier is far tighter: $1,958 per month in income and $1,600 in assets for a single applicant as of January 2026.⁶ Some Medicaid waivers cap income at 300% of the federal SSI rate, which works out to $2,982 per month in 2026 based on the individual SSI rate of $994,⁷ and hold the asset limit at $1,600.⁸

Whether Your Relationship Qualifies

This is where families most often hit a wall. Not every relative can be paid under every program.

The PCA Waiver allows family members to serve as attendants but excludes “legally liable relatives,” which generally means a spouse or the parent of a minor child.³ An adult child caring for an elderly parent typically qualifies; a spouse caring for a spouse does not.

Connecticut closed that gap on the DDS side. A 2023 statute authorizes compensation for legally responsible relatives, including spouses, parents, and legal guardians, under DDS Medicaid waiver programs, defining “family caregiver” broadly as anyone related by blood or marriage, or a legal guardian.⁹ DDS implemented the program in May 2024. Legal guardians and parents of school-age children can now be compensated for certain waivered supports, though parents of school-age children must undergo an age dependency assessment.⁵

One rule cuts across every self-directed program: the person acting as Employer of Record, meaning the one managing the care plan and authorizing timesheets, cannot also be the paid caregiver. If a single family member has been filling both roles informally, a different relative or representative needs to take one of them before payment can begin.⁵

For Adult Family Living under CHCPE, you also need to live with the care recipient.¹

What You Have to Be and Do as the Caregiver

You must be at least 18 years old and pass a background check to work as a paid family caregiver through any of these programs. Connecticut operates a Long-Term Care Background Search Program through the Department of Public Health, and you should expect to pay for both a state criminal records check and a federal FBI check. Your fiscal intermediary or provider agency handles the submission.

Training requirements depend on the program. Personal care attendants under the PCA Waiver must complete a standardized 17-module curriculum covering universal precautions, safe transfers, emergency procedures, medication policies, reporting abuse and neglect, and personal care tasks like bathing and dressing. New hires have 90 days to finish it and must score at least 70 on the certification test.

For Adult Family Living, the intermediary agency provides orientation, competency evaluations, and continuing education, and a nurse from the provider agency visits at least every two months to supervise care.¹⁰ For DDS waiver programs, caregivers also enroll as a Direct Support Professional, which includes background clearance and required training.⁵

What You Can Expect to Earn

Personal care attendants serving Medicaid clients earn a minimum of $23 per hour effective January 1, 2026, up from $18.25 under the previous contract. The rate applies to PCAs regardless of whether they are family members or unrelated workers.

Community First Choice pays out of a budget rather than at a set hourly rate. DSS assesses the participant’s needs, assigns a dollar amount, and the participant decides how to allocate it among their caregivers. Hourly pay depends on total budget and hours needed. Adult Family Living compensation is set through the intermediary agency and varies by the level of care required.

How to Apply

Start with a phone call to the Department of Social Services or your local Area Agency on Aging. Connecticut’s 211 information line can also route you. The PCA Waiver requires a specific request form (W-982) submitted to DSS,¹¹ and the ABI Waiver has its own form (W-1130).⁴

After the referral, your family member undergoes the functional assessment. That determines which services they qualify for and, under CFC, sets their budget.²

Once they’re approved, you enroll as their paid provider through a fiscal intermediary. The intermediary handles the employer paperwork so you and your family member aren’t managing payroll taxes, workers’ compensation, or year-end tax reporting on your own. You’ll fill out a W-4 for federal tax withholding, an I-9 for employment eligibility verification, and direct deposit forms.¹²

Plan for the process to take several weeks at minimum. The PCA Waiver has a waiting list, so the gap between applying and starting paid work can be significant. Don’t quit other employment or make financial commitments based on anticipated caregiver income until enrollment is confirmed.

Staying Compliant Once You’re Paid

Getting approved is the easier part. Staying compliant is where problems arise. You must follow the care plan developed during the assessment and document every visit. Connecticut uses an Electronic Visit Verification (EVV) system to track when you arrive, when you leave, and what tasks you performed.

EVV offers three ways to record visits:

Telephony: call a toll-free number from the client’s home phone at the start and end of each visit, entering your provider ID and the tasks completed.
Mobile Visit Verification: use a smartphone app to check in and out and log tasks without the client’s phone.
Fixed Visit Verification: a small device in the client’s home generates a code when pressed; you record the code at arrival and departure, then call it in within 15 minutes after the visit.

Missed check-ins or unlogged tasks create discrepancies that can delay payment or trigger compliance reviews. Build the call-in habit from day one.

Stay in contact with your case manager and report any changes in your family member’s condition or living situation. If their needs shift, the care plan and budget may be adjusted. Failing to report changes can jeopardize the whole arrangement.

How Your Pay Is Taxed

Your living arrangement decides the tax treatment. Under IRS Notice 2014-7, Medicaid waiver payments you receive for caring for someone who lives in your home are treated as “difficulty of care” payments and excluded from federal gross income. This applies whether you are related to the person or not, as long as you share a home.¹³

The IRS defines “the provider’s home” as the place where you live and carry out the routines of your private life, like sharing meals and holidays with family. If you moved into your parent’s house and it became your primary residence, waiver payments qualify for the exclusion. If you commute from your own separate residence, the payments are taxable income.¹⁴

Any direct payments from a family member’s personal funds, outside of a Medicaid waiver program, are always taxable regardless of living situation. Keep records of every payment and its source. If you receive both waiver and private payments, only the waiver portion qualifies for the exclusion.

1
MyPlaceCT.org. CT Home Care Program for Elders (CHCPE)
2
MyPlaceCT. Community First Choice (CFC)
3
State of Connecticut Department of Social Services. The Personal Care Attendant Program
4
CT.gov. Acquired Brain Injury Program Community Options
5
Connecticut Developmental Services. Paid Family Caregivers Information
6
SWCAA. CHCPE Financial Guidelines
7
Social Security Administration. SSI Federal Payment Amounts for 2026
8
CT.gov. DDS Medicaid Waiver Income/Asset Basic Overview
9
Justia Law. Connecticut General Statutes 17a-215h – Compensation of Family Caregivers in Medicaid Waiver Programs for Clients of the Department of Developmental Services
10
HUSKY Health: Connecticut Department of Social Services. CT Home Care Program for Elders – Provider Bulletin 2013-50
11
State of Connecticut Department of Social Services. Overview of Connecticut Medicaid Waiver Programs
12
State of Connecticut Department of Developmental Services. Individual and Family Fact Sheet – Using a Fiscal Intermediary
13
Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
14
Internal Revenue Service. Notice 2014-7