[ { "code": "AZ", "state": "Arizona", "slug": "arizona-altcs", "program": "Arizona Long Term Care System (ALTCS)", "medicaid_name": "AHCCCS", "agency_url": "https://www.azahcccs.gov/Members/AlreadyCovered/coveredservices.html", "summary": "AHCCCS lists member-directed options for most ALTCS members living in their own home. Self-directed attendant care is one option to discuss; ALTCS coverage and a specific service authorization are different decisions.", "steps": { "en": [ "Start with the AHCCCS ALTCS application route if the person is not enrolled; keep copies of requested documents.", "Ask the ALTCS case manager which approved in-home services can use member direction.", "Compare Agency with Choice and SDAC, including the employer role and the proposed relative’s eligibility.", "Complete the correct worker agreement, training and payroll setup with the assigned organization.", "Obtain the authorized start date, service units and caregiver rate before calculating expected income." ], "es": [ "Inicia la solicitud de ALTCS ante AHCCCS si la persona no está inscrita y conserva los documentos solicitados.", "Pregunta al gestor de ALTCS qué servicios domiciliarios aprobados permiten autodirección.", "Compara Agency with Choice y SDAC, incluidas las obligaciones del empleador y la elegibilidad del familiar.", "Completa el acuerdo del trabajador, la formación y el alta en nómina con la entidad asignada.", "Obtén la fecha de inicio, las unidades autorizadas y la tarifa del cuidador antes de calcular ingresos." ] }, "caution": "Confirm family hiring rules and the service budget with the health plan before assuming pay.", "spouse_policy": "unknown", "allows_spouse": null, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "AHCCCS: ALTCS member-directed options", "url": "https://www.azahcccs.gov/PlansProviders/CurrentProviders/SDAC.html", "access": "direct", "checked_on": "2026-11-15" }, { "label": "AHCCCS: ALTCS contract, effective October 2026", "url": "https://www.azahcccs.gov/Resources/Downloads/ContractAmendments/ALTCS/ALTCSCYE2026/EPD_EFF100126_FINAL.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "AHCCCS: application denials and missing eligibility information", "url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_1300_Applications/1310_Denial_of_Applications/A_General_Information_on_Denial_of_Applications.htm", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Arizona", "slug_es": "arizona-altcs-cuidadores-familiares", "agency": { "en": "Arizona Health Care Cost Containment System (AHCCCS)", "es": "Arizona Health Care Cost Containment System (AHCCCS), agencia de Medicaid de Arizona" }, "fms": { "en": "The Fiscal Employer Agent arranged for the member-directed option; ask the ALTCS case manager for the assigned organization.", "es": "El agente fiscal asignado a la modalidad autodirigida; el gestor de ALTCS debe identificar la entidad correspondiente." }, "payment": { "en": "Authorized attendant-care services; distinguish the caregiver wage from the agency or service reimbursement.", "es": "Servicios de asistencia autorizados; distinguir el salario del cuidador del reembolso a la agencia o al servicio." }, "spouse": { "en": "ALTCS has a spouse-as-paid-caregiver option, but it must not be assumed to follow the same rules as SDAC. Confirm the delivery model.", "es": "ALTCS contempla una modalidad de cónyuge cuidador remunerado, pero no se deben aplicar automáticamente las reglas de SDAC. Confirmar la modalidad." }, "minors": { "en": "Parents as Paid Caregivers is a distinct ALTCS delivery arrangement with its own requirements. This adult-focused guide does not determine eligibility.", "es": "Parents as Paid Caregivers es una modalidad diferenciada de ALTCS con requisitos propios. Esta guía para cuidados de adultos no determina su elegibilidad." }, "overview": { "en": "In Arizona, start by separating ALTCS eligibility from the way approved care is delivered. A family may hear the names Agency with Choice and Self-Directed Attendant Care, or SDAC, during the same conversation. They distribute employer responsibilities differently. Choosing a trusted relative is only one part of arranging an authorized service; it is not a separate government salary available to every household.", "es": "En Arizona conviene separar la elegibilidad para ALTCS de la forma de prestar los cuidados aprobados. Una familia puede oír hablar de Agency with Choice y de Self-Directed Attendant Care, o SDAC, en la misma conversación. Ambas modalidades reparten de manera distinta las obligaciones del empleador. Elegir a un familiar de confianza es solo una parte de organizar un servicio autorizado, no un salario público disponible para cualquier hogar." }, "sections": [ { "key": "programs", "title": { "en": "Agency with Choice and SDAC are different decisions", "es": "Agency with Choice y SDAC son decisiones distintas" }, "paragraphs": { "en": [ "AHCCCS describes member direction as a service-delivery model rather than an extra benefit. Under Agency with Choice, an agency remains the legal employer while the member can help choose, schedule and supervise the worker. Under SDAC, the member or legal guardian assumes the employer role, supported by a Fiscal Employer Agent. Ask who handles replacement staff, training and payroll before choosing; a familiar agency name does not tell you which arrangement its contract supports." ], "es": [ "AHCCCS describe la autodirección como una forma de prestar servicios, no como una prestación adicional. En Agency with Choice, la agencia sigue siendo el empleador legal, mientras que el beneficiario puede participar en la selección, los horarios y la supervisión. En SDAC, el beneficiario o su tutor legal asume el papel de empleador con apoyo de un agente fiscal. Antes de elegir, pregunta quién gestiona sustituciones, formación y nóminas; conocer el nombre de una agencia no identifica su modalidad contractual." ] } }, { "key": "eligibility", "title": { "en": "ALTCS approval and care authorization", "es": "La aprobación de ALTCS y la autorización de cuidados" }, "paragraphs": { "en": [ "ALTCS reviews medical and financial eligibility. AHCCCS application guidance identifies medical records and financial or medical interviews as parts of that review. Once enrolled, the case manager helps determine which services fit the member’s assessed needs. The member-directed options described by AHCCCS are generally for members living in their own homes, rather than nursing facilities or alternative residential settings. Describe the assistance actually needed at home instead of assuming a diagnosis automatically authorizes a particular number of hours." ], "es": [ "ALTCS examina la elegibilidad médica y económica. Las instrucciones de solicitud de AHCCCS incluyen expedientes médicos y entrevistas económicas o médicas como partes de esa revisión. Tras la inscripción, el gestor ayuda a determinar qué servicios corresponden a las necesidades evaluadas. Las modalidades autodirigidas descritas por AHCCCS se destinan generalmente a personas en su propio hogar, no en centros de enfermería u otros entornos residenciales. Explica qué ayuda se necesita realmente, sin suponer que un diagnóstico autoriza un número concreto de horas." ] } }, { "key": "waiting", "title": { "en": "Track the application and the service start separately", "es": "Distingue la solicitud del inicio del servicio" }, "paragraphs": { "en": [ "Keep the date of the ALTCS application, interview requests and any outstanding-document notices together. Missing requested records or an interview can interrupt the eligibility process. After an eligibility decision, there can still be plan coordination, caregiver enrollment and a service start date to resolve. This guide does not assign Arizona a universal waiting period or promise that care already provided will be reimbursed. Request a written explanation of the next outstanding step from the office or case manager handling that stage." ], "es": [ "Conserva juntas la fecha de solicitud de ALTCS, las convocatorias de entrevistas y las peticiones de documentos pendientes. No aportar expedientes o faltar a una entrevista puede interrumpir el procedimiento. Después de resolver la elegibilidad aún puede faltar coordinación con el plan, inscripción del cuidador y fecha de inicio. Esta guía no atribuye a Arizona un plazo universal ni promete pagar cuidados ya prestados. Solicita por escrito cuál es el siguiente trámite pendiente a la oficina o al gestor responsable de esa fase." ] } }, { "key": "enrollment", "title": { "en": "Match the family relationship to the delivery model", "es": "Relaciona el parentesco con la modalidad de servicio" }, "paragraphs": { "en": [ "Arizona’s ALTCS contract materials describe separate arrangements for spouses and for parents providing care to minor children. Their existence is not permission to use every family member within every self-directed option. Give the case manager the proposed caregiver’s exact relationship and any guardian or representative role. Then confirm the applicable hiring route, the named employer and all required worker training. If the family prefers SDAC, request its member-worker agreement and training materials before agreeing to employer responsibilities." ], "es": [ "Los contratos de ALTCS describen modalidades diferenciadas para cónyuges y para progenitores que cuidan a menores. Que existan no permite contratar a cualquier familiar en todas las opciones autodirigidas. Indica al gestor el parentesco exacto y cualquier función de tutor o representante. Confirma después la vía de contratación aplicable, quién será el empleador y la formación exigida. Si la familia prefiere SDAC, pide el acuerdo entre beneficiario y trabajador y los materiales de formación antes de asumir las obligaciones del empleador." ] } }, { "key": "records", "title": { "en": "Get a usable payroll and backup-care plan", "es": "Obtén instrucciones de nómina y cuidados de respaldo" }, "paragraphs": { "en": [ "Ask the assigned agency or Fiscal Employer Agent to distinguish the written caregiver pay rate from the total amount billed for the service. Obtain instructions for recording visits, correcting mistakes and reporting a hospital admission or other change in where care occurs. Confirm whether EVV applies to the particular service and whether any live-in exception needs documentation; do not rely on another state’s exemption. Keep a backup contact so an absence does not leave an essential authorized task uncovered." ], "es": [ "Distingue la tarifa del cuidador del importe facturado por el servicio. Solicita instrucciones para registrar visitas, corregir errores y comunicar hospitalizaciones o cambios de lugar de atención. Confirma si el servicio exige verificación electrónica y qué documentos requiere una posible excepción por convivencia; no apliques reglas de otro estado. Organiza sustituciones para las tareas esenciales." ] } } ], "faqs": [ { "q": { "en": "Is Agency with Choice the same as SDAC?", "es": "¿Agency with Choice es lo mismo que SDAC?" }, "a": { "en": "No. The agency is the legal employer in Agency with Choice; SDAC places employer responsibilities with the member or legal guardian and provides fiscal-agent support.", "es": "No. En Agency with Choice la agencia es el empleador legal; en SDAC esa responsabilidad corresponde al beneficiario o tutor, con apoyo de un agente fiscal." } }, { "q": { "en": "Can my spouse be paid through ALTCS?", "es": "¿Puede cobrar mi cónyuge a través de ALTCS?" }, "a": { "en": "A spouse option exists, but the case manager must confirm its requirements and delivery arrangement. Do not assume that SDAC and agency-based spouse care are interchangeable.", "es": "Existe una modalidad para cónyuges, pero el gestor debe confirmar sus requisitos y forma de prestación. No presupongas que SDAC y la atención del cónyuge mediante agencia son intercambiables." } }, { "q": { "en": "Does living in assisted living qualify me for these member-directed options?", "es": "¿Vivir en una residencia asistida permite estas modalidades autodirigidas?" }, "a": { "en": "The AHCCCS member-direction page describes options for members in their own homes and excludes alternative residential settings and nursing facilities from those options.", "es": "La página de autodirección de AHCCCS describe estas opciones para el propio hogar y excluye otros entornos residenciales y centros de enfermería." } }, { "q": { "en": "Which number belongs in the calculator?", "es": "¿Qué importe debo introducir en la calculadora?" }, "a": { "en": "Use the caregiver’s documented rate and authorized units. An agency reimbursement figure can include costs that are not paid to the caregiver.", "es": "Usa la tarifa documentada del cuidador y las unidades autorizadas. El reembolso de una agencia puede incluir costes que no recibe el trabajador." } } ], "slug_en": "arizona-altcs", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "CA", "state": "California", "slug": "california-ihss", "program": "In-Home Supportive Services (IHSS)", "medicaid_name": "Medi-Cal", "agency_url": "https://www.cdss.ca.gov/in-home-supportive-services", "summary": "IHSS uses a county assessment to authorize services and monthly hours. Pay varies by county. An approved care plan and provider enrollment matter separately from Medi-Cal coverage.", "steps": { "en": [ "Submit the county IHSS application and keep a copy.", "Arrange the health care certification and home assessment.", "Read the written services and monthly-hours decision.", "Complete provider enrollment and confirm the recipient link.", "Set up timesheets and confirm wages and the payable start date." ], "es": [ "Presenta la solicitud IHSS al condado y conserva copia.", "Organiza la certificación sanitaria y la visita al hogar.", "Revisa la decisión escrita sobre servicios y horas mensuales.", "Completa el alta del proveedor y verifica la vinculación.", "Configura las hojas de horas y confirma salario e inicio pagadero." ] }, "caution": "Do not use the old claim that all Medi-Cal programs have no asset limit in 2026. Some programs count assets again.", "spouse_policy": "unknown", "allows_spouse": null, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "CDSS: IHSS overview", "url": "https://www.cdss.ca.gov/in-home-supportive-services", "access": "direct", "checked_on": "2026-11-15" }, { "label": "DHCS: Medi-Cal asset rules", "url": "https://www.dhcs.ca.gov/medi-cal/help/asset-limit-frequently-asked%20questions/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "CDSS: provider orientation", "url": "https://www.cdss.ca.gov/inforesources/ihss/ihss-providers/orientation-process/quot", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "CDSS: EVV help", "url": "https://cdss.ca.gov/inforesources/cdss-programs/ihss/evvhelp", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "CDSS: IHSS for children", "url": "https://cdss.ca.gov/ihss-for-children", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DHCS: WPCS questions", "url": "https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/waiver-personal-care-services-frequently-asked-questions-2/", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "California", "slug_es": "california-ihss-pago-cuidadores", "agency": { "en": "California Department of Social Services and county IHSS offices; Medi-Cal eligibility is handled separately.", "es": "Departamento de Servicios Sociales de California y oficinas IHSS del condado; la elegibilidad de Medi-Cal se tramita por separado." }, "fms": { "en": "County IHSS office or Public Authority for enrollment; the state issues individual-provider payments.", "es": "Oficina IHSS o Autoridad Pública del condado para el alta; el estado emite los pagos a proveedores individuales." }, "payment": { "en": "Authorized service hours, with county-specific wages and timesheets.", "es": "Horas de servicios autorizados, con salarios del condado y hojas de horas." }, "spouse": { "en": "Ask the county to identify the IHSS subprogram and the spouse rules for the authorized tasks.", "es": "Pide al condado que identifique el subprograma IHSS y las reglas del cónyuge para las tareas autorizadas." }, "minors": { "en": "Parent providers may be allowed in CFCO, IPO or IHSS-R; the PCSP subprogram excludes a parent providing for their minor child.", "es": "Se pueden admitir padres proveedores en CFCO, IPO o IHSS-R; PCSP excluye al padre o madre que atiende a su hijo menor." }, "overview": { "en": "California IHSS starts with the needs of the person receiving assistance. The county decides which services and monthly hours can be authorized; a family member then completes a separate provider process. A Medi-Cal card, shared address or history of unpaid care does not establish a payable schedule.", "es": "IHSS de California parte de las necesidades de quien recibe ayuda. El condado decide qué servicios y horas mensuales puede autorizar; después, el familiar realiza un alta separada como proveedor. Tener Medi-Cal, compartir domicilio o haber cuidado sin cobrar no establece un horario remunerado." }, "sections": [ { "key": "programs", "title": { "en": "IHSS and WPCS solve different questions", "es": "IHSS y WPCS responden a necesidades distintas" }, "paragraphs": { "en": [ "IHSS supports eligible older, blind or disabled people in their own homes. Waiver Personal Care Services, or WPCS, is an additional route tied to the Home and Community-Based Alternatives waiver. WPCS requires HCBA enrollment, IHSS services and a physician-directed treatment plan; it is not another name for ordinary IHSS. Ask which office owns each authorization so hours are not duplicated.", "For an initial IHSS inquiry, use the county office rather than a payroll company advertising a statewide wage. The state explains that hourly wages differ by county. Request the current county rate and effective date before using a pay estimate. A reimbursement amount from an agency contract may describe a different arrangement." ], "es": [ "IHSS ayuda a personas mayores, ciegas o con discapacidad que reúnen los requisitos y viven en su hogar. Waiver Personal Care Services, o WPCS, es una vía adicional ligada a la exención Home and Community-Based Alternatives. WPCS exige inscripción en HCBA, servicios IHSS y un plan de tratamiento indicado por un médico; no es otro nombre para IHSS ordinario. Pregunta qué oficina autoriza cada servicio para evitar duplicar horas.", "Para iniciar IHSS, contacta con el condado en lugar de elegir una empresa por un salario estatal anunciado. El estado explica que la tarifa por hora varía según el condado. Solicita la tarifa vigente y su fecha antes de calcular ingresos. Un importe de reembolso de una agencia puede corresponder a un modelo diferente." ] }, "source_urls": [ "https://www.cdss.ca.gov/in-home-supportive-services", "https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/waiver-personal-care-services-frequently-asked-questions-2/" ] }, { "key": "eligibility", "title": { "en": "Two reviews: Medi-Cal and assistance at home", "es": "Dos revisiones: Medi-Cal y ayuda en casa" }, "paragraphs": { "en": [ "A county social worker visits the home and examines what the applicant can safely do. Describe the assistance actually needed with bathing, dressing, meals, mobility or other requested tasks; a diagnosis alone does not state how much help is needed. IHSS requires a completed health care certification, commonly SOC 873, before services can be authorized.", "Medi-Cal financial eligibility is a separate decision. California resumed asset tests for some coverage categories in January 2026, so old advice that assets never count is unsafe. Ask the county which category applies, which household members count and which resources are exempt. Do not transfer property based on a website calculator." ], "es": [ "Un trabajador social del condado visita el domicilio y valora lo que la persona puede hacer con seguridad. Explica la ayuda real para bañarse, vestirse, preparar comida, desplazarse u otras tareas solicitadas; el diagnóstico por sí solo no indica cuánta asistencia necesita. IHSS exige una certificación sanitaria cumplimentada, habitualmente SOC 873, antes de autorizar servicios.", "La elegibilidad económica de Medi-Cal es una decisión distinta. California recuperó las pruebas de patrimonio para algunas categorías en enero de 2026, por lo que ya no sirve afirmar que los bienes nunca cuentan. Pregunta qué categoría corresponde, qué familiares se computan y qué recursos están exentos. No transfieras patrimonio basándote en una calculadora web." ] }, "source_urls": [ "https://www.cdss.ca.gov/in-home-supportive-services", "https://www.dhcs.ca.gov/medi-cal/help/asset-limit-frequently-asked%20questions/" ] }, { "key": "waiting", "title": { "en": "Track the application, assessment and start date", "es": "Distingue solicitud, evaluación y fecha de inicio" }, "paragraphs": { "en": [ "Keep the date the county received your application and ask whether certification or other documents are missing. A pending needs assessment and a pending provider enrollment are different delays. WPCS or HCBA availability must also be checked separately; an IHSS application does not automatically enroll someone in the waiver.", "The approval notice identifies services and monthly hours. Read any denial or reduction notice promptly and use its stated review instructions. If circumstances change, the recipient may request reassessment. This guide does not assign a universal approval time or promise payment for all earlier unpaid family care." ], "es": [ "Guarda la fecha de recepción de la solicitud y pregunta si falta la certificación u otro documento. Una evaluación de necesidades pendiente y un alta del proveedor pendiente son retrasos distintos. La disponibilidad de WPCS o HCBA también debe comprobarse aparte; solicitar IHSS no inscribe automáticamente en la exención.", "La notificación de aprobación identifica servicios y horas mensuales. Lee pronto cualquier denegación o reducción y sigue las instrucciones de revisión indicadas. Si cambian las circunstancias, la persona puede pedir una nueva evaluación. Esta guía no fija un plazo universal ni promete cobrar todos los cuidados familiares prestados anteriormente." ] }, "source_urls": [ "https://www.cdss.ca.gov/in-home-supportive-services", "https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/waiver-personal-care-services-frequently-asked-questions-2/" ] }, { "key": "enrollment", "title": { "en": "The family member must enroll as a provider", "es": "El familiar debe darse de alta como proveedor" }, "paragraphs": { "en": [ "The recipient hires and supervises the individual provider. County orientation, provider enrollment paperwork and background requirements must be completed through the county or Public Authority. Confirm that the worker is linked to the correct recipient and that the intended first work date is accepted before relying on payroll.", "Children have additional subprogram rules. CDSS distinguishes PCSP, which restricts a parent serving their minor child, from CFCO, IPO and IHSS-R arrangements that may permit an enrolled parent. Tell the county about the proposed family relationship at the start rather than treating every IHSS household alike." ], "es": [ "La persona beneficiaria contrata y supervisa al proveedor individual. La orientación, los formularios y los requisitos de antecedentes se completan mediante el condado o su Autoridad Pública. Comprueba que el trabajador esté vinculado a la persona correcta y que la fecha prevista de inicio sea aceptada antes de contar con la nómina.", "Los menores tienen reglas adicionales por subprograma. CDSS distingue PCSP, que restringe que un padre atienda a su hijo menor, de CFCO, IPO e IHSS-R, que pueden permitir a un progenitor inscrito. Comunica el parentesco desde el principio; no todas las familias IHSS se rigen por la misma regla." ] }, "source_urls": [ "https://www.cdss.ca.gov/inforesources/ihss/ihss-providers/orientation-process/quot", "https://cdss.ca.gov/ihss-for-children" ] }, { "key": "records", "title": { "en": "Electronic timesheets and live-in arrangements", "es": "Hojas electrónicas y cuidadores convivientes" }, "paragraphs": { "en": [ "IHSS uses electronic or telephone timesheets. Non-live-in providers also record check-in, check-out and service location through an approved method. Providers who live with the recipient can submit the live-in self-certification; that changes specified EVV fields, not the duty to report actual hours. Ask for accessible or language assistance if the timekeeping system is difficult to use." ], "es": [ "IHSS utiliza hojas de horas electrónicas o telefónicas. Los proveedores que no conviven registran además entrada, salida y lugar mediante un método aprobado. Quienes viven con la persona pueden presentar la declaración de convivencia; cambia determinados campos de EVV, no la obligación de declarar horas reales." ] }, "source_urls": [ "https://cdss.ca.gov/inforesources/cdss-programs/ihss/evvhelp" ] } ], "faqs": [ { "q": { "en": "Is there one California IHSS wage?", "es": "¿Existe un único salario IHSS en California?" }, "a": { "en": "No. CDSS directs recipients to the county social worker because county wage agreements differ.", "es": "No. CDSS remite al trabajador social del condado porque los acuerdos salariales varían." } }, { "q": { "en": "Does living together remove timekeeping duties?", "es": "¿Convivir elimina el registro de horas?" }, "a": { "en": "No. Self-certified live-in providers still report daily and total hours even when some EVV fields do not apply.", "es": "No. Los convivientes declarados siguen registrando horas diarias y totales aunque no se apliquen ciertos campos EVV." } }, { "q": { "en": "Can a parent provide IHSS to a child?", "es": "¿Puede un progenitor prestar IHSS a su hijo?" }, "a": { "en": "Possibly, depending on the IHSS subprogram and completed enrollment. Tell the county about the parent-provider preference.", "es": "Es posible según el subprograma y el alta completada. Comunica al condado la preferencia por un progenitor proveedor." } }, { "q": { "en": "Does IHSS approval automatically add WPCS?", "es": "¿Aprobar IHSS añade WPCS automáticamente?" }, "a": { "en": "No. WPCS has HCBA enrollment and treatment-plan requirements and is coordinated with the assigned waiver agency.", "es": "No. WPCS exige inscripción HCBA y un plan de tratamiento, y se coordina con la agencia de la exención." } } ], "slug_en": "california-ihss", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "CO", "state": "Colorado", "slug": "colorado-ihss", "program": "Community First Choice: IHSS and CDASS", "medicaid_name": "Health First Colorado", "agency_url": "https://hcpf.colorado.gov/community-first-choice-option", "summary": "Colorado implemented Community First Choice in July 2025, with IHSS and CDASS among its service delivery options. These options involve different responsibilities for arranging and managing support.", "steps": { "en": [ "Contact the local Case Management Agency for CFC assessment.", "Confirm Medicaid coverage, level of care and any separate waiver requirements.", "Compare IHSS and CDASS responsibilities and worker eligibility.", "Complete the service plan, training and employment or financial management enrollment.", "Confirm current hour rules, wage, start date and EVV instructions." ], "es": [ "Contacta a la Case Management Agency para evaluar CFC.", "Confirma cobertura, nivel asistencial y requisitos de otra exención.", "Compara responsabilidades IHSS/CDASS y elegibilidad laboral.", "Completa plan, formación y alta laboral o financiera.", "Confirma reglas de horas, salario, inicio e instrucciones EVV." ] }, "caution": "Provider reimbursement schedules are not necessarily the amount a family caregiver receives.", "spouse_policy": "conditional", "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "Colorado HCPF: CFC implementation memo", "url": "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-057%20Community%20First%20Choice%20%28CFC%29%20Program%20Implementation.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Colorado HCPF: CFC service transition bulletin", "url": "https://hcpf.colorado.gov/sites/hcpf/files/Bulletin%200725_B2500525_0.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Colorado HCPF: CFC FAQ, updated July 2026", "url": "https://docs.google.com/document/d/1P7rRa9Go3ftbwwISsebcdLe_A5VoIGxKgwll9-7aDn8/edit", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Colorado HCPF: FMS comparison chart", "url": "https://hcpf.colorado.gov/sites/hcpf/files/FMS%20Comparison%20Chart%202.2024.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Colorado HCPF: CDASS and children", "url": "https://hcpf.colorado.gov/sites/hcpf/files/Consumer%20Directed%20Attendant%20Support%20Services%20and%20Kids%20April%202025.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Colorado HCPF: live-in EVV exemption process memo", "url": "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-068%20Temporary%20Pause%20of%20the%20Provider%20Portal%20EVV%20Exemption%20Process%20for%20Live-in%20Caregivers.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Jefferson County: CFC information and official FAQ link", "url": "https://www.jeffco.us/5000/Community-First-Choice", "access": "direct", "checked_on": "2026-11-15" } ], "state_es": "Colorado", "slug_es": "colorado-cfc-ihss-cdass-cuidadores", "spouse_policy_override": "conditional", "agency": { "en": "Colorado HCPF administers Health First Colorado; the local Case Management Agency handles assessment and service planning.", "es": "HCPF administra Health First Colorado; la Case Management Agency local gestiona evaluación y planificación." }, "fms": { "en": "CDASS uses a selected financial management services vendor; IHSS uses an enrolled agency. Confirm current provider choices with the case manager.", "es": "CDASS utiliza un proveedor elegido de gestión financiera; IHSS utiliza una agencia inscrita. Confirma opciones actuales con el gestor." }, "payment": { "en": "Approved CFC attendant services delivered through the chosen model, with a service allocation and separate employment terms.", "es": "Servicios de asistencia CFC aprobados mediante la modalidad elegida, con asignación asistencial y condiciones laborales separadas." }, "spouse": { "en": "HCPF permits legally responsible persons, including spouses, to provide certain services through IHSS or CDASS, subject to service and hour rules.", "es": "HCPF permite que personas legalmente responsables, incluidos cónyuges, presten determinados servicios mediante IHSS o CDASS, sujetos a reglas de servicios y horas." }, "minors": { "en": "Parents can be attendants in appropriate IHSS or CDASS arrangements; assessment distinguishes extraordinary disability-related care from ordinary age-appropriate parenting.", "es": "Los padres pueden ser asistentes en modalidades IHSS o CDASS apropiadas; la evaluación distingue cuidados extraordinarios de la crianza ordinaria correspondiente a la edad." }, "overview": { "en": "Colorado’s Community First Choice changed how many attendant services are funded. CFC began in July 2025, and the state’s transition bulletin moved the affected services out of waiver funding by July 2026. An older guide describing every IHSS or CDASS service solely as a waiver benefit may therefore point families toward an outdated process.", "es": "Community First Choice cambió la financiación de numerosos servicios de asistencia en Colorado. CFC empezó en julio de 2025 y el boletín estatal trasladó los servicios afectados fuera de las exenciones para julio de 2026. Una guía que describa todo IHSS o CDASS exclusivamente como beneficio de una exención puede indicar trámites desactualizados." }, "sections": [ { "key": "programs", "title": { "en": "CFC is the benefit; IHSS and CDASS are delivery models", "es": "CFC es el beneficio; IHSS y CDASS son modalidades" }, "paragraphs": { "en": [ "CFC is a Medicaid state-plan option that can coexist with an HCBS waiver when services do not duplicate each other. The important distinction is between the funding benefit and the way attendants are employed. Families should ask which services are now CFC and which separate waiver services remain in the plan.", "CDASS gives the member or authorized representative employer and budget responsibilities with financial management support. IHSS involves an enrolled agency and a different support structure. Ask the case manager to compare these responsibilities before choosing; familiar program initials alone do not explain the family’s workload or employment terms." ], "es": [ "CFC es una opción del plan estatal Medicaid que puede coexistir con una exención HCBS sin duplicar servicios. La distinción importante es entre el beneficio que financia la atención y la modalidad laboral. Pregunta qué servicios pertenecen ahora a CFC y cuáles siguen en una exención separada.", "CDASS atribuye a la persona o representante autorizado responsabilidades laborales y presupuestarias con apoyo financiero. IHSS utiliza una agencia inscrita y otra estructura de apoyo. Pide al gestor comparar responsabilidades antes de elegir; las siglas conocidas no explican por sí solas el trabajo administrativo familiar ni las condiciones laborales." ] }, "source_urls": [ "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-057%20Community%20First%20Choice%20%28CFC%29%20Program%20Implementation.pdf", "https://hcpf.colorado.gov/sites/hcpf/files/Bulletin%200725_B2500525_0.pdf", "https://www.jeffco.us/5000/Community-First-Choice" ] }, { "key": "eligibility", "title": { "en": "Coverage, level of care and family roles all matter", "es": "Importan cobertura, nivel asistencial y funciones familiares" }, "paragraphs": { "en": [ "CFC does not create a new financial eligibility category. The applicant needs the applicable Health First Colorado coverage and institutional level-of-care determination. A waiver participant may also have requirements for retaining the separate waiver. Ask the case manager to explain both decisions rather than assuming enrollment in one program proves eligibility for every service.", "The state’s current FAQ permits legally responsible relatives, including spouses and parents, to provide specified services under IHSS or CDASS. Such care must follow the assessed tasks and restrictions. For a child, document the additional disability-related assistance beyond ordinary expectations for that age; routine parenting is not automatically billable care." ], "es": [ "CFC no crea una categoría nueva de elegibilidad económica. Se necesita cobertura Health First Colorado aplicable y determinación del nivel asistencial institucional. Quien participa en una exención puede tener además requisitos para conservarla. Pide al gestor explicar ambas decisiones; estar inscrito en un programa no acredita todos los servicios.", "La FAQ vigente permite que familiares legalmente responsables, incluidos cónyuges y padres, presten servicios concretos mediante IHSS o CDASS. Deben respetar tareas evaluadas y restricciones. En menores, documenta la ayuda adicional por discapacidad que excede lo habitual para su edad; la crianza ordinaria no se convierte automáticamente en atención facturable." ] }, "source_urls": [ "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-057%20Community%20First%20Choice%20%28CFC%29%20Program%20Implementation.pdf", "https://docs.google.com/document/d/1P7rRa9Go3ftbwwISsebcdLe_A5VoIGxKgwll9-7aDn8/edit", "https://hcpf.colorado.gov/sites/hcpf/files/Consumer%20Directed%20Attendant%20Support%20Services%20and%20Kids%20April%202025.pdf" ] }, { "key": "waiting", "title": { "en": "Start with the local Case Management Agency", "es": "Empieza por la Case Management Agency local" }, "paragraphs": { "en": [ "A person seeking CFC should contact the local Case Management Agency about intake and assessment. Someone already receiving services should ask the existing case manager to confirm the current funding and authorization. Avoid restarting an entire application based only on an old webpage that still describes the transition as upcoming.", "CFC assessment, financial processing, provider availability and employee onboarding are different stages. Ask what remains incomplete and who owns each step. A waiting list for a separate waiver should not be assumed to answer whether CFC assessment is available. Request a written decision and the review instructions if a service is denied." ], "es": [ "Quien solicita CFC debe consultar a su Case Management Agency local sobre admisión y evaluación. Quien ya recibe servicios debe pedir al gestor actual confirmar financiación y autorización vigentes. Evita reiniciar toda la solicitud solo porque una página antigua todavía describe la transición como futura.", "Evaluación CFC, trámite económico, disponibilidad de proveedor y alta laboral son etapas distintas. Pregunta qué falta y quién responde por cada paso. Una lista de espera de otra exención no resuelve por sí sola el acceso a evaluación CFC. Si deniegan servicios, pide decisión escrita e instrucciones de revisión." ] }, "source_urls": [ "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-057%20Community%20First%20Choice%20%28CFC%29%20Program%20Implementation.pdf", "https://hcpf.colorado.gov/sites/hcpf/files/Bulletin%200725_B2500525_0.pdf", "https://www.jeffco.us/5000/Community-First-Choice" ] }, { "key": "enrollment", "title": { "en": "Build the service plan before estimating wages", "es": "Prepara el plan antes de estimar salarios" }, "paragraphs": { "en": [ "For CDASS, discuss the attendant support management plan, employer training, budget and selected financial management vendor. For IHSS, confirm the enrolled agency, supervision and worker enrollment process. The financial management comparison materials describe administrative support; they do not establish a statewide salary for every family caregiver.", "Obtain the approved tasks, hours and actual worker wage. Colorado’s 2026 guidance changed legally responsible homemaker limits and introduced phased caregiver-hour limits. These limits constrain staffing; they are not automatic awards of that much care. Ask the case manager for the rule and effective date applicable to your arrangement." ], "es": [ "En CDASS, revisa plan de gestión de asistentes, formación del empleador, presupuesto y proveedor financiero elegido. En IHSS, confirma agencia inscrita, supervisión y alta del trabajador. Los materiales comparativos financieros describen apoyo administrativo; no establecen un salario estatal para todos los familiares.", "Obtén tareas, horas aprobadas y salario real. Las instrucciones de 2026 modificaron límites de tareas domésticas por personas legalmente responsables e introdujeron límites escalonados de horas por cuidador. Restringen la organización del personal; no conceden automáticamente esa cantidad de atención. Solicita la regla y fecha efectiva aplicables." ] }, "source_urls": [ "https://docs.google.com/document/d/1P7rRa9Go3ftbwwISsebcdLe_A5VoIGxKgwll9-7aDn8/edit", "https://hcpf.colorado.gov/sites/hcpf/files/FMS%20Comparison%20Chart%202.2024.pdf", "https://hcpf.colorado.gov/sites/hcpf/files/Consumer%20Directed%20Attendant%20Support%20Services%20and%20Kids%20April%202025.pdf" ] }, { "key": "records", "title": { "en": "Confirm live-in documentation and visit verification", "es": "Confirma documentación de convivencia y visitas" }, "paragraphs": { "en": [ "Colorado has issued specific instructions about live-in EVV exemptions, including a pause in one portal submission process while providers retain supporting records. A shared home does not erase documentation duties. Ask the agency or financial management vendor for its current instructions, the applicable exception process and how different service types must be recorded. Keep authorization and actual work records aligned." ], "es": [ "Colorado ha publicado instrucciones específicas sobre exenciones EVV por convivencia, incluida una pausa de un trámite del portal mientras los proveedores conservan justificantes. Compartir vivienda no elimina la documentación. Pide a la agencia o proveedor financiero instrucciones vigentes, procedimiento de excepción y registro de los distintos servicios. Mantén alineados autorización y trabajo realizado." ] }, "source_urls": [ "https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2025-068%20Temporary%20Pause%20of%20the%20Provider%20Portal%20EVV%20Exemption%20Process%20for%20Live-in%20Caregivers.pdf" ] } ], "faqs": [ { "q": { "en": "Did CFC abolish all HCBS waivers?", "es": "¿CFC eliminó todas las exenciones HCBS?" }, "a": { "en": "No. CFC and a waiver can coexist when eligibility and nonduplication requirements are met.", "es": "No. Pueden coexistir si se cumplen elegibilidad y ausencia de duplicación." } }, { "q": { "en": "Can parents participate in CDASS?", "es": "¿Pueden participar los padres en CDASS?" }, "a": { "en": "Yes, under appropriate eligibility, service and legally responsible person rules; ordinary parenting is not automatically payable.", "es": "Sí, según elegibilidad y reglas de servicios y responsabilidad legal; la crianza ordinaria no se paga automáticamente." } }, { "q": { "en": "Does a CFC reimbursement rate equal my wage?", "es": "¿La tarifa de reembolso CFC equivale a mi salario?" }, "a": { "en": "No. Confirm the worker wage and employment costs under the chosen delivery model.", "es": "No. Confirma salario y costes laborales en la modalidad elegida." } }, { "q": { "en": "Do live-in caregivers still need records?", "es": "¿Los cuidadores convivientes necesitan registros?" }, "a": { "en": "Yes. Ask the agency or fiscal vendor about current EVV exception documentation and payroll records.", "es": "Sí. Consulta a la agencia o proveedor financiero la documentación EVV y de nómina vigente." } } ], "slug_en": "colorado-ihss", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "connecticut-community-first-choice", "state": "Connecticut", "code": "CT", "program": "Community First Choice (CFC)", "medicaid_name": "HUSKY Health / Connecticut Medicaid", "summary": "Connecticut describes Community First Choice as a self-directed way for eligible people living in the community to access personal attendant care and other supports. The Department of Social Services provides an application route and telephone assistance. Its page also links information about a proposed participant transition to waivers, which applicants should review.", "steps": { "en": [ "Use the DSS CFC application route.", "Prepare the Medicaid and functional-assessment information requested.", "Ask DSS to confirm the proposed caregiver’s relationship and roles.", "Complete the assigned fiscal intermediary’s hiring and recording setup.", "Keep current authorizations separate from proposed future changes." ], "es": [ "Utiliza la vía de solicitud CFC de DSS.", "Prepara la información solicitada sobre Medicaid y necesidades funcionales.", "Pide a DSS que confirme parentesco y funciones del cuidador propuesto.", "Completa contratación y registro con el intermediario fiscal asignado.", "Distingue las autorizaciones vigentes de los cambios futuros propuestos." ] }, "caveat": "The current page discusses a proposed transition to waivers. Confirm the application route and program applicable to the individual with DSS; do not assume a guaranteed wage, family relationship approval or start date.", "agency_url": "https://portal.ct.gov/dss/community-first-choice?language=en_US", "sources": [ { "label": "DSS Community First Choice", "url": "https://portal.ct.gov/dss/community-first-choice", "access": "direct", "checked_on": "2026-11-15" }, { "label": "CFC proposed transition FAQs, March 2026", "url": "https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/community-first-choice/cfc-transition-faqs-final_31126.pdf?hash=AED5EE74D1BBFFB016FE916E0195A81B&rev=d71d954eb57047049a21ea5929ae7f9c", "access": "direct", "checked_on": "2026-11-15" }, { "label": "DSS fiscal consultation procurement addendum, April 2026", "url": "https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/dss-rfps/addendum-1-hcbs-programmatic-and-fiscal-consultation-services-rfq-04022026.pdf?hash=A3B64724397125BE12A3E731DC17D0D5&rev=5187d797ea0b4f548c1f381a0369126b", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSS community-based services overview", "url": "https://portal.ct.gov/dss/health-and-home-care/long-term-care/community-options/about-hcbs", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSS 2025 decision explaining CFC assessment standards", "url": "https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/fair-hearings/medical-services/medical-services-2025/msrv_2025_251241.pdf?rev=b5fd0a0629ba4d7fb8db0e2d2fb9fb78", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": null, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Connecticut", "slug_es": "connecticut-community-first-choice-cuidados", "spouse_policy_override": "unknown", "agency": { "en": "Connecticut Department of Social Services (DSS)", "es": "Departamento de Servicios Sociales de Connecticut (DSS)" }, "fms": { "en": "An April 2026 DSS procurement document names Guardiantrac LLC, doing business as GT Independence. Confirm the current assignment with DSS.", "es": "Un documento de contratación de DSS de abril de 2026 identifica Guardiantrac LLC, que opera como GT Independence. Confirma la entidad vigente con DSS." }, "payment": { "en": "Authorized services and the approved individual arrangement determine payment; a program budget is not the caregiver’s take-home pay.", "es": "El pago depende de los servicios y la organización individual autorizados; el presupuesto del programa no equivale al salario neto del cuidador." }, "spouse": { "en": "Do not assume spouses qualify. Ask DSS to verify the current relationship and representative restrictions for the specific service.", "es": "No supongas que se admite al cónyuge. Pide a DSS que confirme las restricciones vigentes de parentesco y representación para ese servicio." }, "minors": { "en": "A child’s support assessment and a parent’s eligibility for paid work are separate questions. Obtain current DSS guidance.", "es": "La evaluación de apoyos de un menor y la posibilidad de remunerar al progenitor son cuestiones distintas. Solicita instrucciones vigentes de DSS." }, "overview": { "en": "Community First Choice, or CFC, is Connecticut’s self-directed route to personal attendant care and other supports for eligible Medicaid members. The immediate task is to establish the person’s needs and authorized services. A proposed change to CFC is also under discussion, making dates especially important: information about a future transition should not be read as an instruction to stop current services or as confirmation of a new payment entitlement.", "es": "Community First Choice, o CFC, es la vía autodirigida de Connecticut para asistencia personal y otros apoyos de beneficiarios elegibles de Medicaid. Primero hay que establecer las necesidades y los servicios autorizados. También se debate un cambio en CFC, por lo que las fechas importan especialmente: la información sobre una transición futura no debe interpretarse como una orden para suspender servicios actuales ni como la confirmación de un nuevo derecho de cobro." }, "sections": [ { "key": "programs", "title": { "en": "Understand CFC and the proposed transition", "es": "Distingue CFC de la transición propuesta" }, "paragraphs": { "en": [ "DSS currently describes CFC as a State Plan service. Its March 2026 transition FAQ proposes moving participants to waiver or other authorities with a proposed effective date of April 1, 2027. That document describes a proposal, not a completed change. Read subsequent DSS notices before drawing conclusions about your own services. Keep copies of communications identifying your program, service coordinator and effective dates so that a future reassessment can be compared with the existing plan." ], "es": [ "DSS describe actualmente CFC como un servicio del plan estatal. Sus preguntas frecuentes de marzo de 2026 proponen trasladar participantes a programas waiver u otras modalidades, con fecha prevista del 1 de abril de 2027. Ese documento presenta una propuesta, no un cambio completado. Consulta las comunicaciones posteriores de DSS antes de sacar conclusiones sobre tus servicios. Conserva los avisos que identifican programa, coordinador y fechas para comparar una futura evaluación con el plan actual." ] } }, { "key": "eligibility", "title": { "en": "Medicaid coverage and functional assessment both matter", "es": "Importan Medicaid y la evaluación funcional" }, "paragraphs": { "en": [ "CFC eligibility includes the assessed need for an institutional level of care that can be supported in the community. Having a Medicaid card alone does not settle the amount or kind of assistance. Describe hands-on help, supervision, existing services and unpaid support accurately during assessment. Ask how the proposed schedule fits with any other home or community program the person receives. A general family-care calculation cannot replace this individualized determination or identify which relative may be hired." ], "es": [ "La elegibilidad para CFC incluye una necesidad evaluada de cuidados de nivel institucional que puedan prestarse en la comunidad. Tener una tarjeta Medicaid no determina por sí solo la cantidad o el tipo de ayuda. Describe con precisión asistencia física, supervisión, servicios existentes y apoyos no remunerados. Pregunta cómo encaja el horario propuesto con otros programas domiciliarios o comunitarios. Una calculadora familiar general no sustituye esta decisión individual ni identifica qué familiar puede contratarse." ] } }, { "key": "waiting", "title": { "en": "Ask what stage your application has reached", "es": "Pregunta en qué fase está la solicitud" }, "paragraphs": { "en": [ "Start with the CFC application route on the DSS program page. Then distinguish a received application from an assessment appointment, an approved plan and completed worker onboarding. Request the contact responsible for the next step and retain any requests for missing documents. Neither the proposed transition date nor an online application receipt promises a first payday. If already receiving support, seek instructions for your own case before changing workers or altering the authorized schedule." ], "es": [ "Empieza por la vía de solicitud CFC de la página de DSS. Distingue después entre solicitud recibida, cita de evaluación, plan aprobado e incorporación terminada del trabajador. Pide el contacto responsable del siguiente paso y conserva las peticiones de documentos pendientes. Ni la fecha prevista de transición ni el justificante de solicitud prometen una primera nómina. Si ya recibes apoyos, solicita instrucciones para tu caso antes de cambiar trabajadores o modificar el horario autorizado." ] } }, { "key": "enrollment", "title": { "en": "Confirm the worker and fiscal arrangement", "es": "Confirma quién trabaja y quién gestiona los pagos" }, "paragraphs": { "en": [ "Connecticut’s April 2026 procurement material identifies GT Independence in the state’s fiscal-intermediary arrangement. Use DSS instructions to confirm where your hiring paperwork belongs. Explain the proposed worker’s family relationship, household address and any guardianship or decision-making role. Ask explicitly whether that combination is permitted. The proposed-transition FAQ also distinguishes a caregiver from a support-and-planning coach; families should not assume that one person may hold both paid roles." ], "es": [ "La documentación de contratación de Connecticut de abril de 2026 identifica GT Independence en la gestión fiscal estatal. Sigue las instrucciones de DSS para confirmar dónde presentar los documentos laborales. Explica parentesco, domicilio y posibles funciones de tutela o representación del trabajador propuesto. Pregunta expresamente si esa combinación está permitida. Las preguntas sobre la transición también distinguen al cuidador del asesor de apoyo y planificación; no debe suponerse que alguien puede ocupar ambos puestos remunerados." ] } }, { "key": "records", "title": { "en": "Keep a usable record through any changes", "es": "Mantén un registro útil durante los cambios" }, "paragraphs": { "en": [ "Electronic Visit Verification is part of CFC administration. Ask the fiscal intermediary which recording method applies and whether any documented exception fits your situation; do not treat co-residence as an automatic exemption. Keep the plan, approved schedule, worker enrollment confirmation and corrections together. If the state sends a transition or reassessment notice, note the action requested and response date. Request clarification when the proposed service description differs from what the person currently receives." ], "es": [ "La verificación electrónica de visitas forma parte de la gestión CFC. Pregunta al intermediario fiscal qué método corresponde y si existe una excepción documentada aplicable; convivir no debe interpretarse como exención automática. Guarda juntos plan, horario aprobado, inscripción del trabajador y correcciones. Si recibes una notificación de transición o reevaluación, apunta qué solicita y hasta cuándo responder. Pide aclaraciones si la descripción propuesta del servicio difiere de lo que recibe actualmente la persona." ] } } ], "faqs": [ { "q": { "en": "Has the proposed April 2027 transition already happened?", "es": "¿Ya se ha realizado la transición propuesta para abril de 2027?" }, "a": { "en": "No. The cited March 2026 FAQ describes a future proposal; check later DSS notices.", "es": "No. El documento citado de marzo de 2026 describe una propuesta futura; consulta los avisos posteriores de DSS." } }, { "q": { "en": "Does a CFC application authorize my relative’s pay?", "es": "¿Solicitar CFC autoriza el pago a mi familiar?" }, "a": { "en": "No. Assessment, service authorization and permitted worker enrollment still need to be resolved.", "es": "No. Aún deben resolverse evaluación, autorización e inscripción de un trabajador permitido." } }, { "q": { "en": "Is CFC only an hourly wage for relatives?", "es": "¿CFC es solo un salario por hora para familiares?" }, "a": { "en": "No. DSS describes personal attendant care and other self-directed services and supports.", "es": "No. DSS describe asistencia personal y otros servicios y apoyos autodirigidos." } }, { "q": { "en": "Should I assume a live-in EVV exemption?", "es": "¿Debo suponer una exención de EVV por convivencia?" }, "a": { "en": "No. Ask the assigned fiscal intermediary for the applicable rules and documentation.", "es": "No. Solicita al intermediario fiscal las reglas aplicables y los documentos necesarios." } } ], "slug_en": "connecticut-community-first-choice", "spouse_policy": "unknown", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "FL", "state": "Florida", "slug": "florida-ltc-waiver", "program": "Long-Term Care Participant Direction Option (PDO)", "medicaid_name": "Florida Medicaid", "agency_url": "https://ahca.myflorida.com/content/download/28429/file/LTC%20Waiver%20Final%2004.01.25.PDF", "summary": "Florida offers participant direction within its Long-Term Care waiver for people living in their own or a family home with a PDO-eligible service on the authorized care plan. PDO is a delivery option within the program.", "steps": { "en": [ "Contact the local ADRC about the appropriate LTC entry screening.", "Complete the applicable financial and CARES assessments.", "After plan enrollment, ask the case manager about PDO services.", "Confirm representative and worker eligibility and complete training.", "Agree pay, authorized shifts, backup care and recording instructions." ], "es": [ "Contacta al ADRC local para la evaluación de acceso LTC.", "Completa las evaluaciones económicas y CARES correspondientes.", "Tras la afiliación, consulta servicios PDO con el gestor.", "Confirma representante y trabajador y completa formación.", "Acuerda salario, turnos autorizados, sustituciones y registros." ] }, "caution": "Having Medicaid does not establish waiver enrollment, an authorized PDO service or permission to pay a particular family member.", "spouse_policy": "unknown", "allows_spouse": null, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "Florida AHCA: Participant Direction Option", "url": "https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/long-term-care-plans-participant-direction-option-pdo.html", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Florida Elder Affairs: Medicaid managed LTC", "url": "https://elderaffairs.org/programs-and-services/statewide-medicaid-managed-care-long-term-care-program/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Florida Elder Affairs: CARES", "url": "https://elderaffairs.org/programs-and-services/comprehensive-assessment-and-review-for-long-term-care-services-cares-program/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Florida AHCA: July 2026 LTC contract exhibit", "url": "https://ahca.myflorida.com/file/medicaid/Health_Exhibit%20II-B%20-%20Long-Term%20Care%20%28LTC%29%20Program_July%202026.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Florida AHCA: approved LTC waiver background", "url": "https://ahca.myflorida.com/content/download/25511/file/1915%20%28c%20%29%20LTC%20approved%202023.PDF", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Florida AHCA: LTC recipient FAQs", "url": "https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/statewide-medicaid-managed-care-long-term-care-recipient-faqs.html", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Florida", "slug_es": "florida-pdo-cuidados-larga-duracion", "agency": { "en": "Florida AHCA administers Medicaid LTC; Elder Affairs, CARES and financial eligibility offices have separate roles.", "es": "AHCA administra Medicaid LTC; Elder Affairs, CARES y las oficinas de elegibilidad económica tienen funciones separadas." }, "fms": { "en": "Ask the enrolled LTC plan who administers its PDO payroll and worker onboarding.", "es": "Pregunta al plan LTC quién gestiona nóminas PDO y el alta del trabajador." }, "payment": { "en": "Plan-authorized PDO services with an agreed worker rate and recorded service time.", "es": "Servicios PDO autorizados por el plan, con tarifa acordada y tiempo de atención registrado." }, "spouse": { "en": "Ask the plan to confirm current legally responsible relative rules for the specific PDO service before assuming a spouse can be paid.", "es": "Pide al plan confirmar las reglas vigentes para familiares legalmente responsables según el servicio PDO antes de suponer que el cónyuge puede cobrar." }, "minors": { "en": "This guide covers the adult LTC route; it does not establish eligibility for a parent caring for a minor.", "es": "Esta guía trata la vía LTC para adultos; no acredita elegibilidad de padres que cuidan a menores." }, "overview": { "en": "Florida’s Participant Direction Option sits inside the Statewide Medicaid Managed Care Long-Term Care program. It offers an employment choice for certain covered services after eligibility and a care plan are established. A family cannot bypass LTC screening simply by finding a relative willing to become an employee.", "es": "La opción Participant Direction Option de Florida pertenece al programa Statewide Medicaid Managed Care Long-Term Care. Permite elegir cómo contratar para ciertos servicios cubiertos una vez establecidos elegibilidad y plan de atención. Encontrar un familiar dispuesto a trabajar no permite saltarse la evaluación LTC." }, "sections": [ { "key": "programs", "title": { "en": "PDO is an option within an LTC plan", "es": "PDO es una opción dentro de un plan LTC" }, "paragraphs": { "en": [ "The LTC plan’s case manager is the practical contact for participant direction once coverage is active. State PDO materials cover services such as personal care, homemaker, companion and certain nursing services, subject to the authorized plan and worker qualifications. Not every LTC service becomes a cash budget controlled by the family.", "Other Florida programs use similar consumer-direction language. In particular, Consumer Directed Care Plus is a separate program and should not be substituted for the LTC PDO enrollment process. Begin each inquiry with the recipient’s exact program and plan name so the office can give the correct forms." ], "es": [ "Una vez activa la cobertura, el gestor de casos del plan LTC es el contacto práctico para autodirección. Los materiales PDO incluyen atención personal, tareas domésticas, acompañamiento y determinados servicios de enfermería, según el plan autorizado y las cualificaciones laborales. No todos los servicios LTC se convierten en un presupuesto libre para la familia.", "Otros programas de Florida utilizan términos parecidos. Consumer Directed Care Plus es un programa separado y no debe sustituir el trámite PDO de LTC. Empieza cada consulta indicando el programa y plan exactos de la persona para que la oficina facilite los documentos correctos." ] }, "source_urls": [ "https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/long-term-care-plans-participant-direction-option-pdo.html", "https://ahca.myflorida.com/content/download/25511/file/1915%20%28c%20%29%20LTC%20approved%202023.PDF" ] }, { "key": "eligibility", "title": { "en": "Financial and care assessments are separate", "es": "La evaluación económica y la asistencial son distintas" }, "paragraphs": { "en": [ "Florida uses CARES to evaluate the level of care relevant to long-term services. Financial eligibility is handled through the applicable Medicaid eligibility process, with agencies such as the Department of Children and Families involved. An ordinary Medicaid approval is not, by itself, approval of all LTC services or permission to hire a relative.", "For PDO, discuss whether the participant can fulfill employer duties or needs an eligible representative. The representative’s role and the paid worker’s role have separate requirements. Ask the plan about the proposed worker’s relationship, background screening, qualifications and permitted tasks before treating that person as approved." ], "es": [ "Florida utiliza CARES para evaluar el nivel de atención relacionado con servicios de larga duración. La elegibilidad económica se resuelve mediante el trámite Medicaid correspondiente, con participación de oficinas como Department of Children and Families. Una aprobación ordinaria de Medicaid no autoriza por sí sola todos los servicios LTC ni contratar a un familiar.", "En PDO, consulta si la persona puede cumplir sus obligaciones de empleador o necesita un representante elegible. Representante y trabajador remunerado tienen requisitos distintos. Pregunta por parentesco, verificación de antecedentes, cualificaciones y tareas permitidas antes de considerar aprobado al familiar propuesto." ] }, "source_urls": [ "https://elderaffairs.org/programs-and-services/comprehensive-assessment-and-review-for-long-term-care-services-cares-program/", "https://ahca.myflorida.com/content/download/25511/file/1915%20%28c%20%29%20LTC%20approved%202023.PDF", "https://ahca.myflorida.com/file/medicaid/Health_Exhibit%20II-B%20-%20Long-Term%20Care%20%28LTC%29%20Program_July%202026.pdf" ] }, { "key": "waiting", "title": { "en": "An ADRC screening is not a service start date", "es": "La evaluación ADRC no es una fecha de inicio" }, "paragraphs": { "en": [ "For someone seeking community LTC services, the local Aging and Disability Resource Center provides the entry screening and information about the waiting-list process. Florida prioritizes applicants using screening information; the list is not simply a promise of service after a fixed number of days.", "Report meaningful changes in health, safety or available informal support to the responsible screening office and ask how reassessment works. Keep contact details current. After a release or eligibility decision, there may still be plan enrollment, a service plan and PDO employee steps to complete. Those stages should be tracked separately." ], "es": [ "Para solicitar servicios comunitarios LTC, el Aging and Disability Resource Center local realiza la evaluación inicial e informa sobre la lista de espera. Florida prioriza a solicitantes según esa información; la lista no supone una promesa de atención tras un número fijo de días.", "Comunica cambios importantes de salud, seguridad o apoyo familiar disponible a la oficina responsable y pregunta cómo solicitar una reevaluación. Mantén actualizados los datos de contacto. Tras una liberación de lista o decisión de elegibilidad, pueden faltar afiliación al plan, planificación de servicios y alta PDO. Conviene seguir estos pasos por separado." ] }, "source_urls": [ "https://elderaffairs.org/programs-and-services/statewide-medicaid-managed-care-long-term-care-program/", "https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/statewide-medicaid-managed-care-long-term-care-recipient-faqs.html" ] }, { "key": "enrollment", "title": { "en": "Request the PDO documents from your plan", "es": "Solicita al plan los documentos PDO" }, "paragraphs": { "en": [ "Once the case manager confirms PDO is appropriate for an authorized service, request the current participant agreement, training and worker enrollment materials. Clarify who will recruit, supervise and approve the worker’s time, and who will process payroll. The plan must explain its operating process; a commercial caregiver calculator cannot supply those decisions.", "Ask for the wage offered to the worker, any employment costs in the arrangement, the approved schedule and the first payable service date. Arrange a backup for missed shifts. A family member’s professional license, when required for a particular service, must fit that service rather than a generic caregiver description." ], "es": [ "Cuando el gestor confirme que PDO es apropiado para un servicio autorizado, solicita acuerdo del participante, formación y documentos laborales vigentes. Aclara quién contratará, supervisará y aprobará horas y quién procesará la nómina. El plan debe explicar su procedimiento; una calculadora comercial no puede tomar esas decisiones.", "Pide el salario ofrecido, los costes laborales aplicables, horario aprobado y primera fecha remunerable. Organiza sustituciones para ausencias. Cuando un servicio exige licencia profesional, la del familiar debe corresponder a ese servicio concreto; no basta con describirse genéricamente como cuidador." ] }, "source_urls": [ "https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/long-term-care-plans-participant-direction-option-pdo.html", "https://ahca.myflorida.com/file/medicaid/Health_Exhibit%20II-B%20-%20Long-Term%20Care%20%28LTC%29%20Program_July%202026.pdf" ] }, { "key": "records", "title": { "en": "Keep plan authorization and payroll aligned", "es": "Mantén alineados autorización y nómina" }, "paragraphs": { "en": [ "Use the LTC plan’s current timekeeping and visit-verification instructions. Ask how live-in workers are handled rather than assuming a shared address removes documentation. Save the service authorization, participant agreement, worker approval and submitted records. If care needs increase, ask the case manager to review the plan; additional unpaid family help does not automatically become reimbursable time." ], "es": [ "Utiliza las instrucciones vigentes del plan para horas y verificación de visitas. Pregunta cómo se trata a trabajadores convivientes; compartir dirección no elimina automáticamente la documentación. Conserva autorización, acuerdo PDO, aprobación laboral y registros enviados. Si aumentan las necesidades, solicita revisión al gestor; la ayuda familiar adicional no se convierte automáticamente en tiempo reembolsable." ] }, "source_urls": [ "https://ahca.myflorida.com/file/medicaid/Health_Exhibit%20II-B%20-%20Long-Term%20Care%20%28LTC%29%20Program_July%202026.pdf" ] } ], "faqs": [ { "q": { "en": "Does regular Medicaid enrollment activate PDO?", "es": "¿Medicaid ordinario activa PDO?" }, "a": { "en": "No. PDO depends on the LTC route, an authorized service plan and the plan’s enrollment process.", "es": "No. Depende de la vía LTC, servicios autorizados y el trámite del plan." } }, { "q": { "en": "Who explains my position in the screening process?", "es": "¿Quién explica mi situación en la evaluación?" }, "a": { "en": "The local ADRC or responsible screening office can explain the applicable stage and reassessment route.", "es": "El ADRC u oficina responsable puede explicar la fase y la reevaluación." } }, { "q": { "en": "Is PDO the same as CDC+?", "es": "¿PDO es lo mismo que CDC+?" }, "a": { "en": "No. Similar self-direction terms can refer to different Florida programs and enrollment rules.", "es": "No. Los términos parecidos de autodirección pueden referirse a programas y trámites diferentes." } }, { "q": { "en": "Can I use an advertised agency rate as my wage?", "es": "¿Puedo usar una tarifa de agencia como salario?" }, "a": { "en": "No. Request the actual PDO worker wage and approved schedule from the enrolled plan.", "es": "No. Solicita al plan el salario real del trabajador PDO y el horario autorizado." } } ], "slug_en": "florida-ltc-waiver", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "IL", "state": "Illinois", "slug": "illinois-ccp", "program": "Community Care Program (CCP)", "medicaid_name": "Illinois Medicaid / CCP", "agency_url": "https://ilaging.illinois.gov/programs/ccp.html", "summary": "CCP helps eligible older adults remain at home with community services. It is administered by the Department on Aging. This guide covers CCP; the separate Home Services Program should not be treated as the same program.", "steps": { "en": [ "Contact the local CCU for an older adult’s CCP assessment.", "Confirm eligibility and the person-centered service plan.", "Ask which approved In-Home Service agencies hire relatives.", "Complete the selected agency’s checks, preservice training and hiring process.", "Confirm pay, authorized tasks, start date and ongoing supervision." ], "es": [ "Contacta a la CCU local para evaluar CCP.", "Confirma elegibilidad y plan centrado en la persona.", "Pregunta qué agencias aprobadas contratan familiares.", "Completa verificaciones, formación previa y contratación.", "Confirma salario, tareas autorizadas, inicio y supervisión." ] }, "caution": "Do not apply a Home Services Program wage or eligibility rule to CCP without confirmation.", "spouse_policy": "conditional", "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "Illinois Department on Aging: CCP", "url": "https://ilaging.illinois.gov/programs/ccp.html", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Illinois Department on Aging: in-home care", "url": "https://ilaging.illinois.gov/programs/caregiver/in-home-care.html", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Illinois Department on Aging: In-Home Service", "url": "https://ilaging.illinois.gov/programs/homemaker.html", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Illinois Administrative Code: care coordination and reassessment", "url": "https://my.ilga.gov/commission/jcar/admincode/089/089002400B02600R.html", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Illinois Department on Aging: appeal form", "url": "https://ilaging.illinois.gov/content/dam/soi/en/web/aging/programs/ccp/documents/notice-of-appeal-form-1551.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Illinois", "slug_es": "illinois-ccp-cuidadores-familiares", "spouse_policy_override": "conditional", "agency": { "en": "Illinois Department on Aging and the local Care Coordination Unit for Community Care Program services.", "es": "Illinois Department on Aging y Care Coordination Unit local para servicios del Community Care Program." }, "fms": { "en": "For CCP family aides, a participating In-Home Service agency hires and supervises the worker. This is not the same arrangement as an HSP personal assistant.", "es": "En CCP, una agencia participante de In-Home Service contrata y supervisa al familiar. No es la misma modalidad que un asistente personal HSP." }, "payment": { "en": "Agency employment for authorized CCP in-home services; confirm the offered wage directly with the employer.", "es": "Empleo mediante agencia para servicios domiciliarios CCP autorizados; confirma el salario con el empleador." }, "spouse": { "en": "CCP agencies may hire a qualified spouse. The worker must meet checks and training requirements, and the agency must agree to employ family members.", "es": "Las agencias CCP pueden contratar a un cónyuge cualificado. Debe cumplir verificaciones y formación, y la agencia debe aceptar contratar familiares." }, "minors": { "en": "CCP serves eligible adults age 60 or older. A parent caring for a minor needs a different program assessment.", "es": "CCP atiende a adultos elegibles de 60 años o más. Los padres que cuidan a menores necesitan evaluación para otro programa." }, "overview": { "en": "Illinois does not have a single family-caregiver employment arrangement covering every age and disability. For an older adult, the Community Care Program offers one relevant route: an approved in-home service agency may hire a family member. The local Care Coordination Unit helps determine needs, eligibility and available provider options.", "es": "Illinois no tiene una única modalidad de empleo familiar para todas las edades y discapacidades. Para una persona mayor, Community Care Program ofrece una vía: una agencia de servicios domiciliarios puede contratar al familiar. La Care Coordination Unit local ayuda a determinar necesidades, elegibilidad y proveedores disponibles." }, "sections": [ { "key": "programs", "title": { "en": "CCP and Home Services Program are different routes", "es": "CCP y Home Services Program son vías diferentes" }, "paragraphs": { "en": [ "The Department on Aging’s CCP is aimed at eligible adults age 60 and older who need support to remain at home. Its services can include in-home assistance, adult day services and other supports. The Department of Human Services Home Services Program serves a different population, including people under 60 with severe disabilities, and has different employment models.", "An HSP personal assistant may be selected and supervised directly by the customer. CCP’s family-aide route described here uses an In-Home Service agency. Ask which program is responsible before comparing salaries or assuming that a direct-hire form from another Illinois program applies." ], "es": [ "CCP, de Department on Aging, se dirige a personas elegibles de 60 años o más que necesitan apoyo para permanecer en casa. Puede incluir ayuda domiciliaria, servicios diurnos y otros apoyos. Home Services Program, de Department of Human Services, atiende a otra población, incluidas personas menores de 60 con discapacidad grave, y utiliza otras modalidades laborales.", "En HSP, el cliente puede seleccionar y supervisar directamente a un asistente personal. La vía familiar CCP explicada aquí utiliza una agencia In-Home Service. Identifica el programa antes de comparar salarios o suponer que sirve un formulario de contratación directa de otro programa de Illinois." ] }, "source_urls": [ "https://ilaging.illinois.gov/programs/ccp.html", "https://ilaging.illinois.gov/programs/caregiver/in-home-care.html" ] }, { "key": "eligibility", "title": { "en": "The recipient and the family employee have separate requirements", "es": "Persona atendida y familiar empleado cumplen requisitos distintos" }, "paragraphs": { "en": [ "The CCP eligibility review includes age, Illinois residence, the applicable citizenship or immigration requirements, financial rules and a determination of care needs. The program also addresses applying for and enrolling in Medicaid when eligible. Do not use a single national Medicaid income number as a substitute for the local review.", "Illinois explicitly allows participating CCP agencies to consider family members, including spouses and certain representatives, if they meet worker requirements. The state describes background checks and 24 hours of preservice training. These rules do not force every agency to hire a particular relative or turn an unapproved household arrangement into paid employment." ], "es": [ "La revisión CCP incluye edad, residencia en Illinois, ciudadanía o situación migratoria aplicable, reglas económicas y necesidades asistenciales. El programa también contempla solicitar e inscribirse en Medicaid cuando corresponde. Una cifra nacional de ingresos Medicaid no sustituye la evaluación local.", "Illinois permite expresamente que agencias CCP consideren familiares, incluidos cónyuges y determinados representantes, si cumplen los requisitos laborales. El estado describe verificaciones de antecedentes y 24 horas de formación previa. Estas reglas no obligan a todas las agencias a contratar a un familiar ni convierten un acuerdo doméstico sin aprobación en empleo remunerado." ] }, "source_urls": [ "https://ilaging.illinois.gov/programs/ccp.html", "https://ilaging.illinois.gov/programs/caregiver/in-home-care.html", "https://ilaging.illinois.gov/programs/homemaker.html" ] }, { "key": "waiting", "title": { "en": "Ask the CCU about assessment and provider availability", "es": "Consulta evaluación y disponibilidad con la CCU" }, "paragraphs": { "en": [ "The first practical contact is the local Care Coordination Unit. Ask what documents are needed, when the needs assessment can occur and which providers serve the address. Availability of an agency willing to employ relatives is a separate issue from whether the older adult meets CCP eligibility.", "Keep the person-centered plan and notices. Illinois has an appeal route for decisions or failures to process service requests correctly. If needs change or the main caregiver becomes unavailable, request a reassessment rather than waiting for a generic annual date. The care coordination rules also provide for regular reassessment." ], "es": [ "El primer contacto práctico es la Care Coordination Unit local. Pregunta qué documentos necesita, cuándo puede evaluar las necesidades y qué proveedores atienden ese domicilio. Encontrar una agencia dispuesta a contratar familiares es distinto de cumplir los requisitos CCP.", "Conserva el plan centrado en la persona y las notificaciones. Illinois dispone de una vía de recurso para decisiones o falta de tramitación correcta de solicitudes. Si cambian necesidades o deja de estar disponible el cuidador principal, pide reevaluación sin esperar una fecha anual genérica. Las reglas también contemplan reevaluaciones periódicas." ] }, "source_urls": [ "https://ilaging.illinois.gov/programs/homemaker.html", "https://my.ilga.gov/commission/jcar/admincode/089/089002400B02600R.html", "https://ilaging.illinois.gov/content/dam/soi/en/web/aging/programs/ccp/documents/notice-of-appeal-form-1551.pdf" ] }, { "key": "enrollment", "title": { "en": "Ask the agency whether it hires relatives", "es": "Pregunta a la agencia si contrata familiares" }, "paragraphs": { "en": [ "The state warns that not every In-Home Service provider employs family members. Tell the CCU that family employment is your preferred arrangement and ask which approved providers offer it. The chosen agency must still interview and qualify the worker, arrange checks and training, and supervise the services.", "Obtain the actual employment terms from that agency: wage, covered tasks, approved schedule, reporting contact and first payable date. Being listed in the care plan as an unpaid family support does not itself create an employee position. Clarify who covers care during training, absences or a change of provider." ], "es": [ "El estado advierte que no todos los proveedores In-Home Service contratan familiares. Comunica a la CCU que prefieres esa modalidad y pregunta qué proveedores aprobados la ofrecen. La agencia elegida debe evaluar al trabajador, gestionar verificaciones y formación y supervisar los servicios.", "Solicita las condiciones reales de empleo: salario, tareas cubiertas, horario aprobado, contacto de supervisión y fecha de inicio remunerable. Figurar como apoyo familiar no remunerado en un plan no crea por sí solo un puesto laboral. Aclara quién atenderá durante formación, ausencias o cambios de proveedor." ] }, "source_urls": [ "https://ilaging.illinois.gov/programs/homemaker.html" ] }, { "key": "records", "title": { "en": "Report changes through both the agency and CCU", "es": "Comunica cambios a la agencia y a la CCU" }, "paragraphs": { "en": [ "The agency manages employment records while the CCU manages the care coordination process. Follow the employer’s current timekeeping and visit-verification instructions and ask how any live-in arrangement is documented. Report service problems to the agency and changes in the person’s needs to the CCU. If the plan is revised, check that the agency receives the new authorization before changing paid hours." ], "es": [ "La agencia gestiona registros laborales y la CCU coordina la atención. Sigue las instrucciones vigentes del empleador para horas y verificación de visitas; pregunta cómo documentar convivencia. Comunica problemas del servicio a la agencia y cambios de necesidades a la CCU. Si se revisa el plan, comprueba que la agencia recibe la nueva autorización antes de modificar horas remuneradas." ] }, "source_urls": [ "https://ilaging.illinois.gov/programs/caregiver/in-home-care.html", "https://my.ilga.gov/commission/jcar/admincode/089/089002400B02600R.html" ] } ], "faqs": [ { "q": { "en": "Are spouses automatically excluded from CCP employment?", "es": "¿CCP excluye automáticamente a los cónyuges?" }, "a": { "en": "No. Illinois permits agencies to hire qualified spouses, subject to agency participation and worker requirements.", "es": "No. Illinois permite contratar cónyuges cualificados según participación de la agencia y requisitos laborales." } }, { "q": { "en": "Must every CCP agency hire my daughter?", "es": "¿Todas las agencias CCP deben contratar a mi hija?" }, "a": { "en": "No. The state expressly notes that some providers do not employ relatives.", "es": "No. El estado indica expresamente que algunos proveedores no contratan familiares." } }, { "q": { "en": "Is CCP the same as HSP?", "es": "¿CCP es lo mismo que HSP?" }, "a": { "en": "No. They involve different populations, administering departments and service arrangements.", "es": "No. Atienden poblaciones distintas, con departamentos y modalidades diferentes." } }, { "q": { "en": "Who reviews a change in my mother’s needs?", "es": "¿Quién revisa cambios en las necesidades de mi madre?" }, "a": { "en": "Contact the CCU for reassessment and tell the service agency about immediate scheduling or service problems.", "es": "Contacta a la CCU para reevaluación y comunica a la agencia problemas inmediatos del servicio." } } ], "slug_en": "illinois-ccp", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "indiana-pathways-family-caregiving", "state": "Indiana", "code": "IN", "program": "PathWays for Aging HCBS Waiver — Structured Family Caregiving", "medicaid_name": "Indiana Medicaid", "summary": "Indiana lists Structured Family Caregiving among services available through its home and community-based waivers. It involves a caregiver living with the person receiving daily support and an agency providing oversight and training. The PathWays waiver serves the older-adult population; the Health and Wellness waiver is a separate route for younger applicants.", "steps": { "en": [ "Contact the aging agency or current PathWays coordinator about waiver access.", "Confirm assessment, Medicaid eligibility and any waiting-list status.", "Discuss SFC suitability, co-residence and the caregiver relationship.", "Choose an enrolled SFC provider and review its caregiver agreement.", "Complete training and confirm the authorized service start and daily records." ], "es": [ "Consulta el acceso al waiver con la agencia de envejecimiento o coordinador PathWays.", "Confirma evaluación, Medicaid y situación en la lista de espera.", "Consulta idoneidad de SFC, convivencia y parentesco del cuidador.", "Elige un proveedor SFC inscrito y revisa su acuerdo con el cuidador.", "Completa formación y confirma inicio autorizado y registros diarios." ] }, "caveat": "PathWays health coverage and the PathWays HCBS waiver are distinct: the waiver has a waiting list. Structured Family Caregiving is not a uniform hourly wage. Confirm the waiver, agency arrangement and approved service before calculating any payment.", "agency_url": "https://www.in.gov/medicaid/members/home-and-community-based-services/aged-and-disabled-waiver", "sources": [ { "label": "PathWays waiver specification, August 2026", "url": "https://www.in.gov/pathways/files/PathWays1915cAug2026.PDF", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "FSSA Structured Family Caregiving provider fact sheet", "url": "https://www.in.gov/dA/1d74e4b50b/Structured-Family-Caregiving.pdf?language_id=1", "access": "direct", "checked_on": "2026-11-15" }, { "label": "SFC provider questions: spouses and daily payment", "url": "https://www.in.gov/fssa/files/SFC-FAQ-Providers.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "PathWays provider questions", "url": "https://www.in.gov/pathways/provider-frequently-asked-questions/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "HCBS waiver waiting-list information", "url": "https://www.in.gov/fssa/ddars/resources/individuals/hcbs-waiver-waiting-list-information/", "access": "direct", "checked_on": "2026-11-15" }, { "label": "PathWays HCBS waiting process checklist", "url": "https://www.in.gov/fssa/ddars/files/7-1-25ChecklistPathWaysinPathWaysProgram.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Indiana", "slug_es": "indiana-pathways-cuidados-familiares", "spouse_policy_override": "conditional", "agency": { "en": "Indiana Family and Social Services Administration (FSSA), with PathWays health plans and service coordinators", "es": "Administración de Servicios Familiares y Sociales de Indiana (FSSA), junto a los planes PathWays y sus coordinadores" }, "fms": { "en": "For Structured Family Caregiving, an enrolled SFC provider agency administers the caregiver arrangement; this is not one statewide hourly-payroll intermediary.", "es": "En Structured Family Caregiving, una agencia proveedora inscrita administra la relación con el cuidador; no existe aquí un único intermediario estatal de nóminas por horas." }, "payment": { "en": "Structured Family Caregiving uses a daily caregiver stipend. The Medicaid daily payment to the provider is not automatically the amount the caregiver receives.", "es": "Structured Family Caregiving utiliza una asignación diaria al cuidador. El pago diario de Medicaid al proveedor no equivale automáticamente a lo recibido por el cuidador." }, "spouse": { "en": "A spouse may provide approved SFC under the applicable service-plan and provider requirements. This does not authorize every hourly attendant-care option.", "es": "Un cónyuge puede prestar SFC aprobado según los requisitos del plan y del proveedor. Esto no autoriza cualquier modalidad de asistencia por horas." }, "minors": { "en": "PathWays concerns adults aged 60 and older. Ask about the separate Health and Wellness or TBI rules for a child and a legally responsible parent.", "es": "PathWays se dirige a personas de 60 años o más. Para un menor y su progenitor legalmente responsable, consulta las reglas independientes de Health and Wellness o TBI." }, "overview": { "en": "Indiana’s Structured Family Caregiving, or SFC, supports an approved living arrangement in which the person receiving care and the principal caregiver share a home. The caregiver may be a relative, but an enrolled provider agency supplies training and oversight. For an older adult, the relevant pathway may be the PathWays HCBS waiver. Two distinctions matter immediately: the waiver has its own access process, and a daily stipend cannot be estimated by multiplying an invented hourly rate by care hours.", "es": "Structured Family Caregiving, o SFC, apoya en Indiana una convivencia aprobada entre la persona atendida y su cuidador principal. Puede ser un familiar, pero una agencia proveedora inscrita ofrece formación y supervisión. Para un adulto mayor, la vía puede ser el waiver HCBS de PathWays. Hay dos distinciones fundamentales: ese waiver tiene su propio proceso de acceso y una asignación diaria no puede calcularse multiplicando una tarifa por hora inventada por el tiempo de cuidados." }, "sections": [ { "key": "programs", "title": { "en": "SFC is a live-in daily-care arrangement", "es": "SFC organiza cuidados diarios con convivencia" }, "paragraphs": { "en": [ "The August 2026 PathWays waiver describes a principal caregiver living with the member, with provider oversight and a per-day stipend. The agency’s Medicaid reimbursement also supports its responsibilities, so it should not be presented as the family’s earnings. Request the caregiver agreement: what amount is paid, which days qualify, what happens during an absence, and how replacement care is arranged. Compare agreements using the same assumptions instead of comparing an agency’s reimbursement with another provider’s caregiver offer." ], "es": [ "El waiver PathWays de agosto de 2026 describe convivencia del cuidador principal, supervisión de una entidad y asignación diaria. El reembolso Medicaid a la agencia también financia sus obligaciones, por lo que no debe presentarse como ingreso familiar. Solicita el acuerdo del cuidador: importe, días que se pagan, consecuencias de las ausencias y organización de sustituciones. Compara acuerdos con los mismos supuestos, sin enfrentar el reembolso de una agencia con la oferta salarial de otra." ] } }, { "key": "eligibility", "title": { "en": "Identify the age group and waiver", "es": "Identifica el grupo de edad y el waiver" }, "paragraphs": { "en": [ "FSSA distinguishes the PathWays waiver for people 60 and older from Health and Wellness for those 59 and younger. These waiver routes require Medicaid eligibility and nursing-facility level of care. A diagnosis or family relationship alone does not establish access. For SFC, discuss whether sharing a home is suitable and whether the proposed caregiver can meet assessed needs. Ask the service coordinator to identify the authorized service before treating informal support as paid work." ], "es": [ "FSSA distingue el waiver PathWays para personas de 60 años o más de Health and Wellness para quienes tienen 59 o menos. Estas vías exigen elegibilidad Medicaid y necesidad de cuidados de nivel de residencia de enfermería. Ni el diagnóstico ni el parentesco establecen por sí solos el acceso. Para SFC, consulta si la convivencia es adecuada y si el cuidador propuesto puede atender las necesidades evaluadas. Identifica con el coordinador el servicio autorizado antes de considerar remunerada la ayuda informal." ] } }, { "key": "waiting", "title": { "en": "PathWays coverage and the HCBS waiting list differ", "es": "La cobertura PathWays y la espera HCBS son distintas" }, "paragraphs": { "en": [ "FSSA explicitly separates enrollment in the broader PathWays program from the HCBS waiver waiting list. Being enrolled in the health program does not mean SFC can start immediately. Invitations depend on available waiver capacity and applicable priority rules, rather than a guaranteed position that counts down predictably. Confirm placement and contact details through the official dashboard or aging agency. Keep the level-of-care date and any invitation letter; respond to the instructions addressed to your household." ], "es": [ "FSSA distingue expresamente la inscripción general en PathWays de la lista de espera del waiver HCBS. Pertenecer al programa de salud no permite iniciar SFC inmediatamente. Las invitaciones dependen de plazas disponibles y prioridades aplicables, no de un puesto garantizado que avance de forma previsible. Confirma inscripción y datos de contacto mediante el panel oficial o la agencia de envejecimiento. Conserva la fecha de evaluación y cualquier invitación; responde a las instrucciones dirigidas a tu hogar." ] } }, { "key": "enrollment", "title": { "en": "Use the coordinator and the SFC provider", "es": "Coordina la incorporación con la agencia SFC" }, "paragraphs": { "en": [ "Indiana permits spouse participation in SFC under the approved arrangement. That should not be generalized to every self-directed or agency attendant service. Tell the coordinator the caregiver’s relationship and any legally responsible role, then identify an enrolled SFC agency. Ask about training, home review, backup caregivers and ongoing contact. The state’s SFC provider fact sheet includes business-certification paperwork for agencies; an individual family caregiver should obtain the agency’s own onboarding checklist rather than apply as an agency owner." ], "es": [ "Indiana permite la participación del cónyuge en SFC bajo una organización aprobada. No debe generalizarse a cualquier servicio de asistencia autodirigida o mediante agencia. Comunica al coordinador parentesco y posibles responsabilidades legales, e identifica una entidad SFC inscrita. Pregunta por formación, revisión del hogar, sustituciones y seguimiento. La ficha estatal para proveedores incluye documentos empresariales de certificación; un cuidador familiar debe pedir a su agencia la lista de incorporación individual, no solicitar inscripción como propietario de una agencia." ] } }, { "key": "records", "title": { "en": "Daily documentation is not an hourly-pay assumption", "es": "Documentar cada día no supone cobrar por horas" }, "paragraphs": { "en": [ "Obtain the provider’s instructions for documenting care, reporting absences and checking stipend statements. Do not manufacture hourly timesheets from the time spent together at home. For any separately authorized hourly service, ask its provider about Electronic Visit Verification and avoid assuming that SFC instructions apply. Keep the written plan and provider agreement together, and notify the coordinator when living arrangements or care needs change so the authorized service can be reviewed." ], "es": [ "Obtén las instrucciones del proveedor para documentar cuidados, informar de ausencias y revisar pagos. No conviertas el tiempo compartido en casa en partes de horas inventados. Para un servicio por horas autorizado por separado, pregunta a su proveedor por EVV y no supongas que sirven las instrucciones SFC. Conserva juntos plan y acuerdo, e informa al coordinador de cambios de convivencia o necesidades para que pueda revisar el servicio autorizado." ] } } ], "faqs": [ { "q": { "en": "Is SFC an hourly wage?", "es": "¿SFC paga un salario por hora?" }, "a": { "en": "No. The PathWays waiver describes a daily caregiver stipend, not an hourly wage.", "es": "No. El waiver PathWays describe una asignación diaria al cuidador." } }, { "q": { "en": "Must the caregiver live with the member?", "es": "¿Debe convivir el cuidador con el beneficiario?" }, "a": { "en": "Yes. Co-residence is part of the SFC arrangement described by FSSA.", "es": "Sí. La convivencia forma parte de SFC según FSSA." } }, { "q": { "en": "Does PathWays enrollment bypass the waiver wait?", "es": "¿Inscribirse en PathWays evita la espera del waiver?" }, "a": { "en": "No. General PathWays coverage and the HCBS waiver waiting list are distinct.", "es": "No. La cobertura general y la lista de espera HCBS son distintas." } }, { "q": { "en": "Can a spouse provide SFC?", "es": "¿Puede prestar SFC un cónyuge?" }, "a": { "en": "Potentially, through the approved SFC service plan and provider arrangement; not automatically through every care option.", "es": "Puede hacerlo mediante un plan SFC y una entidad aprobados; no automáticamente en cualquier modalidad de cuidados." } } ], "slug_en": "indiana-pathways-family-caregiving", "spouse_policy": "conditional", "payment_basis": "daily", "sample": { "rate": 80, "units": 5, "kind": "hypothetical_not_state_rate" } }, { "slug": "massachusetts-pca", "state": "Massachusetts", "code": "MA", "program": "MassHealth Personal Care Attendant (PCA) Program", "medicaid_name": "MassHealth", "summary": "MassHealth's PCA program supports people with chronic or permanent disabilities who need personal assistance. The person receiving services acts as the employer and manages their attendants. A Personal Care Management agency can explain enrollment and the assessment process. Being a relative does not by itself establish eligibility to be paid.", "steps": { "en": [ "Check Standard or CommonHealth coverage.", "Contact a Personal Care Management agency for PCA assessment.", "Disclose the caregiver’s relationship and any representative role.", "Complete Tempus enrollment and confirm authorized service dates.", "Review activity records and pay statements together." ], "es": [ "Comprueba la cobertura Standard o CommonHealth.", "Contacta con una agencia Personal Care Management para evaluar PCA.", "Comunica el parentesco y cualquier función de representación del cuidador.", "Completa la inscripción en Tempus y confirma las fechas autorizadas.", "Revisa conjuntamente registros de actividad y nóminas." ] }, "caveat": "PCA is a specific MassHealth service, not a universal caregiver allowance. The member must qualify and the services must be covered. This guide does not determine which relatives can be hired.", "agency_url": "https://www.mass.gov/masshealth-personal-care-attendant-program", "sources": [ { "label": "MassHealth PCA program", "url": "https://www.mass.gov/masshealth-personal-care-attendant-program", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "PCA eligibility fact sheet", "url": "https://www.mass.gov/info-details/masshealth-personal-care-attendant-program-fact-sheet", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Consumer-employer handbook, July 2026", "url": "https://www.mass.gov/doc/pca-consumer-employer-handbook-effective-july-1-2026/download", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "MassHealth PCA fiscal intermediary: Tempus", "url": "https://www.mass.gov/info-details/masshealth-personal-care-attendant-pca-fiscal-intermediary-tempus", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "EVV for consumer-directed programs", "url": "https://www.mass.gov/info-details/learn-about-evv-for-consumer-directed-programs", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Adult Foster Care fact sheet", "url": "https://www.mass.gov/info-details/masshealth-adult-foster-care-program-fact-sheet", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Massachusetts", "slug_es": "massachusetts-pca-cuidados-familiares", "spouse_policy_override": "not_allowed", "agency": { "en": "MassHealth, Massachusetts Executive Office of Health and Human Services", "es": "MassHealth, Oficina Ejecutiva de Salud y Servicios Humanos de Massachusetts" }, "fms": { "en": "Tempus Unlimited is the fiscal intermediary for the MassHealth PCA program.", "es": "Tempus Unlimited es el intermediario fiscal del programa PCA de MassHealth." }, "payment": { "en": "Pay for authorized PCA service hours, processed through Tempus; Adult Foster Care uses a different arrangement.", "es": "Remuneración por horas autorizadas de servicios PCA, tramitada mediante Tempus; Adult Foster Care utiliza otra modalidad." }, "spouse": { "en": "The consumer’s legal spouse cannot be their paid PCA.", "es": "El cónyuge legal del beneficiario no puede ser su PCA remunerado." }, "minors": { "en": "A parent or foster parent cannot be the paid PCA of their minor child; other prohibited roles also apply.", "es": "Un padre o padre de acogida no puede ser el PCA remunerado de su hijo menor; también existen otras incompatibilidades." }, "overview": { "en": "Massachusetts offers several kinds of home support, but a search for family caregiver pay often leads to the Personal Care Attendant program. PCA is a consumer-employer arrangement: the person receiving care manages the worker. A Personal Care Management agency helps with assessment and program skills, while Tempus handles fiscal administration. These organizations have different jobs, so identifying the right contact can prevent a payroll question from becoming a delayed care request.", "es": "Massachusetts ofrece varios tipos de apoyo domiciliario, pero buscar una remuneración como cuidador familiar suele conducir al programa Personal Care Attendant. PCA funciona con el beneficiario como empleador: la persona atendida dirige al trabajador. Una agencia Personal Care Management ayuda con la evaluación y el aprendizaje del programa, mientras Tempus gestiona la administración fiscal. Son funciones distintas; identificar el contacto adecuado evita que una duda de nómina retrase una solicitud de cuidados." }, "sections": [ { "key": "programs", "title": { "en": "PCA and Adult Foster Care serve different arrangements", "es": "PCA y Adult Foster Care organizan cuidados distintos" }, "paragraphs": { "en": [ "PCA supports self-directed assistance with approved daily tasks. Adult Foster Care, or AFC, instead involves a caregiver living with the member and an AFC provider supplying oversight and support. The AFC fact sheet also excludes spouses and legal guardians as caregivers. Do not substitute an AFC stipend advertisement for the PCA wage, or assume that living together changes PCA family restrictions. Ask which service matches the person’s actual care and living arrangements." ], "es": [ "PCA permite dirigir la ayuda con actividades diarias aprobadas. Adult Foster Care, o AFC, implica en cambio convivencia entre cuidador y beneficiario, con supervisión y apoyo de una entidad AFC. La ficha de AFC también excluye a cónyuges y tutores legales como cuidadores. No sustituyas el salario PCA por una asignación anunciada para AFC ni supongas que convivir modifica las restricciones familiares de PCA. Pregunta qué servicio corresponde a las necesidades y al lugar de residencia." ] } }, { "key": "eligibility", "title": { "en": "Describe hands-on assistance, not just a diagnosis", "es": "Explica la ayuda física, además del diagnóstico" }, "paragraphs": { "en": [ "MassHealth’s PCA fact sheet identifies Standard or CommonHealth coverage, a chronic or permanent disability, and physical assistance with at least two activities of daily living as core requirements. The member must manage the service or receive permitted surrogate or administrative-proxy support. For assessment, prepare concrete examples: who helps with transfers, what happens during bathing, and how frequently assistance is necessary. Separate household tasks from hands-on personal assistance so the evaluator can understand the request." ], "es": [ "La ficha PCA de MassHealth señala como requisitos principales cobertura Standard o CommonHealth, una discapacidad crónica o permanente y ayuda física en al menos dos actividades de la vida diaria. El beneficiario debe dirigir el servicio o contar con apoyo permitido de un sustituto o representante administrativo. Prepara ejemplos concretos para la evaluación: quién ayuda con transferencias, qué ocurre al bañarse y con qué frecuencia hace falta ayuda. Distingue las tareas domésticas de la asistencia personal física." ] } }, { "key": "waiting", "title": { "en": "Follow each authorization stage", "es": "Comprueba cada fase de autorización" }, "paragraphs": { "en": [ "A request to a Personal Care Management agency is not a payroll start date. Track the assessment, the submission to MassHealth, the authorization decision and worker onboarding as separate items. If approved hours do not match the request, read the notice and discuss the difference with the agency. Keep the notice and its instructions rather than relying on a verbal estimate. This guide does not promise reimbursement for work performed before the required authorization and enrollment are complete." ], "es": [ "Contactar con una agencia Personal Care Management no fija el inicio de la nómina. Anota por separado la evaluación, el envío a MassHealth, la resolución de autorización y la incorporación del trabajador. Si las horas aprobadas difieren de las solicitadas, lee la notificación y consulta la diferencia con la agencia. Conserva el documento y sus instrucciones, en lugar de depender de una estimación verbal. Esta guía no promete pagar trabajos anteriores a completar autorización e inscripción." ] } }, { "key": "enrollment", "title": { "en": "Resolve incompatible roles before hiring", "es": "Resuelve las incompatibilidades antes de contratar" }, "paragraphs": { "en": [ "The July 2026 consumer-employer handbook excludes the legal spouse, a parent or foster parent of a minor consumer, and people holding specified guardian, surrogate or proxy roles. An adult child should therefore disclose any additional decision-making role, not merely say that they are a relative. Ask the management agency to check the proposed arrangement. Complete the current Tempus hiring packet and confirm acceptance before placing the worker on the paid schedule." ], "es": [ "El manual del empleador de julio de 2026 excluye al cónyuge legal, a padres o padres de acogida de beneficiarios menores y a personas con determinados cargos de tutela, sustitución o representación. Un hijo adulto debe comunicar también cualquier función de representación, no limitarse a indicar el parentesco. Pide a la agencia que compruebe la organización propuesta. Completa el expediente vigente de contratación de Tempus y confirma su aceptación antes de programar trabajo remunerado." ] } }, { "key": "records", "title": { "en": "Keep authorization, activity records and payroll aligned", "es": "Coordina autorización, actividad y nómina" }, "paragraphs": { "en": [ "MassHealth uses Electronic Visit Verification for consumer-directed services. Follow Tempus instructions for recording and correcting PCA activity; do not assume a shared address creates an exemption. Compare authorized hours, submitted activity and the pay statement each period. The consumer also manages scheduling and overtime requests, so an overtime discussion belongs before extra shifts are worked. Maintain a backup-care plan for absences and ask the management agency how to request reassessment when needs change." ], "es": [ "MassHealth utiliza verificación electrónica de visitas para servicios autodirigidos. Sigue las instrucciones de Tempus para registrar y corregir la actividad PCA; no supongas que compartir domicilio crea una exención. Compara horas autorizadas, actividad presentada y nómina en cada período. El beneficiario también organiza horarios y solicitudes de horas extra, por lo que debe consultar antes de añadir turnos. Prepara sustituciones para ausencias y pregunta cómo solicitar otra evaluación si cambian las necesidades." ] } } ], "faqs": [ { "q": { "en": "Can my spouse be my PCA?", "es": "¿Puede mi cónyuge ser mi PCA?" }, "a": { "en": "No. The PCA consumer handbook excludes a legal spouse.", "es": "No. El manual PCA excluye al cónyuge legal." } }, { "q": { "en": "Who processes PCA payroll?", "es": "¿Quién tramita la nómina PCA?" }, "a": { "en": "MassHealth identifies Tempus Unlimited as its PCA fiscal intermediary.", "es": "MassHealth identifica a Tempus Unlimited como intermediario fiscal de PCA." } }, { "q": { "en": "Is AFC the same as PCA?", "es": "¿AFC es lo mismo que PCA?" }, "a": { "en": "No. AFC is a separate service involving a live-in caregiver and provider oversight.", "es": "No. AFC es otro servicio, con convivencia del cuidador y supervisión de una entidad." } }, { "q": { "en": "Is needing help with shopping sufficient by itself?", "es": "¿Basta necesitar ayuda para comprar?" }, "a": { "en": "PCA eligibility requires physical help with at least two daily living activities; discuss the complete situation with a management agency.", "es": "PCA exige ayuda física con al menos dos actividades de la vida diaria; consulta la situación completa con la agencia." } } ], "slug_en": "massachusetts-pca", "spouse_policy": "not_allowed", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "MI", "state": "Michigan", "slug": "michigan-home-help", "program": "Home Help", "medicaid_name": "Michigan Medicaid", "agency_url": "https://www.michigan.gov/en/mdhhs/adult-child-serv/adults-and-seniors/independent", "summary": "Home Help uses a needs assessment and requires caregiver approval. MDHHS excludes a spouse as the paid caregiver and a parent caring for their minor child. This guide does not apply those rules to every Michigan program.", "steps": { "en": [ "Apply for Medicaid if necessary and contact the local MDHHS Adult Services unit about Home Help.", "Submit the Adult Services Application and medical-needs certification and keep copies.", "Attend the home assessment; include the proposed caregiver when possible and explain actual task needs.", "Complete CHAMPS enrollment, the background review and any documented live-in EVV-exemption request.", "Read the decision, confirm the approved tasks and rate, and follow current service-verification instructions." ], "es": [ "Solicita Medicaid si hace falta y contacta con la unidad local de servicios para adultos de MDHHS.", "Entrega la solicitud de servicios para adultos y la certificación médica, conservando copias.", "Participa en la evaluación domiciliaria, preferiblemente con el cuidador propuesto, y explica las tareas necesarias.", "Completa CHAMPS, la revisión de antecedentes y, si corresponde, la solicitud documentada de excepción por convivencia.", "Lee la resolución, confirma tareas y tarifa y sigue las instrucciones vigentes de verificación de servicios." ] }, "caution": "Home Help and MI Choice are different programs; their eligibility limits and payment arrangements should not be merged.", "spouse_policy": "not_allowed", "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "MDHHS: Home Help application and caregiver rules", "url": "https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/independent", "access": "direct", "checked_on": "2026-11-15" }, { "label": "MDHHS: Home Help individual caregiver EVV", "url": "https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/electronic-visit-verification/data/program-specific-information/home-help-individual-caregiver/home-help-individual-caregiver", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "MDHHS: Home Help services brochure", "url": "https://www.michigan.gov/-/media/Project/Websites/mdhhs/Adult-and-Childrens-Services/Adults-and-Seniors/Forms-and-Publications/DHS-PUB-0815.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "MDHHS: EVV numbered letter L 26-23", "url": "https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/2026-L-Letters/Numbered-Letter-L-26-23-EVV.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "MDHHS: 2026 Services Portal training", "url": "https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Medicaid-Provider-Assets/EVV/EVV-Services-Portal-for-Home-Help-Individual-Providers.pdf?hash=65EB28764D58718687F40DE48AF3E8A5&rev=76088409b9124f809adcd63d78aec067", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Míchigan", "slug_es": "michigan-home-help-pago-cuidadores", "spouse_policy_override": "not_allowed", "agency": { "en": "Michigan Department of Health and Human Services (MDHHS), local Adult Services unit", "es": "Departamento de Salud y Servicios Humanos de Míchigan (MDHHS), unidad local de servicios para adultos" }, "fms": { "en": "MDHHS Home Help provider enrollment and service verification through CHAMPS; do not substitute an unrelated waiver payroll vendor.", "es": "Inscripción y verificación de servicios de Home Help de MDHHS mediante CHAMPS; no sustituir por un proveedor de nómina de otra exención." }, "payment": { "en": "Payment for assessed, approved tasks and service time; obtain the applicable caregiver rate from MDHHS.", "es": "Pago por tareas y tiempo evaluados y aprobados; obtener de MDHHS la tarifa aplicable al cuidador." }, "spouse": { "en": "A client’s spouse cannot be the paid Home Help caregiver.", "es": "El cónyuge del beneficiario no puede ser cuidador remunerado de Home Help." }, "minors": { "en": "A parent cannot be paid through Home Help to care for their minor child.", "es": "Home Help no permite pagar a un progenitor por cuidar a su hijo menor." }, "overview": { "en": "Michigan Home Help supports eligible people who need hands-on assistance with daily tasks. The person receiving care employs the caregiver; the State of Michigan is not that person’s employer. A local Adult Services Worker assesses the need, while CHAMPS enrollment determines whether the selected provider is approved for payment. Keep those two decisions separate when planning to hire a relative.", "es": "Home Help de Míchigan apoya a personas elegibles que necesitan ayuda física en tareas diarias. La persona atendida emplea al cuidador; el Estado de Míchigan no es su empleador. Un trabajador local de servicios para adultos evalúa las necesidades, mientras que la inscripción en CHAMPS determina si el proveedor elegido está aprobado para cobrar. Conviene separar ambas decisiones al planificar la contratación de un familiar." }, "sections": [ { "key": "programs", "title": { "en": "Home Help and MI Choice have different routes", "es": "Home Help y MI Choice siguen vías distintas" }, "paragraphs": { "en": [ "Home Help is handled through MDHHS adult services. MI Choice is a separate waiver program; its care-management and eligibility arrangements should not be copied into a Home Help application. Start by naming the exact service when contacting an office or reading a provider advertisement. A family that needs a broader package of long-term supports can ask about other routes, but a different program name is not evidence that a spouse exclusion or enrollment requirement disappears automatically." ], "es": [ "Home Help se tramita mediante los servicios para adultos de MDHHS. MI Choice es una exención distinta y no se deben copiar sus mecanismos de gestión o elegibilidad en una solicitud de Home Help. Identifica el servicio concreto al contactar con una oficina o leer publicidad de proveedores. Si la familia necesita un conjunto más amplio de apoyos, puede preguntar por otras vías; el nombre de otro programa no demuestra que desaparezcan automáticamente las exclusiones de cónyuges o los requisitos de inscripción." ] } }, { "key": "eligibility", "title": { "en": "Document hands-on needs, not just a diagnosis", "es": "Documenta la ayuda física y no solo el diagnóstico" }, "paragraphs": { "en": [ "The Home Help application uses the Adult Services Application and a medical-needs certification. During the home visit, describe what the person can do independently, what requires physical assistance and how often that assistance is needed. Explain changes across a normal week without inflating tasks to reach a desired income. Medicaid financial eligibility remains a separate issue; some applicants with a deductible may still qualify under the applicable rules. Ask the Adult Services Worker how that deductible affects service authorization and payment." ], "es": [ "La solicitud emplea el formulario de servicios para adultos y una certificación de necesidades médicas. Durante la visita domiciliaria, explica qué hace la persona por sí sola, qué requiere asistencia física y con qué frecuencia. Describe las variaciones de una semana normal sin exagerar tareas para alcanzar un ingreso deseado. La elegibilidad económica de Medicaid es independiente; algunas personas con deducible pueden reunir las condiciones aplicables. Pregunta al trabajador de servicios para adultos cómo afecta ese deducible a la autorización y al pago." ] } }, { "key": "waiting", "title": { "en": "Use the written decision and hearing information", "es": "Conserva la decisión escrita y la información de audiencia" }, "paragraphs": { "en": [ "MDHHS says the Home Help application process can take up to 45 days and describes a written approval or denial. This is a published application timeframe, not a promise that a new caregiver will receive a first paycheck on day 45. Worker enrollment and payroll verification are additional steps. Keep submission dates, copies of the two application documents and the decision notice. If the authorized tasks do not reflect the assessment, ask for an explanation and follow the hearing instructions in the notice." ], "es": [ "MDHHS indica que la solicitud puede tardar hasta 45 días y describe una aprobación o denegación escrita. Es un plazo publicado del trámite, no una promesa de que un cuidador nuevo cobre el día 45. La inscripción del trabajador y la verificación de nómina son pasos adicionales. Conserva fechas de presentación, copias de los dos documentos y la resolución. Si las tareas autorizadas no reflejan la evaluación, pide una explicación y sigue las instrucciones para solicitar audiencia incluidas en el aviso." ] } }, { "key": "enrollment", "title": { "en": "CHAMPS approval is required for the chosen caregiver", "es": "El cuidador elegido necesita aprobación en CHAMPS" }, "paragraphs": { "en": [ "An individual caregiver must be at least 18, cannot be the client’s spouse or a parent caring for their minor child, and cannot also receive Home Help. MDHHS requires CHAMPS enrollment and a background check before payment eligibility. An adult child or friend may therefore be a possible candidate, not an automatically approved worker. Ask whether an existing provider record needs updating, who must sign service verification and when the provider identification number will be available. Do not assume a submitted application means approval." ], "es": [ "El cuidador individual debe tener al menos 18 años, no puede ser cónyuge ni progenitor de un hijo menor atendido y no puede recibir Home Help a su vez. MDHHS exige inscripción en CHAMPS y comprobación de antecedentes para poder cobrar. Por ello, un hijo adulto o amigo puede ser candidato, pero no queda aprobado automáticamente. Pregunta si hay que actualizar un expediente existente, quién firma la verificación del servicio y cuándo se obtiene el identificador del proveedor. Presentar una solicitud no equivale a aprobarla." ] } }, { "key": "records", "title": { "en": "EVV and service verification are separate obligations", "es": "El fichaje electrónico y la verificación son obligaciones distintas" }, "paragraphs": { "en": [ "Michigan uses HHAeXchange for Home Help individual-caregiver EVV, with a mobile app or telephone option. Approved live-in caregivers can be exempt after submitting the required attestation and residence evidence. Service verification is still required, including for exempt workers. State materials describe an evolving Services Portal rollout, so check the current MDHHS instructions before changing the method used for payment records. A live-in exemption should be confirmed with the Adult Services Worker; receiving a vendor email does not itself cancel or establish that exemption." ], "es": [ "Míchigan utiliza HHAeXchange para la verificación electrónica de cuidadores individuales, con aplicación o teléfono. Los trabajadores convivientes aprobados pueden quedar exentos tras presentar la declaración y pruebas de residencia requeridas. La verificación de servicios sigue siendo necesaria, también para exentos. Los materiales estatales describen un despliegue del Services Portal en evolución: revisa las instrucciones vigentes antes de cambiar el registro usado para cobrar." ] } } ], "faqs": [ { "q": { "en": "Can a spouse receive Home Help pay?", "es": "¿Puede cobrar Home Help un cónyuge?" }, "a": { "en": "No. MDHHS explicitly excludes a client’s spouse as the paid caregiver in Home Help. This answer should not be applied automatically to every Michigan benefit.", "es": "No. MDHHS excluye expresamente al cónyuge como cuidador remunerado de Home Help. No debe extrapolarse automáticamente a todas las prestaciones de Míchigan." } }, { "q": { "en": "Is there a fixed 40-hour Home Help entitlement?", "es": "¿Existe un derecho fijo a 40 horas de Home Help?" }, "a": { "en": "No. MDHHS describes individualized authorized time based on assessed tasks. A 20-, 30- or 40-hour calculator row is only a mathematical scenario.", "es": "No. MDHHS describe tiempo autorizado individualmente según las tareas evaluadas. Una fila de 20, 30 o 40 horas es solo un supuesto matemático." } }, { "q": { "en": "Does living together remove all timekeeping requirements?", "es": "¿Convivir elimina todos los registros de tiempo?" }, "a": { "en": "No. A documented EVV exemption does not remove service verification. Ask the Adult Services Worker and provider support which records remain required.", "es": "No. Una excepción documentada de fichaje electrónico no elimina la verificación del servicio. Consulta qué registros siguen siendo obligatorios." } }, { "q": { "en": "Does the 45-day application timeframe guarantee a paycheck?", "es": "¿El plazo de 45 días garantiza una nómina?" }, "a": { "en": "No. The application decision, worker approval and payment verification are different stages. Confirm your specific authorized start date and payroll status.", "es": "No. La resolución, la aprobación del trabajador y la verificación del pago son fases distintas. Confirma la fecha de inicio autorizada y el estado de la nómina." } } ], "slug_en": "michigan-home-help", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "minnesota-cdcs", "state": "Minnesota", "code": "MN", "program": "Consumer Directed Community Supports (CDCS)", "medicaid_name": "Minnesota Medical Assistance", "summary": "CDCS lets people eligible for certain Minnesota waivers or Alternative Care design supports within an assessed budget. Participants can hire people they know and develop a community support plan, with financial-management assistance for employer tasks. The state explains that family members, including spouses and parents, may be hired within the program's rules.", "steps": { "en": [ "Contact the county or Tribal Nation; eligible older managed-care members can also start with their health plan.", "Confirm the qualifying waiver or Alternative Care program, assessment and CDCS budget.", "Write the community support plan, including worker duties, payroll-related costs and other necessary supports.", "Choose an approved FMS, clear family-worker requirements and obtain authorization before submitting payable services." ], "es": [ "Contacta con el condado o nación tribal; las personas mayores en atención gestionada también pueden acudir a su plan.", "Confirma la exención o Alternative Care, la evaluación y el presupuesto CDCS.", "Prepara el plan comunitario con tareas, costes laborales y otros apoyos necesarios.", "Elige un FMS aprobado, confirma los requisitos del familiar y obtén autorización antes de declarar servicios pagaderos." ] }, "caveat": "CDCS is a service option within specific qualifying programs, not a separate automatic cash benefit. Family hiring remains subject to the approved plan, budget and underlying waiver or Alternative Care rules.", "agency_url": "https://mn.gov/dhs/disability-aging/home-and-community-services/programs-and-services/cdcs/cdcs.jsp", "sources": [ { "label": "Minnesota DHS: Consumer Directed Community Supports", "url": "https://mn.gov/dhs/disability-aging/home-and-community-services/programs-and-services/cdcs/cdcs.jsp", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Minnesota DHS: Approved FMS providers", "url": "https://mn.gov/dhs/disability-aging/home-and-community-services/programs-and-services/fms/", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Minnesota DHS: CFSS and lead agencies FAQ", "url": "https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/long-term-services-and-supports/cfss/cfss-faq-la.jsp", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Minnesota DHS: Electronic visit verification", "url": "https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/long-term-services-and-supports/evv/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Minnesota statute 256B.4911: CDCS family-provider provisions", "url": "https://www.revisor.mn.gov/statutes/2026/cite/256B.4911", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Minnesota DHS: PCA Choice and FMS provider information", "url": "https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-programs/provider/types/hcbs/pca-choice-and-fms-info.jsp", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Minnesota", "slug_es": "minnesota-cdcs-pago-cuidadores", "spouse_policy_override": "conditional", "agency": { "en": "Minnesota Department of Human Services, with county, Tribal Nation or health-plan lead agencies", "es": "Departamento de Servicios Humanos de Minnesota, con agencias gestoras del condado, nación tribal o plan de salud" }, "fms": { "en": "A DHS-approved financial management services provider selected for the arrangement", "es": "Proveedor de servicios de gestión financiera aprobado por DHS y seleccionado para el acuerdo" }, "payment": { "en": "Personal-assistance wages and other approved supports from the CDCS individual budget", "es": "Salarios de asistencia personal y otros apoyos aprobados con cargo al presupuesto individual CDCS" }, "spouse": { "en": "CDCS can permit a spouse to provide approved personal assistance, subject to the plan, qualifications and specific statutory limits.", "es": "CDCS puede permitir que el cónyuge preste asistencia personal aprobada, sujeto al plan, los requisitos y límites legales específicos." }, "minors": { "en": "Paid parents of minors are possible under CDCS rules. The arrangement needs specific approval and does not authorize unlimited hours.", "es": "CDCS contempla padres remunerados de menores. El acuerdo necesita aprobación específica y no autoriza horas ilimitadas." }, "overview": { "en": "Consumer Directed Community Supports is a service option within qualifying Minnesota waivers or Alternative Care. It is not a separate payment available to every family caregiver. Participants build a community support plan around assessed needs and an individual budget. A financial management services provider assists with payroll and employer tasks. Family hiring is possible, including some spouse and paid-parent arrangements, but the approved plan and underlying program control what can be funded.", "es": "Consumer Directed Community Supports es una opción de servicios dentro de determinadas exenciones de Minnesota o de Alternative Care. No es un pago independiente disponible para cualquier cuidador familiar. El participante prepara un plan comunitario según sus necesidades evaluadas y presupuesto individual. Un proveedor de gestión financiera ayuda con la nómina y las obligaciones laborales. Es posible contratar a familiares, incluidos determinados cónyuges y padres, pero el plan aprobado y el programa de origen determinan qué se financia." }, "sections": [ { "key": "programs", "title": { "en": "CDCS and CFSS should not be confused", "es": "CDCS y CFSS no deben confundirse" }, "paragraphs": { "en": [ "CDCS is available through specified waivers and Alternative Care. Community First Services and Supports, or CFSS, is the program replacing PCA and Consumer Support Grant services. Some people can use both CDCS and CFSS, but that does not create two unrelated pots of money: DHS describes how CFSS costs affect the CDCS budget. When the CFSS budget model is used alongside CDCS, the same FMS must be used. Ask the lead agency to show the combined plan before comparing caregiver earnings." ], "es": [ "CDCS se ofrece mediante exenciones concretas y Alternative Care. Community First Services and Supports, o CFSS, sustituye los servicios PCA y Consumer Support Grant. Algunas personas pueden utilizar CDCS y CFSS, pero eso no crea dos bolsas de dinero independientes: DHS explica cómo los costes CFSS afectan al presupuesto CDCS. Cuando se combina el modelo presupuestario CFSS con CDCS, debe utilizarse el mismo FMS. Pide a la agencia gestora que explique el plan conjunto antes de comparar ingresos del cuidador." ] } }, { "key": "eligibility", "title": { "en": "The assessment comes before the spending plan", "es": "La evaluación precede al plan de gastos" }, "paragraphs": { "en": [ "The person must first qualify for an eligible waiver or Alternative Care. Their assessment informs the CDCS budget, while the underlying program determines applicable financial and care-level requirements. A community support plan describes outcomes, workers, goods, services and costs. Minnesota provides a plan template; an alternative format must still contain the required elements. Explain what assistance is actually needed and how the proposed supports meet it. A diagnosis alone does not tell the lead agency the full daily support picture." ], "es": [ "La persona debe reunir primero los requisitos de una exención elegible o de Alternative Care. La evaluación informa el presupuesto CDCS, mientras el programa de origen establece las reglas económicas y de nivel de atención. El plan comunitario describe objetivos, trabajadores, productos, servicios y costes. Minnesota ofrece una plantilla; otro formato debe incluir los mismos elementos requeridos. Explica la ayuda que realmente se necesita y cómo la propuesta la cubre. Un diagnóstico por sí solo no describe todo el apoyo cotidiano necesario." ] } }, { "key": "waiting", "title": { "en": "Ask about the underlying waiver and plan approval", "es": "Consulta la exención de origen y la aprobación del plan" }, "paragraphs": { "en": [ "A CDCS inquiry is not itself enrollment in a waiver. Ask the county, Tribal Nation or health plan whether eligibility, waiver access, budget calculation or approval of the support plan is the outstanding step. We do not assign one Minnesota waiting period to all these programs. If an existing plan is being changed, ask how services continue during the transition. Keep the written budget and authorization dates, because an FMS payroll setup cannot replace a service decision from the responsible lead agency." ], "es": [ "Consultar sobre CDCS no equivale a inscribirse en una exención. Pregunta al condado, nación tribal o plan de salud si falta resolver la elegibilidad, el acceso a la exención, el presupuesto o la aprobación del plan. No atribuimos un único plazo de espera a todos estos programas. Si se modifica un plan existente, pregunta cómo continuarán los servicios durante la transición. Conserva el presupuesto escrito y las fechas autorizadas: preparar la nómina con un FMS no sustituye la decisión de la agencia gestora." ] } }, { "key": "enrollment", "title": { "en": "Plan for payroll costs as well as wages", "es": "Presupuesta los costes laborales además del salario" }, "paragraphs": { "en": [ "Choose from DHS's enrolled FMS providers and compare what their fees include. The participant recruits, trains and supervises workers, while the FMS supports the employer's financial duties. A proposed hourly wage must fit the approved budget after other required costs and services. Minnesota has particular rules for personal assistance provided by a spouse or parent of a minor. Ask the lead agency and FMS to explain those restrictions and document the worker's approved role before changing another job or committing to a care schedule." ], "es": [ "Elige entre los proveedores FMS inscritos en DHS y compara qué incluyen sus tarifas. El participante selecciona, forma y supervisa al trabajador, mientras el FMS ayuda con las obligaciones financieras del empleador. El salario propuesto debe encajar en el presupuesto después de otros costes y servicios necesarios. Minnesota tiene reglas específicas para la asistencia de un cónyuge o progenitor de menor. Pide que las expliquen y documenten la función autorizada antes de cambiar de empleo o comprometerte con un horario de cuidados." ] } }, { "key": "records", "title": { "en": "Live-in EVV flexibility still requires daily information", "es": "La flexibilidad EVV por convivencia sigue exigiendo datos diarios" }, "paragraphs": { "en": [ "Minnesota includes CDCS personal assistance among EVV-covered services. Live-in caregivers are not required by DHS to interact with EVV in real time, but they must enter the required visit information at least daily; a provider may require real-time use. This differs from a complete exemption. Ask the FMS which system it uses and how to correct entries. Also review paid-time-off and other payroll obligations when building the budget, so an estimate based only on wage times hours does not overstate the hours the budget can support." ], "es": [ "Minnesota incluye la asistencia personal CDCS entre los servicios sujetos a EVV. DHS no exige que los convivientes interactúen con el sistema en tiempo real, pero deben introducir los datos necesarios al menos diariamente; el proveedor puede exigir registro inmediato. No es una exención completa. Pregunta al FMS qué sistema utiliza y cómo corregir entradas. Revisa también vacaciones pagadas y otras obligaciones laborales al preparar el presupuesto, para que un cálculo limitado a salario por horas no exagere las horas financiables." ] } } ], "faqs": [ { "q": { "en": "Can my spouse or a parent of my minor child be paid?", "es": "¿Puede cobrar mi cónyuge o un progenitor de mi hijo menor?" }, "a": { "en": "CDCS permits these arrangements within specific rules. The worker, tasks, hours and budget need approval; do not treat the relationship as automatic entitlement.", "es": "CDCS permite estos acuerdos con reglas específicas. Deben aprobarse trabajador, tareas, horas y presupuesto; el parentesco no otorga un derecho automático." } }, { "q": { "en": "Is CFSS simply a new name for CDCS?", "es": "¿CFSS es simplemente el nuevo nombre de CDCS?" }, "a": { "en": "No. CFSS replaces PCA and Consumer Support Grant services. CDCS remains a waiver/Alternative Care service option, with coordination rules when both are used.", "es": "No. CFSS sustituye PCA y Consumer Support Grant. CDCS sigue siendo una opción de exenciones o Alternative Care, con reglas de coordinación cuando se combinan." } }, { "q": { "en": "Can I spend the entire CDCS budget on a relative's wages?", "es": "¿Puedo dedicar todo el presupuesto CDCS al salario de un familiar?" }, "a": { "en": "The plan must cover assessed support needs and applicable employer costs. Review the whole budget with the lead agency and FMS before committing it to wages.", "es": "El plan debe cubrir las necesidades evaluadas y los costes laborales aplicables. Revisa el presupuesto completo con la agencia y el FMS antes de asignarlo a salarios." } }, { "q": { "en": "Can a live-in caregiver ignore EVV?", "es": "¿Un cuidador conviviente puede ignorar la EVV?" }, "a": { "en": "No. DHS permits flexibility on real-time entry, but requires visit information at least daily. The provider may impose real-time recording requirements.", "es": "No. DHS permite flexibilidad en el registro inmediato, pero exige datos de visitas al menos diariamente. El proveedor puede requerir registro en tiempo real." } } ], "slug_en": "minnesota-cdcs", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "NJ", "state": "New Jersey", "slug": "new-jersey-ppp", "program": "Personal Preference Program (PPP)", "medicaid_name": "NJ FamilyCare", "agency_url": "https://www.nj.gov/humanservices/dmahs/individuals-families/njppp.shtml", "summary": "PPP lets eligible NJ FamilyCare members direct Personal Care Assistant services without using a traditional home health agency. It is an alternative way to arrange qualifying PCA support, not an automatic salary for every family caregiver.", "steps": { "en": [ "Apply for NJ FamilyCare if needed, then contact the health plan for an assessment.", "Request PPP options counseling and identify the participant or authorized representative who will direct services.", "Confirm the MCO’s current fiscal intermediary and build a spending and backup-care plan.", "Enroll the chosen worker and complete all employment and any live-in-exemption documents.", "Check the authorized start date, wage, record-submission method and who approves each payroll period." ], "es": [ "Solicita NJ FamilyCare si procede y pide al plan médico una evaluación de asistencia personal.", "Solicita orientación sobre PPP e identifica al participante o representante que dirigirá los servicios.", "Confirma el intermediario fiscal del plan y prepara el presupuesto y los cuidados de respaldo.", "Inscribe al trabajador elegido y completa los documentos laborales y de excepción por convivencia, si corresponde.", "Confirma inicio, salario, registro y quién aprueba cada nómina." ] }, "caution": "A budget allocation is not the same as a guaranteed hourly take-home wage.", "spouse_policy": "conditional", "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "DMAHS: Personal Preference Program and current FI table", "url": "https://www.nj.gov/humanservices/dmahs/individuals-families/njppp.shtml", "access": "direct", "checked_on": "2026-11-15" }, { "label": "DMAHS: PPP fiscal intermediary transition FAQ, Version II", "url": "https://www.nj.gov/humanservices/dmahs/documents/individuals-families/PPP_Fiscal_Intermediary_Transition_Frequently_Asked_Questions_Version_2.pdf", "access": "direct", "checked_on": "2026-11-15" }, { "label": "DMAHS: PPP fact sheet", "url": "https://www.nj.gov/humanservices/dmahs/documents/individuals-families/PPP_Fact_Sheet.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DMAHS: PPP operations policy manual", "url": "https://www.nj.gov/humanservices/dmahs/documents/news/PPP_MCO_VF_EA_Operations%20_Policy_Manual.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Nueva Jersey", "slug_es": "nueva-jersey-ppp-cuidadores", "spouse_policy_override": "conditional", "agency": { "en": "New Jersey Division of Medical Assistance and Health Services (DMAHS), NJ FamilyCare", "es": "División de Asistencia Médica y Servicios de Salud de Nueva Jersey (DMAHS), NJ FamilyCare" }, "fms": { "en": "Palco for Horizon NJ Health; PPL for the other plans currently listed by DMAHS. Recheck when changing plans.", "es": "Palco para Horizon NJ Health; PPL para los demás planes actualmente enumerados por DMAHS. Comprobar al cambiar de plan." }, "payment": { "en": "An approved personal-care budget funds enrolled workers and permitted costs; the budget is not a promised wage.", "es": "Un presupuesto aprobado de asistencia personal financia trabajadores inscritos y gastos permitidos; no equivale a un salario prometido." }, "spouse": { "en": "The official PPP fact sheet includes spouse caregiving; individual worker and representative rules still apply.", "es": "La ficha oficial de PPP contempla cuidados del cónyuge; siguen aplicándose las reglas individuales del trabajador y del representante." }, "minors": { "en": "A parent can be the child’s paid worker with a separate authorized representative who is not that worker; assessed need and parental responsibilities still matter.", "es": "Un progenitor puede ser trabajador remunerado de su hijo con un representante autorizado distinto que no sea ese trabajador; se valoran las necesidades y responsabilidades parentales." }, "overview": { "en": "New Jersey’s Personal Preference Program changes how approved Personal Care Assistant services are organized. An eligible NJ FamilyCare member can direct care instead of relying exclusively on a traditional home health agency. The member or authorized representative manages workers and a service budget, with help from a fiscal intermediary. Start with the health plan’s PCA assessment, not with an advertised hourly earnings figure.", "es": "El Personal Preference Program de Nueva Jersey cambia la organización de los servicios aprobados de asistencia personal. Un afiliado elegible de NJ FamilyCare puede dirigir sus cuidados en lugar de depender exclusivamente de una agencia domiciliaria tradicional. El beneficiario o representante autorizado gestiona trabajadores y presupuesto con ayuda de un intermediario fiscal. El punto de partida es la evaluación de asistencia personal del plan médico, no una cifra salarial publicitaria." }, "sections": [ { "key": "programs", "title": { "en": "PPP is not the same as DDD self-direction", "es": "PPP no equivale a la autodirección de DDD" }, "paragraphs": { "en": [ "PPP sits within NJ FamilyCare’s personal-care pathway. New Jersey’s Division of Developmental Disabilities also has self-directed options, but its vendor transitions and service rules are separate. The distinction matters when families receive a notice naming Acumen or another organization: do not move PPP payroll solely because a DDD communication names a different vendor. If a person receives support through both systems, ask the MCO care manager and DDD support coordinator to clarify which service and budget each organization administers." ], "es": [ "PPP forma parte de la asistencia personal de NJ FamilyCare. La División de Discapacidades del Desarrollo también ofrece autodirección, pero sus cambios de proveedor y reglas son independientes. Esto importa cuando llega una carta que menciona Acumen u otra entidad: no traslades la nómina de PPP solo porque una comunicación de DDD indique otro proveedor. Si la persona recibe apoyo de ambos sistemas, pide al gestor del plan y al coordinador de DDD que identifiquen qué servicio y presupuesto administra cada entidad." ] } }, { "key": "eligibility", "title": { "en": "PCA eligibility comes before a self-directed budget", "es": "La elegibilidad para asistencia personal precede al presupuesto" }, "paragraphs": { "en": [ "DMAHS requires NJ FamilyCare eligibility, approval for PCA services and a need expected to last at least six months. The participant must be able to direct services or have an authorized representative. An assessment considers help with personal tasks and relevant household activities. Children are evaluated individually, taking developmental milestones and parental responsibilities into account. A diagnosis alone does not set the budget. Prepare descriptions of specific daily assistance and ask how the assessment translates those needs into authorized services." ], "es": [ "DMAHS exige elegibilidad para NJ FamilyCare, aprobación de asistencia personal y una necesidad prevista de al menos seis meses. El participante debe poder dirigir los servicios o contar con representante autorizado. La evaluación considera la ayuda en tareas personales y domésticas pertinentes. Los menores se evalúan individualmente teniendo en cuenta el desarrollo y las responsabilidades parentales. Un diagnóstico por sí solo no fija el presupuesto. Describe la asistencia diaria concreta y pregunta cómo se traduce en servicios autorizados." ] } }, { "key": "waiting", "title": { "en": "Separate enrollment from a fiscal-intermediary transition", "es": "Distingue la inscripción del cambio de intermediario" }, "paragraphs": { "en": [ "PPP’s current state page identifies Palco for Horizon NJ Health and PPL for the other listed plans. A vendor transition is not the same event as a new clinical approval. Keep notices about both processes, especially if changing MCOs. Ask the outgoing and incoming organizations which dates, worker records and timesheets they will handle. No single completion period is verified here. If payroll is delayed, identify whether the obstacle is eligibility, authorization, enrollment paperwork or a correctly submitted payment record." ], "es": [ "La página estatal vigente identifica Palco para Horizon NJ Health y PPL para los demás planes enumerados. Cambiar de proveedor no equivale a obtener una nueva aprobación clínica. Conserva los avisos de ambos procesos, sobre todo al cambiar de plan médico. Pregunta qué fechas, expedientes de trabajadores y registros tramitará cada entidad. Aquí no se verifica un plazo único. Si se retrasa la nómina, distingue si falta elegibilidad, autorización, documentación de contratación o un registro de pago correctamente enviado." ] } }, { "key": "enrollment", "title": { "en": "Decide who employs and who provides the care", "es": "Decide quién emplea y quién presta los cuidados" }, "paragraphs": { "en": [ "The fiscal intermediary supports employment administration, including payroll and employer-related costs, but the participant retains important responsibilities. For a child whose parent will be the paid worker, the state FAQ requires a different authorized representative to manage the program. Discuss conflicts of roles before completing forms. Have the worker complete required employment documentation, including work-authorization verification, and ask for the written approved rate. Build backup care into the spending plan rather than spending the entire allocation on an unsupported assumption about wages." ], "es": [ "El intermediario fiscal ayuda con la administración laboral, incluidas nóminas y gastos del empleador, pero el participante conserva responsabilidades importantes. Si un progenitor será trabajador remunerado de su hijo, las preguntas frecuentes estatales exigen otro representante autorizado para gestionar el programa. Aclara los posibles conflictos antes de completar formularios. El trabajador debe entregar la documentación laboral requerida, incluida la verificación de autorización de trabajo, y obtener su tarifa aprobada por escrito. Incluye cuidados de respaldo en el presupuesto, sin comprometerlo sobre supuestos salariales no confirmados." ] } }, { "key": "records", "title": { "en": "Live-in EVV exceptions still need documentation", "es": "Las excepciones por convivencia necesitan documentación" }, "paragraphs": { "en": [ "The state’s fiscal-transition FAQ says PPP retains an EVV exemption for live-in workers when the required documentation is completed and kept current. That does not remove payroll records or authorization limits. Ask the assigned intermediary what replaces clock-in records for the approved exception and how hours are approved. Report hospital or nursing-facility stays and changes in Medicaid eligibility to the MCO. The official page also requests reporting trips abroad and extended absences from New Jersey; ask how a planned absence affects your own services." ], "es": [ "Las preguntas frecuentes estatales mantienen una excepción de verificación electrónica para convivientes con documentación vigente. Siguen siendo necesarios los registros de nómina y respetar la autorización. Pregunta cómo registrar los servicios exentos y aprobar las horas. Comunica hospitalizaciones, ingresos en centros y cambios de elegibilidad. También debes informar de viajes al extranjero y ausencias prolongadas de Nueva Jersey; consulta su efecto antes de viajar." ] } } ], "faqs": [ { "q": { "en": "Can a parent be a PPP worker for a child?", "es": "¿Puede un progenitor trabajar en PPP para su hijo?" }, "a": { "en": "The state FAQ allows this with a separate authorized representative who is not the paid worker. The child still needs an individualized PCA assessment and approval.", "es": "Las preguntas frecuentes estatales lo permiten con otro representante autorizado que no sea el trabajador remunerado. El menor necesita evaluación y aprobación individual de asistencia personal." } }, { "q": { "en": "Is PPL the only PPP fiscal intermediary?", "es": "¿PPL es el único intermediario fiscal de PPP?" }, "a": { "en": "No. DMAHS currently lists Palco for Horizon NJ Health and PPL for other listed plans. Recheck the official table and any transition notice.", "es": "No. DMAHS enumera actualmente Palco para Horizon NJ Health y PPL para otros planes. Revisa la tabla oficial y cualquier aviso de transición." } }, { "q": { "en": "Do live-in PPP workers need EVV?", "es": "¿Los trabajadores convivientes necesitan fichaje electrónico?" }, "a": { "en": "The official transition FAQ retains a documented live-in exemption. Ask the intermediary how to establish it and which service records still have to be submitted.", "es": "El documento oficial mantiene una excepción documentada por convivencia. Pregunta cómo acreditarla y qué registros del servicio deben seguir presentándose." } }, { "q": { "en": "Is the monthly PPP allocation my salary?", "es": "¿La asignación mensual de PPP es mi salario?" }, "a": { "en": "No. The allocation supports an approved service arrangement and can include employer costs and other permitted expenses. Confirm the worker’s actual wage separately.", "es": "No. Financia un plan de servicios y puede incluir gastos del empleador y otros costes permitidos. Confirma por separado el salario real del trabajador." } } ], "slug_en": "new-jersey-ppp", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "NY", "state": "New York", "slug": "new-york-cdpap", "program": "Consumer Directed Personal Assistance Program (CDPAP)", "medicaid_name": "New York Medicaid", "agency_url": "https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap/index.htm", "summary": "CDPAP lets eligible participants direct personal assistance. New York identifies Public Partnerships LLC (PPL) as its statewide fiscal intermediary. A spouse or designated representative cannot be the paid assistant under this program.", "steps": { "en": [ "Ask the Medicaid plan or district for the current CDPAP assessment route.", "Confirm minimum-needs and any legacy status that applies.", "Review the approved plan and the consumer or representative responsibilities.", "Register the consumer and eligible assistant with PPL.", "Confirm wages, start date, timekeeping and backup coverage." ], "es": [ "Solicita al plan o distrito la vía vigente de evaluación CDPAP.", "Confirma necesidades mínimas y posibles reglas de continuidad.", "Revisa el plan aprobado y las obligaciones del representante.", "Inscribe a la persona y al asistente elegible en PPL.", "Confirma salario, inicio, registro de horas y sustituciones." ] }, "caution": "Parents caring for a CDPAP participant younger than 21 are also excluded. A family relationship alone never establishes eligibility.", "spouse_policy": "not_allowed", "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "NYS DOH: CDPAP", "url": "https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NYS DOH: minimum-needs requirements", "url": "https://www.health.ny.gov/health_care/managed_care/policy/min_needs.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NYS DOH: family relationship clarification", "url": "https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/cdpap_clarification.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NYS DOH: statewide FI coordination policy", "url": "https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2025/25-03.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NYS DOH: excessive assistant hours, 2026", "url": "https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2026/26-02.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NYS DOH: fiscal intermediary rates", "url": "https://healthweb-back.health.ny.gov/facilities/long_term_care/reimbursement/cdpap/index.htm", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Nueva York", "slug_es": "nueva-york-cdpap-cuidadores", "agency": { "en": "New York State Department of Health; Medicaid plan or local social services district.", "es": "Departamento de Salud de Nueva York; plan Medicaid o distrito local de servicios sociales." }, "fms": { "en": "Public Partnerships LLC (PPL), the statewide fiscal intermediary.", "es": "Public Partnerships LLC (PPL), intermediario fiscal estatal." }, "payment": { "en": "Authorized personal-assistance hours; wages and payroll terms confirmed with PPL.", "es": "Horas autorizadas de asistencia personal; salario y nómina confirmados con PPL." }, "spouse": { "en": "A spouse and the designated representative cannot be the paid personal assistant.", "es": "El cónyuge y el representante designado no pueden ser el asistente personal remunerado." }, "minors": { "en": "A parent cannot be the personal assistant of their child younger than 21.", "es": "Un progenitor no puede ser asistente personal remunerado de su hijo menor de 21 años." }, "overview": { "en": "CDPAP allows eligible New York Medicaid members to choose and train a personal assistant. It differs from an agency assigning an aide because the consumer, or an approved representative, directs the work. Statewide fiscal administration is handled by PPL; approval of the care plan remains a separate Medicaid responsibility.", "es": "CDPAP permite a miembros elegibles de Medicaid de Nueva York elegir y formar a su asistente personal. Se diferencia de una agencia que asigna un auxiliar porque la persona, o su representante autorizado, dirige el trabajo. PPL gestiona la administración fiscal estatal; aprobar el plan de cuidados sigue siendo una función separada de Medicaid." }, "sections": [ { "key": "programs", "title": { "en": "CDPAP, agency care and PPL have different roles", "es": "CDPAP, atención de agencia y PPL tienen funciones distintas" }, "paragraphs": { "en": [ "An agency-managed personal-care service and CDPAP may address similar daily tasks, but the hiring and supervision arrangements differ. Under CDPAP, the participant or designated representative recruits, trains and oversees assistants and arranges backup coverage. A relative who prefers an agency to manage staffing should ask the plan to explain that alternative rather than assuming CDPAP is the only home-care route.", "PPL processes payroll and employment records as the statewide fiscal intermediary. Its registration process does not replace the plan or district assessment. The state administrative payment to the fiscal intermediary is not the assistant’s hourly wage; do not convert a published per-member administrative rate into a family paycheck." ], "es": [ "La asistencia personal gestionada por una agencia y CDPAP pueden cubrir tareas parecidas, pero cambian la contratación y supervisión. En CDPAP, la persona o representante recluta, forma y supervisa asistentes y organiza sustituciones. Si la familia prefiere que una agencia gestione el personal, debe pedir al plan que explique esa alternativa en lugar de asumir que CDPAP es la única vía.", "PPL procesa nóminas y registros laborales como intermediario fiscal estatal. Inscribirse con PPL no sustituye la evaluación del plan o distrito. El pago administrativo del estado al intermediario no es el salario por hora del asistente; una tarifa administrativa por afiliado no debe convertirse en sueldo familiar." ] }, "source_urls": [ "https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap/", "https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2025/25-03.htm", "https://healthweb-back.health.ny.gov/facilities/long_term_care/reimbursement/cdpap/index.htm" ] }, { "key": "eligibility", "title": { "en": "Check the current minimum-needs rules", "es": "Comprueba las reglas actuales de necesidades mínimas" }, "paragraphs": { "en": [ "New York changed minimum-needs requirements from September 1, 2025. For applicable adult applicants, the assessment examines assistance with more than two activities of daily living; a separate threshold applies to people with documented dementia or Alzheimer’s disease. The exact assistance level matters, so a list of diagnoses or household chores is not a substitute for the assessment.", "Legacy protections may apply to people already authorized for services before the change. Ask the Medicaid plan or district which assessment pathway and legacy rules apply to this case. Medicaid financial eligibility, clinical need, ability to direct services and worker eligibility are distinct decisions; passing one does not automatically settle the others." ], "es": [ "Nueva York cambió los requisitos de necesidades mínimas desde el 1 de septiembre de 2025. Para los solicitantes adultos afectados, la evaluación examina la ayuda en más de dos actividades de la vida diaria; existe un umbral diferente para quienes tienen demencia o Alzheimer documentados. Importa el nivel concreto de ayuda: una lista de diagnósticos o tareas domésticas no sustituye la evaluación.", "Pueden existir protecciones para personas que ya tenían servicios autorizados antes del cambio. Pregunta al plan Medicaid o al distrito qué procedimiento y reglas de continuidad corresponden. La elegibilidad económica, la necesidad clínica, la capacidad de dirigir servicios y la admisión del trabajador son decisiones distintas; superar una no resuelve automáticamente las demás." ] }, "source_urls": [ "https://www.health.ny.gov/health_care/managed_care/policy/min_needs.htm" ] }, { "key": "waiting", "title": { "en": "Separate approval delays from payroll enrollment", "es": "Distingue autorización y alta de nómina" }, "paragraphs": { "en": [ "Ask whether the outstanding step is a clinical assessment, a service authorization, a representative agreement or PPL enrollment. Keep the plan’s case reference and the PPL enrollment reference separately. That makes it easier to contact the organization that can actually resolve the problem instead of repeating the entire application to each caller.", "This guide does not promise a fixed number of days or automatic back pay. Before a family member starts relying on earnings, obtain the authorized schedule, the accepted worker start date and the payroll submission instructions. If care is urgently needed while a decision is pending, ask the plan about available interim arrangements." ], "es": [ "Pregunta si falta una evaluación clínica, autorización de servicios, acuerdo del representante o inscripción en PPL. Guarda por separado la referencia del expediente del plan y la del alta en PPL. Así podrás contactar con quien realmente puede resolver el problema, sin repetir toda la solicitud en cada llamada.", "Esta guía no promete un número fijo de días ni pagos retroactivos automáticos. Antes de depender de estos ingresos, obtén el horario autorizado, la fecha aceptada de inicio del trabajador y las instrucciones de nómina. Si se necesita atención urgente mientras se decide, consulta al plan las alternativas temporales disponibles." ] }, "source_urls": [ "https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2025/25-03.htm" ] }, { "key": "enrollment", "title": { "en": "Check the relationship before completing onboarding", "es": "Comprueba el parentesco antes del alta" }, "paragraphs": { "en": [ "New York excludes a consumer’s spouse, their designated representative and a parent caring for their own child younger than 21 from being that consumer’s paid CDPAP assistant. Other relatives may qualify. Living in the same home is not by itself disqualifying. A parent of an adult aged 21 or older must still satisfy the rules and cannot simultaneously serve as designated representative.", "Confirm the proposed roles with the plan and PPL, complete the worker documents they request and establish a backup plan. The representative role is important when the consumer cannot direct the care independently; it should not be assigned casually to the same person expected to receive wages." ], "es": [ "Nueva York excluye como asistente CDPAP remunerado al cónyuge, al representante designado y al progenitor que cuida a su propio hijo menor de 21 años. Otros familiares pueden cumplir los requisitos. Convivir no excluye por sí solo. Un progenitor de una persona de 21 años o más también debe cumplir las reglas y no puede ejercer a la vez de representante designado.", "Confirma los roles previstos con el plan y PPL, completa la documentación laboral solicitada y organiza sustituciones. El representante es importante cuando la persona no puede dirigir sus cuidados; no conviene atribuir ese papel sin revisar si se pretende que la misma persona cobre como asistente." ] }, "source_urls": [ "https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/cdpap_clarification.htm", "https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2025/25-03.htm" ] }, { "key": "records", "title": { "en": "Authorized care is not unlimited caregiver availability", "es": "La atención autorizada no equivale a disponibilidad ilimitada" }, "paragraphs": { "en": [ "The participant remains responsible for accurate assistant payroll records and sufficient staffing. New York’s July 2026 guidance addresses excessive hours worked by individual assistants and requires plans to intervene. A large care authorization therefore does not mean one relative should work every hour. Review scheduling, timekeeping and any live-in arrangements with PPL and the plan before submitting hours." ], "es": [ "La persona participante mantiene responsabilidades sobre registros de nómina correctos y personal suficiente. La guía estatal de julio de 2026 aborda las horas excesivas de asistentes individuales y exige intervención de los planes. Una autorización amplia no significa que un solo familiar deba cubrir todas las horas. Revisa horarios, registro y cualquier convivencia con PPL y el plan antes de declarar horas." ] }, "source_urls": [ "https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/2026/26-02.htm" ] } ], "faqs": [ { "q": { "en": "Can my spouse be my CDPAP assistant?", "es": "¿Puede mi cónyuge ser mi asistente CDPAP?" }, "a": { "en": "No. The state expressly excludes a consumer’s spouse from this role.", "es": "No. El estado excluye expresamente al cónyuge de ese puesto." } }, { "q": { "en": "Must we use PPL?", "es": "¿Debemos utilizar PPL?" }, "a": { "en": "The state identifies PPL as the statewide fiscal intermediary for CDPAP. A plan or facilitator still has a different coordination role.", "es": "El estado identifica PPL como intermediario fiscal de CDPAP. El plan o facilitador cumple una función de coordinación diferente." } }, { "q": { "en": "Does a shared home disqualify a relative?", "es": "¿Convivir excluye a un familiar?" }, "a": { "en": "Not by itself. The relationship and representative restrictions still apply.", "es": "No por sí solo. Siguen aplicándose las restricciones de parentesco y representación." } }, { "q": { "en": "Are older eligibility summaries reliable for a new application?", "es": "¿Sirven las guías antiguas para una solicitud nueva?" }, "a": { "en": "Check the post-September 2025 minimum-needs policy and any legacy exception before relying on them.", "es": "Comprueba las necesidades mínimas posteriores a septiembre de 2025 y cualquier excepción de continuidad." } } ], "slug_en": "new-york-cdpap", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "north-carolina-cap-da", "state": "North Carolina", "code": "NC", "program": "Community Alternatives Program for Disabled Adults (CAP/DA) — Consumer Direction", "medicaid_name": "NC Medicaid", "summary": "CAP/DA supports eligible adults with disabilities who would otherwise need institutional care. Its consumer-directed option allows the participant or a representative to take on employer responsibilities for personal assistance. A local CAP/DA case-management entity handles referrals. Eligibility, the needs assessment and the approved service arrangement determine what support is available.", "steps": { "en": [ "Request a referral through the CAP/DA case-management entity for the applicant's county.", "Complete the needs and Medicaid eligibility reviews; ask whether a waiver slot or waitlist applies.", "Discuss consumer direction, worker relationships and any guardian or power-of-attorney exception.", "Complete employer orientation and financial-management enrollment, then confirm tasks, rate, records and start date." ], "es": [ "Solicita la derivación a través de la entidad CAP/DA del condado del solicitante.", "Completa las revisiones de necesidades y Medicaid; pregunta por plaza o lista de espera.", "Revisa autodirección, parentescos y posibles excepciones por tutela o poder legal.", "Completa la orientación y el alta financiera; confirma tareas, tarifa, registros y fecha de inicio." ] }, "caveat": "The participant must meet CAP/DA and long-term-care Medicaid requirements. Choosing a worker or pay rate is an employer responsibility within program rules, not proof of eligibility or an unrestricted funding commitment.", "agency_url": "https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/community-alternatives-program-disabled-adults-capda", "sources": [ { "label": "NC Medicaid: CAP/DA program and referrals", "url": "https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/community-alternatives-program-disabled-adults-capda", "access": "direct", "checked_on": "2026-11-15" }, { "label": "NC Medicaid: CAP/DA beneficiary overview", "url": "https://medicaid.ncdhhs.gov/beneficiaries/get-started/find-programs-and-services/community-alternatives-program-disabled-adults", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NC Medicaid: Clinical Coverage Policy 3K-2, September 2025", "url": "https://medicaid.ncdhhs.gov/3k-2-community-alternatives-program-disabled-adults-capda/download", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NC Medicaid: CAP/DA waitlist notice, March 2024", "url": "https://medicaid.ncdhhs.gov/blog/2024/03/05/waitlist-nc-medicaid-community-alternatives-program-disabled-adults-program", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NC Medicaid: CAP/C legally responsible caregiver requirements", "url": "https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/community-alternatives-program-children-capc/requirements-legally-responsible-individuals-paid-caregivers", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "NC Medicaid: CAP/DA approved waiver application", "url": "https://medicaid.ncdhhs.gov/cap-d-waiver-approved-application/download?attachment=", "access": "direct", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Carolina del Norte", "slug_es": "carolina-del-norte-cap-da-cuidadores", "spouse_policy_override": "conditional", "agency": { "en": "NC Medicaid, working with local CAP/DA case-management entities and NC LIFTSS", "es": "NC Medicaid, con entidades locales de gestión CAP/DA y NC LIFTSS" }, "fms": { "en": "An approved financial-management provider coordinated through the CAP/DA consumer-direction arrangement", "es": "Proveedor autorizado de gestión financiera coordinado mediante la modalidad de autodirección CAP/DA" }, "payment": { "en": "Consumer-directed personal assistance within the authorized plan; coordinated caregiving is a separate service", "es": "Asistencia personal autodirigida dentro del plan autorizado; coordinated caregiving es un servicio distinto" }, "spouse": { "en": "Policy 3K-2 permits a qualified spouse or other adult relative for adult CAP/DA personal assistance. Guardian or power-of-attorney roles require separate exception review.", "es": "La política 3K-2 permite cónyuges u otros familiares adultos cualificados para asistencia personal CAP/DA. Ser tutor o apoderado requiere revisar excepciones por separado." }, "minors": { "en": "CAP/DA serves adults aged 18 or older. CAP/C has different children's and legally responsible caregiver rules.", "es": "CAP/DA atiende a adultos desde los 18 años. CAP/C tiene reglas distintas para menores y cuidadores legalmente responsables." }, "overview": { "en": "North Carolina's CAP/DA waiver helps qualifying adults remain in a community setting when they would otherwise need institutional care. Consumer direction is one service-delivery option within that waiver. It gives the participant or representative employer responsibilities for personal assistance, with case-management and financial-management support. The first practical contact is the CAP/DA case-management entity serving the applicant's county. Selecting a relative is only one part of the service decision.", "es": "La exención CAP/DA de Carolina del Norte ayuda a adultos elegibles a permanecer en la comunidad cuando, sin esos apoyos, necesitarían atención institucional. La autodirección es una modalidad dentro de la exención. Da al participante o representante responsabilidades de empleador para la asistencia personal, con apoyo de gestión del caso y de pagos. El primer contacto práctico es la entidad CAP/DA del condado del solicitante. Elegir a un familiar es solo una parte de la decisión sobre el servicio." }, "sections": [ { "key": "programs", "title": { "en": "Consumer direction, CAP/C and coordinated caregiving", "es": "Autodirección, CAP/C y cuidado coordinado" }, "paragraphs": { "en": [ "CAP/DA is for adults aged eighteen or older. CAP/C is a separate children's program, so a paid-parent rule quoted from CAP/C should not be transferred without checking. CAP/DA also lists coordinated caregiving among its services; that is not simply another name for hourly personal assistance. Ask the case manager to identify the exact service and delivery model. The employee-hiring process, payment method and permitted tasks follow that choice, not a generic online description of North Carolina family-caregiver pay." ], "es": [ "CAP/DA se dirige a adultos desde los dieciocho años. CAP/C es un programa infantil diferente, por lo que una regla de pago a padres tomada de CAP/C no debe trasladarse sin comprobarla. CAP/DA también incluye cuidado coordinado entre sus servicios; no es simplemente otro nombre para la asistencia personal por horas. Pide que identifiquen el servicio y la modalidad exactos. De esa elección dependen la contratación, el pago y las tareas, no de una descripción genérica en internet sobre cuidadores familiares." ] } }, { "key": "eligibility", "title": { "en": "Explain why community supports are needed", "es": "Explica por qué hacen falta apoyos comunitarios" }, "paragraphs": { "en": [ "CAP/DA requires the relevant institutional level of care and a need for at least one waiver service, alongside applicable Medicaid requirements. The assessment considers the person's needs and existing support rather than simply the family's preferred schedule. Describe hands-on help, risks and tasks that other available services do not meet. A spouse or adult relative may qualify as a personal assistant, but legal guardianship or power of attorney creates additional issues under policy 3K-2. Tell the case manager about all roles held by the proposed worker." ], "es": [ "CAP/DA exige el nivel de atención institucional correspondiente y necesidad de al menos un servicio de la exención, además de los requisitos Medicaid aplicables. La evaluación examina necesidades y apoyos existentes, no solo el horario preferido por la familia. Describe ayuda directa, riesgos y tareas que otros servicios no cubren. Un cónyuge o familiar adulto puede reunir los requisitos como asistente, pero ser tutor o apoderado plantea cuestiones adicionales bajo la política 3K-2. Comunica todos los papeles que ejerce el posible trabajador." ] } }, { "key": "waiting", "title": { "en": "CAP/DA can have a statewide waitlist", "es": "CAP/DA puede tener lista de espera estatal" }, "paragraphs": { "en": [ "NC Medicaid published a statewide waitlist notice when waiver slots reached capacity. That notice is a reason to ask about current availability, not a reliable forecast of today's waiting time. The county case-management entity and NC LIFTSS can explain referral status and the applicable entry process. If placed on a list, keep the notification and ask how to report a significant change in need. Also request information about other Medicaid or community services that may be available while the waiver request is pending." ], "es": [ "NC Medicaid publicó un aviso de lista estatal cuando se agotó la capacidad de plazas. Ese aviso justifica preguntar por la disponibilidad actual, pero no permite calcular cuánto se espera hoy. La entidad del condado y NC LIFTSS pueden explicar el estado de la derivación y el proceso de entrada. Si entras en una lista, guarda la notificación y pregunta cómo comunicar un cambio importante de necesidad. Solicita también información sobre otros servicios Medicaid o comunitarios disponibles mientras se tramita la exención." ] } }, { "key": "enrollment", "title": { "en": "Taking on the employer role", "es": "Asumir el papel de empleador" }, "paragraphs": { "en": [ "Consumer direction means recruiting, hiring, supervising and, when needed, replacing a personal assistant. It also involves agreeing a pay rate and tasks within program rules and the authorized plan. Work through the case manager's orientation and financial-management arrangements before promising a wage to a relative. Ask who approves employment paperwork, verifies qualifications and confirms the start date. If the worker also has another job, discuss scheduling honestly: the CAP/DA service must meet the beneficiary's assessed needs and cannot be displaced by other obligations." ], "es": [ "La autodirección supone seleccionar, contratar, supervisar y, si hace falta, sustituir al asistente personal. También implica acordar remuneración y tareas dentro de las reglas y del plan autorizado. Completa con el gestor la orientación y la organización financiera antes de prometer un salario a un familiar. Pregunta quién aprueba los documentos, comprueba los requisitos y confirma el inicio. Si el trabajador tiene otro empleo, revisa el horario con claridad: el servicio CAP/DA debe atender las necesidades evaluadas y no quedar desplazado por otras obligaciones." ] } }, { "key": "records", "title": { "en": "Get service-specific recording instructions", "es": "Obtén instrucciones de registro para el servicio concreto" }, "paragraphs": { "en": [ "Keep the approved plan, employee agreement and service records together. Ask the case manager and financial-management provider which electronic visit verification method applies to personal assistance, and whether a documented live-in arrangement changes that process. Do not infer an exemption from a policy for another state or another CAP service. The worker should record actual delivered care and flag missed shifts, hospital stays or changes in the service plan promptly. A caregiver's availability for an entire day is not the same as a full day of authorized billable work." ], "es": [ "Conserva juntos el plan, el acuerdo laboral y los registros de servicios. Pregunta al gestor y al proveedor financiero qué método EVV corresponde a la asistencia personal y si una convivencia documentada modifica ese proceso. No deduzcas una excepción a partir de otro estado o servicio CAP. El trabajador debe registrar los cuidados prestados y comunicar turnos perdidos, hospitalizaciones o cambios del plan. Estar disponible durante todo el día no equivale a tener autorizada una jornada completa facturable." ] } } ], "faqs": [ { "q": { "en": "Can my spouse provide paid CAP/DA personal assistance?", "es": "¿Mi cónyuge puede prestar asistencia personal CAP/DA remunerada?" }, "a": { "en": "Policy 3K-2 permits qualified spouses and other adult relatives for adult beneficiaries. A legal guardian or power-of-attorney role needs separate review; disclose it before hiring.", "es": "La política 3K-2 permite cónyuges y familiares adultos cualificados. La tutela o un poder legal requieren revisión aparte; comunícalos antes de contratar." } }, { "q": { "en": "Can CAP/DA pay me for caring for a child under eighteen?", "es": "¿CAP/DA puede pagarme por cuidar a un menor de dieciocho años?" }, "a": { "en": "CAP/DA serves adults. Ask about CAP/C and its separate eligibility and legally responsible caregiver rules for a child.", "es": "CAP/DA atiende a adultos. Para menores, pregunta por CAP/C y sus reglas propias de elegibilidad y cuidadores legalmente responsables." } }, { "q": { "en": "Does applying reserve an immediate waiver slot?", "es": "¿Solicitar la ayuda reserva una plaza inmediata?" }, "a": { "en": "No. CAP/DA can have a waitlist. Confirm the current entry status with the case-management entity or NC LIFTSS rather than relying on an estimated date online.", "es": "No. CAP/DA puede tener lista de espera. Confirma el estado actual con la entidad gestora o NC LIFTSS en lugar de confiar en una fecha estimada en internet." } }, { "q": { "en": "Can I keep another job while providing paid care?", "es": "¿Puedo conservar otro empleo mientras presto cuidados remunerados?" }, "a": { "en": "The care arrangement must still meet assessed needs. Policy 3K-2 says outside employment must not interfere with the services; discuss a feasible schedule before approval.", "es": "El acuerdo debe atender las necesidades evaluadas. La política 3K-2 exige que otro empleo no interfiera con el servicio; revisa un horario viable antes de aprobarlo." } } ], "slug_en": "north-carolina-cap-da", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "ohio-passport", "state": "Ohio", "code": "OH", "program": "PASSPORT Medicaid Waiver — Consumer-Directed Service Options", "medicaid_name": "Ohio Medicaid", "summary": "PASSPORT helps eligible older Ohioans receive long-term services at home. The state describes an initial telephone screening followed, for approved participants, by a case manager's service planning. Consumer-directed options may allow a participant to choose care workers, but family relationships and provider requirements must be checked for the specific service.", "steps": { "en": [ "Contact the local aging agency about PASSPORT screening.", "Identify the participant-directed service in the proposed plan.", "Disclose family and legal-representative relationships.", "Complete required certification, training and fiscal enrollment.", "Confirm authorization dates and the service’s visit-recording rules." ], "es": [ "Contacta con la agencia local para el examen inicial de PASSPORT.", "Identifica el servicio autodirigido en el plan propuesto.", "Comunica parentescos y funciones de representación legal.", "Completa certificación, formación e inscripción fiscal exigidas.", "Confirma fechas autorizadas y reglas de registro del servicio." ] }, "caveat": "The state's consumer-direction information excludes several legally responsible or representative roles. Structured Family Caregiving is a separate PASSPORT service and must not be treated as having identical hiring rules. Direct access to the main page failed during this review; the official indexed text was available.", "agency_url": "https://aging.ohio.gov/care-and-living/get-help/home-and-community-care/passport-1", "sources": [ { "label": "PASSPORT overview", "url": "https://aging.ohio.gov/care-and-living/get-help/home-and-community-care/passport-1", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "PASSPORT eligibility", "url": "https://aging.ohio.gov/care-and-living/get-help/home-and-community-care/passport-eligibility-1", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "PASSPORT participant direction", "url": "https://aging.ohio.gov/care-and-living/get-help/home-and-community-care/passport-participant-direction", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Provider training and education", "url": "https://aging.ohio.gov/care-and-living/get-help/home-and-community-care/passport-direction-provider-training-and-education", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Ohio Administrative Code 5160-44-32", "url": "https://codes.ohio.gov/ohio-administrative-code/rule-5160-44-32", "access": "direct", "checked_on": "2026-11-15" }, { "label": "ODA EVV notice, January 2026", "url": "https://aging.ohio.gov/see-news-and-events/provider%2Bmemos/provider-memo-jan-06-2026", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Ohio", "slug_es": "ohio-passport-cuidados-autodirigidos", "spouse_policy_override": "conditional", "agency": { "en": "Ohio Department of Aging, through local PASSPORT Administrative Agencies", "es": "Departamento de Envejecimiento de Ohio, mediante agencias administrativas locales de PASSPORT" }, "fms": { "en": "Use the state-contracted financial management service assigned to the arrangement. A January 2026 ODA notice names PPL for participant-directed Choices Home Care Attendant Service.", "es": "Utiliza el servicio fiscal contratado por el estado y asignado a la modalidad. Un aviso de ODA de enero de 2026 identifica PPL para Choices Home Care Attendant Service autodirigido." }, "payment": { "en": "Authorized participant-directed service units and the applicable agreement determine pay; distinguish wages from provider reimbursement.", "es": "El pago depende de las unidades de servicio autorizadas y del acuerdo aplicable; distingue salario y reembolso al proveedor." }, "spouse": { "en": "Conditional: rule 5160-44-32 permits certain spouse arrangements subject to extraordinary-care and other requirements documented in the care plan.", "es": "Condicional: la norma 5160-44-32 admite determinadas modalidades con cónyuges, sujetas a cuidados extraordinarios y otros requisitos documentados en el plan." }, "minors": { "en": "PASSPORT is for older adults. Parent-of-minor provisions in Ohio’s broader waiver rules are not a route to enrolling a child in PASSPORT.", "es": "PASSPORT se dirige a adultos mayores. Las disposiciones generales de Ohio sobre padres de menores no permiten inscribir a un niño en PASSPORT." }, "overview": { "en": "Ohio’s PASSPORT waiver can connect eligible older adults with care at home. Participant direction is an optional way to arrange certain services, including Choices Home Care Attendant and consumer-directed personal care. It gives the participant employer responsibilities as well as more control. Before a relative changes employment or commits to a schedule, the family needs to identify the exact service, confirm worker certification and obtain its authorization through the local PASSPORT agency.", "es": "El programa waiver PASSPORT de Ohio puede facilitar cuidados domiciliarios a adultos mayores elegibles. La dirección por el participante es una modalidad opcional para determinados servicios, incluidos Choices Home Care Attendant y atención personal autodirigida. Aporta control, pero también obligaciones como empleador. Antes de que un familiar cambie de empleo o se comprometa con un horario, conviene identificar el servicio, comprobar la certificación del trabajador y obtener autorización mediante la agencia local de PASSPORT." }, "sections": [ { "key": "programs", "title": { "en": "Choose a service before comparing pay", "es": "Elige el servicio antes de comparar remuneraciones" }, "paragraphs": { "en": [ "Choices and consumer-directed personal care are named PASSPORT options, not interchangeable labels for every type of home support. Ask the case manager what each proposed service covers and what training it requires. The participant or a permitted representative handles hiring, supervision and scheduling, while a contracted financial management service handles assigned payroll functions. Keep the case-management contact and fiscal contact separately: neither a payroll account nor a caregiver application substitutes for an approved service plan." ], "es": [ "Choices y atención personal autodirigida son modalidades concretas de PASSPORT, no nombres intercambiables de cualquier apoyo domiciliario. Pregunta al gestor qué cubre cada servicio propuesto y qué formación exige. El participante o un representante permitido gestiona contratación, supervisión y horarios; un servicio fiscal contratado realiza las funciones de nómina asignadas. Guarda por separado los contactos del gestor y de administración fiscal: ni una cuenta de nómina ni la solicitud de un cuidador sustituyen el plan aprobado." ] } }, { "key": "eligibility", "title": { "en": "PASSPORT evaluates the older adult first", "es": "PASSPORT evalúa primero a la persona mayor" }, "paragraphs": { "en": [ "The Department of Aging lists age 60 or older, Medicaid financial eligibility and the required level of care among PASSPORT conditions. The assessment considers whether a community arrangement can meet the person’s needs. Start with the local aging agency rather than selecting a wage from an online table. Bring a description of daily assistance, available support and current services. Some official pages contain older financial examples; verify the applicable current eligibility rules instead of reusing a dated income figure." ], "es": [ "El Departamento de Envejecimiento incluye entre los requisitos tener 60 años o más, cumplir la elegibilidad económica de Medicaid y necesitar el nivel de cuidados correspondiente. La evaluación considera si una organización comunitaria puede atender las necesidades. Empieza por la agencia local de envejecimiento, en lugar de elegir un salario de una tabla de internet. Describe ayuda diaria, apoyos disponibles y servicios actuales. Algunas páginas oficiales contienen ejemplos económicos antiguos; comprueba las reglas vigentes antes de reutilizar esas cifras." ] } }, { "key": "waiting", "title": { "en": "Separate program entry from worker certification", "es": "Distingue la entrada al programa de la certificación" }, "paragraphs": { "en": [ "An initial screening, a care assessment, Medicaid eligibility and worker certification can progress on different timelines. Ask the PASSPORT Administrative Agency which stage is pending and whether service availability affects the proposed start. ODA requires participant-direction providers to complete initial and continuing education, with agency contact before certification and annually. Allow for that preparation when organizing family care. This guide offers no fixed approval period or promise of payment for assistance delivered before the authorized arrangement begins." ], "es": [ "El contacto inicial, la evaluación, la elegibilidad Medicaid y la certificación del trabajador pueden avanzar a ritmos diferentes. Pregunta a la agencia administrativa qué fase está pendiente y si la disponibilidad afecta al inicio propuesto. ODA exige formación inicial y continua a proveedores autodirigidos, con contacto con la agencia antes de certificarse y anualmente. Considera esa preparación al organizar los cuidados. Esta guía no promete un plazo fijo ni pagar asistencia anterior al inicio de la modalidad autorizada." ] } }, { "key": "enrollment", "title": { "en": "Family relationships need an individual review", "es": "El parentesco exige una revisión individual" }, "paragraphs": { "en": [ "Ohio rule 5160-44-32 permits some spouse and legally responsible caregiver arrangements under specified conditions. For spouses, the extraordinary-care assessment is part of that review; being married does not itself establish eligibility. Disclose powers of attorney, guardianship and representative duties to the case manager. In participant-directed services, a representative designated through the financial management service cannot also be the direct care worker. Request a written explanation of the approved roles before completing payroll enrollment." ], "es": [ "La norma 5160-44-32 permite determinadas modalidades con cónyuges y cuidadores legalmente responsables bajo condiciones concretas. En el caso del cónyuge, la evaluación de cuidados extraordinarios forma parte de la revisión; el matrimonio no establece por sí mismo la elegibilidad. Comunica poderes, tutela y representación al gestor. En servicios autodirigidos, el representante designado mediante el servicio fiscal no puede ser también el trabajador de atención directa. Pide una explicación escrita de las funciones aprobadas antes de completar la inscripción laboral." ] } }, { "key": "records", "title": { "en": "Use the EVV instructions for the exact service", "es": "Utiliza las instrucciones EVV de ese servicio" }, "paragraphs": { "en": [ "ODA’s January 2026 notice links PASSPORT claims processing with Electronic Visit Verification and directs Choices workers using PPL to that fiscal service for questions. Confirm how visits, corrections and any applicable exceptions are handled; living together is not enough to assume an exemption. Ohio’s relationship rule also separates the worker from verification on the participant’s behalf. Record only the authorized care actually delivered, and resolve discrepancies before submitting overlapping work or care for another person." ], "es": [ "El aviso de ODA de enero de 2026 relaciona la tramitación de reclamaciones PASSPORT con EVV y remite a PPL las dudas de trabajadores Choices que utilizan ese servicio fiscal. Confirma cómo registrar visitas, correcciones y posibles excepciones; convivir no basta para suponer una exención. La norma sobre parentesco también separa al trabajador de la verificación en nombre del participante. Registra únicamente los cuidados autorizados realmente prestados y aclara cualquier solapamiento con otro trabajo o persona atendida." ] } } ], "faqs": [ { "q": { "en": "Can spouses ever be paid in Ohio?", "es": "¿Puede remunerarse a un cónyuge en Ohio?" }, "a": { "en": "Yes, qualifying arrangements exist under rule 5160-44-32, with conditions; approval is individualized.", "es": "Sí, existen modalidades bajo la norma 5160-44-32, con condiciones y aprobación individual." } }, { "q": { "en": "Is PASSPORT the child-care waiver?", "es": "¿PASSPORT es el programa para menores?" }, "a": { "en": "No. PASSPORT’s age threshold is 60; other programs have different populations and rules.", "es": "No. PASSPORT exige 60 años; otros programas atienden poblaciones distintas con otras reglas." } }, { "q": { "en": "Can the FMS representative also provide paid direct care?", "es": "¿Puede el representante del servicio fiscal prestar cuidados remunerados?" }, "a": { "en": "The cited rule prohibits that combination in participant-directed services.", "es": "La norma citada prohíbe combinar esas funciones en servicios autodirigidos." } }, { "q": { "en": "Who handles Choices payroll questions?", "es": "¿Quién atiende dudas de nómina de Choices?" }, "a": { "en": "ODA’s January 2026 EVV notice directs Choices participants using PPL to PPL. Confirm your assigned arrangement.", "es": "El aviso EVV de enero de 2026 remite a PPL a quienes utilizan esa entidad. Confirma tu modalidad asignada." } } ], "slug_en": "ohio-passport", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "oregon-homecare-worker", "state": "Oregon", "code": "OR", "program": "ODHS In-Home Services — Homecare Worker", "medicaid_name": "Oregon Medicaid", "summary": "Oregon's home-care guidance explains how eligible consumers can receive publicly funded help and hire a homecare worker. The workforce route includes family caregivers. Caregiver enrollment and the recipient's service eligibility are separate decisions. The state distinguishes homecare workers for older adults and people with disabilities from other personal-support and behavioral-health roles.", "steps": { "en": [ "Contact the local APD or Area Agency on Aging office to identify Medicaid LTSS, OPI or OPI-M eligibility.", "Discuss the assessed service plan and whether Consumer Employer, Independent Choices or agency care fits the participant.", "If hiring a relative, confirm spouse/representative restrictions and complete the appropriate worker enrollment.", "Receive written authorization, complete training and learn the required payroll and time-capture process." ], "es": [ "Contacta con APD o la agencia local de envejecimiento para identificar la vía Medicaid LTSS, OPI u OPI-M.", "Revisa el plan y si conviene Consumer Employer, Independent Choices o una agencia.", "Si se contrata a un familiar, confirma las reglas de cónyuge y representante y completa el alta correspondiente.", "Obtén la autorización escrita, completa la formación y aprende el procedimiento de nómina y registro horario." ] }, "caveat": "The consumer page covers Medicaid and Oregon Project Independence, which are different funding routes. Confirm the applicable program and any relationship-specific conditions before assuming a family caregiver or spouse can be paid.", "agency_url": "https://www.oregon.gov/odhs/home-care-consumers/Pages/default.aspx", "sources": [ { "label": "ODHS: Home Care Services", "url": "https://www.oregon.gov/odhs/home-care-consumers/Pages/default.aspx", "access": "direct", "checked_on": "2026-11-15" }, { "label": "ODHS: Spousal Pay Program guide", "url": "https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/sp-program-wg.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Oregon Home Care Commission workforce checklist", "url": "https://www.oregon.gov/odhs/providers-partners/homecare-workforce/Documents/ohcc-workforce-checklist-en.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "ODHS: Oregon Provider Time Capture", "url": "https://www.oregon.gov/odhs/providers-partners/orptc/Pages/default.aspx", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "ODHS: Provider Navigator Program", "url": "https://www.oregon.gov/odhs/providers-partners/homecare-workforce/pages/navigator.aspx", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "ODHS: Homecare Worker FAQ", "url": "https://www.oregon.gov/odhs/providers-partners/homecare-workforce/Documents/faq-en.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Oregón", "slug_es": "oregon-cuidador-domiciliario-pago", "spouse_policy_override": "conditional", "agency": { "en": "Oregon Department of Human Services, Aging and People with Disabilities (APD)", "es": "Departamento de Servicios Humanos de Oregón, Aging and People with Disabilities (APD)" }, "fms": { "en": "Consumer-Employed Provider program payroll arrangements through ODHS; Independent Choices uses a different employer/payment model", "es": "Nóminas del programa Consumer-Employed Provider mediante ODHS; Independent Choices utiliza otro modelo de empleador y pago" }, "payment": { "en": "Hourly homecare work under authorized tasks and hours; do not substitute an Independent Choices cash budget for a wage", "es": "Trabajo domiciliario por tareas y horas autorizadas; el presupuesto de Independent Choices no equivale a un salario" }, "spouse": { "en": "Possible through specific Spousal Pay or Independent Choices arrangements, with program-specific approval. Not a general right for every married caregiver.", "es": "Puede ser posible mediante Spousal Pay o Independent Choices, con autorización específica. No es un derecho general de todo cónyuge cuidador." }, "minors": { "en": "This guide concerns the APD homecare route. Children's disability programs and paid-parent arrangements need their own assessment.", "es": "Esta guía trata la vía domiciliaria de APD. Los programas infantiles y acuerdos de pago a padres requieren una evaluación propia." }, "overview": { "en": "Oregon separates the program that funds care from the way a worker is hired. Medicaid long-term services, Oregon Project Independence and OPI-M are not interchangeable. A family may use the Consumer Employer route, an agency, or another approved arrangement. Identifying the exact route with Aging and People with Disabilities or an Area Agency on Aging is more useful than searching for one statewide payment for relatives.", "es": "Oregón distingue entre el programa que financia los cuidados y la forma de contratar al trabajador. Medicaid de larga duración, Oregon Project Independence y OPI-M no son equivalentes. Una familia puede utilizar el modelo Consumer Employer, una agencia u otro acuerdo aprobado. Identificar la vía exacta con Aging and People with Disabilities o con la agencia local de envejecimiento resulta más útil que buscar un pago estatal único para familiares." }, "sections": [ { "key": "programs", "title": { "en": "Medicaid LTSS, OPI, OPI-M and Independent Choices", "es": "Medicaid LTSS, OPI, OPI-M e Independent Choices" }, "paragraphs": { "en": [ "OPI is a state-funded home-support program for people without Medicaid long-term-care benefits; OPI-M uses Medicaid funding under different financial rules. Independent Choices is a self-directed option for eligible Medicaid LTSS participants, using a cash benefit that the participant manages for services. By contrast, the Consumer Employer arrangement lets the person hire workers while the program pays them. These differences affect employer tasks, financial eligibility and how money is accounted for. Ask which name appears on the actual service authorization." ], "es": [ "OPI es un programa estatal de apoyo domiciliario para personas sin prestaciones Medicaid de larga duración; OPI-M utiliza financiación Medicaid y otras reglas financieras. Independent Choices es una opción de autodirección para participantes elegibles en Medicaid LTSS, con una cantidad que la persona administra para servicios. En el modelo Consumer Employer, la persona contrata a los trabajadores y el programa les paga. Estas diferencias afectan a las obligaciones laborales, los requisitos económicos y la justificación del dinero. Pregunta qué nombre figura en la autorización real." ] } }, { "key": "eligibility", "title": { "en": "Explain the care needs and the relationship", "es": "Explica las necesidades y el parentesco" }, "paragraphs": { "en": [ "The Medicaid LTSS review considers finances and the assistance needed at home. A spouse who wants to become the paid worker should specifically ask about the Spousal Pay Program rather than assume the normal family-worker process is sufficient. That program has additional conditions and department approval. Oregon's current Spousal Pay guide also discusses what happens when a worker marries the consumer. Because the details depend on the service arrangement, take both the marriage relationship and any employer-representative role to the case manager." ], "es": [ "La revisión Medicaid LTSS tiene en cuenta la situación económica y la ayuda necesaria en casa. Si el cónyuge quiere cobrar como trabajador, debe preguntar específicamente por Spousal Pay, sin asumir que basta con el proceso habitual para familiares. Ese programa tiene condiciones adicionales y necesita aprobación del departamento. La guía vigente también aborda el caso de un trabajador que se casa con la persona atendida. Como los detalles dependen del acuerdo, comunica al gestor tanto el parentesco como cualquier función de representante del empleador." ] } }, { "key": "waiting", "title": { "en": "Availability depends on the funding route", "es": "La disponibilidad depende de la financiación" }, "paragraphs": { "en": [ "ODHS states that OPI has waiting lists in some areas, with priority based on need. That does not establish the same queue for Medicaid LTSS or OPI-M. Ask the local office whether you are waiting for an eligibility decision, a funded service opening, a worker or a completed hiring step. Request a written description of what remains and discuss other community support while waiting. A caregiver application and a recipient application are not interchangeable, and neither creates an automatic promise of back pay." ], "es": [ "ODHS indica que OPI tiene listas de espera en algunas zonas y que prioriza según la necesidad. Eso no significa que Medicaid LTSS u OPI-M utilicen la misma lista. Pregunta si falta resolver la elegibilidad, disponer de una plaza financiada, encontrar trabajador o completar el alta. Pide que expliquen por escrito lo pendiente y consulta otros apoyos comunitarios mientras esperas. La solicitud del cuidador y la del beneficiario son distintas, y ninguna supone por sí misma una promesa de pago retroactivo." ] } }, { "key": "enrollment", "title": { "en": "A provider number is part of the worker process", "es": "El número de proveedor forma parte del alta" }, "paragraphs": { "en": [ "Oregon's Home Care Commission checklist includes an application, identity documents, a background check, orientation, acknowledgment of the worker guide and required training. A provider number identifies an enrolled worker; it is not a grant award or proof that every requested hour is payable. Provider Navigators can help with forms and getting started. For an adult relative, confirm which worker category applies: homecare worker, personal support worker and personal care attendant are different roles, and the wrong application can send you to the wrong system." ], "es": [ "La lista de la Home Care Commission incluye solicitud, documentos de identidad, antecedentes, orientación, aceptación de la guía del trabajador y formación obligatoria. El número de proveedor identifica al trabajador inscrito; no es una concesión de ayuda ni demuestra que todas las horas solicitadas sean pagaderas. Los Provider Navigators pueden ayudar con los formularios y el inicio. Confirma qué categoría corresponde: homecare worker, personal support worker y personal care attendant son funciones distintas, y una solicitud equivocada puede llevarte a otro sistema." ] } }, { "key": "records", "title": { "en": "Use Oregon's approved time-capture process", "es": "Utiliza el registro horario autorizado de Oregón" }, "paragraphs": { "en": [ "Homecare workers and personal care attendants record time through OR PTC DCI. ODHS describes app, landline and fob options, with procedures for historical entries and corrections. Confirm the method suitable for the home, including what to do if a device or connection fails. Compare entries with the approved tasks and hours before submitting. Living with a relative does not by itself justify skipping records; ask the office which rule applies to your worker type and payment model, particularly if using Independent Choices." ], "es": [ "Los homecare workers y personal care attendants registran el tiempo mediante OR PTC DCI. ODHS describe opciones con aplicación, teléfono fijo y dispositivo fob, además de procedimientos para entradas posteriores y correcciones. Confirma el método adecuado para la vivienda y qué hacer si falla el dispositivo o la conexión. Compara los registros con las tareas y horas aprobadas antes de presentarlos. Convivir no permite por sí solo omitir registros; consulta la regla de tu categoría y modalidad, especialmente si utilizas Independent Choices." ] } } ], "faqs": [ { "q": { "en": "Can a spouse be a paid Oregon homecare worker?", "es": "¿Puede cobrar un cónyuge como cuidador en Oregón?" }, "a": { "en": "Some approved arrangements permit it. Ask specifically about Spousal Pay or Independent Choices; marriage alone does not establish eligibility or the payable service amount.", "es": "Algunos acuerdos aprobados lo permiten. Pregunta por Spousal Pay o Independent Choices; el matrimonio no determina por sí solo la elegibilidad ni la cantidad pagadera." } }, { "q": { "en": "Is OPI the same as OPI-M?", "es": "¿OPI y OPI-M son lo mismo?" }, "a": { "en": "No. OPI uses state funding and OPI-M uses Medicaid funding. Financial rules, costs and availability should be checked separately with the local office.", "es": "No. OPI utiliza fondos estatales y OPI-M fondos Medicaid. Comprueba por separado las reglas económicas, los costes y la disponibilidad en la oficina local." } }, { "q": { "en": "Does a provider number let me start billing immediately?", "es": "¿El número de proveedor permite facturar inmediatamente?" }, "a": { "en": "It identifies your enrollment. Payment also needs the participant's service authorization, the correct worker assignment and completion of applicable hiring and training requirements.", "es": "Identifica tu inscripción. El pago también necesita la autorización del servicio, la asignación correcta y el cumplimiento de los requisitos laborales y de formación." } }, { "q": { "en": "What if I cannot use a smartphone for timekeeping?", "es": "¿Qué hago si no puedo fichar con un teléfono inteligente?" }, "a": { "en": "ODHS lists landline and fob options as well as the mobile app. Ask the local office to set up the supported option before the first paid shift.", "es": "ODHS ofrece opciones con teléfono fijo y fob además de la aplicación. Pide que configuren el método admitido antes del primer turno remunerado." } } ], "slug_en": "oregon-homecare-worker", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "PA", "state": "Pennsylvania", "slug": "pennsylvania-chc", "program": "Community HealthChoices (CHC)", "medicaid_name": "Pennsylvania Medical Assistance", "agency_url": "https://www.pa.gov/agencies/dhs/resources/medicaid/chc", "summary": "CHC coordinates long-term services and supports. The state describes coverage for certain adults with Medicare and Medicaid and people receiving Medicaid long-term supports. Participant direction must be discussed within the applicable care plan.", "steps": { "en": [ "Identify whether the person is applying for CHC or already enrolled.", "Request the relevant eligibility assessment and service-plan discussion.", "Disclose the worker’s family relationship and legal roles.", "Choose the appropriate participant-direction model and complete employer and worker enrollment.", "Confirm authorization, pay, start date and timekeeping with the plan and fiscal agent." ], "es": [ "Identifica si se solicita CHC o ya existe afiliación.", "Pide evaluación y conversación sobre el plan de servicios.", "Declara parentesco y funciones legales del trabajador.", "Elige modalidad y completa altas del empleador y trabajador.", "Confirma autorización, salario, inicio y registros con plan y agente fiscal." ] }, "caution": "CHC membership alone does not establish paid hours or authorize a family caregiver.", "spouse_policy": "not_allowed", "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "Pennsylvania DHS: Community HealthChoices", "url": "https://www.pa.gov/agencies/dhs/resources/medicaid/chc", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Pennsylvania DHS: 2026 CHC agreement", "url": "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-providers/documents/2026-chc-agreement.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Pennsylvania DHS: Tempus common law employer handbook", "url": "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/tempus-pa-chc-cle-handbook.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Pennsylvania DHS: approved CHC waiver renewal", "url": "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/documents/2025-chc-renewal.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Pennsylvania DHS: 2026 CHC Appendix C", "url": "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/contact/dhs-offices/documents/oltl/oltl-waivers/2026-chc-waiver/2026-01-28-chc-1915c-appendix-c.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Pennsylvania DHS: participant-direction workgroup report", "url": "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/participant-direction-workgroup-report.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Pensilvania", "slug_es": "pensilvania-chc-asistencia-familiar", "spouse_policy_override": "not_allowed", "agency": { "en": "Pennsylvania Department of Human Services, Office of Long-Term Living and the participant’s CHC plan.", "es": "Departamento de Servicios Humanos, Office of Long-Term Living y plan CHC de la persona participante." }, "fms": { "en": "State CHC materials identify Tempus Unlimited as fiscal/employer agent within the participant-direction arrangement. Confirm onboarding with the plan.", "es": "Los materiales estatales identifican Tempus Unlimited como agente fiscal y del empleador en autodirección CHC. Confirma el alta con el plan." }, "payment": { "en": "Approved personal assistance or other eligible participant-directed services, with worker wages administered through the fiscal/employer agent.", "es": "Asistencia personal u otros servicios autodirigidos aprobados, con salarios gestionados por el agente fiscal y del empleador." }, "spouse": { "en": "The CHC waiver excludes a spouse, legal guardian, representative payee and power of attorney from paid services described in its family-provider policy.", "es": "La exención CHC excluye del trabajo remunerado descrito en su política familiar al cónyuge, tutor legal, representante de pagos y apoderado." }, "minors": { "en": "CHC is an adult program for people age 21 and older in its covered groups; it is not a parent-of-minor payment route.", "es": "CHC es un programa para personas de 21 años o más de los grupos cubiertos; no es una vía de pago por cuidar a un hijo menor." }, "overview": { "en": "Pennsylvania’s Community HealthChoices combines managed care coordination with long-term services for eligible adults. A participant may be able to direct approved personal assistance and employ an eligible relative. CHC membership alone does not mean a relative has been hired or that a particular number of home-care hours is covered.", "es": "Community HealthChoices de Pensilvania combina coordinación de atención administrada y servicios de larga duración para adultos elegibles. Puede permitir dirigir asistencia personal aprobada y contratar a un familiar elegible. La afiliación CHC por sí sola no contrata a un familiar ni garantiza determinadas horas de atención domiciliaria." }, "sections": [ { "key": "programs", "title": { "en": "Choose the correct participant-direction model", "es": "Elige el modelo correcto de autodirección" }, "paragraphs": { "en": [ "CHC distinguishes agency-delivered services from participant-directed employment. Under employer authority, the participant or eligible representative acts as common law employer and takes responsibility for recruiting, supervising and directing the worker. Financial management supports the employment arrangement without taking over decisions about the person’s needs.", "Services My Way adds a budget-authority approach with its own requirements and permitted services or goods. It should not be described as a cash allowance to spend without restrictions. Ask the service coordinator to explain which model fits the authorized plan, how the budget works and what responsibilities the family would accept." ], "es": [ "CHC distingue servicios prestados por agencia de contratación autodirigida. Con autoridad de empleador, la persona o un representante elegible actúa como empleador legal y asume contratación, supervisión y dirección del trabajador. La gestión financiera apoya esa relación laboral sin sustituir las decisiones sobre necesidades asistenciales.", "Services My Way incorpora autoridad presupuestaria, con requisitos propios y servicios o bienes permitidos. No debe describirse como dinero disponible para gastar libremente. Pide al coordinador que explique qué modelo encaja con el plan autorizado, cómo funciona el presupuesto y qué responsabilidades asumiría la familia." ] }, "source_urls": [ "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-providers/documents/2026-chc-agreement.pdf", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/tempus-pa-chc-cle-handbook.pdf" ] }, { "key": "eligibility", "title": { "en": "Check legal roles as well as family ties", "es": "Comprueba funciones legales además del parentesco" }, "paragraphs": { "en": [ "The CHC waiver permits eligible relatives to provide certain services but expressly excludes spouses, legal guardians, representative payees and people holding power of attorney. An adult child may therefore face a restriction because of a legal role, even though the family relationship itself is allowed. Disclose both facts during worker screening.", "Do not change legal arrangements simply to fit an internet eligibility summary. Ask the plan to review the actual documents and proposed worker. Other relatives must still meet the applicable qualifications. The recipient also needs the relevant financial, functional and service eligibility; dual Medicare and Medicaid enrollment is not itself authorization for paid family care." ], "es": [ "La exención CHC admite determinados servicios por familiares elegibles, pero excluye expresamente cónyuges, tutores legales, representantes de pagos y personas con poder de representación. Un hijo adulto puede estar restringido por su función legal aunque el parentesco se permita. Declara ambas circunstancias al evaluar al trabajador.", "No cambies acuerdos legales solo para encajar en un resumen de internet. Pide al plan revisar documentos reales y trabajador propuesto. Los demás familiares también deben cumplir las cualificaciones correspondientes. La persona atendida necesita elegibilidad económica, funcional y de servicios; tener Medicare y Medicaid no autoriza por sí solo cuidados familiares remunerados." ] }, "source_urls": [ "https://www.pa.gov/agencies/dhs/resources/medicaid/chc", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/documents/2025-chc-renewal.pdf", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/contact/dhs-offices/documents/oltl/oltl-waivers/2026-chc-waiver/2026-01-28-chc-1915c-appendix-c.pdf" ] }, { "key": "waiting", "title": { "en": "Track enrollment and service approval separately", "es": "Sigue por separado afiliación y autorización" }, "paragraphs": { "en": [ "For a new application, use the state’s CHC entry information and enrollment assistance route. For someone already enrolled, begin with the CHC service coordinator. These are different starting points: one may still need eligibility determinations while the other needs a review of existing services and participant-direction options.", "Keep copies of notices and ask which office must act next. A completed Medicaid application, a plan choice and an approved worker file are separate milestones. Request a written explanation if services are denied or reduced, including the available review process; do not treat a payroll registration confirmation as the service decision." ], "es": [ "Para una solicitud nueva, utiliza la información estatal de acceso CHC y su vía de ayuda a la inscripción. Si la persona ya está afiliada, empieza por el coordinador CHC. Son situaciones diferentes: una puede requerir decisiones de elegibilidad y otra revisar servicios existentes y opciones de autodirección.", "Conserva notificaciones y pregunta qué oficina debe actuar después. Solicitud Medicaid completa, elección de plan y expediente laboral aprobado son hitos separados. Si deniegan o reducen servicios, pide explicación escrita y procedimiento de revisión; una confirmación de registro en nómina no equivale a la decisión asistencial." ] }, "source_urls": [ "https://www.pa.gov/agencies/dhs/resources/medicaid/chc", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/tempus-pa-chc-cle-handbook.pdf" ] }, { "key": "enrollment", "title": { "en": "Coordinate the plan, employer and Tempus", "es": "Coordina plan, empleador y Tempus" }, "paragraphs": { "en": [ "The state-published common law employer handbook identifies Tempus Unlimited as the fiscal/employer agent. The participant’s CHC plan remains involved in service coordination and authorization. Ask the coordinator to connect the approved plan to the employer and worker enrollment process so names, dates and authorized services match.", "Before the relative begins payable work, confirm required checks, training, wage documents and the effective start date. Discuss backup staffing with the coordinator. A proposed wage must fit the approved arrangement; neither the amount billed to Medicaid nor a recruitment advertisement establishes what this particular worker will receive." ], "es": [ "El manual estatal del empleador identifica Tempus Unlimited como agente fiscal y del empleador. El plan CHC mantiene funciones de coordinación y autorización. Pide al coordinador enlazar el plan aprobado con el alta del empleador y trabajador para que coincidan nombres, fechas y servicios autorizados.", "Antes de iniciar trabajo remunerable, confirma verificaciones, formación, documentos salariales y fecha efectiva. Habla de sustituciones con el coordinador. El salario propuesto debe encajar en la modalidad aprobada; ni lo facturado a Medicaid ni un anuncio de contratación establece cuánto cobrará ese trabajador concreto." ] }, "source_urls": [ "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/tempus-pa-chc-cle-handbook.pdf", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/participant-direction-workgroup-report.pdf" ] }, { "key": "records", "title": { "en": "Authorization controls the payable time", "es": "La autorización determina el tiempo remunerable" }, "paragraphs": { "en": [ "The fiscal/employer agent checks service authorizations against reported work. Use the current timekeeping and visit-verification instructions and ask how any live-in arrangement is recorded. Keep employer approvals and worker records distinct. If the care plan changes, verify that the updated authorization reaches the payroll process before assuming additional shifts can be paid." ], "es": [ "El agente fiscal comprueba autorizaciones frente al trabajo declarado. Utiliza instrucciones vigentes de horas y verificación de visitas y pregunta cómo documentar la convivencia. Separa aprobaciones del empleador y registros del trabajador. Si cambia el plan, verifica que la autorización actualizada llegue al proceso de nómina antes de suponer que se pagarán turnos adicionales." ] }, "source_urls": [ "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/tempus-pa-chc-cle-handbook.pdf", "https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/contact/dhs-offices/documents/oltl/oltl-waivers/2026-chc-waiver/2026-01-28-chc-1915c-appendix-c.pdf" ] } ], "faqs": [ { "q": { "en": "Can a spouse be paid through CHC family-provider rules?", "es": "¿Puede cobrar un cónyuge según las reglas CHC?" }, "a": { "en": "No. The waiver’s family-provider policy excludes the participant’s spouse.", "es": "No. La política familiar de la exención excluye al cónyuge." } }, { "q": { "en": "Can a daughter with power of attorney be the paid worker?", "es": "¿Puede ser trabajadora una hija con poder de representación?" }, "a": { "en": "The CHC policy excludes a power of attorney; ask the plan to review the actual role before enrollment.", "es": "La política CHC excluye al apoderado; pide al plan revisar la función concreta antes del alta." } }, { "q": { "en": "Is Tempus the CHC health plan?", "es": "¿Tempus es el plan de salud CHC?" }, "a": { "en": "No. Its fiscal/employer-agent role is distinct from the plan’s service coordination and authorization.", "es": "No. Su función fiscal y laboral es distinta de la coordinación y autorización del plan." } }, { "q": { "en": "Does Services My Way mean unrestricted cash?", "es": "¿Services My Way entrega dinero sin restricciones?" }, "a": { "en": "No. Budget authority operates under approved services, rules and an individual plan.", "es": "No. La autoridad presupuestaria funciona dentro de servicios, reglas y un plan aprobados." } } ], "slug_en": "pennsylvania-chc", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "code": "TX", "state": "Texas", "slug": "texas-star-plus", "program": "STAR+PLUS Consumer Directed Services (CDS)", "medicaid_name": "Texas Medicaid", "agency_url": "https://fhb.hhs.texas.gov/handbooks/starplus-handbook/8200-consumer-directed-services", "summary": "CDS is a way to manage eligible services within STAR+PLUS and STAR+PLUS HCBS, rather than a separate promise of caregiver pay. Participants may hire eligible people subject to the program and CDS rules.", "steps": { "en": [ "Identify the recipient’s exact Medicaid and STAR+PLUS coverage.", "Ask the service coordinator about approved CDS services and the entry route.", "Confirm the proposed worker’s relationship using current CDS requirements.", "Choose an FMSA and complete employer and employee enrollment.", "Obtain the budget, start date and timekeeping instructions before billing care." ], "es": [ "Identifica la cobertura Medicaid y STAR+PLUS exacta.", "Consulta servicios CDS aprobados y vía de acceso con el coordinador.", "Confirma el parentesco del trabajador según las reglas CDS vigentes.", "Elige agencia financiera y completa ambas altas.", "Obtén presupuesto, fecha de inicio e instrucciones de horas antes de facturar." ] }, "caution": "The underlying program and service determine the rules; not every relative or care task is covered.", "spouse_policy": "not_allowed", "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "rate_status": "not_verified", "reviewed_on": "2026-11-15", "sources": [ { "label": "Texas STAR+PLUS handbook: CDS", "url": "https://fhb.hhs.texas.gov/handbooks/starplus-handbook/8200-consumer-directed-services", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Texas HHS: how CDS works", "url": "https://www.hhs.texas.gov/providers/long-term-care-providers/consumer-directed-services-cds/how-cds-works", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Texas HHS: CDS frequently asked questions", "url": "https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/cds/cds-faqs.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Texas HHS: relationship certification Form 1734", "url": "https://fhb.hhs.texas.gov/forms/1000-1999/form-1734-service-provider-employer-certification-relationship-status-cds", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Texas HHS: STAR+PLUS HCBS eligibility", "url": "https://fhb.hhs.texas.gov/handbooks/starplus-program-support-unit-operational-procedures-handbook/1200-starplus-hcbs-program-eligibility", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Texas HHS: administrative entry procedures", "url": "https://fhb.hhs.texas.gov/handbooks/starplus-program-support-unit-operational-procedures-handbook/3300-administrative-procedures", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "state_es": "Texas", "slug_es": "texas-star-plus-cds-cuidadores", "spouse_policy_override": "not_allowed", "agency": { "en": "Texas Health and Human Services Commission and the member’s STAR+PLUS managed care organization.", "es": "Comisión de Salud y Servicios Humanos de Texas y organización de atención administrada STAR+PLUS." }, "fms": { "en": "A Financial Management Services Agency chosen from the applicable program’s provider options.", "es": "Una agencia de gestión financiera elegida entre los proveedores del programa correspondiente." }, "payment": { "en": "Wages for approved CDS services within the individual service plan and employer budget.", "es": "Salarios por servicios CDS aprobados dentro del plan individual y presupuesto del empleador." }, "spouse": { "en": "A spouse cannot be the paid CDS employee under STAR+PLUS. The separate CMPAS exception does not change this rule.", "es": "El cónyuge no puede ser empleado CDS remunerado de STAR+PLUS. La excepción del programa separado CMPAS no modifica esta regla." }, "minors": { "en": "A legally authorized representative, including a minor’s parent, cannot also be that person’s CDS employee. Confirm the appropriate children’s program separately.", "es": "El representante legal autorizado, incluido el padre o madre de un menor, no puede ser también su empleado CDS. Consulta por separado el programa infantil aplicable." }, "overview": { "en": "In Texas, Consumer Directed Services is a way of arranging certain approved services, not a separate benefit that pays every family caregiver. Start with the recipient’s Medicaid coverage, service needs and STAR+PLUS service coordinator. Selecting CDS changes who handles employment responsibilities; it does not create extra authorized care hours.", "es": "En Texas, Consumer Directed Services es una forma de organizar determinados servicios aprobados, no una ayuda independiente para cualquier familiar cuidador. Empieza por la cobertura Medicaid, las necesidades y el coordinador STAR+PLUS. Elegir CDS cambia quién gestiona el empleo; no crea horas adicionales de atención autorizada." }, "sections": [ { "key": "programs", "title": { "en": "Separate STAR+PLUS coverage from the CDS option", "es": "Distingue STAR+PLUS de la opción CDS" }, "paragraphs": { "en": [ "STAR+PLUS and its HCBS services have their own eligibility and service-plan rules. CDS lets an eligible participant or legally authorized representative take an employer role for services the program permits to be self-directed. The financial management agency supports payroll and related administration. It does not replace the managed care organization’s service coordinator or decide clinical eligibility.", "Texas offers CDS in several programs. A description of Primary Home Care, Community Attendant Services or CMPAS should not be treated as a STAR+PLUS rule. Ask the coordinator to name the exact funding program and the services available under your selected delivery option." ], "es": [ "STAR+PLUS y sus servicios HCBS tienen reglas propias de acceso y planificación. CDS permite que una persona elegible o su representante legal asuma funciones de empleador para los servicios que admiten autodirección. La agencia financiera ayuda con nóminas y administración. No sustituye al coordinador de la organización de atención administrada ni decide la elegibilidad clínica.", "Texas ofrece CDS en varios programas. Una descripción de Primary Home Care, Community Attendant Services o CMPAS no debe interpretarse como norma de STAR+PLUS. Pide al coordinador el nombre exacto del programa financiador y los servicios disponibles con la modalidad elegida." ] }, "source_urls": [ "https://fhb.hhs.texas.gov/handbooks/starplus-handbook/8200-consumer-directed-services", "https://www.hhs.texas.gov/providers/long-term-care-providers/consumer-directed-services-cds/how-cds-works" ] }, { "key": "eligibility", "title": { "en": "Check the employee’s legal relationship", "es": "Comprueba la relación legal del empleado" }, "paragraphs": { "en": [ "Family membership alone does not qualify a worker. Texas requires relationship checks, including restrictions on a spouse, legally authorized representative and designated representative. A designated representative helps the employer voluntarily; that role cannot simply be relabeled as paid attendant work. Form 1734 documents relationship information for CDS.", "For a parent caring for an adult child, identify whether the parent is also a court-appointed guardian or another excluded representative. For spouses, do not rely on the CMPAS exception when discussing STAR+PLUS. Ask the FMSA to confirm employee eligibility before employment paperwork or wage estimates are finalized." ], "es": [ "El parentesco por sí solo no habilita a un trabajador. Texas exige comprobar relaciones y restricciones, entre ellas las del cónyuge, representante legal autorizado y representante designado. Este último ayuda voluntariamente al empleador; su función no puede convertirse sin más en trabajo remunerado de asistente. El formulario 1734 documenta la relación en CDS.", "Si un padre cuida a su hijo adulto, debe aclarar si también actúa como tutor judicial u otro representante excluido. Para cónyuges, no apliques la excepción CMPAS a STAR+PLUS. Pide a la agencia financiera que confirme la elegibilidad laboral antes de finalizar documentos o estimaciones salariales." ] }, "source_urls": [ "https://www.hhs.texas.gov/providers/long-term-care-providers/consumer-directed-services-cds/how-cds-works", "https://fhb.hhs.texas.gov/forms/1000-1999/form-1734-service-provider-employer-certification-relationship-status-cds" ] }, { "key": "waiting", "title": { "en": "The entry route determines the waiting question", "es": "La vía de acceso determina la espera" }, "paragraphs": { "en": [ "Texas distinguishes people seeking a STAR+PLUS HCBS slot through an interest list from other qualifying entry routes, including certain existing members and transitions from facilities. A family should not assume that every STAR+PLUS member joins the same queue, or that a place on an interest list means services are approved.", "Ask which process applies today: Medicaid eligibility, HCBS screening, interest-list release, plan assessment or employee enrollment. Record the responsible office for each unfinished step. Funding and available slots affect some routes, so an online promise of a fixed approval period cannot describe every application." ], "es": [ "Texas distingue entre quienes solicitan una plaza HCBS de STAR+PLUS mediante lista de interés y otras vías de acceso, incluidas ciertas personas ya afiliadas y transiciones desde centros. No todos los miembros entran necesariamente en la misma cola; estar en una lista tampoco equivale a tener servicios autorizados.", "Pregunta qué trámite corresponde ahora: elegibilidad Medicaid, evaluación HCBS, liberación de lista, evaluación del plan o alta del empleado. Anota la oficina responsable de cada paso pendiente. La financiación y las plazas afectan algunas vías; una promesa en internet de un plazo fijo no describe todas las solicitudes." ] }, "source_urls": [ "https://fhb.hhs.texas.gov/handbooks/starplus-program-support-unit-operational-procedures-handbook/1200-starplus-hcbs-program-eligibility", "https://fhb.hhs.texas.gov/handbooks/starplus-program-support-unit-operational-procedures-handbook/3300-administrative-procedures" ] }, { "key": "enrollment", "title": { "en": "Agree a budget before arranging shifts", "es": "Acuerda el presupuesto antes de organizar turnos" }, "paragraphs": { "en": [ "After CDS is selected, the employer chooses an FMSA and completes required orientation and employer documents. The agency assists with employment checks and payroll setup, while the employer recruits, trains and supervises workers. Discuss a backup plan if the family caregiver is unavailable.", "The budget must cover the allowed employment costs, not only the hourly amount a worker hopes to receive. Ask for the proposed wage, approved services, scheduling limits and service start date in writing. An agency’s Medicaid reimbursement figure is not automatically the employee’s gross hourly wage." ], "es": [ "Tras elegir CDS, el empleador selecciona una agencia financiera y completa orientación y documentación. La agencia ayuda con verificaciones laborales y nóminas; el empleador contrata, forma y supervisa al personal. Conviene acordar sustituciones si el familiar cuidador no puede trabajar.", "El presupuesto debe cubrir los costes laborales permitidos, no solo el salario por hora que se desea cobrar. Solicita por escrito salario propuesto, servicios aprobados, límites de horario y fecha de inicio. La cantidad que Medicaid reembolsa a una agencia no es automáticamente el salario bruto del empleado." ] }, "source_urls": [ "https://fhb.hhs.texas.gov/handbooks/starplus-handbook/8200-consumer-directed-services", "https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/cds/cds-faqs.pdf" ] }, { "key": "records", "title": { "en": "Use the program’s timekeeping process", "es": "Utiliza el registro de horas del programa" }, "paragraphs": { "en": [ "Ask the FMSA which electronic visit verification requirements apply to the authorized service and worker situation, including any documented live-in exception. Living with the recipient does not remove the need for correct payroll records. Keep the service plan, worker approval and submitted time together; contact the coordinator when needs change rather than expanding shifts without authorization." ], "es": [ "Pregunta a la agencia financiera qué verificación electrónica de visitas corresponde al servicio y al trabajador, incluida cualquier excepción documentada por convivencia. Vivir con la persona no elimina la obligación de registrar correctamente la nómina. Conserva plan, aprobación laboral y horas declaradas; comunica cambios de necesidades al coordinador en vez de ampliar turnos sin autorización." ] }, "source_urls": [ "https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/cds/cds-faqs.pdf" ] } ], "faqs": [ { "q": { "en": "Is CDS a separate Texas caregiver grant?", "es": "¿CDS es una subvención independiente?" }, "a": { "en": "No. It is a delivery option for services authorized through an eligible program.", "es": "No. Es una modalidad para servicios autorizados dentro de un programa elegible." } }, { "q": { "en": "Can a STAR+PLUS recipient employ their spouse?", "es": "¿Puede contratar a su cónyuge en STAR+PLUS?" }, "a": { "en": "The CDS spouse exclusion applies; a separate CMPAS exception should not be transferred to STAR+PLUS.", "es": "Se aplica la exclusión del cónyuge en CDS; no debe trasladarse la excepción CMPAS." } }, { "q": { "en": "Does everyone face the same interest list?", "es": "¿Todos pasan por la misma lista de interés?" }, "a": { "en": "No. Texas distinguishes entry routes, including some existing-member and institutional-transition situations.", "es": "No. Texas distingue vías de acceso, incluidas algunas de afiliados actuales y transición desde centros." } }, { "q": { "en": "Does the FMSA decide my parent’s service hours?", "es": "¿La agencia financiera decide las horas de mi padre?" }, "a": { "en": "Service authorization belongs to the program and plan process; the FMSA supports the employer and payroll.", "es": "La autorización corresponde al programa y al plan; la agencia financiera apoya al empleador y la nómina." } } ], "slug_en": "texas-star-plus", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "virginia-ccc-plus", "state": "Virginia", "code": "VA", "program": "Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed Services", "medicaid_name": "Virginia Medicaid", "summary": "Virginia's CCC Plus waiver offers home and community-based services to qualifying people who would otherwise need institutional care. Personal care and respite can be consumer-directed. The participant or a representative manages the attendant, while a services facilitator helps explain employer responsibilities. Medicaid eligibility and long-term-services screening are separate parts of enrollment.", "steps": { "en": [ "Ask local Social Services or the hospital discharge team for an LTSS screening.", "Complete Medicaid eligibility through CommonHelp, Cover Virginia or local Social Services.", "After waiver approval, discuss consumer direction with the services facilitator and choose an eligible Employer of Record.", "Confirm any LRI exception, the current fiscal agent, worker checks, service authorization and timekeeping before paid care begins." ], "es": [ "Solicita la evaluación LTSS a Servicios Sociales o al equipo hospitalario de alta.", "Tramita Medicaid mediante CommonHelp, Cover Virginia o Servicios Sociales.", "Tras aprobarse la exención, revisa la autodirección con el facilitador y selecciona un empleador registrado elegible.", "Confirma cualquier excepción LRI, agente fiscal, antecedentes, autorización y fichaje antes de comenzar los cuidados remunerados." ] }, "caveat": "The waiver has specific care-level and service-authorization requirements. Rules for legally responsible individuals require separate review; this overview does not approve a spouse, parent or other relative as an attendant.", "agency_url": "https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/ccc-plus-waiver", "sources": [ { "label": "Virginia DMAS: CCC Plus waiver", "url": "https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/ccc-plus-waiver", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Virginia DMAS: Consumer Directed Services", "url": "https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/consumer-directed-services", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Virginia DMAS: Legally Responsible Individuals", "url": "https://dmas.virginia.gov/for-members/benefits-and-services/waivers/legally-responsible-individuals/", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Virginia DMAS: Waiver overview and waiting-list distinction", "url": "https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Virginia Cardinal Care managed-care contract FY2026-2027, LRI requirements", "url": "https://www.dmas.virginia.gov/media/cdclvnox/virginia-cardinal-care-managed-care-contract-fy-2026.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Virginia CCC Plus provider requirements, November 2026", "url": "https://vamedicaid.dmas.virginia.gov/sites/default/files/2026-11/CCC%20Plus%20Waiver%20Chapter%202%20%28updated%2011.5.26%29_Final.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Cover Virginia: Long-Term Services and Supports", "url": "https://coverva.dmas.virginia.gov/learn/coverage-for-adults/long-term-services-supports/", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Virginia", "slug_es": "virginia-ccc-plus-cuidados-autodirigidos", "spouse_policy_override": "conditional", "agency": { "en": "Virginia Department of Medical Assistance Services (DMAS)", "es": "Departamento de Servicios de Asistencia Médica de Virginia (DMAS)" }, "fms": { "en": "Consumer Direct Care Network or Public Partnerships, depending on the current health-plan or fee-for-service arrangement", "es": "Consumer Direct Care Network o Public Partnerships, según el plan de salud o la modalidad de pago directo vigente" }, "payment": { "en": "Authorized consumer-directed personal care or respite; legally responsible individuals have specific personal-care rules", "es": "Cuidado personal o respiro autodirigido autorizado; los responsables legales tienen reglas específicas para cuidado personal" }, "spouse": { "en": "A spouse may be approved as a legally responsible paid caregiver for extraordinary personal care under current DMAS conditions.", "es": "El cónyuge puede ser aprobado como cuidador legalmente responsable para cuidado personal extraordinario, según las condiciones vigentes de DMAS." }, "minors": { "en": "Parents or legal guardians of minors may be approved for extraordinary disability-related personal care, with separate role and documentation requirements.", "es": "Padres o tutores de menores pueden ser aprobados para cuidado personal extraordinario relacionado con discapacidad, con requisitos específicos de funciones y documentación." }, "overview": { "en": "Virginia's CCC Plus waiver supports people whose needs would otherwise require nursing-facility or other qualifying institutional care. Consumer direction allows the member or an Employer of Record to hire and supervise an attendant. A services facilitator helps the family understand those responsibilities. The waiver, the health plan and the payroll agent are different parts of the arrangement. Start with LTSS screening and Medicaid eligibility rather than a promise of a fixed caregiver salary.", "es": "La exención CCC Plus de Virginia apoya a personas cuyas necesidades exigirían, sin estos servicios, una residencia de enfermería u otra atención institucional elegible. La autodirección permite al miembro o empleador registrado contratar y supervisar a un asistente. Un facilitador ayuda a entender las responsabilidades. La exención, el plan de salud y el agente de nóminas son partes distintas del acuerdo. Empieza por la evaluación LTSS y la elegibilidad Medicaid, no por una promesa de sueldo fijo." }, "sections": [ { "key": "programs", "title": { "en": "CCC Plus waiver is distinct from DD waiver access", "es": "CCC Plus y las exenciones DD tienen accesos distintos" }, "paragraphs": { "en": [ "Virginia distinguishes the CCC Plus waiver from Developmental Disability waivers such as Community Living and Family and Individual Supports. They serve different needs and have different entry arrangements. DMAS says CCC Plus does not have a waiting list; that is not the case for every Virginia waiver. Consumer direction is a delivery model used for certain services, not a separate waiver. Ask which waiver and service are named in the authorization before assuming another family's experience will apply to yours." ], "es": [ "Virginia distingue CCC Plus de las exenciones para discapacidad del desarrollo, como Community Living y Family and Individual Supports. Atienden necesidades y utilizan accesos distintos. DMAS indica que CCC Plus no tiene lista de espera; eso no sucede con todas las exenciones de Virginia. La autodirección es una modalidad de determinados servicios, no otra exención. Pregunta qué exención y servicio aparecen en la autorización antes de asumir que la experiencia de otra familia se aplicará a la tuya." ] } }, { "key": "eligibility", "title": { "en": "Request an LTSS screening and a financial review", "es": "Solicita la evaluación LTSS y la revisión económica" }, "paragraphs": { "en": [ "The local Department of Social Services can arrange a community LTSS screening, involving social-work and nursing assessment. A hospitalized person can ask the discharge planner about screening. Medicaid financial eligibility must also be established; CommonHelp, Cover Virginia and local Social Services provide application routes. Describe how the person manages daily tasks and what would happen without support at home. Ask for the written outcome and the services recommended. Being screened does not by itself complete a caregiver's employment or payroll enrollment." ], "es": [ "El Departamento local de Servicios Sociales puede organizar una evaluación comunitaria LTSS con trabajo social y enfermería. Una persona hospitalizada puede preguntar al responsable del alta. También debe establecerse la elegibilidad financiera Medicaid; CommonHelp, Cover Virginia y Servicios Sociales ofrecen vías de solicitud. Explica cómo realiza la persona sus tareas diarias y qué ocurriría sin apoyo domiciliario. Solicita el resultado escrito y los servicios recomendados. La evaluación no completa por sí sola la contratación ni el alta de nómina del cuidador." ] } }, { "key": "waiting", "title": { "en": "No waiver waitlist does not mean immediate payroll", "es": "No tener lista de espera no significa cobrar inmediatamente" }, "paragraphs": { "en": [ "Although CCC Plus has no waiver waiting list, screening, financial review, service authorization and finding a qualified attendant can still take time. Keep those stages separate when following up. Ask which office is waiting for information and who can confirm the next action. If care needs change during the process, tell the screening team or case manager. Do not assume that all help given before the written start date will be reimbursed; obtain instructions about any requested earlier service dates directly from the responsible payer." ], "es": [ "Aunque CCC Plus no tenga lista de espera para plazas, la evaluación, revisión financiera, autorización y búsqueda de asistente cualificado pueden llevar tiempo. Distingue esas etapas al consultar el expediente. Pregunta qué oficina espera información y quién confirma el siguiente paso. Comunica cualquier cambio de necesidades al equipo evaluador o gestor. No supongas que se reembolsará toda la ayuda prestada antes de la fecha escrita de inicio; consulta directamente al pagador cualquier petición de fechas anteriores." ] } }, { "key": "enrollment", "title": { "en": "Family workers and the Employer of Record have separate roles", "es": "El familiar trabajador y el empleador registrado tienen funciones distintas" }, "paragraphs": { "en": [ "The Employer of Record directs the attendant; the services facilitator explains responsibilities and helps develop the care arrangement. DMAS permits certain spouses and parents or guardians of minors to provide extraordinary personal care under its legally responsible individual rules. Ordinary parenting, general supervision and household chores do not automatically become payable extraordinary care. When that arrangement is proposed, review the current form, approval criteria and employer-role restrictions. The fiscal agent depends on the payment arrangement; confirm the correct agent with the health plan or facilitator before opening payroll paperwork." ], "es": [ "El empleador registrado dirige al asistente; el facilitador explica responsabilidades y ayuda a preparar los cuidados. DMAS permite a determinados cónyuges y padres o tutores de menores prestar cuidado personal extraordinario conforme a sus reglas de responsables legales. La crianza ordinaria, supervisión general y tareas domésticas no se convierten automáticamente en cuidado extraordinario pagadero. Revisa el formulario vigente, los criterios y restricciones del empleador. El agente fiscal depende de la modalidad de pago; confírmalo con el plan o facilitador antes de iniciar los documentos laborales." ] } }, { "key": "records", "title": { "en": "Document personal care and verify the current LRI rules", "es": "Documenta el cuidado personal y comprueba las reglas LRI" }, "paragraphs": { "en": [ "Approved attendants need records of actual services and the required timekeeping process. Virginia's current managed-care contract specifically requires paid legally responsible individuals to document daily tasks and use EVV. Do not assume a live-in exception from another state applies. The LRI guidance also restricts respite availability when an LRI is being paid for personal care. Because this policy has changed over time, use the current DMAS page and ask the facilitator to identify the rule applied to your case in writing." ], "es": [ "Los asistentes aprobados necesitan registrar los servicios reales y utilizar el fichaje exigido. El contrato vigente de atención gestionada requiere expresamente que los responsables legales remunerados documenten tareas diarias y utilicen EVV. No supongas que se aplica una excepción de convivencia de otro estado. Las reglas LRI también restringen el respiro cuando un responsable legal cobra por cuidado personal. Esta política ha cambiado con el tiempo: utiliza la página actual de DMAS y pide al facilitador que identifique por escrito la regla de tu caso." ] } } ], "faqs": [ { "q": { "en": "Does CCC Plus have a waiting list?", "es": "¿CCC Plus tiene lista de espera?" }, "a": { "en": "DMAS says the waiver does not have a waiting list. Eligibility, screening, authorization and worker enrollment still need to be completed; other Virginia waivers differ.", "es": "DMAS indica que esta exención no tiene lista de espera. Aun así, deben completarse elegibilidad, evaluación, autorización y alta laboral; otras exenciones son diferentes." } }, { "q": { "en": "Can a spouse or parent of a minor be paid?", "es": "¿Puede cobrar un cónyuge o progenitor de menor?" }, "a": { "en": "Current DMAS LRI rules allow approved extraordinary personal care under specific conditions. Ask about the current approval form and employer-role restrictions.", "es": "Las reglas LRI vigentes permiten cuidado personal extraordinario aprobado bajo condiciones específicas. Consulta el formulario actual y las restricciones del empleador." } }, { "q": { "en": "Is the services facilitator my payroll company?", "es": "¿El facilitador es mi empresa de nóminas?" }, "a": { "en": "No. The facilitator supports the care arrangement and employer duties. A fiscal employer agent handles payroll functions; confirm the agent assigned to the plan or payment route.", "es": "No. El facilitador apoya el plan y las obligaciones del empleador. El agente fiscal gestiona funciones de nómina; confirma cuál corresponde a tu modalidad." } }, { "q": { "en": "Will previous unpaid family care automatically be paid later?", "es": "¿Se pagarán automáticamente después los cuidados familiares anteriores?" }, "a": { "en": "Do not assume that. Ask the authorizing payer about service dates and enrollment requirements; general Medicaid eligibility does not itself authorize every past caregiver hour.", "es": "No lo supongas. Consulta al pagador sobre fechas y alta; reunir los requisitos generales de Medicaid no autoriza todas las horas anteriores del cuidador." } } ], "slug_en": "virginia-ccc-plus", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "washington-individual-provider", "state": "Washington", "code": "WA", "program": "Apple Health Long-Term Services and Supports — Individual Provider", "medicaid_name": "Washington Apple Health", "summary": "Washington's Medicaid in-home care route can employ family caregivers as Individual Providers through Consumer Direct Care Network Washington. The person receiving care must qualify for Medicaid long-term services and supports. Hiring, screening and training are separate requirements for the caregiver. The state's guidance distinguishes this route from the WA Cares benefit program.", "steps": { "en": [ "Contact DSHS Home and Community Services about the client's LTSS application and CARE assessment.", "Confirm the approved program, covered tasks, service amount and whether your relationship is allowed.", "Complete CDWA hiring, screening and relationship-specific training requirements.", "Obtain the authorized start date and ask CDWA how to report visits or attest to live-in status." ], "es": [ "Consulta a Home and Community Services de DSHS sobre la solicitud LTSS y la evaluación CARE.", "Confirma el programa, las tareas, la cantidad autorizada y si se permite tu parentesco.", "Completa la contratación, los antecedentes y la formación correspondiente en CDWA.", "Obtén la fecha autorizada de inicio y pregunta cómo registrar visitas o declarar convivencia." ] }, "caveat": "DSHS says a spouse cannot be paid under Apple Health LTSS. WA Cares and Veteran Directed Care are separate programs with different rules; this exclusion must not be generalized to them.", "agency_url": "https://www.dshs.wa.gov/adult-and-aging-services/caregiving-resources/becoming-paid-caregiver", "sources": [ { "label": "DSHS: Becoming a Paid Caregiver", "url": "https://www.dshs.wa.gov/adult-and-aging-services/caregiving-resources/becoming-paid-caregiver", "access": "direct", "checked_on": "2026-11-15" }, { "label": "DSHS: Consumer Directed Employer for clients", "url": "https://dshs.wa.gov/adult-and-aging-services/getting-started-long-term-care/information-individual-providers/consumer-directed-employer-clients", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSHS: Medicaid eligibility and how to apply", "url": "https://www.dshs.wa.gov/medicaid-eligibility-and-how-apply", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSHS: CARE assessment", "url": "https://www.dshs.wa.gov/comprehensive-assessment-reporting-evaluation-care", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSHS: Electronic Visit Verification", "url": "https://www.dshs.wa.gov/altsa/stakeholders/electronic-visit-verification", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "DSHS: Caregiver background checks", "url": "https://www.dshs.wa.gov/adult-and-aging-services/caregiving-resources/background-checks", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": false, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Washington", "slug_es": "washington-cuidador-proveedor-individual", "spouse_policy_override": "not_allowed", "agency": { "en": "Washington DSHS, with Apple Health financial eligibility rules", "es": "DSHS de Washington, con las reglas financieras de Apple Health" }, "fms": { "en": "Consumer Direct Care Network Washington (CDWA), the Consumer Directed Employer", "es": "Consumer Direct Care Network Washington (CDWA), empleador de proveedores individuales" }, "payment": { "en": "Authorized hourly personal care or respite; an Individual Provider employment arrangement", "es": "Cuidado personal o respiro por horas autorizadas; contratación como proveedor individual" }, "spouse": { "en": "A spouse cannot be paid through the Apple Health LTSS route described here. WA Cares and Veteran Directed Care have separate rules.", "es": "El cónyuge no puede cobrar por esta vía de Apple Health LTSS. WA Cares y Veteran Directed Care tienen reglas distintas." }, "minors": { "en": "Parent-of-minor arrangements require a separate program review; an adult-relative rule is not permission to provide paid care to one's child.", "es": "El pago a padres de menores requiere revisar el programa concreto; la regla para familiares adultos no autoriza automáticamente el cuidado remunerado de un hijo." }, "overview": { "en": "In Washington, getting paid to help a relative at home usually involves two separate conversations: the relative's eligibility for Apple Health long-term services and supports, and your employment as an Individual Provider. Consumer Direct Care Network Washington handles the employment side. The person receiving services continues to direct day-to-day care. Start with the actual funding program, because Washington also offers WA Cares benefits and other pathways whose rules are different.", "es": "En Washington, cobrar por ayudar a un familiar en casa suele requerir dos gestiones distintas: comprobar que la persona reúne los requisitos de los servicios de larga duración de Apple Health y tramitar tu contratación como proveedor individual. Consumer Direct Care Network Washington gestiona la parte laboral. La persona que recibe los servicios sigue dirigiendo los cuidados cotidianos. Primero identifica la financiación concreta, porque Washington también ofrece prestaciones WA Cares y otras vías con reglas diferentes." }, "sections": [ { "key": "programs", "title": { "en": "Apple Health and WA Cares are different routes", "es": "Apple Health y WA Cares son vías distintas" }, "paragraphs": { "en": [ "An Individual Provider, or IP, is a worker role rather than the name of a cash benefit. Under the Consumer Directed Employer arrangement, CDWA employs the IP while the client selects, schedules and supervises the worker. A licensed home care agency is another delivery option. WA Cares has its own benefit eligibility and provider arrangements; the fact that it permits some family-care arrangements does not change Apple Health's spouse exclusion. When calling, use the exact program name instead of asking only about 'Washington caregiver pay'." ], "es": [ "Proveedor individual, o IP, describe un puesto de trabajo y no una prestación en efectivo. Con el modelo Consumer Directed Employer, CDWA contrata al proveedor, mientras el cliente selecciona, organiza y supervisa al trabajador. También existe la posibilidad de recibir servicios mediante una agencia de cuidado domiciliario. WA Cares tiene requisitos y proveedores propios; que permita determinados acuerdos familiares no modifica la exclusión de cónyuges de Apple Health. Al consultar, menciona el programa exacto en lugar de preguntar únicamente por el pago a cuidadores en Washington." ] } }, { "key": "eligibility", "title": { "en": "Financial review and the CARE assessment", "es": "Revisión financiera y evaluación CARE" }, "paragraphs": { "en": [ "DSHS uses the Comprehensive Assessment Reporting Evaluation, known as CARE, to examine functional needs and develop a care plan. The financial review is a separate step. Washington Connection is used for many long-term-care applications; Healthplanfinder is not the main application route for every LTSS case. Prepare concrete examples of help needed with bathing, dressing, walking and meals. Ask the case manager which needs are covered, how the authorized service amount was calculated, and how to request review if important information was missed." ], "es": [ "DSHS utiliza la evaluación Comprehensive Assessment Reporting Evaluation, conocida como CARE, para examinar las necesidades funcionales y preparar el plan de cuidados. La revisión financiera es un trámite separado. Washington Connection se utiliza para muchas solicitudes de larga duración; Healthplanfinder no es la vía principal para todos los casos de LTSS. Prepara ejemplos concretos de ayuda para bañarse, vestirse, caminar y comer. Pregunta qué necesidades se cubren, cómo se calculó la cantidad autorizada y cómo solicitar una revisión si faltó información importante." ] } }, { "key": "waiting", "title": { "en": "Separate eligibility delays from hiring delays", "es": "Distingue la aprobación del servicio de la contratación" }, "paragraphs": { "en": [ "A pending benefits application, an unscheduled CARE assessment and an incomplete CDWA hiring file are different problems. Ask who owns each next step and keep the case reference. We have not verified a universal approval period for Washington, and an accepted employment application does not authorize a client's services. If the family needs help immediately, ask the case manager about available interim support and a backup plan. Do not plan a household budget around a proposed start date until both service authorization and worker readiness are confirmed." ], "es": [ "Una solicitud de prestaciones pendiente, una evaluación CARE sin fecha y un expediente laboral incompleto en CDWA son problemas diferentes. Pregunta quién gestiona el siguiente paso y conserva la referencia del caso. No hemos verificado un plazo universal de aprobación para Washington, y aceptar una candidatura laboral no autoriza los servicios del cliente. Si la familia necesita ayuda inmediata, consulta al gestor sobre apoyos provisionales y un plan de sustitución. No organices el presupuesto familiar alrededor de una fecha propuesta hasta confirmar el servicio y el alta del trabajador." ] } }, { "key": "enrollment", "title": { "en": "Getting hired as an Individual Provider", "es": "Alta como proveedor individual" }, "paragraphs": { "en": [ "Tell the client's case manager that the client wishes to select you. Then follow CDWA's hiring instructions, including identity, work authorization, background checks and the training assigned to your worker category. Training depends on the relationship and caregiving role; family status is not a reason to skip instructions. Keep the hiring confirmation alongside the service plan. A family can divide responsibilities among more than one approved worker, but scheduling must stay within the authorized arrangement and any applicable workweek limits." ], "es": [ "Informa al gestor de que el cliente desea seleccionarte. Después sigue las instrucciones de contratación de CDWA: identidad, autorización para trabajar, revisión de antecedentes y formación correspondiente a tu categoría. La formación depende del parentesco y del puesto; ser familiar no permite ignorar esos requisitos. Guarda la confirmación del alta junto al plan de servicios. La familia puede repartir responsabilidades entre varios trabajadores aprobados, pero los horarios deben respetar la autorización y los límites de trabajo que correspondan." ] } }, { "key": "records", "title": { "en": "EVV has a specific live-in exception", "es": "La EVV tiene una excepción concreta por convivencia" }, "paragraphs": { "en": [ "Washington requires electronic visit verification for covered in-home services, but Individual Providers who live with their client have a specific exception after the required attestation. This exception does not extend automatically to employees of home care agencies. Non-live-in CDWA providers use the employer's EVV process. A live-in worker still needs to follow CDWA's instructions for reporting shifts and receiving pay. Confirm the recorded living arrangement when moving, and correct inaccurate entries through the employer rather than duplicating a shift." ], "es": [ "Washington exige verificación electrónica de visitas para los servicios domiciliarios cubiertos, pero los proveedores individuales que conviven con el cliente tienen una excepción específica tras declarar esa convivencia. La excepción no se extiende automáticamente a empleados de agencias domiciliarias. Los proveedores de CDWA que no conviven deben utilizar el procedimiento EVV del empleador. Quien convive sigue teniendo que cumplir las instrucciones para declarar turnos y cobrar. Actualiza la situación si cambia el domicilio y corrige los errores mediante el empleador, sin duplicar un turno." ] } } ], "faqs": [ { "q": { "en": "Can I receive Apple Health pay for caring for my spouse?", "es": "¿Puedo cobrar de Apple Health por cuidar a mi cónyuge?" }, "a": { "en": "DSHS says no under Apple Health LTSS. Ask separately about WA Cares or Veteran Directed Care if relevant; their eligibility is independent.", "es": "DSHS indica que no mediante Apple Health LTSS. Consulta por separado WA Cares o Veteran Directed Care si corresponde; sus requisitos son independientes." } }, { "q": { "en": "Does CDWA decide how many care hours my parent receives?", "es": "¿CDWA decide cuántas horas recibe mi padre o madre?" }, "a": { "en": "The client's service amount is determined through the care assessment and authorization. CDWA handles employment and payroll, not an unrestricted increase in the benefit.", "es": "La cantidad del servicio se determina mediante evaluación y autorización. CDWA gestiona contratación y nóminas, no aumentos ilimitados de la prestación." } }, { "q": { "en": "Does living together mean no time records are needed?", "es": "¿Convivir elimina todos los registros de tiempo?" }, "a": { "en": "No. The IP live-in exception concerns EVV requirements. Follow CDWA's separate instructions for recording and submitting worked shifts.", "es": "No. La excepción para proveedores convivientes afecta a la EVV. Sigue las instrucciones de CDWA para registrar y presentar los turnos trabajados." } }, { "q": { "en": "Can I apply as a caregiver before my relative is approved?", "es": "¿Puedo iniciar mi alta antes de que aprueben a mi familiar?" }, "a": { "en": "You can ask CDWA about hiring preparation, but preparation is not a service authorization. Confirm when paid work may begin before relying on reimbursement.", "es": "Puedes preguntar a CDWA cómo preparar el alta, pero eso no autoriza el servicio. Confirma cuándo puede empezar el trabajo remunerado antes de contar con su pago." } } ], "slug_en": "washington-individual-provider", "spouse_policy": "not_allowed", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } }, { "slug": "wisconsin-iris", "state": "Wisconsin", "code": "WI", "program": "IRIS (Include, Respect, I Self-Direct)", "medicaid_name": "Wisconsin Medicaid", "summary": "IRIS is Wisconsin's self-directed Medicaid long-term care program for older adults and adults with disabilities. Participants choose supports within an assessed budget and take responsibility for managing providers and spending. Aging and disability resource centers explain eligibility and alternatives; an IRIS consultant supports participants with managing their services after enrollment.", "steps": { "en": [ "Ask the local ADRC or Tribal resource specialist about adult long-term-care eligibility and IRIS alternatives.", "Complete the functional and financial reviews and choose IRIS if it fits the participant's preferences.", "Select the consultant agency and fiscal employer agent; identify services, budget costs and backup care.", "Clear each worker and family-role arrangement, then confirm the authorized start date and EVV or live-in documentation." ], "es": [ "Consulta al ADRC o especialista tribal sobre elegibilidad para larga duración y alternativas a IRIS.", "Completa las revisiones funcional y financiera y elige IRIS si responde a tus preferencias.", "Selecciona agencia consultora y FEA; concreta servicios, costes y cuidados de sustitución.", "Aprueba cada trabajador y parentesco, y confirma la fecha de inicio y la documentación EVV o de convivencia." ] }, "caveat": "IRIS uses an individual service budget. It does not establish a statewide caregiver salary merely because a person needs family care. Hiring permissions and authorized services must be confirmed during planning.", "agency_url": "https://www.dhs.wisconsin.gov/iris/index.htm", "sources": [ { "label": "Wisconsin DHS: IRIS participant information", "url": "https://www.dhs.wisconsin.gov/iris/participants.htm", "access": "direct", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: IRIS program overview", "url": "https://www.dhs.wisconsin.gov/adiln/iris.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: IRIS Self-Directed Personal Care", "url": "https://www.dhs.wisconsin.gov/iris/sdpc.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: 2026 IRIS HCBS waiver, spouse provisions", "url": "https://www.dhs.wisconsin.gov/iris/hcbw.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: IRIS EVV information", "url": "https://www.dhs.wisconsin.gov/evv/iris-evv.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: IRIS frequently asked questions", "url": "https://www.dhs.wisconsin.gov/iris/faqs.htm", "access": "search_excerpt", "checked_on": "2026-11-15" }, { "label": "Wisconsin DHS: IRIS background checks", "url": "https://www.dhs.wisconsin.gov/publications/p00708e.pdf", "access": "search_excerpt", "checked_on": "2026-11-15" } ], "allows_spouse": true, "hourly_min": null, "hourly_max": null, "avg_rate": null, "max_hours_week": null, "income_limit_2026": null, "reviewed_on": "2026-11-15", "state_es": "Wisconsin", "slug_es": "wisconsin-iris-cuidadores-familiares", "spouse_policy_override": "conditional", "agency": { "en": "Wisconsin Department of Health Services (DHS)", "es": "Departamento de Servicios de Salud de Wisconsin (DHS)" }, "fms": { "en": "A participant-selected fiscal employer agent (FEA), separate from the IRIS consultant agency", "es": "Agente fiscal empleador (FEA) seleccionado por el participante, distinto de la agencia consultora IRIS" }, "payment": { "en": "Participant-hired worker pay within authorized services and the individual budget; SDPC is a distinct personal-care arrangement", "es": "Pago a trabajadores contratados dentro del plan y presupuesto individual; SDPC es una modalidad específica de cuidado personal" }, "spouse": { "en": "The 2026 IRIS waiver permits a spouse for specified services and documented extraordinary care, subject to qualifications and a provider agreement.", "es": "La exención IRIS de 2026 permite contratar al cónyuge para determinados servicios y cuidados extraordinarios documentados, con requisitos y acuerdo de proveedor." }, "minors": { "en": "IRIS is an adult long-term-care program. Children's services and paid-parent rules are not established by an IRIS listing.", "es": "IRIS es un programa de larga duración para adultos. Esta guía no determina las reglas de servicios infantiles ni de pago a padres de menores." }, "overview": { "en": "Wisconsin's IRIS program gives eligible adults more control over long-term supports and an individual service budget. It also brings employer responsibilities when the participant hires workers directly. The practical starting point is an Aging and Disability Resource Center or Tribal resource contact, not a payroll company. An IRIS consultant helps with planning, while a fiscal employer agent handles payment-related tasks after the arrangement is approved.", "es": "El programa IRIS de Wisconsin permite a adultos elegibles controlar mejor sus apoyos de larga duración y su presupuesto individual. También conlleva responsabilidades laborales cuando el participante contrata directamente. El primer contacto práctico es un Aging and Disability Resource Center o un recurso tribal, no una empresa de nóminas. Un consultor IRIS ayuda a preparar el plan y un agente fiscal empleador gestiona los pagos después de autorizar el acuerdo." }, "sections": [ { "key": "programs", "title": { "en": "IRIS, Family Care and personal care are not identical", "es": "IRIS, Family Care y cuidado personal no son equivalentes" }, "paragraphs": { "en": [ "IRIS is a self-directed alternative within Wisconsin's adult long-term-care system. Family Care uses a managed-care organization. IRIS Self-Directed Personal Care, or SDPC, is an additional arrangement for qualifying personal-care needs, with nurse involvement in the plan. A person cannot receive agency-based Medicaid personal care and IRIS SDPC at the same time. Discuss the services you already receive before changing models; a decision about one service can affect how another is arranged or paid." ], "es": [ "IRIS es una alternativa de autodirección dentro del sistema de larga duración para adultos de Wisconsin. Family Care utiliza una organización de atención gestionada. IRIS Self-Directed Personal Care, o SDPC, es una modalidad adicional para necesidades elegibles de cuidado personal y requiere participación de enfermería en el plan. No se puede recibir simultáneamente cuidado personal Medicaid por agencia e IRIS SDPC. Antes de cambiar, explica qué servicios recibes; decidir sobre uno puede afectar a la organización o financiación de otros." ] } }, { "key": "eligibility", "title": { "en": "The functional screen does not replace financial eligibility", "es": "La evaluación funcional no sustituye la revisión económica" }, "paragraphs": { "en": [ "The adult long-term-care functional screen evaluates whether the person meets the required level of care. Medicaid financial eligibility is a separate question. Bring descriptions of support with everyday tasks, equipment and existing unpaid help. The individual budget supports an approved plan; it is not simply converted into a salary for a relative. Ask the IRIS consultant which proposed services fit the program, what costs the budget must cover and how a change in needs can be reviewed." ], "es": [ "La evaluación funcional de larga duración para adultos determina si se alcanza el nivel de atención requerido. La elegibilidad económica para Medicaid es otra cuestión. Lleva una descripción de la ayuda cotidiana, el equipamiento y los apoyos no remunerados existentes. El presupuesto individual financia un plan autorizado; no se convierte simplemente en sueldo para un familiar. Pregunta al consultor qué servicios encajan, qué costes deben cubrirse y cómo revisar el plan si cambian las necesidades." ] } }, { "key": "waiting", "title": { "en": "Keep enrollment, planning and worker approval separate", "es": "Distingue inscripción, planificación y aprobación del trabajador" }, "paragraphs": { "en": [ "An ADRC or Tribal resource contact can explain enrollment choices and the sequence of eligibility, agency selection and service planning. This guide does not promise a uniform approval time. If there is a delay, identify whether it concerns Medicaid eligibility, the functional screen, the IRIS plan or a worker's background check. Request the relevant decision and next action in writing. Discuss a backup arrangement with the consultant so that a delayed worker approval does not leave an essential task uncovered." ], "es": [ "El ADRC o recurso tribal puede explicar las opciones de inscripción y la secuencia de elegibilidad, selección de agencias y planificación. Esta guía no promete un plazo uniforme. Si existe una demora, identifica si afecta a Medicaid, a la evaluación funcional, al plan IRIS o a los antecedentes del trabajador. Solicita por escrito la decisión y el siguiente paso. Acuerda un plan de sustitución con el consultor para que un retraso en el alta no deje una tarea esencial sin cubrir." ] } }, { "key": "enrollment", "title": { "en": "Choose the right helper for each employer task", "es": "Acude al apoyo correcto para cada obligación laboral" }, "paragraphs": { "en": [ "The IRIS consultant agency supports planning and ongoing eligibility. The FEA processes payroll, invoices and worker screening. The participant remains responsible for directing workers and approving time. Spouse employment requires the service-specific conditions in the waiver, including documented care beyond ordinary spousal responsibilities. For SDPC, a person acting as the participant's representative cannot also supply their personal care. Discuss overlapping family roles before completing employment papers, rather than assuming one person can hold every role." ], "es": [ "La agencia consultora IRIS apoya la planificación y la continuidad de los requisitos. El FEA tramita nóminas, facturas y comprobaciones del trabajador. El participante sigue dirigiendo el trabajo y aprobando las horas. Contratar al cónyuge exige las condiciones de la exención y documentar cuidados que superen las responsabilidades matrimoniales ordinarias. En SDPC, el representante del participante no puede prestar también su cuidado personal. Aclara los papeles familiares antes de firmar documentos laborales, sin asumir que una persona puede ocuparlos todos." ] } }, { "key": "records", "title": { "en": "Live-in workers need the proper EVV paperwork", "es": "La excepción EVV por convivencia requiere documentación" }, "paragraphs": { "en": [ "Wisconsin requires EVV for covered IRIS personal-care and supportive-home-care services. Participant-hired workers who live with the participant have an exception after the correct paperwork is submitted. The consultant can help document that status. Workers who do not live there use the system selected by the FEA. An exception from EVV does not remove the need for accurate timesheets or payment approval. If a worker has not been paid, contact the FEA with the pay-period details rather than submit the same hours twice." ], "es": [ "Wisconsin exige EVV para los servicios IRIS cubiertos de cuidado personal y apoyo domiciliario. Los trabajadores contratados que conviven con el participante tienen una excepción tras presentar la documentación correspondiente. El consultor puede ayudar a demostrar esa situación. Quienes no conviven utilizan el sistema elegido por el FEA. La excepción no elimina las hojas de horas ni la aprobación del pago. Si falta una nómina, contacta con el FEA indicando el período, en lugar de presentar las mismas horas dos veces." ] } } ], "faqs": [ { "q": { "en": "Can IRIS pay my spouse?", "es": "¿Puede IRIS pagar a mi cónyuge?" }, "a": { "en": "The waiver permits certain spouse services when extraordinary care is documented and provider requirements are met. Ask the consultant about the exact service; this is not blanket approval.", "es": "La exención permite determinados servicios del cónyuge con cuidados extraordinarios documentados y requisitos cumplidos. Consulta el servicio concreto; no es una aprobación general." } }, { "q": { "en": "Who handles an unpaid IRIS timesheet?", "es": "¿Quién gestiona una hoja de horas IRIS sin pagar?" }, "a": { "en": "Contact the fiscal employer agent. Keep the service dates and submission confirmation available; the consultant can help identify whether a plan problem also needs correction.", "es": "Contacta con el agente fiscal empleador y conserva fechas y justificante de envío. El consultor puede comprobar si también existe un problema del plan." } }, { "q": { "en": "Can my representative also be my SDPC worker?", "es": "¿Mi representante puede ser también mi trabajador SDPC?" }, "a": { "en": "DHS says the representative for IRIS SDPC cannot also provide that participant's personal care. Review family roles before hiring.", "es": "DHS indica que el representante en IRIS SDPC no puede prestar también el cuidado personal del participante. Revisa las funciones familiares antes de contratar." } }, { "q": { "en": "Do live-in family workers use EVV?", "es": "¿Los familiares convivientes utilizan EVV?" }, "a": { "en": "IRIS participant-hired live-in workers have an exception that needs proper paperwork. Accurate timesheets and authorized services remain necessary.", "es": "Los trabajadores contratados y convivientes tienen una excepción que debe documentarse. Siguen siendo necesarios registros correctos y servicios autorizados." } } ], "slug_en": "wisconsin-iris", "spouse_policy": "conditional", "payment_basis": "hourly", "sample": { "rate": 18, "units": 30, "kind": "hypothetical_not_state_rate" } } ]