Florida:
Long-Term Care Participant Direction Option (PDO)

PDO is an option within an LTC plan

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.

Financial and care assessments are separate

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.

An ADRC screening is not a service start date

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.

Request the PDO documents from your plan

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.

Keep plan authorization and payroll aligned

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.

Your next steps

1. Contact the local ADRC about the appropriate LTC entry screening.
2. Complete the applicable financial and CARES assessments.
3. After plan enrollment, ask the case manager about PDO services.
4. Confirm representative and worker eligibility and complete training.
5. Agree pay, authorized shifts, backup care and recording instructions.

Explore a pay scenario

The table uses a hypothetical amount of $18.00 per hour. This is not a rate verified for this state. Approved units depend on the assessment and written plan; the table does not establish a maximum or entitlement.

Monthly average = weekly × 52 ÷ 12. Overtime and taxes are not calculated.

Does caregiver pay qualify for IRS Notice 2014-7?

IRS Notice 2014-7 can exclude certain qualifying Medicaid waiver payments from federal gross income when the care recipient lives in the provider’s home. Sharing a home alone is not enough: the payment and program must qualify. This is not an exemption for all caregiver wages, all taxes or all state programs. Ask payroll which payments are covered and check the IRS guidance or a qualified tax adviser. Our calculator does not apply a tax exemption.

Questions families ask

Official sources and review notes

• Florida AHCA: Participant Direction Option
• Florida Elder Affairs: Medicaid managed LTC
• Florida Elder Affairs: CARES
• Florida AHCA: July 2026 LTC contract exhibit
• Florida AHCA: approved LTC waiver background
• Florida AHCA: LTC recipient FAQs

Sources describe the named programs; they do not endorse this website. Rules and provider arrangements can change. Check the linked agency before making a financial decision.