Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Employing Family Members

10/29/2010

All of the participant direction Medicaid authorities allow participants to hire friends and relatives to provide personal care services. States also have the option under the HCBS waiver authority, and §1915(i) and §1915(j), to allow participants to hire legally responsible relatives (i.e., spouses, and parents and legal guardians of minor children) within certain parameters.64 Generally, to be a paid personal care provider, a legally responsible relative has to be providing services that a spouse or parent would not be providing for a non-disabled spouse or minor child; for example, feeding a 15-year-old child or bathing a spouse. Medicaid prohibits the hiring of legally responsible relatives in participant direction programs under the Medicaid State Plan Personal Care benefit.

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