Authorizations
IHSS in California: What Home Care Agencies Need to Know
IHSS is consumer-directed: the recipient hires the provider and the state pays. Agencies mostly serve IHSS clients with private-pay hours, plus contract mode in a few counties.
Can family members get paid to be caregivers?
In most states, yes, through Medicaid programs that let the person receiving care hire a relative. Pick a state to see the programs, who can be paid and where to apply.
Last reviewed October 17, 2026
| State | Programs | Spouses can be paid |
|---|---|---|
| Alabama | 2 | Yes |
| Alaska | 2 | Yes |
| Arizona | 2 | Yes |
| Arkansas | 1 | — |
| California | 1 | Yes |
| Colorado | 2 | Yes |
| Connecticut | 2 | — |
| Delaware | 2 | — |
| District of Columbia | 2 | No |
| Florida | 2 | Yes |
| Georgia | 3 | No |
| Hawaii | 1 | Yes |
| Idaho | 2 | No |
| Illinois | 1 | — |
| Indiana | 2 | — |
| Iowa | 2 | No |
| Kansas | 1 | — |
| Kentucky | 1 | Yes |
| Louisiana | 2 | Yes |
| Maine | 2 | Yes |
| Maryland | 1 | — |
| Massachusetts | 2 | No |
| Michigan | 2 | — |
| Minnesota | 1 | — |
| Mississippi | 1 | — |
| Missouri | 2 | Yes |
| Montana | 2 | — |
| Nebraska | 2 | Yes |
| Nevada | 2 | — |
| New Hampshire | 2 | — |
| New Jersey | 1 | — |
| New Mexico | 2 | — |
| New York | 1 | No |
| North Carolina | 1 | Yes |
| North Dakota | 2 | Yes |
| Ohio | 2 | Yes |
| Oklahoma | 1 | Yes |
| Oregon | 3 | Yes |
| Pennsylvania | 2 | — |
| Rhode Island | 2 | — |
| South Carolina | 2 | — |
| South Dakota | 2 | — |
| Tennessee | 2 | — |
| Texas | 3 | Yes |
| Utah | 2 | — |
| Vermont | 3 | Yes |
| Virginia | 2 | No |
| Washington | 2 | — |
| West Virginia | 2 | — |
| Wisconsin | 2 | — |
| Wyoming | 2 | Yes |
How Caregiver Scheduling handles this
Agencies that employ family caregivers under these programs still need verified visits and timesheets. Caregiver Scheduling records GPS check-ins today, and timesheets and a payroll export are coming soon. See check-in.
Sources
Frequently asked questions
Usually through a Medicaid self-directed program: the person receiving care, or their representative, hires the relative, and a fiscal agent runs payroll. Some states also pay family caregivers through structured family caregiving or adult foster care.
In some states and programs. Many programs exclude spouses and parents of minor children; check the state page.
Yes. The VA runs Veteran Directed Care and the Program of Comprehensive Assistance for Family Caregivers, which can pay or support a family caregiver for an eligible veteran.
Related guides
Authorizations
How to Become a Medicaid Provider for Home Care
To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.
These free tools are made by the team behind Caregiver Scheduling, caregiver scheduling software for home care agencies.
Simple pricing
From $199 /month
Up to 10 caregivers on Starter, 50 on Growth.
More than 50 caregivers? We'll put together a custom Scale plan for your agency.