Key takeaway
ALTCS is the primary path in Arizona to pay family caregivers, with self‑direction options like AWC/SDAC. Veterans’ benefits and local supports can complement these programs.
- ALTCS: Medicaid long‑term care; many families can hire relatives (including spouses) via agencies.
- Self‑direction: Agency with Choice and SDAC provide flexibility in hiring and managing family caregivers.
- No state Paid Family Leave; use FMLA, employer leave, or earned sick time.
- Veterans: PCAFC, A&A, and VDC support family caregiving depending on eligibility.
Overview
Becoming a paid caregiver for a family member in Arizona is possible through ALTCS Medicaid, self‑directed care models, veterans’ programs, and private agreements.
Programs that pay family caregivers in Arizona
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Arizona Long Term Care System (ALTCS) (Medicaid) | Medical and financial eligibility; nursing‑home level of care; income and asset limits apply. | Allows hiring many family members via agencies; covered ADLs/IADLs include bathing, dressing, cooking, housekeeping, and transportation. |
| Agency with Choice (AWC) (ALTCS self‑direction) | ALTCS member needing in‑home personal care; agency is employer of record. | Care recipient chooses/supervises caregiver; agency handles HR/payroll; family (often including spouse) can serve as caregiver. |
| Self‑Directed Attendant Care (SDAC) (ALTCS self‑direction) | ALTCS member or representative willing to manage hiring/scheduling; fiscal intermediary handles payroll. | Greater control over hiring and scheduling; many family members eligible under program rules. |
| Veterans Programs (PCAFC, A&A, VDC) (Federal) | Eligible veterans; program‑specific criteria (service era, disability, ADL needs). | PCAFC provides stipend/training; A&A increases pension; VDC funds a flexible budget to hire family. |
| Caregiver Supports (AAA, AZ Caregiver Coalition) (State/Local) | Varies by county and program funding. | Respite, training, and vouchers through programs like Lifespan Respite (no direct salary). |
| Private Pay / Long‑Term Care Insurance (Private) | Policy coverage or private agreement. | Some LTC policies reimburse family caregiving; otherwise use a written caregiver agreement. |
Arizona Medicaid: ALTCS and self‑direction
ALTCS provides in‑home support and the ability to hire family caregivers via agencies or self‑direction models such as AWC and SDAC.
ALTCS basics
State Medicaid for long‑term care; requires nursing‑home level of care and financial eligibility; services can be delivered at home.
- Apply via AHCCCS/ALTCS; assessments cover both medical and financial criteria.
- Care plans can include personal care, homemaker services, and respite.
Agency with Choice (AWC)
Agency employs the caregiver while the member directs daily activities; simplifies HR while preserving choice.
Self‑Directed Attendant Care (SDAC)
Member or representative hires and manages the caregiver directly; payroll is handled by a fiscal intermediary.
Family caregiver supports (AAA and AZ Caregiver Coalition)
Arizona’s caregiver resources include respite, education, and coordination through AAAs and the Arizona Caregiver Coalition.
Lifespan Respite Voucher Program provides temporary relief for caregivers.
Help with skills and program navigation; no direct salary.
Who qualifies
- Family caregivers of older adults or people with disabilities; criteria vary by county and program.
Veterans’ programs
Federal programs that support family caregivers in Arizona include PCAFC, Aid & Attendance, and Veteran‑Directed Care.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Monthly stipend, training, and supports for the primary family caregiver of an eligible veteran.
Aid & Attendance Pension
Adds to a qualifying veteran’s monthly pension to offset in‑home care costs.
Veteran‑Directed Care
Provides a flexible budget for veterans to hire caregivers, including family.
Private pay and long‑term care insurance
Where public programs do not apply, families can use private caregiver agreements or long‑term care insurance benefits if policies allow family caregiving.
What to check in the policy
- Policy explicitly covers in‑home personal care (not only facility care).
- Benefits pay the policyholder (cash/indemnity model) to allow hiring a family caregiver.
How to apply in Arizona (step-by-step)
- Choose the path: ALTCS, AWC/SDAC, VA programs, caregiver supports, or private insurance.
- Gather documents: ID, Medicaid status, income/assets info, medical records, and medications list.
- Start with the right agency:
- ALTCS: call 602‑417‑6600 or visit your local ALTCS office to begin assessments.
- Self‑direction: discuss AWC/SDAC with your ALTCS case manager during care planning.
- Veterans: contact the VA Caregiver Support Program.
- Caregiver supports: contact your AAA or the Arizona Caregiver Coalition.
- Complete functional and financial assessments as required by the program.
- If allowed, select self‑direction and designate your family caregiver; complete enrollment and orientation.
- Begin services; track hours/claims and retain documentation for renewals and audits.
Arizona paid caregiver FAQs
Can a spouse be paid as a caregiver in Arizona?
Often yes under ALTCS when hired through agencies or certain self‑direction models. Confirm with your case manager and plan.
What are AWC and SDAC?
Two ALTCS self‑direction options: AWC hires the caregiver via an agency; SDAC lets the member directly hire/manage the caregiver with payroll support.
Is there state paid leave for caregiving?
No statewide paid family leave. Use FMLA, employer leave, or earned sick time if available.
