Key takeaway
California offers multiple paths to pay family caregivers. IHSS and Medi‑Cal HCBS are core options, with Paid Family Leave for short‑term wage support and VA/AAA programs as complements.
- IHSS: Pays family (including spouses in most cases) for in‑home assistance; pay rates vary by county.
- Medi‑Cal HCBS waivers: Allow self‑direction to hire family caregivers when eligible.
- Paid Family Leave: Up to 8 weeks of partial wages while caring for a seriously ill family member.
- Veterans: Aid & Attendance and PCAFC can fund family caregiving support.
- Local AAAs: May offer stipends, respite, and training; availability varies by county.
Overview
Becoming a paid caregiver for a family member in California is possible through state, federal, and private programs. The best path depends on Medi‑Cal eligibility, the level of care needed, and employment status (for Paid Family Leave).
Programs that pay family caregivers in California
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| In‑Home Supportive Services (IHSS) (State program) | California resident with functional need for in‑home assistance; generally requires Medi‑Cal eligibility and county assessment. | Pays family caregivers for ADLs/IADLs; most family members can be hired, including spouses; hourly rates vary by county (~$16–$20+). |
| Medi‑Cal HCBS Waivers (Medi‑Cal) | Medi‑Cal eligible with medical and functional needs for long‑term services; program availability by waiver. | Self‑direction options allow hiring family as paid caregivers depending on waiver rules. |
| Paid Family Leave (PFL) (State wage benefit) | Employed Californians who paid into SDI; caring for a seriously ill family member. | Up to 8 weeks partial wage replacement; complements but does not replace IHSS/HCBS services. |
| VA Benefits (Federal) | Eligible veterans; program‑specific criteria apply (e.g., need for ADL help). | Aid & Attendance increases pension; PCAFC provides monthly stipend and supports to a designated family caregiver. |
| Area Agencies on Aging (AAA) (State/Local) | Varies by county programs and funding. | May offer respite, training, and occasional stipends to support family caregivers. |
| Long‑Term Care Insurance (Private) | Policy must cover in‑home personal care and pay benefits to the policyholder. | Some policies permit paying a family caregiver; otherwise may require a licensed agency. |
California programs: IHSS and Medi‑Cal
California’s primary avenues for paying family caregivers are IHSS and Medi‑Cal HCBS waivers. IHSS pays for in‑home assistance with daily activities; HCBS waivers can allow self‑directed hiring of family caregivers for long‑term support.
In‑Home Supportive Services (IHSS)
IHSS helps low‑income seniors and people with disabilities remain safely at home by paying for caregiver assistance. Counties assess needs and authorize hours; pay rates are set locally.
- Most family members can be hired, including spouses (county rules apply).
- Covered tasks include bathing, dressing, cooking, cleaning, and transportation to medical appointments.
- Requires Medi‑Cal eligibility and an in‑home assessment with medical certification.
Medi‑Cal Home & Community‑Based Services (HCBS) Waivers
Several California waivers support in‑home care with self‑direction options, including programs for older adults, individuals with disabilities, or those transitioning from facilities.
- Eligibility requires Medi‑Cal and a qualifying level of need.
- Self‑direction can allow hiring relatives as caregivers subject to waiver rules.
- Contact DHCS or your local Medi‑Cal office to identify the right waiver and begin assessment.
Area Agencies on Aging (AAA) and local supports
Local AAAs coordinate caregiver resources such as respite care, education, and sometimes limited stipends. Availability and amounts vary by county and funding year.
Short‑term breaks for caregivers and free/low‑cost training resources.
Some counties pilot small stipends to support unpaid family caregivers.
Who qualifies
- Generally targeted to older adults and family caregivers; income and need criteria may apply.
- Programs differ by county; check your local AAA.
Veterans’ programs
Veterans and their families can leverage VA benefits to fund in‑home care with family as caregivers.
Aid & Attendance Pension
Adds to a veteran’s monthly pension to offset care costs when help with daily activities is needed; payments can cover family‑provided care.
- Qualifying service era, income/asset limits, and ADL need required.
- Often used to pay adult children or relatives for care costs.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Provides a monthly stipend, training, and support to the primary family caregiver of an eligible veteran.
- Eligibility and stipend tier depend on veteran’s care needs and era of service.
- Apply through the VA Caregiver Support Program.
Private pay and long‑term care insurance
If public programs do not apply, families can use private contracts for paid caregiving or leverage long‑term care insurance policies.
What to check in the policy
- Policy should explicitly cover in‑home personal care.
- Cash/indemnity‑style policies that pay the policyholder provide the most flexibility to hire family.
If a policy pays only licensed agencies, a family caregiver could operate or partner with a licensed agency so benefits can cover the services.
How to apply in California (step-by-step)
- Decide the path: IHSS, Medi‑Cal HCBS, Paid Family Leave, VA benefits, AAA resources, or private insurance.
- Gather documents: ID, proof of California residency, Medi‑Cal status, income/assets (if relevant), and medical verification.
- Start with the right agency:
- IHSS: contact your county IHSS office or social services website to request an in‑home assessment.
- Medi‑Cal HCBS: contact DHCS or your local Medi‑Cal office to determine waiver eligibility.
- Paid Family Leave: apply through California EDD (Paid Family Leave).
- Veterans: contact the VA Caregiver Support Program or a VA clinician/social worker.
- AAA: use the California Department of Aging site to find your county AAA.
- Complete functional and financial assessments as required (IHSS/HCBS).
- If allowed, select consumer direction/self‑direction and designate your family caregiver; complete enrollment and orientation.
- Begin services; track hours and submit timesheets or claims as required; keep documentation for renewals.
California paid caregiver FAQs
Can a spouse be paid as a caregiver in California?
Yes. Under IHSS, spouses can often be hired as the paid caregiver when eligible. Paid Family Leave can also provide short‑term wage replacement for caregiving time off.
How much does IHSS pay?
IHSS hourly rates vary by county and change periodically, generally around $16–$20+ per hour.
How long does IHSS approval take?
Timelines vary by county. After requesting IHSS, you will complete an assessment and orientation; approvals can take several weeks depending on volume.
Can I combine IHSS with Paid Family Leave?
Yes. PFL replaces wages during time off from your job, while IHSS pays for in‑home caregiving hours. They serve different purposes and can complement each other.
Do I need a license to be a family caregiver?
No license is required for IHSS or most HCBS self‑directed roles. You must complete enrollment steps and follow program rules.
