Key takeaway
Washington supports paid family caregiving through Medicaid programs (CFC, COPES, MAC), self-directed Individual Providers, strong PFML, and veterans’ benefits.
- CFC and COPES: In-home personal care with options to hire family; rates influenced by union contracts.
- MAC: Resources that support unpaid caregivers of Medicaid-eligible adults.
- Individual Provider (self-direction): Hire and manage family caregivers directly via Consumer Direct.
- PFML: Up to 12 weeks paid family leave with partial wage replacement.
Overview
Paid caregiving in Washington is enabled by Medicaid LTSS programs, a robust paid family leave system, and federal veterans’ benefits. Self-direction allows many families to hire relatives as caregivers.
Programs that pay family caregivers in Washington State
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Community First Choice (CFC) (Medicaid) | Medicaid and ADL need; assessed by DSHS. | Allows hiring most family (not spouses for certain services); common tasks include ADLs/IADLs. |
| COPES Waiver (Medicaid HCBS Waiver) | Medicaid and nursing facility level of care. | Self-direction via Individual Provider; includes respite and possible home mods. |
| Medicaid Alternative Care (MAC) (Medicaid caregiver support) | Adult is Medicaid-eligible and living at home; caregiver is unpaid. | Provides training, respite, equipment, and sometimes stipends. |
| Individual Provider (IP) Program (Self-direction) | Participant chooses to self-direct under Medicaid; completes training/orientation. | Hire/manage caregivers directly; payroll via Consumer Direct. |
| Paid Family & Medical Leave (PFML) (State wage benefit) | 820+ work hours in WA during the qualifying period. | Up to 12 weeks paid leave (18 in special cases) with partial wage replacement. |
| Veterans Programs (PCAFC, A&A, VDC) (Federal) | Eligible veterans; program-specific criteria apply. | PCAFC stipend/training; A&A increases pension; VDC budget to hire family. |
| AAA supports (State/Local) | Varies by region and funding. | Caregiver training, support groups, and respite vouchers. |
| Private Pay / Long-Term Care Insurance (Private) | Policy or private agreement. | Some policies reimburse family caregiving; use a written caregiver agreement otherwise. |
Washington Medicaid: CFC, COPES, MAC, and self-direction
Washington’s LTSS programs fund in-home care and support unpaid caregivers. Many families use Individual Provider self-direction to hire relatives under CFC or COPES.
Community First Choice (CFC)
Personal care at home for Medicaid recipients with ADL needs; can hire many family caregivers (spousal exclusions apply to some services).
COPES Waiver
HCBS waiver for adults at nursing facility level of care; supports self-directed Individual Providers and includes respite/home mods.
Medicaid Alternative Care (MAC)
Supports unpaid caregivers of adults who are Medicaid-eligible but not yet in residential care; includes training, respite, equipment.
Individual Provider (IP) Program
Self-direction pathway where the participant hires and manages caregivers; payroll via Consumer Direct; training required.
Caregiver supports (Area Agencies on Aging)
Local AAAs offer respite, training, and navigation to DSHS services and PFML.
Short-term relief and respite vouchers where available.
Skills resources and help connecting to Medicaid/PFML/VA programs.
Who qualifies
- Family caregivers of older adults or people with disabilities; criteria vary by county and funding.
Veterans’ programs
Veterans in Washington can use PCAFC, Aid & Attendance, and VDC to support in-home family caregiving.
PCAFC
Stipend, training, and supports for the primary family caregiver of an eligible veteran.
Aid & Attendance
Adds to a veteran’s pension to offset care costs.
Veteran-Directed Care
Flexible budget to hire caregivers, including family members.
Private pay and long‑term care insurance
If public programs do not apply, families can use private caregiver agreements or long‑term care insurance to fund in-home care when policies allow family caregiving.
What to check in the policy
- Confirm policy covers in‑home personal care and whether benefits pay the policyholder.
How to apply in Washington State (step-by-step)
- Choose the path: CFC, COPES, MAC, IP Program, PFML, veterans’ programs, AAA supports, or private insurance.
- Gather documents: ID, Medicaid status, medical records, and provider contacts; income/assets if requested.
- Start with the right agency:
- Medicaid LTSS: call DSHS Home and Community Services at 1‑855‑587‑0255 to request a CARE assessment.
- Self‑direction/IP: learn requirements and payroll steps via Consumer Direct Care Network WA.
- PFML: apply through Washington Paid Family & Medical Leave.
- Veterans: apply via the VA Caregiver Support Program.
- AAAs: use w4a to find your local Area Agency on Aging for respite and training.
- Complete functional and financial assessments as required.
- If available, designate your family caregiver and complete enrollment/orientation and payroll setup.
- Begin services; track hours/claims and maintain documentation for renewals and audits.
Washington State paid caregiver FAQs
Can a spouse be paid as a caregiver in Washington?
Generally no under CFC/COPES, with limited exceptions. Other relatives can often be hired as Individual Providers.
How much do caregivers get paid under Medicaid?
Rates vary by county and union contracts; often in the ~$19–$23/hour range.
What training is required to become an Individual Provider?
Orientation and basic training are required; details provided by Consumer Direct Care Network.
