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Home care programs · District of Columbia

District of Columbia home care programs

District of Columbia pays for care at home through 4 programs. Consumer-directed care is available through Services My Way (Participant-Directed Community Support Services) (PDCS). Family members can be paid caregivers in 4 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
4
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way District of Columbia pays for care at home

District of Columbia pays for care at home through 4 programs. Consumer-directed care is available through Services My Way (Participant-Directed Community Support Services) (PDCS). Family members can be paid caregivers in 4 of them.

ProgramTypeCan family be paidHow it differs
Personal Care Aide (PCA) Services — State PlanState Plan personal care; 29 DCMR Chapter 50Agency personal careYesAgency personal care: non-medical daily help from aides a licensed agency employs; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Services My Way (Participant-Directed Community Support Services) (PDCS)Participant direction under 1915(c) DC.0334Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, available through fee-for-service and managed care.
Elderly and Persons with Physical Disabilities (EPD) Waiver1915(c) waiver DC.0334Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, available through fee-for-service and managed care.
People with Intellectual and Developmental Disabilities (IDD) Waiver and Individual and Family Support (IFS) Waiver1915(c) waivers DC.0307 (IDD) and DC.1766 (IFS)Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in District of Columbia

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

Skilled home health is a Medicaid benefit in every state, District of Columbia included: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care.

Only a licensed home health agency enrolled with District of Columbia Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating, toileting and household tasks is "home care" or personal care. In District of Columbia the agency route is Personal Care Aide (PCA) Services — State Plan. No skilled need is required; the person qualifies on functional need, usually measured by an assessment of daily activities.

The agency recruits, trains, schedules and pays the aides, and it is the employer. Personal Care Aide (PCA) Services — State Plan lets the agency hire a family member as the aide, with the agency still the employer.

Consumer-directed care: the person hires their own aide

District of Columbia's consumer-directed option is Services My Way (Participant-Directed Community Support Services) (PDCS). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: Services My Way (Participant-Directed Community Support Services) (PDCS) allows a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

District of Columbia has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Services My Way (Participant-Directed Community Support Services) (PDCS)), by the hour, as the participant's chosen aide.

Other ways District of Columbia pays for care at home

Waiver in-home services: Elderly and Persons with Physical Disabilities (EPD) Waiver and People with Intellectual and Developmental Disabilities (IDD) Waiver and Individual and Family Support (IFS) Waiver. These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health.
  • Needs daily help and wants an agency to supply and manage the aide: Personal Care Aide (PCA) Services — State Plan.
  • Wants to choose the aide, including a relative where allowed: Services My Way (Participant-Directed Community Support Services) (PDCS).
  • Meets nursing-home level of care and needs more than personal care: Elderly and Persons with Physical Disabilities (EPD) Waiver and People with Intellectual and Developmental Disabilities (IDD) Waiver and Individual and Family Support (IFS) Waiver.
In the workspace

District of Columbia program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 53 details across 4 programs.

ProgramFamily rulesEmployerEligibilityPay
See District of Columbia's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 4 programs.

  • Family caregiver rules
  • Provider requirements
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Program by program

District of Columbia's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Personal Care Aide (PCA) Services — State Plan

Agency personal care

State Plan personal care; 29 DCMR Chapter 50 · DC Department of Health Care Finance (DHCF)

Agency personal care: non-medical daily help from aides a licensed agency employs; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?Yes
How to get set up
Provider track · 8 steps
  1. Register the business
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Medicaid financial eligibility
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

Services My Way (Participant-Directed Community Support Services) (PDCS)

Consumer-directed

Participant direction under 1915(c) DC.0334 · DC DHCF

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, available through fee-for-service and managed care.

Can family be paid?Yes
How to get set up
Provider track · 5 steps
  1. Single District FMS
  2. 4 more steps: forms, fees, timelines and links
Family / participant track · 10 steps
  1. Medicaid financial eligibility
  2. 9 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Elderly and Persons with Physical Disabilities (EPD) Waiver

Waiver in-home

1915(c) waiver DC.0334 · DC Department of Health Care Finance (DHCF) Long Term Care Administration; a QIO prior-authorizes services

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, available through fee-for-service and managed care.

Can family be paid?Yes
How to get set up
Provider track · 7 steps
  1. Register the business
  2. 6 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Medicaid financial eligibility
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

People with Intellectual and Developmental Disabilities (IDD) Waiver and Individual and Family Support (IFS) Waiver

Waiver in-home

1915(c) waivers DC.0307 (IDD) and DC.1766 (IFS) · DC DHCF with the Department on Disability Services (DDS)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 7 steps
  1. Register the business
  2. 6 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Apply to DDS
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordProvider requirementsEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in District of Columbia?

Yes. Personal Care Aide (PCA) Services — State Plan, Services My Way (Participant-Directed Community Support Services) (PDCS), Elderly and Persons with Physical Disabilities (EPD) Waiver, and People with Intellectual and Developmental Disabilities (IDD) Waiver and Individual and Family Support (IFS) Waiver let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does District of Columbia have consumer-directed care?

Yes: Services My Way (Participant-Directed Community Support Services) (PDCS). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does District of Columbia have structured family caregiving?

No. District of Columbia does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in District of Columbia?

Home health is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care (Personal Care Aide (PCA) Services — State Plan) is non-medical help with daily activities, based on functional need.

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