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Home care programs · Virginia

Virginia home care programs

Virginia pays for care at home through 6 programs. Consumer-directed care is available through Consumer-Directed (CD) Personal Assistance and Respite. Family members can be paid caregivers in 3 of them.

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

Every state
Programs
6
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Virginia pays for care at home

Virginia pays for care at home through 6 programs. Consumer-directed care is available through Consumer-Directed (CD) Personal Assistance and Respite. Family members can be paid caregivers in 3 of them.

ProgramTypeCan family be paidHow it differs
Home Health ServicesState Plan home health (12VAC30-50-160)Home healthNot statedSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Consumer-Directed (CD) Personal Assistance and RespiteParticipant direction in 1915(c) waiver VA.0321 (also available in the DD waivers)Consumer-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.
Commonwealth Coordinated Care Plus (CCC Plus) Waiver1915(c) waiver VA.0321Waiver 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.
Developmental Disability Waivers: Family and Individual Supports (FIS), Community Living (CL), Building Independence (BI)1915(c) waivers VA.0358 (FIS), VA.0372 (CL), VA.0430 (BI)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, available through fee-for-service and managed care.
Program of All-Inclusive Care for the Elderly (PACE)PACE State Plan option (42 CFR Part 460)PACENot statedPACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.
Personal Assistance Services (PAS) — State PAS, Brain Injury PAS, Vocational Rehabilitation PASState-funded (and Vocational Rehabilitation)State-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Virginia

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

Home health: the medical benefit

In Virginia, skilled home health is Home Health Services. It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Virginia 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 and household tasks is "home care" or personal care. In Virginia it is paid through the programs below rather than a separate agency personal care benefit.

Consumer-directed care: the person hires their own aide

Virginia's consumer-directed option is Consumer-Directed (CD) Personal Assistance and Respite. 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: Consumer-Directed (CD) Personal Assistance and Respite 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

Virginia has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Consumer-Directed (CD) Personal Assistance and Respite), by the hour, as the participant's chosen aide.

Other ways Virginia pays for care at home

Waiver in-home services: Commonwealth Coordinated Care Plus (CCC Plus) Waiver and Developmental Disability Waivers: Family and Individual Supports (FIS), Community Living (CL), Building Independence (BI). 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.

PACE: Program of All-Inclusive Care for the Elderly (PACE). One PACE organization covers medical care, a day center and home care for people 55 and over who need nursing-home level care.

State-funded: Personal Assistance Services (PAS) — State PAS, Brain Injury PAS, Vocational Rehabilitation PAS. Paid from state funds outside Medicaid, for people who do not qualify for Medicaid or are waiting for it.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home Health Services).
  • Wants to choose the aide, including a relative where allowed: Consumer-Directed (CD) Personal Assistance and Respite.
  • Meets nursing-home level of care and needs more than personal care: Commonwealth Coordinated Care Plus (CCC Plus) Waiver and Developmental Disability Waivers: Family and Individual Supports (FIS), Community Living (CL), Building Independence (BI).
In the workspace

Virginia 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: 69 details across 6 programs.

ProgramFamily rulesEmployerEligibilityPay
See Virginia'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 6 programs.

  • Family caregiver rules
  • Provider requirements
  • CSV export
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Program by program

Virginia's programs

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

Home Health Services

Home health

State Plan home health (12VAC30-50-160) · Virginia Department of Medical Assistance Services (DMAS)

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?Not stated
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 · 5 steps
  1. Medicaid financial eligibility
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Consumer-Directed (CD) Personal Assistance and Respite

Consumer-directed

Participant direction in 1915(c) waiver VA.0321 (also available in the DD waivers) · Virginia Department of Medical Assistance Services (DMAS)

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 · 6 steps
  1. Contracted F/EA
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Medicaid financial eligibility
  2. 8 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 capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

Commonwealth Coordinated Care Plus (CCC Plus) Waiver

Waiver in-home

1915(c) waiver VA.0321 · Virginia Department of Medical Assistance Services (DMAS)

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 · 9 steps
  1. Register the business
  2. 8 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 →

Developmental Disability Waivers: Family and Individual Supports (FIS), Community Living (CL), Building Independence (BI)

Waiver in-home

1915(c) waivers VA.0358 (FIS), VA.0372 (CL), VA.0430 (BI) · DMAS with the Department of Behavioral Health and Developmental Services (DBHDS) and local Community Services Boards

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 · 8 steps
  1. Register the business
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Contact the CSB
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordProvider requirementsHow to become a providerEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

Program of All-Inclusive Care for the Elderly (PACE)

PACE

PACE State Plan option (42 CFR Part 460) · Virginia Department of Medical Assistance Services (DMAS)

PACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.

Can family be paid?Not stated
How to get set up
Provider track · 5 steps
  1. Form the organization
  2. 4 more steps: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Contact a PACE organization
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordPay rateWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Personal Assistance Services (PAS) — State PAS, Brain Injury PAS, Vocational Rehabilitation PAS

State-funded

State-funded (and Vocational Rehabilitation) · Virginia Department for Aging and Rehabilitative Services (DARS), Division for Community Living

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 2 steps
  1. No provider enrollment
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Apply to DARS
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerWaiting list or capHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Virginia?

Yes. Consumer-Directed (CD) Personal Assistance and Respite, Commonwealth Coordinated Care Plus (CCC Plus) Waiver, and Developmental Disability Waivers: Family and Individual Supports (FIS), Community Living (CL), Building Independence (BI) let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Virginia have consumer-directed care?

Yes: Consumer-Directed (CD) Personal Assistance and Respite. The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Virginia have structured family caregiving?

No. Virginia 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 Virginia?

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

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