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Getting paid to care for a parent in Delaware

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Delaware's door is Diamond State Health Plan-Plus (DSHP-Plus) — Self-Directed Attendant Care (SDAC), run by Delaware Division of Medicaid & Medical Assistance (DMMA), Delaware Health and Social Services (DHSS). Pay: No single published wage: Delaware's SFY25 HCBS fee schedule lists self-directed personal/attendant care as "manual pricing," and DMMA's SDAC FAQ (Dec 2024) states "each MCO sets their own plan rate for SDAC. Rates may also differ by FMS." Realistic caregiver take-home is roughly $14-17/hr (Givers cites $14.80/hr; paid.care cites $13-21/hr, avg ~$16.75 — both checked Aug 2026, neither official). The $29.51-$41.92/hr figures on the state fee schedule are agency billing rates, not what a family caregiver receives. Confirm the exact rate with your MCO and the FMS (e.g., GT Independence) before counting on a number.

One or more details on this page could not be fully confirmed against official sources at publish time — confirm specifics with the agency below.

Who can be the paid caregiver

Adult children, other relatives, friends, and neighbors can all be hired — state SDAC materials say members may hire "a legally responsible family member, family member, neighbor, or friend." The paid attendant must be 18+, have a valid SSN, pass criminal background, Adult Abuse Registry, and sex-offender checks, and cannot simultaneously be the member's "employer representative" (the person who directs care and signs timesheets) — so one family member gives the care while another (or the parent themself) directs it. Payroll, taxes, and workers' comp run through a financial management services company (GT Independence is an active FMS for Delaware First Health members).

The spouse question

Yes, with conditions. Delaware allows "legally responsible" family members — which for an adult means a spouse or legal guardian — to be paid attendants, but they are capped at 40 paid hours per week and someone else must serve as employer representative to direct care and approve timesheets (DMMA SDAC town hall, Mar 2024; Delaware First Health payment policy DE.PP.003, updated May 2024). Secondary sources (American Council on Aging, Paying for Senior Care) confirm spouses can be hired under DSHP-Plus. For an adult child caring for a parent, the spouse rule isn't the barrier — adult children are not "legally responsible" for parents and face no special cap beyond authorized hours. Note: live-in caregivers do not receive overtime pay.

Waitlist reality

Effectively none for DSHP-Plus itself — it operates under an 1115 demonstration as managed care with no enrollment cap, so everyone who qualifies gets in (unlike 1915(c) waiver states). The real wait is the eligibility determination: expect 45-90 days, sometimes longer, for financial plus medical (nursing-home level of care) approval. The state-funded DSAAPD attendant services route is appropriation-limited and capacity can be tight — ask about wait status when you call.

Worth knowing: Confidence is 'partial' solely because Delaware publishes no caregiver wage — the state fee schedule marks SDAC as 'manual pricing' and DMMA confirms each MCO sets its own rate, so the $14-17/hr range comes from unofficial guide sites and must be confirmed with the MCO/FMS. Everything else (program name, spouse/family rules, intake phone, no-waitlist structure) is from official Delaware sources. Disqualifiers to name plainly: your parent must need nursing-home level of care (help with at least one ADL) and meet strict money limits (2026: ~$2,485/mo income — fixable with a Miller Trust — and $2,000 in countable assets; home exempt up to $752,000); no SDAC pay if the parent lives in assisted living or a nursing home; the caregiver must be 18+, pass criminal/abuse-registry checks, and cannot be the same person who directs care and approves timesheets; whoever is 'legally responsible' (spouse/guardian) is capped at 40 paid hrs/week; live-in caregivers get no overtime; the caregiver cannot kick back funds to the parent. Applications can take 45-90+ days — start early and keep every document. Watch item: Delaware's dhss.delaware.gov site was reorganized in 2025 and several old DSAAPD FAQ URLs now 404; phone numbers above were verified against live pages on 2026-08-04.

Other doors in Delaware

ProgramWhat to know
DSAAPD Personal Attendant Services (state-funded, via Easterseals)Non-Medicaid door for adults with physical disabilities who don't qualify for Medicaid. Consumer becomes the household employer and hires their own attendant; Easterseals Delaware runs the program (302-324-4444). Family-hiring specifics and any waitlist must be confirmed by phone — capacity is appropriation-limited. Entry point: DSAAPD/ADRC 1-800-223-9074.
Veteran-Directed Care (Wilmington VA Medical Center)If your parent is a veteran enrolled in VA health care, VDC gives a flexible budget to hire caregivers of choice, including family. Available through the Wilmington VA, which has been expanding long-term-care options; ask the VA social worker or the Caregiver Support Program at Wilmington VAMC (802-994-2511 is not verified — use va.gov/wilmington-health-care). Also ask about VA Aid & Attendance and PCAFC (stipend for caregivers of eligible veterans).
DDDS Lifespan Waiver (self-direction via Easterseals)Only relevant if the parent has a developmental/intellectual disability diagnosed before age 22. Allows self-directed services with paid family caregivers through the Division of Developmental Disabilities Services.
Delaware Caregiver Support Program (DSAAPD)Does NOT pay you a wage — provides respite vouchers, counseling, and supports for unpaid family caregivers of people 60+ or with dementia. Worth stacking on top of SDAC. Call 1-800-223-9074.
No structured family caregiving benefitDelaware has no per-diem 'structured family caregiving' model (like GA/IN/OH) and no state paid-family-leave caregiver wage for long-term care; DE Paid Leave (starting 2026) covers only short job-protected leave, not ongoing caregiving pay.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Call the DMMA Long Term Care Medicaid Central Intake Unit at 1-866-940-8963 (or apply online at assist.dhss.delaware.gov) and say you're applying for long-term care Medicaid / DSHP-Plus home and community-based services for your parent.
  2. 2. Complete financial eligibility (2026: income under ~$2,485/mo — a Miller Trust fixes over-income; assets under $2,000 single) and the medical screening showing your parent needs nursing-home level of care (help with at least one ADL). Allow 45-90 days.
  3. 3. Once approved, your parent enrolls with one of the three Medicaid MCOs — AmeriHealth Caritas Delaware, Highmark Health Options, or Delaware First Health — and is assigned a case manager.
  4. 4. Tell the case manager you want Self-Directed Attendant Care (SDAC) with a family member as the paid attendant. The MCO connects you to its financial management services company (e.g., GT Independence, 1-877-659-4500).
  5. 5. The caregiver completes the FMS hiring packet: background/registry checks, SSN verification, payroll enrollment. The care plan authorizes weekly hours; the caregiver logs time and is paid by the FMS.
  6. 6. Not sure where to start? Call Delaware's Aging & Disability Resource Center at 1-800-223-9074 — they route you to the right door.

Where to start: DMMA Medicaid Central Intake Unit (Long Term Care), 1-866-940-8963; general help: Delaware ADRC 1-800-223-9074; online: assist.dhss.delaware.gov

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

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Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.