Guides → Kentucky

Getting paid to care for a parent in Kentucky

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Kentucky's door is Participant-Directed Services (PDS) — the self-direction option inside the Home and Community Based (HCB) Waiver (also available in the Michelle P., SCL, and ABI waivers), run by Kentucky Cabinet for Health and Family Services — Department for Medicaid Services (DMS), with the Department for Aging and Independent Living (DAIL) running PDS day-to-day. Pay: Medicaid's official rate for HCB waiver PDS Attendant Care is $7.26 per 15-minute unit = $29.04/hr (fee schedule effective 1/1/2025; confirmed directly from the DMS HCBS Rates 2025 file, checked 8/4/2026). Michelle P. Waiver PDS: Personal Care $9.08/15 min ($36.32/hr), Attendant Care $6.36/15 min ($25.44/hr). Important honesty note: that is what Medicaid pays out per hour of service, not the caregiver's paycheck — the caregiver's gross wage is set within the participant's approved budget and comes out lower after employer payroll taxes handled by the Financial Management Agency. Kentucky publishes no statewide caregiver wage figure.

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, siblings, other relatives, friends, and neighbors can be hired as the participant's PDS employee. But Kentucky is stricter than most states: an "immediate family member" (which includes an adult child), a guardian, or a legally responsible individual may only be paid with written state approval via the "PDS Request Form for Immediate Family Member, Guardian, or Legally Responsible Individual as Paid Support." Separately, per the DAIL PDS Standard Operating Procedures, a person serving as the participant's representative cannot also be that participant's paid employee — confirm this with DAIL for your situation, since it turns on how the representative role is documented.

The spouse question

Yes, a spouse can be paid, but only through the same exception path — a spouse is explicitly defined as a "legally responsible individual" in 907 KAR 7:010, so they need the PDS Request Form and written department approval, meeting all the criteria (unique abilities, training beyond direct care, provider more than 30 miles away or no provider able to serve). It is approval-by-exception, not a default right, and the services must go beyond what a spouse would ordinarily do anyway ("natural supports").

Waitlist reality

Be prepared to wait — even the elderly/disabled HCB waiver now has a waitlist, which is a change from past years. Official numbers presented to the legislature (as of 9/2/2025): HCB waiver 5,360 people waiting, average 119 days, max 243 days. Michelle P. Waiver: 7,636 waiting, average about 3.5 years. Supports for Community Living (SCL): 3,742 waiting, average 2,830 days (about 7.7 years), maximum 10,938 days. ABI waivers also have waiting lists. For an aging parent, HCB is the realistic door.

Worth knowing: Confidence is "partial" for one specific reason: all billed rates, program rules, phone numbers, and waitlist counts are verified from official Kentucky sources, but Kentucky does not publish what the family caregiver actually grosses per hour — the $29.04/hr HCB attendant-care figure is the Medicaid reimbursement rate, and the employee wage is set individually within each participant's budget after employer payroll costs. Do not promise families $29/hr. Key disqualifiers to state plainly: (1) the parent must need nursing-facility level of care and meet Medicaid financial rules; (2) immediate family — including adult children, not just spouses — need written state approval showing training beyond direct care and a lack of accessible providers (nearest provider >30 miles or none can cover the schedule), so approval is not automatic; (3) care that is just "natural supports" (what family would do anyway) is not payable; (4) failed drug screen, criminal record per regulation, abuse-registry listing, or being under 18 disqualifies the caregiver; (5) the paid caregiver cannot also be the participant's PDS "representative." Recent changes worth flagging: the HCB waiver now carries a waitlist (5,360 people, avg ~4 months as of Sept 2025) — older guides saying "no HCB waitlist" are out of date; PDS rates rose 10% in FY2023 and another 10% in FY2024; the renewed HCB waiver took effect 8/1/2025. Per-employee cap: 40 paid hours/week; HCB attendant care itself caps at 45 hrs/week or $200/day.

Other doors in Kentucky

ProgramWhat to know
Veteran-Directed Care (VDC)Available in Kentucky through the Lexington VA Medical Center and Louisville (Robley Rex) VA Medical Center, partnered with Area Agencies on Aging (Bluegrass, Pennyrile, Barren River, KIPDA/Kentuckiana, Lake Cumberland, Kentucky River). A veteran parent gets a flexible budget and can hire family — including in most cases a spouse or adult child — as the paid caregiver. Ask the parent's VA social worker for a VDC referral.
Personal Care Attendant Program (PCAP)Kentucky's state-funded (non-Medicaid) attendant program run by DAIL for adults with severe physical disabilities who can self-direct; the consumer hires and supervises their own attendant. Funding is limited and slots are few. Details on family-member hiring and current wages could not be fully verified — ask the ADRC at (877) 925-0037.
Michelle P., SCL, and ABI waivers (with PDS)If the person needing care is an adult with an intellectual/developmental disability or brain injury rather than an aging parent, these waivers also offer PDS — but waitlists run 3.5 to 7.7 years on average (Sept 2025).
National Family Caregiver Support Program (via the 15 Area Agencies on Aging)Not wages — respite care, supplies, and support for unpaid caregivers of people 60+. The separate Kentucky Family Caregiver Program pays only grandparents 55+ raising grandchildren, not adult children caring for parents.
Structured Family CaregivingKentucky does NOT have a structured family caregiving / daily-stipend model like Georgia or Indiana. Hourly PDS employment is the model here.

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 Kentucky's Aging and Disability Resource Center (ADRC) at (877) 925-0037 — they route you to your regional Area Agency on Aging and start HCB waiver screening. For HCB program questions you can also call DAIL at (877) 315-0589 or email HCBInquiries@ky.gov.
  2. 2. Get your parent financially approved for Medicaid: apply at kynect.ky.gov or call DCBS at (855) 306-8959 (special HCB income rules apply — up to 300% of SSI).
  3. 3. Apply for the HCB waiver itself (through kynect or the ADRC/AAA). Your parent must meet nursing-facility level of care; expect the waitlist (avg ~4 months as of Sept 2025).
  4. 4. Once enrolled, tell the case manager you want Participant-Directed Services (PDS). A support broker and a Financial Management Agency (which runs payroll and taxes) are set up.
  5. 5. As an adult child or spouse, submit the PDS Request Form for Immediate Family Member/Guardian/Legally Responsible Individual and get written DMS approval; complete background check, abuse-registry check, and drug screen.
  6. 6. Get hired as your parent's employee through the FMA, log hours on timesheets, and get paid via payroll (taxes withheld). Max 40 paid hours/week per employee.

Where to start: Kentucky Aging and Disability Resource Center (ADRC): (877) 925-0037; Medicaid financial application via kynect.ky.gov or DCBS (855) 306-8959; HCB waiver questions: DAIL (877) 315-0589 / HCBInquiries@ky.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.