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Getting paid to care for a parent in Maine

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Maine's door is Consumer Directed Attendant Services (CDAS) — MaineCare Benefits Manual Section 12 (self-directed option also available inside the Section 19 Home and Community Benefits for the Elderly and Adults with Disabilities waiver), run by Maine Department of Health and Human Services — Office of MaineCare Services and Office of Aging and Disability Services (OADS); self-direction supported by Alpha One and its fiscal intermediary, Attendant Services Maine. Pay: Maine does publish rates — and the number you will see published is a MEDICAID BILLING rate, not your paycheck. Know which one you are being quoted. What the state's own rate schedules say (MaineCare Benefits Manual, Chapter III, checked 8/10/2026): - Section 19 waiver, self-directed Attendant Care (code S5125 U7): $4.86 per 15 minutes, which is $19.44 an hour. Rates effective 4/1/2020. By rule (19.01-25) this single figure bundles your gross hourly wage together with the employer's share of Social Security, Medicare, federal and state unemployment tax, and workers' compensation. Those come out before you are paid, so the actual gross wage is meaningfully lower than $19.44 — in practice closer to $17. - Section 12 CDAS, attendant care (code S5125 U2): $3.73 per 15 minutes, which is $14.92 an hour. That figure has not been updated in the posted rule since 7/1/2019. - If a spouse is paid as an agency Personal Support Specialist under Section 19 (code T1019 U7), MaineCare pays the AGENCY $6.55 per 15 minutes ($26.20 an hour). The agency sets your wage out of that, and it will be well below the billing rate. There is also a wage floor in Maine law: PL 2021, ch. 398, Part AAAA directs that the labor portion of these MaineCare rates fund direct-care wages of at least 125% of the state minimum wage. Maine's minimum wage is $15.10 as of 1/1/2026, so 125% is $18.88 an hour. But the rate schedules above have not been rewritten to show that, so treat $18.88 as the target the Legislature set rather than a number you can bank on. Bottom line: before you cut your hours at another job, get your exact gross hourly wage in writing from the fiscal intermediary (Attendant Services Maine) or the personal care agency. Do not plan around a rate you read anywhere, including here.

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, grandchildren, other relatives and friends can be hired and paid. Maine's rules exclude a short, specific list — not "family" in general. - Section 12 CDAS excludes only the member's spouse, the parents or stepparents of a minor child, and a "legally responsible relative" (definition at 12.02-10, made non-covered by 12.07 F). An adult child is not a legally responsible relative for their parent in Maine, so an adult son or daughter is squarely allowed. - The Section 19 waiver's self-directed Attendant option excludes the member's spouse and the parents or stepparents of a minor child (19.07 E). Adult children and siblings are fine. About power of attorney and guardianship: holding your parent's POA or being their guardian does NOT by itself stop you from being the paid caregiver. No MaineCare rule says that — Section 12 does not mention representatives, guardians or powers of attorney anywhere. The real restriction is narrower and only comes up in the Section 19 Participant-Directed Option. If your parent cannot manage hiring and supervising on their own, someone has to serve as their "Representative." The rule says a Representative is not compensated, must not be an attendant who is reimbursed for caring for that member, and cannot manage for more than two people at once. So one person cannot be both the unpaid Representative and the paid attendant — but you can hold POA and have a different relative serve as Representative, or serve as Representative and let another relative take the paid job. Sort that out before enrollment, not after. Whoever is hired must pass a criminal background check and a check of the Maine Registry of Certified Nursing Assistants and Direct Care Workers, and is paid as a W-2 employee through the fiscal intermediary.

The spouse question

Sometimes YES — and this is the part most guides get wrong. A husband or wife CAN be paid in Maine, but only through one specific door. Under the Section 19 waiver, since July 1, 2020, a spouse may be paid as a Personal Support Specialist (PSS) providing Personal Care Services when the member needs "Extraordinary Care" — care beyond what a spouse would ordinarily do for a partner of the same age who did not have a disability or chronic illness, and that is needed to keep them out of a nursing home (rule 19.08, Other Qualified Staff; definition at 19.01-14). The strings attached are real. The spouse must complete the state-approved 50-hour PSS training and be employed by a licensed home health agency or a registered personal care agency — you cannot do this through the self-hire route. The need for Extraordinary Care has to be identified, documented and re-checked in the person-centered planning process and authorized by the Service Coordination Agency. And it only covers hands-on personal care (ADLs — bathing, dressing, transferring, toileting, eating). A spouse cannot be paid for housekeeping, laundry, meals or errands (IADLs), and cannot be paid for respite (19.07 D). What a spouse cannot do: be the self-directed Attendant. Section 19.07(E) excludes Attendant Services provided by a spouse, and Section 12 CDAS excludes spouses entirely (Family Member is defined at 12.02-10 as the spouse, the parents or stepparents of a minor child, or a legally responsible relative; 12.07(F) makes their services non-covered). Under Section 96, a spouse is barred from paid personal care outright (96.05 E) but may be paid for nursing in rare "special circumstances nursing" cases (96.05 D, pointing to 96.04 B). So the practical script: ask your parent's Service Coordination Agency, in those words, about "spouse as PSS under the Extraordinary Care provision in Section 19." Do not accept "spouses can never be paid in Maine" as the final answer — it is not what the rule says.

Waitlist reality

Good news on the MaineCare side: there is no line. Maine DHHS/OADS publishes these counts quarterly, and for the quarter ending 3/31/2026 they were: - Section 19 waiver (Home and Community Benefits): 3,718 people served, 0 waiting. - Section 12 CDAS: 357 people served, 0 waiting. These MaineCare services work as an entitlement — if your parent meets the medical and financial rules, they get served, they do not get a number in a queue. The waiting is on the state-funded programs, the ones people land on when they are over the MaineCare income or asset limits: - State-funded Home Based Care (Section 63): 708 served, 1,204 waiting. - State-funded Independent Support Services / homemaker (Section 69): 1,168 served, 1,405 waiting. And if your family member's needs are developmental-disability or brain-injury related rather than age related, the picture is much worse: Section 21 comprehensive services had 2,990 served and 2,524 waiting; brain injury services (Section 18) had 210 served and 286 waiting. The practical takeaway: push hard on getting MaineCare eligibility and file the Long-Term Care application. That is the route with no wait. Treat the state-funded programs as a backup that could take years, not as a plan.

Worth knowing: Disqualifiers to name plainly: (1) Money. Section 12 CDAS uses regular MaineCare financial rules — in 2026, about $1,330/month in income and $10,000 in assets for a single person, $1,804/month and $15,000 for a married couple. The Section 19 waiver uses the nursing-home-level income standard of 300% of the SSI benefit, which is $2,982/month in 2026 (SSI is $994/month for an individual). So a parent who is over the CDAS limit very often still fits Section 19. File the one Long-Term Care application and let DHHS decide which door they belong in. (2) Level of need and where they live. A nurse assessor from Maximus must find that your parent needs nursing-facility-level help. They must be living at home or in a family home — not a nursing facility, and not assisted living or another licensed setting that already provides personal care. (3) Being able to run the show. This is the one that blindsides families. Section 12 CDAS requires YOUR PARENT, personally, to direct the care: rule 12.02-20 says the member hires, discharges, trains, schedules and supervises the attendant, and 12.03 sets minimum cognitive scores on the assessment form (decision-making scored 0 or 1; making self understood and understanding others scored 0 to 2). There is no surrogate or representative option in CDAS. A parent with significant dementia will not qualify for CDAS, full stop. The Section 19 waiver is the alternative — it does allow an unpaid Representative to manage attendant services on the member's behalf, but that Representative cannot also be the paid attendant. (4) Relationship. A spouse cannot be the self-directed attendant in either program and cannot be paid at all under Section 12, but a spouse CAN be paid under Section 19 as an agency Personal Support Specialist when Extraordinary Care is documented and approved. Parents and stepparents of a minor child are excluded. Holding POA or guardianship is not by itself a bar. Caveat on pay: MaineCare's posted rate schedules are old — the Section 19 participant-directed rate is dated 4/1/2020 and the Section 12 rate 7/1/2019 — and the participant-directed figure is a bundled billing rate that includes the employer's payroll taxes and workers' comp, not your wage. Get your gross hourly wage in writing from the fiscal intermediary before you count on it. Other practical points: CDAS caps personal care at 28 hours a week at the highest level (Level III is 24 hours of ADL help plus 4 hours of IADL help; Level II is 18, Level I is 12). Section 19 hours are set by the assessment. Skills training under CDAS is capped at 14.25 hours a year and care coordination at 18 hours a year. Caregivers are W-2 employees and need a clean criminal background check and Maine Registry of Certified Nursing Assistants and Direct Care Workers check. Under Section 12 you pick a Service Coordination Agency from the enrolled MaineCare providers — Alpha One is one option, not the only one — and the Department's contracted fiscal intermediary handles payroll.

Other doors in Maine

ProgramWhat to know
Home Based Care (OADS Section 63, state-funded)Non-Medicaid fallback for people over MaineCare limits; includes a consumer-directed option where family (not spouses) can be paid — but 1,204 people were waitlisted as of 3/31/2026, so treat it as a long-shot backup, not a plan.
Independent Support Services / Homemaker (OADS Section 69)State-funded light housekeeping help via Catholic Charities Maine (1-888-477-2263); no caregiver pay, and 1,405-person waitlist as of 3/31/2026.
Veteran-Directed Care (VDC)Available in Maine through VA Maine Healthcare System (Togus) with Alpha One as the local partner; a veteran gets a flexible budget and CAN hire family — including a spouse. ACL's directory notes Togus had made few/no referrals as of the last update, so ask the VA social worker to push for it. VA Maine: 1-877-421-8263.
Family Caregiver Support Program (Area Agencies on Aging)Respite grants, training, and support — not ongoing wages. Statewide line 1-877-353-3771 connects to Maine's five Area Agencies on Aging.
MaineCare Section 96 Private Duty Nursing/Personal CareFor very high medical needs; family including spouses are excluded except under a narrow special-circumstances provision (96.04(B)).

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. Apply for long-term-care MaineCare: file the Long-Term Care application online at mymaineconnection.gov or call the Office for Family Independence at 1-855-797-4357 (help also available at any DHHS district office or your local Aging and Disability Resource Center, 1-877-353-3771).
  2. 2. Call Maine's Assessing Services Agency (Maximus) at 1-833-525-5784 to schedule the free in-home functional assessment — this decides whether your parent medically qualifies and how many hours they get.
  3. 3. When the assessment offers a program, ask specifically for the self-directed option: Section 12 Consumer Directed Attendant Services or the participant-directed option under the Section 19 waiver.
  4. 4. Contact Alpha One at 1-800-640-7200 (alphaonenow.org) for the skills-training/enrollment step; their affiliate Attendant Services Maine (1-866-964-9315) becomes the payroll agent.
  5. 5. Hire your family member: they pass a Maine background check and CMS registry check through Attendant Services Maine, then start work and submit timesheets for pay.

Where to start: Maine Office for Family Independence (MaineCare application): 1-855-797-4357 / mymaineconnection.gov; functional assessment: Maximus 1-833-525-5784; self-direction enrollment: Alpha One 1-800-640-7200

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.