If your child is approved for provider hours, the person providing those authorized services is paid for the hours they work.
Depending on your child’s Medicaid service and the service-delivery option your family chooses, the provider may work through a provider agency or may be hired through the Consumer Directed Services (CDS) option.
A provider may be:
- a qualified attendant from a provider agency;
- another qualified adult you know;
- or, in some circumstances, a qualified relative.
The person must meet the requirements for the particular Medicaid service.
Can I Be Paid to Provide the Care if I Am the Parent?
For a child under age 18, the parent or other legally responsible adult generally cannot be the paid provider for the child’s PCS or CFC PAS/HAB hours.
This is important because families sometimes hear that “a family member can be paid” and assume that means the child’s parent.
Other qualified relatives may be allowed to work as the provider, depending on the service and the person’s relationship to the child.
For example, a qualified adult relative who is not legally responsible for the child may potentially be hired if that person meets the program’s provider requirements.
Always ask the Medicaid plan, provider agency or CDS Financial Management Services Agency to confirm whether the person you want to use is eligible before that person begins providing paid services.
Does the Provider Actually Get Paid?
Yes.
These are paid service hours when the child has been assessed, the service has been authorized and an eligible provider performs the approved services.
If your family uses an agency, the agency employs and pays the attendant.
If your family chooses Consumer Directed Services (CDS) for an eligible service, the child’s parent or legally authorized representative can act as the employer and select and manage the worker. A Financial Management Services Agency (FMSA) handles functions such as payroll and employment taxes.
This means a parent of a minor can be involved in choosing and managing the provider, even though the parent generally cannot hire themselves to be the child’s paid PCS or CFC PAS/HAB provider.
What If I Already Know Someone I Trust?
Ask whether that person can become your child’s provider.
That person may even be a qualified adult relative who lives in your home, such as an adult sibling, if the Medicaid service allows it and the person meets the provider requirements
For example, you may have an adult relative or another trusted adult who already knows your child well.
Ask:
“My child has approved provider hours. Can this person become my child’s paid provider?”
The answer will depend on the service, the person’s relationship to your child and whether the person meets the required qualifications.
If the person qualifies, they can be paid for the authorized services they actually provide.
Choose Your Child’s Provider Carefully
Being able to choose someone you know can be helpful, but choose carefully.
This person may spend many hours with your child and may help with personal care, daily activities or supervision.
A provider should be someone who is reliable, patient and able to safely meet your child’s needs.
Before choosing someone, consider:
- Does this person understand my child’s disability and needs?
- Can I trust this person when I am not present?
- Will this person follow my child’s service plan and the provider’s rules?
- Is the person dependable and likely to show up for scheduled hours?
- Can the person safely provide the type of assistance my child needs?
- Does my child appear comfortable with this person?
- Does the person meet the Medicaid program’s provider requirements?
Even when the person is a relative or close family friend, the same questions matter.
A qualified adult relative who lives in your home, such as an adult sibling, may be allowed to provide paid services under some programs if the person meets the applicable requirements. For a child under 18, the child’s parent or other legally responsible adult generally cannot be the paid PCS or CFC PAS/HAB provider.
Remember: This Is a Paid Caregiving Job
If someone becomes your child’s approved provider, they are not simply “helping out.”
They are being paid to provide authorized services to your child and have responsibilities that come with that role.
Do not choose someone only because they need a job or because they are a relative.
Choose someone because you trust them to care for your child.
If something does not feel right, ask questions. If you have concerns about your child’s safety or the quality of the care being provided, contact the appropriate provider agency, Medicaid health plan or service coordinator.
Your child’s safety comes first.
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Already Have Provider Hours but Not Sure What to Do Next?
If your child has already been approved for provider hours but you are unsure what to do next, you are welcome to contact NUDO Homes.
We can listen to your situation, help you understand the questions you may need to ask, and share information about resources that may be available.
When you contact us, it is helpful to know:
- which Medicaid plan your child has;
- what type of service has been approved;
- how many hours have been authorized; and
- whether you already have someone you would like to use as the provider.
Don’t be afraid to ask. Understanding what has been approved is an important first step toward finding the right support for your child.
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