Can a Family Member Be Your Paid PCA in Alaska?

In Alaska, Community First Choice (CFC) can pay a spouse or court-appointed guardian for personal care through a certified provider, but State Plan Personal Care Services (PCS) cannot pay a spouse.1,2 Alaska PCS pays a guardian only when a court authorizes it under Alaska Statutes (AS) 13.26.311(c).2 Neither Alaska program's rules say whether another family member, such as an adult child, can be a paid PCA, so ask Alaska's Senior and Disabilities Services to confirm.2,1 Alaska's CFC regulations do let the recipient select a recipient's representative to provide personal care if that representative designates a designee.1

The Two Programs That Pay a Personal Care Assistant

Both are Alaska Medicaid programs run through the Division of Senior and Disabilities Services (SDS), and they hire under different rules.

Personal Care Services (PCS) is a state plan benefit that helps with daily tasks such as bathing, dressing and eating, plus shopping, laundry and light housework. It comes in Agency-Based and Consumer-Directed options; under Consumer-Directed, the person receiving care can choose, hire, supervise and even fire their own personal care assistant.3

Community First Choice (CFC) is Alaska's 1915(k) state plan option. It can include personal care services, personal emergency response systems, case management and chore services. To join Alaska's Community First Choice, a person must meet federal financial and medical rules, including needing the level of care usually provided in an institution, and Alaska says the first step is to contact your local Aging and Disability Resource Center (ADRC) or Developmental Disabilities Resource Connection (DDRC).3

Because CFC requires an institutional level of care, the program the person you care for is assessed for decides which family-hire rule applies to you.3

Which Family Members Can Be a Paid PCA in Alaska?

Under the PCS regulations (7 AAC 125), covering both agency-based and consumer-directed care, Alaska Medicaid pays only for care by a personal care assistant who is at least 18 and is not the recipient's spouse, the parent of a minor recipient, a person with a duty to support the recipient under state law, the recipient's representative, or the representative's designee, unless that person is a court-appointed guardian whom a court authorizes to provide personal care.2 SDS states that legally responsible individuals are not permitted to provide State Plan PCS, per the federal Centers for Medicare & Medicaid Services (CMS).2

CFC runs the other way. Under 7 AAC 127.015, CFC personal care may be provided by a legally responsible individual, including the recipient's spouse, the parent of a minor recipient, or a court-appointed legal guardian, if that person is qualified and is employed by a provider certified under 7 AAC 127.050. Alaska Statute 47.07.045(d) directs the state to allow a legally responsible person to provide CFC personal care unless federal law prohibits it. An Alaska CFC personal care assistant must be at least 18 and employed in either a consumer-directed or an agency-based program.1

For the spouse route in full, including VA options, see our guide to getting paid to care for your spouse in Alaska. The Alaskans Living Independently (ALI) waiver has no personal care service at all (see our Alaska HCBS waiver guide).4

Guardians, Representatives and Powers of Attorney

PCS excludes the recipient's representative, which Alaska's Medicaid rules define as a parent, guardian, or other individual with legal authority to act for the recipient. The exception to the Alaska PCS bar on representatives is a court-appointed guardian whom a court authorizes under AS 13.26.311(c) to provide personal care.2

Under CFC, a court-appointed guardian can be paid but must appoint a designee, on a department form, to act on the guardian's behalf.1

CFC also departs from PCS on representatives. Under 7 AAC 127.115(d), the recipient may select a recipient's representative to provide CFC personal care. That representative must then designate a designee to carry out the responsibilities set out in 7 AAC 127.115(b), and the designee must be at least 18, present in the recipient's community and involved in the recipient's day-to-day care, and willing to manage and evaluate the personal care services as they are provided in the home.1

For a power of attorney (POA), SDS's October 15, 2024 Director's Memo allows a recipient's POA to provide State Plan or CFC personal care with limits: under AS 13.26.630 an additional person must be named jointly on the POA documentation, that person cannot be affiliated with a provider agency, and the POA must appoint a designee to carry out the representative's duties. That allowance comes from the SDS memo, not the regulation text.2

Adult Children, Siblings and Live-In Relatives

Alaska's rules don't settle this one. The PCS regulations do not name adult children, siblings or other relatives, either to permit or to exclude them, and they do not bar an assistant who lives with the recipient.2

The open point is Alaska Statute 25.20.030, which says each child is bound to maintain the child's parents when they are poor and unable to work. The Alaska PCS rules exclude anyone with a duty to support the recipient under state law, and don't say whether AS 25.20.030 puts an adult child in the excluded group.2

Apart from legally responsible individuals and a recipient-selected representative, the CFC regulations likewise do not name adult children, siblings or other relatives, either to permit or to exclude them.1 Ask SDS, in writing if you can, whether that route or any other fits your family before you start care you expect to be paid for.

Living together brings two limits. PCS won't pay for respite to relieve a household member, family member or caregiver.2 CFC will deny or limit chore time when a live-in immediate family member, duty-holder or caregiver is responsible for those chores, or when the chore worker lives in the same residence.1

How Many Hours Can a Family Member Be Paid as a PCA in Alaska?

Hours are set by an assessment, not by who the caregiver is. PCS follows a service level authorization the department sets after assessing the recipient's functional limitations, and the PCS rules state no family-specific weekly cap. PCS is authorized only when assessed needs cannot be met by the recipient's representative, immediate family members, or natural supports, and it doesn't pay for household tasks that are the spouse's responsibility or a duty-holder's.2

Under CFC, regulation 7 AAC 127.015(a)(3) still says a legally responsible individual's services may not exceed 40 paid hours within a seven-day period. SDS's June 27, 2025 Director's Memo says SDS will not enforce that 40-hour limit for CFC personal care and will remove it in the future, because neither CMS nor the 2023 legislation imposed an hourly limit.1 If someone quotes you the cap, ask SDS whether it applies to you.

What the Job Pays and How It's Taxed

Typical pay: about $19.11 an hour (estimate based on home care aide wages in Alaska, BLS, May 2025). It is the Alaska median for home health and personal care aides, and it reflects what agencies pay aides, so the program's actual pay may differ.5

On federal income tax, IRS Notice 2014-7 lets some live-in caregivers exclude Medicaid payments from income, but it is written for 1915(c) waiver programs.6 PCS and CFC are not 1915(c) waivers, so the exclusion isn't automatic; the IRS says it depends on the nature of the payments and the purpose and design of the program. Check with a tax professional.6 Our guide to whether a Medicaid-paid caregiver gets a W-2 or a 1099 explains the payroll side.

Questions to Ask SDS Before Care Starts

Learn More

Find personalized help working out whether your family member can be hired as an Alaska PCA at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.