Arizona's Medicaid long-term care program pays for hands-on help at home for children and adults with disabilities, and a parent caring for their own child can be the one who gets paid., Through the Arizona Parents as Paid Caregivers program (PPCG), a parent or legal guardian of a minor child enrolled in the Arizona Long Term Care System (ALTCS) can be paid for up to 40 hours of care a week per child, working through one agency. If your child is already on ALTCS, ask the case manager or support coordinator about PPCG.

Who the Arizona Parents as Paid Caregivers Program Covers

The Arizona Parents as Paid Caregivers program has been a permanent part of the state's Medicaid program since February 2024, according to the Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid agency. Arizona's PPCG applies only to children who are eligible for and enrolled in ALTCS. ALTCS covers people with an age-related, physical, or intellectual or developmental disability who need a nursing facility level of care, and members don't have to live in a nursing home.

For PPCG, AHCCCS counts as a parent anyone with formal physical or legal custody of the minor child, including a legal guardian. A stepparent qualifies as a PPCG parent in Arizona only after legally adopting the child.

Under AHCCCS policy 1240-A, a paid Arizona PPCG parent's care must also be medically necessary and extraordinary: care beyond what a parent would ordinarily do in the household if the child didn't have a disability or chronic illness., A 2025 Arizona law required a stronger assessment tool for this test by October 1, 2025, but that tool isn't in use: AHCCCS paused its new Home and Community-Based Services (HCBS) Needs Tool for children in mid-October 2025, and health plans, including DDD, went back to earlier tools. AHCCCS plans to launch the revised tool and an Extraordinary Care Review process on December 1, 2026.

PPCG ends at 18, but paid family care doesn't have to: AHCCCS policy lets parents and other relatives of adult children be paid caregivers without PPCG's hourly limit, though the 16-hour daily cap below still applies (see our ALTCS attendant care page)., DDD re-checks eligibility at 18, and services continue meanwhile.

What Are Arizona's Hour and Billing Rules for Paid Parents?

Under Arizona's PPCG, the number of hours you can be paid for, up to 40 a week, is set through your child's person-centered planning and must be medically necessary. The other rules come from the AHCCCS PPCG FAQ (revised September 2026), policy 1240-A and state law.,

Rule What it means for you
Weekly cap Up to 40 paid hours a week per child; two paid parents share the 40. With two children receiving services, up to 80 hours combined.
Hours above 40 Your child can still get more approved hours; the agency must find another worker for them.
Daily cap No more than 16 paid hours in any 24-hour period.
Time of day Between 6 a.m. and 10 p.m., unless your child's plan of care says otherwise.
Child not present No billing while your child is at school, in inpatient care or getting care in a clinical setting.
Ordinary chores No billing for housekeeping, laundry or meal preparation a parent of a child without a disability would ordinarily do.
One agency Each parent works for a single agency for PPCG hours; two parents may use two different agencies.
Residency Six months as an Arizona resident, under a state law that is subject to federal approval.

Arizona's 40-hour weekly limit for paid parents took effect July 1, 2025. Arizona's PPCG 40-hour cap applies per child, not per parent, so two parents can't each be paid 40 hours for one child.,

How Pay Works Under PPCG

Under Arizona's PPCG, a direct care worker agency hires or contracts you; DDD calls its agencies Qualified Vendors., AHCCCS's self-directed options, Agency with Choice and Self-Directed Attendant Care, don't let a parent of a minor child be the paid worker.

Under Arizona's PPCG, AHCCCS doesn't set your take-home pay. Agencies are paid from the fee-for-service fee schedule (Elderly and Physically Disabled (EPD) health plans may negotiate different rates), and DDD pays its agencies from its rate book. Your wage is worked out between you and the agency, so ask what an agency pays parents before you sign on. Under AHCCCS policy 1240-A, an Arizona paid parent's rate can't be higher than a non-parent caregiver would get for similar care.

AHCCCS's 2026 fee-for-service rate for attendant care is $6.80 per 15 minutes statewide; that's what the program pays an agency, not your wage.

A PPCG parent needs CPR and first aid certification and the Level I caregiving training, and the agency can't waive its background check rules for a PPCG parent. AHCCCS also requires parents to log visits through Electronic Visit Verification (EVV).

How to Start in the Arizona Parents as Paid Caregivers Program

  1. Check DDD eligibility if your child has a developmental disability. DDD serves Arizona residents who apply. Children 3 to 6 qualify for Arizona DDD services with, or at risk for, autism, cerebral palsy, intellectual disability, epilepsy or Down syndrome, or another condition DES accepts at that age; from age 6, a qualifying diagnosis before 18 plus significant limits in three life-skill areas. Call 1-844-770-9500. ALTCS also covers children with a physical disability, so a child who doesn't qualify for DDD can still apply for ALTCS directly.
  2. Apply for ALTCS. ALTCS has its own financial and medical tests: your child must need a nursing facility level of care, and AHCCCS's ALTCS application guide, DE-828, explains how income and resources are treated. Apply online through Health-e-Arizona Plus (HEAplus) or call 888-621-6880.
  3. Complete the needs assessment. Your child's needs and hours are set through person-centered planning and an assessment, using the health plan's earlier tools while the HCBS Needs Tool is revised.
  4. Ask about PPCG. Raise PPCG with the case manager or support coordinator; if you choose it, you'll sign the Parents as Paid Caregivers Acknowledgement of Understanding.
  5. Join one agency. Get hired or contracted by a single agency, which handles your training and testing.,

If DDD denies eligibility, you can request an administrative review.

Frequently Asked Questions

Is PPCG pay taxable?

It depends. The IRS treats certain payments for care in the caregiver's own home under 1915(c) Medicaid waivers as excludable; for other state Medicaid programs, the IRS says it depends on the program's nature and design. PPCG runs under Arizona's Section 1115 demonstration waiver, so ask a tax professional. Our guide to whether Medicaid waiver payments are taxable explains the rule.

Can PPCG pay affect our other benefits?

Yes, it can. AHCCCS warns that Arizona PPCG pay is extra income that could affect eligibility for programs such as SNAP, and that change could affect others in your household.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in ArizonaPaid family caregiver in Arizona: 2026 ALTCS attendant care, Agency with Choice, Self-Directed Attendant Care, the spouse-pay rule, and VA caregiver options. CaregiverCaregiver Programs in ArizonaEvery caregiver program in Arizona: ALTCS paid pathways (spouses can be paid), respite, NFCSP grants, VA benefits, and taxes explained for 2026. CaregiverGetting Paid to Care for Your Spouse in ArizonaCan you get paid to care for your spouse in Arizona? Yes, if the care qualifies, through ALTCS. Here is the Medicaid rule, the 40-hour cap, and the VA routes. CaregiverYour Guide to Respite Care Options in ArizonaArizona respite care, four ways: ALTCS covers up to 600 hours a benefit year, plus Lifespan Respite, NFCSP through your local AAA, and VA respite.

Find personalized help getting paid to care for your child through Arizona's Parents as Paid Caregivers program 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.

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