Arizona's ALTCS program pays family members to give in-home care. A spouse can be paid when the care goes beyond what a spouse would ordinarily do, within a 40-hour weekly cap on all paid attendant care. Respite and VA benefits add more options.

If you are caring for an aging parent, a spouse, or an adult child with a disability in Arizona, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state for 2026.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

Arizona Caregiver Programs at a Glance

Program What It Offers Who Qualifies Cost to You
ALTCS member-directed attendant care Family member paid as direct-care worker (AWC or SDAC model) ALTCS members living in their own home Paid by Medicaid; ALTCS may require a share of cost
Spouse as Paid Caregiver Legally responsible spouse paid for up to 40 hrs/week; the 40 hours include any other direct care worker ALTCS members living at home whose care is assessed as extraordinary Paid by Medicaid; ALTCS may require a share of cost
NFCSP caregiver support Respite, counseling, support groups, caregiver training Caregivers of adults 60+ or of a person with Alzheimer's or a related disorder; respite requires the person cared for to need help with 2+ daily activities No means test for a service that accepts contributions; a state may set an income-based sliding scale
VA PCAFC Monthly tax-free stipend; pays spouses Veteran with 70%+ VA rating, a discharge, 6+ months of in-person care needs, and VA health care enrollment (all required) Free (VA benefit)
VA Aid and Attendance Pension of up to $29,093/yr (veteran, no dependents), minus countable income Veteran or surviving spouse who qualifies for VA pension and for Aid and Attendance, with net worth at or under $163,699 Free to apply (VSO help)

Programs That Pay Family Caregivers

If money is the worry keeping you up at night, start here: in Arizona, the care you are already giving can become paid work.

Arizona's Medicaid long-term-care program, the Arizona Long Term Care System (ALTCS), administered by AHCCCS, pays for direct-care services (attendant care, personal care, and homemaker services) and lets a family member be the paid direct-care worker. These services are available only to ALTCS members who live in their own home, must be medically necessary, and are not reimbursable in a nursing facility or other institutional or alternative residential setting. One exception: attendant care and personal care, but not homemaker services, can continue during a hospital inpatient or emergency room stay when they're in the care plan, meet needs the hospital doesn't, and don't substitute for care the hospital must provide. Parents of minor children can't be paid during that stay.

Nearly every paid pathway below runs through ALTCS; if your loved one isn't enrolled, start with the application steps below.

Member-Directed Models: AWC and SDAC

ALTCS members who live in their own home can receive attendant care through two member-directed models that differ in who is the legal employer:

  • Agency with Choice (AWC): the member and a provider agency share employer responsibilities. The agency keeps legal authority to hire, fire, and arrange the required caregiver training, while the member may recruit, select, schedule, supervise, and dismiss the caregiver.
  • Self-Directed Attendant Care (SDAC): available since 2008, the member (or their legal guardian) is the full legal employer, supported by a Fiscal Employer Agent that handles taxes, payroll, and paychecks.

Both options are limited to members living in their own home and are not available in an alternative residential setting or nursing facility.

Who can be the paid worker also differs. Under AWC, the member's Individual Representative cannot be paid, and a guardian automatically serves as that representative. Under SDAC, a legal guardian cannot be the paid worker, and a Spouse as Paid Caregiver cannot be reimbursed for SDAC services.

Under SDAC, the worker also needs proof of citizenship or legal residency and two identity documents, one with a photo. If the member wants a background check, the case manager provides a consent form for the new hire to sign, and the Fiscal Employer Agent runs it and shares results with the member and the health plan.

If you live with your relative, the ALTCS DCW agency must record in the electronic visit verification system, within 30 days of hire, that you live with the member and how you're related. DDD says members with live-in caregivers can choose whether to set a schedule.

What ALTCS Pays for Attendant Care

AHCCCS publishes no ALTCS caregiver wage, only what the program pays for the service: fee-for-service attendant care reimbursement rates, effective January 1, 2026 and unchanged in its October 1, 2026 notice.

Area Attendant care (S5125), per 15 minutes Self-Directed Attendant Care (S5125 U2), per 15 minutes
Statewide $6.80 (about $27.20 an hour) $4.89 (about $19.56 an hour)
Flagstaff (ZIPs 86001, 86004, 86005) $7.22 (about $28.88 an hour) $5.20 (about $20.80 an hour)
Tucson $6.88 (about $27.52 an hour) $4.95 (about $19.80 an hour)

These aren't your paycheck: under SDAC, AHCCCS's member manual says the member's ALTCS health plan decides the worker's pay, so ask for your hourly wage before budgeting.

Spouse and Parent Pathways

Being paid to care for your husband or wife can feel strange at first, but Arizona is one of the states that lets a legally responsible relative be paid. Under AHCCCS Medical Policy Manual 1240-A, the Spouse as Paid Caregiver model permits a legally responsible spouse to be compensated for providing direct care services to a spouse who is an ALTCS member. First, because a spouse is a legally responsible relative, the paid care must be extraordinary: care that exceeds the range of activities a spouse would ordinarily perform in the household if the member did not have a disability or chronic illness. Second, the spouse may not be paid for more than 40 hours of services in a seven-day period, and that cap covers the spouse and any other direct care worker combined. The spouse must be employed or contracted by a direct care worker agency that subcontracts with the member's ALTCS Contractor; if the member is served by the DES Division of Developmental Disabilities (DDD), the spouse can instead be employed by the member under DDD's Independent Provider Network. A parent can be paid too, for a son or daughter of any age, but by two different mechanisms. If the ALTCS member is a minor child, the route is the Parent as Paid Caregiver (PPCG) model, which permits legally responsible parents and legal guardians holding formal physical and/or legal custody to be compensated for direct care and habilitation services, capped at 40 hours of paid services in a seven-day period to a single minor child member. The same extraordinary-care test applies to a parent of a minor child. If the member is an adult child, PPCG does not apply: 1240-A lists parents, stepparents, and adoptive parents among the relatives who may be paid, so the parent is an ordinary family member direct care worker who can work through an agency or AWC, or be hired directly under SDAC. Under the spouse and minor-child parent models, a fee-for-service American Indian or Alaska Native member's paid spouse or parent must work through an AHCCCS-registered agency. Either way a parent is capped at 16 hours of paid care within a 24-hour period at any member age, and a paid spouse or parent is paid at a rate that does not exceed what would otherwise be paid to a non-spouse, non-parent caregiver for a similar level of attendant care.,

For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Arizona.

How to Apply for ALTCS and Request a Paid Caregiver

Because every paid pathway above depends on ALTCS enrollment, here is the practical order of operations, from application to the case manager who authorizes a family member as the paid caregiver.

1
Step 1

Confirm ALTCS eligibility and apply

ALTCS is health insurance for people with an age-related, physical, or intellectual/developmental disability who require nursing facility level of care. Register an application online through Health-e-Arizona Plus, or call the ALTCS toll-free line at 1-888-621-6880.

2
Step 2

Complete the eligibility interview

An ALTCS caseworker reviews both financial eligibility (income and resources) and medical eligibility (a level-of-care assessment).

3
Step 3

Ask for member-directed attendant care

Once enrolled, tell your ALTCS case manager you want a family member to be the paid direct-care worker, and choose a model: Agency with Choice (AWC) or Self-Directed Attendant Care (SDAC). A paid spouse, or a parent of a minor child, is employed or contracted by a direct care worker agency that subcontracts with the member's Contractor (a DDD member can use the Independent Provider Network for a spouse).

4
Step 4

Finish direct-care worker training and testing

Through an agency, including under AWC, an Arizona family caregiver may provide care during the agency's 90-day train-and-test window, unless they have no direct care work experience in the last two years, in which case they must pass the tests first. CPR and first aid certification is verified before care begins. These AHCCCS 1240-A rules do not apply under SDAC.

AHCCCS names three ALTCS E/PD health plans: UnitedHealthcare Community Plan LTC, Banner-University Family Care LTC and Mercy Care LTC, under a contract amendment effective October 1, 2026. ALTCS E/PD members in Gila, Maricopa, Pinal and Pima counties get a choice of health plan. New ALTCS E/PD contracts are scheduled to start October 1, 2027, a timeline AHCCCS says may change.

Respite Care Programs

Medicaid Respite (ALTCS)

ALTCS covers respite care as an interval of rest or relief for a family member or other person caring for an ALTCS member, delivered either by a respite provider coming to the member's home or by admitting the member to a licensed facility or approved alternative setting. Respite may only be delivered as specified in the member's service plan and as authorized by the case manager, and the combined total cannot exceed 600 hours per benefit year (October 1 through September 30), counting behavioral health and ALTCS respite together. AHCCCS's respite policy does not itself say whether a family member may be paid for respite hours, so ask the case manager.

NFCSP Grants Through Arizona's Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, funds services delivered by area agencies on aging; in Arizona, the Department of Economic Security Division of Aging and Adult Services offers them through its aging contractors, the local Area Agencies on Aging. Services include information and help getting access to services, counseling, support groups, caregiver training, respite, and limited supplemental services. Two Arizona gates apply to respite: the person you care for must be an older individual unable to perform at least two activities of daily living without substantial help, and you must be assessed at moderate or high risk on the Division's assessment tool. Federal law bars an Area Agency on Aging from means testing a service for which it accepts contributions, but a state may set a sliding-scale cost share based on income (never for a low-income older individual whose income is at or below the federal poverty line), so ask your local Area Agency on Aging what you would pay., To find your local Area Agency on Aging, call the Eldercare Locator at 1-800-677-1116.

Arizona's Division of Aging and Adult Services also runs the Lifespan Respite Programs, under different rules: the respite provider may be a family member, but not the spouse, child, parent, guardian, or anyone who lives with the care receiver, the caregiver must live full-time with the care recipient, and the caregiver and care recipient cannot be receiving any other respite services paid with federal, state or insurance funds. To apply, call the Caregiver Resource Line at 888-737-7494.

For the full respite guide: Respite Care in Arizona.

Support, Training, and Area Agencies

Arizona's Area Agencies on Aging are the front door for most caregiver support not tied to ALTCS, including the NFCSP services above; start by contacting yours.

In the Phoenix metro area, the Area Agency on Aging Region One serves Maricopa County; Pima Council on Aging serves Pima County, including Tucson; and other regional AAAs cover the rest of the state. To find your regional agency, use the Eldercare Locator at 1-800-677-1116.

VA Caregiver Benefits in Arizona

If the person you care for served in the military, VA runs caregiver programs separate from Medicaid for veterans enrolled in VA health care.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. The stipend is calculated from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). In the current program (§ 71.20(a)) the factor is 0.625, or 1.00 when VA determines the veteran is unable to self-sustain in the community. A household already in PCAFC under the pre-October 2020 rules (a legacy participant) may use a different schedule based on the veteran's 2019 clinical ratings. A veteran who qualifies under both is paid the higher amount, and the legacy schedule lapses October 1, 2028. The PCAFC caregiver stipend guide explains which schedule applies, so don't treat 0.625 as your ceiling. The stipend is federal tax-free and allows paid spouses. VA lists four requirements for the veteran, and all of them must be true: a VA disability rating (individual or combined) of 70% or higher, a discharge from the U.S. military or a date of medical discharge, a need for at least six months of continuous, in-person personal care, and enrollment in VA health care. VA decides eligibility after you and the veteran apply together. Once approved, the Primary Family Caregiver must be enrolled in direct deposit through the VA customer engagement portal before the monthly stipend is paid.

Veteran-Directed Care (VDC) lets a veteran receive home and community based services in a consumer-directed way: the veteran or a representative gets help developing a spending plan and hiring workers, which VA says might include a family member or neighbor. Enrolled veterans are eligible if they are eligible for community care, meet the clinical criteria, and the service is available; services vary by location. VA's program description does not say whether a spouse can be the paid worker, so confirm with the VA medical center.

Arizona VA health care systems: ACL's Veteran-Directed Care list pairs three Arizona systems with approved partner agencies: the Carl T. Hayden VA Health Care System (Phoenix) with Ability360, Area Agency on Aging 1 and the Central Arizona Area Agency on Aging; the Southern Arizona VA Health Care System with the Pima Council on Aging and the Central Arizona Area Agency on Aging; and the VA Northern Arizona Health Care System with the Pima Council on Aging and the Northern Arizona Council of Governments. A listing does not guarantee referrals, so ask your local VA medical center about availability.

VA Aid and Attendance Pension

Veterans and surviving spouses who qualify for VA pension and for Aid and Attendance, and whose net worth is at or under the limit ($163,699 from December 1, 2025, to November 30, 2026) may receive the Aid and Attendance pension. VA sets these as annual maximums: a single veteran with Aid and Attendance receives up to $29,093 a year; a veteran with one dependent up to $34,488 a year, minus the claimant's countable income, since VA pays only the difference between the two.

Arizona Department of Veterans' Services and county Veterans Service Officers help file at no cost.

VA Caregiver Support Line: 1-855-260-3274

Taxes for Arizona Caregivers

IRS Notice 2014-7

Under IRS Notice 2014-7, the IRS treats payments to a care provider under a state Medicaid Home and Community-Based Services waiver described in section 1915(c) of the Social Security Act as difficulty-of-care payments excludable from federal gross income. The exclusion only applies to care in the provider's own home, where the care recipient also lives; a caregiver who keeps a separate home may not exclude the payments. For a state Medicaid program that is not a 1915(c) waiver, the IRS says only that the answer depends on the nature of the payments and the purpose and design of the program, so confirm the authority behind your ALTCS pay with a tax professional before assuming the exclusion. Excluded payments generally are still wages for Social Security and Medicare tax purposes, but when the care recipient is the employer, payments for services performed for a spouse or a child, or for a parent by a child under the age of 21, generally are not subject to those taxes. The IRS gives reporting instructions for excludable payments on a Form W-2 or a Form 1099.

Arizona State Income Tax

For tax year 2023 and beyond, Arizona has a flat individual income tax rate of 2.5%, so caregiver wages that are not excluded under Notice 2014-7 are taxed at 2.5% in Arizona as well as federally.

VA PCAFC Stipend

The PCAFC monthly stipend is federal tax-free and is not reported on a W-2.

Your next step Not sure which Arizona caregiver program fits your family? Chat with Brevy's care navigator for a personalized comparison.

Frequently Asked Questions

Can I get paid to care for my spouse in Arizona?

Yes, for care assessed as extraordinary, beyond what a spouse would ordinarily do, capped at 40 paid hours in a seven-day period for the spouse and any other direct care worker combined. The spouse works through a direct care worker agency (or, for a DDD member, DDD's Independent Provider Network), not SDAC.,

What is the difference between AWC and SDAC?

Both are member-directed ALTCS attendant care models for members living in their own home. Under Agency with Choice (AWC), the member and a provider agency share employer duties; under Self-Directed Attendant Care (SDAC), the member is the full legal employer, supported by a Fiscal Employer Agent.

Can a parent be paid to care for their child in Arizona?

Yes, at any age. For a minor ALTCS member, a parent with formal physical and/or legal custody is paid under the Parent as Paid Caregiver (PPCG) model, capped at 40 paid hours in a seven-day period and only for care assessed as extraordinary. For an adult member, the parent is hired as an ordinary family member direct care worker. Either way, a parent is capped at 16 paid hours in 24.

Is there respite in Arizona without Medicaid?

Yes. The National Family Caregiver Support Program funds respite through Arizona's Area Agencies on Aging for caregivers of an older person who can't do at least two daily activities without substantial help, when the caregiver is assessed at moderate or high risk; ask what you would pay. The Lifespan Respite Programs are another route (Caregiver Resource Line, 888-737-7494), with their own rules on who can be the provider.,

Are caregiver wages taxed in Arizona?

Arizona's flat 2.5% state income tax applies to caregiver wages not excluded under IRS Notice 2014-7, which covers section 1915(c) Medicaid waiver pay for care in the caregiver's own home, where the care recipient also lives; for other Medicaid programs, the IRS says it depends. The taxes section covers Social Security and Medicare. Confirm with a tax professional.

Where to Get Help in Arizona

ALTCS (Arizona Long Term Care System) Apply for ALTCS; once enrolled, a family member can be the paid direct care worker for an ALTCS member living at home., 1-888-621-6880 www.azahcccs.gov/Members/GetCovered/Categories/ALTCS.html
Caregiver Resource Line (Lifespan Respite) Apply for the Lifespan Respite Programs here. NFCSP respite, counseling, and caregiver training come through your local Area Agency on Aging. 888-737-7494 des.az.gov/FamilyCaregiver
VA Caregiver Support Line Reach a VA Caregiver Support Coordinator about the PCAFC stipend. For Veteran-Directed Care availability and eligibility, contact your local VA medical center., 1-855-260-3274 www.caregiver.va.gov

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. 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. CaregiverRespite Care 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. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in ArizonaVA Aid and Attendance in Arizona for 2026: who qualifies, pension rates up to $34,488 a year, how to apply, and free help from ADVS Veteran Benefit Counselors. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help navigating Arizona caregiver programs 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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