How to Get Paid as a Family Caregiver in Arkansas (2026)

If you are caring for an aging parent or spouse in Arkansas, you may be able to get paid as a family caregiver through Medicaid self-direction, VA programs, or a private agreement. Arkansas's ARChoices in Homecare waiver covers attendant care, and in some situations beneficiaries can hire and choose their own providers for personal care services through a self-direction program called Independent Choices.1

On the Medicaid side, the answer depends on who you are to the person you care for. Arkansas's provider manuals let an adult child or other relative who meets the program's requirements be the paid caregiver, but Medicaid will not pay a spouse, a legal guardian, or an attorney-in-fact with authority to direct the person's care.2,3 If you are caring for a veteran, VA's caregiver stipend program does accept a spouse as the Family Caregiver.4

In This Guide

• How Do You Get Paid as a Family Caregiver in Arkansas?
• What Makes Arkansas Different
• VA Paid Caregiver Programs in Arkansas
• Private Caregiver Agreement
• Which Pathway Pays the Most?
• How to Choose Your Arkansas Pathway
• Is Caregiver Pay Taxable in Arkansas?
• Common Misconceptions
• Frequently Asked Questions
• Learn More

How Do You Get Paid as a Family Caregiver in Arkansas?

On the Medicaid side, the ARChoices in Homecare Waiver covers attendant care, and in some situations beneficiaries can hire and choose their own providers for personal care services through a self-direction program called Independent Choices.1

For veteran families, VA's caregiver stipend uses the same factors in every state, and Veteran-Directed Care lets a veteran hire family or friends where it is offered.4,8

For families with private assets, a written caregiver agreement matters under Arkansas's 60-month Medicaid look-back.7

What Makes Arkansas Different

ARChoices Waiver and Independent Choices

The ARChoices in Homecare Waiver is an Arkansas Medicaid waiver program that provides home and community-based services to eligible adults with physical disabilities and people aged 65 or older. It is operated by the Division of Aging and Adult Behavioral Health Services under the administrative authority of the Division of Medical Services. Its services include attendant care (help with tasks such as eating, dressing, bathing, meal planning, laundry, and shopping for essentials), adult day health, and respite care.1

An applicant must meet all three requirements, not just the age or disability one: be aged 21 through 64 with a physical disability or aged 65 and older; meet established financial criteria; and meet the nursing home admission level of care criteria.1

Independent Choices is a Medicaid state plan service under section 1915(j) of the Social Security Act. It covers State Plan personal care, and attendant care for ARChoices participants who choose it instead of attendant care through a certified agency. The participant is the employer of record and hires the personal assistant.3 Participants or their representatives receive a cash allowance for personal care assistance and decide how to spend it, including paying the personal assistant. DHS's self-direction page does not publish an allowance figure. A Financial Management Service vendor, which DHS names as PPL First, handles payroll and withholds and files taxes for the participant.9

Can a spouse or adult child be paid? An adult child, yes; a spouse, no. The Independent Choices provider manual says family members other than those with legal responsibility to the beneficiary may serve as personal assistants, but a court-appointed legal guardian, spouse, power of attorney, or income payee may not. A participant's representative cannot be paid for that role or be the participant's employee.3 Under the ARChoices waiver, a relative who meets provider licensure or certification and Medicaid enrollment requirements may provide services, but Medicaid will not pay for any waiver service rendered by the participant's spouse, legal guardian of the person, or attorney-in-fact with authority to direct care, and self-directing does not get around that bar.2

How many hours are paid? Hours are set by assessment, not by the caregiver. Independent Choices covers up to 14.75 hours a week (64 hours a calendar month) of State Plan personal care for participants aged 21 and older; for ARChoices participants, a DHS nurse sets personal care and attendant care hours using Arkansas's Task and Hour Standards, within the ARChoices Individual Services Budget.3 ARChoices attendant care covers only tasks that are not available from another source, including family members, a member of the participant's household, or other unpaid caregivers.2

What to confirm with Choices in Living:

• How many hours the assessment approves, and what the cash allowance will be
• Whether there is a wait for an ARChoices opening in your area

How to Apply Through ARChoices Self-Direction in Arkansas

VA Paid Caregiver Programs in Arkansas

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who can be paid: A designated Primary Family Caregiver who is at least 18 and is either a spouse, son, daughter, parent, stepfamily member, or extended family member of the eligible veteran, or someone who lives full time with the veteran (or is willing to if VA designates them). The two are alternatives, so an unrelated caregiver who lives with the veteran can qualify. A veteran may also have up to two Secondary Family Caregivers.4

2026 stipend: Indexed to the OPM GS-4 Step 1 annual rate for the veteran's locality, divided by 12 to give a monthly base, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). There is more than one factor, and which one applies turns on whether the veteran is in the current program or is a legacy participant or legacy applicant under the pre-October 2020 rules:4

• Current program (the veteran was approved under 38 CFR 71.20(a)): 62.5% of the monthly base (a 0.625 factor), or the full 100% (1.00) if VA determines the veteran is unable to self-sustain in the community.4
• Legacy participant or legacy applicant (38 CFR 71.20(b) or (c)): the factor comes from the sum of the veteran's 2019 clinical ratings, with no self-sustain determination: 21 or higher pays 100%, 13 to 20 pays 62.5%, and 1 to 12 pays 25%. That schedule lapses October 1, 2028.4
• A veteran who meets both is paid whichever amount is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible to receive the day before October 1, 2020, while the veteran stays at the same address.4

In OPM's Rest of U.S. locality pay area, the 2026 GS-4 Step 1 annual rate is $36,409, and the monthly stipend rate is that figure divided by 12; other localities use their own 2026 table.10 Do not treat 62.5% as your ceiling: ask your VA Caregiver Support Coordinator which schedule applies and confirm the figure.4

Veteran eligibility: VA lists four requirements, 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 6 months of continuous, in-person personal care services; and enrollment in VA health care. Those four are a first screen rather than the decision: you and the veteran apply together, and VA determines eligibility through its application process.4

Additional benefits for the primary caregiver: access to health care benefits through CHAMPVA if you don't already qualify for care under another health plan; at least 30 days of respite per year; mental health counseling; free legal and financial planning help related to the veteran's needs; certain travel benefits when traveling with the veteran for care.4

How the caregiver is paid: Monthly, by direct deposit. You must enroll in direct deposit through the VA customer engagement portal to receive the stipend, so do that as soon as you are approved.4 VA treats the stipend as a non-taxable benefit.5

Apply: Through the Program of Comprehensive Assistance for Family Caregivers page or with the VA Caregiver Support Coordinator at your VA medical center. VA's Caregiver Support Line at 1-855-260-3274 is staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Time.11

VA Veteran-Directed Care

Who can be paid: Veterans in VA Veteran-Directed Care can hire their own personal care aides, which VA says might include their own family member or neighbor.8

How it works: The veteran gets a flexible budget based on care needs, and a financial management services provider handles payroll and taxes. No one can be hired until the spending plan and budget are approved and background checks are complete. Details vary by local program.12

Veteran eligibility: VA says enrolled veterans are eligible if they meet the clinical need and the program is available, and it is only offered in certain locations. A copay may apply. Ask your VA social worker.8

VA Aid and Attendance Pension

Who is paid: The veteran or surviving spouse receives the pension, not the caregiver. A family that wants to pay a relative from it does so through its own private arrangement. VA's rules say a relative or another household member providing the aid and attendance does not prevent VA from granting the allowance.13

2026 benefit maximums (Maximum Annual Pension Rate, effective Dec 1, 2025 through Nov 30, 2026). VA publishes these as yearly amounts. Each is the maximum amount of pension payable, and VA bases the payment on the difference between the veteran's or survivor's income for VA purposes and that limit, so most households receive less than the full figure:6

• Single veteran with Aid and Attendance: up to $29,093/year
• Veteran with one dependent: up to $34,488/year
• Two veterans married to each other who both qualify for Aid and Attendance: up to $46,143/year
• Surviving spouse with Aid and Attendance: up to $18,697/year
• Each additional dependent adds $2,984/year

Net worth limit (2026): $163,699. The calculation counts your and your dependents' assets and income for VA purposes; assets exclude the primary residence, the car, and basic home items.6

Eligibility: Aid and Attendance is added to a monthly VA pension, so the veteran must qualify for VA pension and meet at least 1 Aid and Attendance requirement. For service, the veteran needs at least 1 day during wartime plus a minimum period of active duty: at least 90 days for someone who started before September 8, 1980, and, with some exceptions, at least 24 months or the full period ordered for an enlisted person who started after September 7, 1980 (VA lists a separate rule for officers who started after October 16, 1981). VA pension also requires no dishonorable discharge, at least one of these (age 65 or older, a permanent and total disability, a nursing-home stay for long-term care because of a disability, or SSDI or SSI), and income and net worth within VA's limits. The Aid and Attendance requirements are needing another person to help with daily activities like bathing, feeding, and dressing; having to stay in bed, or spend a large portion of the day in bed, because of illness; being a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or eyesight limited to 5/200 or less in both eyes, or a visual field of 5 degrees or less, even with glasses or contacts.13

Surviving spouses should confirm Survivors Pension eligibility with VA or an Arkansas Veterans Service Officer.

36-month look-back: VA pension is subject to a 36-month look-back on asset transfers for less than fair market value made on or after October 18, 2018, under 38 CFR 3.276.6

Apply: Through va.gov/pension/aid-attendance-housebound or with your county Veterans Service Officer. The Arkansas Department of Veterans Affairs and county Veterans Service Offices provide their services without charge, and VA says an accredited VSO's help on a claim is always free, while an accredited attorney or claims agent can charge fees.14

Private Caregiver Agreement (Personal Services Contract)

A written caregiver agreement formalizes payment of a family member from private funds.

The look-back issue: Arkansas Medicaid looks back 60 months from the date of a nursing facility or waiver application. A transfer for less than fair market value in that window is presumed to have been made to qualify for Medicaid, a presumption the applicant can rebut, and it leads to months of ineligibility for nursing facility payment or waiver services, with no cap on the number of months.7 Federal law exempts transfers to a spouse from that penalty.15 Arkansas excepts a transfer made at fair market value or for other valuable consideration, but the applicant must present convincing evidence and documents, so put the agreement in writing at a fair market rate before payments start.7

What to ask an elder-law attorney to put in the agreement:

• A start date, signed before services begin
• Specific services and a weekly schedule
• A reasonable, customary hourly rate documented against local market rates
• Payment terms and method
• Daily caregiver logs of hours and tasks

Best for: Families with private assets paying an adult child or other relative who want documentation in place before the person receiving care applies for Medicaid.

Which Pathway Pays the Most?

How to Choose Your Arkansas Pathway

1. Medicaid-eligible, not a veteran? Start with the Arkansas Choices in Living Resource Center at choicesinliving.ar.gov and ask about self-direction through Independent Choices. An adult child or other relative can be the paid personal assistant; a spouse, guardian, power of attorney, or income payee cannot.3 Remember that ARChoices requires the age or disability test, the financial criteria, and the nursing home level of care criteria together.

2. Caring for a veteran? The PCAFC stipend can come with CHAMPVA access for a caregiver without other health coverage, and it accepts a spouse as the Family Caregiver.4 Contact the VA Caregiver Support Coordinator at your VA medical center.

3. Want to hire a family member or friend through VA? VA Veteran-Directed Care, where it is offered, gives the veteran a flexible budget to hire their own aides, including family members.8

4. Have private assets and concerned about Medicaid later? Work with an Arkansas elder-law attorney to draft a caregiver agreement before any payments to a relative begin. Arkansas Medicaid looks back 60 months when someone applies for nursing facility or waiver care.7

5. Both a veteran family and ARChoices-eligible? See the last FAQ below, and talk to both programs before combining them.

Is Caregiver Pay Taxable in Arkansas?

• Independent Choices personal assistant wages: the Financial Management Service vendor withholds and files federal, state, local, and unemployment taxes for the participant.9 Confirm how the pay is treated on your own return with a tax preparer.
• VA PCAFC stipend: VA treats it as non-taxable, and for that reason it earns no Social Security retirement credits.5 For SSI, Social Security counts it as unearned income.16
• VA Veteran-Directed Care wages run through the financial management services provider, which in ACL's model program handbook issues W-2 forms and pays payroll taxes on the veteran's behalf.12
• VA Aid and Attendance is a VA pension benefit, and federal law exempts VA benefit payments from taxation.17
• Private caregiver agreement pay is the caregiver's income. The IRS says in-home caregivers are typically employees of the people they care for, and one who is not still reports the pay and may owe self-employment tax.18

IRS Notice 2014-7: The IRS treats qualified payments under a section 1915(c) Medicaid waiver as excludable from the caregiver's federal gross income, but only for care given in the caregiver's own home, where the person receiving care also lives; it does not apply when the caregiver has a separate home.19 Independent Choices runs under section 1915(j) rather than a 1915(c) waiver, and the IRS says whether it treats payments under a program other than a Medicaid waiver as excludable depends on the program's nature and design.19 Confirm with a tax preparer familiar with the rule before filing.

Common Misconceptions

"Anyone 65 or older qualifies for ARChoices." Age is only one of three requirements. An applicant must also meet established financial criteria and the nursing home admission level of care criteria.1 And even when someone qualifies, Medicaid will not pay their spouse to be the caregiver.2

"Medicare pays family caregivers." Medicare covers part-time or intermittent skilled home health care from a Medicare-certified home health agency for homebound beneficiaries. It does not pay for 24-hour care at home, or for help with bathing, dressing, or using the bathroom when that is the only care the person needs.20 Family caregiver pay comes from Medicaid, the VA, or private arrangements.

"I can start paying myself from my parent's savings and document it later." Arkansas presumes that a transfer for less than fair market value during the 60-month look-back was made to qualify for Medicaid, and it is up to the applicant to rebut that.7 Put the agreement in writing before payments begin rather than trying to reconstruct it afterward.

"VA Aid and Attendance is only for combat veterans." VA's service test asks for at least 1 day during a wartime period, not combat; its Vietnam War era even covers veterans who served outside the Republic of Vietnam.13

Learn More

Find personalized help navigating Arkansas paid family caregiver options 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.