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

If you're caring for an aging parent or disabled relative and wondering how to get paid as a family caregiver in California, the answer depends on which program fits your family. Beyond IHSS, several pathways let a California family caregiver be paid or compensated in 2026. Between In-Home Supportive Services (IHSS), the Self-Determination Program, VA caregiver pathways, California Paid Family Leave, and the network of 11 nonprofit Caregiver Resource Centers, there may be more than one door to try.

But more options don't make the system easier to work through. The eight pathways below run through several different agencies, and each has its own eligibility test, its own pay structure, and its own application. Some pay you to be a caregiver outright. Some replace your wages while you take time off work. Some help pay for respite. Some are tax exclusions that can lower what you owe.

This guide maps eight California pathways in 2026, who qualifies, what it actually pays, and how the pieces stack together.

How to Get Paid as a Family Caregiver in California: The Eight Pathways

Here are eight pathways through which a California family caregiver can be paid or compensated in 2026:

On top of these eight payment pathways, California's 11 nonprofit Caregiver Resource Centers serve family caregivers of adults affected by chronic and debilitating health conditions or neurocognitive disorders. They provide services at low or no cost, including financial help with respite.3,10

The remainder of this guide walks each pathway in detail, then closes with the cross-cutting tax exclusions, common pitfalls, and a phone reference.

1. IHSS, The Backbone of California Paid Family Caregiving

IHSS is primarily delivered as a Medi-Cal benefit, with an estimated 771,650 recipients projected for fiscal year 2025-26 and approximately $28.5 billion in total funding (about $10.6 billion General Fund) in the Governor's budget. If your loved one has Medi-Cal, start here.1

We've published a dedicated deep dive at /medicaid/california/ihss. The summary version:

Who can be paid through IHSS: CDSS says an approved recipient must hire their own individual provider and is that provider's employer. Family members can fill that role, including spouses for some services (state law lets an able and available spouse be paid for personal care and paramedical services, DHCS says the IHSS Plus Program pays enrolled providers including spouses, and the PCSP sub-program bars spouse providers) and parents of minor IHSS recipients (under AB 120, Chapter 43, Statutes of 2023, in the CFCO, IPO, and IHSS-R sub-programs but not PCSP). A minor in those three sub-programs may hire any provider that successfully completes provider enrollment.1

2026 wages: "All provider rates are set by individual counties," CDSS says, and they vary because "unions negotiate with the employer of record in each county." The LAO attributes IHSS wage growth in part to increases in California's statewide minimum wage, which rose to $16.90/hour on January 1, 2026, and estimates IHSS wages averaged $18.66 an hour as of January 2025. The LAO also reports that the Governor's budget estimates the cost per hour of IHSS services at $21.65 in 2025-26, a figure that covers other provider benefits and administrative costs as well as wages, so it is not an average hourly wage. See the IHSS guide for the current county rates.1

Hours: California Welfare and Institutions Code §12303.4 sets monthly maximums: services generally may not exceed 195 hours/month, and a recipient the county finds needs at least 20 hours a week of the services defined in §12304 may receive up to 283 hours/month. These are ceilings, not an entitlement. A county social worker assesses your loved one's needs in the home, and that assessment decides how many hours are actually authorized, up to the cap that applies. Ask for the result in writing.1

How to apply: Contact your county IHSS office to apply. Before services are authorized, the county must receive a completed Health Care Certification (SOC 873). A county social worker assesses your loved one's needs in the home to determine the amount and type of service hours. Ask your county IHSS office for the current application packet.1

Provider enrollment (the caregiver): the provider must complete IHSS provider enrollment; ask your county IHSS office who handles provider enrollment in your county. Federal law, the 21st Century Cures Act, requires states to use Electronic Visit Verification (EVV) for Medicaid personal care services that require an in-home visit by a provider.1

Tax treatment: IRS Notice 2014-7 is written for Medicaid waiver payments. For IHSS, CDSS says a 2016 IRS ruling excludes wages received by a provider who lives in the same home as the recipient from gross income for federal income tax. Self-certify on SOC 2298, which covers federal and state income tax but not FICA and Medicare.1 CDSS says the IRS ruling it received for live-in IHSS providers applies to state income tax as well.6

For the full IHSS walkthrough, including spouse and parent providers, county-set wages, application step-by-step, hours allocation, the in-home assessment, and the live-in income tax exclusion, see our dedicated guide at /medicaid/california/ihss.

2. WPCS, Waiver Personal Care Services

Waiver Personal Care Services (WPCS) is a second program that pays individual providers, and CDSS treats its live-in providers the same way as IHSS live-in providers for income tax. Under IRS Notice 2014-7, CDSS says, wages received by WPCS providers who live with the recipient are not part of gross income for federal income tax, and live-in WPCS providers claim that with the same SOC 2298 form IHSS providers use.6

IHSS hours have monthly maximums under state law (see section 1). Whether hours from another program, such as a home- and community-based services waiver, can be added on top of them is not something our sources state.1 Our sources also do not describe who qualifies for WPCS, who may be the WPCS provider, or how WPCS hours are set.

How to ask: If your loved one is enrolled in a Medi-Cal HCBS waiver, such as HCBA, ALW or MSSP, and their IHSS hours fall short of their need, ask the county IHSS office, in writing, whether WPCS hours are available on top of IHSS and who may be paid to provide them. See our HCBS waivers guide for how waiver enrollment works.

3. The Self-Determination Program, for the IDD Population

For Californians with intellectual or developmental disabilities (IDD), the Self-Determination Program (SDP) provides a separate paid-caregiver pathway. SDP is run by the Department of Developmental Services (DDS), which says it gives individuals and families more freedom, control, and responsibility in choosing their services, and that since July 1, 2021 it has been open to every eligible person served by a regional center. Medi-Cal counts it among California's §1915(c) home- and community-based services waivers.3,2

How SDP works for the family caregiver: DDS says SDP gives individuals and their families "more freedom, control, and responsibility in choosing services and supports to help them meet objectives in their Individual Program Plan."3 On who can be paid, DDS's SDP FAQ says a legally responsible person, generally a participant's spouse or the parents of a minor child, cannot be paid to provide services they would usually perform or be responsible for performing, and SDP respite cannot be provided by the primary care provider or that person's spouse. DDS also says a parent who is the conservator of an adult consumer, or holds a durable power of attorney for one, may be paid to provide SDP services, and it refers to family members who live in the participant's home and are paid to provide direct personal care.11 Our sources do not say how the SDP budget is set or who runs payroll, so ask the regional center service coordinator, in writing, whether the relative you have in mind can be the paid provider for your loved one's specific services before you plan around it.

How to apply: SDP enrollment runs through the participant's Regional Center. Ask the regional center service coordinator about enrollment and any orientation it requires; our HCBS waivers guide covers the waiver side.

4. VA Aid & Attendance Pension

If your care recipient is a wartime veteran or a surviving spouse of one, look at the VA Aid & Attendance (A&A) Pension. A&A adds monthly payments to a VA pension, and a veteran or survivor who gets that pension may be eligible if they meet at least one of VA's requirements: they need another person's help with daily activities, have to stay in bed because of illness, are in a nursing home because of a disability, or have severely limited eyesight.12

2026 Maximum Annual Pension Rates (effective 12/1/2025 to 11/30/2026, after a 2.8% COLA):3,8

These are ceilings, not guaranteed payments: VA pays the difference between countable income and the MAPR, so a veteran or spouse with income receives less than the full rate. VA publishes these as annual amounts; pension is paid monthly. Countable income is not the same as gross income: VA says some expenses, like non-reimbursable medical expenses, may reduce your income for VA purposes, which matters when you are already paying for care.8 A surviving spouse with one dependent child has a higher A&A rate, $22,304/yr.8

Eligibility requirements:

• Service: for a veteran who started active duty before September 8, 1980, at least 90 days of active duty with at least 1 day during wartime; for an enlisted veteran who started after September 7, 1980, generally at least 24 months or the full period called to active duty, with at least 1 day during wartime12
• Discharge and age or disability: no dishonorable discharge, plus at least one of: age 65 or older, a permanent and total disability, a nursing-home patient for long-term care because of a disability, or receiving SSDI or SSI12
• Functional need (38 C.F.R. §3.352): needing help with daily activities, having to stay in bed because of illness, being in a nursing home because of a disability, or severely limited eyesight12
• Means test: the net worth limit from December 1, 2025 to November 30, 2026 is $163,699. It counts assets and income for VA purposes, but assets do not include the primary residence, the car, or basic home items like appliances. VA also reviews asset transfers made in the 36 months before it receives the pension claim, under 38 C.F.R. §3.276, and can assess a penalty period of up to 5 years.3,8,12

How A&A can reach a family caregiver: VA says Aid and Attendance provides monthly payments added to the amount of a monthly VA pension for qualified Veterans and survivors.3 So the money goes to the veteran or survivor, not to a caregiver. A relative or other household member providing the care does not stop VA from granting the A&A allowance, under 38 C.F.R. §3.352(c).12 If the veteran pays a family caregiver from that income, put the arrangement in a written caregiver agreement (see section 8). We do not have a VA source on how such payments are treated, so ask a CVSO before you set one up.

How to apply:

CalVet's toll-free line: 1-800-952-5626.13

5. VA Veteran-Directed Care (VDC)

The Veteran-Directed Care program is a VA program that, in VA's words, lets veterans of all ages receive home and community services "in a consumer-directed way." The Administration for Community Living (ACL) developed it with VA's Veterans Health Administration (VHA) in 2008.4 VA medical centers deliver it through local aging and disability network agencies.9

How VDC works: The veteran gets a flexible monthly budget, sized from their own needs for help with daily activities, and uses it to hire their own workers, who can include family members, friends, or neighbors. The veteran or a representative such as a family member manages it. A Financial Management Services (FMS) provider acts as payroll agent, handling timesheets, payroll, and taxes, and everyone who self-directs in VDC must use it.9 On eligibility, VA says VDC is part of its standard medical benefits package, so any veteran enrolled in VA health care can take part if they meet the clinical need for the service and the program is available where they live.4

Important caveat: VA says VDC "is only available in certain locations," and ACL tells veterans to find out if a VA Medical Center near them offers it.4 Ask your VA social worker whether it is offered where you live before planning around it. If VDC is not offered near you, PCAFC (section 6) is a separate program with its own eligibility rules.

How to enroll: The veteran must already be enrolled in VA health care. VA tells a veteran who thinks VDC may be right for them to talk with their VA social worker and find out whether it is available in their location. VA also says a copay for VDC services may be charged, based on the veteran's service-connected disability status.4 A veteran cannot hire anyone until the spending plan and budget are approved and background checks on that person are complete.9

6. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

For California families caring for a veteran with a serious service-connected injury, the Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays the approved Primary Family Caregiver directly. Its rules are in 38 C.F.R. Part 71 (§§71.15, 71.20 and 71.40).5

What PCAFC provides to the Primary Family Caregiver:

• A monthly stipend, which VA has described as nontaxable. In the preamble to its March 2020 proposed PCAFC rule, VA called the stipend "a nontaxable benefit"; ask a tax professional how that applies to you.5 VA starts from the federal Office of Personnel Management (OPM) General Schedule grade-4, step-1 annual rate for the veteran's locality and divides it by 12. That is a monthly figure, not an hourly wage. It then applies a multiplier, and the multiplier is not a single number: 38 C.F.R. §71.40(c)(4)(i) sets five rungs using three multipliers (0.625, 1.00 and 0.25), and which one applies turns first on whether the veteran is in the current program or is a legacy participant or legacy applicant.3,5
• CHAMPVA health coverage for the Primary Family Caregiver, unless the caregiver is entitled to care or services under a health-plan contract3
• Respite care of at least 30 days per year, more if clinically appropriate and requested, including in-home care3
• Counseling and training. The regulation's counseling covers individual and group therapy, individual counseling and peer support groups; it does not include medication, inpatient psychiatric care, or other medical procedures related to mental health treatment. The regulation also provides continuing instruction, preparation and training.3

How VA Picks the PCAFC Stipend Multiplier

Getting this wrong in either direction costs money. Here is what the regulation actually says.

Two further rules are worth raising with the Coordinator. First, a legacy participant under §71.20(b) has a floor: the stipend is not less than what the caregiver was eligible to receive the day before October 1, 2020, so long as the veteran still resides at the address on record with PCAFC on that date. Second, the legacy schedule is time-boxed. The regulation runs it "for eight years beginning on October 1, 2020," so it lapses October 1, 2028, after which only the current-program multipliers remain and a legacy household's amount can change.5

Eligibility: VA's first screen has four requirements, and the veteran must meet all of them: a VA disability rating (individual or combined) of 70% or higher; a discharge from the military or a date of medical discharge; a need for at least six months of continuous, in-person personal care services; and enrollment in VA health care. Meeting those four is necessary but not enough. The regulation adds further conditions VA weighs during the application, including that the same personal care is not already being provided regularly by another person or program. Service era is no longer a barrier: since October 1, 2022, the regulation's service periods together cover service on any date.5

Important distinctions:

• PCAFC is not paid to the veteran. Unlike A&A, the PCAFC stipend is paid directly to the designated Primary Family Caregiver.5
• PCAFC is restricted to veterans with a serious injury. The regulation defines a serious injury as a service-connected disability rated, alone or combined, at 70% or more, so a veteran without a service-connected disability, or with a lower rating, does not meet that requirement.5
• Whether PCAFC can run alongside A&A or VDC is a case-by-case question. The three programs have separate authorities and separate payees, but we do not have a VA source stating that all three may be received at once, so ask the VAMC's Caregiver Support Coordinator about your specific combination rather than assuming they stack.

How to apply:

VA Caregiver Support Line: 1-855-260-3274, Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Time (5:00 a.m. to 5:00 p.m. Pacific). It is not staffed at weekends and is not a crisis line; anyone in crisis can call 988 and press 1, any hour of any day.16

7. California Paid Family Leave (PFL)

If you are employed and need to take time off work to care for a seriously ill family member, California Paid Family Leave (PFL) is the wage-replacement benefit you'll use. PFL is administered by the California Employment Development Department (EDD).3

PFL is not a paid-caregiver program. It does not pay you to be a long-term caregiver. It is short-term wage replacement for up to 8 weeks in a 12-month period while you take time off work to care for a seriously ill family member.3

2026 PFL Benefit Rates

EDD's current figures:

• Weekly benefit range: a minimum of $50 and a maximum of $1,765/week
• Maximum benefit duration: 8 weeks in a 12-month period
• Wage replacement rate: about 70% to 90% of the wages you earned 5 to 18 months before your claim start date, depending on income. EDD's table pays 90% of weekly wages where your highest-quarter earnings are $722.50 to $16,279.90, and 70% of weekly wages, up to the $1,765 maximum, where they are above $20,931.31.3

Who You Can Care For, and How to Claim

EDD describes PFL as covering time off to "care for a seriously ill family member."3 Our sources do not carry EDD's full family-member definition or its claim form and filing deadline, so check all three on EDD's Paid Family Leave page before you file, especially if the person you care for is an in-law, a grandparent, a sibling, or not a relative at all. The same page lists EDD's current PFL phone lines, including Spanish and TTY.

PFL Pitfall: Wage Replacement, Not Job Protection

PFL replaces a portion of your wages. EDD says PFL "provides benefit payments but not job protection," and that other laws such as FMLA or the California Family Rights Act (CFRA) may protect your job.3 To keep your job during a leave, check whether you qualify under:

• Federal FMLA: see the U.S. Department of Labor's FMLA page for which employers and employees it covers.
• California Family Rights Act (CFRA): see the California Civil Rights Department for which employers, employees and family members it covers.

Our sources do not carry either law's eligibility thresholds, so confirm your own coverage with your employer's HR office in writing before you take leave.

Self-Employed? Check Your Coverage First

If you are self-employed, an independent contractor or a gig worker, do not assume PFL covers you. Our sources do not carry EDD's rules for self-employed coverage, so ask EDD whether and how you can be covered before you plan around PFL.

8. Private Caregiver Agreements

For families whose loved one has assets above Medi-Cal limits or whose loved one prefers to pay privately, a written caregiver agreement between the care recipient and the family caregiver puts the arrangement on paper. It does three jobs:

1. Clear documentation of fair-market wages, pay rates, hours, services performed
2. Tax questions, which a written record helps a tax preparer answer. IRS Notice 2014-7 is written for payments under a §1915(c) Medicaid waiver, so do not assume it covers private pay.3
3. Future Medi-Cal eligibility planning, where California's look-back is shorter than the federal one but is also mid-transition17

How California's Look-Back Rules Affect a Caregiver Agreement

The federal Medicaid look-back is 60 months under 42 U.S.C. §1396p(c)(1)(B)(i). California's look-back rules are different and currently in transition. Under AB 116 (Ch. 21, Stats. 2025) and DHCS ACWDL 25-18, transfers made between January 1, 2024 and December 31, 2025 are not reviewed in the look-back, because the asset test did not apply during those months. Since July 1, 2026, the number of months reviewed has grown by one each month, and will keep growing until California's full look-back applies (a maximum of 30 months, not the federal 60), reaching full effect for long-term-care applications on or after July 1, 2028.17

Read the penalty rule precisely, because it is narrower than it is usually described. DHCS ACWDL 25-18 says the look-back review happens "When applying for Medi-Cal or entering an LTC facility," calls the resulting penalty a "period of ineligibility (POI) for nursing facility level-of-care," and states that "[t]he POI does not apply to Medi-Cal members enrolled in community-based Medi-Cal programs." That tells you whom the nursing-facility penalty reaches. It is not a statement that an HCBS waiver applicant escapes the look-back, and you should not treat a transfer as consequence-free on the HCBS side. We cover the mechanics in our HCBS waivers guide and long-term care guide.7

Practical consequence: A senior who pays a family caregiver a lump sum for past care, with nothing in writing, may see that payment reviewed as a transfer if she later needs nursing-facility Medi-Cal. DHCS presumes that assets transferred by someone in long-term care were transferred to establish eligibility, though evidence that the transfer was made for another reason can rebut that, and every case must be reviewed for undue hardship before a period of ineligibility is imposed.17 Whether that same transfer affects a later HCBA, ALW, MSSP, Self-Determination Program, IHSS, CBAS, or PACE application is the question to put to your county eligibility worker before any money moves, in writing if you can get it. Do not plan a transfer on the assumption that the community-side programs disregard it.

One further timing note for anyone weighing PACE: DHCS Policy Letter 25-02 paused the PACE application process effective November 20, 2025, "until November 19, 2027, at minimum or until otherwise notified through a superseding PL."7

Best Practices for Caregiver Agreements

• Written and dated before services begin. Then you have a record to show the county if a payment is ever questioned.
• Fair-market wages. Document the hourly rate, hours per week, and services performed. The IHSS provider rate your county sets is one useful benchmark.1 If the caregiver lives in, see our guides to paying a live-in caregiver in California and to workers' comp and liability for a paid family caregiver.
• Ask a tax preparer how the pay must be reported. Whether a family caregiver is a household employee or an independent contractor, and which payroll filings follow, is a question our sources do not answer; get professional advice before the first payment.
• Engage an elder-law attorney before any money changes hands.

The Live-In Tax Exclusion: IRS Notice 2014-7 + SOC 2298

If you are an IHSS provider, including a paid spouse, paid parent, or any other family member, and you live with the recipient, a benefit worth checking isn't a paycheck at all. It's a tax exclusion.

IRS Notice 2014-7 treats qualified Medicaid waiver payments for care in the provider's own home, where the care recipient lives, as "difficulty of care" payments excludable from gross income under section 131 of the Internal Revenue Code.3 For IHSS, CDSS says it received a ruling from the IRS on March 1, 2016 that wages of IHSS providers who live in the same home as the recipient are also excluded from federal gross income, and that the ruling applies to state income tax as well.6 If you are paid through a program other than IHSS, read the notice's scope carefully: the IRS wrote it for payments under a state Medicaid HCBS waiver program described in section 1915(c), and for any other state program it says the treatment "will depend on the nature of the payments and the purpose and design of the program."3

For California IHSS and WPCS, the implementation is Form SOC 2298, Live-In Self-Certification, filed on paper or through the IHSS Electronic Services Portal. CDSS says:6

• Your wages stay taxable until the form is processed, which may take up to 30 days from receipt, so file it early.
• You don't re-certify each year while you keep working for, and living with, the same recipient. Live with and work for more than one recipient, and you file a separate form for each.
• If the recipient no longer lives with you, file the cancellation form, SOC 2299.
• SOC 2298 covers federal and state income tax only, not Social Security, FICA or Medicare; CDSS says non-family live-in providers who filed it are still subject to that withholding.6

Live-in test: the IRS says the exclusion "only applies to payments for care in the individual care provider's home where the care recipient lives under the recipient's plan of care." A provider who has a separate home, where they reside and regularly perform the routines of their private life, may not exclude the payments.3 So an adult child providing IHSS in a parent's home qualifies only if that home is genuinely where the child lives, not a place they visit from their own apartment.

What it is worth depends on your situation: your hours, your county's wage and your household income all change the answer, and the exclusion can interact with the rest of your return. Have a tax preparer check how it applies to you before you file.

The Caregiver Resource Centers: Consultation and Respite Help

The 11 nonprofit California Caregiver Resource Centers serve family caregivers of adults affected by chronic and debilitating health conditions or neurocognitive disorders.3

The CRCs provide their services at low or no cost.10

What CRCs Provide

• Family consultation and care planning: help working out a care plan with the family.10
• Counseling, education and support: short-term counseling, education workshops, and support groups.10
• Respite care: financial assistance for temporary in-home support, adult day care services, short-term or weekend care, and transportation.10

Ask your center what other services it offers and whether your situation qualifies.

The CRC network publishes its own site, caregivercalifornia.org; ask there which center serves your county.3

Common Pitfalls in California Paid Family Caregiving

1. Confusing PFL with IHSS. PFL is wage replacement for time off work to care for a family member. IHSS is paid caregiving as your job. They are different programs run by different agencies, EDD and CDSS. If you might use both, ask EDD how IHSS wages affect a PFL claim.3,1

2. PFL alone provides no job protection. EDD says PFL pays benefits "but not job protection." Before you take leave, check whether FMLA or CFRA protects your job, and get your employer's answer in writing.3

3. Skipping SOC 2298 if you live with the recipient. If you live with the recipient and you don't file SOC 2298, you may be paying federal and state income tax on wages that could be excluded.1,6

4. Adult children claiming the SOC 2298 exclusion without actually moving in. The IRS says a provider who has a separate home, where they reside and regularly perform the routines of their private life, may not exclude the payments. A daughter who "stays over" but keeps her own apartment elsewhere should not claim it.3

5. IHSS needs a Medi-Cal eligibility determination for the care recipient. CDSS lists one among IHSS's requirements, so a senior who does not qualify for Medi-Cal should not plan around IHSS pay. Note that under AB 116, a non-MAGI asset test returned on January 1, 2026 at $130,000 for one person plus $65,000 for each additional household member (so $195,000 for two people), up to a maximum of 10 people. DHCS adds that some married couples and registered domestic partners may have higher limits under its spousal impoverishment rules.1 That limit is temporary. DHCS says the $130,000/$65,000 figures hold "Through June 30, 2027," and that "Starting July 1, 2027, the asset limit is: $21,000 for one person / $31,000 for two people / Add $1,550 for every extra person in your house (up to 10 people)." A family planning around today's higher limit should plan for the 2027 step-down too. That limit is not a tally of everything you own. DHCS lists what stays outside the count: "The home you live in / One vehicle / Household items / Some savings, like retirement accounts," against a counted list of "Bank accounts / Cash / More than one house or vehicle." A homeowner who measures the $130,000 against the value of her house is reading it wrong. And being over the countable limit is not automatically the end of the road: under DHCS ACWDL 25-14, applicants and members with excess property "are permitted time to reduce their assets, referred to as 'spenddown,'" and the Principe v. Belshe settlement lets some who could not reduce in time do it retroactively by applying qualified medical expenses. Ask the county about both before you conclude you are out. Where countable assets genuinely stay above the limit, the fallbacks are VA pension (if eligible), private pay, or LTC insurance. Talk to a California elder-law attorney before moving any assets.18,2

6. Misreading the VA pension means test, in either direction. The net worth limit through November 30, 2026 is $163,699, and it counts income for VA purposes as well as assets, so savings plus income can put a veteran over. But the home, the car and basic home items are not counted, so do not rule yourself out by adding in the house. VA also reviews transfers made in the 36 months before it receives the claim, and can assess a penalty period of up to 5 years. Consult a CVSO before transferring assets.3,8,12

7. Paying a for-profit "VA pension consultant" charging fees. You do not need to pay anyone to file a pension claim. VA says an accredited VSO representative's help on your claim is always free, and California's County Veterans Service Offices help with pension and Aid and Attendance claims. Use them.13

8. Assuming the parent-provider change does not reach your child. Under AB 120 (Chapter 43, Statutes of 2023), implemented by CDSS All-County Letter 23-106, parents can be paid to provide IHSS to their minor children in the CFCO, IPO, and IHSS-R sub-programs; in PCSP they still cannot, and counties should enroll a minor who wishes to hire a parent in one of the other three. If a county worker tells you otherwise, ask them to cite the current rule.1

9. Assuming VDC is offered near you. VA says VDC "is only available in certain locations." Ask your VA social worker whether your VA Medical Center offers it before you plan around it.4

10. Overlooking the reverse-mortgage occupancy rule. A HECM reverse mortgage must be paid off when the last surviving borrower or eligible non-borrowing spouse no longer lives in the home as a principal residence. If the borrower is away for more than 12 consecutive months in a facility such as a nursing home or assisted living, with no co-borrower in the home, anyone living with the borrower must move out unless they can pay back the loan or qualify as an eligible non-borrowing spouse.19 A family caregiver living in the parent's home should know this before the parent moves into care.

11. Assuming every caregiver payment is tax-free. IRS Notice 2014-7 was written for payments under a §1915(c) Medicaid waiver, and only for care in the provider's own home where the recipient lives. IHSS live-in providers rely on a separate 2016 IRS ruling CDSS received and self-certify through SOC 2298 (see the tax section above).1 For payments from other state programs, the IRS says treatment depends "on the nature of the payments and the purpose and design of the program." Pay under a private caregiver agreement is a different question again. Ask a tax preparer before you skip reporting any of it.3

12. A&A is paid to the veteran or survivor, not to the family caregiver. A&A is added to the veteran's (or surviving spouse's) VA pension.3 If the veteran can no longer manage the money, ask VA about its fiduciary program.

Frequently Asked Questions

Can I be paid by IHSS if my husband or wife needs care?

Yes, for some services. California law lets an able spouse be paid for personal care and paramedical services, and DHCS says the IHSS Plus Program pays enrolled providers, including spouses; the PCSP sub-program bars spouse providers.1 See /medicaid/california/ihss for the spousal-provider rules and provider enrollment.

Can I be paid as the IHSS provider for my disabled minor child?

Yes, outside one sub-program. CDSS All-County Letter 23-106 says AB 120 (Chapter 43, Statutes of 2023) removed the old provider eligibility requirements for minor recipients in the CFCO, IPO, and IHSS-R sub-programs, so a parent can be the paid provider there; parents of minors in PCSP still cannot be paid. See /medicaid/california/ihss for the parent-provider walkthrough.1

Does my SOC 2298 Live-In Exclusion also exempt my wages from California state income tax?

Yes, according to CDSS. It says the March 1, 2016 IRS ruling excluding live-in IHSS providers' wages from federal gross income applies to state income tax as well, and that completing SOC 2298 certifies your IHSS or WPCS wages as exempt from federal and state income tax. It does not cover Social Security, FICA or Medicare.6 If your situation is unusual, have a tax preparer confirm how it applies to you before you file.

Does PFL pay me to be a long-term family caregiver?

No. PFL is wage replacement for up to 8 weeks in a 12-month period when you take time off work to care for a seriously ill family member.3 It is not a paid-caregiver salary. For ongoing paid family caregiving, you'll need IHSS, SDP, VA pathways, or a private caregiver agreement. If you are also paid as the recipient's IHSS provider, ask EDD how those wages affect a PFL claim before you plan around both.

Where do I start if my parent has dementia and we don't know what programs apply?

Three calls in this order: (1) the Caregiver Resource Center that serves your county, for family consultation and care planning and help paying for respite, at low or no cost; (2) your county IHSS office to apply for IHSS if your parent is Medi-Cal-eligible or potentially eligible after spend-down; (3) the California Department of Aging to ask about other programs, such as MSSP, which serves Medi-Cal members 60 or older who could be certified for nursing-facility placement and live in a county with an MSSP site.10,7 Do not build the plan around PACE right now: DHCS Policy Letter 25-02 paused the PACE application process effective November 20, 2025, "until November 19, 2027, at minimum or until otherwise notified through a superseding PL."7

The Bottom Line on How to Get Paid as a Family Caregiver in California

1. California offers more than one way to be paid. Eight pathways pay or compensate caregivers, and the Caregiver Resource Centers and the federal live-in tax exclusion can add support on top.

2. If your loved one has Medi-Cal, the answer starts with IHSS. It's primarily delivered as a Medi-Cal benefit, it can pay a spouse for some services, and (since AB 120) a parent of a minor child outside the PCSP sub-program.1

3. If you live with the recipient, file SOC 2298. Under a 2016 IRS ruling CDSS received, IHSS wages paid to a provider who lives in the same home as the recipient may be excluded from federal gross income,1 and CDSS says from state income tax as well.6

4. PFL is a wage-replacement bridge, not a paid-caregiver job. Use it to take up to 8 weeks off work in a 12-month period for an acute caregiving event.3 For ongoing paid caregiving, layer IHSS, SDP, or VA programs.

5. Veterans have separate VA pathways. Aid & Attendance, Veteran-Directed Care, and PCAFC are three distinct programs with three distinct tests; ask a CVSO and the VAMC Caregiver Support Coordinator which combination your family can actually hold at once. Always consult a CVSO, never pay a for-profit pension consultant.

6. Get any asset transfer checked before you make it. California's transfer penalty is written as a period of ineligibility for nursing-facility level of care, and DHCS says it "does not apply to Medi-Cal members enrolled in community-based Medi-Cal programs." That is a narrower statement than "HCBS applicants are exempt from the look-back," and it should not be read as one. Put the specific transfer to your county eligibility worker, and to an elder-law attorney, before any money moves.7

Reference Numbers

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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.