Caregiver Programs in Delaware: Paid, Respite & Support (2026)

Delaware has real programs that can pay a family caregiver, help cover respite, and add VA support for veterans' families. Delaware Medicaid's Diamond State Health Plan Plus covers consumer-directed attendant care, and a participant who elects to self-direct it has choice and control over who provides the service.1

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

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

• Delaware Caregiver Programs at a Glance
• Who Pays Family Caregivers in Delaware?
• How to Start Paid Caregiver Support in Delaware
• Where to Get Respite Help in Delaware
• Where to Get Help
• VA Caregiver Benefits in Delaware
• Taxes for Delaware Caregivers
• Frequently Asked Questions
• Learn More

Delaware Caregiver Programs at a Glance

Who Pays Family Caregivers in Delaware?

If you are already doing the hands-on work of bathing, dressing, or supervising a loved one, Delaware Medicaid may cover attendant care for your loved one. The state delivers its long-term care through Diamond State Health Plan-Plus (DSHP+), a mandatory managed care Medicaid program that provides long-term care services and supports for Delaware residents who are elderly or physically disabled, and its benefits include consumer-directed attendant care. CMS's approved terms for Delaware's demonstration, which run through December 31, 2028, let a participant elect to self-direct Personal Care/Attendant Care, with choice and control over who provides the service. Delaware's Division of Medicaid and Medical Assistance (DMMA) developed DSHP+ in partnership with the state's Division of Services for Aging and Adults with Physical Disabilities (DSAAPD).1

Those terms set one limit on who may be paid: a person who serves as the participant's representative for directing DSHP+ home and community-based services cannot also serve as the provider of those services for that participant.1 Beyond that, Delaware Medicaid's managed care contract says members who self-direct have the flexibility to hire someone with whom they have a close personal relationship, such as a neighbor, friend, or family member, as the attendant, so an adult child can be hired. Neither the contract nor CMS's terms say whether a spouse may be paid as the attendant. Confirm that with the Delaware Aging and Disability Resource Center (ADRC) at 1-800-223-9074 before you count on that income.2

Delaware also runs a separate, state-funded Attendant Services Program through DSAAPD under the Community-Based Attendant Services Act (16 Del. C. ch. 94), outside Medicaid. The law makes the program primarily participant-directed: the participant has the option to hire, supervise, authorize payment to, and dismiss attendants, and may act through a guardian or appointed representative. To qualify, a person must be 18 or older, have a disability, and meet financial and functional eligibility.10 The cited state sources do not say whether a family member, a spouse, or a relative who lives with the participant may be the paid attendant, and they state no hours cap, so ask about the Attendant Services Program when you call the ADRC at 1-800-223-9074.10,1 Within available funds, the law directs the state to set an income-based sliding fee schedule for attendant services.10

Qualifying for this Medicaid-covered care rests on two tests, both applied to the person receiving care. The first is a medical need: DMMA's Pre-Admission Screening (PAS) unit must find that the person needs a nursing-facility level of care.11 The second is financial eligibility for long-term-care Medicaid: for nursing facility and waiver applicants, Delaware's income limit is 250 percent of the SSI standard, which the state publishes as $2,485 a month for a single applicant in 2026, and assets cannot exceed $2,000 for an applicant who has no spouse. An applicant over the income limit can still qualify by setting up a qualified income trust, often called a Miller trust, and Delaware applies a 60-month look-back on transfers made for less than fair market value.12

If your loved one does not qualify for long-term-care Medicaid and is not a veteran, you are not out of options. The NFCSP support below does not depend on Medicaid status.3 The ADRC can help you understand available services, explore care options, and connect with local programs and support groups.4 For more on paid family caregiving in Delaware, see How to Get Paid as a Family Caregiver in Delaware.

How to Start Paid Caregiver Support in Delaware

Getting your loved one into Medicaid-covered attendant care feels bureaucratic from the outside, but it comes down to four steps, and the last one is confirming whether a family member can be the paid attendant.

Where to Get Respite Help in Delaware

Caregiving without a break is how burnout starts, and respite exists precisely because no one can be on call around the clock indefinitely. Help with it does not depend on whether your loved one is on Medicaid.

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, makes grants to states, and its services are provided by an area agency on aging or an agency it contracts with. They include information about available services, help gaining access to them, individual counseling, support groups and caregiver training, respite care, and limited supplemental services. Because NFCSP is a caregiver-support grant program separate from Medicaid, you qualify based on the caregiving relationship (caring for an adult 60 or older, or a person of any age with Alzheimer's or a related dementia) rather than on your loved one's Medicaid status. NFCSP-funded respite carries one more federal condition: the older person you care for must be frail, meaning unable to perform at least two activities of daily living without substantial help, or needing substantial supervision because a cognitive or other mental impairment creates a serious health or safety hazard.3

Delaware's Lifespan Respite Program lets eligible caregivers apply for respite vouchers to help cover the cost; you may qualify if you care for an older adult, a child or adult with disabilities, or, at 55 or older, a relative's child. Call the Delaware ADRC at 1-800-223-9074, Delaware's first call for caregiver services.4

If your loved one is enrolled in DSHP-Plus, respite care is also among its listed benefits.9 For the full respite guide, see Respite Care in Delaware.

Where to Get Help

You do not need to know which program you qualify for before you call. The ADRC helps families get answers about eligibility, benefits, and how to apply.9 These are the front doors.

VA Caregiver Benefits in Delaware

If the person you care for is a veteran enrolled in VA health care, a separate set of VA benefits opens up. VA says a veteran and caregiver may take part in more than one in-home care program, but PCAFC carries a limit: the personal care the Family Caregiver would provide cannot be simultaneously and regularly provided by or through another person or program, and VA will revoke the caregiver's designation if the veteran no longer meets that requirement. Before a Delaware Medicaid program pays for that same personal care, ask your local VA Caregiver Support Program team how the two fit together.13

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. VA called the stipend a nontaxable benefit when it proposed the current rules in 2020, and it allows paid spouses. VA's first screen has four conditions, and all must be true for the veteran: a VA disability rating of 70 percent or higher, discharge from the 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. Those four are necessary but not sufficient: the veteran and caregiver apply together, and the regulation adds further conditions VA checks, including that the same personal care is not already being regularly provided by another person or program. After approval, the caregiver must enroll in direct deposit through VA's customer engagement portal to get the stipend. The amount starts from the federal General Schedule (GS) grade 4, step 1 annual rate for the veteran's locality, divided by 12, so the base depends on the locality pay area where the veteran lives.5

That monthly base is then multiplied by one of three factors (1.00, 0.625, or 0.25) set in 38 CFR 71.40(c)(4)(i), and which one applies depends on how the household came into the program. Under the current program (38 CFR 71.20(a)) the factor is 0.625, or 1.00 when the VA determines the veteran is "unable to self-sustain in the community." For a legacy participant or legacy applicant (38 CFR 71.20(b) or (c)), meaning a household carried over from the program as it stood before October 2020, the factor comes from the sum of the veteran's 2019 clinical ratings instead: 1.00 for a sum of 21 or higher, 0.625 for 13 to 20, and 0.25 for 1 to 12. No self-sustain determination is required on that route, so a legacy household rated 21 or higher reaches the full 1.00 on the rating sum alone.5

A veteran who meets both routes is paid whichever of the two amounts is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible to receive the day before October 1, 2020, as long as the veteran stays at the address the VA has on record. The legacy schedule runs eight years from October 1, 2020 and lapses October 1, 2028. If you are not sure which route your household is on, ask your VA Caregiver Support Coordinator before you assume the lower number.5

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who already qualify for a VA pension, meet at least one of VA's listed Aid and Attendance tests (such as needing another person's help with daily activities like bathing, feeding, and dressing), and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension.5,7 VA publishes these as annual ceilings, not flat payments: a single veteran can receive up to $29,093 a year; a veteran with one dependent up to $34,488 a year. VA pays the difference between countable income and the ceiling, so income lowers what a veteran receives. The pension is paid to the veteran, not to the caregiver.7

Accredited Veteran Service Officers at the Delaware Office of Veterans Services (302-739-2792) help veterans apply for federal and state benefits, including pension, and an accredited VSO representative never charges for claims services.14

Taxes for Delaware Caregivers

Once you are being paid to provide care, the natural next question is how that income is taxed, and the rules confuse almost everyone the first time through. The good news is that they are often more favorable than families expect.

IRS Notice 2014-7

If you live in the same home as the person you care for and are paid through a Medicaid waiver program, your pay may be excluded from federal gross income under IRS Notice 2014-7. The home test turns on where you actually live, not who owns the house: a caregiver who moved into a parent's home and has no separate home qualifies, while one who keeps a separate home to return to does not. The exclusion does not reach payments made directly from the care recipient's own private funds. If you're paid through a Medicaid program that isn't a waiver, the IRS says the answer depends on the nature of the payments and the purpose and design of the program, and Delaware delivers DSHP-Plus attendant care under its Section 1115 demonstration, so don't assume the exclusion applies or doesn't.8,9 Talk to a tax preparer familiar with the rule before filing, and see whether Medicaid caregiver payments are taxable.

Delaware State Income Tax

This guide's sources do not say how Delaware's state income tax treats caregiver pay from a Medicaid program. Confirm the current treatment of caregiver wages with the Delaware Division of Revenue or a tax preparer before you file.

VA PCAFC Stipend

VA called the PCAFC monthly stipend "a nontaxable benefit" when it proposed the current program rules in 2020.5

Learn More

Find personalized help navigating Delaware 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.