In Washington, DC, Medicaid can pay a family member to give hands-on care, and the District's aging agency offers respite, training, and dementia help for unpaid caregivers.

If you're caring for a parent or a partner in the District, you're probably doing it on top of a job and everything else. The help exists. The hard part is that DC caregiver programs are split between two District agencies with different front doors, and the rules about who can be paid are stricter than most families expect. This page puts it in one place.

In This Guide

DC Caregiver Programs at a Glance

Program What It Offers a Caregiver Who It's For Run By
DC Medicaid State Plan personal care (PCA) A paid aide through a home care agency; a relative who isn't excluded can be that aide DC Medicaid members who need help with daily activities DC Department of Health Care Finance (DHCF)
DC EPD Waiver and Services My Way More personal care hours, respite, and a self-directed option where the member hires the worker DC residents 65+, or 18-64 with a physical disability, who need a nursing-facility level of care DC Department of Health Care Finance (DHCF)
DACL caregiver programs Respite programs, support groups, training, case management, the DC Caregivers Institute Unpaid caregivers of District seniors and adults with disabilities DC Department of Aging and Community Living (DACL)
DACL dementia supports Dementia Navigators and a caregiver support group and lounge District residents living with dementia and their family caregivers DC Department of Aging and Community Living (DACL)
DC Paid Family Leave Partial wage replacement while you care for a family member People who work in DC for a covered private employer DC Department of Employment Services (DOES)
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) stipend A tax-free monthly stipend; a spouse can qualify Primary family caregivers of eligible veterans VA

Which DC Caregiver Programs Pay a Family Member?

For a lot of families this is the question underneath all the others: you're already doing the work, so can any of it be paid? In the District, the answer is often yes, and there are two routes. Neither one is the only way, and which fits depends on how much help your family member needs and how much of the paperwork you want to carry.

Route #1: through a home care agency. DC Medicaid, run by the DC Department of Health Care Finance (DHCF), covers Personal Care Aide (PCA) services under its regular State Plan, and those services run through home health agencies. Under 29 DCMR § 5006.5, an individual or family member other than a spouse, a parent of a minor child, any other legally responsible relative, or a court-appointed guardian may provide DC Medicaid PCA services. In plain terms, an adult daughter or son can be the paid DC Medicaid PCA aide for a parent, but a husband or wife can't. Under the same 29 DCMR § 5006.5, a parent of an adult child is not a legally responsible relative for DC Medicaid PCA services. A relative hired this way works as the agency's aide and still has to meet the District's worker qualifications for DC Medicaid PCA services. Day to day, that means you answer to the agency rather than to your parent, which suits a family that doesn't want to run the employer side itself. Based on a face-to-face assessment by Liberty Healthcare, DHCF can approve up to 8 hours of State Plan PCA services a day.

Route #2: Services My Way, where your family member is the employer. Services My Way is the self-directed option inside the DC EPD Waiver, and under 29 DCMR § 10100.2 it's open only to DC EPD Waiver participants who live in their own home or in the home of a family member or friend. So a parent who has moved in with an adult child in the District can still use Services My Way. In Services My Way, the participant or an authorized representative is the common law employer who recruits, hires, and supervises the Participant-Directed Worker. That's more control over who comes and when, and more paperwork for your family to carry. Under 29 DCMR § 10103.3, Services My Way care may be provided by family members other than the participant's spouse, another legally responsible relative, or a court-appointed guardian, and parents of adult children are not precluded. The participant sets the Services My Way worker's hourly wage within a range DHCF sets, which can't be lower than the District's living wage. A Services My Way worker must be at least 18, pass a criminal background check, and hold current CPR and First Aid certification, among other requirements.

Who qualifies for the EPD Waiver. The DC EPD Waiver is for District residents who would otherwise need nursing-home care and who are 65 or older, or 18 to 64 with a physical disability. An applicant for the DC EPD Waiver needs a Prescription Order Form from a DC Medicaid provider, a Liberty Healthcare assessment, and countable assets of no more than $4,000 for an individual in 2026. DACL's own example of a countable asset for the DC EPD Waiver is a savings or checking account, so a parent with even modest savings can be over the $4,000 line. The District's income standard for its Medicaid waivers is 300% of the Supplemental Security Income (SSI) benefit rate, which is $2,982 a month for an individual in 2026, and DACL says an applicant over the income limit can still qualify by meeting a spend-down., Unlike the State Plan benefit, the EPD Waiver can approve more than 8 hours of PCA services a day. Our guide to how DC Medicaid pays for care at home walks through the application, and our guide to getting paid as a family caregiver in DC takes each route step by step.

Caring for a Spouse in DC

This is the hardest answer on the page, and it's better to hear it now than after months of paperwork. DC Medicaid's home-care rules don't allow a spouse to be the paid caregiver through the agency PCA benefit, Services My Way, or EPD Waiver respite. That doesn't mean you're out of options. If your spouse is a veteran, the VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays an approved primary family caregiver a tax-free monthly stipend, and a spouse can be that caregiver. If you work in the District for a covered employer, DC Paid Family Leave does cover time off to care for a spouse with a serious health condition. Our guide to getting paid to care for your spouse in DC lays out each of these paths, and the national guide covers the rest.

How to Get a Break: Respite in DC

Caregiving without a break wears anyone down, and needing one isn't a failure. The District has two kinds of respite.

Medicaid respite through the EPD Waiver. DHCF describes EPD Waiver respite as temporary relief for a primary caregiver, provided as personal care in the caregiver's absence, hourly or daily, in the place where the participant receives care. The DC EPD Waiver's respite rule, 29 DCMR § 4231.12, lets the waiver participant choose a family member other than the primary caregiver, a spouse, another legally responsible relative, or a court-appointed guardian to provide EPD Waiver respite. Ask the EPD case manager to add respite to the care plan.

Respite and support through DACL. DACL runs programs for unpaid caregivers of District seniors and adults with disabilities, including caregiver respite programs, support groups, educational programs, and case management. One of them is the District of Columbia Caregivers' Institute, which DACL says helps caregivers solve problems, cope with changing situations, and build practical daily skills. DACL's caregiver support, funded under the Older Americans Act, also includes stipends and transportation for eligible caregivers. DACL doesn't publish who counts as an eligible caregiver on those pages, so the quickest way to find out is to call DACL's intake line, listed under Where to Start below. Our guide to finding respite care in DC goes deeper on both, and for the bigger picture, see our guide to respite care for family caregivers.

Help When the Person You Care For Has Dementia

Dementia caregiving has its own kind of exhaustion, and the District has help built for it. DACL's Alzheimer's Disease Supportive Services Program, funded by the federal Administration for Community Living, supports District residents living with dementia and their family caregivers. DACL's Dementia Navigators link older adults with dementia and their family care partners to community resources, teach about dementia, and help manage behavioral symptoms; the provider is IONA Senior Service at (202) 895-9448. DACL also lists a monthly Caregiver Support Group and a weekly Caregiver Lounge with wellness activities and meditation, run by the Genevieve N. Johnson Senior Day Care Center. Our guide to dementia care in DC covers costs and how DC Medicaid can help pay. If care at home stops being enough, our guide to memory care in Washington, DC covers the next step.

Getting to Appointments Without Driving Them Yourself

Rides take up a surprising share of a caregiver's week. DACL's Senior MedExpress gives eligible DC residents age 60 and older with a certified medical condition free round-trip rides to essential medical appointments, such as dialysis or chemotherapy. DACL's ConnectorCard program gives qualified older adults 60 and over a debit card for rides to the destination of their choice, with the subsidy set on a sliding fee scale. For a person whose disability keeps them off Metro Bus and Metro Rail, WMATA's MetroAccess is a door-to-door, shared-ride paratransit service, and as of 2026 a MetroAccess trip costs twice the fare of the equivalent transit trip, up to $4.50. With a MetroAccess ID, the rider can also ride Metro Bus and Metro Rail free with a Personal Care Assistant or companion. Our guide to senior transportation in DC covers MetroAccess, Transport DC, and DC Medicaid rides in more depth, and the national guide covers what to do when a parent stops driving.

Where to Start: One Call to DACL

If all of this feels like too much to sort out alone, you don't have to. The District has no county Area Agency on Aging: DACL is both the State Unit on Aging and the Area Agency on Aging for all of DC. DACL's Information & Referral/Assistance line, 202-724-5626, is open Monday through Friday, 9:30 AM to 4:30 PM, for adults 60 and older, adults with disabilities, and their caregivers. DACL case managers can help fill out public benefits applications and apply for long-term programs. Most DACL services for older adults are based on age rather than income, including in-home services, case management, and caregiver support.

The Medicaid application itself goes through a different door. A District resident can apply for DC Medicaid online at District Direct or by phone at (202) 727-5355. Our step-by-step guide to applying for DC Medicaid covers the other ways.

If You Work: DC Paid Family Leave

If you're holding down a job while you care for someone, DC Paid Family Leave, run by the DC Department of Employment Services (DOES), can replace part of your pay while you take time off. The program is changing soon: starting October 1, 2026, DC Paid Family Leave's Family Leave benefit covers up to 6 weeks a year, down from 12, and the maximum weekly benefit is $1,100. Coverage depends on where you work, not where you live: DC Paid Family Leave covers private-sector employees who work in the District for an employer that pays the program's tax, and federal and District government jobs aren't covered. DC Paid Family Leave doesn't protect your job on its own, so check whether the federal FMLA also applies to you. Our guide to paid family leave for caregivers explains how the pieces fit together.

VA Caregiver Help for DC Veterans

If the person you care for is a veteran, a second set of benefits sits on top of anything DC Medicaid offers. The VA's caregiver program pays an approved primary family caregiver a tax-free monthly stipend and adds respite of at least 30 days a year, caregiver training, and counseling. The District's Mayor's Office of Veterans Affairs (MOVA) helps DC veterans and their families with federal VA claims and benefits at (202) 724-5454. Our guide to using VA Aid and Attendance for home care in DC covers the pension route.

Frequently Asked Questions

How many hours of personal care will DC Medicaid pay for?

It depends on the route. DC Medicaid's State Plan benefit can approve up to 8 hours of PCA services a day, and the DC EPD Waiver can approve more than 8 hours a day. In DC's Services My Way, a participant is limited to 16 hours a day of participant-directed care, and any additional authorized hours, up to 8 a day, come from a home health agency under the DC Medicaid State Plan PCA benefit.

How much does a Services My Way worker get paid in DC?

DC's Services My Way rule doesn't set a dollar figure. The participant sets the hourly wage within a range DHCF establishes, no lower than the District's living wage and no higher than the wage DHCF pays for personal care aide services under 29 DCMR Chapter 42. Services My Way wages are paid out of the participant's participant-directed services budget, so the worker's hours and wage have to fit inside it.

Can an adult child be paid to care for a parent in DC?

Usually, yes. DC Medicaid's rules don't exclude an adult child by relationship, so an adult child can be the paid PCA or Services My Way worker if they meet that route's worker qualifications. Confirm your situation with the home care agency or the EPD case manager before you count on the income.

Do DACL's caregiver services in DC cost money?

DACL describes its offerings as more than 40 free or low-cost programs for District residents 60 and older, adults living with disabilities, and those who care for them. For DACL's caregiver support, the eligibility DACL publishes turns on things like age, District residence, and caregiver status, and no income figure appears in those criteria.

Can I use DC Paid Family Leave if I live in Maryland or Virginia?

Yes, if you work in the District for a covered employer. DC Paid Family Leave coverage is set by where the work is done, not where the worker lives, so a Maryland or Virginia resident who works in DC for an employer that pays the program's tax can qualify.

Learn More

CaregiverCaregiver Programs by State: The 50-State DirectoryA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverHow to Get Paid as a Family Caregiver: The 50-State GuideHow to get paid to care for a family member in 2026: Medicaid self-direction, VA caregiver programs, personal care agreements, plus all 50 state guides. MedicaidHow DC Medicaid Pays for Care at Home: The EPD WaiverHow District of Columbia Medicaid HCBS waivers work in 2026: the EPD Waiver, who qualifies, what it covers, income and asset limits, and how to apply. Care TypesHome Care vs. Home Health in Washington, DCHome care vs. home health in Washington, DC: what Medicare won't pay for, what DC Medicaid's personal care aide benefit covers, and how DC licenses agencies. FinancialHow to Pay for Senior Care in Washington, DCHow to pay for senior care in Washington, DC: a semi-private nursing home room runs $146,730 a year, and DC Medicaid's 2026 income limit is $2,982 a month. CaregiverThe National Family Caregiver Support ProgramWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging.

Find personalized help sorting out DC 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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