Illinois is one of the few states where a spouse can be paid to care for a husband or wife, but only through one specific door. If your loved one is 60 or older and enrolled in the Community Care Program, the agency that delivers their In-Home Service is allowed to hire a family member, including a spouse, as the paid home care aide.
That spouse allowance does not extend to the program for younger adults. Under the Home Services Program for people with disabilities under 60, an adult child or sibling can be a paid Personal Assistant, but a spouse generally cannot.
This guide lays out every legitimate way to be paid as a family caregiver in Illinois for 2026: who can be hired under each program, how the money actually reaches you, and how to pick the route that fits your family.
The Short Version
If your loved one is 60 or older and would otherwise need nursing-home care, the route that can pay almost any relative, including a spouse, is the Community Care Program's In-Home Service. A local Care Coordination Unit assesses need, and an In-Home Service provider agency hires you as the paid aide.
If your loved one is under 60 and has a severe disability, the Home Services Program lets them hire you as a Personal Assistant paid by the State. An adult child, sibling, or other non-legally-responsible relative can be hired. A spouse generally cannot.
If your loved one is a veteran, check the VA programs first. The VA's caregiver stipend and Veteran-Directed Care often pay as well as or better than the state programs, and they allow a paid spouse.
If your family has enough private assets, a written personal services contract can pay a caregiver now while documenting the arrangement for any later Medicaid application. Illinois enforces a 60-month look-back, so the contract format matters.
The rest of this guide walks through each pathway in detail.
What Makes Illinois Different: Two Programs Split by Age 60
Illinois does not run one paid-caregiver program. It runs two, divided by the care recipient's age, and the rules for hiring family differ sharply between them.
The Community Care Program, administered by the Illinois Department on Aging (IDoA), serves residents age 60 and older who would otherwise need nursing-home care. It was established in 1979 and operates as a Medicaid 1915(c) home and community-based services waiver (the Elderly Waiver) with a state-funded component; roughly three out of four CCP customers are Medicaid-waiver eligible.
The Home Services Program, administered by the Illinois Department of Human Services, Division of Rehabilitation Services (DHS-DRS), serves people with severe disabilities who are under age 60 and at risk of nursing-facility placement. HSP customers select, employ, and supervise their own Personal Assistant.
The split matters for one reason above all: the Community Care Program can pay a spouse, and the Home Services Program generally cannot. That single difference, tied entirely to whether your loved one is 60, decides which door your family walks through.
The Illinois Paid Family Caregiver Pathways
1. Community Care Program In-Home Service: The Spouse-Eligible Route
Who pays: The Community Care Program, administered by the Illinois Department on Aging through local Care Coordination Units, with an In-Home Service provider agency as your direct employer.
Who can be paid: Here is the Illinois difference. The In-Home Service provider agency may choose to hire any family member, including a spouse, as well as a Power of Attorney, representative payee, legal guardian, friend, or neighbor, to work as the customer's paid home care aide. The person must meet the provider's qualifications, pass a background check, complete 24 hours of pre-service training, and agree to be supervised by the provider.
The catch to plan around: Not all In-Home Service providers employ family members. The allowance is permissive, not mandatory, so the provider decides. Ask your Care Coordination Unit to identify a provider that hires family before you assume the spouse route is open.
What it is: CCP helps residents age 60 and older who would otherwise need nursing-home care stay at home. In-Home Service is one of its core services, alongside Adult Day Service, Emergency Home Response, and an automated medication dispenser.
Eligibility, recipient: The applicant must be age 60 or older, an Illinois resident, a U.S. citizen or eligible non-citizen, have non-exempt assets of $17,500 or less (the home, car, and personal furnishings are exempt), and score 29 or higher on the Determination of Need assessment that a Care Coordination Unit conducts. Applicants must apply for Medicaid if they are eligible. Confirm the current Determination of Need threshold and asset limit with your local Care Coordination Unit, since these figures are updated periodically.
Eligibility, caregiver: Meet the provider's hiring qualifications, pass a background check, and complete 24 hours of pre-service training.
How you get paid: The In-Home Service provider agency employs you and runs payroll. You are its employee, not a direct State employee and not someone paid out of your relative's bank account.
Best for: A relative, including a spouse, caring for someone 60 or older who qualifies for CCP and needs help at home.
2. Home Services Program: Personal Assistants for Adults Under 60
Who pays: The Home Services Program, administered by DHS Division of Rehabilitation Services, with Personal Assistants paid directly by the State of Illinois.
Who can be paid: A customer may hire many family members as a paid Personal Assistant, but 89 Ill. Admin. Code 684.30 prohibits HSP from paying the customer's legally responsible family members. That category covers the customer's spouse, the parent of a child under 18, and the legal guardian of a minor, and the rule also bars paying the customer's minor child and certain step- and foster parents of a minor. In practice, an adult child, sibling, or other non-legally-responsible relative can be a paid Personal Assistant, but a spouse generally cannot. A temporary exception during the COVID-19 disaster proclamations allowed some of these excluded relatives to be paid; that exception was time-limited.
What it is: HSP helps people with severe disabilities under 60 who are at risk of nursing-facility placement stay in their own homes. The customer develops a service plan jointly with a DRS rehabilitation counselor, then selects, employs, and supervises their Personal Assistant, who helps with household tasks, personal care, and, with a physician's approval, certain health-care procedures. Customers age 60 and older are served by the Department on Aging instead.
How you get paid: Personal Assistants are Individual Providers represented by SEIU Healthcare Illinois & Indiana under a collective bargaining agreement with the State. The State pays them on a set payroll schedule, so the family does not run a private payroll. The base wage for DRS Personal Assistants increased to $19.50 per hour effective January 1, 2026, with a seniority add-on of $1.00 per hour at the first 10,000 cumulative-service-hour milestone and at each 10,000-hour increment after. Because the wage scale changes each contract cycle, confirm the current base wage with DRS when you apply rather than relying on a figure you read secondhand.
Best for: An adult child or other non-spouse relative caring for someone under 60 with a severe disability who qualifies for HSP.
3. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Who can be paid: A designated Primary Family Caregiver of an eligible veteran, which can be a spouse, adult child, parent, or other family member.
2026 stipend: The PCAFC stipend is calculated from the federal General Schedule GS-4, Step 1 annual rate for the locality where the veteran lives, divided by 12, then multiplied by a level factor. Level One is 0.625, and the higher Level Two (a 1.0 factor) applies when the veteran cannot self-sustain in the community. Because the rate keys to the veteran's locality, the stipend differs between the Chicago locality and the Rest of U.S. locality that covers much of downstate Illinois. Confirm your exact stipend with your VA Caregiver Support Coordinator.
Veteran eligibility: A service-connected disability rating of 70 percent or higher, a need for in-person personal care for at least six continuous months, and enrollment in VA health care.
Why it stands out: The stipend is federal tax-free, it allows paid spouses, and the Primary Family Caregiver also gets CHAMPVA health coverage (if otherwise uninsured), mental health counseling, and at least 30 days of respite care per year.
Best for: Families of an eligible veteran where one person provides substantial daily care.
4. VA Veteran-Directed Care (VDC)
Who can be paid: Almost any caregiver the veteran chooses, including a spouse. VDC has the most permissive family-hire rules of any program in this guide.
How it works: The veteran receives a flexible monthly budget set by their VA care team based on assessed need and uses it to hire and pay caregivers at a rate they set within that budget. A fiscal agent handles the payroll.
Availability in Illinois: Veteran-Directed Care is delivered through participating VA medical centers in partnership with Area Agencies on Aging. In Illinois, the Northeastern Illinois Area Agency on Aging (AgeGuide) partners with VA medical centers including the Edward J. Hines, Jr. VA Hospital and the Jesse Brown VA Medical Center, along with the Captain James A. Lovell Federal Health Care Center and the VA Illiana Health Care System in Danville. Availability varies by VA medical center, so confirm with your VA care team or Caregiver Support Coordinator whether VDC is offered where your loved one receives care.
Best for: An Illinois veteran with daily-living needs who wants to pay a spouse or to set their caregiver's schedule and rate directly.
5. VA Aid and Attendance Pension
Who is paid: The veteran or surviving spouse receives the pension directly, and a family caregiver is typically paid out of it under a private arrangement.
2026 maximums (effective December 1, 2025 through November 30, 2026): a single veteran with Aid and Attendance receives up to $2,424 per month ($29,093 per year); a veteran with one dependent up to $2,874 per month ($34,488 per year); two married veterans both receiving Aid and Attendance up to $3,845 per month combined. A surviving spouse with Aid and Attendance receives up to $1,558 per month ($18,697 per year). The net worth limit is $163,699. Confirm current figures on the VA pension rate page before applying.
Eligibility: A wartime veteran (90 days of active duty including at least one day during a recognized wartime period) or a surviving spouse, who also meets the Aid and Attendance functional criteria and whose countable income and assets fall under the limit. VA pension carries its own 36-month look-back on asset transfers, separate from the Medicaid look-back.
How caregivers get paid: The pension goes to the veteran, who then pays the family caregiver, ideally under a written caregiver agreement. Illinois county Veterans Assistance Commissions and accredited Veterans Service Officers help file at no cost; avoid for-profit pension consultants who charge a fee.
Best for: A wartime veteran or surviving spouse with income and assets under the limit who needs help with daily activities.
6. Private Personal Services Contract
Who can be paid: Any family member, including an adult child, sibling, or other relative, under a written contract. Spouses are generally not paid this way for Medicaid-planning purposes, because transfers between spouses are treated differently.
What it is: A written, arm's-length contract between the care recipient (or their legal representative) and the caregiver, signed before care begins. It should spell out the services, the schedule, a reasonable and customary hourly rate documented against local agency quotes, how and when the caregiver is paid, and a requirement that the caregiver keep daily logs and report the income on their taxes.
Why the format matters: Illinois enforces a 60-month Medicaid look-back, administered by the Illinois Department of Healthcare and Family Services (HFS). Without a written contract, money that flows from an aging parent to an adult child for care is presumed to be a gift and can create a penalty period when the parent later applies for Medicaid long-term care. A properly drafted contract converts the payment into a documented exchange of value. The penalty length is figured from a statewide transfer-penalty divisor that HFS updates periodically, so confirm the current Illinois divisor with HFS or an Illinois elder-law attorney before relying on it.
Best for: Families with enough assets to private-pay a caregiver who also want to preserve eligibility for future Medicaid planning. Work with an Illinois elder-law attorney to draft the contract.
Comparing the Illinois Pathways
| Pathway | Pay a spouse? | Recipient age | Who pays | Best fit |
|---|---|---|---|---|
| CCP In-Home Service | Yes (if provider hires family) | 60+ | In-Home Service provider agency | Relative or spouse of someone 60+ |
| Home Services Program | No | Under 60 | State of Illinois (DRS payroll) | Non-spouse relative of an adult with a disability |
| VA PCAFC | Yes | Any | VA (tax-free stipend) | Eligible veteran's primary caregiver |
| VA Veteran-Directed Care | Yes | Any | VA (veteran-set budget) | Veteran wanting to pay a spouse |
| VA Aid and Attendance | Pension paid to veteran | Any | VA (pension) | Wartime veteran under income/asset limits |
| Personal services contract | No | Any | Private funds | Family with assets, planning ahead |
How to Choose an Illinois Pathway
Start with two questions: how old is the care recipient, and is your loved one a veteran?
- Is your loved one a veteran? Check the VA pathways first. PCAFC pays a tax-free stipend, Veteran-Directed Care lets you pay a spouse, and Aid and Attendance can stack with a state program. Your county Veterans Assistance Commission helps for free.
- Is your loved one 60 or older? The Community Care Program is your route, and it is the one that can pay a spouse. Call your local Care Coordination Unit through the Department on Aging to request a Determination of Need assessment, and ask which In-Home Service providers in your area hire family members.
- Is your loved one under 60 with a severe disability? The Home Services Program lets them hire you as a paid Personal Assistant through DRS, as long as you are not their spouse or the parent of their minor child. Contact your local DRS office to start.
- Do you have substantial private assets and want to plan ahead? Talk to an Illinois elder-law attorney about a personal services contract before any money changes hands.
Not sure which Illinois pathway fits your family? Chat with Brevy's care navigator for a side-by-side comparison based on your situation: the care recipient's age, whether you are a spouse or another relative, and whether your loved one is a veteran.
Tax Considerations
Most Illinois caregiver pay is reportable income, with one valuable federal exception.
- CCP In-Home Service pays W-2 wages through the provider agency.
- HSP Personal Assistants receive W-2 wages from the State payroll.
- VA PCAFC is a federal tax-free stipend, not reported on a W-2.
- VA Aid and Attendance is tax-free to the veteran; when the veteran uses it to pay a caregiver, the caregiver receives ordinary taxable income.
- Personal services contracts pay W-2 or 1099 income depending on how the caregiver is classified.
IRS Notice 2014-7: If you live in the same home as the person you care for and you are paid through a Medicaid program, your wages may be excluded from federal gross income. This applies to many Illinois CCP and HSP arrangements and is a common, valuable benefit. Talk to a tax preparer familiar with the rule before filing.
Illinois state income tax: Unlike states with no wage income tax, Illinois levies a flat 4.95% individual income tax on net income at every income level. Caregiver wages are subject to that flat state tax on top of federal tax, except where a federal exclusion such as IRS Notice 2014-7 removes the income from the federal base. Verify the current rate at tax.illinois.gov.
Common Misconceptions
"My spouse and I are both retired, so I can finally be paid to care for him." In Illinois you actually can, but only through the Community Care Program, and only if he is 60 or older and his In-Home Service provider hires family. The Home Services Program for younger adults will not pay a spouse.
"If Mom has Medicare, I can get paid through Medicare." Medicare does not pay family caregivers. It only covers short-term skilled home health through certified agencies. Paid family caregiving in Illinois comes through the Community Care Program, the Home Services Program, the VA, or a private contract.
"The Home Services Program pays me out of my relative's account." No. HSP Personal Assistants are paid by the State of Illinois on a set payroll schedule, not out of the customer's own money.
"I can just start getting paid out of Dad's bank account." Not without a written personal services contract. An informal transfer of a parent's money to a child for care is treated as a gift under Illinois's 60-month look-back and can delay the parent's Medicaid eligibility later.
Frequently Asked Questions
Yes, but only through the Community Care Program, and only if your spouse is 60 or older. CCP In-Home Service providers may hire any family member, including a spouse, who passes a background check and completes 24 hours of pre-service training. Not every provider hires family, so ask your Care Coordination Unit to find one that does. The Home Services Program for adults under 60 generally cannot pay a spouse.
They split by the care recipient's age. The Community Care Program, run by the Department on Aging, serves people 60 and older and can pay a spouse through an In-Home Service provider. The Home Services Program, run by the Division of Rehabilitation Services, serves people under 60 with severe disabilities and pays their Personal Assistant directly through the State, but it cannot pay a spouse.
The base wage for Home Services Program Personal Assistants (Individual Providers in the Division of Rehabilitation Services) rose to $19.50 per hour on January 1, 2026, with a $1.00-per-hour seniority add-on at the first 10,000 cumulative service hours and at each 10,000-hour milestone after. Because the wage is bargained and changes each contract cycle, confirm the current rate with DRS. Community Care Program In-Home Service aides are paid by their provider agency, which sets that wage separately.
You do not need to be a certified nursing assistant. For Community Care Program In-Home Service, you must meet the provider's qualifications, pass a background check, and complete 24 hours of pre-service training. For the Home Services Program, the customer hires and trains you under a service plan they build with a DRS rehabilitation counselor.
Yes. A veteran's spouse or other family member can be paid through VA programs. PCAFC pays a tax-free monthly stipend to a designated Primary Family Caregiver, and Veteran-Directed Care lets the veteran hire and pay a caregiver, including a spouse, from a flexible budget. Veteran-Directed Care is available through participating Illinois VA medical centers, so confirm it is offered where your loved one receives care.
Related Terms
- Consumer Directed Services (CDS): The national term for self-directed programs like Illinois's Home Services Program, where the care recipient hires and supervises their own worker.
- HCBS waiver: The federal authority behind the Community Care Program's Elderly Waiver.
- Activities of Daily Living (ADLs): The functional basis for authorizing personal care across Illinois's programs.
- Nursing Facility Level of Care: The clinical threshold both Illinois programs use to gauge who is at risk of nursing-facility placement.
Learn More
- How to Get Paid as a Family Caregiver in Washington
- Caregiver Burnout: Signs, Stages, and How to Get Support
- VA Aid and Attendance in Illinois
- The Cost of Senior Care in Illinois
- Medicaid Planning Strategies
Find personalized help getting paid as a family caregiver in Illinois 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.