Kentucky Participant Directed Services lets an older or disabled adult on a Medicaid waiver hire their own home-care worker, and a family caregiver can be paid in that role., A spouse or adult child needs Kentucky's approval first; the Kentucky Department for Aging and Independent Living answers HCB waiver questions at (877) 315-0589.,,

What Kentucky Participant Directed Services Does

Kentucky Participant Directed Services (PDS) lets someone on a Kentucky 1915(c) Medicaid waiver hire their own providers for non-medical, non-residential waiver services instead of an agency, with the Kentucky Department for Aging and Independent Living (Kentucky DAIL) answering policy questions.

Of the five PDS waivers, the one for older adults is the Home and Community Based (HCB) waiver, for people 65 or older or with a physical disability who meet nursing-facility level of care and qualify financially for Kentucky Medicaid.,, PDS doesn't get anyone onto a waiver, and HCB's waiting list goes by the date your completed application arrives, so apply early.,,

Which Relatives PDS Can Pay on the HCB Waiver

On HCB, an immediate family member, guardian or legally responsible individual can be paid only through PDS and only with the department's written approval. Kentucky law defines immediate family as a parent, grandparent, spouse, child, stepchild, sibling, grandchild and certain in-laws; the rules go by relationship, not address, and don't address nieces, nephews, cousins, aunts or uncles, so ask Kentucky DAIL.

What written approval requires

Under 907 KAR 7:010, the department, not the case manager, gives HCB written approval when:

  • you submit the PDS Request Form for Immediate Family Member, Guardian, or Legally Responsible Individual as a Paid Service Provider
  • you have unique abilities your loved one needs, plus education, job experience, volunteer work or training beyond caring for them
  • your services aren't natural supports and help them take part in the community
  • the nearest provider is over 30 miles away, or no qualified provider can deliver the person-centered service plan or fit their schedule

Caring for your loved one alone doesn't count as experience, so gather proof of past caregiving jobs, training or volunteering. An adult child skips Kentucky DAIL's separate review of spouses and guardians but still needs the written approval.

The Extra Steps for Spouses and Guardians

A legally responsible individual (LRI) is a spouse, appointed guardian or anyone else with legal authority to make decisions for an adult, but not a power of attorney who doesn't fit that definition., On HCB, an LRI can provide only non-specialized respite and attendant care, and only in extraordinary circumstances.

On HCB, an adult's LRI is paid only if one of these is verified: caregiving has reduced or ended your ability to keep a paying job in the past 12 months and no one else in the home can provide the care; you tried within the first 30 days to recruit a qualified provider, agency or PDS, without finding one or enough coverage; or your loved one has a communication barrier that affects how they tell a caregiver their needs and wishes.

Kentucky's regulation and HCB waiver application don't say how a spouse's written-approval and LRI tests fit together, so plan to meet both. The LRI hiring form must be approved before paid work, LRIs hired on or after July 1, 2024 go through Kentucky DAIL's review first, and approval doesn't guarantee payment.,

Hours and the Representative Rule

On HCB, a PDS worker is capped at 40 hours per Sunday-to-Saturday week across all participants, so two parents share 40 hours. Your employee contract should state your maximum hours. As the PDS employer, your loved one finds workers, approves timesheets, sets schedules and handles discipline. A Kentucky PDS participant may instead choose a representative, who on HCB can't also be hired as their worker.,

How Kentucky Participant Directed Services Sets Family Caregiver Pay

Wages and employer taxes share one pot, your loved one's yearly renewable authorization, so taxes shrink your pay. Kentucky DAIL's PDS guide, as of 2026, puts typical employer taxes around 11.30% of wages, and the Financial Management Agent (FMA) sets the exact rate. Kentucky's June 2024 PDS FAQ puts PDS in the state's 21% legislature-directed rate increase. For a raise, start with the case manager; pay can't exceed the HCBS Waiver Rates maximums on Kentucky Medicaid's Fee and Rate Schedule page.

Getting Hired: Checks and Paperwork

On HCB, a Kentucky PDS worker needs a $20 court criminal-record check and two registry checks before hire, then a $10 Central Registry check within 30 days, all paid by your loved one (2026 fees). On HCB, each Kentucky PDS check has an out-of-state version if you lived or worked outside Kentucky in the past 12 months, and a felony, abuse or neglect conviction, or Medicaid or Medicare fraud, among other records, bars you from PDS work.

If Your Loved One Is on Another Waiver

The Supports for Community Living (SCL) waiver can pay family on conditions, up to 40 hours a week; see our programs guide. For the Michelle P. Waiver and two brain injury waivers, ask the case manager about family pay; all five PDS waivers have waiting lists.

How to Start Getting Paid Through Kentucky PDS

  1. Apply for Medicaid through kynect or the Department for Community Based Services (DCBS) at (855) 306-8959 or a DCBS office, then for the HCB waiver through kynect, an Aging and Disability Resource Center or a Community Mental Health Center.
  2. Choose PDS, a case management agency and an FMA.
  3. Submit the PDS Request Form (plus the LRI form for a spouse or guardian), finish background checks, and wait for approval.,

Frequently Asked Questions

Is Kentucky PDS pay taxable?

Under IRS Notice 2014-7, qualifying Medicaid waiver payments can be excluded from federal income only for care in your own home where your loved one also lives. See whether Medicaid waiver payments are taxable.

Do I need CPR or First Aid training to be a Kentucky PDS worker?

On all Kentucky PDS waivers, CPR or First Aid training is required only if your loved one chooses; otherwise they sign a personnel-file attestation. Kentucky PDS workers complete a TB risk assessment showing whether testing is needed.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in KentuckyHow to get paid to care for a family member in Kentucky in 2026: Participant Directed Services, who can be hired, the spouse rule, and VA options. CaregiverGetting Paid to Care for Your Spouse in KentuckyCan you get paid to care for your spouse in Kentucky? Medicaid PDS sets conditions rather than saying no, and VA programs pay a husband or wife. CaregiverCaregiver Programs in KentuckyKentucky caregiver programs for 2026: Participant Directed Services paid pathways, waiver respite, NFCSP grants, VA benefits, how to apply, and taxes. MedicaidHow Kentucky Medicaid Pays for Home and Community CareKentucky Medicaid HCBS waivers explained: the HCB waiver's services, who qualifies at nursing-facility level of care, the waiting list, and how to apply. MedicaidHow to Apply for Kentucky MedicaidThe fastest way to apply for Kentucky Medicaid is online at kynect; you can also apply by phone or at a DCBS office. Here's what you need and how long it takes.

Find personalized help getting paid through Kentucky Participant Directed Services 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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