If you are caring for an aging parent, a spouse, or an adult child in Kentucky, the state can pay many family members for the care they already give. Participant Directed Services lets a Medicaid waiver participant hire and pay their own workers, with a narrow new exception that can even pay a spouse. Add waiver respite, NFCSP grants, and VA benefits, and the support is broader than most families realize.

The hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major Kentucky caregiver program for 2026: the ones that pay family members, the free respite grants, the VA benefits, how to apply, and how the payments are taxed.

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

Kentucky Caregiver Programs at a Glance

Program What It Offers Who Qualifies Cost to You
Participant Directed Services (PDS) Participant hires and directs their own workers, including relatives Medicaid 1915(c) waiver participants (HCB, SCL, Michelle P., ABI) Free (paid by Medicaid)
LRI extraordinary-care exception Spouse or parent of a minor paid for extraordinary care (since 7/1/2024) PDS participants whose legally responsible individual provides documented extraordinary care Free (paid by Medicaid)
NFCSP respite grants Free in-home respite, adult day vouchers, training, counseling Caregivers of adults 60+ or a person with ADRD; no income test Free
VA PCAFC Monthly tax-free stipend; can pay a spouse Veteran with a 70%+ VA rating, enrolled in VA health care, needing 6+ months of in-person care Free (VA benefit)
VA Aid and Attendance Pension up to $2,424/mo to the veteran; caregiver paid from it Wartime veteran or surviving spouse under the net-worth limit Free to apply (VSO help)

Programs That Pay Family Caregivers

If you have been providing unpaid care for a parent, spouse, or adult child in Kentucky, you may be wondering whether the state can pay you for work you are already doing. For many families it can. There is one threshold worth naming up front, though: paid family caregiving in Kentucky runs almost entirely through Medicaid or the VA, so the person you care for usually needs to be enrolled in a Medicaid waiver or be a qualifying veteran. If neither is true yet, focus on the free NFCSP respite and support below while you work toward eligibility.

Participant Directed Services (PDS)

Participant Directed Services (PDS) is the self-directed option within Kentucky's Medicaid 1915(c) waivers, administered by the Department for Aging and Independent Living (DAIL) under the Department for Medicaid Services (DMS). The waiver participant acts as the employer of record: they hire, train, schedule, and may dismiss their own workers for non-medical waiver services, and they may hire family members, friends, and neighbors within Medicaid guidelines. Workers are paid from the participant's approved waiver budget rather than a flat statewide rate.,

PDS is available through the Home and Community Based (HCB) waiver for aging and physical disabilities, the Supports for Community Living (SCL) and Michelle P. Waiver (MPW) for intellectual or developmental disabilities, and the Acquired Brain Injury (ABI and ABI-LTC) waivers. A PDS case manager or support broker helps develop the plan of care and budget.

Who can be paid, and the spouse rule. Adult children, other relatives, friends, and neighbors may be hired and paid as PDS workers. A spouse generally cannot be paid, and legally responsible individuals, meaning a spouse or the parent of a minor child, generally cannot be paid either. A rule effective July 1, 2024 created a limited exception: a legally responsible individual can be paid when they provide extraordinary or specialized care beyond what a typical caregiver provides, subject to documentation requirements. If that might describe your situation, ask the participant's case manager and Financial Management Services agency to confirm before you count on it.

A Financial Management Services (FMS) agency handles the employer back-office work so you don't have to: processing employee timesheets and wages, and calculating and submitting the employer taxes. The participant remains the employer of record who hires, schedules, and may dismiss workers, and is responsible for the fees for the required worker background checks, which are coordinated through the case manager or service advisor. The FMS agency processes the pay within your approved annual budget.

For the full guide to paid pathways, including how the pay is set: How to Get Paid as a Family Caregiver in Kentucky.

How to Apply for Kentucky Caregiver Programs

The path into Kentucky's paid-caregiver programs starts the same way for most families, with one phone call. Here is the order it usually follows.

1
Step 1

Call the CHFS helpline at 1-877-925-0037

Tell them you want in-home care or to be paid to care for a family member. The helpline, also reachable by dialing 2-1-1, routes you to DAIL and DMS for a waiver eligibility screening and to your regional Area Agency on Aging for free respite.

2
Step 2

Apply for the right Medicaid waiver

To be paid through PDS, the person you care for must be enrolled in one of Kentucky's 1915(c) waivers, the HCB, SCL, Michelle P., or Acquired Brain Injury waiver. DAIL and DMS run eligibility, and a waitlist may apply for some waivers, so apply as early as you can.

3
Step 3

Build the plan of care and choose your workers

Once enrolled, a PDS case manager or support broker helps you develop the budget and plan of care. You, as the participant or a designated representative, then hire your own workers, including adult children and other relatives.

4
Step 4

Set up payroll through the Financial Management Services agency

The FMS agency processes timesheets and wages and calculates and submits your employer taxes, while you stay the employer of record who hires and schedules and who pays the fees for the required worker background checks (coordinated through your case manager or service advisor).

Respite Care Programs

Caring for someone around the clock is exhausting, and needing a break does not make you a worse caregiver. Kentucky funds respite two ways, one through Medicaid and one free to any family.

Medicaid Respite (PDS Waivers)

The HCB, SCL, Michelle P., and Acquired Brain Injury waivers authorize respite as a covered service within the participant's plan of care, delivered by an eligible PDS worker. Ask your PDS case manager or support broker to add respite hours.

NFCSP Grants Through Kentucky's 15 Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through the Kentucky Cabinet for Health and Family Services, Division of Aging Services, to 15 regional Area Agencies on Aging. Services include in-home respite, adult day vouchers, caregiver training, and counseling, with no income test for respite services. Call the CHFS helpline at 1-877-925-0037.

For the full respite guide: Respite Care in Kentucky.

VA Caregiver Benefits in Kentucky

If the person you care for is a veteran, a second door opens, and it is one that can pay a spouse. Because Participant Directed Services generally will not pay a husband or wife, a spouse caring for a veteran often finds PDS closed to them. The VA programs below were built differently, and they are frequently more generous than Medicaid. Veterans enrolled in VA health care in Kentucky can use them alongside, or instead of, the state programs above.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. The stipend is not a flat national figure: it is calculated from the federal Office of Personnel Management GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by 62.5 percent, or by 100 percent if the VA determines the veteran is unable to self-sustain in the community. It is federal tax-free and can pay a spouse. To qualify, the veteran needs a VA disability rating of 70 percent or higher, a need for at least six continuous months of in-person personal care, and enrollment in VA health care.

Because PDS generally excludes spouses, the PCAFC stipend and Veteran-Directed Care are often the routes through which a Kentucky spouse can be paid to provide care. To confirm eligibility and start an application, call the VA Caregiver Support Line at 1-855-260-3274.

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. 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. The pension goes to the veteran, who typically pays a family caregiver from it.

The Kentucky Department of Veterans Affairs and county Veterans Service Officers help file both PCAFC and pension claims at no cost.

Taxes for Kentucky Caregivers

IRS Notice 2014-7

If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under IRS Notice 2014-7. This applies to many Kentucky PDS arrangements. Talk to a tax preparer familiar with the rule before filing.

Kentucky State Income Tax

Kentucky levies a flat individual income tax of 4% for 2026 under KRS 141.020. Because Kentucky starts from federal adjusted gross income, the IRS Notice 2014-7 exclusion generally flows through to the Kentucky return, so wages excluded federally are usually excluded on the state return too. Confirm the current rate with the Kentucky Department of Revenue before you file.

VA PCAFC Stipend

The PCAFC monthly stipend is federal tax-free and is not reported on a W-2.

Not sure which Kentucky caregiver program fits your family? Chat with Brevy's care navigator for a comparison based on your loved one's Medicaid enrollment, veteran status, and whether you are a spouse or non-spouse caregiver.

Where to Get Help in Kentucky

You do not have to hold all of these numbers in your head. These are the front doors that route you to the rest.

Kentucky CHFS Helpline (2-1-1) Start here for anything: the helpline routes you to your regional Area Agency on Aging for free NFCSP respite and to DAIL and DMS for a Medicaid waiver eligibility screening. 1-877-925-0037 (or dial 2-1-1)
Kentucky Participant Directed Services (DAIL) Administers PDS across the HCB, SCL, Michelle P., and Acquired Brain Injury waivers, the programs that pay family caregivers. www.chfs.ky.gov/agencies/dail/Pages/pds.aspx
VA Caregiver Support Line For families of veterans: explains PCAFC eligibility and connects you with your local VA Caregiver Support Program coordinator. 1-855-260-3274 www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers

Frequently Asked Questions

Can I get paid to care for my spouse in Kentucky?

Generally not through Participant Directed Services, which excludes legally responsible individuals, meaning a spouse or the parent of a minor. A rule effective July 1, 2024 created a narrow exception allowing a legally responsible individual to be paid for extraordinary or specialized care, with documentation. If your spouse is a veteran enrolled in VA care, the PCAFC stipend and Veteran-Directed Care can pay a spouse.,

Who can be a paid PDS worker, and which waivers offer PDS?

Adult children, other relatives, friends, and neighbors may be hired and paid as PDS workers, with the participant acting as the employer who hires, schedules, and may dismiss them. PDS is available through the Home and Community Based (HCB) waiver, the Supports for Community Living (SCL) and Michelle P. waivers, and the Acquired Brain Injury (ABI and ABI-LTC) waivers.,

How do I get on a Kentucky PDS waiver if my loved one isn't enrolled yet?

Call the CHFS helpline at 1-877-925-0037 and ask to apply for the relevant 1915(c) waiver through DAIL and DMS. Because paid family caregiving runs through these waivers, enrollment is the first step, and a waitlist may apply for some waivers, so it is worth applying early.,

Is there free respite in Kentucky without Medicaid?

Yes. The National Family Caregiver Support Program provides free respite through Kentucky's 15 Area Agencies on Aging with no income test. Call the CHFS helpline at 1-877-925-0037.

How do I reach my Area Agency on Aging in Kentucky?

Call the CHFS helpline at 1-877-925-0037 to reach your regional Area Agency on Aging and Independent Living, or dial 2-1-1. They handle NFCSP respite grants, adult day referrals, and caregiver training.

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. 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. CaregiverRespite Care in KentuckyFunded respite options for Kentucky family caregivers in 2026: PDS waivers, free NFCSP grants through 15 AAAs, adult day programs, and VA options. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in KentuckyVA Aid and Attendance in Kentucky for 2026: who qualifies, monthly rates up to $2,874, how to apply, and free accredited help from KDVA field reps. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.
Your next step Find personalized help navigating Kentucky 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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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.