Virginia DD Waiver Family Caregiver: Who Can Be Paid? (2026)

If you care for a relative with a developmental disability, Virginia Medicaid's developmental disability waivers can pay an approved family member to help with personal care at home.1,2 Two of the three waivers, Community Living and Family and Individual Support, cover personal assistance, and a Virginia DD waiver family caregiver who is a parent of an adult, a sibling or another relative must meet the same provider requirements as any other provider.1,2 Under Virginia's DD waivers, spouses and parents of minor children face stricter, and conflicting, official rules.2

In This Guide

• What Virginia's DD Waivers Cover
• Who Qualifies and How to Apply
• Who Can Be a Paid Virginia DD Waiver Family Caregiver
• Spouses and Parents of Minor Children
• How to Start as a Virginia DD Waiver Family Caregiver

What Virginia's DD Waivers Cover

The Virginia Department of Medical Assistance Services (DMAS) runs Virginia's three developmental disability (DD) waivers jointly with the Virginia Department of Behavioral Health and Developmental Services (DBHDS).1 Only two of Virginia's three DD waivers cover personal assistance, the hands-on daily help a family caregiver usually gives.

Service lists are from the Centers for Medicare & Medicaid Services (CMS) factsheet for Virginia.1

Being paid can also bring an employer's duties. Under consumer direction on Virginia's waivers, DMAS says the member or their designated representative "performs all of the employer responsibilities including hiring, training, managing, and if necessary, terminating the attendant." You don't have to learn that role alone: a Services Facilitator helps the family.1

Typical pay: about $14.57 an hour (estimate based on home care aide wages in Virginia, BLS, May 2025). That's Virginia's statewide median for home health and personal care aides, not a DD waiver rate. After years of unpaid care any paycheck matters, so confirm the actual rate before you plan around it.4

Who Qualifies and How to Apply

Virginia's DD waivers serve people with autism, intellectual disabilities or developmental disabilities who meet the level of care for an intermediate care facility for individuals with intellectual disabilities.1

To apply for a Virginia DD waiver, contact your local Community Services Board. Waiting is the hard part for many families: DMAS says of its DD waivers that "there is a waiting list for these waivers, and the slots are assigned based on urgency of need."1

Who Can Be a Paid Virginia DD Waiver Family Caregiver

Virginia's DD waiver regulation, 12VAC30-122-120, names only two groups who "shall not be" providers: parents or guardians of an enrolled minor child, and an enrolled adult's spouse. For other family members paid through Medicaid, 12VAC30-122-120 says those "approved to provide services for the purpose of receiving Medicaid reimbursement, shall meet the same provider requirements as all other licensed providers."2

If you're a parent of an adult child or a sibling who has given this care unpaid for years, Virginia's DD waiver regulation doesn't rule you out, though you'll meet the same requirements as any other provider.2

If you live with the person, 12VAC30-122-120 lets a Virginia DD waiver pay you only with "objective, written documentation" showing "there are no persons available to provide supports to the individual other than the unpaid family/caregiver who lives in the home."2 That paperwork can be what stands between your household and a paycheck for care you already give, so ask early who prepares it.

Spouses and Parents of Minor Children

If you're the spouse of an adult on a DD waiver, or the parent of a child on one, Virginia's official texts disagree, and that's frustrating.

What DMAS's 2025 rules say. DMAS's legally responsible individual (LRI) rules, approved by CMS on April 17, 2025 and in effect since July 1, 2025, cover the Community Living and Family and Individual Support waivers (and the CCC Plus Waiver). An LRI is a spouse, or the parent or legal guardian of a minor. Under DMAS's 2025 rules, an LRI can be the paid aide or attendant for personal care that is "extraordinary in nature," above and beyond what they're obligated to provide.3

• Hours: DMAS's 2025 rules pay an LRI for up to 40 hours a week, and up to 40 hours a week for each child when the LRI cares for more than one.3
• Tasks: DMAS limits a paid LRI to activities of daily living; "Instrumental Activities of Daily Living (IADLs) and general supervision are not considered extraordinary care."2
• Documentation: under DMAS's 2025 rules, providers document the need for extraordinary care during person-centered planning.3

DMAS's bulletin frames extraordinary care around "the extraordinary needs of the member under the age of 18" and states no separate standard for the spouse of an adult.2

What the regulation still says. Virginia's DD waiver regulation, 12VAC30-122-120 B, derived effective March 31, 2021, still bars parents of minors and spouses, and its text hasn't been amended to match DMAS's 2025 rules.2 Get written confirmation from DMAS or the Community Services Board before you count on the income. Our guide to getting paid to care for your spouse in Virginia covers other routes.

How to Start as a Virginia DD Waiver Family Caregiver

Learn More

Find personalized help getting paid through Virginia's DD waivers 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.