Caregiver Programs in Virginia: Paid, Respite, Support (2026)

Virginia caregiver programs now include permanent pay for a spouse who provides extraordinary care, on top of consumer-directed pay for most other relatives, respite grants, and VA benefits.1

If you are caring for an aging parent, a spouse, or an adult child with a disability, the hardest part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in Virginia for 2026: who qualifies, what it pays, and the first call to make.

You don't have to figure this out alone, and you don't have to fund all of it from your own savings.

Virginia Caregiver Programs at a Glance

Which Virginia Caregiver Programs Pay Family Members?

For a lot of families, this is the real question: can the person already doing the caregiving get paid for it? In Virginia, the answer is often yes. Virginia Medicaid, administered by the Department of Medical Assistance Services (DMAS), offers consumer-directed (CD) services under its 1915(c) home and community-based waivers, including the Commonwealth Coordinated Care Plus (CCC Plus) waiver under Cardinal Care and the developmental-disability waivers.2

Consumer Direction (Most Relatives)

Under consumer direction, the waiver member (or their representative) hires, trains, schedules, and directs their own paid attendant. The member may hire most family members, including adult children, siblings, grandchildren, nieces, nephews, and other relatives, as well as friends and neighbors. A fiscal/employer agent handles payroll and taxes.1

Spouses and Parents: LRI Extraordinary Care (Now Permanent)

Virginia permanently allows legally responsible individuals (LRIs), defined as the parent or legal guardian of a minor or the participant's spouse, to be paid as consumer-directed attendants under the Community Living (CL), Family and Individual Supports (FIS), and CCC Plus waivers. CMS approved the waiver amendments on April 17, 2025, effective July 1, 2025, making this permanent rather than a temporary pandemic flexibility.1

If you are a husband or wife who has been providing care without pay, this is a real change. The catch: the care an LRI provides must be "extraordinary in nature," meaning above and beyond the personal-care assistance the LRI is otherwise legally obligated to provide. It is documented during person-centered planning, with the specific ADL tasks and evidence that the task is not typical for the individual's age and development. LRI reimbursement is capped at up to 40 hours per week (40 hours per week per child when an LRI assists multiple children). Instrumental ADLs, supervision, and respite are not reimbursable to an LRI.1

For a side-by-side of every paid pathway, see How to Get Paid as a Family Caregiver in Virginia.

How Do I Get a Break? Respite Options in Virginia

Every caregiver needs to step away sometimes, and needing a break does not make you any less devoted. Virginia funds respite through several doors, and one of them does not require Medicaid at all.

Medicaid Respite (CCC Plus and Cardinal Care)

The CCC Plus waiver under Cardinal Care authorizes in-home and facility respite as covered services for enrolled members. Respite can be added to the member's care plan and delivered by an agency or a consumer-directed worker. Note that a spouse paid as an LRI cannot be paid for respite hours specifically. Ask the Cardinal Care plan care coordinator to authorize respite in the plan.3

NFCSP Grants Through Virginia's 25 Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through Virginia's Department for Aging and Rehabilitative Services (DARS) to 25 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 1-800-552-3402 to reach your regional agency.3

Virginia also funds the dedicated Virginia Caregiver Services Program through DARS, providing in-home respite specifically for caregivers of people with Alzheimer's disease and related dementias.3

For the full breakdown, see Respite Care in Virginia.

Where to Get Help in Virginia

When you are ready to make calls, these are the front doors, and every one of them is free.

VA Caregiver Benefits in Virginia

If your loved one served, do not skip this section. With one of the largest veteran populations in the country, Virginia routes veterans enrolled in VA health care to caregiver support that is separate from Medicaid and often more generous, and it is the one place a spouse can almost always be paid.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. It is calculated from the federal General Schedule (GS) grade 4, step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a level factor (0.625 at Level 1, or 1.00 when the VA finds the veteran unable to self-sustain in the community). The stipend 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 months of continuous, in-person personal care, and enrollment in VA health care.4

Veteran-Directed Care (VDC) is also available in Virginia, letting the veteran direct a flexible monthly budget toward caregiver pay, including a spouse. It is not offered at every VA medical center, so ask your VA social worker or Caregiver Support Coordinator whether it is available where you are.6

Virginia is served by several VA medical centers. Find the one nearest you, and its Caregiver Support Coordinator, through VA's facility locator at va.gov/find-locations.

VA Aid and Attendance (A&A) Pension

Wartime veterans and surviving spouses who meet the functional criteria and fall under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance (A&A) pension. A single veteran with A&A receives up to $2,424 per month ($29,093 a year); a veteran with one dependent up to $2,874 per month. The pension goes to the veteran, who often pays a family caregiver from it.7

The Virginia Department of Veterans Services and county Veterans Service Officers help file at no cost, so there is no reason to pay a for-profit consultant.

Will I Owe Taxes on Caregiver Pay in Virginia?

Getting paid to care for someone you love raises a practical worry: will a tax bill eat into it? Here is the short version, though a tax preparer who knows caregiver pay is worth a call before you file.

IRS Notice 2014-7 (Federal Exclusion)

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 an IRS rule called Notice 2014-7. This applies to many Virginia consumer-directed arrangements and can be a meaningful benefit, so raise it with your preparer before filing.

Virginia State Income Tax

Virginia levies a graduated individual income tax. The rates run up to 5.75% on taxable income above $17,000. Most family-caregiver wages fall in the 5.75% range. Because Virginia starts from your federal adjusted gross income, the IRS Notice 2014-7 exclusion generally flows through to your Virginia return, so income excluded federally is generally not taxed by Virginia either.5

The PCAFC Stipend

The PCAFC monthly stipend is federal tax-free and is not reported on a W-2.4

Learn More

Find personalized help navigating Virginia 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.