Personal care
Respectful help with bathing, grooming, dressing, eating, toileting, and mobility when authorized.
Autism and special needs
Paid Parent Caregiver Support for Children With Autism and Disabilities
Does your child need significantly more hands-on daily care than another child the same age? You may be able to become your child's paid caregiver through Virginia Medicaid.
Support for everyday life
Your Child Is More Than a Diagnosis
Good support begins by listening. We work from the approved plan of care, respect how each person communicates, and help make home life safer and more sustainable for the whole family.
A diagnosis alone does not determine Medicaid, waiver, service, or paid-family-caregiver eligibility. Functional needs, assessments, coverage, and program requirements also matter.
Familiar routines
We listen to how your child communicates and what helps them feel comfortable. Routines alone do not qualify as extraordinary care.
Safety in the care plan
Support follows the person’s assessed needs. General supervision alone is not qualifying paid LRI care.
Growing independence
Encouragement that builds skills, choice, participation, and confidence at the individual’s pace.
What extraordinary care can mean
Think about the help your child needs, day by day.
Activities of daily living, or ADLs, are the basic personal-care tasks below. For paid parent caregiving, an assessment looks at hands-on help beyond what another child of the same age typically needs. These examples help start the conversation; they do not guarantee qualification.
- Bathing and personal hygienePhysical help washing, drying, and completing personal hygiene safely.
- Dressing and groomingHands-on help getting dressed, managing fastenings, or completing grooming tasks.
- Toileting and continence carePhysical assistance using the toilet and meeting related personal hygiene needs.
- Eating or hands-on feedingDirect help eating when a child needs more than age-typical assistance.
- Transfers, positioning, and mobilityHands-on help moving between a bed and chair, changing position, or moving safely.
- Other authorized personal-care tasksTasks within the personal-care service that are documented in the assessment and approved care plan.
Ordinary parenting, keeping a child company, general safety supervision, routines, and medication reminders alone should not be treated as qualifying extraordinary care. The responsible assessor and program review the individual care needs.
Education checked September 10, 2026 against the DMAS Extraordinary Care Guide (PDF). The guide compares care needs with a child’s chronological age.
Family knowledge mattersCare plans work better when families are heard
Support across disabilities
Every family’s care looks different.
This pathway is not limited to autism. Families may be caring for a child with:
- Autism
- Intellectual or developmental disabilities
- Down syndrome
- Cerebral palsy
- Genetic syndromes
- Neurological conditions
- Physical disabilities
- Complex medical needs
- Other lifelong disabilities that may involve extraordinary hands-on personal care
What matters is the child’s assessed need for extraordinary hands-on personal care, alongside Virginia Medicaid and the applicable program rules.
A parent may be part of the care team
A familiar caregiver. An authorized plan.
A parent or legal guardian of a minor is a Legally Responsible Individual (LRI). In qualifying circumstances, Virginia Medicaid may pay an eligible LRI for extraordinary personal care.
Hours follow assessed need
A paid LRI may receive up to 40 reimbursable hours per week for each qualifying child. The program, assessment, care plan, authorization, and health-plan rules determine what is allowed.
Approval is a separate decision
The preliminary screening identifies the next questions to ask. First Choice does not make the final Medicaid eligibility or service authorization decision.
Respite needs a careful review
DMAS does not make respite available when there is a paid LRI providing personal care or assistance. Do not assume it is available outside paid shifts; discuss the full arrangement with the plan or support coordinator.
Support continues into adulthood
Our existing home-care services also support adults with developmental, physical, and complex care needs. Caregiver relationships and program rules should be reviewed as a child approaches adulthood.
Learn more in Virginia Medicaid’s LRI guidance.
Questions from families
Clear answers, without assumptions.
Can I get paid to care for my autistic child in Virginia?
Possibly. Autism alone does not qualify a child. Virginia Medicaid, the applicable benefit or waiver, extraordinary hands-on ADL needs compared with a child of the same age, caregiver requirements, and service authorization must all be reviewed.
Do you only support children with autism?
No. First Choice can support children and adults with a range of developmental, physical, and complex care needs when the requested services fit our scope and the individual care plan.
Can care happen with a familiar family member?
In some programs, yes. The caregiver relationship, Medicaid program, assessed needs, and service authorization all affect whether a family member can be paid for approved care.
How is the care plan created?
The responsible Virginia program, health plan, or care coordinator determines authorized services through its assessment and planning process. First Choice then helps implement the approved plan.
What if I do not know our health plan or waiver?
You can choose “I do not know” in the screening. Start with your child’s age range, ZIP code, broad daily care needs, and your contact preference. No member number, medical records, or detailed diagnosis is needed.
Where do you provide support?
Serving Fairfax County, Loudoun County, Prince William County, Arlington County, the City of Alexandria and the City of Falls Church. Ask our team to confirm availability for the requested service and location.
Tell us what daily care looks like for your family.
We will help you identify a practical next step.