Paid Family Caregiver FAQ

You may be considered if your child meets the applicable Virginia Medicaid and program requirements, needs extraordinary hands-on ADL care beyond what is typical for their age, and the services are assessed and authorized. An autism diagnosis alone does not qualify a child. You must also meet the caregiver requirements.

Read the parent caregiver guide

Virginia’s LRI policy allows up to 40 reimbursable hours per week for a qualifying child. This is a ceiling, not a guaranteed award. The actual amount depends on the child’s assessment, extraordinary ADL needs, care plan, program and authorization. Do not assume that all time spent parenting or supervising can be paid.

How the 40-hour LRI rule works

Contact a Care Navigator for current pay information for the role and care arrangement you are considering. Confirm the rate and employment terms before you accept a role. Rates may change, and payment depends on the authorized care, approved hours and applicable employment requirements.

Ask the Care Navigator to confirm the employment arrangement, eligibility conditions, required training and onboarding for the role offered to you, including whether it is a W-2 employee position. Completing an eligibility check is not a job offer or a promise of paid hours.

Choose “I do not know” in the screening. If available, have the name on the health-plan card and an existing care or support coordinator’s name ready for follow-up. A health plan and a waiver are different, so one name may not answer both questions. You do not need to send a card image or member number in the first-contact form.

Help finding your plan or waiver

For the Medicaid-funded paid family caregiver path described here, the person receiving care needs applicable Virginia Medicaid coverage and must meet the relevant program and authorization requirements. If they do not have Medicaid or you are unsure, you can still ask about the next steps or other home care options. First Choice does not decide Medicaid eligibility.

Read the Virginia Medicaid and LRI guide

General supervision does not qualify as extraordinary paid LRI care. The LRI standard focuses on authorized ADL assistance beyond ordinary age-typical care. Routines, reminders and household tasks alone do not meet it. Broader home care services may address other needs, but they should not be confused with the narrower paid LRI benefit.

What counts as extraordinary care?

Respite cannot cover the same time that a paid LRI provides personal care or assistance. DMAS also states that respite is not available when there is a paid LRI because it is intended to relieve an unpaid primary caregiver. Do not assume respite is covered outside your paid shifts. Ask the health plan or support coordinator to review the arrangement.

Read the Virginia Medicaid and LRI guide

Contact a Care Navigator with the name of your plan to check current participation for the services you need. Confirm coverage and authorization before starting services. A plan offering Virginia Medicaid coverage does not by itself establish that First Choice is in its network or that the requested service is authorized.

Tell us that hours are approved and give an approximate number if you know it. The team will need to check the current authorization, service type, provider arrangement and caregiver requirements. Existing hours may simplify the review, but they do not guarantee that a family caregiver or a new agency can begin paid services immediately.

What to do with approved hours

You can ask First Choice to review a possible transfer. Confirm service availability, plan participation, the receiving agency’s authorization and a coordinated start date before changing the current arrangement. A transfer is not an automatic increase in hours or approval of a paid parent. Tell your current care or support coordinator that you are exploring the change.

Review the transfer process

Have your county or city, the caregiver’s relationship, an age range for the person receiving care, Medicaid status if known, general ADL needs and contact preferences. If you know the plan, waiver or approved hours, include them. “I do not know” is welcome. Do not include a Social Security number, member number, birth date, medical records or detailed diagnoses in the public screening.