What the Participant-Directed Option is
The Participant-Directed Option (PDO) lets a Florida Medicaid long-term care enrollee choose and direct their own caregiver. That includes hiring a family member — and, unlike most other states, Florida also allows a spouse to be paid through this option under the Statewide Medicaid Managed Care Long-Term Care program (SMMC-LTC).
Who qualifies — the care recipient
- Must be enrolled in Florida Medicaid's SMMC-LTC program.
- As of 2026, a single applicant's monthly income generally cannot exceed $2,982, with countable assets capped at $2,000.
- If married, spousal impoverishment protections apply and the rules are more complex.
Who qualifies — the caregiver
- Family members, including spouses, can be paid under PDO — a genuine exception compared to most other states.
- Must pass required background checks and be legally authorized to work in the U.S.
- Must accept the Medicaid hourly compensation rate for the service provided.
How pay works
Florida's Medicaid-funded caregiver rate was raised to a minimum of $15 per hour (as of a 2022 increase; confirm the current rate for the year you are applying).
How to apply
- Confirm the care recipient's Medicaid/SMMC-LTC eligibility, or apply through Florida Department of Children and Families (DCF).
- Request a long-term care assessment through your local Aging and Disability Resource Center (ADRC).
- Once approved, select the Participant-Directed Option through your managed care plan.
- Identify and designate the family caregiver (spouse or otherwise).
- Complete required background checks and enrollment.
- Begin services, and keep ongoing documentation of hours for renewals and audits.
A note on program stability
Federal Medicaid funding changes taking effect from late 2026 onward may affect optional home-and-community-based programs like this one over time. Check the current program status directly with Florida's Agency for Health Care Administration.
What you'll need to keep track of once approved
- Timesheets and hours submitted to the managed care plan.
- Background check and enrollment records.
- Ongoing eligibility documentation for renewals.
Keeping this organized
Once approved, keeping accurate timesheets and documentation for renewals is an ongoing responsibility. FeatherKeep organizes this automatically as you go.