Kentucky doesn't use the "Structured Family Caregiving" name you'll see in some other states — but family members can still get paid to provide care, through a Medicaid mechanism called the Consumer Directed Option (CDO).
What it is
Kentucky pays family caregivers through Medicaid Home and Community Based Services (HCBS) waivers — specifically the HCB Waiver (for adults 65+ or with disabilities) and the Michelle P. Waiver (for Kentuckians with intellectual or developmental disabilities). Both can be paired with the Consumer Directed Option, which lets the Medicaid participant act as the employer of record and hire a family member as their paid caregiver.
Could your family member qualify?
- Must be Medicaid-eligible
- Must meet a nursing facility level of care requirement (HCB Waiver) or relevant disability criteria (Michelle P. Waiver)
- Must meet income and asset limitations
Not sure about any of these? Don't guess.
A short, free check can tell you what may be worth applying for — no obligation.
Check my eligibilityCan you be the paid caregiver?
- Generally cannot be a spouse or legal guardian — a firm exclusion under CDO
- Must pass required background checks and enrollment steps
Are you the spouse of the person receiving care?
Spousal rules vary a lot by state and by program — don't assume you're disqualified or automatically eligible.
See the spouse answer for this stateAn important exception for veterans
If the person you care for is a veteran, Veteran Directed Care (VDC) works differently and can pay a spouse as caregiver — a notable contrast to the CDO spousal exclusion above.
Ready to apply? Here's where to start
- Confirm the care recipient's Medicaid eligibility
- Request a formal functional/level-of-care assessment
- Contact a Medicaid case manager to discuss HCB Waiver or Michelle P. Waiver eligibility and CDO
- Identify the family member who will serve as the paid caregiver
- Complete enrollment, background checks, and register with the fiscal intermediary that handles payroll
Getting approved is only part of it. Family caregivers often need to keep track of care hours, documents, reassessment dates and other benefits — FeatherKeep helps keep that organized in one place.
See how FeatherKeep helpsWhat you'll need to keep track of once approved
- Documentation of care hours and tasks performed
- Records supporting the ongoing level-of-care determination
- Payroll/employment records through the fiscal intermediary
Keeping this organized
Once set up as a paid caregiver through CDO, staying compliant with documentation and hour-logging requirements is an ongoing task. FeatherKeep organizes this automatically as you go.