Step 1: Check if your parent has Medicaid

Consumer-directed pay is only available through Virginia Medicaid’s CCC Plus Waiver. If your parent already has Medicaid, this step is done. If not, you can apply through CommonHelp, the Cover Virginia call center at 1-833-522-5582, or the local Department of Social Services.

Step 2: Request the CCC Plus Waiver screening

A social worker and a nurse assess how much help your parent needs with daily activities such as bathing, dressing, toileting, transfers and eating. If your parent is in the hospital, the discharge planner can help start this request.

Step 3: Choose consumer-directed care

Once approved for the waiver, your parent chooses a health plan and picks between agency-directed care, where an agency like ours sends a caregiver, and consumer-directed care, where your parent, or you acting on their behalf, hires and directs the attendant. Adult children are among the most common paid attendants under this option.

Step 4: Set up the services facilitator and fiscal agent

A services facilitator helps set up the plan of care. A fiscal agent handles payroll and taxes, so you are paid properly and legally for the approved hours. This part involves paperwork, and the services facilitator walks you through each form.

Step 5: Complete training and start being paid

Once the paperwork is in place, you complete a short orientation and begin recording your hours. Payment follows the schedule set by the fiscal agent.

Who cannot be the paid attendant

Program rules generally exclude a spouse and, for an adult, a legal guardian from being the paid attendant. The attendant must be legally able to work in the United States. Rules change, and eligibility is always decided by Medicaid and the health plan.