Paid Family Caregiver Programs in West Virginia

Last updated: 6 April 2026

Bottom line: Yes, some West Virginia seniors can have a family member paid to help at home, but there is not a simple statewide program that just sends a paycheck to any relative caregiver. The main path is the West Virginia Aged and Disabled Waiver with self-direction through Personal Options. A faster backup for some families is the West Virginia Medicaid Personal Care Services Program, where a certified agency may be able to hire an adult child or other relative. State-funded programs like FAIR and Lighthouse can help many families, but they generally do not pay the family member directly.

Emergency help now

1. If the senior is not safe right now, call 911 or go to the emergency room.
2. If the senior already has West Virginia Medicaid and needs hands-on help soon, start the Personal Care Services Program right away by sending the PC-MNER form to Acentra.
3. If you are not sure which program fits, call the West Virginia Aging and Disability Network at 1-866-981-2372 and ask for the fastest in-home option in your county.

What this help actually looks like in West Virginia

In West Virginia, “getting paid to care for a parent” usually means fitting into a real program with rules, forms, assessments, and worker standards. The state’s main consumer-directed option for older adults is the Aged and Disabled Waiver. That waiver lets some members use Personal Options, which means the older adult can hire and supervise their own worker.

If the senior already has Medicaid and needs help with bathing, dressing, walking, toileting, or similar daily tasks, the Personal Care Services Program may be the most practical first move. It is not the same as self-direction. Instead, Acentra assesses the person and refers the case to the agency the member chooses. In some cases, that agency may hire a relative who meets the rules.

If the senior is not on Medicaid, West Virginia still has real help. The FAIR program gives respite to unpaid dementia caregivers, and the Lighthouse program gives county-based in-home help to some seniors age 60 and older who do not qualify for Medicaid in-home services. Those programs can be lifesavers, but they are not simple family-pay programs.

Quick facts

• The main West Virginia program that can let an older adult hire family is the Aged and Disabled Waiver using Personal Options.
• The Personal Care Services Program is Medicaid-based and agency-run. It may let an agency hire some relatives.
• Under the main state Medicaid senior-care programs, a spouse cannot usually be paid. Adult children often have a better chance.
• The ADW page says the average ADW application process takes about 56 days, and the average waitlist time in the last fiscal year was 44 days.
• The state’s public long-term-care Medicaid fact sheet still showed home-and-community waiver asset limits of $2,000 for one person and $3,000 for a couple, and an income rule based on 300% of the SSI amount. Because SSI-based income figures can change, confirm the current number with your local DoHS office before you rely on it.
• FAIR and Lighthouse can help while you wait, but they usually do not pay the family caregiver directly.

Program	Medicaid required?	Can family be paid?	Main catch	How to start
ADW Personal Options	Yes	Often yes, for some adult relatives	Waiver openings, financial review, nursing-home level of care	ADW MNER and financial eligibility
Medicaid Personal Care	Yes	Sometimes, if an agency hires the relative	Not self-directed; agency controls employment	PC-MNER through Acentra
FAIR respite	No	No	Dementia diagnosis required	County aging provider or Aging and Disability Network
Lighthouse	No	No	Age 60+, not eligible for Medicaid in-home programs, county openings vary	County aging provider or Aging and Disability Network
VA Veteran-Directed Care / caregiver support	No state Medicaid required	Sometimes	Veteran must qualify through VA; local availability matters	VA Caregiver Support

Who qualifies

For the two main state-paid paths for seniors in West Virginia, Medicaid is usually the key. The state’s Medicaid for Long Term Care page explains that home and community-based waiver care uses special medical and financial rules. The public long-term-care fact sheet still posted as of March 2026 showed a home-and-community waiver income rule based on 300% of the SSI amount and asset limits of $2,000 for one person and $3,000 for a couple. Because West Virginia’s public fact sheet had not posted a March 2026 SSI-based dollar update, call your local DoHS office to confirm the current income number before you apply.

Function also matters. The ADW program requires a nursing-home level of care assessment and needs in at least five areas of daily living. The Personal Care Services Program requires active West Virginia Medicaid and needs in at least three activities of daily living. If dementia is the main issue but Medicaid is not in place, FAIR may help. If the senior is older than 60 and does not qualify for Medicaid in-home services, Lighthouse may be the nearest state option.

Who can usually be paid?	Spouse	Adult child	POA / MPOA / health care surrogate	Court-appointed guardian / conservator
ADW Personal Options	No	Usually yes, if 18+ and qualified	Possible, but self-direction needs a separate program representative	No
Medicaid Personal Care	No	Often possible if a certified agency hires them	Yes, if employed by a PC agency	No
VA programs	Ask VA	Ask VA	Ask VA	Ask VA

Why this matters: West Virginia’s ADW manual and Personal Care manual block spouses and court-appointed guardians from being paid in the main Medicaid senior-care routes. Those same rules leave more room for an adult child, sibling, grandchild, or other adult relative if they meet age, training, background-check, and program rules.

Best programs, protections, and options in West Virginia

Aged and Disabled Waiver with Personal Options

What it is: The Aged and Disabled Waiver is West Virginia’s main Medicaid waiver for seniors and adults with disabilities who would otherwise need nursing-home care. The self-directed part is called Personal Options.

Who can get it or use it: The state says ADW is for West Virginians age 18 and older who meet waiver financial rules, pass a nursing-home level of care assessment, and need help in at least five daily-living areas. The ADW policy manual says legally responsible persons such as a spouse cannot be paid, and court-appointed legal guardians are also barred.

How it helps: Personal Options lets the member hire, schedule, train, and supervise their own worker. The state’s Palco brochure says the member can hire friends and family, set the worker’s rate within the approved budget and legal limits, and have payroll, tax withholding, background checks, and year-end reporting handled through Palco. ADW also includes case management and may cover other supports such as nursing oversight, transportation, adult day care, and safety equipment.

How to apply or use it: Start with the Medical Necessity Evaluation Request. The form goes to Acentra, and the state says financial eligibility must be decided before medical eligibility is finished. For help, call the Bureau of Senior Services ADW line at 1-866-767-1575. The official ADW page says the average application process takes 56 days and the average waitlist time last fiscal year was 44 days.

What to gather or know first: Have the senior’s Medicaid or Medicare cards, doctor name, diagnosis list, medicine list, income and asset records, and any POA or guardianship papers ready. If the senior cannot manage employer duties, the ADW manual allows a program representative, but that representative cannot also be the paid worker. Also know that the state’s rate chart effective October 1, 2025 lists personal attendant reimbursement at $6.75 per 15 minutes; that is not a promise of take-home pay to the family worker.

Medicaid Personal Care Services Program

What it is: The West Virginia Medicaid Personal Care Services Program is an in-home program for Medicaid members who need help with daily tasks such as bathing, dressing, mobility, grooming, and toileting.

Who can get it or use it: The program page says the person must have active West Virginia Medicaid and need help in at least three ADLs. The Personal Care manual says a spouse, a parent of a minor child, and a court-appointed guardian or conservator cannot be paid. It also says legal representatives such as a POA, MPOA, or health care surrogate may provide services if employed by a certified Personal Care agency. That means an adult child can often be the paid aide if an agency hires them and they meet training rules.

How it helps: This route can be easier than waiting for waiver self-direction if the senior already has Medicaid and needs help soon. The application-through-enrollment flyer shows a simple process: send the PC-MNER to Acentra, complete the PAS assessment, choose an agency, and start services if approved. The manual also sets a maximum of 210 hours per month based on assessed need. The state’s rate code set effective October 1, 2025 lists direct-care reimbursement at $6.75 per 15 minutes, but agencies set the worker’s actual wage.

How to apply or use it: Send the PC-MNER form to Acentra Health-PC. The official PCS page lists the mailing address as 1007 Bullitt Street, 2nd Floor, Charleston, WV 25301, toll-free number 1-866-385-8920, and fax 1-844-794-6729.

What to gather or know first: Have the Medicaid card, doctor contact, medication list, and names of one or two preferred agencies ready. If you want a relative hired, ask the agency that question up front. The family member must still meet worker qualification rules, including age 18+, training, and background screening.

FAIR: Family Alzheimer’s In-Home Respite

What it is: The FAIR program is West Virginia’s statewide respite option for families caring for someone with Alzheimer’s disease or a related dementia.

Who can get it or use it: The state’s in-home care guide says the care receiver can be any age but must have a written diagnosis, and there must be an unpaid family caregiver age 18 or older providing care in West Virginia.

How it helps: The ADW page says FAIR is available in all 55 counties and can provide up to 16 hours of relief per week, based on need and the availability of hours and trained staff. The cost depends on the income of the person with dementia. This is relief for the family. It is not direct pay to the family caregiver.

How to apply or use it: Call your county senior center or the West Virginia Aging and Disability Network at 1-866-981-2372.

What to gather or know first: Have the dementia diagnosis, the caregiver’s name and phone number, the county of residence, and a simple list of the hours when the family most needs relief.

Lighthouse Program

What it is: The Lighthouse Program is a state-funded, county-run in-home support program for older adults.

Who can get it or use it: The state’s service guide says Lighthouse is for West Virginians age 60 and older who need significant help at home and are not eligible for the state’s Medicaid-funded in-home programs.

How it helps: The official ADW page says Lighthouse is available in each county, provides help in personal care, mobility, diet, and environmental needs, and uses a sliding cost based on income. Openings can change by county. Like FAIR, this is not a simple paycheck to the family member.

How to apply or use it: Call the county senior center or the Aging and Disability Network at 1-866-981-2372 and ask if Lighthouse openings are available in your county.

What to gather or know first: Have proof of age, address, basic income information, and a short list of the daily tasks the senior can no longer do safely.

VA caregiver support and Veteran-Directed Care

What it is: If the older adult is a veteran, West Virginia families should also look at the VA Caregiver Support Program and Veteran-Directed Care. These are separate from state Medicaid.

Who can get it or use it: The VA says Veteran-Directed Care is for enrolled veterans who are eligible for community care, meet the clinical criteria, and have the program available in their area. The Caregiver Support Program can also screen families for other VA help, including PCAFC when the veteran meets that program’s rules.

How it helps: The VA says VDC gives the veteran or their representative a budget and may allow hiring a family member or neighbor. This can be a strong backup when the state Medicaid path is not available or is taking too long.

How to apply or use it: Call the VA Caregiver Support Line at 1-855-260-3274 or speak with the veteran’s VA social worker.

What to gather or know first: Have the veteran’s VA enrollment information, current care needs, diagnosis list, and a clear description of how much hands-on help is needed each day.

Take Me Home if the senior is already in a facility

What it is: West Virginia’s Take Me Home Transition Program helps eligible people move from an institution back into the community.

Who can get it or use it: This option matters when a parent is in a nursing home or other facility but the family wants them back at home with services.

How it helps: It can connect the family to home-based services and transition planning instead of waiting until discharge day to figure everything out.

How to apply or use it: The official program page says referrals can be made through the Aging and Disability Resource Center at 1-866-981-2372 or the Take Me Home office at 1-855-519-7557.

What to gather or know first: Have the facility name, discharge contact, possible home address, and the name of the person who will coordinate housing and care at home.

How to apply without wasting time

1. Decide whether your goal is speed or self-direction. If the senior already has Medicaid and needs daily help now, start with Personal Care. If the goal is to hire family directly, start the ADW waiver and ask about Personal Options.
2. Start the medical form fast. West Virginia uses an MNER for ADW and a PC-MNER for Personal Care. Incomplete forms slow everything down.
3. Do not wait on the financial side. The long-term-care Medicaid page makes clear that financial eligibility matters. Gather proof of income and assets right away.
4. If you want a family member hired, say that early. Ask the case manager or agency if your relative can meet the program’s rules, training, and background-check steps.
5. Keep paper proof. In the official ADW/PC/TBIW FAQ, the state advises people to keep copies of what they submit and get date-stamped proof when turning in paperwork.
6. While you wait, ask for backup help. The ADW page specifically points people on the waitlist to Personal Care, Lighthouse, FAIR, and the Aging and Disability Network.

Checklist of documents or proof

• Photo ID and Social Security number for the senior
• Medicaid card, Medicare card, and any other insurance cards
• Doctor name, phone number, diagnoses, and medicine list
• Recent income proof such as Social Security award letters or pension stubs
• Recent bank statements and other asset records for long-term-care Medicaid review
• Mortgage or rent information and proof of West Virginia address
• POA, MPOA, guardianship, or representative papers if someone helps make decisions
• Name and contact information for the family member or agency you hope will provide care

Reality checks

• West Virginia does not have a simple state stipend for any family caregiver of a senior.
• The main state-paid paths usually require Medicaid and a real care-needs assessment.
• The state’s ADW manual and Personal Care manual do not let spouses be paid under the main Medicaid senior-care routes.
• The official Personal Options brochure says Palco withholds taxes and handles year-end reporting. Do not assume caregiver pay is tax-free.
• The ADW manual warns that paid family attendants cannot bill for family events or visits that are not for the member’s approved care needs.

Common mistakes to avoid

• Waiting only for ADW when Personal Care might start sooner
• Assuming a spouse can be the paid worker
• Thinking the Medicaid reimbursement rate is the worker’s take-home wage
• Forgetting the financial review side of long-term-care Medicaid
• Letting a POA or representative fill two roles without checking the program rules
• Turning in papers without keeping copies or proof of submission

Best options by need

• Need help soon and already have Medicaid: start with Personal Care Services.
• Want an adult child or other relative on payroll: push for ADW Personal Options.
• Not on Medicaid or over the Medicaid limits: ask about Lighthouse.
• Caring for someone with dementia and burning out: ask about FAIR.
• The senior is a veteran: call VA Caregiver Support.
• The senior is in a facility and wants to come home: call Take Me Home.

What to do if denied, delayed, blocked, or waitlisted

First, ask for the decision in writing. Do not rely on a phone answer alone. If the notice says the case was denied, closed, or reduced, follow the hearing instructions on that notice right away. The ADW manual and Personal Care manual both provide for hearing and grievance rights.

If the problem is delay, call the program contact listed on the official page, not just the local provider. For ADW, use the Bureau of Senior Services and Acentra contacts. For Personal Care, use the Personal Care program contacts. If ADW is waitlisted, ask about Personal Care, FAIR, Lighthouse, meals, transportation, and county senior-center help while you wait.

Plan B / backup options

If the state cannot pay your family member right away, use bridge help. The state in-home care guide says some services are private pay, insurance-based, or partly state-funded. West Virginia also has the In-Home Care Worker Registry for finding workers, plus county senior-center supports such as meals, transportation, chore help, and respite.

If a veteran is involved, the VA route may work even when Medicaid does not. If money must come from the family for a while, keep clear records of hours and duties and get legal advice before making large gifts or transfers if Medicaid may be needed later.

Local resources in West Virginia

• West Virginia Aging and Disability Network: 1-866-981-2372
• Bureau of Senior Services ADW help: 1-866-767-1575
• Personal Care Services Program: 1-866-385-8920 to start the PC-MNER process
• Medicaid for Long Term Care and local DoHS office help
• WV 211 information through the state community resources page
• VA Caregiver Support Line: 1-855-260-3274
• Take Me Home: 1-855-519-7557

Rural West Virginia families: one extra thing to expect

In many rural counties, the biggest problem is not the rule book. It is finding a worker. If one agency says it cannot staff your area, do not stop there. Ask for another agency, ask whether Personal Options would solve the staffing problem, and call your county senior center about FAIR, Lighthouse, meals, and transportation.

FAQ

Can a senior in West Virginia have a family member paid to provide care?

Yes, sometimes. The best direct path is the Aged and Disabled Waiver using Personal Options. A second path is the Medicaid Personal Care Services Program, where a certified agency may hire a relative. But West Virginia does not list a separate, simple state cash stipend for any family caregiver of a senior.

Can a spouse be paid in West Virginia?

Usually no under the main state Medicaid senior-care programs. The ADW manual and Personal Care manual both bar spouses from being paid caregivers in those programs. If the senior is a veteran, ask the VA Caregiver Support Program because VA rules are separate.

Can an adult child be paid to care for a parent?

Often yes. Under the ADW rules, the main people barred are spouses and court-appointed guardians, which usually leaves room for an adult child who meets the program’s worker rules. Under Personal Care rules, an adult child may be able to work for a certified agency as the direct-care worker.

Does the senior need Medicaid?

For the main state-paid family caregiver paths, yes, usually. The Medicaid for Long Term Care page explains the financial and medical review process. If the senior does not have Medicaid, ask about Lighthouse, FAIR, or the VA if the senior is a veteran.

How much do family caregivers get paid in West Virginia?

There is no one statewide family-caregiver paycheck amount. West Virginia’s ADW rate chart and Personal Care rate code set both list reimbursement at $6.75 per 15 minutes effective October 1, 2025, but that is a program payment rate, not the worker’s guaranteed wage. Actual pay depends on the approved hours, the member’s budget, agency rules, payroll taxes, and the service model.

What if my parent has dementia?

If dementia is the main issue, ask about FAIR even if Medicaid is not ready yet. FAIR is statewide and can provide up to 16 hours a week of relief based on need and staffing. If the person also needs heavy daily care and may meet nursing-home level of care, ask about ADW too.

What if the ADW waiver is full or taking too long?

Do not wait with no backup. The official ADW page says people on the waitlist should ask about Personal Care, Lighthouse, and FAIR. If the senior is in a facility, ask about Take Me Home.

What is the best first phone call to make?

For most West Virginia families, start with the West Virginia Aging and Disability Network at 1-866-981-2372. It is the best first sorting call if you do not yet know whether your family should pursue ADW, Personal Care, Lighthouse, FAIR, or a facility-to-home transition plan.

Resumen en español

Resumen corto: En West Virginia, sí existe una forma para que algunas familias reciban pago por cuidar a un adulto mayor en casa, pero casi siempre pasa por Medicaid. La opción principal es el Aged and Disabled Waiver con Personal Options. Un hijo adulto puede calificar con frecuencia, pero un cónyuge normalmente no puede ser el cuidador pagado bajo los programas principales de Medicaid para adultos mayores.

Si la persona ya tiene Medicaid y necesita ayuda pronto, pregunte por Personal Care Services. Si hay demencia, pregunte por FAIR. Si la persona no califica para Medicaid, pregunte por Lighthouse. La mejor primera llamada para muchas familias es la West Virginia Aging and Disability Network al 1-866-981-2372.

About This Guide

Editorial note: This guide was written for older adults, caregivers, and adult children in West Virginia. It focuses on the real programs the state and VA actually list, not generic national advice.

Verification: We checked official West Virginia and VA sources on 6 April 2026 and used the latest public program details we could verify that were available through March 2026, including program pages, manuals, rate sheets, and application instructions.

Corrections: If you find an official change, send the updated source through the GrantsForSeniors.org contact page so this guide can be reviewed and corrected.

Disclaimer: This article is informational only. It is not legal, tax, medical, or benefits advice. Program rules, staffing, and income limits can change, and county-level availability can differ across West Virginia.