Arizona · self-direction option
ALTCS Self-Directed Attendant Care (SDAC) in Arizona
Self-Directed Attendant Care is an ALTCS (Arizona Long Term Care System) option where the member becomes the legal employer of their own direct care worker. The member can hire family members such as adult children, and a Fiscal Employer Agent handles taxes, payroll and paychecks. Spouses, parents of minor children and the member's legal guardian cannot be paid through SDAC.
Also called: SDAC · ALTCS self-directed care · self-directed attendant care Arizona · ALTCS member-directed options · AHCCCS self directed
Who do you care for?
Quick facts
- Pay
- $13–$16/hr
- Adult children & other relatives
- Yes
- Spouse
- Not right now
- Parent of a minor child
- Not right now
- Waitlist
- none
Who qualifies for SDAC
- Enrolled in ALTCS Elderly and Physically Disabled (E/PD) or Fee-For-Service Tribal ALTCS.
- Needs nursing-home level of care (ALTCS medical and financial eligibility).
- Lives in their own home, not an assisted living or nursing facility.
- Able to direct their own care, or has a legal guardian who can.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- AHCCCS policy lets members hire family members, including adult children, siblings, grandchildren and in-laws.
- Spouse Not right now
- AMPM 1320-A says a Spouse as Paid Caregiver may not be reimbursed for SDAC; spouses use the agency route instead.
- Parent of a minor child Not right now
- parents of minor children are prohibited from serving as a paid worker in SDAC.
- Living together
- the worker may or may not live with the member.
Who employs the caregiver: The member (or legal guardian) is the legal employer; a Fiscal Employer Agent handles payroll, tax withholding and paychecks.
Spouse rules differ by program — see spouse pay in Arizona.
How much SDAC pays
$13–$16/hr. No set family wage is published. Pay is commonly reported at $13–$16/hour, at or near Arizona's minimum wage, which rose to $15.15/hour on January 1, 2026; rates vary by health plan.
Hours and budget: The ALTCS case manager assesses needs with the member and family and sets the number and frequency of attendant care, personal care and homemaker hours, subject to a cost-effectiveness study.
Compare with other Arizona programs on the Arizona caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
ALTCS is an entitlement; once eligible, members are enrolled.
How to apply for SDAC
- Apply for ALTCS by calling 1-888-621-6880, online through Health-e-Arizona Plus, or at a local ALTCS office.
- Complete the ALTCS financial review and the pre-admission screening for level of care.
- Once enrolled, ask your ALTCS case manager to choose Self-Directed Attendant Care.
- Hire your worker and enroll them with the Fiscal Employer Agent; the worker completes the required training.
- AHCCCS – ALTCS applications · 1-888-621-6880 · official site
- AHCCCS Self-Directed Attendant Care · official site
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SDAC questions
Can I get paid to take care of my parent in Arizona?
Yes. If your parent is on ALTCS, they can choose Self-Directed Attendant Care and hire you, or use Agency with Choice.
Can a spouse be paid through SDAC?
No. AHCCCS policy says a Spouse as Paid Caregiver cannot be reimbursed for SDAC. A spouse can be paid through a direct care worker agency under the spouse caregiver model.
Who handles taxes and payroll?
A Fiscal Employer Agent. The member is the legal employer, but the agent withholds taxes and issues paychecks.
Can a legal guardian be the paid worker?
No. Under SDAC the legal guardian can direct care for the member but cannot be the member's paid worker.
Is there a waitlist for ALTCS?
No. ALTCS is an entitlement, so people who qualify are enrolled.
Sources: azahcccs.gov · azahcccs.gov · azahcccs.gov · medicaidplanningassistance.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Arizona caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Arizona — pick yours for the local picture.
Across the line
States that border Arizona
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.