Arizona · waiver service
Spouse as Paid Caregiver in Arizona
Arizona's ALTCS program lets a spouse be paid for attendant care, personal care or similar services for their husband or wife. The spouse must be employed by a direct care worker agency (or by the member through DDD's Independent Provider Network) and can be paid for no more than 40 hours a week.
Also called: SPCG · spouse attendant care Arizona · ALTCS pay spouse caregiver
Who do you care for?
Quick facts
- Pay
- $13–$16/hr
- Adult children & other relatives
- this model is for spouses; other relatives use SDAC or Agency with Choice.
- Spouse
- Yes
- Parent of a minor child
- parents use the Parents as Paid Caregivers model.
- Waitlist
- none
Who qualifies for Spouse as Paid Caregiver
- Enrolled in ALTCS and living in their own home.
- The care meets the definition of extraordinary care — beyond what a spouse ordinarily does.
- The member is told they can choose a caregiver other than their spouse, and this choice is recorded at least once a year.
- The spouse meets direct care worker training and qualification rules.
Who can be paid as the caregiver
- Adult children & other relatives
- this model is for spouses; other relatives use SDAC or Agency with Choice.
- Spouse Yes
- up to 40 hours of paid care in a seven-day period, through a direct care worker agency.
- Parent of a minor child
- parents use the Parents as Paid Caregivers model.
- Living together
- in practice — the member must live in their own home.
Who employs the caregiver: Agency: the spouse must be employed by a direct care worker agency. Members served by DDD can also employ the spouse through the Independent Provider Network. Spouses cannot be paid through SDAC.
Spouse rules differ by program — see spouse pay in Arizona.
How much Spouse as Paid Caregiver pays
$13–$16/hr. The spouse's rate may not exceed what a non-spouse worker would earn for similar care. Commonly reported pay is $13–$16/hour; Arizona's minimum wage is $15.15/hour as of January 1, 2026.
Hours and budget: The case manager assesses needs. The spouse can be paid for at most 40 hours a week, and total care from the spouse and any other worker combined is limited to 40 hours a week.
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.
How to apply for Spouse as Paid Caregiver
- Apply for ALTCS at 1-888-621-6880 or through Health-e-Arizona Plus.
- Tell the ALTCS case manager you want your spouse as the paid caregiver; you will sign a Spouse Attendant Care Acknowledgement of Understanding.
- Your spouse applies to and is hired by a contracted direct care worker agency and completes training.
- AHCCCS – ALTCS applications · 1-888-621-6880 · official site
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Spouse as Paid Caregiver questions
Can I get paid to take care of my husband or wife in Arizona?
Yes, if your spouse is on ALTCS. You must be hired by a direct care worker agency, and you can be paid for up to 40 hours a week.
Can a spouse be paid through self-directed care?
No. AHCCCS policy bars paying a spouse through Self-Directed Attendant Care; it must go through an agency (or DDD's Independent Provider Network).
What if my spouse needs more than 40 hours of care?
Under this model, total attendant care from the spouse and any other worker is capped at 40 hours a week.
When did Arizona start paying spouses?
AHCCCS began the spouse as paid caregiver option on October 1, 2007, under a CMS waiver.
Sources: azahcccs.gov · azahcccs.gov · azahcccs.gov · 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.