Iowa · waiver service
Consumer Directed Attendant Care (CDAC) — agency-delivered in Iowa
Consumer Directed Attendant Care pays for hands-on help at home for Iowa Medicaid waiver members. After December 31, 2025, CDAC can only be delivered by an enrolled agency, not an individual provider. An agency can hire a member's adult child or other relative as the attendant and pay them a wage.
Also called: CDAC · agency CDAC · Iowa consumer directed attendant care · Iowa attendant care agency
Who do you care for?
Quick facts
- Pay
- Agency wage (not published)
- Adult children & other relatives
- Yes
- Spouse
- Not right now
- Parent of a minor child
- Not right now
- Waitlist
- possible
Who qualifies for Consumer Directed Attendant Care (CDAC) — agency-delivered
- Enrolled in Iowa Medicaid and an Iowa HCBS waiver that covers CDAC.
- Meets the waiver's level-of-care requirement.
- CDAC is listed in the member's service plan.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- an enrolled agency can employ an adult child or other relative as the attendant.
- Spouse Not right now
- a spouse is not eligible to be the CDAC provider.
- Parent of a minor child Not right now
- a parent or stepparent of a minor cannot be the CDAC provider.
- Living together
- the attendant may live with the member or not.
Who employs the caregiver: Agency. Since individual CDAC ended December 31, 2025, an enrolled agency employs the attendant. Members who want to be the employer use CCO.
Spouse rules differ by program — see spouse pay in Iowa.
How much Consumer Directed Attendant Care (CDAC) — agency-delivered pays
Agency wage (not published). Iowa Medicaid or the MCO pays the agency under the HCBS fee schedule; the agency sets the attendant's wage.
Hours and budget: Units of CDAC are set in the service plan by the case manager or MCO based on assessed need and waiver limits.
Compare with other Iowa programs on the Iowa caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
Depends on the waiver: the Elderly Waiver had no waitlist in January 2026, but most other Iowa waivers have waitlists.
How to apply for Consumer Directed Attendant Care (CDAC) — agency-delivered
- Apply for Iowa Medicaid and the HCBS waiver through Iowa HHS (800-338-8366).
- Ask your case manager or MCO to add CDAC to your service plan.
- Choose an enrolled CDAC agency and ask whether it will hire your relative.
- Iowa Medicaid Member Services · 1-800-338-8366 · official site
- Iowa HHS · 800-972-2017 · official site
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Consumer Directed Attendant Care (CDAC) — agency-delivered questions
Can I still be an individual CDAC provider in Iowa?
No. Iowa ended individual CDAC on December 31, 2025 after a federal tax compliance issue. You can work for a CDAC agency or be hired under CCO.
Can a CDAC agency hire me to care for my dad?
Yes, if the agency agrees to hire you and you meet its requirements. Spouses and parents of minors cannot be paid.
What is the difference between CDAC and CCO?
With agency CDAC, the agency is your employer. With CCO, the member is the employer and Veridian handles payroll.
How much do CDAC agency workers earn?
The agency sets the wage. Iowa does not publish a family-caregiver wage.
Sources: hhs.iowa.gov · hhs.iowa.gov · provider.wellpoint.com · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Iowa caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Iowa — pick yours for the local picture.
Across the line
States that border Iowa
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.