Kentucky · self-direction option
Participant Directed Services (PDS) in Kentucky
Participant Directed Services is Kentucky's self-direction option across its Medicaid waivers (HCB, Michelle P., SCL and the two ABI waivers). The member hires, trains and schedules their own workers, who can be friends or relatives, and a financial management agency handles payroll. A support broker or case manager helps build the plan and budget.
Also called: PDS · Consumer Directed Option · CDO · Kentucky self-directed waiver · Kentucky PDS family caregiver
Who do you care for?
Quick facts
- Pay
- $29.04/hr (reported max)
- Adult children & other relatives
- Yes
- Spouse
- Sometimes
- Parent of a minor child
- Sometimes
- Waitlist
- long
Who qualifies for PDS
- Enrolled in a Kentucky 1915(c) waiver: Home and Community Based (HCB), Michelle P. (MPW), Supports for Community Living (SCL), Acquired Brain Injury (ABI) or ABI Long Term Care.
- Willing to act as employer (or choose an authorized representative).
- Follows the person-centered service plan and spending plan, and meets any patient liability set by DCBS.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- friends, adult children and other relatives can be hired; on HCB, immediate family members need written approval from the Department for Medicaid Services.
- Spouse Sometimes
- allowed under Michelle P. PDS (capped at 40 hours a week); on HCB a spouse needs written DMS approval under specific conditions.
- Parent of a minor child Sometimes
- parents of minors can be paid under Michelle P./HCB only within the rules for legally responsible individuals, capped at 40 hours a week combined.
- Living together
- the worker may live with the member or not.
Who employs the caregiver: Self-directed. The member is the employer; a mandatory financial management agency handles payroll and taxes; a support broker or case manager assists.
Spouse rules differ by program — see spouse pay in Kentucky.
How much PDS pays
$29.04/hr (reported max). PDS pay cannot exceed what Medicaid allows for the same service from an agency. Kentucky's Michelle P. regulation lists PDS rates effective January 1, 2025 of $6.36 per 15 minutes for attendant care and $9.08 per 15 minutes for personal care; a 2026 attendant care maximum of $29.04/hr is reported. Take-home pay is lower after employer taxes and FMS costs.
Hours and budget: The support broker builds a budget from the person-centered service plan; PDS providers are generally limited to 40 hours a week.
Compare with other Kentucky programs on the Kentucky caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
PDS itself has no list, but the member must first get a waiver slot. HCB, MPW, SCL and ABI waivers have waiting lists.
How to apply for PDS
- Apply for Medicaid and the waiver at kynect.ky.gov or by calling 855-306-8959.
- Get on the waiver waiting list if needed and complete the level-of-care assessment.
- Once on the waiver, ask your case manager to enroll you in PDS.
- Work with your support broker on the plan and budget, then hire your worker through the financial management agency.
- Dept. for Aging and Independent Living (DAIL) · 877-315-0589 · official site
- kynect (apply for Medicaid) · 855-306-8959 · official site
- Medicaid Waiver Help Desk · 844-784-5614 · official site
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PDS questions
Can I get paid to care for my mother in Kentucky?
Yes, if she is on a Kentucky waiver and uses PDS. She can hire you, and the financial management agency pays you.
Can a spouse be paid under PDS in Kentucky?
On the Michelle P. waiver, yes, up to 40 hours a week. On the HCB waiver, a spouse needs written approval from the Department for Medicaid Services.
How many hours can a family PDS worker work?
Generally no more than 40 hours a week per PDS provider.
What does the support broker do?
Helps you build your plan and budget, find training, and hire workers.
Can I switch back to agency services?
Yes. You can return to traditional waiver services without losing eligibility.
Sources: chfs.ky.gov · apps.legislature.ky.gov · apps.legislature.ky.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Kentucky caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Kentucky — pick yours for the local picture.
Across the line
States that border Kentucky
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.