Maryland
Maryland programs that pay family caregivers
Maryland pays family members through 4 Medicaid programs. Each has its own rules for who qualifies, who can be paid and what it pays.
Who do you care for?
Community First Choice (CFC)
Community First Choice is a Maryland Medicaid state plan benefit that pays for personal assistance and related supports at home for people of any age who need an institutional level of care. Since October 1, 2023, participants can choose an agency model or a self-directed model, and a family member can be the paid personal assistant. Because CFC is a state plan benefit, there is no waiting list.
$16–$20/hr reported wage; agency rate $25.58/hr (FY2025)
How it works →Community Personal Assistance Services (CPAS)
Community Personal Assistance Services is a Maryland Medicaid state plan benefit for people who need help with at least one daily activity but do not need an institutional level of care. It pays for personal assistance, nurse monitoring and supports planning. Like CFC, it can be delivered through an agency or self-directed, and relatives can be hired as the personal assistant.
$16–$20/hr reported wage; agency rate $25.58/hr (FY2025)
How it works →Community Options Waiver (Home and Community-Based Options Waiver)
The Community Options Waiver helps adults 18 and older who need nursing facility level of care live at home or in assisted living. It lets people with income up to 300% of the SSI benefit qualify for Medicaid, and members get all Medicaid benefits, including Community First Choice personal assistance, where a family member can be the paid worker. There is a long registry to get in.
Via CFC: $16–$20/hr reported; agency rate $25.58/hr (FY2025)
How it works →DDA Waivers (Community Pathways Waiver)
Maryland's Developmental Disabilities Administration (DDA) runs Medicaid waivers for children and adults with intellectual and developmental disabilities. Starting October 6, 2025, the Family Supports Waiver (birth to 21) and Community Supports Waiver were folded into the Community Pathways Waiver. Through Personal Supports and self-directed services, relatives, legal guardians and legally responsible persons, including parents of minors, can be paid as staff, with new hour caps in the FY2027 budget.
Set by self-directed budget or provider — not published
How it works →The overview: the Maryland caregiver program · Maryland caregiver pay · spouse rules
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Across the line
States that border Maryland
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.