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National question: Can a family caregiver get paid? Official programs decide eligibility.

DC Elderly and Persons with Physical Disabilities Waiver (Self-Direction)

The District of Columbia's Elderly and Persons with Physical Disabilities (EPD) waiver provides home and community-based services for Medicaid-eligible DC residents who would otherwise require nursing home care. Services My Way is the participant-directed option inside EPD, allowing eligible participants to self-direct participant-directed community support and individual-directed goods and services. Family members can serve as participant-directed workers subject to exclusions for spouses, legally responsible relatives, and court-appointed guardians.

Services My Way lets EPD Waiver participants who live in their natural home self-direct participant-directed community support and individual-directed goods and services. Participant-directed community support is similar to personal care aide support and can include cueing, safety monitoring, and hands-on help with ADLs and IADLs when included in the person-centered service plan, PDS budget, and prior authorization. The participant or authorized representative is the common-law employer of the participant-directed worker, with FMS/support broker help. Workers may be individual or family members, but spouses, legally responsible relatives, and court-appointed guardians are excluded; parents of adult participants are not precluded. EPD uses the 300% SSI Federal Benefit Rate income standard, which is $2,982/month for an individual in 2026, plus a $4,000 individual countable-asset limit. PDW wages are set through the approved PDS budget within DHCF's prescribed range: no less than the current DC living wage and no more than the current agency-based PCA rate, with taxes and insurance inside the budget rather than a single public fixed dollar amount.

Eligibility

  • U.S. citizenship or qualified immigrant status required
  • Care recipient must have a qualifying disability
  • Care recipient age: at least 18
  • Relationship: parent, child, sibling, grandparent, other relative, non relative

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

  • Does the person receiving care live in District of Columbia? — Residency is usually the first thing a program checks.
  • Does your relationship to the person — parent, child, sibling, grandparent, other relative, or non relative — count for this program?
  • What are the current income and asset limits, and whose income counts? — Our record lists gross monthly limit around $2,743 for a household of one — limits change, so confirm the current figures.
  • Is the person receiving care in the covered age range (18 or older)?
  • What counts as a qualifying disability or level of care need, and what documentation shows it?
  • Which citizenship or immigration statuses does the program accept, and which documents show it?
  • Is there a caregiver-specific department, coordinator, or support line? Ask for it by name. — Many agencies have one that isn’t advertised on the website.
  • What documents do you need from us to start an application?
  • Is there a waitlist right now, and how long is it?

Services

Services My Way lets EPD Waiver participants who live in their natural home self-direct participant-directed community support and individual-directed goods and services. Participant-directed community support is similar to personal care aide support and can include cueing, safety monitoring, and hands-on help with ADLs and IADLs when included in the person-centered service plan, PDS budget, and prior authorization. The participant or authorized representative is the common-law employer of the participant-directed worker, with FMS/support broker help. Workers may be individual or family members, but spouses, legally responsible relatives, and court-appointed guardians are excluded; parents of adult participants are not precluded. EPD uses the 300% SSI Federal Benefit Rate income standard, which is $2,982/month for an individual in 2026, plus a $4,000 individual countable-asset limit. PDW wages are set through the approved PDS budget within DHCF's prescribed range: no less than the current DC living wage and no more than the current agency-based PCA rate, with taxes and insurance inside the budget rather than a single public fixed dollar amount.

How to apply

Use the official program page for application details: official program page.