On April 16, 2026, Health and Human Services Secretary Robert F. Kennedy Jr. testified before the House Ways and Means Committee that Medicaid home and community-based services (HCBS) waivers pay family members "for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor's appointment." Four days later, CMS Administrator Dr. Mehmet Oz posted a video on social media describing personal care services as help with "something that our families would normally do for us, like carrying groceries." The message was clear: paying family caregivers through Medicaid is wasteful, possibly fraudulent, and certainly not what the program should cover. If you're enrolled in a Consumer Directed Personal Assistance Program (CDPAP), a self-directed care waiver, or any Medicaid program that pays a family member to provide care, you need to understand what this rhetoric signals, what the actual policy threat is, and what you should do now to protect your services. What CDPAP and Self-Directed Care Programs Are. CDPAP is one of the largest self-directed care programs in the country, primarily operating in New York State. It allows Medicaid members who need personal care services to hire their own personal assistant, including family members, to provide that care at home. The personal assistant is paid by Medicaid through a fiscal intermediary. As of 2026, typical pay rates are $23.81 per hour in New York City, Long Island, and Westchester. Most states have similar programs under different names: participant-directed services, self-directed care waivers, or consumer-directed personal care. The structure...

RFK Jr. and Dr. Oz called paid family caregiver programs fraudulent. Here's what CDPAP and self-directed care families should do now.

RFK Jr. and Dr. Oz Are Calling Medicaid Family Caregiver Payments Fraud-Rife. Here's What Self-Directed Care Families Need to Know.

On April 16, 2026, Health and Human Services Secretary Robert F. Kennedy Jr. testified before the House Ways and Means Committee that Medicaid home and community-based services (HCBS) waivers pay family members "for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor's appointment." Four days later, CMS Administrator Dr. Mehmet Oz posted a video on social media describing personal care services as help with "something that our families would normally do for us, like carrying groceries." The message was clear: paying family caregivers through Medicaid is wasteful, possibly fraudulent, and certainly not what the program should cover. If you're enrolled in a Consumer Directed Personal Assistance Program (CDPAP), a self-directed care waiver, or any Medicaid program that pays a family member to provide care, you need to understand what this rhetoric signals, what the actual policy threat is, and what you should do now to protect your services. What CDPAP and Self-Directed Care Programs Are. CDPAP is one of the largest self-directed care programs in the country, primarily operating in New York State. It allows Medicaid members who need personal care services to hire their own personal assistant, including family members, to provide that care at home. The personal assistant is paid by Medicaid through a fiscal intermediary. As of 2026, typical pay rates are $23.81 per hour in New York City, Long Island, and Westchester. Most states have similar programs under different names: participant-directed services, self-directed care waivers, or consumer-directed personal care. The structure...

RFK Jr. and Dr. Oz called paid family caregiver programs fraudulent. Here's what CDPAP and self-directed care families should do now.

In Washington state, if you're the parent of a disabled child under 18, you can't receive Medicaid compensation for providing their care. If you're their grandparent, aunt, or uncle, you can. If you're a professional agency worker, the state will pay them. But if you're the parent, the answer is no. That exclusion isn't unique to Washington. Most states bar parents of minor children from receiving payment through Medicaid self-directed care programs, even when the parent has quit their job to provide full-time care and the state has no paid workers available to deliver the services the child qualifies for. In April 2026, families in Washington filed a class-action lawsuit in federal court challenging that policy, arguing that the state is failing to provide the nursing and personal care services children with developmental disabilities are entitled to under Medicaid. The lawsuit doesn't claim the parent exclusion itself is discriminatory. It argues that when the state excludes parents but can't provide alternative workers to deliver the care, it's violating the Medicaid Act. For families across the country watching labor shortages shrink the pool of available caregivers, this case could set a precedent that changes how states are required to meet their obligations when no one else is available to do the work. Why States Exclude Parents From Caregiver Programs. Medicaid allows states to run self-directed care programs where recipients can choose and pay their own caregivers, including family members. The programs go by different names: Consumer Directed Personal Assistance Program (CDPAP)...

Most states bar parents from Medicaid caregiver pay. A lawsuit tests whether that's legal when workers aren't available.

Parents of Minor Disabled Children Can't Get Paid as Medicaid Caregivers in Most States. One Lawsuit Could Change That.

In Washington state, if you're the parent of a disabled child under 18, you can't receive Medicaid compensation for providing their care. If you're their grandparent, aunt, or uncle, you can. If you're a professional agency worker, the state will pay them. But if you're the parent, the answer is no. That exclusion isn't unique to Washington. Most states bar parents of minor children from receiving payment through Medicaid self-directed care programs, even when the parent has quit their job to provide full-time care and the state has no paid workers available to deliver the services the child qualifies for. In April 2026, families in Washington filed a class-action lawsuit in federal court challenging that policy, arguing that the state is failing to provide the nursing and personal care services children with developmental disabilities are entitled to under Medicaid. The lawsuit doesn't claim the parent exclusion itself is discriminatory. It argues that when the state excludes parents but can't provide alternative workers to deliver the care, it's violating the Medicaid Act. For families across the country watching labor shortages shrink the pool of available caregivers, this case could set a precedent that changes how states are required to meet their obligations when no one else is available to do the work. Why States Exclude Parents From Caregiver Programs. Medicaid allows states to run self-directed care programs where recipients can choose and pay their own caregivers, including family members. The programs go by different names: Consumer Directed Personal Assistance Program (CDPAP)...

If you're caring for a disabled family member through a Medicaid self-directed care program and getting paid for that work, you need to verify your state's program status immediately. Maryland just announced it's cutting family caregiver wages by more than 25% and capping weekly hours starting July 1. Households that currently depend on this income are looking at losses of $18,000 to $80,000 per year. Other states are watching Maryland's move, and similar cuts are expected to follow. This isn't about the federal Medicaid work requirements that don't take effect until January 2027. This is about state governments acting preemptively to close their own budget gaps before federal cuts even hit. Maryland's Democratic-controlled legislature and Gov. Wes Moore adopted the cuts after hearings where dozens of disabled program recipients and families pleaded with lawmakers to restore funding. The cuts are happening, and families have six weeks to prepare. What Self-Directed Medicaid Programs Are and Why They Matter. Self-directed care goes by different names depending on your state: Consumer Directed Personal Assistance Program (CDPAP) in New York, Cash & Counseling programs in some states, participant-directed care, or self-directed Home and Community-Based Services (HCBS) waiver programs. The structure is the same. Medicaid pays family members or friends chosen by the person with disabilities to provide personal care at home instead of requiring care from agency-employed workers. These programs exist in all 50 states in some form, according to KFF data. The average hourly rate for Medicaid personal care is around $18 per...

Maryland is cutting family caregiver wages by 25% starting July 1. Here's what self-directed care families need to do now.

States Are Cutting Medicaid Family Caregiver Wages. Here's What Self-Directing Families Need to Do Now.

If you're caring for a disabled family member through a Medicaid self-directed care program and getting paid for that work, you need to verify your state's program status immediately. Maryland just announced it's cutting family caregiver wages by more than 25% and capping weekly hours starting July 1. Households that currently depend on this income are looking at losses of $18,000 to $80,000 per year. Other states are watching Maryland's move, and similar cuts are expected to follow. This isn't about the federal Medicaid work requirements that don't take effect until January 2027. This is about state governments acting preemptively to close their own budget gaps before federal cuts even hit. Maryland's Democratic-controlled legislature and Gov. Wes Moore adopted the cuts after hearings where dozens of disabled program recipients and families pleaded with lawmakers to restore funding. The cuts are happening, and families have six weeks to prepare. What Self-Directed Medicaid Programs Are and Why They Matter. Self-directed care goes by different names depending on your state: Consumer Directed Personal Assistance Program (CDPAP) in New York, Cash & Counseling programs in some states, participant-directed care, or self-directed Home and Community-Based Services (HCBS) waiver programs. The structure is the same. Medicaid pays family members or friends chosen by the person with disabilities to provide personal care at home instead of requiring care from agency-employed workers. These programs exist in all 50 states in some form, according to KFF data. The average hourly rate for Medicaid personal care is around $18 per...

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Special Needs
Articles

RFK Jr. and Dr. Oz Are Calling Medicaid Family Caregiver Payments Fraud-Rife. Here's What Self-Directed Care Families Need to Know.

Parents of Minor Disabled Children Can't Get Paid as Medicaid Caregivers in Most States. One Lawsuit Could Change That.

States Are Cutting Medicaid Family Caregiver Wages. Here's What Self-Directing Families Need to Do Now.

Find Providers Near You

Special Needs Articles

RFK Jr. and Dr. Oz Are Calling Medicaid Family Caregiver Payments Fraud-Rife. Here's What Self-Directed Care Families Need to Know.

Parents of Minor Disabled Children Can't Get Paid as Medicaid Caregivers in Most States. One Lawsuit Could Change That.

States Are Cutting Medicaid Family Caregiver Wages. Here's What Self-Directing Families Need to Do Now.

Find Providers Near You

Special Needs
Articles