A family member or someone living in the home may know the individual’s needs especially well. Becoming a paid attendant also involves rules that can affect what can be paid for and which other services remain available.
ConnectChoice helps individuals, families, and EORs understand those considerations so they can make informed choices about their support arrangements.
Understanding the different roles
A family member may live with the individual or elsewhere. A live-in caregiver shares the individual’s home. A Legally Responsible Individual (LRI) is a parent or legal guardian of a minor, or the individual’s spouse.
A parent of an adult is not an LRI solely because of the parent-child relationship. Living together does not, by itself, make someone an LRI.
When an LRI becomes a paid attendant
An LRI may be paid for qualifying extraordinary personal care—care beyond their ordinary responsibilities. For a child, this means disability-related care beyond what a child of the same age typically needs.
Paid assistance is limited to covered Activities of Daily Living (ADLs), such as bathing, dressing, eating, toileting, and transferring. Household tasks, known as Instrumental Activities of Daily Living (IADLs), and general supervision do not qualify as extraordinary care.
Payment is limited to up to 40 hours per week for each individual, based on approved needs. The LRI must also meet the qualifications that apply to other paid attendants.
Respite services are not available when a paid LRI provides personal care or assistance. Understanding this effect on other supports is an important part of deciding whether becoming a paid attendant is the right arrangement for your family.
Read DMAS policy and guidance for LRIs
Making an informed choice
Choosing a paid caregiver involves considering the individual’s full support needs, the family’s circumstances, and how different arrangements may affect available services. ConnectChoice helps you understand those options before making a decision.
When an LRI is considering becoming a paid attendant, we discuss what assistance can be paid for, what needs may call for another attendant, and how the arrangement affects access to respite.
Family members often know the individual’s routines, needs, and concerns especially well. We value that knowledge and include it in assessment and planning. We also train and guide the Employer of Record so they understand how to manage the chosen arrangement and the attendant’s responsibilities.
Our goal is to help you make an informed choice that reflects the individual’s needs and the family’s circumstances.
Approval for a family member living in the home
A family member who lives with the individual is not automatically eligible to be paid for providing supports. For family members who are not LRIs, Virginia’s DD waiver rules call for factual, written information explaining why no other providers are available.
This information may include:
- Recruitment efforts, such as advertisements and interview notes.
- Difficulty retaining paid attendants.
- Medical or behavioral needs that affect the availability of suitable caregivers.
- Language barriers affecting service delivery.
ConnectChoice works with the individual, family, Employer of Record, and support coordinator to gather information about these circumstances. When behavioral needs are involved, we review relevant assessments and any existing behavior support plan.
We prepare objective written documentation explaining why the proposed arrangement is needed, include it with the authorization request, and respond to requests for additional information from DBHDS.
We help you understand the process and present a complete, accurate explanation for review. Approval rests with the responsible Medicaid reviewers.
Read Virginia’s requirements for family members living in the home—12VAC30-122-120(B)
Recording paid time when you live in the home
Since October 1, 2026, live-in paid attendants must use an approved Electronic Visit Verification (EVV) method to clock in at the beginning of each shift and clock out at the end.
Consumer Direct Care Network Virginia (CDCN) offers the CareAttend mobile app and a telephone option for recording visits. When using the app, location services must be turned on. Manually entering time in the web portal does not replace using an approved EVV method.
ConnectChoice helps attendants and Employers of Record understand these expectations and find training resources. For technical problems or questions about correcting time entries, contact CDCN for guidance.
DMAS EVV requirements and updates
CDCN training for CareAttend, telephone time recording, and the web portal
Talk through your options
Considering a family member or someone living in your home as a paid attendant? ConnectChoice can help you understand the options, how they may affect your supports, and the steps involved in requesting approval.
Call 540-215-0022 or email amanda@connectchoice.care.
We’re available Monday through Friday, 9 a.m.–4 p.m. Eastern.