Getting paid to care for a family member in Washington
In Washington, a family member can be paid to provide care through Medicaid, and there is real support if you are doing it unpaid. Here is who qualifies, how the pay actually works, and the one door that opens for spouses.
8 minute read. Last reviewed 2026-06-30.
If you are already caring for a relative, or about to start, you may be able to get paid for it. In Washington the main path runs through Medicaid. The key thing to understand up front is that the eligibility gate is on the person you care for, not on you. If your relative is on Apple Health (Washington's Medicaid) for long-term care and a state assessment says they need help with daily tasks, you can be hired and paid to provide that help. Your own income does not decide this. This guide walks through who can be paid, how the pay works, what to do if you are unpaid and running on empty, and the separate door that lets a spouse be paid starting in 2026.
Common misconceptions
The myths that stop caregivers from ever applying. Every one of these is wrong or incomplete.
MisconceptionFamily can never be paid. That is just for agencies and strangers.
RealityWashington pays family members to provide care all the time. An adult child, a sibling, another relative, a friend, or a neighbor age 18 or older can be hired as a paid caregiver, as long as the person receiving care qualifies for Apple Health long-term care and is assessed as needing the help.
MisconceptionYou have to be a nurse, or bill Medicaid yourself, to get paid.
RealityYou do not. You apply as an Individual Provider through Consumer Direct Care Network Washington (CDWA), the state's single employer for these caregivers. You become a W-2 employee of CDWA. They handle payroll and the Medicaid billing. You provide the care and turn in your hours.
MisconceptionThe caregiver has to be low-income to qualify.
RealityThe financial test is on the care recipient, not on you. They have to be on Apple Health long-term care and assessed as needing personal-care hours. Your income is not part of that decision. A DSHS Home and Community Services or Area Agency on Aging case manager does the assessment that sets how many paid hours are authorized.
MisconceptionA spouse can get paid right now, same as any other relative.
RealityNot through regular Medicaid. Under Apple Health, a spouse or registered domestic partner cannot be the paid caregiver, and neither can a parent of a child under 18. There are two exceptions. The WA Cares Fund goes statewide on July 1, 2026 and explicitly allows paying a spouse, and Veteran-Directed Care can pay a spouse for eligible veterans.
MisconceptionWA Cares and Apple Health are the same program.
RealityThey are two different things. Apple Health is Medicaid, based on income and assets. WA Cares is a separate state benefit funded by a payroll contribution, with a lifetime benefit of $36,500 in 2026, and its care trigger is needing help with at least 3 activities of daily living. You do not have to be low-income to use WA Cares.
What to do
Do these in order. The first two get you enrolled and paid. The rest depend on your situation.
- Step 1Confirm your relative is on Apple Health long-term care and get the assessment
This is the gate. The person you care for has to qualify for Apple Health (Medicaid) long-term care, and a state assessment has to find that they need help with personal care. A DSHS Home and Community Services or Area Agency on Aging case manager does this assessment. It sets how many paid hours per month are authorized. If your relative is not on Apple Health yet, this is the first call, because nothing downstream works without it.
What to say
“My mother needs help with daily care at home and I want to be her paid caregiver. Can we start an Apple Health long-term care application and schedule the assessment that sets her hours?”
What to expect
A case manager will screen for Apple Health long-term care eligibility and schedule an in-home assessment. That assessment decides the authorized personal-care hours you can later be paid for.
- Step 2Apply as an Individual Provider with CDWA
Once the hours are authorized, you enroll as an Individual Provider through Consumer Direct Care Network Washington (CDWA), the state's single Consumer Directed Employer. You do not bill Medicaid yourself. You become a W-2 employee of CDWA. They run payroll, taxes, and the paperwork. You call CDWA at (866) 214-9899 to start. There is a background check and onboarding before your first paid hours.
What to say
“My relative's care hours have been authorized and I want to enroll as her Individual Provider. What do you need from me to get started and get through the background check?”
What to expect
CDWA walks you through enrollment, the background check, and onboarding. Once you clear it and finish the required training, you are paid for the authorized hours as a CDWA employee.
- Step 3Do the 35-hour family caregiver training
If you are paid only to care for your own relative, you complete 35 hours of training and you are exempt from the Department of Health Home Care Aide credential. This is different from a general home care aide, who does 75 hours plus the DOH Home Care Aide certification within 200 days, an exam through Prometric, and 12 hours of continuing education a year. Both numbers are correct. They apply to different people. Training is provided by the SEIU 775 Benefits Group. The 35-hour path is the one for family caregivers.
- Step 4If you are the spouse, look at the WA Cares door
A spouse cannot be paid through regular Apple Health. Starting July 1, 2026, the WA Cares Fund goes statewide and explicitly allows paying a spouse. WA Cares is separate from Apple Health. It is funded by a payroll contribution, the lifetime benefit is $36,500 in 2026, and it opens once someone needs help with at least 3 activities of daily living. For an eligible veteran, Veteran-Directed Care is another route that can pay a spouse.
- Step 5If you are unpaid, call the Family Caregiver Support Program
You do not have to be a paid caregiver to get help. The Family Caregiver Support Program (FCSP) runs through Area Agencies on Aging and offers respite, counseling, support groups, and training. It uses the TCARE assessment to figure out what you need. It generally does not require the person you care for to be on Medicaid. Reach it through Community Living Connections at 1-855-567-0252.
- Step 6If you work, use Paid Family and Medical Leave
If you have a job and need time off to care for a seriously ill family member, Washington Paid Family and Medical Leave can pay you while you are out. In 2026 the maximum benefit is $1,647 a week, up to 90% of your weekly pay, for up to 12 weeks of family leave. You qualify after 820 hours worked in the qualifying period. You apply through the Employment Security Department.
What other caregivers have learned
Patterns caregivers describe again and again, put into our voice. Not direct quotes.
- The thing almost nobody knows going in is that the eligibility test is on the person you care for, not on you. Caregivers turn themselves away because they think they earn too much, when their income was never part of the decision.
- The 35-hour versus 75-hour training numbers confuse people into thinking they misheard something. If you are caring only for your own relative, it is 35 hours. The bigger number is for people who want to work as a general home care aide for anyone.
- Spouses often get the hardest news, that they cannot be paid through regular Medicaid. The ones who kept asking found the two real doors, WA Cares starting in July 2026, or Veteran-Directed Care if their partner is an eligible veteran.
- Caregivers who were running themselves into the ground unpaid describe the Family Caregiver Support Program as the call they wish they had made a year earlier. Respite is the piece that keeps people from burning out.
- The paperwork with CDWA and the background check take time. Caregivers say to start that step early, in parallel with the assessment, so you are not waiting on onboarding after the hours are already approved.
Synthesized from public caregiver communities. Paraphrased, not quoted.
Local resources for this
The local office that ties most of this together for your area.
- Your Area Agency on Aging
Your Area Agency on Aging is the hub for both paths. Its case managers do the assessment that sets paid-care hours, and it runs the Family Caregiver Support Program if you are unpaid and need respite, counseling, or training. This is the local office to call first. It is a free service.
When to bring in a professional
The verified statewide lines for each piece of this.
To enroll as a paid Individual Provider, or with questions about pay and onboarding, call CDWA. To apply for wage-replacement while you take leave from a job, use Paid Family and Medical Leave. For respite money, Lifespan Respite Washington offers vouchers up to $1,000 per qualifying household. If you are worn down or in crisis, the last two lines are for you, not just for the person you care for.
- Consumer Direct Care Network Washington (CDWA)
The state's single employer for Individual Providers. Enrollment, background check, payroll, and questions about paid caregiving.
- WA Paid Family and Medical Leave (Employment Security Department)
Wage replacement while you take leave from a job to care for a seriously ill family member. The 2026 maximum is $1,647 a week for up to 12 weeks.
- Lifespan Respite Washington (a program of PAVE)
Respite vouchers up to $1,000 per qualifying household, to pay for a break from caregiving.
- 988 Suicide and Crisis Lifeline
Call or text 988. Free, confidential, 24/7, for caregivers under strain, not only for a mental health emergency.
- Alzheimer's Association 24/7 Helpline
Around-the-clock help for dementia caregivers, including the hard nights. Free and confidential.