Quick Reference - Parents as Paid Caregivers

Return to Member and Family Resources

• Download Parents as Paid Caregivers (English).
• Download Parents as Paid Caregivers (Spanish).

PPCG - Parents as Paid Caregivers

AHCCCS received temporary authority from the Centers for Medicare and Medicaid Services (CMS) to allow parents of minor children with disabilities to be paid caregivers during the federal COVID-19 Public Health Emergency (PHE) on April 6, 2020. This ensured children received Attendant Care or Habilitation services during the PHE. AHCCCS sent an 1115 Waiver amendment to CMS requesting to make the Parents as Paid Caregivers (PPCG) service model authority permanent on September 27, 2023.

In February 2024, CMS approved the request to make the PPCG service model permanent with some conditions. One of those conditions is a 40-hour per week per child service model limit for parents. This includes assessed hours for both Attendant Care and Habilitation. This limit applies when the member is assessed for more than 40 hours of service per week. Beginning July 1, 2025, any additional assessed hours for Attendant Care or Habilitation must be completed by an alternate Direct Support Professional.

This condition applies to a member’s “legally responsible parent.” AHCCCS defines a “legally responsible parent” as “Parents who have formal physical and/or legal custody of their minor child including guardians of minor children.” Below are a few common examples to provide clarity to this requirement.

• A child with two parents. The hours of the two parents combined cannot exceed 40 hours of total paid care in a given week.
• Two children with a parent. The parent may provide up to 40 hours of paid care per child, per week. The total amount of paid care cannot exceed 80 hours of paid care in a given week for both children.
• A child’s parents are divorced or separated and the child lives with both during the week. The hours of the two parents, combined, cannot exceed 40 hours of paid care in a given week.
• A child with a parent and step-parent. The parent may provide up to 40 hours per child, per week. The weekly service model limitation does not apply to step-parents unless they have legally adopted the child.

Parents using the PPCG service model cannot exceed 40 hours of paid care in a given week even if they work for multiple agencies. It is also important to remember that paid caregivers can only provide 16 hours of paid care in a 24-hour period. This applies to all caregivers providing all services. It is not specific to parents in the PPCG service model.

AHCCCS and DDD hosted public meetings on February 5 & 6, 2025. The PPCG Program Update presentation and the frequently asked questions on the AHCCCS website have more details about the PPCG program update.

How Parents Can Become Direct Care Workers (DCW)

A parent who wants to be a DCW must meet these qualifications:

• Be at least 18 years old.
• Have the following documents:
  
  • Proof of training in Article 9
  • Proof of training in CPR/ First Aid
  • Proof of completing DCW Training
  • Proof of training in the delivery of habilitation services
  • Proof that he/she sent a request for a fingerprint clearance card. A fingerprint clearance card is not needed if the parent is providing only Attendant Care and lives in the same home as the member
  • Background check approval from the Department of Child Safety (DCS) Central Registry and the Adult Protective Services (APS) Registry
• Be trained on and follow the Qualified Vendor’s requirements.

Qualified Vendors can help a parent become a Direct Care Worker if their child needs Attendant Care or Habilitation-Hourly.