How to get paid to care for a family member in Alaska: consumer-directed personal care

Personal Care Services, Community First Choice and the waivers

Alaska's Division of Senior and Disabilities Services (SDS) runs three overlapping Medicaid programs that matter here:

• Personal Care Services (PCS). Hands-on help with daily tasks such as bathing, dressing and eating, along with errands, laundry and light housework, provided through private agencies. SDS puts the number of seniors and people with disabilities it helps at roughly 2,000. There are two versions: agency-based, where the agency manages and supervises care, and consumer-directed, where the person receiving care chooses, hires, supervises and can fire their own PCA. Both are offered in most Alaska communities.
• Community First Choice (CFC), also called 1915(k). A program for people who need the level of care usually given in an institution. It can include personal care, emergency response systems, case management and chore services, and also has a consumer-directed personal care option.
• Home and community-based waivers. Alaska operates five. The one most families of older adults meet is Alaskans Living Independently (ALI), for adults 21 and over who need nursing facility level of care. The ALI waiver in effect from July 1, 2026 states that it has no waitlist.

How consumer-directed PCS works for a family caregiver

Under the consumer-directed contract (form PCS-07/CFC-04), the recipient, or their representative, is responsible for:

• hiring the person who will be their PCA;
• training, scheduling, supervising and managing the PCA;
• signing the PCA's timesheets;
• ending the PCA's employment if the services are unsatisfactory or no longer needed;
• showing they have the decision-making capacity to direct their own care.

The recipient picks a consumer-directed agency, which signs the same contract. That agency is enrolled as a Medicaid provider and handles the administrative and fiscal intermediary tasks: it collects and verifies timesheets, bills Medicaid only for verified time, reviews the services every six months (including an interview with the PCA), and works out a backup plan for days the regular PCA cannot work. The SDS Conditions of Participation add that the agency must pay employee salaries and employment taxes on time and keep proof that each PCA has CPR and first aid training from within the previous two years, plus critical incident reporting training at least every two years.

The Department of Labor's notice of February 5, 2026 describes PCAs as hired by agency-based and consumer-directed agencies, and says a joint-employer relationship exists between the recipient and the agency in the consumer-directed model.

Which relatives can be paid in Alaska

For PCS and CFC personal care, the rules on who may work as a PCA sit in the state regulation 7 AAC 125.090, which the Conditions of Participation point to. We could not retrieve that regulation, and the PCS program page, Conditions of Participation and PCS-07 contract we read do not list which relatives are allowed. Before your family relies on a PCA job, ask the consumer-directed agency you plan to use, or SDS at 907-269-3666, whether you can be the PCA. Ask specifically about spouses, parents of minor children, legal guardians and the person acting as the recipient's representative.

For the ALI waiver, the waiver document effective July 1, 2026 is explicit:

• Relatives (related by blood, marriage or adoption, with no legal duty to support the participant) who are older than 18 may be employed by an SDS-certified provider to deliver some ALI services, including respite, adult day, meals, transportation and nursing oversight and care management, if they meet the provider's hiring and training rules.
• Legally responsible individuals, which include a spouse and the parent of a minor child, may not provide any ALI waiver service.
• Court-appointed guardians may provide services only when the court order explicitly authorizes it.
• Care coordination may not be provided by immediate family, a guardian, a power of attorney holder or the participant's own PCA.

Because ALI excludes spouses, do not assume a spouse can be paid under PCS either until the agency or SDS confirms it in writing.

Who qualifies and how to apply

1. Medicaid. The person needing care must have Alaska Medicaid. The Division of Public Assistance takes applications through healthcare.gov, the state ARIES screener or Alaska Connect, and the waivers require an interview with DPA to confirm income and resource limits. The Medicaid page notes that changes to Alaska Medicaid start in January 2027.
2. Start with the ADRC for CFC and waivers. According to the CFC page, step one is a call or visit to your nearest Aging and Disability Resource Center. The statewide line, 1-855-565-2017, runs a pre-screening in person, by phone or by video.
3. PCS application. PCS uses the PCA-08 Personal Care Services Initial Application, which asks you to tick agency-based or consumer-directed and name the agency. Instructions are on the PCS page.
4. Assessment. SDS assesses how much help is needed and issues a service level authorization listing the activities a PCA may be paid to help with. For waivers, nurses or trained staff do a functional assessment and a nurse supervisor decides whether nursing facility level of care is met.

What a family PCA earns in Alaska

The state does not publish a PCA wage; the agency sets it, within Alaska wage law. Three published figures frame it:

• Medicaid rate to the agency. The FY27 rate chart (with a 3.2% increase from July 1, 2026) pays $9.30 per 15 minutes for both agency-based and consumer-directed personal care, under PCS and CFC. The rate is adjusted by region: no change for Anchorage, 3% more for Fairbanks, 9% for Juneau, 48% for the Arctic region and 49% for Bethel/Dillingham. This is the agency's revenue, not the PCA's hourly pay.
• Minimum wage and overtime. Alaska's Wage and Hour office lists a $14.00 hourly minimum effective July 1, 2026 (previously $13.00), with $15.00 due on July 1, 2027. Its PCA notice states that PCAs have no overtime exemption, so time past 8 hours in a day or 40 within a workweek carries a 150% pay rate. PCAs also earn one hour of paid sick leave per 30 hours worked, a rule in force since July 1, 2025, and are owed a written hiring agreement that states their rate.
• Market wage. In the May 2025 OEWS survey, Alaska counted 6,530 workers in the occupation BLS calls home health and personal care aides (31-1120); their statewide median was $19.11 per hour and the average $19.45.

The labor notice also says there is no family or friend exemption from workers' compensation liability.

VA caregiver programs and taxes

VA stipend. When the person needing care is a veteran, PCAFC, the VA's Comprehensive Assistance for Family Caregivers program, may send a monthly stipend to the person designated as Primary Family Caregiver. Eligibility on the veteran's side: a disability rating of 70% or more, VA health care enrollment, and a need for continuous in-person personal care lasting six months or longer. On your side: age 18 or over, and either a family tie (spouse, son or daughter, parent, step-relative or extended family) or full-time residence with the veteran. Veteran and caregiver apply together, online, by mail or in person, using VA Form 10-10CG.

Veteran Directed Care. This VA option lets an eligible veteran manage a services budget and, with a counselor, employ helpers who may include a relative. Not every VA location runs it, so check with a VA social worker.

Income tax. IRS Notice 2014-7 excludes Medicaid 1915(c) waiver payments for care given in a home the provider shares with the recipient. PCS, though, is not a waiver, and the IRS Q&A says the treatment of other Medicaid programs turns on how each one is designed and what it is for, so talk to a tax professional before leaving PCS wages off a return. If instead you hire privately, IRS Topic 756 makes $3,000 in 2026 cash wages to any single household worker the usual trigger for Social Security and Medicare tax.

Where to get help in Alaska

• Aging and Disability Resource Centers: 1-855-565-2017, or a regional office, for example the Municipality of Anchorage ADRC at 907-343-7770 or LINKS Resource Center in Wasilla at 907-373-3632.
• Senior and Disabilities Services: 907-269-3666 for PCS and CFC questions.
• Adult Protective Services: report online, or call 1-800-478-9996 in Alaska or 907-269-3666 and ask for Centralized Reporting. Anyone can report; mandated reporters must report within 24 hours. In an emergency, call law enforcement first.
• Wage questions: Department of Labor Wage and Hour, 907-269-4900.

Where CaregiverConnect fits

CaregiverConnect does not provide Medicaid services, is not a PCS agency or fiscal intermediary, and cannot enroll anyone in PCS, CFC or a waiver. On the site, a family posts its care need without charge and hires a private caregiver on its own terms, taking on the role of household employer. Caregivers make a profile for free and respond to posts. No background checks are run by us; caregivers may upload proof that they have one. For families in and around Anchorage, start with caregivers in Anchorage, then read how it works and optional plans. For more background, see hiring a private caregiver and Medicaid programs that pay relatives.

Frequently asked questions

Sources

1. Alaska DOH, Personal Care Services program
2. Alaska DOH, PCS and CFC PCS Provider Conditions of Participation
3. Alaska DOH, PCS-07/CFC-04 Recipient and consumer-directed agency contract
4. Alaska DOH, PCA-08 Personal Care Services Initial Application
5. Alaska DOH, Community First Choice
6. Alaska DOH, Home and Community-Based Services waivers
7. Alaska DOH, ALI 1915(c) waiver effective July 1, 2026
8. Alaska DOH, FY27 PCS and CFC rate chart
9. Alaska DOH, Apply for Medicaid
10. Alaska DOH, Aging and Disability Resource Centers
11. Alaska DOH, Adult Protective Services report of harm
12. Alaska DOLWD, Wage and Hour (minimum wage)
13. Alaska DOLWD, PCA industry notice, February 5, 2026
14. BLS OEWS May 2025, SOC 31-1120, Alaska (OESServices query)
15. VA, Program of Comprehensive Assistance for Family Caregivers
16. VA, Veteran-Directed Care
17. IRS, Certain Medicaid waiver payments may be excludable from income (Notice 2014-7 Q&A)
18. IRS, Topic 756, Employment taxes for household employees