Virginia's Consumer-Directed Alternative: CD-PAS
Unlike CDPAP, which operates under New York's Medicaid system, Virginia’s equivalent is known as Consumer-Directed Personal Assistance Services (CD-PAS). This program is an option for eligible participants in certain Medicaid waiver programs, such as the Commonwealth Coordinated Care Plus (CCC Plus) waiver. The core philosophy is the same: to empower individuals with disabilities or chronic illnesses to direct their own care, hiring and managing their personal care attendants.
How Caregivers Are Compensated in Virginia
Payment for caregivers in Virginia’s CD-PAS program is handled differently than in the New York CDPAP. The Virginia Department of Medical Assistance Services (DMAS) oversees the program, but the pay rate is ultimately facilitated by a fiscal employer agent (F/EA) or managed care organization (MCO), like the Consumer Direct Care Network (CDCN). The hourly rate a caregiver receives is a portion of the total state reimbursement rate designated for personal care services, and this can fluctuate based on location and the specific waiver program. As of September 2025, various sources cite average hourly wages for personal care assistants and in-home caregivers in Virginia ranging from around $14 to $22 per hour, but these figures are averages and can vary significantly.
Eligibility Requirements for Virginia's CD-PAS
To become a paid caregiver, both the care recipient and the potential attendant must meet certain criteria for the CD-PAS program.
Recipient Eligibility:
- Medicaid Eligibility: The individual requiring care must be enrolled in Virginia Medicaid and participating in a relevant waiver program, such as the CCC Plus waiver.
- Level of Care: A needs assessment must be completed to determine if the individual requires assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). The assessment helps determine the number of authorized care hours.
- Self-Direction: The recipient must be capable of directing their own care. If not, they must appoint a designated representative, also known as the Employer of Record (EOR), to manage the attendant.
Caregiver Eligibility:
- Relationship Restrictions: While family members can often be hired, there are specific limitations. Spouses and parents of minor children are typically ineligible for payment.
- Age: The attendant must be at least 18 years old.
- Background Checks: Background and criminal record checks are a standard part of the hiring process for attendants.
- No Certification Needed: Unlike agency-directed care, CD-PAS does not require caregivers to have formal certification or licensure, though they will receive training and support from a services facilitator.
The Role of the Employer of Record (EOR)
Under Virginia’s CD-PAS program, the care recipient or their designated representative becomes the Employer of Record. This is a critical distinction that gives the recipient control and comes with specific responsibilities. The EOR's duties include:
- Recruiting and interviewing potential attendants.
- Selecting and training the chosen attendant.
- Setting a work schedule and managing the attendant's tasks.
- Signing timesheets and ensuring hours are accurately recorded.
- Terminating employment if necessary.
The EOR is supported in these duties by a Services Facilitator, who helps with assessments, developing the plan of care, and providing training on employer responsibilities.
Key Differences: CDPAP (NY) vs. CD-PAS (VA)
| Feature | CDPAP (New York) | CD-PAS (Virginia) |
|---|---|---|
| Program Name | Consumer Directed Personal Assistance Program | Consumer-Directed Personal Assistance Services |
| Funding | New York State Medicaid | Virginia Medicaid Waivers (e.g., CCC Plus) |
| Eligible Caregivers | Includes most family members, friends, and trusted acquaintances | Excludes spouses and parents of minor children in most cases; other relatives can be hired |
| Administration | Handled by a Fiscal Intermediary (FI) | Managed by a Fiscal/Employer Agent (F/EA) or MCO (e.g., CDCN) |
| Caregiver Training | Caregiver training and responsibilities guided by the Fiscal Intermediary | Services Facilitator provides guidance on employer responsibilities and training |
| Eligibility Basis | Medicaid, medical need for assistance | Medicaid Waiver enrollment, medical need, and capability for self-direction |
How to Find Accurate Pay Information
Instead of searching for how much CDPAP pays in Virginia, a better approach is to investigate the payment structure for Virginia's CD-PAS program. Your best resources are official state and service provider channels.
- Virginia Department of Medical Assistance Services (DMAS): Visit their website to understand the latest waiver information and consumer-directed services guidelines. DMAS provides the foundational rules for the entire program.
- Services Facilitator: If you are a care recipient or designated representative, your Services Facilitator is your primary resource for understanding pay rates, timesheet procedures, and overall program management.
- Fiscal Employer Agent (F/EA) or MCO: The specific agency managing payroll, such as Consumer Direct Care Network (CDCN), can provide the most accurate and current information on hourly rates for attendants. You can find more information here: https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/consumer-directed-services/.
In Virginia, the consumer-directed model offers significant autonomy, but it requires active management of the caregiver relationship, including understanding the payment structure. Researching the specific waiver program and contacting the relevant services facilitator or F/EA is the most reliable way to determine potential caregiver compensation.
