Yes. In Ohio, a family member can be paid to give care through PASSPORT Participant Direction. Whether a spouse can be paid depends on conditions set out below with their sources.
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Medicaid waiver
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People age 60 or older who meet Medicaid's financial criteria, as their county Department of Job and Family Services determines, and who need a nursing facility level of care.
The Ohio Department of Medicaid administers the waiver and the Ohio Department of Aging operates it.
Source: PASSPORT Waiver (Ohio Department of Medicaid, September 2025)Checked
Medicaid self-directed care
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People applying for or enrolled on PASSPORT can choose it. Participant direction is voluntary: the person hires their own worker instead of using a personal care agency, and is the worker's employer.
Two services can be self-directed: Choices Home Care Attendant Service and Consumer-Directed Personal Care Service. A financial management service under contract with the state helps with payroll and taxes.
Source: PASSPORT Participant Direction (Ohio Department of Aging)Checked
Yes. Yes. The person can hire family members, friends, acquaintances or neighbors. The worker must be over 18 and meet the Ohio Department of Aging's certification requirements, including a background check.
A spouse, or a relative who holds a legal representative designation, is covered by a stricter rule: see the next two answers.
Source: PASSPORT Participant Direction (Ohio Department of Aging)Checked
Depends. Only when two conditions are met: no other willing and able provider is available, and the state or its designee has found that the person's health and safety can be ensured. The spouse is then paid through an agency or through the financial management service, for at most 40 hours a week and no more than the care the person is assessed to need.
The care must meet Ohio's extraordinary care requirements (form ODM 10372), and a spouse cannot be paid to provide respite. The state or its designee can grant an exception to the 40-hour limit.
Source: Ohio Administrative Code 5160-44-32Checked
Depends. Only in limited cases. A relative who is the person's guardian can be paid only if the probate court has authorized the guardian to be a direct service provider for the person, and paid care from each relative with legal decision-making authority is limited to 40 hours a week unless the state or its designee determines more is necessary.
A representative designated through the financial management service to handle employer tasks cannot also be the paid worker.
Source: Ohio Administrative Code 5160-44-32Checked
Under Choices Home Care Attendant Service, the person sets the worker's hourly wage with the help of their case manager. Under Consumer-Directed Personal Care Service, the hourly pay rate is set by the state.
Source: PASSPORT Participant Direction (Ohio Department of Aging)Checked
A spouse can be paid for at most 40 hours a week, and so can each relative with legal decision-making authority, never more than the care the person is assessed to need. The state or its designee can grant an exception.
Source: Ohio Administrative Code 5160-44-32Checked
Structured family caregiving
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Adults 18 or older enrolled on PASSPORT, the Ohio Home Care Waiver or MyCare Ohio who live with a caregiver, in either one's private home, and who need help with daily personal care and household support. The person must choose the service.
The caregiver is employed by or contracted with an agency provider and gets monthly coaching from a nurse or social worker on the agency's staff. It is not authorized as a substitute for skilled nursing care for someone who is medically unstable or medically complex.
Source: Ohio Administrative Code 5160-44-33Checked
Depends. Only as Ohio Administrative Code 5160-44-32 allows: a spouse, or another relative with legal decision-making authority, may provide Structured Family Caregiving only under that rule's criteria.
Source: Ohio Administrative Code 5160-44-33Checked
Submit form ODM 02399, Request for Medicaid Home and Community-Based Services (HCBS) Waiver, to your County Department of Job and Family Services. The Ohio Benefits Self Service Portal and the phone line below have more information.
Source: PASSPORT Waiver (Ohio Department of Medicaid, September 2025)Checked
The number the fact sheet gives for requesting the waiver.
Source: PASSPORT Waiver (Ohio Department of Medicaid, September 2025)Checked
Tell the PASSPORT case manager that you want participant direction, and as soon as possible if you already have someone ready to apply as the worker. The PASSPORT Administrative Agency for your county can also help. To hire a spouse, or a relative who is your legal representative, discuss it with the case manager first.
Source: PASSPORT Participant Direction (Ohio Department of Aging)Checked
On PASSPORT, the case manager builds the package of in-home services with you, and Structured Family Caregiving is one of the services PASSPORT lists. Ask the case manager about it.
Source: PASSPORT (Ohio Department of Aging)Checked
How we verify explains these dates.