Start with your child’s care needs, not a promised paycheck
Tell us what your child needs help with during an ordinary day and how that assistance compares with what another child the same age would typically need. Bathing, dressing, toileting, eating, mobility, transfers, and ongoing safety supervision may all be important parts of the conversation.
A diagnosis or Medicaid card alone does not establish paid caregiving. The applicable program, screening or assessment, authorized service, approved care plan, and proposed caregiver must all be reviewed. We will help you identify what is already in place and what still needs clarification.
What does “extraordinary care” mean?
Virginia Medicaid uses “extraordinary care” for disability-related assistance that goes beyond the ordinary care a parent is expected to provide to a child of the same age. The comparison matters because every young child needs some help, while a child with a disability or significant medical need may require substantially more hands-on assistance or supervision.
The term does not guarantee approval or a particular number of hours. The child’s individual needs and the applicable Medicaid requirements determine what may be authorized.
When the caregiver is a parent or legal guardian
A parent or legal guardian of a child under 18 is considered a legally responsible individual. These caregivers follow special Virginia Medicaid requirements. A to Z must review the relationship, the child’s authorized care, and whether the proposed agency-directed arrangement meets current program and employment requirements.
Paid care is connected to approved services actually delivered under the care plan. It is not payment for every hour of parenting, every household responsibility, or care provided before the required arrangements are in place.
When another relative or trusted person provides the care
A grandparent, aunt, uncle, adult sibling, other relative, or trusted family friend may also be proposed as a caregiver. The answer depends on the person’s legal relationship to the child, where they live, the child’s program and authorization, and whether the caregiver meets agency and program requirements.
Tell us whether the proposed caregiver is also the child’s legal guardian. That detail can change which rules apply. Familiarity with the child is valuable, but it does not replace hiring, training, background checks, onboarding, or the ability to perform the authorized care safely.
How A to Z helps families get started
Call with whatever you know: the child’s age and location, Virginia Medicaid health plan, waiver or program name if available, screening or authorization status, daily care needs, and who currently provides the care. You do not need to understand every Medicaid term before calling.
A to Z provides agency-directed services. We can review whether our services fit the child’s current arrangement, explain the proposed caregiver’s next steps, and help organize the conversation. If training is needed, ask about our free PCA classes. We will not promise a program approval, paid role, start date, hours, or income before the required reviews are complete.
Questions families ask
Does having Virginia Medicaid mean my child qualifies for personal care?
No. Medicaid enrollment, disability-related needs, screening or assessment, and service authorization are separate parts of the process.
Can I be paid simply because I am my child’s parent?
No. Parents and legal guardians follow the legally responsible individual rules, and the care must meet the applicable extraordinary-care and authorization requirements.
Can someone other than a parent care for my child?
Possibly. A relative, family friend, or another trusted person may be considered if the arrangement and proposed caregiver meet applicable program and agency requirements.
Can A to Z help if I do not know which waiver or program my child has?
Yes. Tell us what you know and what documents or conversations you have already had. We can help identify what needs clarification and whether A to Z is an appropriate provider for the authorized service.
Can earlier unpaid care be reimbursed?
Do not assume care provided before authorization, employment, and required service records can be paid retroactively. We do not promise back pay.