By the National Health Law Program
This paper explores the critical issue of paying family caregivers to provide necessary supports to people with intellectual and developmental disabilities (IDD). It highlights the current shortage of direct support professionals (DSPs) and the significant role family caregivers play in filling this gap. The paper discusses the potential benefits and challenges of allowing family members to be paid caregivers under Medicaid, including the impact on caregiver burnout, conflicts of interest, and Medicaid eligibility. It also examines the various Medicaid services that may allow paid family caregiving and the flexibility states have in implementing these policies. It is important to develop policies that address state concerns while ensuring that individuals with disabilities receive the care they need.