Parent Caregiver Pay
How to Qualify, Train, and Set Your Schedule
Georgia’s GAPP program can fund Personal Support Services for medically fragile children. Starting around age 5, it is more common for these types of care hours to be authorized by Medicaid. In this case, many families may choose a parent or close relative to be the paid caregiver, when certain criteria are met. This article explains how to qualify, what training and paperwork look like, and how to run the day-to-day once you’re approved.
1) Who qualifies for the family caregiver option
To pursue the parent-caregiver option, you typically need all three:
Child eligibility
Under 21, Georgia Medicaid, and medically fragile (GAPP eligible)
A Plan of Treatment (PPOT) from your physician that shows non-skilled, hands-on daily tasks are needed in addition to any skilled nursing.
Service type
PSS (Personal Support Services) hours approved. (Skilled nursing is separate and performed by an RN/LPN.)
Caregiver eligibility
Parent/guardian or close relative who can pass background checks, complete agency onboarding/training, and reliably document care with EVV (electronic visit verification).
Tip: GAPP often approves skilled nursing before age 5. PSS/parent pay commonly begins age 5+ when daily-living support is clearly documented.
2) What PSS covers (vs. what nurses do)
PSS (Parent Caregiver) – non-skilled, daily support
Bathing, dressing, toileting, peri-care, hygiene
Mobility/positioning, safe transfers, turning/skin checks
Meal prep and assisted feeding (oral feeding)
Supervision for safety; routine activity support
Light housekeeping related to the child’s care (sanitize equipment area, laundry for soiled linens, etc.)
Skilled Nursing (RN/LPN) – clinical tasks
G/J-tube feeds & med administration via tube
Trach/vent care, suction, oxygen/oximeter monitoring
Catheterization, wound care, complex med regimens
Seizure monitoring with rescue meds, clinical assessments
Why this matters: Reviewers want the PPOT to clearly separate skilled vs. non-skilled tasks and include frequency for each. That clarity speeds approvals and prevents denials.
3) How many hours can be approved?
Hours are medically justified, not arbitrary. Reviewers consider:
Diagnoses and functional limits (mobility, self-care, safety risks)
Task frequency & duration (toileting x/day, transfers, repositioning, assisted feeding)
Documented risks without care (falls, pressure injuries, aspiration risk while eating by mouth)
Logs (ADL/symptom logs), IEP/504 notes, therapy notes
Typically, the weekly maximum is 42 hours.
Pro tip: Keep simple ADL logs for 2–4 weeks (how often you’re assisting with bathing, dressing, transfers, eating, etc.). These logs support PSS hour requests.
4) Step-by-step onboarding (what really happens)
Week 0–1: Screening & documentation
We confirm Medicaid/GAPP status and review the PPOT for PSS language.
You provide ID, proof of address, and ADL logs (if you have them).
We request/assemble clinical notes, IEP/504 and therapy notes (to show day-to-day support needs).
Week 2–3: Agency onboarding
Background checks (state & federal as required).
I-9 & W-4, direct deposit forms, confidentiality & HIPAA agreements.
Training: infection control, hand hygiene, ADL safety, boundaries, documentation/EVV, incident reporting.
Orientation to the Plan of Care and scope of PSS tasks (what you can vs. cannot do).
Week 3–4+: Start of care
We set up EVV (mobile app or landline), show you timekeeping, and review your weekly schedule.
First week check-in: verify time entries, resolve questions, and confirm supply needs.
5) EVV, timesheets & getting paid
EVV is mandatory: clock-in/out at the start/end of each authorized shift (GPS/phone verification).
Add brief task notes (e.g., “toileting x3, assisted feeding lunch, repositioning q2h, hygiene”).
No overlap with school services or other paid caregivers for the same time block.
Submit entries by the agency’s weekly deadline; pay cycle is usually weekly or bi-weekly.
Common pitfalls to avoid
Forgetting to clock out (causes delays)
Logging skilled tasks under PSS (not allowed)
Double-billing with school or nursing shifts
Working outside authorized hours or locations
6) Building a sustainable weekly schedule
Sample structure (20 hrs/wk PSS + nursing separate)
Mon–Fri 7:00–8:30 a.m. Morning ADLs, dressing, transfers, oral meds per plan (non-skilled), pack supplies
Mon–Thu 3:00–4:30 p.m. After-school transition, assisted feeding, hygiene, supervision
Sat 10:00 a.m.–12:00 p.m. Bathing, laundry/sanitation, mobility practice, community outing support
Coordinate PSS around nursing (if you also have skilled hours), school, and therapy so there’s no duplication and the plan reflects real life.
7) Training, boundaries & safety
Scope: PSS does not do tube feeds via G/J-tube, trach care, suction, rescue meds, or skilled assessments. Call the nurse/agency if those are needed.
Infection control: handwashing, glove use, surface sanitation.
Transfers/positioning: use equipment safely; ask for re-training if something changes.
Incident reporting: falls, skin breakdown, medication errors (even if not PSS tasks), unusual symptoms—report same day.
Self-care: being the caregiver and the parent is hard—use respite if available, and schedule breaks.
8) Getting ready before age 4 (so you’re set on day one)
Keep daily ADL notes—how much help your child needs with eating, toileting, transfers, hygiene.
Save therapy notes (PT/OT/SLP) and update your IEP/504.
Ask the clinician to include PSS-relevant language in the PPOT near the 4th birthday (task frequency & risks).
Complete caregiver pre-screening with Miralta 4–8 weeks in advance (so background checks/training are ready).
9) FAQs
Can both parents be paid caregivers?
Usually one primary caregiver is authorized; a backup may be allowed. It depends on your plan and agency policy.
Can I be paid while my child is at school?
Not if the child is out of the home or it duplicates another paid service. After-school/evenings/weekends are common PSS times.
What about overtime?
PSS hours are authorized by the plan. Overtime rules vary, get written approval before exceeding authorized hours.
Can we have nursing and PSS?
Yes, many families combine skilled nursing for clinical tasks and PSS for daily-living support. Plans must not overlap.
What if our needs change?
Request a care plan review. New logs, ED visits, device changes, or safety risks can justify increasing hours.
How Miralta makes this easier (free help)
Eligibility screening and a right-the-first-time packet
Physician coordination for PPOT language that clearly separates skilled vs. PSS tasks
Parent onboarding (background checks, training, EVV setup)
Schedule design that fits school, therapies, and nursing
Ongoing support with renewals, audits, and hour change requests
Serving: Atlanta + Fulton, DeKalb, Gwinnett, Cobb, Forsyth, Clayton, Cherokee, Henry, Hall, Paulding.
Ready to explore parent-as-caregiver? Contact us for a free consultation.
