How Consumer-Directed Caregiver Enrollment Works After Medicaid Approval in Virginia

After Medicaid financial eligibility is approved and in-home care hours are authorized under the Virginia CCC Plus Waiver, a caregiver can begin the enrollment process.

This applies when the individual chooses Consumer-Directed care and hires a family member or friend instead of using a home care agency. For a comparison of care models, see: Agency Care vs. Consumer-Directed Care — Which Is Right for You?

A Services Facilitator Must Complete the Setup Visit

The family selects a Services Facilitator from Virginia's approved provider list: Virginia Medicaid Provider Directory

During this visit, the Services Facilitator:

• Confirms the approved weekly caregiver hours
• Completes the Plan of Care
• Submits the service authorization needed for caregiver payroll enrollment

For more information, see: What Is a Services Facilitator in Virginia Medicaid CCC Plus?

The Caregiver Must Complete Payroll Enrollment

Consumer-Directed caregiver payroll in Virginia is handled by a Fiscal Employer Agent (FEA). The payroll company is assigned based on the member's Medicaid health plan.

The caregiver must:

• Pass the Virginia criminal background check
• Complete federal and state tax forms
• Submit direct deposit information
• Complete caregiver employment paperwork

Medicaid does not pay for care provided before caregiver enrollment is approved.

When Caregiver Payment Begins

A caregiver can receive payment only after all of the following occur:

• The Services Facilitator submits the Plan of Care and service authorization
• The caregiver passes the criminal background check
• The assigned payroll company (PPL or CDCN) approves payroll enrollment
• The caregiver works approved hours and records them through Electronic Visit Verification (EVV)

For instructions on submitting hours, see: How to Submit Timesheets as a Medicaid Caregiver in Virginia