What Is the Backup Caregiver Requirement Under Virginia Medicaid?

Under Virginia's CCC Plus Waiver Consumer-Directed program, every member must have a backup caregiver who can step in if the primary caregiver cannot work.

This rule ensures that approved in-home care continues without interruption.

Who Can Be a Backup Caregiver?

A backup caregiver can be:

• Another family member
• A friend
• A neighbor
• Anyone over the age of 18 who is able to safely perform the care tasks listed in the member's Plan of Care

If the backup caregiver will be paid, they must complete caregiver enrollment with the assigned payroll company and pass the Virginia criminal background check before providing paid care.

Does the Backup Caregiver Have to Be Paid?

A backup caregiver does not have to be paid.

Many families list an unpaid backup caregiver who is available only for emergencies. If the backup caregiver will not be paid, no payroll enrollment or background check is required.

How the Backup Caregiver Is Documented

The Services Facilitator records the backup caregiver in the member's Plan of Care. During the care planning visit, the family must:

• Provide the backup caregiver's name
• Confirm the backup caregiver understands the care needs
• Update the Plan of Care if the backup caregiver changes

If no backup caregiver is listed, Consumer-Directed services cannot begin or continue.

What Happens If the Backup Caregiver Is Not Available?

Virginia Medicaid allows those receiving care to list more than one backup caregiver.

If a scheduled caregiver cannot work, the Employer of Record must arrange another caregiver from the approved list.

The Services Facilitator does not coordinate with the caregivers.