Published: 08/17/26

If you are a parent in Indiana caring for a medically complex or developmentally delayed child, you may be wondering whether you can still be paid to provide care at home.

That question has become more complicated for many families. Indiana Medicaid waiver rules have changed in recent years, especially for parents and spouses who are considered Legally Responsible Individuals, often called LRIs. These changes have affected who can be paid to provide certain waiver services, including Attendant Care.

For many families, that has created confusion, frustration, and uncertainty. Parents who were already providing daily care may now be asking what changed, whether any options remain, and where to turn next.

At Team Select Home Care, we help Indiana families understand available care options, including Home Health Aide training, Personal Attendant Care Services, and family caregiver support pathways that may apply based on medical need, eligibility, payer requirements, and state guidelines.

Quick Answer: Can a Parent Be Paid to Care for Their Child in Indiana?

In some situations, yes. Indiana parents may still have options to become paid caregivers, but the pathway depends on the child’s needs, Medicaid or insurance requirements, state guidelines, and the type of service being provided.

Since 2024, Indiana has limited the ability of parents and spouses, also known as Legally Responsible Individuals, to be paid as standard Attendant Care providers under certain Home and Community-Based Services waivers. A narrow extraordinary care allowance may apply for some high-acuity needs, but many families do not qualify under that carve-out.

Another possible pathway is becoming a trained and registered Home Health Aide. Through Team Select’s Indiana Home Health Aide training pathway, eligible family caregivers may be able to complete required training, become credentialed, and provide approved care when medical necessity, payer authorization, and program requirements are met.

Because every family’s situation is different, families should speak with their waiver case manager, insurance plan, physician, or a Team Select team member to understand what may apply.

What Changed for Parents and Spouses (LRIs) in Indiana?

Indiana uses the term Legally Responsible Individual, or LRI, to describe certain family relationships, including a parent of a minor child or a spouse.

Under Indiana FSSA guidance related to Attendant Care and Structured Family Caregiving, parents of minor children, spouses, and legal guardians of minor children are treated differently than other caregivers when it comes to providing paid Attendant Care through certain Medicaid waiver services.

Beginning in July 2024, Indiana guidance stated that parents of minor children, spouses, and legal guardians of minor children may not provide Attendant Care under the affected waiver guidance. Other relatives, stepparents, or non-LRI caregivers may be treated differently depending on the relationship, waiver, and service.

For families, this change matters because many parents were already providing hands-on care every day. When the rules changed, families needed to understand whether they could continue being paid, whether another caregiver could step in, whether Structured Family Caregiving applied, or whether another pathway might be available.

(You can review the state's own Attendant Care and Structured Family Caregiving relationship guidance directly from the Indiana Family and Social Services Administration.)

That's left a lot of parents wondering: does this mean I can't be paid to care for my own child?

Not necessarily. There's another route - and it's one we think is a good option for many families.

Why Structured Family Caregiving May Not Fit Every Family

Structured Family Caregiving (SFC) is one option FSSA points families toward, and it can work well for some households. But it isn't automatically the best fit for every family. SFC has its own tier structure, documentation requirements, and limitations, and for many parents it simply doesn't reflect the level or type of care their child actually needs.

For a lot of the families we work with, there's a more flexible, more sustainable path: becoming a licensed Home Health Aide.

(FSSA publishes its own Structured Family Caregiving vs. Attendant Care comparison if you'd like to see how the state lays out the differences.)

The Alternative Option for Medically Necessary Patients: Becoming a Licensed Home Health Aide in Indiana

Here's the part we're most excited to share - Team Select offers a Home Health Aide (HHA) training program, fully paid for by Team Select, that turns the caregiving you're already doing for your loved one into a professional credential.

Full Program Details:

  • A full 75-hour Home Health Aide training program, meeting Indiana's state licensing requirement
  • 59 hours of self-paced online coursework
  • 16 hours of hands-on clinical training, held in person at Team Select offices
  • Training covers personal care assistance, safety and infection control, communication techniques, mobility and transfer assistance, nutrition and wellness, and professional caregiving standards

This training meets the requirements of the Indiana Department of Health's Home Health Aide Training and Registration Program, and upon completion, you'll be listed on the state's official Aides Registry.

Once you've completed training and obtained your Indiana State Home Health Aide License, here's what happens next: Team Select will evaluate your family member for medical necessity through a clinical intake. From there, we work directly with your insurance or Medicaid plan to obtain a Prior Authorization for the hours you, as a family member, are approved to work. Once that's in place, you're no longer classified the same way an informal LRI caregiver is - which opens the door to being paid for many of the exact caregiving tasks you're already doing.

Important to know: a Home Health Aide cannot administer medications. But HHA services are a strong, appropriate fit for kids who need support with G-tube care, developmental delay–related care, bathing, dressing, and other unskilled daily care needs - which describes a large share of the families we serve.

Who Should Enroll?

This program is designed for people already doing this work every day:

  • Parents caring for a medically complex or developmentally delayed child
  • Spouses providing home care
  • Adult children supporting aging parents
  • Anyone interested in becoming a professional Home Health Aide

What Medically Fragile Families Gain

  • Confidence in your caregiving skills, backed by real training
  • Best practices for safe, effective care
  • Expanded future employment opportunities
  • Higher-quality support for your loved one
  • A recognized Home Health Aide credential - at no cost to you
Note: Medicaid waiver policy changes frequently, and eligibility depends on individual circumstances. This article reflects Indiana policy and available information as of 2026 and is intended for general education only. It is not a guarantee of eligibility, coverage, authorization, or paid hours. Families should speak with their waiver case manager, insurance plan, physician, or a Team Select team member to confirm what applies to their situation.

Frequently Asked Questions About Medicaid, Family Programs and Home Health Care Services

Yes. Parents can become a certified Home Health Aide through a 75-hour training program - 59 hours of self-paced online coursework plus 16 hours of hands-on clinical training held at Team Select offices - fully paid for by Team Select. Once you obtain your Indiana State Home Health Aide License, Team Select evaluates your family member for medical necessity through a clinical intake, then works directly with your insurance or Medicaid to obtain a Prior Authorization for the hours you can be paid to work as a family caregiver.

A Legally Responsible Individual, often called an LRI, generally refers to a parent of a minor child or a spouse. Indiana Medicaid treats care provided by an LRI differently than care provided by some other caregivers, which is why families should ask how LRI rules apply to their specific situation.

Indiana allows an “extraordinary care” allowance that lets certain patients continue to have Waiver care provided by their LRI (a parent of a minor or a spouse). Per IHCP Bulletin BT202603, extraordinary care is defined as needs involving tracheostomy care, continuous ventilator management, Total Parenteral Nutrition (TPN), or other comparable nursing needs that include at least two of the following: frequent, severe, or medically complex seizures requiring monitoring; IV medication administration requiring close monitoring; ongoing complex wound care; or noncontinuous ventilator management. This is a narrow, high-acuity carve-out – it does not typically cover needs like bathing, dressing, mobility support, G-tube feeding, or developmental delay–related care. A waiver case manager makes the determination.

After training, competency, and registration requirements are completed, Team Select can evaluate your loved one’s care needs through a clinical intake. We then work directly with your insurance or Medicaid plan to secure a Prior Authorization that specifies the hours you're approved to work and be paid as your loved one's caregiver.

Structured Family Caregiving (SFC) is one FSSA-supported option, but it comes with its own tier structure and documentation requirements that don't fit every family's situation. Becoming a licensed Home Health Aide offers a different, often more flexible path to being paid for care, since HHAs are credentialed providers rather than informal LRI caregivers.

No. Home Health Aides cannot administer medications. HHA services are well suited to care needs like G-tube care, developmental delay–related support, bathing, dressing, mobility assistance, and other unskilled daily care — which covers a large share of what many families need day to day.

Yes. Medical necessity is generally required for HHA services to be covered. Team Select can complete a clinical intake and work with the applicable insurance or Medicaid plan to pursue prior authorization when appropriate.

Under Indiana guidance beginning in July 2024, parents of minor children, spouses, and legal guardians of minor children may not provide Attendant Care under the affected waiver guidance. Some other family relationships may be treated differently, and a narrow extraordinary care allowance may apply in certain high-acuity situations.

The Home Health Aide pathway allows an eligible caregiver to complete required training, meet competency and registration requirements, and become credentialed to provide certain approved HHA services through a home health agency. For family caregivers, this may create a possible pathway to being paid for approved care when medical necessity, prior authorization, payer requirements, and state guidelines are met.

The program is 75 hours total, meeting Indiana's state licensing requirement: 59 hours of self-paced online coursework, plus 16 hours of hands-on clinical training held in person at Team Select offices.

Yes. Team Select fully covers the cost of the HHA training program for enrolled caregivers.

No. The program is designed for family caregivers — parents, spouses, and adult children — who are already providing care at home and want to turn that experience into a professional, paid credential.

Yes. Team Select provides Indiana home health services and family caregiver support across communities throughout the state, including major metro areas and smaller county communities. Families can contact their local Team Select office to ask what services may be available near them.

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Bill Sczepanski Vice President of Government Relations
Hi there! I bring a powerhouse of experience when it comes to building strong government relations and crafting multi-state strategies that push corporate goals forward—politically, strategically, and operationally. I’ve spent my career championing organizations across legislative and regulatory landscapes, restoring critical partnerships with SNFs, ALFs, and ILFs, and making sure our voice is heard where it matters most. Whether it's delivering real-time political intelligence, advocating before government bodies, or leading transformational initiatives, I thrive at the intersection of policy, business, and innovation. I’m passionate about using data and analytics to boost brand visibility, drive deeper engagement, and create standout experiences for customers and employees alike. On top of that, I’m all about action—directing tech modernization projects, leading turnarounds, building strategic hiring and training programs—and making sure everything ties back to real, measurable success. Adaptable, energized, and always ready to dive into any environment, I’m here to help organizations not just navigate change, but lead it.
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