GAPP Knowledge Center
Can a family member be paid to care for their child under GAPP?
GAPP has a specific program for this: the Family Caregiver Option (FCO). Under the FCO, a legally responsible adult family member who lives with the child may be paid for personal support services through the GAPP agency. Skilled nursing is not covered under the FCO, and foster parents are not eligible. Here is how it works.
The Foundational Rule
The General Rule — and Why It Exists
Understanding what Georgia Medicaid means by “legally responsible relative” is the starting point for any family caregiver question.
Under standard Georgia Medicaid rules, legally responsible relatives (LRRs) — typically parents or legal guardians of a minor child — may not be paid to provide servicesthey are already legally obligated to provide. Georgia Medicaid defines “legally responsible relative” broadly to include parents of minors regardless of household status.
This rule exists because Medicaid's purpose is to supplement care that no one is legally obligated to provide — not to reimburse parents for their existing parental duties. It does not mean the family is doing anything wrong; it reflects how federal and state Medicaid rules are structured.
What this means in practice:
- A parent who is the primary caregiver cannot typically be paid by GAPP to provide personal care or skilled nursing to their own minor child
- The same restriction applies to legal guardians with legal responsibility for the child's care
- This applies to both skilled nursing hours and personal care hours under standard GAPP rules
Family Caregiver Option
The Family Caregiver Option (FCO)
GAPP has a specific program that allows eligible family members to be paid for personal support services — with clear requirements and limits.
GAPP offers the Family Caregiver Option (FCO) for personal support services (PSS). Under the FCO, a legally responsible adult family member who lives with the child may provide PSS and receive reimbursement through the GAPP agency. Three key rules define the FCO:
Personal Support Services Only
The FCO covers personal care services (PSS) only. Skilled nursing and behavioral health aide services cannot be provided under the FCO — those require a licensed nurse.
Must Live With the Child
The family caregiver must be a legally responsible adult family member who lives with the GAPP member. Cohabitation is required.
Hired as Agency Employee
The GAPP agency must hire the family caregiver as an employee. Family caregivers are not paid directly by Medicaid — they are on the agency's payroll and subject to supervision.
Provider Standards
Requirements Any Family Caregiver Must Meet
Relative caregivers are held to the same standards as any other GAPP provider — no exceptions based on family status.
Any relative who serves as a paid GAPP caregiver — regardless of the family relationship — must meet the same requirements as any other GAPP caregiver:
Background Check
Georgia Bureau of Investigation (GBI) and Federal Bureau of Investigation (FBI) criminal background check, including sex offender registry check. Certain disqualifying offenses permanently bar an individual from serving as a paid caregiver.
Training Requirements
Completion of required personal care aide or home health aide training as applicable to the authorized service type. Training must be completed before providing paid services.
EVV Compliance
All GAPP personal care services require Electronic Visit Verification (EVV) — a system that records the caregiver's location and time of service electronically at the start and end of each shift. Relative caregivers must use EVV just like agency staff.
Agency Employment
Family caregivers must be employed by the GAPP provider agency — they cannot be paid directly by Medicaid as individuals. They are on the agency's payroll and subject to the agency's supervision and training requirements.
Supervision
Relative caregivers providing personal care are supervised by a registered nurse (typically the GAPP agency's clinical supervisor). Skilled nursing tasks cannot be performed by a non-licensed relative regardless of family status.
Hard Limits
Services a Family Member Cannot Provide
Certain services remain off-limits to family members regardless of caregiver eligibility status.
Skilled Nursing Tasks
Tracheostomy care, ventilator management, medication administration, wound care, and other nursing procedures require an active Georgia nursing license (RN or LPN). A family member without a nursing license cannot be paid to perform these tasks under GAPP, even if they are highly trained in them informally.
Services the Parent Is Legally Obligated to Provide
For minor children, tasks that fall within normal parental duties may not be separately billable even if a relative is otherwise eligible as a caregiver.
Services Performed Without EVV Documentation
Shifts that are not electronically verified cannot be billed to GAPP, regardless of who performed them.
Common Questions
Family caregiver questions, answered.
In most cases, parents of minor children cannot be paid as substitute caregivers under standard GAPP rules. If your child's nurse cannot make a scheduled shift, contact Core Health Group Corp. — we will arrange coverage through our clinical staff. Do not attempt to bill for caregiver services as a parent without first verifying your eligibility with the agency.
Grandparents who are not the legal guardian of the child may potentially qualify as paid GAPP personal care aides through the standard agency hiring process — separate from the FCO. They must meet the same background check, training, and EVV requirements as any other GAPP caregiver. Contact Core Health Group Corp. to evaluate your mother's specific situation.
For GAPP members aged 18 through 20 years, 11 months, parental legal responsibility typically ends, which may change caregiver eligibility. Contact Core Health Group Corp. to review your specific situation and determine whether the Family Caregiver Option or another pathway applies.
Certain criminal convictions — particularly those involving abuse, neglect, violence, or financial crimes against vulnerable populations — are disqualifying. A failed background check disqualifies any person, relative or not, from serving as a paid GAPP caregiver. Specific disqualifying offenses are governed by Georgia Medicaid provider standards.
We Review Every Situation
Your family's circumstances are unique. Let's talk.
Family caregiver eligibility under GAPP depends on details that vary case by case. Our intake team can review your specific situation and tell you what Georgia Medicaid rules allow for your family — at no cost.