Getting Paid to Care for Your Own Child in Florida: How the FHHA Program Actually Works
Can a parent get paid to care for a child in Florida?
Yes. An eligible parent, guardian, or family caregiver may be able to get paid to care for a medically fragile child through Florida's Family Home Health Aide Program, or FHHA. The child must be under 21 and qualify for medically necessary Private Duty Nursing. The caregiver must meet program requirements, complete required training or qualify for an applicable nursing education exception, pass background screening, and become employed by a participating licensed home health agency. Payment and authorized hours are not automatic and depend on eligibility, medical necessity, the approved care plan, authorization, payer requirements, and agency participation.
Getting paid to care for your child is possible, but eligibility comes first.
Parents searching for how to become a paid caregiver for their child in Florida are often trying to solve two problems at once: making sure their child receives dependable care and understanding whether the care they already provide can become part of an approved home health program.
Florida's FHHA pathway can make that possible for some families of medically fragile children. It is not an informal caregiver payment program. The family caregiver becomes an employee of a participating home health agency and provides authorized aide services within the child's approved care plan, training requirements, supervision rules, and payer requirements.
An eligible parent, guardian, or related caregiver may be trained and employed by a participating home health agency to provide approved FHHA services.
FHHA does not guarantee employment, payment, Medicaid eligibility, coverage, authorization, a specific wage, or a specific number of hours.
The child must be medically fragile, under age 21, and eligible for medically necessary Private Duty Nursing.
What is Florida's FHHA Program?
The Family Home Health Aide Program allows an eligible family member, legal guardian, or caretaker relative to be trained and employed by a licensed home health agency to provide authorized home health aide services for an eligible medically fragile child.
Florida's Agency for Health Care Administration states that the child must already qualify for Private Duty Nursing before FHHA services can be considered.
FHHA creates a regulated pathway for some family caregivers to receive training, become agency employees, and provide approved aide-level care for their child while remaining connected to the child's medical plan and Private Duty Nursing services.
Who may qualify for the Family Home Health Aide Program?
FHHA has requirements for both the child receiving care and the family caregiver who wants to become employed. Meeting one side of the criteria does not automatically establish eligibility for the other.
Child eligibility
- The child is under 21 years of age.
- The child is medically fragile.
- The child is eligible for medically necessary Private Duty Nursing.
- The child is under appropriate practitioner or physician care as required.
- FHHA services are ordered and incorporated into the applicable plan of care.
- Services meet payer, medical necessity, authorization, and documentation requirements.
Parent or family caregiver eligibility
- The caregiver is at least 18 years old.
- The caregiver meets the qualifying relationship requirements.
- The caregiver demonstrates minimum competency to read and write.
- The caregiver completes approved FHHA training or meets an applicable nursing education exception.
- The caregiver passes required background screening.
- The caregiver becomes employed by a participating licensed home health agency.
Children with tracheostomies, ventilator needs, feeding tubes, seizure disorders, cerebral palsy, post-NICU complexity, mobility limitations, or other medically complex needs may require home health services, but a diagnosis alone does not establish FHHA or PDN eligibility.
How much FHHA training does a parent need?
Florida law requires an approved FHHA training program of at least 76 total hours before an eligible family caregiver begins providing services, unless the caregiver qualifies for an applicable prelicensure nursing education pathway.
Home Health Aide Hours
At least 40 hours of required home health aide training.
Child-Specific Skills Hours
At least 20 hours of basic nursing skills training tailored to the child's individualized care needs.
Clinical Training Hours
At least 16 hours of clinical training related to the child's needs under direct RN supervision.
Florida law also includes training requirements concerning HIV infections and current CPR certification. The employing home health agency validates competency through a registered nurse and may provide additional training as the child's care needs change.
How much can a parent work through FHHA in Florida?
Payment, employee wages, and authorized service hours are separate questions. Families should not assume that a Medicaid reimbursement rate paid to a home health agency equals the employee's hourly wage.
Up to 12 hours per day
Florida Medicaid's current coverage policy provides for up to 12 hours of Family Home Health Aide services per day per eligible recipient under age 21 receiving PDN when applicable requirements are met.
Up to 40 hours per week
The standard utilization limit is 40 FHHA hours per week per eligible recipient. Florida law provides a process for exceeding the weekly limit when the applicable justification and approval requirements are met.
Agency rate is not a guaranteed wage
AHCA describes a Medicaid fee-for-service reimbursement rate paid to participating agencies. Managed care arrangements may differ. The agency reimbursement amount should not be interpreted as a guaranteed caregiver wage.
Does FHHA income affect a child's Medicaid eligibility?
FHHA wages are earned income. However, Florida law allows families to request that income earned through the Family Home Health Aide Program be excluded from the child's Medicaid eligibility determination.
AHCA currently directs families to complete its Family Home Health Aide Social Security Number form and submit it to the Florida Department of Children and Families so DCF can evaluate the income for exclusion.
Medicaid eligibility is individual to the child and family. Families should confirm how the exclusion process applies to their circumstances with DCF, AHCA, their Medicaid managed care plan, or their participating home health agency.
Review current AHCA FHHA guidanceDoes FHHA replace a child's nurse?
FHHA does not change the distinction between aide services and medically necessary skilled nursing. However, FHHA hours must be coordinated with the child's Private Duty Nursing services.
Florida requirements provide that FHHA and PDN services cannot be provided concurrently or duplicate one another. Authorized services are coordinated through the child's approved plan of care.
The child must qualify for medically necessary Private Duty Nursing before FHHA is considered.
FHHA services require applicable orders, medical necessity, authorization, agency coordination, and inclusion in the approved plan of care.
The services are scheduled so the family home health aide is not providing FHHA services at the same time as Private Duty Nursing.
FHHA care includes appropriate agency supervision and competency oversight consistent with Florida requirements and the approved care plan.
How can I become a paid caregiver for my child in Florida?
The exact process can vary based on the child's clinical needs, existing PDN services, Medicaid plan, documentation, agency participation, authorization, location, and staffing. A practical starting pathway generally looks like this.
Confirm your child's PDN eligibility
FHHA is tied to medically necessary Private Duty Nursing. If you are unsure whether your child qualifies for PDN, start by discussing the child's clinical needs and current plan of care with the appropriate providers and home health agency.
Contact a participating home health agency
Ask whether the agency currently supports Florida FHHA services, which payer plans it works with, and how it handles family caregiver screening, training, employment, RN supervision, and authorization.
Complete caregiver requirements
The caregiver may need to complete approved training, competency validation, background screening, CPR requirements, employment onboarding, and other agency or payer requirements before providing services.
Coordinate the approved care plan
FHHA services must be ordered when required, authorized when applicable, documented, scheduled appropriately with PDN, and included in the child's approved plan of care.
Begin approved services
Once applicable eligibility, training, employment, documentation, authorization, care plan, and staffing requirements are complete, approved FHHA services may begin according to the authorized schedule.
Questions parents should ask before getting started.
Not every home health agency handles FHHA in exactly the same way. Asking the right questions early can help families understand what may be required before training or employment begins.
Need help understanding whether FHHA may apply to your child?
Dynamiks Home Care helps Florida families understand pediatric home care, Private Duty Nursing, Family Home Health Aide services, and possible next steps based on the child's needs, location, payer requirements, approved care plan, authorization, and current service availability.
Florida paid family caregiver FAQs
Can a parent get paid to care for a medically fragile child in Florida?
Can I get paid to care for my disabled child at home in Florida?
Does my child need to qualify for Private Duty Nursing first?
How many FHHA hours can a parent provide in Florida?
How much does Florida FHHA pay a parent?
How much FHHA training is required?
Does FHHA replace Private Duty Nursing?
Will FHHA wages affect Medicaid eligibility?
Is FHHA the same as a general Florida family caregiver payment program?
Can Dynamiks Home Care help me understand whether FHHA may apply to my child?
Florida FHHA policy references
- Florida Agency for Health Care Administration: Family Home Health Aide Program
- Florida Agency for Health Care Administration: Private Duty Nursing Services
- Florida Administrative Code Rule 59G-4.261
- Florida Statute 400.4765: Home Health Aide for Medically Fragile Children Program
Healthcare laws, Medicaid policies, payer requirements, and program guidance may change. Families should verify current requirements with the appropriate state agencies, Medicaid plan, healthcare providers, and participating home health agency.
Find out whether FHHA may be an option for your family.
If you are caring for a medically fragile child in Florida, Dynamiks Home Care can help you understand FHHA, pediatric Private Duty Nursing, caregiver requirements, and possible next steps. Eligibility, authorization, staffing, coverage, and start dates vary based on the child's needs, location, payer rules, documentation, approved care plan, and qualified staff availability.
