You can get paid for PCA (Personal Care Assistant) hours for an autistic dependent through state Medicaid Home and Community-Based Services (HCBS) waivers. Many states offer a "Consumer-Directed" program that allows family members (including parents) to become the official paid caregiver, track their hours, and receive compensation.

1. Check Your Eligibility
To qualify for paid PCA hours, your child or loved one must typically be enrolled in Medicaid and meet an institutional level of care.

State Waivers: Depending on your location, this is often done through a specific program like a HCBS Waiver, Katie Beckett Waiver, or a state-specific program (e.g., IHSS in California, or specialized Autism Waivers).
Assessments: A social worker or registered nurse will conduct a home assessment to determine how many hours of care are needed per week for tasks like dressing, bathing, or behavior supervision.

2. The Process: How Care Is Tracked and Paid
If approved, you become an employee of the state's Medicaid program

Tracking Hours: You log your daily care hours (often via a state-mandated smartphone app, electronic portal, or paper timesheet).
Payroll Processing: Timesheets are submitted to a fiscal intermediary or an agency. They process your payroll and pay you directly, usually via direct deposit or check, on a biweekly or monthly basis.
Hourly Rates: Your pay rate and maximum allowed hours depend entirely on your county and state. (For instance, parents in some states are approved for 40 hours a week, while other states or programs—such as Protective Supervision in certain counties—can approve much more).

3. Next Steps & Resources
Since PCA rules are hyper-localized, your pay and hours are determined by where you live. For example, if you live in Maryland (your current location), you can look into the Community Pathways Waiver or the Autism Waiver.

Take action by exploring these resources:
Your Local Department: Contact your local County Department of Social Services or Regional Developmental Disabilities office to request a waiver assessment.
State Guidelines: Visit your state's official Medicaid website and navigate to their specific long-term care or disability services page to find HCBS waiver applications.
Parent Advocacy Networks: You can also connect with state-specific autism or special needs parent groups online (like state chapters of the Autism Society) for recommendations on agencies and the application process.

Thank you!