Agency-Directed vs. Consumer-Directed Care
Both models are covered by Virginia's CCC Plus Waiver. The difference is who employs the caregiver — an agency, or you.
Which one does Godaelli provide?
Godaelli provides agency-directed care. We are a licensed Virginia home care agency, which means we employ the caregiver, train and supervise them, run payroll, and send a backup when your regular caregiver is unavailable.
We are not a services facilitator or fiscal agent, so we do not administer consumer-directed services. If a family member being paid is what matters to you, that works here: we hire your relative onto our staff, so they earn a real paycheck and you never take on the employer role.
Side-by-Side Comparison
Every practical difference between the two models, from who signs the paycheck to who covers a missed shift.
| What's being compared | What Godaelli ProvidesAgency-Directed Care | The Other OptionConsumer-Directed Services |
|---|---|---|
| Who employs the caregiver | Godaelli. We hire, train, and supervise the caregiver as our employee. | You do. The Medicaid member (or their representative) is the employer of record. |
| Can a family member be the paid caregiver? | Yes — we hire your relative onto our staff. They get a real paycheck, a W-2, and training. | Yes — you hire your relative directly and manage them yourself. |
| Payroll, taxes, and workers' comp | Handled by Godaelli. Nothing for your family to file. | Handled through a fiscal agent you enroll with, with you as the employer. |
| Day-to-day hiring, scheduling, and timesheets | We manage it, built around your family's routine. | You manage it — recruiting, setting schedules, and approving time. |
| If the caregiver is sick or takes a vacation | We send a trained backup caregiver so coverage never lapses. | You arrange your own replacement. |
| Training and background checks | We train, background-check, and credential every caregiver. | You are responsible for vetting whoever you hire. |
| Nurse oversight | Registered-nurse supervision of the care plan comes with the service. | Not part of the model — a services facilitator checks in, but does not supervise care clinically. |
| Medicaid paperwork and compliance | We handle documentation, visit verification, and MCO requirements. | You stay compliant with help from your services facilitator. |
| Who you call when something goes wrong | Our Northern Virginia office — one number, a staffed local team. | You troubleshoot it, or contact your facilitator or fiscal agent. |
| Cost to your family | $0. Covered by the CCC Plus Waiver for those who qualify. | $0. Also covered by the CCC Plus Waiver for those who qualify. |
| Best suited to | Families who want their loved one cared for — or paid — without running a household payroll. | Families who want to be the employer and manage every detail themselves. |
Who employs the caregiver
Agency-Directed — Godaelli
Godaelli. We hire, train, and supervise the caregiver as our employee.
Consumer-Directed
You do. The Medicaid member (or their representative) is the employer of record.
Can a family member be the paid caregiver?
Agency-Directed — Godaelli
Yes — we hire your relative onto our staff. They get a real paycheck, a W-2, and training.
Consumer-Directed
Yes — you hire your relative directly and manage them yourself.
Payroll, taxes, and workers' comp
Agency-Directed — Godaelli
Handled by Godaelli. Nothing for your family to file.
Consumer-Directed
Handled through a fiscal agent you enroll with, with you as the employer.
Day-to-day hiring, scheduling, and timesheets
Agency-Directed — Godaelli
We manage it, built around your family's routine.
Consumer-Directed
You manage it — recruiting, setting schedules, and approving time.
If the caregiver is sick or takes a vacation
Agency-Directed — Godaelli
We send a trained backup caregiver so coverage never lapses.
Consumer-Directed
You arrange your own replacement.
Training and background checks
Agency-Directed — Godaelli
We train, background-check, and credential every caregiver.
Consumer-Directed
You are responsible for vetting whoever you hire.
Nurse oversight
Agency-Directed — Godaelli
Registered-nurse supervision of the care plan comes with the service.
Consumer-Directed
Not part of the model — a services facilitator checks in, but does not supervise care clinically.
Medicaid paperwork and compliance
Agency-Directed — Godaelli
We handle documentation, visit verification, and MCO requirements.
Consumer-Directed
You stay compliant with help from your services facilitator.
Who you call when something goes wrong
Agency-Directed — Godaelli
Our Northern Virginia office — one number, a staffed local team.
Consumer-Directed
You troubleshoot it, or contact your facilitator or fiscal agent.
Cost to your family
Agency-Directed — Godaelli
$0. Covered by the CCC Plus Waiver for those who qualify.
Consumer-Directed
$0. Also covered by the CCC Plus Waiver for those who qualify.
Best suited to
Agency-Directed — Godaelli
Families who want their loved one cared for — or paid — without running a household payroll.
Consumer-Directed
Families who want to be the employer and manage every detail themselves.
How a Family Member Gets Paid With Godaelli
Agency-directed does not mean a stranger in your home. It means the paperwork is ours instead of yours.
- 1
Tell us who you want
Name the family member or trusted friend you want providing the care. If you would rather we match you with a trained caregiver, we do that instead.
- 2
We confirm eligibility
We check CCC Plus Waiver eligibility for your loved one and confirm the hours their assessed needs support. This is free, and there is never a cost to your family.
- 3
We hire and train them
Your caregiver completes a background check, onboarding, and training, then joins our staff as an employee — with a W-2, payroll, and workers' comp handled by us.
- 4
Care starts, paychecks follow
They provide care on the approved schedule and get paid on our regular payroll cycle. We handle documentation, visit verification, and the MCO paperwork.
Which Model Fits Your Family?
Agency-directed is likely better if…
- You want a relative paid without becoming their employer
- Running payroll and filing employment taxes is not for you
- You need guaranteed coverage when the caregiver is sick
- You want training, nurse oversight, and a local team to call
- You would rather spend the time on care than on admin
Consumer-directed is likely better if…
- You want full control over hiring and scheduling
- You are comfortable acting as the employer of record
- You can arrange your own backup when a shift is missed
- You want to set the caregiver's rate within program limits
- You already work with a services facilitator you trust
Godaelli does not administer consumer-directed services. If that is the right fit, your MCO or the Virginia Department of Medical Assistance Services can point you to a services facilitator.
Frequently Asked Questions
What's the difference between agency-directed and consumer-directed care?
It comes down to who employs the caregiver. Under agency-directed care, the agency hires, trains, supervises, and pays the caregiver, and sends a backup when they are unavailable. Under consumer-directed services, the Medicaid member is the employer of record: you recruit, schedule, and manage the caregiver, and arrange your own coverage. Both are covered by the CCC Plus Waiver.
Which model does Godaelli provide?
Agency-directed care. Godaelli is a licensed Virginia home care agency, not a services facilitator or fiscal agent, so we do not administer consumer-directed services.
Can a family member still get paid if I choose agency-directed care?
Yes. That is how most Godaelli families do it. You tell us who you want as the caregiver, and if they meet the qualifications we hire them onto our staff. They earn a paycheck with taxes and workers' comp handled, and you never become an employer.
Which model should my family choose?
Choose consumer-directed if you want full control and are prepared to act as the employer — recruiting, scheduling, approving time, and covering absences. Choose agency-directed if you want the caregiver paid and supported without taking on payroll, compliance, and backup coverage yourself.
Accepted by All Virginia MCOs
We work with all major Managed Care Organizations in Virginia.
Don't see your insurance? Call us — we may still be able to help.
Not Sure Which Model You Need?
Tell us your situation and we will walk you through it honestly — including when consumer-directed would serve you better. Free, with no obligation.
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