Hawaii Self-Directed Services / Community Living Program¶
Hawaii offers self-directed options under its HCBS waivers, allowing Medicaid-eligible individuals with functional limitations to hire and manage their own caregivers. Family members including spouses can be hired as paid attendants. Hawaii also has the Kupuna Caregivers Act, a separate state-funded program for employed family caregivers.
Hawaii self-directed services provide personal care through QUEST Integration HCBS. Participants can hire family members, including spouses, as paid caregivers; Med-QUEST's 2026 HCBS fee-for-service schedule lists self-directed chore and companion services at $4.00 per 15 minutes, personal assistance at $17.40 per hour, and nurse-delegated personal assistance at $22.72 per hour. Hawaii also offers the Kupuna Caregivers Act, a separate state-funded program providing assistance to employed family caregivers of elderly relatives. QUEST Integration STCs cap medically needy demonstration-group gross income at 300% FPL; Hawaii's 2026 MAGI-excepted chart lists the household-one 300% FPL amount as $4,590/month and the aged/blind/disabled household-one asset limit as $2,000.
Eligibility¶
- Household income at or below 300% of the Federal Poverty Level
- Asset limit of $2,000
- Care recipient must have a qualifying disability
- Relationship: spouse, parent, child, sibling, grandparent, other relative, non relative
Services¶
Hawaii self-directed services provide personal care through QUEST Integration HCBS. Participants can hire family members, including spouses, as paid caregivers; Med-QUEST's 2026 HCBS fee-for-service schedule lists self-directed chore and companion services at $4.00 per 15 minutes, personal assistance at $17.40 per hour, and nurse-delegated personal assistance at $22.72 per hour. Hawaii also offers the Kupuna Caregivers Act, a separate state-funded program providing assistance to employed family caregivers of elderly relatives. QUEST Integration STCs cap medically needy demonstration-group gross income at 300% FPL; Hawaii's 2026 MAGI-excepted chart lists the household-one 300% FPL amount as $4,590/month and the aged/blind/disabled household-one asset limit as $2,000.
How to apply¶
Use the official program page for application details: official program page.