Yes, a family member can get paid for childcare in Missouri. The most common route is the state’s Child Care Subsidy Program, which pays a qualifying non-parent relative directly for caring for an eligible child. Families who don’t qualify for the subsidy can pay a relative privately, and families raising a child with a developmental disability may be able to use a Medicaid waiver to compensate an in-home caregiver.
The Child Care Subsidy Program
The Child Care Subsidy Program is the main way a relative gets paid with state money for watching a child in Missouri. The Department of Elementary and Secondary Education (DESE) Office of Childhood runs it, using state and federal funds to help lower-income families afford care while they work, look for work, or attend school.1Missouri Department of Elementary and Secondary Education. Child Care Subsidy The relative registers as a license-exempt provider, and DESE sends the payments straight to them.
Which Relatives Can Be Paid
The caregiver has to be a non-parent family member. Grandparents, aunts, uncles, and adult siblings are the usual candidates. They don’t need a full child care license, but they do need to clear the same safety requirements every subsidy-funded provider meets.
Background Checks
Every subsidy provider, family or not, must pass a comprehensive background check before caring for children. That includes fingerprinting, a National Sex Offender Registry search, and screening through Missouri’s Family Care Safety Registry.2Missouri Department of Elementary and Secondary Education. Child Care Background Check Process Anyone 18 or older who lives in the home where care is provided has to complete a check too. Checks are renewed every five years.3Legal Information Institute. Missouri Code 5 CSR 25-600.020 – General Requirements
Training and CPR
Federal Child Care and Development Fund rules require every subsidy provider to complete a one-time health and safety training. Missouri offers it free online. Caregivers must also keep current pediatric first aid and CPR certification, which has to be renewed every two years through a nationally recognized program like the American Red Cross or American Heart Association.4Missouri Department of Social Services. Training Requirements for Six or Fewer Child Care Providers
Whether the Family Qualifies
The subsidy is means-tested and tied to a work, school, or job-search reason for needing care. The child has to be from birth through age 13, or up to age 19 if the child has special needs or is receiving protective services through the Children’s Division.5Missouri Department of Elementary and Secondary Education. Child Care Subsidy Information for Families
Income is the tighter gate. To qualify initially, the family’s income has to be at or below 150% of the federal poverty level.5Missouri Department of Elementary and Secondary Education. Child Care Subsidy Information for Families For a family of four in 2026, that’s roughly $49,500, based on a poverty guideline of $33,000.6U.S. Department of Health and Human Services. 2026 Poverty Guidelines Once approved, a family can keep receiving the subsidy as long as income stays under 85% of the State Median Income. Families whose children receive protective services through the Children’s Division have the income test waived entirely.7Missouri Department of Elementary and Secondary Education. Programs
Families whose income sits between 151% and 242% of the federal poverty level can still participate on a transitional basis, paying a daily sliding fee to the provider based on income and hours of care.8Missouri Department of Elementary and Secondary Education. Child Care Subsidy Rates and Sliding Fees
How to Apply
Families apply online at childcare.mo.gov. Paper applications are also accepted by mail, fax, or in person.9Legal Information Institute. Missouri Code 5 CSR 25-200.060 – Eligibility and Authorization for Child Care Subsidy Expect to submit proof of residency (photo ID or a utility bill) and income verification (at least two pay stubs from the last 60 days, or a tax return if self-employed).10Missouri Department of Elementary and Secondary Education. Application for Child Care Subsidy for Children and Families Review typically runs 15 to 30 days, and an interview may happen by phone or in person. Once approved, DESE notifies both the family and the caregiver, and payments start going to the provider.
Paying a Relative Privately
If you don’t qualify for the subsidy, you can still hire a relative directly. The catch is that the IRS treats you as a household employer once you pay a caregiver $3,000 or more in cash wages in 2026 for in-home child care. That means withholding 6.2% for Social Security and 1.45% for Medicare from the caregiver’s pay, and matching those amounts yourself.11Internal Revenue Service. Topic No. 756, Employment Taxes for Household Employees You report the totals on Schedule H with your personal return. If you pay $1,000 or more to a household employee in any single quarter, federal unemployment tax kicks in on the first $7,000 of wages.12Internal Revenue Service. Publication 926, Household Employer’s Tax Guide The IRS doesn’t treat a grandparent differently from any other employee here.
The Child and Dependent Care Credit
Parents paying a relative for care can often claim the federal Child and Dependent Care Credit, but not everyone counts as a qualifying provider. You can’t claim the credit if the caregiver is your spouse, your child under age 19, the other parent of your qualifying child (when the child is under 13), or anyone you claim as a dependent.13Internal Revenue Service. Topic No. 602, Child and Dependent Care Credit Paying a grandparent, aunt, uncle, or adult sibling who isn’t your dependent works, as long as you list their taxpayer identification number on the return.
Medicaid Waivers for a Child With a Disability
Families caring for a child with a developmental disability have a separate option. The Missouri Children with Developmental Disabilities (MOCDD) Waiver, also called the Sarah Jian Lopez Waiver, provides home and community-based Medicaid services to children who would otherwise need institutional care, and it waives the usual counting of parental income when determining the child’s Medicaid eligibility.14Missouri Department of Social Services. 0825.000.00 Eligibility Based on Receipt of MOCDD Waiver Services15Missouri Department of Mental Health. Missouri Children’s Developmental Disabilities Waiver Missouri also runs a Developmental Disabilities Comprehensive Waiver through the Department of Mental Health.16Missouri Department of Mental Health. Comprehensive Waiver Whether family members can serve as paid caregivers, and which services are covered, varies by program, so contact the Division of Developmental Disabilities directly to see what fits.
Taxes on the Caregiver’s Side
How the caregiver’s income is taxed depends on where the money comes from, and this is where paid family caregivers most often overpay.
Subsidy and Private-Pay Income
A relative paid through the Child Care Subsidy Program, or paid directly by the family, generally reports the income as self-employment earnings on Schedule C.17Internal Revenue Service. Instructions for Schedule C (Form 1040) Self-employment income owes regular income tax plus 15.3% self-employment tax for Social Security and Medicare. Legitimate business expenses (supplies, food provided to the child, a share of home utilities if care happens in the caregiver’s home) can be deducted.
Medicaid Waiver Payments May Be Tax-Free
Under IRS Notice 2014-7, Medicaid waiver payments received for caring for a person who lives in the caregiver’s own home are treated as difficulty-of-care payments and excluded from gross income.18Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income If a family member is paid through the MOCDD waiver to care for a child who lives with them, those payments likely qualify. The Schedule C instructions address how to report nontaxable Medicaid waiver payments.17Internal Revenue Service. Instructions for Schedule C (Form 1040) A tax preparer who knows this rule is worth the visit.
What Paid Caregiving Does to SSI and SNAP
A relative already receiving Supplemental Security Income or SNAP should run the numbers before taking paid work. For SSI, childcare payments count as earned income. Social Security excludes the first $65 per month plus half of anything above that, so some cushion exists, but regular payments will still trim the SSI check.19Social Security Administration. Income Exclusions for SSI Program One exception: when the family receiving the subsidy is itself on SSI, the subsidy payment going to the family (as opposed to the provider) may be excluded from the family’s income.
For SNAP, any new childcare income counts toward the household’s gross income limit, and whether it pushes a caregiver over depends on household size and other earnings. A benefits counselor at the local Family Support Division office can model the impact before a paid arrangement starts, which is cheaper than losing food benefits after the fact.