What are Live-In Aides & How to Qualify Them

By 2025, it’s expected that the United States will need 2.3 million new healthcare workers, including 423,200 home healthcare aides. The figures are sobering in light of the 2020 pandemic, which has separated caregivers from disabled or affordable housing tenants.


Allowing a live-in aide for a disabled tenant is both a HUD and fair housing requirement. Knowing what a live-in aide is and how to accurately qualify alive-in-aide for your community will simplify the certification process.


Caregivers. Live-In Aide: What’s the Difference?


Caregivers are typically defined as healthcare workers who visit a disabled or elderly tenant’s home to render healthcare services that the tenant cannot adequately perform. Alive-in aide is not necessarily a professional healthcare worker, but can be a family member, neighbor, or friend. Live-in aides reside with the tenant to provide around-the-clock care. An earned income may not always be the case for a live-in aide’s services.


Many state agencies support live-in aide care over residential facilities, assisted living, and nursing homes due to costs to maintain the facilities and a number of other factors. This includes an effort to provide “community-based housing” options and safeguard disabled and elderly tenants’ rights to control their lives and remain active members of their communities.


A tenant in need of an aide must be elderly (62+), near-elderly (50+), disabled, or qualified for assistance based on the Fair Housing Act’s disability definition.


How to Qualify a Live-In Aide


Tenants can request alive-in aide by filling out a Live-In Aide Request Form. Property owners must then verify the need for a live-in aide. Each affordable housing program has different rules and policies about live-in aides. In most cases a letter from a physician, psychiatrist, or other medical practitioner certifying a tenant’s disability or need for a live-in aide is required. Verifications from a medical practitioner should be on an official letterhead and dated within 120 days prior to the effective date of a certification. Property owners cannot require applicants to provide confidential medical records or submit to a medical examination to ascertain a medical condition.

Owners may verify that the live-in aide request is a reasonable accommodation only to the extent necessary to document that the tenant has a disability related need. In other words, does the tenant have any proof of a disability or situation that may require a live-in aide’s services. Be aware that an applicant might still be working full-time and qualify for disability services.


HUD defines alive-in aide as “a person who resides with one or more elderly persons, near-elderly or persons with disabilities” and is necessary in offer care and well-being services. HUD adds that a live-in aide is:


           1. determined to be essential to the care and well-being of the persons;

           2. is not obligated for the support of the persons; and

           3. would not be living in the unit except to provide the necessary supportive services.


This definition applies to a specific person and not a group of individuals or an organization.


Additional Screening Required by Federally Funded Programs


In addition, each PHA must approve of the live-in aide through screening. An EIV Existing Tenant Search is required for live-in aides. The PHA might disapprove a live-in aide candidate if the person has:


           1. committed fraud, bribery, or any other corrupt or criminal act in connection with a federal housing program;

           2. committed drug-related or violent criminal activities; or

           3. currently owes rent or other amounts to the PHA or to another PHA or public housing assistance program.


State PHAs might have additional requirements for live-in aides, so it’s best to check with your PHA to clear all certifications.


PHAs also determine subsidy standards to provide an adequate number of bedrooms for different family sizes. An apartment unit must be large enough to accommodate alive-in aide. In addition, PHAs may not approve an unidentified live-in aide or authorize a unit that is larger than what qualifies under its subsidy standards.


When considering whether a live-in-aide to reside in a unit is a reasonable accommodation, owners and property managers must make sure the tenant’s file clear documents the aide’s status. Live-in aides should be included on the Tenant Income Certification (TIC), but not permitted to sign the TIC. Most programs do not consider aides to be tenants, usually added to the housing contract as a “live-in aide.”


Does a Live-In Aide Pay Rent?


Live-in aides should not be included on the lease as a household member, and as such, does not pay rent. If the tenant uses a housing voucher, the voucher amount might increase to accommodate an extra bedroom for an aide—a practice called the “payment standard.” The

voucher amount is increased to cover the cost of renting a larger unit to accommodate alive-in aide. Aides will appear on housing vouchers as “live-in aides” and not as household members.


If alive-in aide is compensated by an agency or the tenant for services, the live-in aide’s income in excluded from the household income. However, there is one exception: certain types of senior housing have special rules for adult children who serve as live-in aides to their parents.


HUD apartment, housing voucher, Section 8, public housing, and rural rental assistance programs will not raise a tenant’s rent after requesting a live-in aide. Other affordable housing program might raise a tenant’s rent depending on the type of affordable housing assistance the tenant is using.


Who Can Be a Live-In Aide?


A tenant can select a friend, neighbor, family member, or hire a healthcare worker as a live-in aide as long as the individual meets HUD requirements. Tenants are responsible to find a live-in aide that fits their needs. HUD’s rules state that a live-in aide is someone who is not obligated to support the tenant, will not be living in the unit except to provide necessary supportive services, will live with the tenant full-time, and must pass a criminal background check. Rotating or intermittent caregivers do not qualify.


HUD also allows tenants to have more than one live-in aide if the need is properly documented by a physician and verified by the property owner.


Can a Family Member Be a Live-In Aide?


A family member can seek to qualify as alive-in aide as long as HUD requirements are met. Family members, like other live-in aides, are only allowed to remain in the housing unit as long as a disabled resident requires the aide’s services and remains a tenant.


In HUD Section 2020 PRAC and Section 811 housing communities, adult children of disabled and elderly tenants are not eligible to move into a housing unit unless they will fulfill the services of a live-in aide and meet the necessary criteria.


Put simply, a relative can be a live-in aide if that is the only reason she is living in the unit.


Can a Live-In Aide Bring Minor Children to Senior Affordable Housing?


PHAs can approve alive-in aide’s minor children or another family member to live in the unit. However, the additional occupants are not entitled to have their own bedrooms. Tenants need to show that the live-in aide is the person with minor children is best suited to meet the tenant’s

needs(a letter from a physician is ideal). Many live-in aides have a spouse or children and cannot reasonably be expected to live apart from them. Reach out to your PHA to learn more about its policies regarding a live-in aide’s relatives.


Does a Live-In Aide Have a Right to Remain?


Live-in aides are not considered tenants and do not have tenant rights. For whatever reason a tenant no longer lives in the unit the live-in aide is not allowed to keep a housing voucher or other affordable housing assistance.


The live-in aide qualifies for occupancy only for the time the disabled or elderly tenant requires the aide’s services. This precludes the aide from continuing occupancy as a remaining family member. Under no circumstance should a live-in aide be converted to a household member.


A Live-In Aide Agreement should clarify that a live-in aide holds no right of occupancy and give the property owner the right to evict a live-in aide if any community rules are violated.




Live-in aides are a valuable resource to tenant well-being. Knowing how to qualify alive-in aide will ensure safety for community residents and compliance with affordable housing programs. If you have questions about live-in aides and the qualification process, contact Preferred Compliance Solutions. We will help you learn how to best qualify live-in aides for your area.