Medicaid does not pay the room and board costs for a Medicaid recipient receiving home and community-based services. However, under a specific area of Medicaid law, Medicaid will pay the proportionate room and board costs of a live-in personal care worker. This 2022 National Self-Direction Conference session discussed how the caregiver’s free housing can in effect act as a rent subsidy for a Medicaid recipient who otherwise cannot afford housing. In addition, under Department of Labor rules, the free housing for the live-in caregiver can also offset wages otherwise owed to the caregiver for providing personal care to the Medicaid recipient. In effect, the same Medicaid dollar can assist the Medicaid recipient to afford rent, provide free housing for the caregiver, and offset wages for care provided.