Personal Assistance Services (PAS) employs nearly 900,000 providers of long-term care; many are relatives hired by PAS recipients. Risk of occupational injury and musculoskeletal disorders among PAS providers is a concern and it is unknown if relatives are more vulnerable compared to non-relative providers. This paper explores whether paid relative and non-relative providers differ regarding this vulnerability, using data from a survey of PAS providers (n=855). No differences were found

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... g risk of injury or musculoskeletal disorders, which suggests that PAS programs could continue offering options for recipients to hire relatives as providers, with no additional risks placed on relatives. Publicly-funded PAS programs historically have provided services using workers employed by PAS agencies, but an increasing number of workers are employed through consumer-directed models in which workers are "independent providers" [2] . Such workers are hired and supervised directly by the PAS recipients or "consumers" [3] . This model gives recipients more control over their supportive services, including the ability, in many states, to hire relatives. Recent policy changes, such as the Community Living Assistance Services and Support Act, are fostering an expansion of consumer-directed care. As of 2009, consumer-direction is an option in 38 states' Medicaid programs [4] .