If a person with a disability is already receiving Medicaid, their state may allow a family member or friend to become a paid caregiver. Many states call this a consumer-oriented personal assistance program. Each state has different requirements and rules. And the amount the program pays you to care for a family member varies by state. Contact your state's Medicaid office for more information.
In some states, Medicaid can pay for family members who provide 24-hour supervision and care through the provision of structured family care (SFC). SFC is also known as foster care for adults, family life for adults, and coordinated care. The caregiver doesn't have to be a family member, but they are usually an adult child who has taken the father or mother into their home or lives in their parents' home. Some states allow spouses to be caregivers for CFS.
The SFC is available in Connecticut, Georgia, Indiana, Louisiana, Massachusetts, Missouri, Nevada, North Carolina, North Dakota, Ohio, Rhode Island and South Dakota. In most cases, these services will be provided through a Medicaid exemption offered by your state, but they may be offered through other state Medicaid plan options. To get paid to care for your loved one, some states may require you to become a certified Medicaid provider or to meet other state requirements. The care recipient must meet income requirements and other eligibility requirements established by the state.
For more information, contact Applied Self Direction. This organization maintains a list of state self-direction programs. You can also contact your state's director of Medicaid. All responding states pay family caregivers through one or more Medicaid home care programs (Figure 1, Appendix Table).
Family caregivers are generally allowed to pay for personal care, which can be offered through several different types of Medicaid HCBS programs. Personal care can be provided through exemptions, such as the 1115 or 1915 (c) programs, through the state Medicaid plan, or a combination of both. Exemption services generally cover a wider range of benefits than those of the state plan, but exemptions are often restricted to specific groups of people enrolled in Medicaid depending on geographic region, income, or type of disability; often, they are only available to a limited number of people, generating lists of wait. The Old Age Pension Health and Health Care Program (OAP) provides limited medical care to Coloradans who receive an old-age pension.
If you (or your family or dependant) receive an old age pension and earn too much to qualify for Health First Colorado (Colorado's Medicaid program), you may be eligible. If your loved one is eligible for Medicaid, programs often allow you to hire family caregivers and pay them out of your personal care budget. Eligibility and program names vary by state, so it's important to research local Medicaid exemption programs for the most accurate options available. Some companies offer paid family leave for caregivers; otherwise, families can create informal contracts to pay caregivers directly, although legal advice is recommended because of tax and benefit implications.
This ensures that both parties are protected and maintains eligibility to receive public benefits, where appropriate. Programs and eligibility vary widely between U.S. states. Department of State; the article includes a detailed table of the resources specific to each state and the agencies you can contact.
These local agencies can provide guidance on enrollment, benefits and how to navigate complex Medicaid or caregiver support programs. Self-directed service programs provide people with disabilities and older citizens with the option of managing a budget and determining how to use their money to pay for goods and services directly related to their personal care needs. When they enroll in one of these exemption programs or other self-management options, program participants can use whatever budget they have allocated to hire and pay caregivers. To determine if your family member is eligible for self-directed services available in your state, contact the local Medicaid office.
In many cases, to qualify, your loved one must need help with activities of daily living and meeting income and asset guidelines. If you need more help determining if your loved one is eligible for these veterans benefits, contact your local Veterans Affairs office or local veterans services organization. If you want to become the paid caregiver for a family member, it's critical to know if your loved one qualifies for access to different government programs, insurance policy benefits, employee benefits, and family payment options. To help you learn about the options available, we've prepared a step-by-step guide, state by state, to help you get financial assistance for care services.
Alabama offers the Alabama CARES Program, which is administered by the Alabama Department of Senior Services (ADSS) through the 13 Area Agencies on Aging (AAA). This program offers assistance to caregivers, including training, individual counseling, information, and support (such as personal care, limited homemaker services, and adult day care). Depending on the county in which you live, you'll need to contact your local agency that deals with aging for more information and eligibility requirements. To be eligible for the ALTCS, people must: a) need a level of care in a nursing home as determined by the AHCCCS, b) be qualified citizens or immigrants, c) have a social security number (SSN) or apply for one, d) be an Arizona resident, e) apply for all cash benefits to which they may be entitled, such as pensions or VA benefits, and f) live in an approved housing agreement. There are also certain financial eligibility requirements that must be met.
Spouses and parents of minor children can also receive compensation for care services, as long as they meet the eligibility criteria. The Community Access Exemption for the Inclusion of People with Disabilities (CADI) is a similar program that offers assistance to people with disabilities and includes consumer-led community support (CDCS) as a service option. You can find more information in this fact sheet. North Carolina home care services are a program available in North Carolina for residents who are not eligible for Medicaid.
Previously, this program was known as household chores, home health help, respite, and personal care services. Services are provided to older adults and caregivers so that participants can avoid being placed in nursing homes. Personal care and housework services are among the wide range of services offered, and these services can be provided by family members, including adult children and spouses, if the participant so wishes. Caregivers must be at least 18 years old and must have resigned from other employment in order to care for their loved one. A healthcare professional and case manager will evaluate applicants to determine eligibility and define the services to be provided.
North Dakota's payment programs for services for the elderly and disabled (SPED and former SPED) are available to residents of the state who are not eligible for Medicaid benefits. This program includes two levels of services with different eligibility requirements, and the SPED serves people with the most functional disabilities. Both programs offer services to allow older adults and people with disabilities to stay in their own homes, including foster homes for adults. Both programs allow self-direction through the Family Home Care service option.
Family Home Care “reimburses a family caregiver who meets relationship requirements defined by state law and resides in the client's home 24 hours a day. This program includes three levels of service (Level A, Level B and Level C) with different eligibility criteria. The number of hours of care available varies depending on the participant's level of service. It is aimed at the consumer, and health care providers, who are called qualified service providers, may include a family member, neighbor or friend who has met the standards set by the North Dakota Department of Human Services (DHS).
Payment is made at an hourly rate approved by Medicaid. The CHC provides older adults and people with physical disabilities with medical benefits as well as long-term support services to promote independent living and avoid unnecessary placement in nursing homes. Benefits include personal care services, such as assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL), such as bathing, preparing meals and administering medications. Enrollment in this program is mandatory for those who meet the eligibility requirements.
The Comprehensive Assistance Program for Family Caregivers (PCAFC) for Veterans Affairs offers “increased clinical support” to caregivers of eligible veterans who are seriously injured. Benefits for eligible caregivers include an economic stipend, compensation for travel and per diem (when traveling to attend a medical appointment with the Virginia Veterans Department), as well as respite services, mental health counseling and more. There are seven eligibility requirements that must be met to qualify. More information can be found in this fact sheet.
The Washington Medicaid Personal Care Program is administered by the Home and Community Services (HCS) and Developmental Disabilities (DDA) administrations. A case manager, nurse or social services specialist from DDA, HCS or the Regional Agency on Aging (AAA) performs a CARE evaluation to determine eligibility and the required services. Payment for care does not consist of financial assistance through Medicaid, but this exemption allows the transfer of the parents' home to the adult child as a form of payment. This contract can be used later if your loved one needs to apply for Medicaid or enter an assisted living facility or nursing home.
The COVID-19 pandemic compounded the workforce's existing problem with Medicaid home care, and states used new federal funding and flexibility to maintain service levels by increasing self-directed services and payments to family caregivers. Often, this model allows more people to take advantage of paid family leave, since those who work for smaller employers or who are self-employed can afford the coverage. The Wyoming Community Choices Home & Community Based Services Medicaid Exemption (CCW) is a Medicaid-funded program that offers services that include personal care assistance, home meal delivery, adult day services, respite care, and other services to help people stay in their own homes and avoid being placed in nursing homes. Nebraska offers four state-funded non-Medicaid programs for older adults and disabled residents, including the Support Program for Disabled People and Families (DPFS), the Social Services Program for Older and Disabled Adults (SSAD), the Assistance Program for the Elderly, Blind, or Disabled (AABD), and the Nebraska Lifetime Relief Grant Program.
The exemption for child caregivers allows an older parent to transfer ownership of their home to a qualifying adult child without the home being subject to the Estate Recovery Program or the Medicaid retrospective period, which are described below. If you work for an employer with more than 50 employees, you may be entitled to unpaid leave of up to 12 weeks to care for and protect his work. Medicaid laws have more complicated requirements for states to pay legally responsible family members than for other types of family caregivers and friends. For those who do not qualify for access to the state Medicaid program or exemption programs for home and community-based services, South Dakota offers a state-funded option called the home services program of the South Dakota Division of Adult and Senior Services (ASA).
In addition, if your loved one has savings or investments saved, they will likely have to spend most of that money on health care before they are entitled to long-term care coverage through Medicaid. Utah home and community service exemption programs are state-funded programs that help Utah residents avoid having to spend their assets to qualify for Medicaid. If the person you care for has a disability or chronic condition and is eligible for Medicaid, they may be eligible for financial assistance that can be used to purchase necessary services and supports at home and in the community, including payment to the family caregiver or to pay for a break. State Medicaid plans, also called regular Medicaid, offer an option to become a paid caregiver for a loved one.
Summary Many seniors rely on the care of family or friends, and these loved ones are rarely paid for their efforts, but that doesn't have to be the case...
