Update Sept. 2015 - Our organization has released a Paid Caregiver Program Locator which allows families to search for programs that can be used to pay them as caregivers. Start here.
There
are a variety of ways to help bridge the financial gap when caring for an
elderly loved one. One of the most attractive approaches is to be paid as a
family caregiver. For many families, this option offers two distinct
advantages: receiving a new source of income while also ensuring the quality of
care that your loved one receives.
In
this post, we explain how Medicaid can provide this type of funding. If
you are interested in the other, non-Medicaid based programs to get paid for care giving,
please see this
blog
post (“Five Ways to Pay Family Members as Caregivers”).
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Photo by the Abbeyfield Kent Society.
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Overview
Medicaid, a federal program that is administered by the
states, operates a series of programs referred to generally as ‘Cash &
Counseling.’ The National Resource Center for Participant-Directed Services
oversees the states’ Cash and Counseling programs. Other names include as
Consumer Direction, Participant Direction and Self Directed Care. Most states
have these programs under their own Medicaid waiver programs. They exist with a
variety of names, such as Colorado HCBS Waiver for the Elderly, Blind, and Disabled
and the New Jersey Personal Preference Program. See the full list
here.
Program
Description
At their most basic level, these programs provide cash to
the participant and allow them the choice as to how best to spend it on their
care. Participants can select their own home care agency, which may be someone
from their own family. This means that the adult children and, in some cases,
the spouse of the recipient could be hired as a caregiver.
When an individual is already enrolled
in Medicaid or eligible, the agency will begin with a visit to the home of the
senior to understand their needs. They will also contact the recipient’s
caregivers and doctors. Once the agency has made a decision how much care is
needed, a specific funding benefit is made based on the need and the regional
cost of care. The benefit amount can change as the recipient’s needs change.
Most programs consider the situation where the care
recipient needs a ‘surrogate’ to help them make care provider decisions. In
these situations to avoid conflicts of interest, the care decision maker should
be different from the individual who is employed as a caregiver.
Because the caregiver will actually become an
employee of the senior, in some states, a third party organization might be
required in order to make sure that payroll taxes are filed if those payments
are above a minimum level where taxes are due.
Eligibility
- The care recipient must be enrolled in a
Medicaid consumer directed waiver. Sometimes Medicaid waivers are
oversubscribed and individuals will be placed on a waiting list.
- In most states, individuals must be 65 and/or
disabled. Participants with Alzheimer’s, who require
nursing, or who require assistance with the activities of daily living are
medically eligible.
- Participants must be a resident in one of the
states where these programs are available. See our
list of the state programs for detailed information on your state program.
Understandably, getting paid to provide the care that many
family members are already providing is an attractive option for families.
However, the programs can be complicated. For people who are considering
applying to Medicaid for the first time, a Medicaid planning
professional can help.
Learn More
Individuals wishing to learn more about how
these programs can be accessed for your situation should visit our website for the
full article on the Cash and Counseling programs and to find out more the
program in their state.
