Can you get paid for taking care of your parents?

paid for taking care

Can you get paid for taking care of your parents?

Wondering whether children or grandchildren of senior or disabled parents can be paid caregivers? Read more to find out how and what options are available.

 

Paid family caregivers can provide services in Pennsylvania’s Home and Community-Based Services (HCBS) waiver programs. This includes services as a caregiver, personal care aide, or home health aide (HHA). This includes children, like sons and daughters of individuals that qualify for waiver services. The most common program is under the Home and Community Based Services (HCBS) Medicaid waiver. 

Family caregiver statistics

Studies show that more than one in six Americans working a full- or part-time job assist with the care of a disabled or elderly family member or friend. Providing care for a chronically ill, disabled, or senior family member can place a large burden on the caregiver. 

The value of this caregiving, known as informal caregiving, was estimated at $450 billion in 2011. This care provided has been shown to come at a substantial personal cost. For example, 37 percent of caregivers reported that they have had to quit their jobs or reduce their work hours to provide care for someone aged 50 or older.

Federal regulations and Medicaid waivers allowing paid family caregivers

Federal programs are designed to alleviate this burden and reduce the need for institutional services. As a result, federal regulations allow some family members to serve as paid caregivers under the Home and Community Based waiver programs. Pennsylvania has ten of these waivers. Under these waiver, family members are allowed to be paid for at least some of the services they provide under seven of them.

Home and Community-Based Services

Which family members are not eligible under the program?

Not all family members are eligible and can be compensated under the waiver programs in Pennsylvania. Federal regulations generally preclude “legally responsible” family members. For example, spouses or the parents of a minor child cannot be paid for the services they provide. The reasoning behind this prohibition is that legally responsible individuals should not be paid for providing care that they would otherwise be obligated to provide.

Although this general prohibition is in effect, the Centers for Medicare and Medicaid Services (CMS) does let legally responsible individuals, including spouses, to be paid for providing “extraordinary care.” However, this is only if a state requests such provisions in an approved HCBS waiver. A few states, including Arizona, Colorado, and Oregon, allow for such payments. 

In Pennsylvania, they allow spouses to be paid for a limited number of extraordinary care services. Examples include home and community habilitation and certain transportation services. While this can be seen in some of its waiver programs, it is not done to the extent of these other states.

What family members are most commonly caregivers under the Medicaid waiver program?

The Department of Human Services collects limited data on the family relationship status of paid caregivers. Data collected among five waiver programs shows that an average of 40 percent of paid caregivers are family members. Of these, 4 percent are siblings and 5 percent are parents. A further 16 percent are adult children of the beneficiary and 15 percent are another relative (but not a spouse).

How much do children and family caregivers get paid to provide home care?

The waiver programs provide fixed reimbursement rates that they pay home care agencies for home care services rendered. The home care agency, in turn, will then hire the family caregiver, including family members, and pay them directly. In almost all cases, the family caregiver is hired as a direct employee of the home health or home care agencies. They will also be paid on an hourly basis, in most cases. Since they are treated as regular employees, they will also be eligible for other benefits offered, such as vacation pay, sick pay, a retirement plan, etc. Caregiver pay is set within a range tied to the reimbursement that the state and managed care plans through Community HealthChoices pay to home care and home health agencies.

Locally, salary surveys show that caregivers are paid, on average, between $10 and $15 per hour of non-medical home care services provided here in Philadelphia, Pennsylvania. These job titles include Personal Care Aides, Home Health Aides, or caregivers. 

How do I know if my parent or care recipient is eligible?

The prospective recipient of care must meet financial requirements of Medicaid waiver programs. They also need to meet clinical eligibility. This means that they need to assessed and have certain healthcare needs or functional deficiencies in place as outlined below. Applicants need to meet both eligibility criteria in order to be considered for the Medicaid waiver program

Financial eligibility

Your parent or loved one must have limited financial resources to be approved through the Medicaid waiver program. This is because Medicaid is only available for individuals that have relatively low income and/or limited financial resources. 

  • For the state of Pennsylvania, waiver program applicants must have income no greater than 300% of the Federal Benefit Rate (FBR).
  • As of 2020, this means a single individual cannot have income in excess of $2,349 per month.
  • All sources of income are considered and tabulated. Examples include social security payments, unemployment assistance , disability, pension, alimony, income from working, etc. 
  • The asset limit for a single person is $8,000 after allowances (including savings accounts and investments). In addition, certain exemptions are allowed, such as one’s home that they reside in or intend to return to, and it is valued under $585,000, along with household items, and personal effects.

Senior Care Philadelphia Resources

Clinical eligibility

Applicants must also meet functional eligibility requirements to qualify for waiver Home and Community Based Services. There is a clinical and healthcare needs component under which applicants are assessed. This means that someone has to be considered “Nursing Facility Clinical Eligible.” Basically, the person applying for care and services under Medicaid waiver require care to the level of assistance of a nursing home.  

  • This is done through the state of Pennsylvania with a formal assessment completed of the applicant. It’s called a Level of Care Determination
  • The individual must have an illness, injury, disability, or medical condition diagnosed by a physician
  • The patient’s physician must certify, via signed physician’s certification, that the individual meets this criteria
  • The level of care must go beyond that of just room and board in a nursing home. Basically, the condition, injury, illness, or condition would require a significant amount of hands on care and support from members of a healthcare team

 

The following is a list of criteria that the state considers when determining clinical eligibility. This list is not all-inclusive:

  • The individual has a diagnosis that requires treatment.  The individual’s diagnosis and treatment impact his/her physical and/or psychological ability to manage their own care.
  • The individual’s ability affects managing their care, treatments, and interventions.  
  • If the individual has a diagnosis of Alzheimer’s disease, dementia, traumatic brain injury, or other mental health diagnosis, the Level of Care is based on the degree to which psychological problems are affecting the individual’s functioning and the ability of that individual to maintain himself or herself in their environment.  
  • Deficits in Activities of Daily Living (ADLs) alone will not meet the criteria for an individual to be considered NFCE.  For example, ADLs include things like bathing, dressing, grooming, and cooking. The individual must have a medical condition that is “currently being treated.” The condition must create a medical need that requires care and services of a healthcare professional.  

 

Next steps if program approval is granted

Once the participant is approved by the state waiver program, they will be assessed to determine what services may be available under the Medicaid waiver. They will then be approved for their own set of services, depending on what their individual needs are. We detail the list of services available here.

Home care services and agencies available

Pennsylvania's CHC Medicaid Waiver

Pennsylvania’s CHC Medicaid Waiver

Because of the nature of their needs, most individuals will qualify for some level of home care services. At this point, the care recipient can then choose a home care agency that allows the employment of eligible friends, family members, or loved ones. It is important to find an agency that is reputable, offers comprehensive training, as well as support to both caregivers and to the recipients of care. 

With the right home care agency support, caregivers can make sure they can provide high-quality care to their loved ones. Then, the care recipients can thrive and live as independently as possible, and caregivers have the tools and resources to be successful. Chosen Family offers many training, development, and mentorship opportunities for caregivers and is proud to employ eligible family and friends as caregivers as part of our team. 

Are all home care and home health agencies the same?

Home care agencies vary widely between the level of training, support, and pay they provide to their employees and caregivers. While each organization has the same fixed Medicaid waiver payments received, their pay and benefits packages will all be different. As a result, it is important to consider that when evaluating home care providers. Also, it’s vital to consider additional benefits or perks like ongoing training opportunities, company culture, and other perks specific to each organization. 

For example, Chosen Family Home Care has a comprehensive package for caregivers and is one of the highest paying local Philadelphia home care agencies. Chosen Family will even match or beat pay from any local home care agency. In addition, company culture is a major focus of the organization along with work-life balance and flexibility. Chosen Family believes that stronger support and pay for caregivers leads to happier clients and ultimately better patient care and health outcomes for the recipients of care. Check out the careers section to learn more. 

Do caregivers have to meet the same income or financial requirements as the care recipients?

No. Caregivers just have to meet the same qualifications that any other private caregiver would need to meet. Any selected caregiver would never be screened for income requirements. 

How can I start the process of getting me or my loved one set up?

Do you still have questions? We can help with additional questions. We can help you walk through the Medicaid and waiver application process, understand and determine if your loved one needs help or if they might qualify, or help in choosing a home care provider. Write, text, or give us a call and we can provide support. There is no hassle, no obligation, and satisfaction guaranteed. 

Read more of our insights and follow us on Instagram and Facebook for free resources and tips to improve the health and quality of life for your loved one and for caregiver resources.

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What can I do if I still have questions? 

Still confused or need further assistance? No problem! Reach out to Chosen Family Home Care today and we will gladly help.

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