10 Nov Get Paid to Care For A Loved One in Pennsylvania: A Guide
Learn how Pennsylvania’s innovative Medicaid waiver program can lessen the financial burden of family caregiving. Read more to see how some family members may be eligible to get compensated to provide hands on support to loved ones, plus get a free consultation today.
Providing care assistance to a family member or loved one is one of the most rewarding tasks you can do. You have the opportunity to ensure that they receive the best quality care possible. After all, few can provide the same level of compassion, support, and love that a family member or loved one can. Plus, it provides the opportunity to spend quality time with your loved one.
Additionally, you won’t have to worry about strangers that may not be as sympathetic, caring, or attentive for your loved one when you become the primary caregiver. While there are many supportive, highly trained, and compassionate caregivers out there, that may not be enough to make your loved one comfortable or at ease like a known caregiver can.
Impact of family caregiving
According to a recent report from the AARP, family caregiving impacts out of pocket expenses in America in various ways:
- Family caregivers spend more than $7400 per year on caregiving related expenses
- More than 75% of family caregivers sustain out of pocket expenses because of family caregiving.
- Minorities are disproportionately burdened: Latino/Hispanic and low-income caregivers spend nearly 50% of their total income on family caregiving.
- Family caregivers have to sacrifice a significant portion of personal savings and spending money, save less for retirement, and take unpaid time off at work.
Because of the effects that family caregiving can have financially on a family, several programs out there can offer financial support to loved ones that act as caregivers.
Family caregivers getting compensation for their support
The most common program that pays loved ones for caregiving is a Medicaid option program known as Medicaid Waivers. These Waivers are also referred to Home and Community Based Services (HCBS) Waivers, 1915(c) Waivers, or even Section 1115 Waivers. Waivers, under broad federal guidelines, allow states to pay for certain support and care services for persons that reside outside of long term care facilities such as nursing homes or assisted living.
In most cases, they pay for personal care (which is care that provides direct assistance with activities of daily living such as bathing, getting dressed, and transferring) plus household services offered for older adults or disabled individuals that live in their own homes or the homes of loved ones or family members.
Can you get paid by the state of Pennsylvania to care for a loved one or family member?
The short answer is yes. A caregiver could be eligible to be paid through several programs and plans.
Long term care insurance and VA paid family caregiving
Eligible family members can get paid through a long-term care insurance policy or with a Veterans Affairs program. If you or a family member have long-term care insurance or VA benefits, contact us here for your free consultation! We can help you determine eligibility get paid for family caregiving.
Caretaking for a loved one through PA Medicaid and Community HealthChoices
The rest of this article we will refer to the PA Medicaid waiver program that provides this opportunity through home- and community-based service (HCBS) providers.
The Pennsylvania waiver is the general term for the 10 support service waivers provided by the state. In this guide, we will refer specifically to the Community HealthChoices waiver, known as CHC. This particular waiver is new and is the combination of three former waiver programs: aging waiver, attendant care/ act 150 waiver, and independence waiver.
Community HealthChoices (CHC) Medicaid waiver health plans
CHC is a Medicaid managed care program. It exists for individuals that are 21 years of age or older and are eligible for both Medicaid and Medicare. Plus, these individuals must require a certain level of assistance that we discuss below.
In the state of Pennsylvania, managed care Medicaid is administered by one of three private healthcare insurance companies. These companies are contracted by the state to manage the CHC services provided to program participants. These include Amerihealth Caritas (called Keystone First in Philadelphia), UPMC, and PA Health and Wellness.
Does Pennsylvania allow family members to be caregivers and get paid through Medicaid?
Yes. Every state has different regulations, and some will not allow paid family caregivers through the Medical Assistance program. Luckily, Pennsylvania recognizes the economic and health benefits that can come with having a loved one provide care to a family member. Advantages include the potential for improved care and support through increased familiarity and comfort that come with a loved one providing care directly.
Does Medicaid waiver and/or Pennsylvania state pay family caregivers directly?
No. An approved family caregiver is hired by a home care agency, such as Chosen Family Home Care. When the family member is hired, they become a regular employee of the company. Then, they will be treated just like every other employee of the organization, and get regular paychecks, plus benefits if a home care agency offers them. Read all about why Chosen Family Home Care is a great place to work.
How do I get me or my loved one started?
To start, the patient in question will need to qualify for the medicaid waiver program through the Office of Long Term Living (OLTL). They administer Medical Assistance programs that provide long-term services and supports to older Pennsylvanians and adults with disabilities. This is the program that provides compensation to care providers, including the home care agencies and caregivers employed by them.
The Chosen Family Home Care enrollment guide is a step by step process helping walk you through the process to sign up. andy guide outlines the steps in detail in enrolling with the waiver program.
This guide is your best resource, but your first step is to start with a phone call to the Pennsylvania enrollment broker.
What does the Pennsylvania Independent Enrollment Broker do?
The Independent Enrollment Broker is contracted by the state of Pennsylvania. They are an intermediary that facilitates enrollment and eligibility for CHC. This is for interested individuals that are seeking services under the Community HealthChoices Pennsylvania waiver programs. Referred to as the PA IEB, they can be reached at 877-550-4227 during normal business hours.
Meeting the eligibility criteria for family members in need
The program participants must meet both financial and functional eligibility requirements to qualify for the services. Our Beginner’s Guide to Using Pennsylvania’s Waiver Program for Home Care provides a detailed and comprehensive overview. It demonstrates how to qualify for the program and what steps to enroll are needed.
Physician certification and functional eligibility
An important part of the functional eligibility process is the physician certification. A physician must certify that the individual in question has a condition that results in a need for long-term services and supports.
The certification is not enough to guarantee enrollment or to guarantee a certain number of hours of support. However, it is an important part of the step which can help individuals qualify for these services. It is also a requirement. You can see what the physician certification looks like here.
Having a diagnosed disability is also not enough to be functionally eligible. The disability must result in a person’s inability to perform some activities of daily living.
For example, if someone has a traumatic brain injury, the injury must prevent them from bathing, toileting, transferring, or performing other ADLs to make them eligible.
In addition to the physician certification, a trained assessor will complete the functional eligibility determination.
To receive publicly funded services, the individual must meet income and/or asset requirements. The local County Assistance Office (CAO) determines financial eligibility. You can find the current financial eligibility requirements listed in the document here. The participant must complete forms and provide financial documentation to process the application.
Another step is determining which program provides the best fit for the participant based on their medical and functional determinations. The IEB will direct individuals to the programs in which they are deemed eligible.
If an individual is eligible based on their functional capacity, financial situation, and through a relevant program, they are then enrolled into a program.
Choosing a home care provider
Once the participant is approved by the state waiver program, they can then choose a home care agency that allows the employment of family members. Be sure to find an agency that offers comprehensive training and development to ensure that you can provide high-quality care to your loved one. This training allows loved ones to thrive and live as independently as possible. Chosen Family offers many training, development, and mentorship opportunities for caregivers and is proud to employ family caregivers as part of our team.
Does Medicare pay family caregivers to provide home care support?
Medicare is a government health insurance coverage plan for older adults age 65 and older. Medicare will not pay for long-term care services, like in-home care support and adult day services. In fact, this holds true regardless of whether or not the services are provided by a direct care worker or a family member.
This guide overviews health care costs and discusses in greater detail insurance coverage and payment options for home care services. In some cases, however, caregiving families may receive financial relief. These include respite care.
Another example includes relief for buying certain goods and services. Some programs can sometimes pay for caregiving, usually in limited cases. As a general rule, Medicare cannot be counted on for long term care services such as home care. However, they may provide short term options but only in rare and limited cases. Review your policy and talk to a Medicare specialist for more information.
Are there restrictions on which family members or other individuals can and cannot provide home care services?
Yes, there are restrictions. Specifically, a spouse (husband or wife) or legal guardian cannot provide home care services and be paid for them through the state Medicaid waiver program. Spouses can only provide informal support, i.e. unpaid support. In addition, restrictions do not allow individuals that hold power of attorney (POA) over the recipient of care to be compensated caregivers as well.
How much does Medicaid pay caregivers?
Medicaid has fixed reimbursement rates that they pay home care agencies for direct care provided. This payment ultimately dictates what compensation that companies can provide caregivers, including family members, to those in need of home care services.
Therefore, a family caregiver’s pay is limited by the reimbursement that home care agencies get. This rate is what Pennsylvania state allows for each hour of home care service as they are managed through Community HealthChoices.
Because all home care agencies that pay family caregivers through the Medicaid waiver get the same payment, there is a small range that caregivers will find in their hourly pay. As a result, expect caregiver pay in greater Philadelphia and the Delaware Valley to lie between $10 and $14 per hour of care provided. Companies and their benefits packages will vary greatly.
Therefore, it will be important to consider that when evaluating home care providers. Don’t forget to consider additional benefits too. For example, ongoing training opportunities, company culture, and other perks specific to each organization might be a part of a company’s package. Check out our guide to the highest paying home care agencies in Philadelphia right here!
Why is Chosen Family Home Care a good option for family caregivers?
Chosen Family Home Care is the top home care agency in and around greater Philadelphia. We offer all caregivers high pay, a sign-on bonus, and tons of benefits. Chosen Family Home Care is also transparent about everything we can provide to our family caregivers. Benefits include:
- A minimum average of
$13.75$14 per hour.
- Overtime allowed
- Get a paycheck every week
- Flexible schedules. This includes finding additional caregivers to help you support your family member or loved one.
- Paid time off and other benefits
- Monthly training and support for all family caregivers. You’ll always be confident that you can provide the right care for your loved one with a home care agency that has your back.
- A caring and fun culture
Read our careers page for more information and how to apply.
Reach out to Chosen Family Home Care today for help getting started
You may need assistance walking through the Medicaid and waiver application process, understanding and determining if your loved one needs help, or help switching home care providers. If so, write, text, or give us a call now!. Chosen Family Home Care can provide a comprehensive assessment and review of your situation and that of your loved one. No hassle, no obligation, and it’s free.