Every state, and the District of Columbia, have what are called Cash and Counseling Programs under the Medicaid umbrella that provide for financial assistance. They allow the recipient to choose their own caregiver including adult children, and in 12 states spouses can also be hired.
The process usually starts with an assessment to see what the recipient’s needs are, and will include input from doctors and any caregivers currently providing service. The recipient must need a certain level of assistance in daily activities such as bathing, dressing, toileting, and eating.
After it’s determined how many hours of care need to be provided, a budget is calculated. Since the Medicaid recipient is considered the employer, they decide how to spend the money they are given and select who the caregiver will be.
The enrollment process varies by state, but if the recipient is already receiving Medicaid benefits it usually takes from two to four months to process the application. If the person is not receiving Medicaid benefits families should expect an additional 45-90 days to complete the enrollment process.
Not just Medicare
While the concept of consumer-directed care started with Medicaid, it now extends to other programs including those for military veterans and those who hold long-term care insurance policies.
Military service members can apply for a paid caregiver under the Veteran Directed Care program which is available in the majority of states but not all. The requirements are much the same as Medicaid but V.A. medical centers determine eligibility.
Self-directed care by a family member is also offered by some long-term insurance policies. Your loved one’s insurance company can provide specifics.
Benefits.gov is a resource that can help families determine what government programs and services their loved ones are eligible to receive. As the official benefits website of the U.S. government, it serves as a central access point for local, state, and federal programs across 17 different federal agencies.
The cost can be more than financial
The good news for some families is that they’re eligible to be paid as caregivers. There is, though, a potential downside, which is the emotional pitfalls that can come with the job.
Be sure to nurture and preserve the parent-child relationship.
When a relative becomes a paid caregiver it can change relationships, especially as a loved one requires more care. Be sure to continually express that you’re taking on this role out of love and not as a paid employee.
Is it worth the money?
When one family member becomes a paid caregiver, there can be a few unintended consequences. Firstly, other family members may be less likely to pitch in with help now that one is a paid caregiver.
It’s not uncommon for jealousy to arise with one family member having paid status. It’s important to communicate how much (or how little) you’re making and be sure others understand the expenses that paycheck will offset, such as the price of gas for transporting your loved one to medical appointments.
Finally, it’s important to decide if disrupting family harmony is worth the money. Yes, it’s nice to get paid for a job you’re already doing but you definitely won’t get rich doing it. If jealousy or resentment surfaces within your family try, as with everything, to talk it out with your trusted circle. You might just decide that the paycheck isn’t worth it.