Options for Paying Massachusetts Family Caregivers

by Matthew Karr, Esq. on January 12, 2012

Acting as a family caregiver for a frail senior can be an extremely challenging job. Often, family or friends expend huge personal and financial efforts to help a loved senior stay at home while receiving the care they need. Now, thanks to the Massachusetts Caregiver Homes Program, family members who act as caregivers can be reimbursed for their services by MassHealth while allowing the senior to remain at home instead of having to enter a nursing facility.

Overview of the Massachusetts Caregiver Homes Program
The Massachusetts Caregiver Homes Program, an Enhanced Adult Foster Care Program started in 2006, aims to support local caregivers by paying them to care for an elderly or disabled adult at home. These caregivers, which can be friends or family members of the care recipient, are paid by MassHealth (Medicaid in Massachusetts) for the care they provide to the senior, allowing them to stay in the community. The program offers a previously unavailable benefit to seniors who have a home and willing family caregivers, but who otherwise would have no option financially but to enter a nursing home.

Caregivers, who provide elders with 24-hour supervision, assistance with daily activities and other personal care services, will receive up to $18,000 per year for home based care. They are also supported by a team of MassHealth professionals who provide regular home visits and counseling, and receive training in best practices and linking seniors to other sources of home care services.

In addition to the funds provided by MassHealth, participating seniors can pay $400 to $500 per month directly to their caregivers for room and board, which is not covered by the Caregiver Homes Program. This offers one way in which a senior can pass assets to a family caregiver without violating MassHealth asset transfer rules. Finally, caregivers can receive two weeks of respite care per year.

While friends and family can act as caregivers in the program, spouses, parents of minors or other legal guardians of the elderly or disable participant are not eligible.

Qualifications for the Massachusetts Caregiver Homes Program
Eligibility for the Caregiver Homes Program requires that the elder participant be a MassHealth participant and need assistance with at least three activities of daily living such as bathing, dressing and eating.

In addition to the medical requirements, program participants must be financially eligible for MassHealth. Qualifying for MassHealth is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exemptions, but typically “countable asset” limits, excluding the car and home, cannot exceed $2,000.

Not qualifying can be devastating to the comfort of a senior, their family’s finances and even their health. For these reasons, an elder law attorney should be consulted to ensure families have the best chance of acceptance into the MassHealth program.

Personal Care Contracts
Another option for reimbursing caregivers is the personal care contract. This option is primarily for those who do not yet qualify for MassHealth, but who want to plan ahead for MassHealth eligibility. Without a personal care contract in place, MassHealth may consider any payments made by a senior to a family caregiver as a disqualifying transfer. By establishing an employer/employee relationship through a personal care contract, a senior can pay a family caregiver for their efforts without disqualifying the senior from MassHealth eligibility. Personal care contract must observe strict formalities in order to be considered legitimate, so contacting an elder law attorney to assist you is highly recommended.

Related posts:

  1. Massachusetts Personal Care Contracts
  2. Avoiding the Nursing Home Using Pooled Trusts
  3. How to Discuss Estate Planning with Aging Parents over the Holidays
  4. The High Cost of Elder Care
  5. MassHealth Home-Based Programs for Children and Elders

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