Eldercare Q & A: Paying Family For Care

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Q:Can family members be paid as caregivers?

A:Yes. There are several programs in Massachusetts that allow family members-with the notable exception of spouses-to be paid as a caregiver for an elderly or disabled relative. The Personal Care Attendant (PCA) program, which is for people with personal care needs who qualify for MassHealth (Medicaid), has allowed relatives to be hired since last spring, is the largest program. An individual with a disability can hire their son or daughter to help them eat, bath, dress, etc. Friends or neighbors can also be Personal Care Attendants. The newest caregiver program to include family members is the “Enhanced Adult Foster Care” (EAFC) program, which began December 1st. EAFC services are provided in a home, and include assistance with bathing and dressing, and other supports, such as medication management, food shopping, nursing oversight, and care management. The new program is for elderly and disabled MassHealth members, and provides personal care services and supports 24 hours a day/seven days a week.

Family caregivers will be paid $1,500 a month, plus a room and board payment of $600 from the elderly or disabled person directly (if they have moved into the caregiver’s home), for a total of $25,200 a year. If a family member moves into the elder’s home, there is no room and board payment. The elder or disabled person can attend adult day care 5 days a week, and there is a limited respite care service of 14 days per year.

To qualify for the program, an elderly or disabled adult must need physical assistance with three of the “activities of daily living” (ADLs) such as eating, bathing and dressing. Or, physical assistance with two ADLs plus “management of behaviors” that require caregiver
intervention, such as wandering, or socially inappropriate or disruptive behavior. A person does not need skilled nursing care to qualify.

Most homes will have one resident and one caregiver—but there can be a second participant if a married couple both are eligible for the program. The home itself must be adequately maintained, and be clean, adequately heated and maintained. The home must be accessible to meet the specific needs of a physically disabled client. Each resident must have a separate bedroom, and they must be provided with personal care as needed.

There is also an “Adult Foster Care” for people who are less disabled. Although this program pays family caregivers less money, it still provides 24/7 residential care, which is a great service for people who cannot live on their own.

Families looking to take advantage of any of these programs that pay family members, should call 1-800-AGE-INFO, and push “3” to be connected with the nearest Age Info Center. To find out if you qualify for MassHealth, call 1-800-841-2900.