It is estimated that over 35 million Americans are providing unpaid caregiving for a loved one. The time and energy toll is enormous, but there is also the financial toll to consider. The caregiver must often cut back on work hours or give up their job completely. In fact, it is often those burdens that force caregivers to consider long-term care options for an elderly loved one, such as a nursing home.
Knowing that loved ones often make the best caregivers and recognizing that professional home health care agencies are not always able to provide consistent care, Medicaid in some states now offers a program called Cash and Counseling. This program pays seniors directly to cover their in-home care. The amount they receive depends on a Medicaid assessment of need and the pay rate for in-home care aides in that state.
Seniors can then use the money to pay anyone of their choosing — including family members — to provide care. They can also use some of the money to buy things for the home that would make life more comfortable, such as user-friendly household items, safety equipment, or home modifications. They are also able to use some of the money to pay for services such as cleaning, meal delivery, or transportation. The program gives elderly clients the option to use their own caregivers, direct their own services, and pay for their aides with a budget under their control. Medicaid does supply case managers to advise clients and monitor care.
Cash and Counseling programs, also called Participant-Directed Services, are currently in effect in the following states:
Alabama, Arkansas, Florida, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia.
Other states have programs similar to Cash and Counseling, offering cash for in-home care to seniors who qualify. While there are currently 15 states with some form of the program in effect, another 20 states are expected to rollout similar programs over the next two years.
A Medicaid attorney can help you navigate the confusing rules and regulations that govern this state run program. They can not only help advise you on your state’s Medicaid laws, but on other options available to you in planning for declining health in later years.