How to Become a Paid Caregiver for a Family Member in California

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

As family caregivers struggle to take care of loved ones across the country, several challenges face them. First is the stress of keeping someone at home while providing for their increasingly complex care needs. Secondly, caregiver burnout is not uncommon. Third is caregiving’s financial toll on the caregiver and their loved one.

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The costs of caregiving can add up over time. One of the most significant financial tolls is when a caregiver reduces or leaves employment to care for a family member. This reduction in income affects future Social Security and can negatively impact your ability to get back in the workforce later.

There are programs across states to address this issue, but the criteria for participation can be strict and, for some, unattainable. If you think you and your loved one may qualify, it is well worth making an effort to be paid as a caregiver through state funds.

California’s plan is similar to other state Medicaid plans, but we’ll cover some of the differences. If your loved one does not qualify for Medicaid, we have other suggestions to become a paid caregiver in California.

Can a Family Member Get Paid to Be a Caregiver in California?

A family member can get paid to be a caregiver in California under several different programs. Qualifying for each of these programs varies, so don’t assume that if you don’t qualify for one, you’re completely out of luck. Apply for everything you think you might be entitled to. 

In-Home Supportive Services (IHSS)

The IHSS program, except for the IHSS-R program listed below, requires that your loved one is on the California version of Medicaid, called Medi-Cal. In most states, this entails providing proof that you have a low income and assets that do not exceed $2000. There are four categories of subprograms that make up IHSS: 

  1. IHSS Residual Program (IHSS-R): Provides personal care for people who are not eligible for Medi-Cal.
  2. IHSS Independence Plus Option Program (IPO): Pays spouses for providing personal care.
  3. Personal Care Services Program (PCS): Provides personal care for persons fully Medi-Cal eligible who are older, blind, or disabled and who often do not qualify for the CFCO program.
  4. Community First Choice Option Program (CFCO): Provides personal care and other in-home supports for fully Medi-Cal eligible persons who would otherwise need nursing home care.

The IHSS program allows the recipient to choose to be self-directed, meaning paying a family member, including a spouse, to be their caregiver.

In addition to the income and asset requirements, there are functional criteria, as well. A nursing home level of care is not required for every program, but in general, these are the activities of daily living and instrumental activities of daily living that qualify someone for the program:

  • Mobility: The ability to transfer from a bed or chair, get out of the house, and walk with the aid of a device such as a cane or a walker
  • Dressing: Being able to choose appropriate clothing, put clothes on, and take them off
  • Eating: Being able to eat with utensils and get food to your mouth
  • Toileting: Making it to the bathroom to use the toilet and maintaining hygiene
  • Shopping: The ability to buy food, medications, clothes, and supplies
  • Housework: Maintaining safety in the home and keeping it clean and free of clutter
  • Managing finances: Paying bills and managing financial accounts
  • Transportation: Driving oneself or accessing other means of transportation
  • Medications: Managing and taking medications appropriately
  • Communication: The ability to communicate using the phone and or computer

Veteran’s Aid and Attendance Program

The VA Aid and Attendance Program is a national program for qualified veterans that can pay family members to provide care. The amount available each month depends on the veteran’s income. The monthly amount paid to a family member can also be deducted from taxes (but not the spouse). 

As part of the criteria, the veteran must show a need for assistance in activities of daily living or be bedbound due to disability or illness, be in a nursing home, or have significantly impaired eyesight. The monthly pension for caregiving can be substantial, so it’s worth applying if you think you or your loved one qualifies. 

Veterans Directed Home and Community Based Services or Veteran Directed Care Program (VD-HCBS)

The VD-HCBS Program is for qualified veterans who need help with personal care such as bathing, dressing, toileting, mobility, and preparing meals. The program specifically allows the veteran to hire family members to provide the care they need. The veteran is provided a budget and can self-direct care. Not every county in California offers this program. 

California Paid Family Leave

The California Paid Family Leave (PFL) provides benefit payments of up to 60-70 percent of someone’s weekly wages to care for an ill family member. Eligibility requirements are stringent and include proof that you are unable to do your work, proof of lost wages, and a medical certificate that the primary care physician must complete. 

Receive payment directly from your loved one

If your loved one does not qualify for any of the government programs we have mentioned, you could make arrangements to be paid directly. There are a couple of ways to go about this. One is to get direct payments based on an agreed amount between the two of you. We recommend having a contract in place that outlines the specific tasks you’ll provide and hours of care and rate of pay.

How Much Do Family Members Get Paid for Caregiving in California?

How much you get paid as a family member in California depends on the program you choose. Homecare agencies vary in terms of what they pay caregivers, and the amount could be anywhere from $10 an hour up to $15 an hour.

The maximum yearly amount for Aid and Attendance is approximately $27,765. The amount a caregiver will be paid is dependant on a complicated income and care calculation determined by the VA.

IHSS program pays caregivers between $14 and $17.50 an hour, not to exceed $3,500 a month. Payment depends on the county where you and your loved one live.

Do You Need to Get Training to Become a Paid Family Caregiver in California?

You do not need training to become a paid caregiver in the California IHSS Program. In the VA Aid and Attendance Program, you can receive caregiver education and comprehensive caregiver training as part of the program. 

If you’re considering a contract for payment between you and your loved one, you may want to consider caregiver training. Becoming a CNA is not expensive or time-consuming and could give you the skills to have confidence in your caregiving duties.

4 Steps Become a Paid Caregiver for a Family Member in California

For this section, we will cover the process of becoming a paid family caregiver in California under the IHSS program.

1. Help your loved one apply for Medi-Cal

To qualify for the IHSS program, your loved one must go through a Medi-Cal eligibility determination. They can apply for the program by mail, in person, or online. Remember that qualifying for Medi-Cal is income- and asset-dependant. 

2. Ask them to complete the California Health Care Certification form

The Health Care Certification form is essentially your loved one’s application to the IHSS program and provides evidence of the type of assistance they require. Each county in California has a website for the IHSS Program.

3. A social worker will come to their home

A social worker comes to your loved one’s home to evaluate them and determine their eligibility for the program. The social worker assesses the type of care they need and how many hours of care are necessary to perform those tasks. Also included in the evaluation is feedback and medical information provided by family, friends, and health care providers.

4. Notification of approval or denial

Your loved one will receive a notification for approval and the reasons for denial if they’re denied. If they’re approved, they’ll receive information about the services and the number of hours a month you qualify for.

Becoming a Paid Caregiver in California

As a family caregiver, you’ll want to consider all of the caregiver resources available to you. California, like most states, has support for you and your loved one, but finding and qualifying could take patience and creativity. Consider all of your options to lessen the financial burden on you and your loved one.

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