How to Become a Paid Family Caregiver in Florida: Step-By-Step

Updated

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

As with all Medicaid support services in states across the country, Florida has programs to assist caregivers and care receivers under the Medicaid program. As a caregiver, any support is helpful, but state criteria that include income and asset guidelines can eliminate many people from participation in the program. Since family caregiving is the foundation of caregiving in the US, any help can assist with preventing caregiver burnout

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Medicaid is the country’s public health insurance program for people with low income and assets. The Medicaid program is the primary payment source of long-term care (nursing home) coverage for Americans. The majority of people on Medicaid lack access to other affordable health insurance.

Medicaid covers a broad array of health services and limits an enrollee’s out-of-pocket costs. The Medicaid program is a joint program funded by the federal government and the states. Therefore, each state has different guidelines for coverage and benefits. 

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

There are two main caregiver programs in Florida, but we’ll cover others, as well. The primary caregiver program is called Florida Statewide Medicaid Managed Long-Term Care program (SMMC LTC). 

The purpose of all the statewide programs across the country is to divert participants from nursing homes by providing support services in the home. Nursing home care is very costly, and most people would prefer to be at home anyway, so the program saves the state money and allows people to stay in their homes.

The SMMC LTC Program

Seniors who meet the Medicaid criteria and are financially eligible select a plan from one of the providers in their area. Once the person has qualified for the program, they’re assigned a Long-Term Care case manager. 

Once the family, participant, and case manager develop the care plan, the program allows participants some degree of participation called the Participant Directed Option (PDO). This option is where the caregiver comes in. Program participants or their representatives are allowed to choose who provides care for them. The care recipient can hire family members, friends, or professionals to provide care.

SMMC LTC Eligibility

The financial eligibility for SMMC LTC is complicated in that the state considers both income and assets. Eligibility also depends on whether just one spouse is applying or both are. Expect that there may be a waiting list for services since the need outweighs the availability of funds. The basic criteria follow the guidelines of other states.

  • Age 65 and over and qualify for Florida state Medicaid
  • An assessment determines that the participant meets a nursing home level of care. Nursing home level of care doesn’t necessarily mean that the participant needs a nursing home or skilled medical services. The assessment measures activities of daily living (ADL) such as bathing, eating, dressing, mobility, and personal hygiene. If someone has dementia or Alzheimer’s disease and requires supervision, they may qualify even without personal care needs.
  • Participants must be legal Florida residents

Services offered under SMMC LTC

There are an array of services offered under the SMMC LTC program, and not everyone will be eligible for all services. Some are self-directed, and others are not.

  • Occupational, physical, respiratory, and speech therapies
  • Non-emergency transportation
  • Companion care
  • Adult foster care
  • Adult Day Care
  • Homemaker services
  • Home accessibility
  • Intermittent and skilled nursing
  • Delivered meals
  • Medication management and administration
  • Personal care
  • Caregiver training
  • Medical supplies and equipment
  • Hospice
  • Respite care
  • Emergency response system
  • Nutrition assessment
  • Assisted living services
  • Behavioral management

Home Care for the Elderly Program (HCE)

The HCE program is a Florida Medicaid program that provides payments directly to the caregivers rather than to the participant. However, the HCE program does not pay a family member for their time. Instead, they help reimburse the family for essential items and medical equipment. 

The caregiver can be a family member, but that is not required. There are two types of payments. One is the Special Payment which compensates the caregiver for medical items and medical services. The other is the Basic Payment to help with the cost of housing, food, clothing, and some durable medical equipment. 

HCE eligibility

Eligibility for the HCE program is similar to the SMMC LTC program, but you will notice differences. Participants cannot be enrolled in and receive benefits from both the HCE program and the Statewide Medicaid Managed Care program. Also, applicants must have an adult caregiver who lives in the home with them and can provide care and make care arrangements.

  • Participants must be financially eligible under Medicaid guidelines for the HCE program
  • Care recipients must be 60 years of age or older
  • Recipients must be at risk for nursing home placement
  • The case manager must approve the caregiver and the home where the care recipient lives

Services offered under HCE

You will note that caregivers are not paid to provide services. The idea is to offset costs of care associated with equipment and supplies. Subsidies are provided for the following:

  • Incontinence supplies
  • Medical supplies
  • Assistive devices
  • Durable medical equipment like walkers and wheelchairs
  • Medications
  • Home accessibility such as ramps or widening of doorways
  • Medications
  • Counseling
  • Delivered meals
  • Respite care
  • Therapies
  • Home care such as health aide and nursing
  • Nutritional supplements
  • Transportation
  • Adult Day Care

Program of All-Inclusive Care for the Elderly (PACE)

PACE is another program that helps cover the costs of caring for a family member, but doesn’t pay a family caregiver for their time. Enrolling in PACE can relieve some of the work you might be doing by incorporating professional caregivers at home.  

The PACE program is for dual-eligible residents of Florida who qualify for Medicare and Medicaid. PACE is an alternative to nursing home care. An interdisciplinary care team consisting of physicians, nurse practitioners, nurses, social workers, therapists, van drivers, and aides works with each participant. 

The PACE program is a capitation program that allocates a capped amount of money for services to seniors who would otherwise be in a nursing home.

The interdisciplinary team works together with seniors and their families to create a comprehensive and personal care plan, make all necessary appointments, coordinate health care, fill prescriptions, and provide transportation to and from PACE centers. The PACE program can take the pressure off of caregivers by providing much-needed services directly to the participant.

PACE eligibility

To be eligible for this program, the care recipient must meet these criteria: 

  • 55 years of age or older
  • Live within the geographical service area of a PACE center
  • Meet medical criteria
  • Be dual-eligible for Medicare and Medicaid or Medicaid only
  • Be able to live safely in the community

VA Aid and Attendance Program

The VA Aid and Attendance Program is a pension program that provides a cash benefit to veterans or their spouses. This program is for wartime veterans or their surviving spouses who require assistance with their activities of daily living. 

Spouses cannot be paid as caregivers, but the program does compensate adult children and other relatives, or the veteran can hire professional caregivers. 

Veteran Directed Care Program (VDC)

The VDC program pays caregivers of veterans who would otherwise need nursing home care. The qualified veteran is provided with a budget for care (in place of care that the VA would otherwise offer) and can pay family members, spouses, or friends to provide that care. A veteran that participates in the VA Medical Center Care and requires a nursing home level of care is eligible.

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

How much family members get paid for caregiving in Florida depends on the program they are participating in. 

  • The HCE program pays, under the basic subsidy, $160 a month. Caregivers are not compensated directly for the care they provide, but rather for equipment and supplies. 
  • The SMMC LTC program requires caregivers to accept the Medicaid hourly compensation rate between $9-$13 an hour. 
  • The VDC program pays caregivers an hourly rate set by the Veterans Health Administration and adjusted for local geographic factors. The hourly rate is called the “reimbursement rate,” and caregivers are paid in the range of 50-75% of the average hourly rate for care in their area.  Generally speaking, this may be between $8 and $21 an hour.
  • The VA Aid and Attendance program maximum benefit amount for a veteran who does not have a spouse or dependent child is $23,238 a year or $1,936 a month. The maximum benefit amount for a married veteran is $27,549 a year or $2,295 a month.

4 Steps to Become a Paid Caregiver for a Family Member in Florida

Since each Florida program has slightly, and in some cases, very different criteria, it is best to go to each program site to determine eligibility.

1. Department of Elder Affairs Florida

The Department of Elder Affairs (DOEA) is a one-stop-shop for all the seniors’ programs. They also have an Elder Helpline at 1-800-96-ELDER to find out what programs you might be eligible for.

2. Determine your Medicaid eligibility

Although applying for Florida Medicaid might be complicated, getting an idea of eligibility is a place to start. 

3. Contact the Veteran’s Administration

If you or your spouse is a veteran, contact the Veteran’s Administration to determine the programs you might be eligible for. 

4. Contact your local Area Agency on Aging

Your local Area Agency on Aging can be a great resource for local caregiver support programs. They can help you cut through the red tape and assist with qualifying for programs and let you know about other caregiver resources

Becoming a Paid Caregiver for a Family Member in Florida

Yes, the process of becoming a paid caregiver for a family member in Florida is complicated. But the real advantage, along with any compensation, is the involvement of professionals to assist you in providing the best care possible to your loved one. Caregiving for someone who meets nursing home criteria is demanding, and you deserve all the help you can get.


Sources:
  1. “Benefits and Eligibility for the Aid and Attendance, Household and Basic Pensions for Veterans and Surviving Spouses.” American Council on Aging. medicaidplanningassistance.org.
  2. “Programs of All-Inclusive Care for the Elderly Benefits.” Medicaid.gov. medicaid.gov.
  3. “Program of All-Inclusive Care for the Elderly (PACE).” Department of Elder Affairs. elderaffairs.state.fl.us.
  4. “Statewide Medicaid Managed Care Long-Term Care Program.” Department of Elder Affairs. elderaffairs.state.fl.us.
  5. “VA Aid and Attendance Benefits and Household Allowance.” U.S. Department of Veterans Affairs. va.gov.
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