Page Reviewed / Updated - Feb. 2018
There are several programs available to New York residents that will pay caregivers for providing assistance to their loved ones. However, whether or not you can get paid to provide care for a family member or other loved one depends on several factors. These factors include the income and financial resources of the individual who requires care, the level and type of care they require, whether the care recipient or their spouse is a US war-time veteran and, finally, the type(s) of insurance the care recipient has. Another impacting factor is the relationship between the individual who requires care and the person that will be compensated for providing care. To clarify, some programs allow an adult child to be paid, but not a spouse. Other programs pay relatives, but not unrelated caregivers. Still others allow almost anyone to be compensated for providing care.
This article describes, at length, the different options available to New Yorkers. Alternatively, one can use our interactive Paid Caregiver Program Search Tool. Doing so, help caregivers and care recipients find programs for which they are eligible simply by responding to a series of questions.
The most broadly used program in New York that helps caregivers receive payment for caring for a loved one is CDPAP. First, we will discuss how this program works, followed by its eligibility requirements. CDPAP is a Medicaid program that stands for Consumer-Directed Personal Assistance Program or CDPAP. Consumer-directed means that the beneficiary of the program can direct or chose from whom they receive personal care assistance. As such, family members including the adult children or friends can be hired to provide personal care. Spouses, however, are prohibited from being hired.
Since CDPAP is a Medicaid program, participants must be eligible for New York Medicaid. In addition to having a need for personal care, candidates must meet the financial eligibility criteria. In 2018, single applicants, 65 and older are limited to a monthly income of $842 and the value of their countable assets is limited to $15,150. Notably, “countable assets” exclude the value of a home provided their home equity is valued at less than $858,000. If your loved one meets these limits, you can read more about the program here. Should your loved one’s finances exceed these limits, you can learn about how they might still gain eligibility here.
The Aid and Attendance Pension benefit is for war-time veterans or their surviving spouses who require assistance with their activities of daily living. The amount of financial assistance varies depending on the beneficiary’s current income. Annually, the VA sets a maximum amount of income a beneficiary can have and then the VA supplements the veteran’s income up to the point of the maximum benefit. For example, in 2018, the Maximum Annual Pension Rate (MAPR) for a couple is approximately $26,000. If the couple has $16,000 in income, the VA will give them an additional $10,000.
Importantly, the VA allows families to deduct certain expenses from their income, so in practice they can still be eligible even if their income is considerably higher than $26,000 per year. One expense they can deduct from their countable income is their cost of care. Therefore, an elderly veteran can hire their adult child (or another relative or friend) to provide them with personal care and the amount they pay their caregiver can be deducted from their income. The VA will compensate the veteran an amount equal to what they pay to their caregiver over and above their existing pension benefit. It should be noted that since the VA counts a couple’s income together, this technique will not work to pay a spouse for caregiving.
This technique is complicated and for the purposes of this article we have oversimplified the details. For further information, it is recommended one consult with a Veterans Pension Planner. However, prior to doing so, one should first determine if they are potentially eligible for the A&A benefit. This program is not limited to New York, but is highly relevant as there are nearly one million veterans living in New York and the majority of those veterans served during wartime.
Another interesting option veterans can use to pay their caregivers is a program called Veterans Directed Home and Community Based Services (VD-HCBS). For veterans who require the level of care on par with what is provided in a nursing home, this program gives them the option to receive that care at home and to pay family members or friends for providing care. In brief, how this program works is that the veteran is provided with a budget for care instead of being provided with care by the VA. The responsibility for finding the care providers, then falls onto the veteran and / or their family. With control of the budget, the veteran is able to hire family members, friends and even their spouses to provide them with the hands-on assistance with the activities of daily living they would otherwise receive in a nursing home.
Any veteran that participates in the VA Medical Center Care system and requires “nursing home level care” is eligible for this program. Notably, persons with Alzheimer’s usually meet these criteria. However, there are geographic limitations relevant to New Yorkers. VD-HCBS is a program offered only at specific VA Medical Centers. New York, unfortunately, as of Feb. 2018, has only two VAMCs that offer the program. These are in Albany and Syracuse. It is worth noting that one is not required to go to a VA Medical Center within their home state. As such, two other VA Medical Centers are more accessible to the New York City metro area and offer this program. These are found in Lyons, NJ and Philadelphia, PA. While a commute may be required to initiate the program, once a beneficiary is established, they need not visit their VAMC with great frequency. Read more.
If your loved one has long term care insurance and if their policy meets certain requirements, it can be used to hire family members as caregivers. Unfortunately, this option is only relevant to a few New York residents because most long term care insurance policies are too restrictive. In short, a policy must 1) pay for personal care provided outside of residential care communities and 2) make the payouts to the policyholder directly instead of to a care provider. If these conditions are met, the policyholder / care recipient can choose from whom they wish to receive care and hire a family member to provide it.
One workaround exists in New York, although the process can present some logistical challenges. The family member who wishes to provide care, can start their own home care agency. The family member who requires care then hires that home care agency and the long term care insurance provider then makes payments directly to the home care agency / family member. To learn more about starting a home care agency in New York, read here.
New York is one of just four states to have created a Paid Family Leave Benefits Law (PFLBL). In short, this law allows relatives to take time off from their job to care for a family member. They continue to receive a percentage of their salary while doing so. The actual percentage will vary but is approximately 50%. While, one is not formally being paid to be a caregiver, they do continue to receive compensation from their job while they are caring for their relative. This is a new law in New York which became effective January 1, 2018.
To be eligible to paid as a caregiver under PFLBL, one must be related by blood or marriage to the individual who requires care. One must also be employed and taking time off from their job to provide care. Interestingly, the program will pay caregivers for up to 12 weeks of care annually, but the time off need not be taken consecutively. For example, a program participant could take one day off per week to provide care year round. Read more.