I live with and take care of my mother and grandmother. It's all I have time for. What is the next step to getting paid?

As Margaret McKen asked, what is your situation? What are theirs and your ages, and what education, job skills, and work experience do you have? Who owns the house you are all living in? Do you want to be doing this for them, or are you being guilt-tripped into it? We can be much more helpful if you provide some details.

Your mother and grandmother pay you out of their funds. If it is more than they can afford, and they qualify for an in-home caregiver, Medicaid may pay you to be their caregiver. Talk to the Medicaid case manager. Your grandmother may also be eligible.
It depends what you do to "take care of them". There are specific tasks, attendant care and personal care duties which Medicaid will pay for if the patient is unable to do those things on their own. Medicaid assigns a length of time, in quarter hour increments, which they will pay for. It may total 4 hours a week, or it may total 30 hours per week.
Things like bathing, dressing, incontinence care, preparing meals and feeding, laundry, and even shopping. Managing medications requires a trained medical assistant, so you will not be paid for administering medications.
Your state may require you to get basic certification and training.

Wallbrian82: Go to Medicare.gov and Medicaid.gov.

Brian, please complete your profile. Are you just out of school and have never had a job? Are you middle aged, with a disability yourself which is why you can’t work? How old are M and GM, and what sort of care do they need? Who owns the place where you all live? Who is paying the bills now?

The chances are that you are never going to get paid, other than by M and GM, except perhaps for very short hours at a base pay rate. It sounds as though you really need better information to plan for the future for all of you. Provide more details, and we may be able to help more.

The only way you really can get paid would be thru Medicaid. Talk to Moms caseworker.

It seems you have no questions about your decision to do this, so do check with Medicaid and Medicare in your state. Best of luck.

They should be paying you, or you decide to stop being their caregiver.

Contact social services for your county to see if they can be transitioned into a facility, or if Medicaid can provide in-home aids.