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Big kudos to HaveYourBack! Fabulous answer.

Something I’d like to add, the family caregiver wages paid - if thru State Medicaid IHHS / In Home Healthcare Services programs - will be interdependent on minimum wage for your State AND an assessment done as assessment determines # of hours.

For wages, if low minimum wage State, the rate paid will reflect that. A lot of States are $7.25 minimum wage. TX is and they pay family caregiver an average of $10.60 hr for most of the State with a slight increase for bigger cities. All wages reportable income with FICA.

Assessment realistically cannot go past 32-36 hrs per week as - once administration is factored in - starts being a 40 hr week Full Time care. Full time means residing in a facility or enrolled in a PACE program with perhaps some personal care hours. (There are exceptions to this - like NYC will do 24/7 IHHS as not enough NH.) IHHS assessments tend to be 18-25 hrs per week. So @$10.60 hr; abt $800 mo. Not a substitute for Full Time job with benefits, advancement possibilities, etc. but rather some compensation to a family member care provider who lives in the home.

Each State administers its Medicaid programs. If a State decides not to fund IHHS at all, they can as IHHS is not dedicated funding like funding custodial care in a SNF is.
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Getting Paid by Medicaid for Family Caregiving (All States)
This guide explains how a family member, such as a daughter, can be paid through Medicaid for taking care of a parent. Medicaid rules vary by state, but these general steps apply in most places.
1. Confirm Medicaid Eligibility
Your parent must qualify for Medicaid based on income, assets, and medical need. They may also need to be approved for in-home care.
2. Apply for Medicaid
If your parent isn’t already enrolled, apply through your state’s Medicaid office. Ask if they qualify for Home and Community-Based Services (HCBS).
3. Ask About HCBS Waivers
These waivers allow Medicaid to pay for in-home care instead of nursing home care. Some waivers allow family caregivers to be paid.
4. Request Self-Directed or Consumer-Directed Care
If available, this option lets your parent hire their own caregiver, including a family member (except possibly a spouse or guardian).
5. Enroll as a Paid Caregiver
You may need to complete training, a background check, and register with an agency or fiscal intermediary.
6. Submit Timesheets and Follow Program Rules
You'll typically be paid hourly through a Medicaid-approved payroll system or agency. Care plans and oversight may be required.
Tips for All States
- Contact your local Area Agency on Aging (AAA) for help.
- Ask about HCBS waivers, self-directed care, or family caregiver pay.
- Be prepared for waitlists in some programs.
Note: This is a general guide. Contact your state Medicaid office for specific rules and applications.
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