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Dad moved in with me a couple months ago and things have just calmed down after the passing of his wife to the point that I was able to meet with an elder law attorney yesterday. He doesn't qualify (due to assets) for Medicaid/Veterans Benefits, but he may require it some day, if he ever gets to a point that I'm not longer able to care for him.


Dad has mid-stage dementia and is very uncomfortable around people he doesn't know; he even becomes agitated when new people come to the home that he doesn't know. Because of this, I'm going to have to resign to only family members filling in for me for respite care when my husband and I need time away. One brother lives an hour away and the other is 2.5 hrs. Because of the distance they have to travel, I told the attorney that I'd like the care agreements to pay at a rate of $25/hr. She said this was too high and said she'd like to see it more around $14-16/hr. The Genworth website reflects an hourly rate of $27/hr, so I thought I was safe at $25/hr, but she says that's an agency's rate and includes their overhead. We settled at $20/hr.


I'd like to get some input as to what some of you pay family members or other non-agency affiliated caregivers. I live in Wisconsin and I really don't think $20/hr is outrageous. And if I'm limited to family members (and can't pay mileage rates), I should at least be able to pay the "going rate".


Thoughts?

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I live in sf bay area. My ILs have 24/7. Brother's Wife makes $30/hour for 40 hours. The indy makes $20/hour and is there when Brother's Wife is not.
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Reply to PeggySue2020
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I live in Arizona. I did many months of research on this in my area long before I became less qualified to maintain a great quality of care for my mom.
The price was from 13.00/hr up to 43.00/hr depending on what you needed and if you use a service company or do the leg work yourself. A service company usually has a minimum of hours billed along with a contract. I chose to do the leg work.
I paid 25.00/hr.. Honestly, If I had to do it again I'd start at 19.00/hr. leaving a big gap for raises. My hired help had a lot of down time. She really had it good here. BUT she also went thru the torturous battle of giving my mom a shower which I went thru for soooo long before I decided that I wasn't gonna do that anymore.
Being a family member, perhaps raises aren't a thing? So 25.00/hr isn't so bad. And most importantly, being your siblings, your father's kids, you pay them exactly what you get paid per hour.
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Reply to Telluride
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Try $8.11/HR only 15 hrs a week as a live in care taker, for a person on hospice who is bedridden . I know I am getting the shaft end of the deal.
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Reply to levismommie25
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Telluride Jan 22, 2022
There's a spot in heaven for you.
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Yes, I posted this already. Worth re-posting:

It isn't what you pay per hour, it is what is included in the hourly rate.
Whatever you decide to pay if ind contractor, you can start on a trial basis for a lower hourly and increase after 2 weeks or so. Or tell them you provide bonuses for 'good work' (I used to do this when hiring care givers who were really good and worked very hard, and were committed to my friend/elder).

INDEPENDENT CONTRACTORs
* You need to do all your own screening, i.e.
- Live Scan (finger printing / criminal check)
- Vaccine card; ongoing Covid testing
- get copy of Driver's license and insurance
- insure they are in country legally
- References (and from families, not only the person cared for)
- You need back up care givers if / for : 1) one doesn't work out; 2) they need to take off due to other clients / emergencies / child or self ill; or just do not show up or call and say they can't make it.
- You may be liable for worker's compensation if the person gets hurt on your premises (not sure).
- Lastly, hourly fees depend on where you live and what duties are required.
- Are you taking out taxes ? Draw up an agreement.

HIRE THROUGH AGENCY
* They do all the testing and background checks (ask to see copies if possible. Do ask person / caregiver for copy of vaccine records/covid testing anyway.
* They cover worker's compensation.
* Agencies are insured. They have protections you will not have.

DO:
1) Interview and have a list of questions prepared
2) Ask everyone the same questions to get a sense of comparison
3) Ask how they work with somone resistant to change / new people
4) Have them meet your dad even if briefly. You do not need to tell him what they are there for; you could say they are helping you with house chores or something.
5) Consider getting cameras to observe what is going on.

With all this said, I am a care manager/provider and an independent contractor for the last 8-9 years. My background includes counseling trainings, (I was going to become a psychotherapist and didn't); certified massage therapist, event/ coordinating up to 10,000 people, writing abilities (I write assessments for the families to track changes); studied on-line webinars for two years with Teepa Snow, one of the country's leading experts on Dementia. I am more like a social worker who manages all kinds of needs, including supervising caregivers/ contractors, workers, working with attorneys, medical personnel, real estate agents.

It works out well for me on this side. I was vetted/screened at the main elder care facility where I work 'to be able to work with their residents' although once vetted, I work / contract directly with the residents. The facility required work and personal references, copy of car insurance, Live Scan.

Gena / Touch Matters
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Reply to TouchMatters
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I may have answered this already ? ? ?
Depends where you live and if you decide to hire independent caregivers or through an agency. Whatever you do, be sure to:
1) get live scans (finger printing / criminal record check)
2) references - and check them
3) experience - give them possible scenarios and ask how they would handle the situation
4) Be clear on if foreign born if your dad could / can understand their English. Communication / understanding is important as it could add another layer of frustration for your dad.
5) He likely WILL NOT want anyone unfamiliar person in the house. This is to be expected (and figure out ahead of time how to manage). Bring a person in 'as an old friend' and stay with them for the first 1-2-3 sessions of a shorter timeframe (if you can, to save $).

5a) You must do what is best for him (and you). This doesn't mean he will like it. He may / will act out or certainly let his feelings be known. Be patient and be there when caregiver talks to him, including yourself in the conversation. Tell the caregiver to smile (!) and if possible, ease into holding his hand (if you feel touch will be a good connector - a good way to communicate. But do not rush the touching. If you do incorporate touch, do it with a hand massage (get cream), combing his hair, etc. Ease yourself out of the conversation or room in very short segments so he can get used to someone else there, without you in the immediate area.

Gena / Touch Matters
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Reply to TouchMatters
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I have been paying out of pocket for part time care for my mom (who is in independent living). We pay the aide $25 an hour. She makes less for her full time client through the agency…I find paying more per hour accurately reflects the value I place on my moms care….we’ve just been approved to hire another aide which will be covered by insurance through an agency. We will continue paying our part time aide out of pocket for continuity….plus my mom adores her…
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Reply to Pamhen
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In AZ, agency charged $20/hr but the caregiver was paid $12/hr. Not a fair wage at all. Your offer is very generous and should be able to attract and keep experienced caregivers.
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Reply to lar7959
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Hi l live in San Diego Calif. we paid 20.00 an hr. for 8hrs at nite time then next person 17 an hr due to low funds on our part.. To me their is no price for yr parent being cared for and peace of mind when you are not around.My mom has alzhiemers and bedridden for 13 months,it's hard. These 2 persons are not family members..There are 4 fam members that rotate thru the week we do it voluntarily...We are tired...( I hope this may be of help) Prayers your way...
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Reply to Helpglo21
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I cared for my parents, free of charge…. same as I paid them for their care of infant me.

My parents insisted on paying me for my care of them but I would never have taken a dime.

I think the attorney’s concern may have been that you shouldn’t charge more than the going market rate to avoid future accusations of impropriety. That local rate you mention is likely paid to individuals with extra educational and experience qualifications.

You may think being his daughter increases your qualifications for serving as his caretaker, but ironically, it may make it more challenging.
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Reply to ACaringDaughter
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CTTN55 Dec 28, 2021
Interesting that none of your large group of sibs felt likewise.
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Family will all need to pay taxes on the increased income they get. If dad ever exhausts everything and needs Medicaid, you will need excellent accounting of the expenses. If one does not report taxes then it is considered gifting. BTW, make sure everyone has medical insurance for any injury on the job. I feel hat as time goes on, they may experience burnout, especially if bedridden or incontinence comes along

Consult an elder lawyer to close any loopholes
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Reply to MACinCT
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My dad insisted I be paid for staying eith him and my mom for the two months he was sick before he died. Since I was in control of the money, I had no intention of paying myself for what I considered an honor to do. However, Dad had told his attorney, and the attorney insisted I pay myself.

I finally decided on $20/hour. I paid a caregiving agency $25/hour for incompetent help (they lasted two shifts), so I figured I was worth at least $20.
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TouchMatters Jan 2, 2022
Screening and references are important.
If a caregiver is incompetent, ask for a refund. The last thing a care agency wants is TOO publicity / marketing. Word of mouth marketing is the best way for everyone in business. If you have solid evidence of incompetency, you may get a refund.

Gena / Touch Matters
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For agency, yes it's higher. They charge about $25 and hr around here, but employee only gets about $10 to 15 per hour. So your atty info is in line with wage in Texas.

If you can't pay mileage, according to atty, you could buy gift cards that amount to mileage rate or even a tank of gas (I would think).

Did atty discuss with you setting up all the paperwork since they will be considered employee? As in taking taxes out and reporting the income?

I'm 24/7 caregiver. I don't get paid. It's my parent. Wouldn't charge.
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Reply to my2cents
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What one sibling gets paid all get paid. So whatever you decide on for them your father pays your for caring for him going forward. Family carers can be paid at a reasonable rate and with records kept. (You are also providing a roof over your father's head). Sure $20 sounds fine for brothers if they are going to provided their own food and cover costs whilst in your house if you are going to provide for the period of their stay then it sounds generous - acceptable but generous. I think the more important thing is that the brothers should get used to standing in for you and taking on some of the responsibility. If they don't want to then they should pay for the necessary 24/7 care whilst you are away for reasonable breaks - say 4 weeks a year - but whilst you want to pay them it should not be one rule for them and one for you, pay them the $20 and make sure you pay yourself the same.
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Reply to TaylorUK
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I think $20 is fair but I'd also reimburse for mileage too.
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Reply to apek924
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Im confused why you have to pay your brothers to help? Are you getting paid as a live in nurse/aid??? 24/7? You should be getting paid. If your going to pay your brothers as incentive. I'd get that squared away right quick with them. If they wont drive over to give you a helping hand, let them pay for home health, or pay for your respite care worker. Bc IF and a big IF they aren't lifting a finger to help, they should come up with a solution if your doing all the caring. That is no easy task. I wouldn't pay them that is their DAD. They should be willing to help. If not then pay for the carer in their place.

I worked HH it was $12 pre -inflation. A agency charges double bc of insurance, and screening applicants, background checks, drug tests etc.
If your dad is afraid of new people, maybe you can get a HH aid to come in 1-2x a week for an hour so he gets used to them. That way you can build up hours and he gets accustomed to them. Talk to his doc, maybe get him anti anxiety meds so he's calm when they are there. Maybe not have them do much with him right away. Like not changing his depends, or sheets right away, but do some laundry, put away, or serve lunch, or lite cleaning, even a companion to watch tv and give you a break, and he gets used to them.
I wouldn't pay the brothers as incentive for their help, unless you are getting paid to take care of him. They should be thanking their lucky stars you took that on. And want to help, bc your not asking all that much. Don't let them talk you into its an inconvenience, I can't.
Your doing the work of 3 people/3 shifts. Good luck.
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Reply to Jasmina
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Don't count on the pay rate being a motivator for brothers to help when needed. You had best have other options lined up.
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Reply to gladimhere
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I am responding to your comment about Dad not qualifying for VA benefits. Did your dad serve during a time of war? If yes he may be eligible for a little know benefit called Aid and Attendance. My dad entered the army at the end of WW2 and was discharged after 18 months, 6 months short of qualifying for a VA pension. Korean and Vietnam vets are eligible, really anyone who served in the military since the Spanish war!

After his death I found out about the A&A pension and after a lot of paperwork got Mom a monthly pension of $1250. It was a big help in paying her AL fees. You have to provide proof of need, assets, cost of living expenses, service record, etc. I also had to be appointed as Mom's fiduciary (government speak for POA) as the federal government doesn’t recognize state level POAs.

I don’t know why the VA didn’t offer this when I applied for a pension for Dad. A lovely consultant at A Place for Mom ( not a plug) suggested it when I was looking for an AL for my mother. There are a lot of websites offering help in applying but be careful, you shouldn’t have to pay to apply. Go to a Veteran’s group in your state, city, or county and ask for more info.
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Firstof5 Jan 1, 2022
The VFW, American Legion, and the VA all have omsbudsmen who can help at no cost. We had help from the American Legion and it was such a comfort.
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Here is the real pay that home health aides and caregivers receive. The agency charges more but the aide usually gets close to minimum wage up to about $15/hour. That is why the lawyer suggested those rates.

I agree that having family members help out is awesome. However, you will need somebody who is able to come in if you or your husband has an emergency. Check with friends, members of your faith group and paid help to fill in this gap.

Since dad is having problems with anxiety, please talk with his doctor about symptom management. Usually a consistent routine in a familiar environment is the first thing to try. However, anxiety like you are talking about may need to be treated with a low dose of anti-anxiety medication. It may make him a bit sleepier until he gets used to it. I see this as helping people not be afraid for the last season of life.
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Reply to Taarna
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You may not be able to pay them mileage but, there are always ways to make it work.

2021 is .56 per mile, if they keep track of their mileage, they will be able to deduct it from their taxes.

If dad can afford 20.00 an hour for help then he should pay it. Depending on matching SS/Medicare, workman's comp rate and unemployment insurance it is going to be closer to 25-28 hourly, so keep the labor burder in mind. Whomever is doing the payroll is going to be an added expense, even if it is you, you should be paid for doing it.

Because this is family, it is really important to do everything correctly. Medicaid will say gifting if taxes are not withheld and paid.

I know that all the insurances don't seem necessary because it is family but, there are labor laws that you must abide by to make this legitimate.

Your attorney or CPA can guide you on what your state requires.

This will seem overwhelming when you start getting it set up but, you only have to set it up once and then it is payroll, quarterly filings and year end forms and reports, not bad at all.

I, truly hope, that you are being compensated as a caregiver as well.
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Reply to Isthisrealyreal
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It isn't what you pay per hour, it is what is included in the hourly rate.
Whatever you decide to pay if ind contractor, you can start on a trial basis for a lower hourly and increase after 2 weeks or so. Or tell them you provide bonuses for 'good work' (I used to do this when hiring care givers who were really good and worked very hard, and were committed to my friend/elder).

INDEPENDENT CONTRACTORs
* You need to do all your own screening, i.e.
- Live Scan (finger printing / criminal check)
- Vaccine card; ongoing Covid testing
- get copy of Driver's license and insurance
- insure they are in country legally
- References (and from families, not only the person cared for)
- You need back up care givers if / for : 1) one doesn't work out; 2) they need to take off due to other clients / emergencies / child or self ill; or just do not show up or call and say they can't make it.
- You may be liable for worker's compensation if the person gets hurt on your premises (not sure).
- Lastly, hourly fees depend on where you live and what duties are required.
- Are you taking out taxes ? Draw up an agreement.

HIRE THROUGH AGENCY
* They do all the testing and background checks (ask to see copies if possible. Do ask person / caregiver for copy of vaccine records/covid testing anyway.
* They cover worker's compensation.
* Agencies are insured. They have protections you will not have.

DO:
1) Interview and have a list of questions prepared
2) Ask everyone the same questions to get a sense of comparison
3) Ask how they work with somone resistant to change / new people
4) Have them meet your dad even if briefly. You do not need to tell him what they are there for; you could say they are helping you with house chores or something.
5) Consider getting cameras to observe what is going on.

With all this said, I am a care manager/provider and an independent contractor for the last 8-9 years. My background includes counseling trainings, (I was going to become a psychotherapist and didn't); certified massage therapist, event/ coordinating up to 10,000 people, writing abilities (I write assessments for the families to track changes); studied on-line webinars for two years with Teepa Snow, one of the country's leading experts on Dementia. I am more like a social worker who manages all kinds of needs, including supervising caregivers/ contractors, workers, working with attorneys, medical personnel, real estate agents.

It works out well for me on this side. I was vetted/screened at the main elder care facility where I work 'to be able to work with their residents' although once vetted, I work / contract directly with the residents. The facility required work and personal references, copy of car insurance, Live Scan.

Gena / Touch Matters
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Reply to TouchMatters
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JustVee: The rate of $25 per hour seems about right, accounting for inflation, which this year skyrocketed.
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Reply to Llamalover47
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Wow, my immediate thought is that this attorney has never been a caregiver.

Poverty wages are appropriate for caregiving, really? Lawyer jokes are coming to mind. And what does she make for just sitting on her @55…?!?

Sorry, lost my temper there for a moment! 😉
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JustVee Dec 26, 2021
HA! You're so right... it was a $350 consult fee for just an hour! Wish I could get paid that much to have a chat with someone!
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$25 is the going rate in Boston .
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Clairesmum Jan 22, 2022
Thanks..I'm in the Boston area and this is helpful information.
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Clearly every state and county will be different as the cost of living is different everywhere so to ask such an question won't provide you with the exact dollar amount "acceptable" in your area. You mentioned an Atty and that's great as they are privy to this information, also we will all answer your question depending on where in the U.S. we are located. I am in Massachusetts and here the low end for PCA'S is $22-$27 and CNA'S $27-$35 providing private in home care. Consumers here pay agencies upwards of $45+ an hour and in return pay a CNA $19-$23 hourly. Again please look at your area for competitive wages. I have always found no matter what state you live in the local Council Of Aging is an amazing resource and wealth of information from food programs to how to hire the perfect caregiver- the knowledge these folks have is priceless! I wish the best for you and your family- your family member is blessed to have such a caring family!
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Reply to Seadreamercc
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I live in NY and paid my fabulous caretaker $20.00 hourly rate. - we used my parents account to pay for her care, and Medicaid to pay for additional agency care. The rates your lawyer gave you are correct. My siblings and I did not charge for any time we spent, (I actually slept there 4-5 nights a week, plus errands, extras, etc.)
Your Dad may not qualify for Medicaid now but your lawyer can legally protect his assets so that he can qualify 5 years from now. Believe me, it's worth the process.
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Reply to NYCmama
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Agency rates are higher than you need to pay friend or family respite. There you are paying as well for administrative costs. Twenty dollars an hour is fairly generous as it is. Most families do not pay each other for help at all. Pay separately for gas and essential expenses.
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CTTN55 Dec 27, 2021
" Most families do not pay each other for help at all." While I think you are right, I also think it is wrong.

Usually one sibling is left to do all of the caregiving, and the others do nothing.

My mother said "Family doesn't pay family" when I brought up the dirty C (Compensation) word. When one of the POA brothers took over her finances, he ended up paying me on a hourly rate AND also let me figure out back pay.

When my mother was in rehab and it was obvious she was headed towards LTC, I said she needed to be in a NH near one of the POA brothers. Of course they didn't like that. So getting hourly compensation was pretty easy at that point.
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The minimum wage here is 16.75. Indy aides start at about $20-$21. Agency rates are about $8, $10 more per hour.

$14 seems really low. Almost insulting. If anything family deserves to be paid more, not less. It's not like you're going to be getting rich off this senior simply by doing work for market rrate.
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Reply to PeggySue2020
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I’m curious how much do you pay yourself for proving around the clock care?
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TouchMatters Dec 26, 2021
Good question. Gena
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They are right. Agencies charge $25 an hr and pay mostly just a little more than minimum wage.

You can hire Caregivers for $12 an hr in Texas.

You settled for $20 and that's high, you can get a Nurse for that amount.
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TouchMatters Dec 26, 2021
It depends on where you live.
And if they speak English or if English second language.
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Pay mileage separately. I don't know who sets the "going rate" in the US (might be the IRS?) but here it's about 60 cents a mile for the first 10,000 miles annually, and 33 cents a mile thereafter. If they don't travel by car it's even easier: they can certainly claim back travel expenses incurred on your father's behalf.

The attorney is correct to argue in your father's best interests, and no doubt also has in mind how this might all potentially play with Medicaid; but I'd like to know where else she thinks you can source care at her reduced "family" rate.
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JustVee Dec 26, 2021
I suggested paying mileage separately, but she didn't think that was possible under Medicaid rules and suggested going to the higher hourly rate instead. There's a huge labor shortage here and most fast food places are now at $13-15/hr.
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