Paying family members for caregiving. Any advice?

If your mom is on Medicaid, which is likely if she's on disability, you could see if Medicaid will pay you a stipend for some care. State's vary on their rules for Medicaid so you'll have to check locally. The amount isn't likely to be as much as a full-time job but it would help.

Otherwise, if your mother has some assets, you could draw up a contract between the two of you and have it notarized, or see an estate or elder law attorney to have a contract drawn up. You want to do this legally so that if your mom does go on Medicaid they won't come after you for the money paid out. Since states can be so different, I'd strongly suggest going through an attorney who knows your state Medicaid laws.

Good luck,
Carol

I'm sorry that the answer above didn't quite address your question. I'd answered a similar question and unfortunately that answer copied rather than the one addressed to you. Still, the information may be useful to you in your situation since is comes down to the same thing - a contract.

Your specific question about paying back your sister could be done with a contract, I'd think. Specify what the money is for and why it was paid out for your mother's care. You should at least have it notarized. If you want to be very safe, see an attorney and have it done that way. Yes, it will cost a little, but it could be worth it for your peace of mind.
Take care,
Carol

Little more information please....your profile states that you're caring for your mother, that she's in a independent living facility.

Was your sister specifically asked to come and help out? If so, were any discussions had regarding reimbursement?

Are there other siblings, and if so, have they visited, with or w/o compensation?

If your sister came voluntarily, on her own initiative, I think it's inappropriate to now ask for remuneration.

And evning out the situation, are you compensated for your work?

Thanks for the speedy replies. Mom is in independent senior apartment and we are just starting to provide care service for pay as recommended by the service manager. She is not on Medicaid but may be in the future. That is why I don't what to jeopardize qualification with the appearance of family gifts.

I didn't ask my sister to come up, but certainly did not object to a visit from her. Mom may have asked her. There was no discussion of compensation prior to the visit. This most recent visit I had to loan her airfare.

3 children, me and 2 sisters. Mom in OH. Youngest sister lives 5 miles away. Sister in FL. And me in OH 130 miles away. Younger sis visits often, almost daily, sometime multiple per day, usually short under an hour. Sister in FL not often. Years without a trip to OH. But twice this year since Mom has been ill. I typically see her about monthly. More often this year. I often time visits so I can transport her to doctor appointments. No compensation has been made before aside from Mom slipping a few bucks to younger sis or grandchildren for "gas money".

It may be inappropriate for older sis to ask for remuneration, but as steward of the meager funds the family has, I have to deal with it. We can afford to do it, but that will mean fund will deplete sooner. Once our resource is depleted, Mom will have to apply for Medicaid. She has made family gifts in the past which, to my knowledge, would disqualify her. I am attempting to curtail that.

So I need to know how to make payment to older sis and have it appear legitimate care expense and not a gift.

No, I am not paid or compensated and not really interested in receiving such. I do not like spending time on this. I am not wealthy but I am able to live on retirement income without assistance.

Thanks again for the advice.

Jeff, thank YOU for your quick response as well. You have a very logical, mature yet compassionate approach to caregiving, one I admire and one which is sometimes hard to achieve.

I now understand your position. And honestly I'm now not sure other than Carol's suggstions what I could offer as advice as this isn't something I've dealt with yet. But I am in favor of getting solid legal advice to plan for eventualities, and that's what I would recommend beyond researching Medicaid rules.

Elder law attorneys typically include Medicaid qualification if requested in counseling, so that would be my recommendation. You could tell your sister you're working on a legal way to compensate her, and that the method has to be done in such a way as not to present an issue with Medicaid qualification.

I've worked in law for years so I know the good attorneys in this area, but if I needed a reference, I would ask someone I respected, or would search the state bar association directory for elder law practice groups in my area, check out their websites, then contact them to get more information on their approach (as well as billing terms).

Wish I could offer you more advice but I know that Medicaid rules are tricky and must be adhered to religiously.

Good luck, thanks for sharing your situation and also demonstrating that families really can work together to care for their parents.

Hello Carol,

Yes I know we need a contract. We needed it prior to the visit. But now have to do it retroactively. If possible I'd like to avoid expense for lawyer. Can you lead me to a sample contract? Or do you think a social agency worker in my area could help me determine what is needed to stay clean with regards to possible future Medicaid application?

Thanks,

Jeff in OH

Thanks for the reply GardenArtist. I made it sound a lot easier than it actually is. I find it very difficult to communicate effectively with the sisters. I take the logical path; they go with emotion. Seems the two ways do not mix well.

Jeff, male vs. female thinking - logic vs. not so logical. I know that well! What's the saying about being from Mars or Venus??

As to your response to Carol, excuse me for answering but I do want to issue some cautions. A social agency might offer guidelines on Medicaid apps and qualifications but wouldn't really be qualified to draft contracts (although I understand that's not what you're asking).

There are a couple alternatives, since contracts really should be prepared by attorneys.

Legal aide" in SE Michigan one law school has an elder law planning legal aide clinic, and there are a number of legal aid agencies. Some law firms also provide pro bono services.

Contact your local county bar association and/or find the number for any county bar association legal library. Ask the librarians for information on sample contracts suitable for family caregiving Medicaid compliance.

ICLE: Institute of Continuing Legal Education. The Michigan one has excellent seminars with excellent manuals. The courses are expensive but even if you didn't want to take one (and I'm not sure they would cover Medicaid rules), the cost of the manual would be cheaper than legal counsel.

Some law firms hold informal "seminars" in which they provide a lecture then Q & A sessions afterwards. You could pick up some tips at one of these.

Ask the Area Agency on Aging if they plan to hold their annual AAA Caregiving Expos anytime soon. That's also an excellent place to see which elder law attorneys are very active, offer free handouts with good advice, and may have free "seminars".

The only online source I would ever consider for guidance on forms is Nolo Publishing. I sought advice from their sites years ago and it was "spot on", exactly the kind of advice I'd expect from knowledgeable legal professionals (I've worked in a wide variety of legal practice areas over about 40 years +/- so I knew what I wanted when I did the research).

Good luck.

You sound great, but it seems inappropriate and tacky that your sister is asking for money. Perhaps you should just tell her "no" and tell her end of discussion.

"No" is a logical term. Like on or off. Like 0 or 1. It does not work with the emotions as one would expect. No is not an option here. Believe me, I've tried that before.

O.K. A set back. I don't think a simple contract will do the trick. I got this message from an accountant friend:

"She has to become a W-2 employee. She cannot be an independent contractor and receive a 1099. She can receive a 1099 only if she is in the trade or business of being a health care provider. If a person earns more than $750 in a quarter or more than $1900 for the entire year, payroll taxes must be paid (by your mother). She would be able to do this when she files her 1040 by attaching Schedule H, which calculates Social Security and Medicare taxes for the hired person. The hired person is considered a “household employee” and rules for that type of employee must be followed."

Now it becomes much more than I signed up for :-(

Jeff, this is interesting and I appreciate your sharing it. I did know that household help and caregivers should theoretically be subject to withholding, which is one reason why I decided against having free lance help for my father. I didn't want to get involve in the extra bookkeeping and tax issues, or any liability issues either.

But I'm surprised that a family member would have to be treated as an employee. However, you certainly took the right path in contacting your accountant friend.

I can see a couple options:

a. You wrote in one of your posts that you paid your sister's way this last time, as a loan. If so, then I must have been confused that she wanted reimbursement for travel costs. Or is she just asking to be paid for "services"? What about lodging? If she stayed with your family, there wouldn't even be these costs.

Does she have any professional medical qualifications that would be construed as "services"?

b. E-mail her with your accountant's message (leave his/her name off). I don't know how anyone could legitimately consider a family member an employee for the purpose of coming to visit. So it may be that you won't be able to help her out.

c. If so, you might want to make it clear that any future visits would have to be on her own nickel. After all, you and your family are providing more care on a regular basis and other than miscellaneous costs, your mother is not paying for this care.

d. Alternately, to keep peace in the family, pay her out of your own funds (I wouldn't suggest this though) and let it be the last time.

I honestly think that Medicaid wouldn't look kindly at "hiring" a daughter to come visit her mother, regardless of what she does.

So I asked my accountant friend if that meant Mom would have to start a business with employee(s). Answer: "Yes, your mother would have to get a federal ID number. She would be able to pay the withholding taxes when filing her 1040. However, there would be some Ohio requirements, too. For example, I think she would be required to have coverage through the Bureau of Workers’ Compensation." It just keeps getting worser and worser :-(

Hi GardenArtist,

I was hoping we could include the airfare cost on the care giving contract so I could be repaid, legitimately. Sis stayed in Mom's apartment while in OH. She is after as much money as she can get and has mentioned lost wages even though it was a holiday weekend. I am too embarrassed to mention the dollar amount she asked for (maybe demanded is a better term). I am willing to use an acceptable/customary rate and tell her she has to settle for that. She has no experience or qualifications in the field of which I am aware.

I need to wait to get all my facts and thoughts together before I forward the message to my sister.

In a way, thru me, Mom is paying for this care. And basically sister will say she doesn't have a nickel to use to get to OH to see Mom. If Mom is O.K. with paying sister's transportation cost or even a wage, I'm O.K. with it. I'm just trying to figure how to do it legitimately.

My own pocket has been tapped out with the loan for the airfare and other items with the other sister.

Similar to "no" not being an option, neither is "last time". It looks like I will have to consult an attorney. I'll wait a day or two. Maybe someone else will chime in with an idea.

Thanks.

You're smart to be looking ahead to Medicaid issues. I would really suggest that you get to an elder care attorney for advice going forward. The lawyer will advice you whether you can compensate your sister or whether this will create another hurdle later. This may not be the only time your sister flies up and expects compensation so it'd be best to address this now. Sometimes it helps bridge the communication gap between emotional and logical when a professional third party backs you up.

Not to sound unkind about your sister, but it sounds as if she could have a personality disorder, and possibly be a narcissist.

Jeff, just a quick thought before it escapes my mind:

What about an alternative to a visit by your sister? Could you set up a Skype for your mother - either you or your sister who visits regularly could bring it at a specified time/date and connect with your FL sister (assuming FL sister would spring for the cost of her own Skype)?

I'm wondering also if the facility in which your mother resides has any of its own computer connections for the residents? If they do and have the Skype software and equipment, that would be even better.

I don't have any other suggestions on the other issues in your last post at this time other than to agree to let the issues sit for a few days while you collect your thoughts. It sounds as if this is a situation for which you really want a solid plan going forward.

Mom has a computer and internet access. She uses email. I think she tried Skype with FL sister. Not sure about results. I don't have it. Especially after illness this year there was no substitute for visits, which were very valuable to Mom. I'm sure she (and I) would consider sister's visit a worthwhile expenditure of a reasonable sum. I just need to know how to avoid jeopardizing financial assistance qualifications as I am certain we'll need that down the road.

Hi Jeff,
This is not an unusual situation. You could write up a contract and have everyone sign that this was a care expense (having it notarized) but it may or may not be legal in the end. Other than an by using a qualified attorney, I'm not sure how you can guarantee that it will be. However, as you suggested, a social worker may know of a form that you can use or have other suggestions.

While in the end you may not be able to go back, you could pay this and hope that Medicaid would accept this as an explanation down the road. But be prepared to pay it back if they don't.

You sound wonderful and clear headed so I know that you'll consider these expenses in the future, anyway. It's simply too bad that your sister expects to be paid since your aren't being paid for what you do.

Please let us know how you handle this. We're always interested in answers that may help another member of the community.

Take care,
Carol

Thanks. I am searching for an attorney in the area who indicates Elder Care on their website. Out of a dozen or so there has been one and he is 50 miles away.

Estate attorneys are often easier to find and most of them know the ropes of Medicaid. Also, the National Assn. of Elder Law Attorneys website may be of some help. http://www.naela.org/
Good luck,
Carol

Jeff, contact either your State Bar Association, ask if they list practice group (elder law) specialties on their website as you're looking for an elder law attorney.

These are generally the ones who are the most active in their field, speaking, presenting seminars, etc. I've worked for a few who aren't very reputable so you need to be sure you get a good one.

The bar association for the county in which you live, or a larger county, may also be able to provide you with this information.

Ask about rates - some will prepare documents for a flat fee; others charge by the hour.

From the Bar Association, a one line email reply: It would be best to contact the Columbus Lawyer Referral Service 614-XXX-XXXX.

Thanks guys. I think I got it. I'll call the attorney about 50 miles to the north. He is the only one with the word Medicaid on his website out of about 20-25 so far.

Some always say contact a lawyer..but it may not be necessary everytime..would be interested in what Gabriel would say. It seems to me if you have proof of the airline ticket cost and dates, and document services provided each day (Not duplicated by another caregiver)..and especially if the regular caregiver was given time off...document everything. Seems like that would be sufficient. But if it was just a visit..then reconsider. .but..I am not a lawyer. I have found lawyers can be very expensive..not always helpful or necessary..lots of good info on this site.
.

Shame on your sister thats all i can say isnt it terrible that she couldnt give five days of her time to help out without being paid for it im sorry but i find this disgusting and very WRONG. If my sister dared to ask for money for helping to care for her own mother for a few days i would quite simply disown her. I really dont know what kind of a world we are living in but its getting scary especially when the likes of your sister are asking for money for doing a natural human caring thing gosh i wonder how much my cat OWES me for two years care and food and board ask your sister what does she think would be reasonable? selfish.......

You do not need a lawyer to create a contract, although, we did meet our elder law attorney to make sure we did the contract correctly. My care contract with my grandmother states my duties, hours I work per week, agreed upon hourly wage, as well as some other specifics. Then we both signed and dated it. I hope this helps.

Forgot to ask....Where are you in Ohio? I live in Ohio too, and we use Victoria Shafer, Elder Law Attorney in the Green/Akron area. You can look her up if you live this way. My grandmother moved in with me, which is why we needed our contract...I am no longer working in order to care for her.

I understand getting paid for daily caregiving, but expecting reimbursement for visiting mom for a measly 5 day visit is just ridiculous. Tell sister to save $20 from each paycheck, stay with relatives to avoid hotel cost and plan ahead for cheaper airfare. Everything cannot come with a tab.

Thanks Tulips. I am in NW OH. Looking at the AOA NW O, Area Office on Aging Northwest Ohio for some advice.

Ismiami, the recent visit was somewhat urgent as Mom was just released from 8 days in hospital. Sister did stay with Mom so no hotel or rental car. Sister says she has no money to save up for this type of thing.

Pay for the airfare - now and in the future - via weekly cash withdrawals for Mom, which she is entitled to for "incidentals". Just put an amount aside specifically for that airfare. I don't think it is fair for your sister to incur that expense, especially if she is flying in to help with Mom. Tell her that she would have to claim whatever amount she is paid, with the local going rate for home health aides (non-certified aides) being $9.00 or whatever it is in your area - for a max of 8 hours a day. And does she really want to do that? Food, etc. are NOT included in that rate. I don't believe your mother would need to go so far as to get a federal tax ID #; her SS# should suffice. Her living in an Assisted Living Facility might cover the Workman's Comp issue. Yup - definitely something to discuss with an Elder Care Lawyer. Sticky issue -- one played out all across the country.