Being a caregiver for a family member with a disability or chronic illness is an act of love, but it can also be physically and emotionally taxing. Many family caregivers end up leaving jobs or reducing work hours to provide care. This can lead to financial stress.
If you are caring for a relative in North Carolina, there may be options to get paid for those caregiving hours through Medicaid waivers, veteran benefits, long-term care insurance, respite programs, or direct employment arrangements. This guide will overview different avenues to pursue.
North Carolina has two main Medicaid programs that can potentially pay family members to care for relatives who qualify for Medicaid long-term care services – the CAP/C waiver and the Community Alternatives Program for Disabled Adults (CAP/DA).
To be eligible for CAP/C, your family member must need assistance with at least three activities of daily living, require care provided in a private home, and be approved for skilled nursing facility-level care.
CAP/DA has similar eligibility criteria, except it is focused on younger adults with disabilities vs. seniors. Once deemed eligible by Medicaid, your family member will get allocated a certain number of home care hours per month, which they can use to hire providers.
One thing to note: you cannot be paid as a family caregiver if you are also operating under the power of attorney or legal guardianship for your relative. But CAP/C and CAP/DA open up excellent opportunities for many others.
If your family member served in the military, the VA may pay you to care for them under certain programs. This includes veteran-directed care programs that let qualified veterans hire family members, friends, or neighbors as home health aides using a monthly VA allowance. You must still complete mandatory training and background checks.
Eligibility varies based on factors like your loved one’s disability rating and ability to self-direct care. We can explore the possibilities and paperwork involved to help veterans access benefits like VA Aid and Attendance. This provides up to $2,400 per month to pay family members for in-home care assistance.
If your relative has long-term care insurance, their policy may contain provisions allowing family member caregivers to receive pay. This is contingent on insurance company approvals and meeting relevant licensing or credentialing standards.
Some of the common requirements we’ve seen include need certifications from doctors describing your family member’s functional or cognitive deficits, care plans indicating tasks to be performed, justification for using family vs. agency care, and skills competency verification. We can coordinate with long-term care insurers on the necessary paperwork, which will depend on the specific policy.
Respite care offers family caregivers temporary relief from responsibilities, with a substitute caregiver coming into the home for several hours or days. North Carolina has respite voucher programs at both the state and local levels that provide funding for eligible caregivers to hire their choice of provider. This pool could even include family members or friends if particular conditions are met.
For example, the state’s Lifespan Respite Voucher Program offers up to $500 per year in vouchers to reimburse caregivers for costs they incur for adult day services, in-home nursing care, overnight facility stays, or other support. To qualify, neither you nor the care recipient can already be receiving publicly-funded respite care. We work closely with local respite coordinators who can confirm eligibility status and submit applications on our behalf.
An additional avenue to potentially pay relatives for caregiving is North Carolina’s Home Care Independence Program. This innovative program facilitates seniors hiring caregivers – including family members, friends, or neighbors – while providing guidance from a care advisor and assistance with payroll/taxes through a financial management service.
To be eligible, care recipients must be over 60, require hands-on assistance with daily living activities, be able to self-direct their own care or have a qualified designate, and meet other criteria.
Family member caregivers can get competitive pay rates on the books as independent providers. We are closely connected with local Independence Programs across North Carolina and can link clients and caregivers to this valuable resource.
Beyond formal programs, families may directly hire relatives as private home health aides responsible for personal care, household tasks, medication reminders, transportation, and companionship.
This route requires carefully following tax, employment, and liability regulations. Pay rates typically range from $12-$18 per hour depending on skills, with overtime, payroll taxes, worker’s compensation, and mileage reimbursement as potential supplementary costs.
Alternatively, home care agencies can handle human resources functions like skills verification, payroll, and compliance for families while still facilitating the hiring of relatives or close associates to deliver care. Rates may be higher going through agencies, but invaluable assistance is gained. We have contacts at care agencies across North Carolina open to discussing customized family-based arrangements.
Caring for an aging parent or relative often involves addressing complex financial and healthcare decisions. Johnson Legal can help develop a customized estate plan to ease your caregiving burden. We also have a staff nurse consultant, Joelle Johnson. Joelle has served as Director of Nursing at several elder care facilities, so she can meet with you to help you make decisions for yourself or your parents on the navigation of housing alternatives when needed.
Our experienced estate planning attorneys offer guidance on:
Contact Johnson Legal today for a consultation. Meeting with our lawyers provides peace of mind that your elderly family member’s affairs are in order—reducing future complications as their health and cognition decline.
Shane T. Johnson is the CEO and Managing Partner of Johnson Legal, an estate planning and business law firm in Wilmington, NC. With years of experience in estate and business law, he has zealously represented clients in various legal matters, including small business formation and purchasing, estate planning, probate, domestic violence, and other legal cases.
Shane received his Juris Doctor from the University of Wyoming and is a member of the North Carolina Bar Association. He has received numerous accolades for her work, including being named among the Best Probate Lawyers in Wilmington by Expertise.com.
