Watching a parent, grandparent, or other older relative deteriorate physically and/or mentally can be heart-wrenching. The idea of putting your family member in a long-term care facility may not sit well with you; however, caring for them yourself may not be financially feasible. Will Medicaid pay for a family caregiver? The Carmel Medicaid attorneys at Frank & Kraft explain an Indiana Medicaid program that may allow you to be compensated for caring for a family member.
Medicaid Waiver Programs
Your probably have a general idea how the Medicaid program works; however, you may not be familiar with the concept of “Medicaid waivers.” Medicaid waivers, which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services are programs that provide additional services to specific groups of individuals, limit services to specific geographic areas of the state, and provide medical coverage to individuals who may not otherwise be eligible under traditional Medicaid rules. Unlike the traditional Medicaid program, services or benefits provided through a waiver are only good for a designated period of time. They are often renewed, but there is no guarantee that a waiver will be renewed. These waiver programs allow people who would otherwise receive care in a long-term care (LTC) facility to receive that care in the community through an assisted living facility, a community based care program, or even by family caregivers.
The Indiana Structured Family Caregiving (SFC)
Structured Family Caregiving (SFC), also known as Caregiver Homes of Indiana is a benefit associated with Indiana’s Aged and Disability Medicaid Waiver or Indiana Programs of All-Inclusive Care for the Elderly (PACE). The SFC program provides financial and supportive services for family caregivers and allows them to care for seniors and those with disabilities who wish to remain at home, or in the home of an approved caregiver, rather than become institutionalized.
The SFC program requires a caregiver to move into the home of an elderly or disabled individual or the care recipient moves into the caregiver’s home. Compensation is provided to the caregiver for providing care to the elderly individual who would otherwise require nursing home level care. Although the caregiver is not required to be related to the care recipient, they may be related. Spouses and legal guardians, however, are prohibited from participating as caregivers in the program.
To qualify under the SFC program, an applicant must be a resident of Indiana, be financially eligible for the Aged and Disability Medicaid Waiver, and meet the Level of Care for Nursing Facility placement as determined by a case manager. This generally means that the care recipient needs help with three personal care tasks per day. The eligible individual must also live full time with his or her caregiver.
The primary caregiver must be at least 18 years of age and be deemed physically and mentally capable of performing his or her caregiving responsibilities. He or she must be willing to complete a criminal background check.
How Much Are Caregivers Paid?
Administrators at local state agencies supervise and approve all SFC caregiver / care recipient matchings and are responsible for training and paying caregivers. There are also intermediary agencies who manage much of the eligibility and compliance process with the state, freeing caregivers to provide care. For their role, the intermediary agencies take a percentage of the caregiver compensation. This percentage can be significant (estimates range from 20-50 percent) so you need to factor that in when deciding if you can get by on the compensation offered by the program.
The level of compensation available to a caregiver also depends on the level of care required as determined by a case manager and a registered nurse from the Structured Family Caregiving overseeing agency. They will create a service plan tailored to each individual applicant’s needs and place the applicant into one of three levels.
As of January 1, 2019, estimates for caregiver compensation are as follows:
- Level 1: Total state payment of $1,783.33. Of that, caregiver compensation is $891.67 – $1,426.67 and agency compensation is $356.66 – $891.66.
- Level 2: Total state payment of $2,104.83. Of that, caregiver compensation is $1,052.42 – $1,683.86 and agency compensation is $420.97 – $1,052.41.
- Level 3: Total state payment of $2,431.51. Of that, caregiver compensation is $1,215.76 – $1,945.21 and agency compensation is $486.30 – $1,215.75.
Contact Carmel Medicaid Attorneys
For more information, please join us for an upcoming FREE seminar. If you have additional questions about Medicaid eligibility and benefits for seniors in Indiana, contact the experienced Carmel Medicaid attorneys at Frank & Kraft by calling (317) 684-1100 to schedule an appointment.
Mr. Kraft assists clients primarily in the areas of estate planning and administration, Medicaid planning, federal and state taxation, real estate and corporate law, bringing the added perspective of an accounting background to his work.
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