Recently, a few of my clients have mentioned a Medicaid program that allows a family member to be paid for providing care to a loved one. The clients have seen a commercial on television about a Medicaid program that permits the payment of a family member who provides care to the Medicaid beneficiary.  While I believe the television commercial relates to a New York Medicaid program, in New Jersey, we have a similar program.

Medicaid is a health payment plan for needy individuals.  In order to qualify for Medicaid, an individual must have very limited assets, typically less than $2,000, and insufficient income with which to pay for her care.

If an individual qualifies for Medicaid, Medicaid will pay for many of the costs associated with long-term care.  Long-term care can be care in a nursing home, care in an assisted living residence, or care at home.  At home, long-term care can involve a home health aide or an adult day care center.

There are many home health aide agencies.  Too many probably.  These agencies provide licensed home health aides who will care for a loved one.  Sometimes the aides provided through agencies are employees of the agency, sometimes the aides are merely independent contractors.

While it is inappropriate and illegal, many family members hire aides under the table.  Frequently, the family doesn’t withhold employer taxes when paying the aide.  The aide may not be in the country legally.

Whatever the method is for obtaining a non-family member aide, the aide isn’t a family member and for that reason, the loved one who requires care may feel uncomfortable accepting help from a non-family member.  Furthermore, there might be a family member who wants to provide care to the loved one but who cannot provide the care without being compensated.  To meet this need, the New Jersey Medicaid program created the Personal Preference Program or PPP.

In part, the PPP Medicaid program could allow a family member to be compensated for providing care to a loved one who is a Medicaid beneficiary and who resides at home.  As I understand the program—and a few of my clients have enrolled in the program—it works as follows:

Mrs. Smith lives at home.  She is a Medicaid beneficiary.  She would benefit from having a home health aide several hours a day.  She doesn’t want a stranger in her house, but she is very close to her daughter-in-law Mary.  Mary had a part-time job and her family benefits from having the extra cash, but Mary would be willing to help Mrs. Smith if she could be compensated in some way.  Mary’s husband, Joseph, is Mrs. Smith’s son.  Joseph helped Mary qualify for Medicaid benefits with my office.

PPP permits Mrs. Smith to direct her own care through a cash and counsel program.  At home, the New Jersey Medicaid program provides a benefit worth approximately $3,200 a month.  The cash and counsel program permits Mrs. Smith to hire Mary to provide care to her.

Joseph must oversee Mary providing care to Mrs. Smith as Mrs. Smith’s aide.  Joseph must manage the cash that Medicaid is paying Mary to be Mrs. Smith’s aide. The Medicaid program might provide $2,100 a month to Mrs. Smith to pay for an aide.  Joseph will put a plan together that says he will pay Mary $15 an hour for providing 140 hours of home health aide services to Mrs. Smith.

PPP permits Mrs. Smith to receive care from someone she loves and knows, someone she feels comfortable having in her house.  PPP also permits Mary to receive payment for the services she provides and for her family to have a good life.