A Comprehensive Guide to Getting Paid as a Family Caregiver in California: Exploring Medi-Cal and State Programs

In California, family members who dedicate their time and energy to caregiving may be eligible to receive financial assistance for their work. This guide explores various programs that provide financial support to family caregivers in the state.

Getting Reimbursed as a Family Caregiver in California Through Medi-Cal

California's Medicaid program, known as Medi-Cal, provides several avenues for family caregivers to receive financial compensation for their caregiving work. Here are the primary programs and steps involved to apply.

In-Home Supportive Services (IHSS) Program

The In-Home Supportive Services (IHSS) program is a significant component of Medi-Cal that allows eligible elderly, blind, and disabled individuals to receive care at home. Family members, including spouses, can be paid caregivers under this program. The program provides support for personal care and assistance with household chores, and no special medical training is required.

California’s IHSS program is more flexible than similar programs in other states, allowing participants to choose their caregivers from a broad range of individuals, including siblings, adult children, nieces, nephews, friends, and spouses. This flexibility is referred to as "participant direction" or "self-direction."

Steps to Apply for IHSS

1. Eligibility:
   • Your family member must be eligible for Medi-Cal.
   • Your family member must meet specific medical and financial criteria, such as needing assistance with activities of daily living (ADLs).
   • In 2024, applicants must have a monthly income of less than $1,732. As of 2024, California no longer has asset limits.
2. Application:
   • Contact your local county IHSS office to start the application process.
   • You can find the contact information for your local IHSS office here.
3. Assessment:
   • A county social worker will conduct an in-home needs assessment to determine the number of hours of care required.
   • The assessment will evaluate the level of assistance needed for tasks such as bathing, dressing, meal preparation, and transportation.
4. Caregiver Designation:
   • Once approved, a family member can be hired as paid caregiver.
   • The county IHSS office will provide instructions on how to become an authorized IHSS caregiver, including completing necessary training and background checks.
5. Payment:
   • Caregivers are paid an hourly wage based on the number of approved care hours.
   • Wages are set by the county and may vary.

For more information on applying, contact the IHSS main office at 888-944-4477.

Medi-Cal Waivers

California offers several Medi-Cal waiver programs, such as the Home and Community-Based Services (HCBS) Waiver, which provides financial support for family caregivers. These waivers are designed to help individuals remain in their homes and communities rather than moving to institutional care.

Waiver Programs

1. Home and Community-Based Services (HCBS): Provides a range of services to assist with daily living activities and support family caregivers.
2. Community-Based Adult Services (CBAS): Offers adult day health care services.
3. Multipurpose Senior Services Program (MSSP): Provides social and health care management services.

Steps to Apply

4. Eligibility:
   • Your family member must meet the medical and financial criteria for the specific waiver program.
   • Waivers typically target individuals who would otherwise require nursing home-level care.
5. Application:
   • Contact your local county social services office to apply for a Medi-Cal waiver.
   • The application process may involve providing detailed medical and financial information, as well as proof of the need for in-home care.
6. Assessment and Approval:
   • Similar to IHSS, a social worker or case manager will conduct an assessment to determine eligibility and the level of care needed.
   • If approved, the waiver program will cover various services, including payments to family caregivers.

For detailed information about Medi-Cal waivers, visit the California Department of Health Care Services waiver programs page.

California Paid Family Leave (PFL)

California's Paid Family Leave (PFL) program offers a valuable benefit for family caregivers. It provides up to eight weeks of partial wage replacement benefits for caregivers who need to take time off work to care for an ill family member. This program is designed to help alleviate the financial burden associated with taking unpaid leave from work to fulfill caregiving responsibilities.

Key Features of the PFL Program

1. Eligibility:
   • Employment Status: PFL is available to employees who have paid into the State Disability Insurance (SDI) program through payroll deductions.
   • Family Members: Caregivers can use PFL to care for a parent, parent-in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner with a serious health condition.
2. Benefits:
   • Wage Replacement: The program provides up to eight weeks of partial wage replacement, typically covering 60-70% of an employee's wages, depending on income.
   • Duration: Benefits can be taken all at once or intermittently, allowing caregivers flexibility in managing their leave based on the care recipient's needs.
3. Application Process:
   • Claim Filing: To apply for PFL, caregivers must submit a claim to the Employment Development Department (EDD). This can be done online through the EDD website or by mail.
   • Medical Certification: A medical certification form must be completed by the care recipient's physician or practitioner, verifying the need for care.
   • Supporting Documents: Additional documentation may be required to support the claim, such as proof of the caregiver's relationship to the care recipient.
4. Job Protection:
   • While PFL provides financial benefits, it does not guarantee job protection. However, caregivers may be eligible for job protection under other laws such as the Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA), which provide up to 12 weeks of unpaid, job-protected leave.
5. Coordination with Other Benefits:
   • FMLA/CFRA: Caregivers can use PFL in conjunction with FMLA or CFRA leave. This means they can receive partial wage replacement from PFL while also taking job-protected leave under FMLA or CFRA.
   • SDI Benefits: PFL benefits cannot be received at the same time as State Disability Insurance (SDI) benefits for the same care recipient and period. However, caregivers who are themselves recovering from an illness or injury may transition from SDI to PFL.

Steps to Apply for PFL

1. Determine Eligibility:
   • Ensure you have paid into the SDI program and are eligible to take leave to care for an ill family member.
2. Gather Documentation:
   • Obtain medical certification from the care recipient’s healthcare provider.
   • Prepare any additional documentation required to verify your relationship to the care recipient.
3. File a Claim:
   • Submit your PFL claim online through the EDD website or by mail.
   • Provide all necessary information and documentation to support your claim.
4. Await Approval:
   • The EDD will review your claim and notify you of the approval status. This process typically takes a few weeks.
5. Receive Benefits:
   • Once approved, you will receive partial wage replacement benefits for up to eight weeks, which can be taken consecutively or intermittently.

The PFL program is an essential resource for family caregivers in California, providing financial support and flexibility to help manage caregiving responsibilities without sacrificing income.

Veteran Directed Care (VDC)

Veterans in Arizona can hire family members as caregivers through the Veteran Directed Care (VDC) program. This program provides veterans with a flexible budget to purchase home and community-based services, including hiring family members.

Eligibility:

1. Veterans must be enrolled in VA medical benefits.
2. Apply for the VDC program through the VA Caregiver Support Line at 855-260-3274​​.

Aid and Attendance (A&A) Pension Benefit

Veterans who require long-term in-home, assisted living, or nursing home care may qualify for VA Ad & Attendance, which can provide up to $3,261 per month for caregiving expenses, including payments to family caregivers.

To apply, you’ll need to look at all requirements and, if qualified, complete VA Form 21-2680.

Housebound Pension Benefit

The Housebound Pension Benefit offers up to $1,882 per month to veterans mostly confined to their homes. It can be used to pay family caregivers, although spouses are not eligible for payment under this benefit.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides a stipend, training, counseling, and respite care to family caregivers of veterans seriously injured or ill in the line of duty and require assistance with daily activities.

Additional Support Programs

California offers various support services to family caregivers through organizations like the California Caregiver Resource Centers (CRC).

These services include respite care, caregiver training, support groups, and resources designed to help caregivers manage their responsibilities and maintain their well-being.

Respite Care and Adult Day Services

California provides access to respite care and adult day services through various state programs, giving caregivers temporary relief to take care of their personal needs.

Area Agencies on Aging (AAA)

California's Area Agencies on Aging (AAA) provide support services to family caregivers, including:

• Information and Referrals: Guidance on local resources, support groups, and caregiver training.
• Respite Care: Temporary relief for caregivers to take breaks and attend to their own well-being.
• Support Groups: Facilitation of caregiver support groups for sharing experiences and learning from others​​​​.

Local County Programs

Various county-level programs in California offer additional support and compensation for family caregivers. Check with your local county office for specific programs available in your area.

Contact Information for Caregiver Support

For additional questions and support, contact the following resources:

• IHSS Office: 888-944-4477
• California Caregiver Resource Centers (CRC): Contact through local AAA offices
• VA Caregiver Support Line: 855-260-3274

Conclusion

California offers several programs to support family caregivers through financial assistance and resources. These programs recognize the vital role caregivers play and aim to provide necessary support and compensation. For more detailed information and to apply, contact the relevant offices listed above.

For further assistance and to explore more resources, visit the California Caregiver Resource Center’s website or consult with your Medi-Cal case manager.