Medicaid's 'Cash and Counseling' Allows Pay For Family Caregivers

Mary, a 74-year-old Florida woman, suffered aare providing those services instead of an agency
stroke. She needed help with bathing, dressing,worker.
food shopping, meal preparation, laundry andToday, the grants are available in 12 more states
housekeeping. Her state Medicaid plan covered the- Alabama, Illinois, Iowa, Kentucky, Michigan,
cost of a home-health care worker to provideMinnesota, New Mexico, Pennsylvania, Rhode
those services, but the local agencies wereIsland, Vermont, Washington and West Virginia.
short-staffed and couldn't send helpers on theAccording to the Cash and Counseling website,
schedule Anna needed.the program was created because, "family
So her daughter took time off work to care forcaregivers are the backbone of the long-term
Mary. Soon after, Mary and her daughter learnedcare system, providing millions of hours of care
about Cash and Counseling, a non-traditionalevery year for no compensation and frequently
Medicaid program pioneered by New Jersey,at great cost to their own emotional health.
Florida and Arkansas with seed grants from theThey're burned out and exhausted from juggling
U.S. Department of Health and Human Services,work, family responsibilities, and caregiving. In
the Administration on Aging and The Robertaddition, many caregivers have to reduce their
Wood Johnson Foundation.work hours or even give up their jobs to take
Cash & Counseling participants may use theircare of their loved ones. By supporting caregivers,
Medicaid-provided personal assistance budgets towe're helping them hang in longer, and, hopefully,
hire their own personal care aides as well asrelieving some of their stress. Keep in mind, that
purchase items or services, including homeeven with Cash & Counseling support, family
modifications that help them live independently. Bycaregivers are typically paid lower-than-average
redirecting personal assistance funds fromwages and, in most cases, are paid for only a
agencies to consumers themselves, Cash &small fraction of the hours of service they
Counseling allows people to hire whomever theyprovide."
want to provide their care and decide forTo apply for the program, elders apply through
themselves if they would rather hire a homeMedicaid. They are assessed in the same way
health aide to cook for them, or pay a friend orthey would be for traditional agency-provided
relative to do it. The services paid for by theservices. If they choose the Cash and Counseling
state are all part of the elder's authorized Medicaidoption, they work with the program's staff to
care plan. What's different is that, in many cases,develop an individual budget and care plan.
family members and friends chosen by the elder