June 29, 2022


Outstanding health & fitness

Medicaid’s ‘Cash and Counseling’ Allows Pay For Family Caregivers

Mary, a 74-year-old Florida woman, suffered a stroke. She needed help with bathing, dressing, food shopping, meal preparation, laundry and housekeeping. Her state Medicaid plan covered the cost of a home-health care worker to provide those services, but the local agencies were short-staffed and couldn’t send helpers on the schedule Anna needed.

So her daughter took time off work to care for Mary. Soon after, Mary and her daughter learned about Cash and Counseling, a non-traditional Medicaid program pioneered by New Jersey, Florida and Arkansas with seed grants from the U.S. Department of Health and Human Services, the Administration on Aging and The Robert Wood Johnson Foundation. 

Cash & Counseling participants may use their Medicaid-provided personal assistance budgets to hire their own personal care aides as well as purchase items or services, including home modifications that help them live independently. By redirecting personal assistance funds from agencies to consumers themselves, Cash & Counseling allows people to hire whomever they want to provide their care and decide for themselves if they would rather hire a home health aide to cook for them, or pay a friend or relative to do it. The services paid for by the state are all part of the elder’s authorized Medicaid care plan. What’s different is that, in many cases, family members and friends chosen by the elder are providing those services instead of an agency worker.

Today, the grants are available in 12 more states – Alabama, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.

According to the Cash and Counseling website, the program was created because, “family caregivers are the backbone of the long-term care system, providing millions of hours of care every year for no compensation and frequently at great cost to their own emotional health. They’re burned out and exhausted from juggling work, family responsibilities, and caregiving. In addition, many caregivers have to reduce their work hours or even give up their jobs to take care of their loved ones. By supporting caregivers, we’re helping them hang in longer, and, hopefully, relieving some of their stress. Keep in mind, that even with Cash & Counseling support, family caregivers are typically paid lower-than-average wages and, in most cases, are paid for only a small fraction of the hours of service they provide.”

To apply for the program, elders apply through Medicaid. They are assessed in the same way they would be for traditional agency-provided services. If they choose the Cash and Counseling option, they work with the program’s staff to develop an individual budget and care plan.

To learn more about the Cash and Counseling program, visit the website at www.cashandcounseling.org.

Access the Medicaid website at www.cms.hhs.gov/home/medicaid.asp.