Can Family Members Get Paid for Caregiving in Massachusetts?

In Massachusetts, family members can get paid for caregiving through the state’s Personal Care Attendant Program and the Adult Foster Care Program. These programs may enable seniors to avoid nursing home or residential facility placement and instead obtain in-home care from an eligible family member. To be eligible for these programs, seniors generally must be able to demonstrate a need for financial assistance, and the services they get through these programs must be sufficient for allowing them to remain in the community.

Massachusetts’ Personal Care Attendant Program is for older adults who are permanently or chronically disabled and require help with daily living activities, including dressing, bathing and meal preparation. This program is participant-directed, meaning that the participant acts as the employer and is responsible for hiring, training and firing caregivers. The program funds up to 50 hours of care per week at a fixed hourly rate, which is assessed annually. Under this program, the individual can’t hire their spouse to be their caregiver, but they can hire adult children or grandchildren. There’s no enrollment cap, so everyone who meets program qualifications is guaranteed services.

The Adult Foster Care Program is similar, but instead of the program participants living independently, they must live in the home of their caregiver. This program is open to Medicaid beneficiaries who are unable to live alone due to physical or mental impairments and who require help with daily living activities. Similar to the PCA program, spouses can’t serve as paid caregivers, but participants can designate another eligible family member or non-family member, including an adult child, as their caregiver.

Massachusetts operates the Family Caregiver Support Program, which provides free information and assistance to those caring for a family member aged 55 and over. Through this program, family caregivers get free help from options counselors who assess the senior’s needs and provide referrals for community-based services such as home-delivered meals, nonemergency medical transportation and home modification services. Massachusetts also has a network of Area Agencies on Aging, which provide in-home services and supports, information and referral services and assistance with applying for federal and state benefits that may help pay for home care.