Getting Paid as a Caregiver in New York

Overview

There are several programs available to New York residents that will pay caregivers for providing assistance to their loved ones. However, whether or not you can get paid to provide care for a family member or other loved one depends on several factors. These factors include the income and financial resources of the individual who requires care, the level and type of care they require, whether the care recipient or their spouse is a U.S. war-time veteran and, finally, the type(s) of insurance the care recipient has. Another impacting factor is the relationship between the individual who requires care and the person that will be compensated for providing care. To clarify, some programs allow an adult child to be paid, but not a spouse. Other programs pay relatives, but not unrelated caregivers. Still others allow almost anyone to be compensated for providing care.

This article describes, at length, the different options available to New Yorkers. Alternatively, one can use our interactive Paid Caregiver Program Search Tool. Doing so helps caregivers and care recipients find programs for which they are eligible simply by responding to a series of questions. 

1) Medicaid Consumer-Directed Personal Assistance Program

The most broadly used program in New York that helps caregivers receive payment for caring for a loved one is CDPAP. First, we will discuss how this program works, followed by its eligibility requirements. CDPAP is a Medicaid program that stands for Consumer-Directed Personal Assistance Program. Consumer-directed means that the beneficiary of the program can direct or chose from whom they receive personal care assistance. As such, family members including the adult children or friends can be hired to provide personal care. Spouses, however, are prohibited from being hired.

Since CDPAP is a Medicaid program, participants must be eligible for New York Medicaid. In addition to having a need for personal care, candidates must meet the financial eligibility criteria. In 2024, single applicants, 65 and older are limited to a monthly income of $1,732, and the value of their countable assets is limited to $30,182. Notably, “countable assets” exclude the value of a home provided their home equity is valued at less than $1,071,000.00. If your loved one meets these limits, you can read more about the program here. Should your loved one’s finances exceed these limits, you can learn about how they might still gain eligibility here.

2) Non-Medicaid Expanded In-Home Services for the Elderly Program

NY’s Expanded In-Home Services for the Elderly Program, abbreviated as EISEP, is a program intended for seniors who are not eligible for Medicaid. While there are several benefits of EISEP, such as adult day care, respite care, and personal emergency response services, consumer directed in-home services allow program participants to hire and pay the caregiver of their choosing. Family members may be selected as caregivers, though at this time, it is unclear as to whether or not spouses can be payed to fill this role. 

In order to be eligible for EISEP, New Yorkers must be a minimum of 60 years old, ineligible for Medicaid, reside at home, and require assistance with their daily living activities. EISEP does not have fixed, published income limits. However, the program does have cost-sharing rules. Persons whose income exceeds the maximum cost-sharing threshold receive no financial assistance, so the cost-sharing limits are the effective financial limits for EISEP. Learn more here.

3) Veteran’s Aid & Attendance Pension

The Aid and Attendance Pension benefit is for war-time veterans or their surviving spouses who require assistance with their activities of daily living. The amount of financial assistance varies depending on the beneficiary’s current income. Annually, the VA sets a maximum amount of income a beneficiary can have and then the VA supplements the veteran’s income up to the point of the maximum benefit. For example, in 2024, the Maximum Annual Pension Rate (MAPR) for a couple is approximately $32,700. If the couple has $15,000 in income, the VA will give them an additional $17,700.

Importantly, the VA allows families to deduct certain expenses from their income, so in practice they can still be eligible even if their income is considerably higher than $32,700 per year. One expense they can deduct from their countable income is their cost of care. Therefore, an elderly veteran can hire their adult child (or another relative or friend) to provide them with personal care and the amount they pay their caregiver can be deducted from their income. The VA will compensate the veteran an amount equal to what they pay to their caregiver over and above their existing pension benefit. It should be noted that since the VA counts a couple’s income together, this technique will not work to pay a spouse for caregiving.

This technique is complicated and for the purposes of this article we have oversimplified the details. For further information, it is recommended one consult with a Veterans Pension Planner. However, prior to doing so, one should first determine if they are potentially eligible for the A&A benefit. This program is not limited to New York, but is highly relevant, as there are nearly one million veterans living in New York and the majority of those veterans served during wartime.

4) Veteran Directed Care Program

Another interesting option veterans can use to pay their caregivers is a program called the Veteran Directed Care (VDC) Program, previously called the Veterans Directed Home and Community Based Services (VD-HCBS). For veterans who require the level of care on par with what is provided in a nursing home, this program gives them the option to receive that care at home and to pay family members or friends for providing care. In brief, how this program works is that the veteran is provided with a budget for care instead of being provided with care by the VA. The responsibility for finding the care providers, then falls onto the veteran and / or their family. With control of the budget, the veteran is able to hire family members, friends, and even their spouses to provide them with the hands-on assistance with the activities of daily living they would otherwise receive in a nursing home.

Any veteran that participates in the VA Medical Center Care system and requires “nursing home level care” is eligible for this program. Notably, persons with Alzheimer’s usually meet these criteria. However, there are geographic limitations relevant to New Yorkers. VDC is a program offered only at specific VA Medical Centers. As of January 2024, New York has five VAMCs that offer the program. It is worth noting that one is not required to go to a VA Medical Center within their home state. As such, two other VA Medical Centers are accessible to the New York City metro area and offer this program. They are found in Lyons, NJ and Philadelphia, PA. While a commute may be required to initiate the program, once a beneficiary is established, they need not visit their VAMC with great frequency. Read more.

5) Long Term Care Insurance

If your loved one has long term care insurance and if their policy meets certain requirements, it can be used to hire family members as caregivers. Unfortunately, this option is only relevant to a few New York residents because most long term care insurance policies are too restrictive. In short, a policy must 1) pay for personal care provided outside of residential care communities and 2) make the payouts to the policyholder directly instead of to a care provider. If these conditions are met, the policyholder / care recipient can choose from whom they wish to receive care and hire a family member to provide it.

One workaround exists in New York, although the process can present some logistical challenges. The family member who wishes to provide care, can start their own home care agency. The family member who requires care then hires that home care agency and the long term care insurance provider then makes payments directly to the home care agency / family member. To learn more about starting a home care agency in New York, read here.

6) Paid Family Leave Benefits Law (PFLBL)

New York is one of just five states, plus the District of Columbia, to have created a Paid Family Leave Benefits Law (PFLBL). In short, this law allows relatives to take time off from their job to care for a family member. They continue to receive a percentage of their salary while doing so. The actual percentage will vary, but is approximately 65%. While one is not formally being paid to be a caregiver, they do continue to receive compensation from their job while they are caring for their relative.

To be eligible to be paid as a caregiver under PFLBL, one must be related by blood or marriage to the individual who requires care. One must also be employed and taking time off from their job to provide care. Interestingly, the program will pay caregivers for up to 12 weeks of care annually, but the time off need not be taken consecutively. For example, a program participant could take one day off per week to provide care year round. Read more.