Can a family member be paid as a caregiver in Minnesota?

According to the Family Caregiver Alliance, family caregivers provide billions of dollars worth of uncompensated care annually, often leading to financial strain. However, in Minnesota, state-sponsored programs offer a pathway for family members to receive compensation. The key question many families face is: can a family member be paid as a caregiver in Minnesota?

Quick Summary

Yes, family members can be paid for caregiving in Minnesota through various state programs, including the new Community First Services and Supports (CFSS) and Medical Assistance waivers like the Elderly Waiver. Certain requirements and eligibility criteria apply to both the caregiver and the recipient.

Key Points

• CFSS Replaced PCA: The new Community First Services and Supports (CFSS) program has replaced the older PCA program in Minnesota, expanding eligibility for paid family caregivers.

• Spouses and Parents Now Eligible: Unlike the old PCA program, CFSS allows spouses and parents of minor children to receive payment for providing care.

• Waiver Programs Offer Options: Medicaid waivers like the Elderly Waiver (EW) and the Alternative Care (AC) program also provide avenues for family caregivers to be paid, often through a Consumer Directed Community Supports (CDCS) model.

• Use an FMS for Payroll: For self-directed models like CDCS and the CFSS Budget Model, a Financial Management Services (FMS) provider handles payroll and tax administration.

• Multiple Requirements Must Be Met: To become a paid caregiver, individuals must be over 18, pass a background check, complete training, and be employed through a licensed agency or FMS.

• Veteran Programs Available: The VA offers a separate program (PCAFC) with a monthly stipend for family caregivers of eligible veterans with serious service-related injuries.

Yes, Family Caregivers Can Get Paid in Minnesota

For many years, families provided care for loved ones with little to no financial support. Today, Minnesota offers several pathways for family members to be compensated for their caregiving services, thanks to state and federal programs. The landscape has evolved recently with the implementation of the Community First Services and Supports (CFSS) program, which has expanded eligibility for paid family caregivers, including spouses and parents of minor children. Navigating these options can be complex, but understanding the primary programs available is the first step toward securing financial relief.

Community First Services and Supports (CFSS)

As of October 1, 2024, Minnesota's CFSS program replaced the Personal Care Assistance (PCA) program, bringing with it expanded opportunities for family compensation. This shift was designed to offer greater flexibility and control to the care recipient. Under CFSS, spouses and parents of minor children are now eligible to be paid as caregivers, a significant change from the previous PCA rules. The program operates with two main service delivery models:

• Agency Model: The caregiver is employed by a licensed provider agency. The agency handles payroll, benefits, and administrative tasks, ensuring compliance with all state regulations.
• Budget Model: This self-directed option gives the care recipient more control over their budget. They can hire, train, and manage their own caregivers, including family members. A financial management services (FMS) provider, like Partners in Community Supports (PICS), assists with the payroll and financial management aspects.

To be eligible for CFSS, the care recipient must be enrolled in Minnesota's Medical Assistance (MA) program, have an assessed need for assistance with activities of daily living (ADLs) or health-related tasks, and undergo a MnCHOICES assessment to determine their level of need.

Medicaid Waiver Programs

Beyond CFSS, several Medicaid Home and Community-Based Services (HCBS) waiver programs can fund family caregiving. These programs allow individuals who require a nursing home level of care to receive services at home or in the community instead. A popular option within these waivers is the Consumer Directed Community Supports (CDCS) model, which works similarly to the CFSS Budget Model.

Elderly Waiver (EW)

The Elderly Waiver is for individuals aged 65 and older who are eligible for Medical Assistance and require a nursing home level of care. Through the CDCS option under EW, a senior can hire and pay a family member, including their spouse, to provide necessary care.

Alternative Care (AC) Program

The Alternative Care Program serves seniors aged 65 and older who are at risk of nursing home placement but are not yet financially eligible for Medical Assistance. It provides a state-funded alternative to Medicaid services and also allows for family compensation, including spouses.

Other Disability Waivers

For individuals with disabilities, Minnesota offers several other waiver programs that can facilitate paid family caregiving through the CDCS option, including the Community Access for Disability Inclusion (CADI) Waiver and the Brain Injury (BI) Waiver.

The Role of Financial Management Services (FMS)

For those utilizing the CFSS Budget Model or the CDCS option under a waiver, an FMS provider is essential. This company serves as a fiscal agent, handling the administrative details of employing a caregiver. Their responsibilities typically include:

• Processing payroll for caregivers, including withholding and paying taxes.
• Managing background checks and caregiver enrollment with the state.
• Tracking expenditures to ensure they fall within the allocated budget.
• Providing documentation for tax purposes.

By partnering with an FMS, families can focus on providing care rather than getting bogged down in complex paperwork.

Caregiver Eligibility and Requirements

To become a paid family caregiver in Minnesota, certain steps and requirements must be met. These are largely consistent across the various programs:

1. Be at least 18 years old: There are exceptions for 16- and 17-year-olds in some cases.
2. Pass a background study: All prospective caregivers must undergo a state-mandated criminal background check.
3. Complete required training: Caregivers must complete training and pass a certification test. This is often provided online by the Department of Human Services or a provider agency.
4. Be employed by an agency: Compensation is typically processed through a licensed provider agency or an FMS provider, not directly from the state.
5. Not be compensated for typical family responsibilities: The compensation is specifically for assistance with ADLs and other assessed needs that go beyond standard familial duties. The MnCHOICES assessment helps to make this distinction.

Comparison of Minnesota Family Caregiving Programs

Feature	CFSS (Budget Model)	Elderly Waiver (EW) (via CDCS)	Alternative Care (AC) (via CDCS)	Traditional Agency Model (CFSS/PCA)
Eligible Caregivers	Spouses, parents of minors, other family members (meeting requirements)	Spouses, other family members (meeting requirements)	Spouses, other family members (meeting requirements)	Depends on agency policy, generally allows most relatives (but not spouses/parents under old PCA)
Care Recipient Eligibility	MA-eligible, requires assistance with ADLs/health tasks, MnCHOICES assessment	Age 65+, MA-eligible, needs nursing home level of care, MnCHOICES assessment	Age 65+, not MA-eligible, at risk of nursing home placement, needs nursing home level of care	MA-eligible, requires assistance with ADLs/health tasks, MnCHOICES assessment
Service Delivery	Self-directed, managed with an FMS provider	Self-directed, managed with an FMS provider	Self-directed, managed with an FMS provider	Agency-managed; agency handles all administrative tasks
Level of Control	High control over caregiver choice, scheduling, and budget	High control over caregiver choice, scheduling, and budget	High control over caregiver choice, scheduling, and budget	Low control; agency handles employment and scheduling
Administrative Burden	Moderate (working with FMS provider)	Moderate (working with FMS provider)	Moderate (working with FMS provider)	Low (all handled by agency)

Getting Started: The Application Process

For many, the process begins with a long-term care consultation and the MnCHOICES assessment. This tool helps determine the level of assistance needed and identifies which programs and services, such as CFSS or a specific waiver, the individual qualifies for.

1. Contact your local county or tribal nation's social services agency. They will guide you through the process and arrange the MnCHOICES assessment. The Senior LinkAge Line can also provide assistance.
2. Complete the MnCHOICES assessment. This comprehensive evaluation identifies the individual's needs and functional abilities.
3. Establish program eligibility. Based on the assessment, you will be directed to the appropriate program, such as CFSS or a Medicaid waiver like the Elderly Waiver.
4. Choose a service model. Decide whether you prefer the budget model (CFSS or CDCS) for greater control or the agency model for simplicity.
5. Select a provider and enroll. Partner with a licensed provider agency or an FMS provider. The family caregiver will then need to meet all state requirements, including background checks and training, before receiving payment.

Veteran Benefits for Caregivers

It's also important to note that the U.S. Department of Veterans Affairs (VA) has a Program of Comprehensive Assistance for Family Caregivers (PCAFC). This program provides a monthly stipend to family caregivers of eligible veterans who sustained a serious injury or illness during military service. The veteran must have a VA disability rating of 70% or higher and need personal care services. This is a separate federal program but an important resource for qualifying families.

Financial and Legal Considerations

When a family member becomes a paid caregiver, there are financial and legal aspects to consider. It's crucial to consult with a financial advisor or elder law attorney to understand how compensation might affect eligibility for other benefits. Taxes must also be considered, and the FMS provider will generally handle the necessary reporting. Having a formal care agreement in place can clarify the caregiver's responsibilities, hours, and payment rate, protecting both the caregiver and the care recipient.

Conclusion

In Minnesota, the option for a family member to be paid as a caregiver is not only possible but increasingly accessible through programs like CFSS, CDCS, and the Elderly Waiver. The transition to CFSS has been particularly beneficial, removing previous restrictions on paying spouses and parents of minors. By understanding the available programs, completing the necessary assessments and training, and working with a provider agency or FMS, families can secure much-needed compensation. The process requires careful navigation but ultimately provides invaluable support for both the caregiver and the recipient, allowing for dignified care in a familiar home setting.

For more detailed information, consult the official Minnesota Department of Human Services website on long-term care services.

Frequently Asked Questions

Does Minnesota's CFSS program allow parents of minors to be paid caregivers?

Yes, unlike the previous PCA program, Minnesota's Community First Services and Supports (CFSS) program explicitly allows parents of minor children to be paid for providing care.

Can I be paid to care for my spouse in Minnesota?

Yes, under the new CFSS program and some Medicaid waivers like the Elderly Waiver, a spouse can be paid to act as a personal care provider.

What is the MnCHOICES assessment and why is it required?

The MnCHOICES assessment is a comprehensive evaluation conducted by the county to determine a person's eligibility for long-term care services, including paid caregiving through programs like CFSS and Medicaid waivers.

Do I need to pass a background check to become a paid family caregiver in Minnesota?

Yes, all prospective paid caregivers, including family members, are required to undergo and pass a criminal background study conducted by the Department of Human Services.

What is the difference between the CFSS Agency Model and the Budget Model?

In the Agency Model, a licensed provider agency employs the caregiver and handles all administration. In the Budget Model, the care recipient directs their own care and hires family members, with an FMS provider managing payroll.

What is the Elderly Waiver (EW) program?

The Elderly Waiver is a Medicaid program for individuals aged 65 or older who need a nursing home level of care but prefer to receive services in their home or community. It can be used to pay family caregivers.

Does being paid as a family caregiver in Minnesota affect taxes?

Yes, as a paid worker, your income is generally taxable. When using a self-directed option like CDCS, a Financial Management Services (FMS) provider will handle payroll, tax withholding, and reporting on your behalf.