How to become a paid caregiver for a family member

How to become a caregiver for a family member and get paid

If you want to become a caregiver for a family member and be paid for it, start by flipping the question around. You don't apply for a job; your relative applies for a benefit. When their state's Medicaid program approves home care, and lets them choose who gives it, they choose you. That is how nearly every family caregiver in the country gets on payroll.

So there are really two applications. Your relative's is the Medicaid and home care application. Yours is the short set of hiring forms that follows. Understanding that order saves weeks of calling the wrong office. The full picture of how the money flows is in how to get paid to care for a family member.

1. Your relative qualifies for Medicaid on income, assets and need for help with daily activities.
2. An assessor sets the hours your relative needs each week.
3. Your relative picks the self-directed option — often called consumer-directed care — and names you.
4. You enroll with the payroll agency (a fiscal intermediary), pass a background check and start logging hours.

Caregiver requirements and qualifications

People worry that they need nursing school. For self-directed programs, the caregiver requirements are close to what any employer asks. Typical caregiver qualifications look like this:

Those are the medicaid caregiver requirements you'll meet in most states. The bigger question is the relationship rule: spouses and parents of minor children are "legally responsible relatives," and many programs limit paying them. See spousal caregiver rules and paid parent caregivers, or check a specific state such as Minnesota's spouse rules.

How to apply to be a caregiver for a family member

When you apply to be a caregiver for a family member, the paperwork comes in a set order. Families who search "apply for caregiver for family member" or "sign up to be a caregiver" are usually looking for the second half of it, but the first half has to happen first.

Step 1: The Medicaid caregiver application (your relative's)

The medicaid caregiver application is really your relative's Medicaid application plus a request for home care. It is filed with the state Medicaid agency, the county social services office or the Area Agency on Aging, depending on the state. If your relative is already on Medicaid, they skip straight to asking for a home care assessment. This is what people mean when they search apply for home care, apply for home health care, a home care application or a home health care application.

Step 2: Caregiver applications (yours)

Once your relative is approved and names you, you fill in the caregiver applications: the payroll agency's enrollment packet, a background check release, an I-9, a W-4 and direct deposit. In some states you also sign a provider agreement with the state. Ask whether the agency has an online portal — many do.

State caregiver applications: Michigan, Ohio, Oregon, Georgia and California

Each state names its forms differently. A few that families ask about most:

• Michigan Home Help application: your relative contacts the county MDHHS office to apply for the Home Help Program and request an adult-services assessment. You then enroll as an individual provider in the state's CHAMPS system, with a background check. See the Michigan caregiver program.
• Ohio caregiver application: your relative applies for Ohio Medicaid through the Ohio Benefits portal or county Job and Family Services and answers yes to the long-term care question; PASSPORT screening goes through the Area Agency on Aging. See the Ohio caregiver program and Franklin County.
• Oregon caregiver application: your relative asks the local Area Agency on Aging or APD office for an assessment. To be paid as a homecare worker, you complete the Oregon Home Care Commission's enrollment, which includes a background check and orientation. See the Oregon caregiver program.
• Caregiver for family member in Georgia: the main route is Structured Family Caregiving, which requires you to live with your relative and enroll through a licensed SFC provider agency. See the Georgia caregiver program.
• California: IHSS providers attend a county provider orientation, submit the provider enrollment form, sign the provider agreement and complete a Department of Justice fingerprint background check. See IHSS and Los Angeles County.

Every state's own steps are on its page — start from the list of states or check eligibility to see which program fits your relative.

Do you need to become a certified caregiver?

Usually not. If you're hired through a self-directed program, you don't need to become a certified caregiver first. The person you care for is your employer, and they decide what training you need — which, for a relative you've been helping for years, is often very little.

A certified caregiver credential matters in three situations: when a home care agency employs you, when the service is skilled home health billed to Medicare or Medicaid, and when a specific waiver requires it. Colorado's Family CNA pathway, for example, pays parents as certified nursing assistants through a home health agency — see the Colorado caregiver program.

Is there a caregiving license? Caregiver license California rules

There is no national caregiving license for family caregivers. States license *agencies*, and some keep registries of the aides those agencies employ.

California is the example people search most. The caregiver license California families ask about is usually the state's Home Care Aide Registry, run by the Department of Social Services, which requires a criminal background check before an aide is approved. That applies to aides working in private home care. IHSS providers — including relatives — enroll through the county IHSS program instead, with its own orientation and fingerprint check. See the California caregiver program and California caregiver pay.

Becoming a home health aide for a family member

Some families prefer a more formal role: becoming a home health aide for a family member through an agency. The agency hires you, trains you if needed, and assigns you to your own relative. This is how home health aide for family member arrangements usually work when a state's program runs through agencies rather than self-direction. An HHA for family member care is paid on the agency's payroll.

To become a home health aide at a Medicare-certified agency, federal rules require at least 75 hours of classroom and supervised practical training, including at least 16 hours of supervised practical training, plus a competency check and 12 hours of in-service training each year. Non-medical home care and self-directed programs don't carry that federal requirement.

Become a home health aide: family member rules

If you want to join an agency's staff to care for your relative, you'll apply for home health aide work through the agency's home health application, then ask three things: whether it hires relatives, whether it pays for your training, and whether your relative's program lets an agency be used. Our guide to home care agencies that hire family members walks through it, and what a home health aide does explains the job itself.

Whatever the title — a home health aide for family, a home health care aide for family member care, a home care aide for family member needs or a home health aide for relative care — the paycheck comes from the same Medicaid money.

Becoming a PCA for a family member

PCA means personal care assistant or attendant. In many states, becoming a PCA for a family member is the self-directed route by another name: Massachusetts' PCA Program lets the member hire their own attendant, and Minnesota's CFSS does the same. A PCA for family member care usually needs no certificate — just enrollment, a background check and whatever orientation the program sets.

For state details, see Massachusetts caregiver pay and the Minnesota caregiver program.

Caregiver training programs: when training is required and who pays

Training is useful even when it isn't required, and it's often free. There are three kinds of caregiver training program you'll come across.

Many agencies offer caregiver paid training: they cover the course and sometimes pay your hours while you train, because they need aides. A home health aide program or home care aide program run by an agency is the usual source of this. Searches like "paid pca training near me" and "free caregiver training programs near me" usually lead to these agency programs or to your local Area Agency on Aging.

Florida is one state that has a family home health aide program by name — its Family Home Health Aide option lets a parent of a medically complex child be paid as a trained aide. See the Florida caregiver program.

Caregiver training for family members

Free caregiver training for family members is widely available. Oregon, for instance, funds free classes for anyone caring for an older adult through Oregon Care Partners. Caregivers training on transfers, dementia and medication safety makes the work safer for both of you, and home caregiver training can also help if your relative's needs grow. See family caregiver support programs and respite care.

The needs assessment: how to prepare

The assessment decides how many hours you'll be paid for. A nurse or caseworker visits (or calls) and scores how much help your relative needs with bathing, dressing, eating, toileting, moving around, medications and household tasks.

1. Keep a care log for one to two weeks before the visit. Write down every task and how long it takes.
2. Describe a typical bad day. People downplay their needs in front of strangers. Be honest about falls, confusion and nights.
3. Gather records: diagnoses, medication list, recent hospital stays and any therapy notes.
4. Be in the room. Your relative can speak for themselves, but you know what the nights look like.
5. Ask how to appeal if the hours come back too low. Every program has an appeal process.

Hours drive pay far more than the hourly rate. See family caregiver pay rates for what each state reports.

Becoming a caregiver for a parent

Adult children are the largest group of paid family caregivers. Becoming a caregiver for a parent follows the steps above, and in almost every state adult children can be hired. Becoming a caregiver for your parents when you live apart is usually fine; some daily-stipend programs, like Structured Family Caregiving, require you to live together.

For the bigger picture — money, housing and siblings — see caring for aging parents.

"I want to be a caregiver" — for family or as a job

Some readers aren't caring for a relative yet. If your thought is "I want to be a caregiver" or "I want to become a caregiver" for other families, the path is different: you apply to agencies or find private clients. Our caregiver jobs guide covers pay, training and where the openings are.

People type the question in every order — even "caregiver how to become" — but the choice is the same: become a caregiver for your own relative through a Medicaid caregiver program for family member care, or become a home care provider for the public. Some go on to start a home care agency.

If the family route is yours, you become a family caregiver on payroll the day the payroll agency finishes your enrollment.

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