How to Get Paid as a Family Caregiver in Missouri

Family caregivers provide vital support for adults with chronic, disabling, or serious health conditions. In the United States, 38 million people take on this role (AARP 2021), offering crucial physical and emotional care to spouses, parents, and even friends or neighbors. Despite their invaluable contributions, many family caregivers face significant financial challenges, spending about $7,200 annually out of pocket for caregiving expenses, while trying to manage their time and energy. Fortunately, various programs are available that may offer financial relief and support. This guide will explore specific options in Missouri to help you navigate potential pathways for support and compensation.

Get Paid Through Missouri Medicaid

Medicaid is a joint federal and state program that provides health coverage to eligible low-income individuals. This includes families, seniors, and people with disabilities.

Many states offer extra services through Medicaid waiver programs, which allow them to expand support to specific groups in the community, like those needing long-term care. In Missouri, there are several waivers that can help family caregivers get paid for taking care of their loved ones.

Adult Day Care Waiver: Provides adult day care services to individuals with physical or other disabilities ages 18-63 who meet a nursing facility level of care.
Aged and Disabled Waiver: Offers adult day care, basic respite, homemaker, advanced respite, chore, and home-delivered meals to individuals ages 65 or older and individuals with physical disabilities ages 63-64 who meet a nursing facility level of care.
AIDS Waiver: Provides waiver personal care, attendant care, and specialized medical supplies to individuals with HIV/AIDS ages 21 or older who meet a nursing facility level of care.
Brain Injury Waiver: Offers personal care services, applied behavior analysis, assistive technology, cognitive rehabilitation therapy, environmental access and modification, neuropsychological evaluation, occupational therapy, physical therapy, and speech therapy services to individuals with brain injury ages 21-65 who meet a nursing facility level of care.
Children with Developmental Disabilities (MOCDD) Waiver: Provides a range of services including day habilitation, in-home respite, personal assistant services, and more to individuals with intellectual or developmental disabilities ages 0-17 who meet an ICF/IID level of care.
Developmental Disabilities (DD) Comprehensive Waiver: Offers extensive services such as day habilitation, group home, in-home respite, and more to individuals with intellectual or developmental disabilities ages 0 or older who meet an ICF/IID level of care. This waiver operates with a concurrent 1915(b)(4) authority.
Division of Developmental Disabilities (DD) Community Support Waiver: Provides services like day habilitation, in-home respite, personal assistant, and more to individuals with intellectual or developmental disabilities ages 0 or older who meet an ICF/IID level of care.
Independent Living Waiver: Offers case management, personal care, financial management services, environmental accessibility adaptations, and specialized medical equipment and supplies to individuals with physical disabilities ages 18-64 who meet a nursing facility level of care.
Medically Fragile Adult Waiver: Provides waiver attendant care, private duty nursing, and specialized medical supplies to individuals who are medically fragile ages 21 or older and individuals with developmental disabilities ages 21 or older who meet an ICF/IID level of care.
Partnership for Hope Waiver: Offers services such as day habilitation, personal assistant services, prevocational services, and more to individuals with autism, intellectual disabilities, or developmental disabilities ages 0 or older who meet an ICF/IID level of care.
Structured Family Caregiving Waiver: Provides structured family caregiving services to individuals ages 65 or older and individuals with other disabilities ages 21-64 who meet a nursing facility level of care.

Medicaid waiver programs can change over time. Please visit the official Missouri Medicaid website or contact the Missouri Department of Health and Human Services directly to verify the most current details around waiver eligibility, caregiver compensation, and application requirements.

Process to Get Paid

Getting paid as a caregiver in Missouri generally follows this process:

Check Eligibility: The care recipient must be eligible for Medicaid and meet the requirements for one of the Medicaid waiver programs.
Apply for Medicaid: The care recipient should complete the Medicaid application process through the Missouri Department of Health and Human Services.
Assessment: The Department of Health and Human Services will conduct a functional assessment to determine the level of care needed.
Enroll in a Waiver Program: Once eligibility is confirmed, enroll in the appropriate waiver program (e.g., Aged and Disabled Waiver, Brain Injury Waiver).
Select and Train Caregivers: The care recipient or their representative can select and train family caregivers.

Pay Rates

The average pay rate for caregivers in Missouri is generally around $16.00 per hour.

Veteran’s Benefits

Veterans and their families have access to several programs through the U.S. Department of Veterans Affairs (VA), intended to support caregivers. If you're caring for a veteran, these benefits can provide crucial financial assistance and resources.

The Program of Comprehensive Assistance for Family Caregiver

This program offers a monthly stipend directly to caregivers of veterans who sustained or aggravated a serious injury or illness during military service. To qualify, the veteran must have a VA disability rating of 70% or higher and need personal care services for at least six months. The stipend ranges from $1,750 to $3,000, reimbursed directly to the caregiver and depends on the locality and level of support the veteran needs. To find out more on how to enroll, visit caregiver.va.gov or call the VA Caregiver Support Line at 1-855-260-3274.

Veteran Aid & Attendance and Housebound Allowance Benefit

Veterans and surviving spouses receiving a VA Pension may qualify for additional financial support through Aid and Attendance or Housebound benefits. These benefits are provided on top of the monthly pension and can be used to pay for in-home care, assisted living, or nursing home costs.

Aid and Attendance (A&A) increases the monthly pay rate for those needing help with daily activities like bathing, dressing, and feeding.
Housebound Allowance increases the pay rate for those who are substantially confined to their homes due to a permanent disability.
The pay ranges based on you and your spouse’s veteran status and if you have dependents (Learn more here). You cannot receive both benefits at the same time. For more information on enrollment, visit here.

Veteran-Directed Home & Community Based Care

This program provides veterans of all ages with a flexible budget to access home and community-based services. Veterans, or their family caregivers, can manage these funds to create a personalized care plan, allowing them to live independently at home or in their communities. For more information, visit: acl.gov.

Other Ways to Get Paid

Tax Credits

The Child Tax Credit allows you to claim up to $2,000 per child off your taxes owed if you have any qualifying children who lived in your home for at least half of the year, are your dependents, and are under the age of 17 by the end of the year.
The Credit for Other Dependents allows you to claim up to $500 for any dependents under your care (including parents and other relatives) if they live with you and rely on you for financial support.
The Child and Dependent Care Credit can be claimed if you pay someone to care for a child under 13 or a dependent of any age who is incapable of self-care. The purpose of the care must be to allow you (and your spouse, if filing jointly) to work or look for work. The amount of the credit is a percentage of your expenses, determined by your income.

Long-term Care Insurance

Some long-term care insurance policies offer the option to compensate family members as caregivers, providing a potential source of financial support. However, coverage can vary significantly between policies. It's important to carefully review the terms to understand whether in-home care and payments to informal caregivers, like family members, are included.

Employer-Sponsored Leave

Some employers may have sponsored leave for those leaving work to take care of their relatives. Check with your HR Department to see if this benefit is offered to you. Additionally, employees can take unpaid leave with job protection through The Family and Medical Leave Act, which allows employees to take up to 12 weeks of unpaid leave per year to care for a family member with a serious health condition.

Resources

Here are some useful resources for caregivers in Missouri:

Missouri Family Caregiver Support Program: Provides information on support programs for family caregivers, including respite care, counseling, and training.
Missouri Caregiver Program: Supports caregivers of persons with Alzheimer’s disease and related dementias through education, respite care, and assistive technology services.
Missouri Medicaid Waivers: Offers information on the Medicaid Waivers available in Missouri.
Area Agencies on Aging: Provides contact information for local Area Agencies on Aging in Missouri, which offer various support services for caregivers.