How to Get Paid as a Family Caregiver in Texas

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 Texas to help you navigate potential pathways for support and compensation.

Get Paid Through Texas 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 Texas, there are several waivers that can help family caregivers get paid for taking care of their loved ones.

Community Living Assistance & Support Services (CLASS) Waiver: This program offers a wide range of services such as case management, residential habilitation, and respite care to individuals with developmental disabilities of any age who meet an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care.
Deaf Blind with Multiple Disabilities Waiver: Provides comprehensive support including case management, residential habilitation, and supported employment for individuals with developmental disabilities of any age who meet an ICF/IID level of care.
Home and Community-Based Services (HCS) Program Waiver: Offers services like employment readiness, respite, and residential assistance to individuals with intellectual or developmental disabilities of any age who meet an ICF/IID level of care.
Home Living Program Waiver: This waiver provides day habilitation, employment readiness, and respite services to individuals with intellectual or developmental disabilities of any age who meet an ICF/IID level of care.
Medically Dependent Children Program (MDCP) Waiver: Tailored for medically fragile children ages 0-20 years, this program provides respite, supported employment, and flexible family support services for those who meet a hospital or nursing facility level of care.
Youth Empowerment Services (YES) Waiver: Designed for individuals ages 3-18 years with serious emotional disturbances, offering respite, community living supports, and specialized therapies for those who meet a hospital level of care.

Medicaid waiver programs can change over time. Please visit the official Texas Medicaid website or contact the Texas 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 Texas 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 Texas Health and Human Services Commission (HHSC).
Assessment: HHSC 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., CLASS Waiver, HCS Program 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 Texas is generally around $12.90 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 Texas:

Texas Health and Human Services Commission (HHSC): Provides information for health services in Texas.
Texas Medicaid Waiver Programs: Offers information on Medicaid waivers available in Texas.
Area Agency on Aging Texas: Provides contact information for the local Area Agencies on Aging in Texas.