What Goes into a Caregiver Contract?
September 21, 2009
If as a parent and child, you have agreed that the child will care for her parent in exchange for compensation, you need to work with an elder law attorney to draft a caregiver contract, as discussed in earlier posts.
What will your attorney put into the contract? She will list details of the care to be provided, ranging from the hands-on care, meal preparation, shopping, laundry, to the right to a private room and evening quiet hours. Most likely, the attorney will bring in a geriatric care manager to develop a thorough care plan, and the attorney will incorporate the terms of that plan into the contract.
Rate of pay will be included. Can you just ask your parent to pay whatever salary you would like? No. The rate will be based on comparable work performed by professional agencies in your geographic area, such as home health care agencies.
The attorney will also help you arrange for the appropriate payroll deductions, such as Social Security and worker’s compensation.
Beware of trying to write a caregiver contract on your own – this contract will very likely be scrutinized in the future by MassHealth, Social Security, and the IRS. Avoid issues with these agencies later by working with an elder law attorney now to draft an appropriate contract.
Paying Your Children to Care for You? Put it in Writing.
August 30, 2009
As they need more help with daily tasks, many parents prefer to have their kids helping them rather than hiring an aide. And many children want to be helping their parents, if only they could afford to quit their job.
One solution is for the parent to hire the child. I discuss some of the nuts and bolts of how to draft a caregiver contract in another post. I also previously discussed the advantages of caregiver contract in a down economy.
The message for this post is that if you plan to hire your child, or if you plan to work for your parents, everything must be in writing. If the parent eventually needs to apply for MassHealth, your chances of having the application approved significantly increase if the agreement was in writing during all those years that the child provided care. If it is not in writing, MassHealth may well declare that any money passing from the parent to the child was a gift – and a gift disqualifies a person from receiving MassHealth assistance.
Working with an elder law attorney will improve your chances of having the agreement approved by MassHealth, because an elder law attorney understands what needs to be in the contract not only to satisfy MassHealth, but also to help you comply with Social Security laws, income tax regulations, and employment laws.
Rising Unemployment Means Rising Uninsured
January 12, 2009
Rising numbers of unemployment inevitably lead to a significant number of people losing their employer sponsored health insurance. Where do these people turn for insurance? States provide Medicaid for people who meet their income and asset requirements. Medicaid is much more generous with children, even the children of parents who themselves have too much money or assets to qualify. So hopefully most kids will still have coverage. But what about the adults?
The Kaiser Family Foundation, a nonprofit that does extensive nonpartisan, high quality research into health care finance matters, including Medicare, Medicaid, and private insurance, recently released a daunting report. Their figures estimate in 2009, 5.9 people will lose their employer coverage, Medicaid and SCHIP (for kids) will pick up 2.4 million, and 2.6 million people will remain uninsured. State governments provide some assistance to hospitals who treat uninsured, but of course with declining tax revenues, there will be less funding available for such reimbursement (the “compensated care pool.”)
Where will the funding come from to cover the 2.4 million new MassHealth and SCHIP enrollees? And what about increasing funding to cover more of the people left uninsured? Medicaid (and Medicare) already make up unwieldy percentages of state and federal budgets. President Obama and his team have announced that they will take on these programs. It will be a difficult but very worthy project. I expect that NAELA, the organization supporting the nation’s elder law and disability law attorneys, will provide leadership on this issue. Our organization has many individuals well schooled in these issues and passionate about redesigning the health care system to make it serve more people more effectively.