A goal that my clients bring up in meetings time after time is that they wish to stay in their own homes for as long as possible. Many people, however, find the cost of bringing help into their homes to be daunting. Elders are increasingly turning to their adult children for in-home care. As thanks, to reimburse the child for their time and expenses, or a combination of both, elders often wish to “pay” the child. But should the elder need nursing home care in the future, MassHealth will view informal payments as gifts, which could prevent the elder from receiving public assistance. So the question is, what is a family to do?
One solution is a “caregiver contract.” This is a written agreement between the elder(s) and their adult children, laying out tasks the child will perform and a rate of pay. Set up along with worker’s compensation and the usual payroll deductions, this provides an income stream to the caregiver while giving the parent what most elders want – being cared for by his or her own family.
Caregiver contracts benefit both parties. The caretaker child gets the benefit of worker’s compensation, in addition to reportable, reliable income for state and federal income tax purposes. (You may not think that’s a benefit – but paying taxes can be much better than the consequences of being discovered as delinquent!) The elder gets to remain in his or her home with a familiar caretaker, often at a rate much less expensive than those charged by home health agencies. Should the elder require MassHealth to pay for nursing home care, he or she can prove that the payments were just that – payments – and not gifts.
Only an elder law attorney familiar with the ever-changing MassHealth rules should draft a caregiver contract, so that it will protect the elder in the event he or she needs nursing home care in the future. If you believe a caregiver contract would be helpful to you, please do not hesitate to contact my office.