State Home Aide programs are designed to help people with disabilities stay in their homes instead of moving to nursing homes.
This program provides free home aides or care attendants, along with a variety of other services. If someone is already caring for you, the state home aide program may provide a salary for that person.
These programs are called different things in different states. They may be called a “waiver programs” or “medicaid long-term care” or “home and community based services” something else. If you have too much money to qualify for Medicaid, you may still qualify for this program.
Services are different in every state. Here’s a common ones:
🌷Home aides for personal care (dressing, bathing, eating, etc)
🌷Most programs also provide household care (shopping, cooking, cleaning, driving to doctor’s appointments, etc).
🌷 Some states offer other benefits, such as home modifications, assistive technology, home delivered meals, dental care, and transportation.
🌷 Home aide hours are often 20-30 hours per week. Can be higher for severe needs.
🌷 All states have self-directed options. After you are approved, you can select a caregiver through an agency or select the person of your choice. Many people select a friend, neighbor, or family member to be their aide.
Where to apply
Here’s where: How to Find Home Aide Programs in Your State
Financial criteria is different in every state. However, most people are able to qualify, even if they have income or savings. If you have too much money to qualify for Medicaid or if you are being given a high spend down or share-of-cost, or if anyone tells you that you cannot qualify financially, see this page: How to Apply for a Medicaid Waiver When You Have Too Much Money.
To qualify for this program, you will need to show that you have a certain level of care needs. It does not matter what your diagnosis is.
💠 Here’s an overview of the criteria to qualify and what happens during a Screening interview for State Home Aides
💠 Here’s a few Sample Policies for Qualifying for State Home Aides.
Do I need to be on Disability?
Depends on your state. In most states, you can apply even if you were turned down or you are still applying for disability. A few states require SSA approval, or require that you be screened by the state Medicaid program to see if they consider you disabled.
“Someone Said I Can’t Apply”
Some people start this process by calling Medicaid or another agency. Then the person who answers the phone tells them something, and whatever that something is, it causes the people to hang up and never apply! Don’t do this! People are often turned away or given wrong information over the phone. Here’s How to Respond When Someone Tells You That You Can’t Get in a Medicaid Program.
“I called my Department of Social Services and Medicaid for FOUR YEARS and asked to apply for a Medicaid Waiver for my daughter. Every time they discouraged me and told me my daughter would not qualify. Finally, I insisted on an appointment with a nurse for screening. After the interview, she told me my daughter definitely qualified, and she should have applied years ago.”
💠 You have an interview with Medicaid (can be in your home or over the phone).
💠 Your doctor fills out a form. (Please talk to your doctor before this happens!)
💠 You fill out financial forms (if you are already on Medicaid, this step is skipped)
How does it work? How hard is it to get approved?
Real life stories from people with ME, Lyme and other chronic illnesses who are in this program. What worked, how they got in, and what kind of help they are now getting: How I Got Approved for a Home Aide
Can they provide childcare or help for my family?
No. They cannot care for your kids. They cannot shop, cook or clean for anyone else in your home. The services are only for you. If your child is disabled, in some states your child can get his or her own home aides.
How Many Hours Per Week? How long to get approved?
Varies quite a bit. Here’s how it worked for others: How Did You Get Home Care? (Survey Results)
Who will be my caregiver?
You have a choice: Agency care (they send an aide from an agency) or Self-Directed care (you choose and hire the person you want). There are pros and cons both ways. Learn more: How to Decide: Agency Care or Self-Directed Care
What are other people doing? What works and what doesn’t? Great stories and great advice: Do You Hire Your Own Home Aides? Or Use an Agency?
Some states allow spouses to be aides. Here’s a list of States That Allow Spouses as Aides
Parents are allowed to be aides for adult children. A few states allow parents to be aides for minor children. This is common in California and some parents of children with disabilities relocate to California for this reason.
“I Have More Questions”
Here’s some Facebook Groups for People in Medicaid Home Care. Learn from the real experts.
Extra Special Benefits
💠 If you are in a waiver program Extra Benefits and Services for People in State Home Care Programs
💠 If you have a live-in aide: Extra Benefits and Services if You Have a Live-In Caregiver
If you get turned down or run into a problem
💠 If you have looked at the regulations and you agree that you do not meet the criteria, you may be able to find other kinds of assistance here: Other Programs that Provide Caregivers. Other programs may provide less hours, less services, and won’t be available in all areas.
💠 If you think that you might qualify, but someone tells you that you cannot apply, ignore what you are told and research the regs yourself. The people who work at Medicaid often tell people the wrong thing.
💠 No matter what happens, if you feel that you qualify: Never Take No for an Answer Over the Phone. It is common for people to call and be told they are not eligible or cannot even apply when it isn’t true. Always request that the denial be made in writing and ask to be given information on your rights to appeal.
💠It is also common for people to be sent to the wrong program. Make sure you request to speak to someone who screens applicants in Medicaid Waivers and Medicaid Long Term Care. Use the links above to find the name of the specific program you want to apply for.
💠 If you get turned down and wish to appeal, you do not need a lawyer to appeal. You can do it yourself. If you would like a lawyer, do not bother contacting disability lawyers, as they will not know anything in this area. In some cases, you may be able to get assistance through your state’s disability rights legal organization and/or through your local nonprofit poverty legal programs.
💠 You can also contact nonprofit disability rights legal organizations in your state. Also contact your local Center for Independent Living and ask if they have an advocate or lawyer who can help you.
ADAPT is a national grassroots community group that organizes disability rights activists. They also have several Facebook groups. Many ADAPT members are in medicaid waiver and caregiver programs and they work to protect and expand these programs.
What Do You Think?
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Updated May 2018. If you found this page helpful, please share it with others by pressing one of these magic little buttons: