Q&A from Paid Family Caregiving Webinar

Find answers to questions from TDC’s June 2025 Webinar on Paid Family Caregiving, along with the slides used during the webinar below.

What does this law do?

The law formally prohibits TennCare and the Department of Disability and Aging (DDA) from making policies that limit the ability of family caregivers to be hired by a Medicaid-participating provider agency to take care of a loved one.

How do I enroll in the paid family caregiver program?

This law did not create a formal program or application for being paid to be a caregiver, so there’s no need to apply or enroll.

How should I get started?

First, you should contact your case manager at the MCO that facilitates your services. You can tell them about the law, and ask for a list of provider agencies in your area who might be willing to hire you. Next, you should contact those provider agencies and ask if they are willing to hire family caregivers. You can also tell them about the law here. If a provider agency is willing to hire you, you will go through that agency’s standard hiring and training procedures.

What kinds of services will I be paid to provide?

According to TennCare and DDA rules, you can be paid for services for which you’re “qualified” under their definitions.
Those are most likely to include non-medical services, such as personal assistance or supportive home care.
For more complex medical services, such as ventilator care or g-tube care, you would likely need to demonstrate a valid credential (such as a CNA certificate) in order to be paid for that service.

How do I get hired to be a paid family caregiver?

To be paid for care you provide to a family member, you need to get hired by a provider agency, who will assign you to your loved one’s services.
To be hired by a provider agency, you would likely need to make contact with them, confirm that they are hiring family caregivers (they are not required to by this law) and ask them to hire you.

What are the eligibility requirements?

Broadly, the person receiving care must be eligible for a TennCare Medicaid waiver program, such as ECF CHOICES, CHOICES, Katie Beckett, etc.
To be eligible, the person must qualify both medically and financially.
If the person receiving care is a dependent and/or minor, financial qualifications depend on the level of income and assets for their parents or guardians.
If the person receiving care is an adult, financial qualifications only apply to the person receiving care, and not their caregiver.

What if I’m a conservator?

Currently, a conservator must be explicitly allowed to be a paid caregiver in their conservatorship agreement.
The following is language provided by TennCare that they have said they would find appropriate for conservatorship documents:
- “If permitted through a waiver program administered or overseen by a state entity such as the Tennessee Department of Disability and Aging or Division of TennCare, the conservator may be a paid caregiver for Respondent; however, the rate of payment shall be in alignment with the allowable rules and regulations at the time of the provided service.”

What Medicaid programs are eligible?

The following Medicaid waiver programs are eligible: ECF CHOICES, CHOICES, Katie Beckett Part A and B, the Comprehensive Aggregate Cap Waiver, Statewide Waiver and Self-Determination Waiver.

What ages can the person receiving care be?

There are no age restrictions on the person receiving care, or the person providing care as a caregiver.

Are there financial requirements for the caregiver?

Financial requirements of the caregiver mostly apply to caregivers of dependent children, and those requirements are the same as the eligibility requirements for the dependent child to qualify for Medicaid (they are not different if the parent/guardian is being paid as a caregiver)
- Note: any income earned as a paid family caregiver will be counted towards eligibility of the dependent child.
There are some financial requirements for spousal caregivers of aging adults, such as limits on yearly income and asset caps.

Where can I find out if my loved one is Medicaid eligible?

Where can I find an agency to hire me?

Currently, the best way to find an agency that hires family caregivers is to ask your MCO case manager for a list of participating provider agencies in your area. Then you will have to contact those agencies to inquire about employment.