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Getting paid to care for a family member in Alabama

Yes. In Alabama, a family member can be paid to give care through Personal Choices. A spouse can be paid through Personal Choices.

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Medicaid waiver

Elderly and Disabled Waiver

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Who qualifies

People who meet the medical admission criteria for nursing facility care and who receive SSI, are deemed to receive SSI, receive State Supplementation or a State or Federal Adoption Subsidy, or qualify under the special income level of 300 percent of the SSI Federal Benefit Rate.

The waiver is a cooperative effort of the Alabama Medicaid Agency and the Alabama Department of Senior Services. Services can be denied if the person's health and safety is at risk in the community or if serving them on the waiver would cost more than nursing facility care.

Source: Alabama Administrative Code Chapter 560-X-36, Home- and Community-Based Services for the Elderly and Disabled (Alabama Medicaid Agency, effective June 12, 2023)Checked

Can a family member be paid

No. Not for the waiver's regular agency services. Alabama's rule says no payment will be made for personal care, respite or companion services furnished by a member of the recipient's family. Family can be paid through Personal Choices, the self-directed option below.

A personal care worker on the regular waiver must be employed by a certified home health agency or another agency the Alabama Medicaid Agency approves, and may not be a relative of the recipient.

Source: Alabama Administrative Code Chapter 560-X-36, Home- and Community-Based Services for the Elderly and Disabled (Alabama Medicaid Agency, effective June 12, 2023)Checked

Medicaid self-directed care

Personal Choices

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Who qualifies

People enrolled in one of Alabama Medicaid's Home and Community-Based Waiver programs. Personal Choices lets them use an allotted budget to hire someone to help with their care, or to save for equipment purchases, with a counselor to guide them.

The page lists Personal Choices contacts for the Elderly and Disabled, Alabama Community Transition (ACT), Technology Assisted (TA) for Adults, State of Alabama Independent Living (SAIL), Intellectual Disabilities (ID), Living at Home (LAH) and Community Waiver Program (CWP) waivers.

Source: Personal Choices (Alabama Medicaid Agency)Checked

Can a family member be paid

Yes. Yes, through Personal Choices. The Elderly and Disabled Waiver says relatives may be paid for waiver services whenever the relative is qualified to provide them, as permitted through the 1915(j) Personal Choices option.

Under the waiver's traditional agency personal care, a relative cannot be the paid worker.

Source: Application for 1915(c) HCBS Waiver AL.0068.R08.00, Elderly and Disabled Waiver, Appendix C-2 (Alabama Medicaid Agency, effective October 1, 2022)Checked

Can a spouse be paid

Yes. Yes, under Personal Choices, if the spouse meets the requirements of the Personal Choices option. Under traditional waiver personal care, a legally responsible individual such as a spouse may not provide personal care.

Alabama's Medicaid State Plan page on Self-Directed Personal Assistance Services (TN AL-20-0016, effective October 1, 2020) also says the state elects to permit participants to hire legally liable relatives as paid providers of the personal assistance services in their service plan and budget.

Source: Application for 1915(c) HCBS Waiver AL.0068.R08.00, Elderly and Disabled Waiver, Appendix C-2 (Alabama Medicaid Agency, effective October 1, 2022)Checked

How to apply

Elderly and Disabled Waiver

How to apply

Contact the Alabama Department of Senior Services for more information about the Elderly and Disabled Waiver.

Source: Elderly and Disabled Waiver handout (Alabama Medicaid Agency, released 9/14/22)Checked

Phone

1-800-243-5463

The Alabama Department of Senior Services.

Source: Elderly and Disabled Waiver handout (Alabama Medicaid Agency, released 9/14/22)Checked

Personal Choices

How to apply

Personal Choices is an option within your waiver. On the Elderly and Disabled, Alabama Community Transition (ACT) or Technology Assisted (TA) for Adults waivers, contact your local Area Agency on Aging. Counselors guide you through the process, including developing a budget for the funds designated for your care.

On the SAIL Waiver, contact the Alabama Department of Rehabilitation Services at 1-844-602-7245. On the ID, LAH or CWP waivers, contact the Alabama Department of Mental Health at 1-800-361-4491.

Source: Personal Choices (Alabama Medicaid Agency)Checked

Phone

1-877-425-2243

Your local Area Agency on Aging, for the Elderly and Disabled, ACT and TA for Adults waivers.

Source: Personal Choices (Alabama Medicaid Agency)Checked

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