Family caregivers could provide Medicaid home care with federal approval

Pennsylvania would run a Medicaid program allowing certified family caregivers to provide home care through home health agencies. Recipients must meet any listed criterion: being under 21, qualifying for private nursing care, or medically needing both services. Family caregivers include relatives, legal guardians, and people with ties like family. Federal approval would be required, and parents or guardians and providers could choose whether to participate. Caregivers would work under a registered nurse, and their services would supplement private nursing care. The program would be established within one year after the program section takes effect, subject to federal approval.

Participating home health agencies would pay family caregivers' certification costs and receive at least $45 per hour for covered care. These rules would cover family caregivers and their employing agencies under the federally approved program. Caregivers would complete 75 hours of training and a skills evaluation. Agencies could not require caregivers to repay certification costs. The $45 minimum would go to the agency; it would not set the caregiver's wage. Agencies would pay certification costs before care begins. When Medicaid requires a home visit, a registered nurse would conduct it every 30 days.

Pennsylvania would seek federal permission to leave program caregiver earnings out when counting family income. The request would cover earnings from employment as a certified family caregiver in this program. Leaving these earnings out of income calculations would require federal approval.