Massachusetts Caregiver Programs: Which Ones Pay a Family Member

If you're caring for an aging parent or spouse in Massachusetts, more help exists than most families realize, spread across four programs run by three different agencies.

That spread is exactly why this feels harder than it should. This guide sorts the Massachusetts caregiver programs by what each actually does: two MassHealth programs that pay a family member to provide care, a Family Caregiver Support Program that funds respite and counseling for unpaid caregivers, and Paid Family and Medical Leave that protects your job during a crisis. It ends with the one number to call to get started.

In This Guide

• How Massachusetts caregiver help is organized
• Massachusetts caregiver programs that pay a family member
• Massachusetts caregiver programs that support unpaid caregivers
• Job leave: Paid Family and Medical Leave
• Where to start

How Massachusetts Caregiver Programs Are Organized

The reason this feels confusing is that help comes through two different systems, and they answer two different questions.1 If your question is "can I be paid to provide this care," the answer runs through MassHealth, the state Medicaid program, which funds the paid-caregiving pathways. If your question is "how do I get a break, some training, or someone to talk to," the answer runs through the Executive Office of Aging & Independence and your local Aging Services Access Point (ASAP), which deliver unpaid-caregiver support. Figure out which question you are asking first, and the rest gets simpler.

Massachusetts Caregiver Programs That Pay a Family Member

Here is the question almost every family asks first: can the state pay me for the care I am already giving? If the person you care for has MassHealth, often the answer is yes, through one of two programs.1,2

• Personal Care Attendant (PCA) program: self-directed care where the MassHealth member hires and directs their own attendants, paid an hourly wage by MassHealth. The member works with a Personal Care Management (PCM) agency for the functional evaluation and a fiscal intermediary that handles payroll. Many relatives can be hired; a spouse and any legally responsible relative cannot. It is an entitlement, so there is no waitlist.1
• Adult Foster Care (AFC) and Group Adult Foster Care (GAFC): AFC pays a live-in caregiver a tax-free monthly stipend for daily care, with agency nursing oversight. It requires the member to have a clinical need for help with activities of daily living, and it does not pay for room and board. Under AFC a relative can serve, with the same exception (not a spouse or the parent of a minor); GAFC is the version for members in a congregate setting such as assisted living.2

How much do they pay? The exact amount is not a single published number. The PCA hourly wage is set under the statewide MassHealth PCA collective-bargaining agreement, and the AFC stipend depends on the member's assessed care level (Level I or Level II) and the AFC agency.1,2 For the current figure, ask the PCM or AFC agency directly, or call MassOptions to be referred to one. For the full walkthrough, see our guide to how to get paid to care for a family member in Massachusetts.

If you are the spouse. This is the exclusion that catches families off guard: if you're the husband, wife, or (for a minor) parent of the person you care for, neither paid program can pay you. That is a federal Medicaid rule, not a Massachusetts choice.1,2 You still have real options. Another relative, an adult child or a sibling, can be hired as the paid PCA or AFC caregiver, and the Family Caregiver Support Program below can fund respite, counseling, and training for you directly.3

If the person you care for does not have MassHealth. Both paid programs run through MassHealth, so if the person you care for is not enrolled, start there: see whether they qualify (our MassHealth guide walks through the income and asset limits). In the meantime, the Family Caregiver Support Program and Paid Family and Medical Leave are both open to you without MassHealth.3,4

Massachusetts Caregiver Programs That Support Unpaid Caregivers

Not every kind of help is a paycheck, and the exhaustion of caregiving is real whether or not anyone is paying you for it. The Family Caregiver Support Program is the main support program, funded under the federal Older Americans Act (as its National Family Caregiver Support Program) and run through your local ASAP.3 It provides:

• Respite care so you can rest, work, or attend to your own needs;
• Counseling and support groups for the emotional weight of caregiving;
• Caregiver training to build skills and confidence; and
• Information and referral to find your way to other services.

The Family Caregiver Support Program serves caregivers of adults 60 and older (and grandparents or older relatives raising children), and it is not tied to MassHealth eligibility. For respite specifically, see our guide to respite care in Massachusetts.

Job Leave: Massachusetts Paid Family and Medical Leave

If you're working and need time off to care for a family member, the fear is usually the same: will I lose my job? In Massachusetts, Paid Family and Medical Leave (PFML) exists for exactly this moment. It gives most Massachusetts workers up to 12 weeks of job-protected, partially paid leave in a benefit year to care for a family member with a serious health condition.4 It is funded through a shared employer and employee payroll contribution, not by MassHealth, and it replaces a portion of your wages rather than paying an ongoing caregiver wage. It is the program that lets a working caregiver step back during a crisis without losing their position. Apply through the Massachusetts Department of Family and Medical Leave (DFML).4

Where to Start

You don't have to figure out which program fits on your own, and you don't have to have it all sorted before you make the first call.1

Learn More

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.