How to Get Paid as a Family Caregiver in New Jersey (2026)

If you're a family caregiver in New Jersey, you may be able to get paid for the care you're already giving. Unlike many of its neighbors, New Jersey does not ban paying a spouse outright, though that question goes to your health plan. The work you do, often around the clock and largely unseen, is work that several public programs will compensate, whether you're caring for an aging parent, a spouse, or a disabled adult. The most important door is the NJ FamilyCare Personal Preference Program (PPP): inside it, an adult child, a sibling, a niece, a friend, or a neighbor can be hired and paid as the Medicaid-enrolled person's Personal Care Assistant, and a spouse is the case to put to the health plan. This guide walks through every legitimate 2026 pathway that pays a family member in New Jersey, the surprisingly liberal rule that makes the spouse pathway possible, and how to stack PPP with state respite, VA benefits, and Family Leave Insurance when one program isn't enough.

The 60-second version

If you are caring for a New Jersey adult who needs nursing-facility-level help at home, the most direct paid path is the Personal Preference Program (PPP) inside NJ FamilyCare MLTSS. Your loved one applies for NJ FamilyCare MLTSS, picks one of the six health plans DMAHS lists (Aetna Better Health of New Jersey, Aetna Assure Premier Plus, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan, or Wellpoint), gets assessed for nursing-facility level of care, asks the Care Manager for PPP enrollment, and hires you as a paid Personal Care Assistant through the assigned Fiscal Intermediary.

If you are a spouse, PPP is the route to ask about, and it is worth asking: Pennsylvania, Ohio, and several other states prohibit spouse-pay outright. NJAC 10:60-3.8(b) excepts the personal preference program from New Jersey's family-member bar, but the same subsection grants no exceptions for legally responsible relatives, a spouse or legal guardian of an adult or a parent or legal guardian of a minor child. Put the spouse question to the MCO rather than treating it as settled either way.

If your loved one is age 60+ with countable income at or below 365% FPL ($4,855/month single in 2026) and is not enrolled in MLTSS, Jersey Assistance for Community Caregiving (JACC) can pay a relative as a "qualified participant-employed provider," up to $1,090/month in services plus an income-based sliding-scale copay. Verify spouse eligibility county-by-county at the ADRC.1

If your loved one is a wartime veteran, the Aid & Attendance supplement to VA Pension pays a veteran with no dependents who qualifies for A&A up to $29,093 a year in 2026, about $2,424/month, money they can use to pay you privately. Eligible 70%+ service-connected veterans can also unlock a PCAFC monthly stipend (a tax-free amount set by the veteran's federal pay-locality, not a flat figure) and a VA Veteran Directed Care (VDC) self-directed budget the veteran can spend on a family caregiver.1,2

If you work in NJ and need leave to care for a family member, Family Leave Insurance (FLI) replaces 85% of your wages up to $1,119/week for up to 12 weeks per 12-month period, funded entirely by employee contributions in 2026.1

The details, and the catches, are below.

The New Jersey paid family caregiver pathway map

Take a breath before you read this: you do not have to understand all seven of these to start. Each row is a separate door, and most families only walk through one or two. Here is how they compare.

Many NJ households combine three or four. A common veteran-caregiver stack: A&A + PCAFC + FLI for the working spouse. A common civilian stack: PPP + FLI + Wounded Warrior credit (when applicable) + Earned Sick & Safe Days.

The rule that lets a family member be paid: the PPP exception in NJAC 10:60-3.8(b)

If you take one thing from this guide, take this: the rule that makes family pay possible lives inside NJAC 10:60-3.8(b). That subsection says that, except as specified under the personal preference program, personal care assistant services provided by a family member are not covered services and are not reimbursed by NJ FamilyCare Plans B and C, and that no exceptions will be granted for legally responsible relatives, defined there as a spouse or legal guardian of an adult, or a parent or legal guardian of a minor child. So the program carve-out and the legally-responsible-relative sentence sit side by side in the same rule. Inside PPP, the consumer is the common-law employer and hires the worker, provided the worker is at least 18, passes a criminal background check, and completes orientation.1

What that means in practice:

• An adult child, a parent of an adult recipient, a sibling, a niece, a nephew, an in-law, a grandchild, a friend, or an unrelated neighbor is the clear case. The state's PPP page tells participants they may hire workers "including trusted individuals like friends, relatives, or neighbors."1
• A spouse, a legal guardian of an adult, and a parent or legal guardian of a minor child are the people named in the legally-responsible-relative sentence. Whether one of them can be hired under PPP is a question for the managed care organization administering the enrollment, and its answer is what governs in practice, so get it before you plan around the income.1
• A worker under 18 cannot be hired.
• A worker who has not passed background checks cannot be hired.

It helps to see how NJ sits against its neighbors. Pennsylvania bans spouse-pay outright. Ohio does not allow spouse-pay through PASSPORT. New York's CDPAP does allow spouse-pay (after the 2024 reauthorization). Maryland's Community First Choice does. New Jersey is on the more permissive end of the national distribution, and a growing share of NJ FamilyCare's MLTSS population is using PPP for exactly that reason.

The mechanics, the cap and the operational steps, are below.

Pathway 1: The main door, Personal Preference Program (PPP) within MLTSS

PPP is the single most important program in this guide. It is the participant-directed (consumer-directed) option inside NJ FamilyCare's Managed Long-Term Services and Supports, what NJ calls MLTSS. It is the NJ equivalent of California's IHSS, New York's CDPAP, Pennsylvania's Services My Way, and Florida's Participant-Directed Option, but with a more generous spouse-pay rule than PA, OH, or NJ's own legacy fee-for-service Medicaid PCA.1

What MLTSS is

NJ consolidated nearly all aged-related home- and community-based-services waivers into a single MLTSS structure effective July 1, 2014. The Global Options for Long-Term Care Waiver (GO), Community Resources for People with Disabilities Waiver (CRPD), Traumatic Brain Injury Waiver (TBI), and AIDS Community Care Alternatives Program (ACCAP) all rolled into MLTSS on that date. The legacy "ABC waiver" nickname refers to the pre-MLTSS HCBS tiers and should not be used in current consumer materials.1

The current legal framework is the NJ FamilyCare Comprehensive 1115 Demonstration, last approved by CMS on April 18, 2024, with a demonstration period running April 1, 2023 through June 30, 2028.

The six MLTSS health plans

DMAHS lists six health plans administering NJ FamilyCare MLTSS, and therefore PPP, as of 2026:1

1. Aetna Better Health of New Jersey.
2. Aetna Assure Premier Plus (D-SNP), the Medicare-aligned Dual-Eligible Special Needs Plan that combines Medicare with NJ FamilyCare MLTSS.
3. Fidelis Care (formerly WellCare).
4. Horizon NJ Health.
5. UnitedHealthcare Community Plan.
6. Wellpoint (formerly Amerigroup).

What PPP actually pays

PPP wages are set by the Fiscal Intermediary and confirmed at enrollment, NJ DMAHS has not separately published a 2026 PPP wage schedule, so there is no public rate card to quote. Two things are worth knowing before you enroll. First, PPP is consumer-directed, so the wage goes to the worker rather than to an agency that keeps a cut, that is why PPP typically pays a worker more than the agency-employed model. Second, the wage applies to the participant's authorized hours (capped at 40 per week, below), so the monthly total is the hourly wage times the authorized weekly hours times roughly 4.3 weeks. Ask your Fiscal Intermediary for the current maximum PPP wage rate the day your enrollment packet arrives, and do the arithmetic against your authorized hours.1

The 40-hour-per-week cap

Under NJAC 10:60-3.8(g), personal care assistant services are limited to a maximum of 40 hours per calendar work week and must be prior authorized, though additional hours may be approved by the NJ Division of Disability Services or DMAHS on a case-by-case basis, based on exceptional circumstances. The regulation states this limit for personal care assistant services, without a separate PPP figure, so ask your MCO how it applies to a PPP budget in your case. The limit runs on the participant's authorization, not on a single worker's schedule, so two PPP workers can share authorized hours.1

Treat 40 hours as the working ceiling. NJ MLTSS Care Managers can authorize fewer, and anything more goes through the exceptional-circumstances route above.

The Fiscal Intermediary, PPL and Palco

PPP has two Fiscal Intermediaries, and DMAHS publishes which serves which plan. Palco serves Horizon NJ Health participants. Public Partnerships LLC (PPL) serves participants in Aetna Better Health of New Jersey, Aetna Assure Premier Plus (D-SNP), Fidelis Care, UnitedHealthcare Community Plan, and Wellpoint. DMAHS also notes that over time MCOs may transition to new FI vendors, so confirm the assigned Fiscal Intermediary with your MCO rather than relying on this mapping indefinitely. If you switch MCOs, expect to re-paper your PPP employment agreement with the new FI, your PCA's W-2, EIN registration, and EVV setup all have to migrate.1

Who can be hired as a PPP PCA

Per the NJ DHS PPP MCO/VF/EA Operations Policy Manual and NJAC 10:60-3.8(b):

• An adult child can be hired.
• A parent of an adult Medicaid recipient can be hired.
• A spouse, a legal guardian of an adult, and a parent or legal guardian of a minor child are the legally responsible relatives NJAC 10:60-3.8(b) says get no exceptions, in the same subsection that excepts PPP from the family-member bar. Confirm any of these with the MCO before hiring.1
• A sibling, in-law, niece, nephew, grandparent, grandchild, friend, or unrelated worker can be hired.
• Live-in caregivers can be paid, and (importantly for federal taxes, see "Tax treatment" below) the participant's home being the PCA's primary residence is what triggers the federal § 131(c) "difficulty-of-care" income exclusion.

Speed to first PPP paycheck

From the day a NJ family applies for MLTSS, the realistic timeline is:

• Days 1–14: ADRC intake (1-877-222-3737), County Office on Aging or DDS scheduling for level-of-care assessment.
• Days 15–45: NJ FamilyCare financial eligibility determination through County Board of Social Services (the MLTSS income limit is three times the SSI Federal Benefit Rate; verify at njfamilycare.dhs.state.nj.us); Plan of Care developed.
• Days 45–60: MCO selected; Care Manager assigned; participant elects PPP; the Fiscal Intermediary sends an enrollment packet.
• Days 60–90: PCA completes background check, signs employment agreement, completes orientation. EVV system configured.
• Days 90–120: First PCA shifts logged; first FI paycheck arrives about 14 days after first time entry.

Total: typically 60–120 days from MLTSS application to first PPP paycheck. The slow stage is the gap between MCO assignment and FI enrollment, about 14–30 days for most participants. Disability Rights New Jersey (drnj.org) is the right resource if you encounter denial or delay.

Pathway 2: Prefer agency oversight? Agency-based Personal Care Assistance (PCA)

If your situation doesn't fit PPP, or if you want professional agency oversight rather than self-direction, agency-based PCA is the alternative inside MLTSS. The participant works with a NJ-licensed home care agency (regulated under N.J.A.C. 8:42 and 8:42C and surveyed by the NJ Department of Health's Health Facilities licensing unit) that hires the PCA, runs payroll, and handles compliance.1

Under the agency model, NJ FamilyCare pays the agency a set hourly rate, and the PCA's wage is whatever the agency pays after its own employer-side taxes, benefits, training, and admin. That is why an agency-employed relative typically earns less per hour than the same relative would under PPP, the agency keeps the difference. If your goal is the highest take-home wage for a family member, PPP is the better route.

The agency model does NOT permit spouse-pay through the standard worker-employed-by-agency arrangement. If you want to be paid as a spouse, your only Medicaid-financed pathway in NJ is PPP.

Why families pick agency anyway:

• The agency handles payroll, taxes, scheduling, and replacement workers when the PCA is sick.
• The agency carries workers' compensation and professional liability.
• The agency is the responsible party for training and competency.
• The participant doesn't have to be a common-law employer with EIN, payroll, and W-2 obligations.

For most families who want a relative paid, PPP wins. For families who want professional staffing without the employer-side workload, agency wins.

Pathway 3: Over the Medicaid income limit? Jersey Assistance for Community Caregiving (JACC)

JACC is NJ's state-funded, non-Medicaid program for adults age 60 or older who meet a Nursing Facility Level of Care standard but exceed MLTSS Medicaid financial limits. It is administered by the NJ Division of Aging Services (DoAS).1

JACC eligibility (2026)

• Age 60 or older.
• Nursing Facility Level of Care.
• Countable income at or below 365% of the Federal Poverty Level: $4,855/month single, $6,582/month couple in 2026.
• Countable assets at or below $40,000 single / $60,000 couple.
• NOT enrolled in MLTSS, NJ FamilyCare, the TBI Fund, Alzheimer's Adult Day Services, the Statewide Respite Care Program (SRCP), the Personal Assistance Services Program (PASP), or the Congregate Housing Services Program. JACC is mutually exclusive with these programs.1

The "and not enrolled in MLTSS" rule is the one most families miss. JACC is for the population that is too high-income for MLTSS but cannot afford private home care. If your loved one is on MLTSS, they can't also be on JACC, they're in PPP territory instead.

What JACC pays

Per the NJ DoAS official program page, the JACC service cap is $1,090 per participant per month, plus separate care management. Some aggregator sites cite a lower monthly figure; the current DoAS number is $1,090.1

JACC services include:

• Personal care services (delivered by qualified service providers OR by qualified participant-employed providers, the relative-pay door).
• Adult day services.
• Home-delivered meals.
• Personal emergency response systems (PERS).
• Respite (in-home or institutional).
• Assistive devices and minor home modifications.
• Caregiver/participant training.
• Transportation.
• Chore services.

Can a spouse be paid under JACC?

The DoAS official page authorizes "qualified service providers OR qualified participant-employed providers" to deliver personal care under JACC. Spouse-specific approval and county-level provider rules must be confirmed at the participant's local ADRC before any worker is hired. JACC is administered through a network of County Offices on Aging across all 21 NJ counties, and operational rules vary slightly by county.1

The JACC copay

JACC participants pay an income-based sliding-scale copay, applied against the participant's monthly JACC service authorization. Your exact copay is set at intake based on income; ask your county Office on Aging for the current schedule.1

How to apply for JACC

Through the Aging & Disability Resource Connection at 1-877-222-3737 or directly through your county Office on Aging. Find your county listing at nj.gov/humanservices/doas/assistance/county-offices/.

JACC has historically operated under a budget-cycle cap and may carry a waitlist. Verify your county's current waitlist status at intake. Some NJ counties run essentially zero waitlist; others can have longer queues.

Pathway 4: Need a break? Statewide Respite Care Program (SRCP)

SRCP is a state-funded program designed to give a primary unpaid family caregiver a break, by paying a substitute caregiver for a defined block of respite hours per year. The primary caregiver themselves cannot be paid by SRCP.1

SRCP eligibility (2026)

• The care recipient is functionally impaired (cannot perform certain activities of daily living without assistance).
• The primary caregiver provides unpaid care.
• Care recipient income at or below $2,982/month gross single / $5,964/month gross married.
• Care recipient assets at or below $40,000 single / $60,000 married.
• NOT enrolled in MLTSS, JACC, Alzheimer's Adult Day Services, or the Congregate Housing Services Program.1

What SRCP pays

SRCP pays a substitute caregiver, someone who is not the primary unpaid family caregiver, for in-home or institutional respite hours, up to a county-specific annual cap set by county budget. The exact cap varies by county, so verify your county's current figure through its Office on Aging.1

A different family member (for example, the primary caregiver's adult child providing respite to a parent who cares for grandma) may be hired as the substitute respite worker, depending on county provider rules. The primary caregiver themselves cannot.

How to apply for SRCP

Through the ADRC at 1-877-222-3737 or your county Office on Aging.

Pathway 5: Caring for a veteran, VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

PCAFC is the only federal program that pays a family caregiver, including a spouse, directly, via a monthly tax-free stipend. It is run by the VA's Caregiver Support Program.2

New Jersey veterans are served primarily by the VA New Jersey Health Care System, with campuses at East Orange (973-676-1000) and Lyons (908-647-0180), plus Wilmington VAMC for South Jersey veterans in Salem, Cumberland, and Cape May counties. Each campus has a Caregiver Support Coordinator who screens for PCAFC.

Eligibility (38 CFR Part 71)

The veteran must be rated 70% or higher service-connected (or have an equivalent functional impairment under the post-2020 criteria), need personal-care services for at least six continuous months, and be enrolled in VA health care.2

The family caregiver must be:

• At least 18 years old.
• A spouse, child, parent, stepfamily member, extended family member, or someone who lives with the veteran full-time.

How the stipend is calculated

The PCAFC monthly stipend is not a flat national dollar figure, and it is not an hourly wage. It starts from the OPM General Schedule grade 4, step 1 annual rate for the veteran's locality pay area, divided by 12. That monthly base is then multiplied by one of four values, and which one you get depends on how the veteran qualifies, per 38 CFR 71.40(c)(4)(i).2

If the veteran qualifies under the current program (38 CFR 71.20(a)), the multiplier is 0.625, or 1.00 if VA determines the veteran is "unable to self-sustain in the community." That is a clinical finding VA makes at the assessment, not something the household elects. If your veteran cannot be left alone safely or needs supervision through the day, say so plainly and ask the assessor to address self-sustainment on the record, because it is the difference between the 0.625 rate and the full rate.2

If the veteran is a legacy participant or legacy applicant (38 CFR 71.20(b) or (c)), the multiplier instead comes from the sum of the veteran's 2019 clinical ratings, and no self-sustain determination is required on this route:2

Two protections sit on top of that. A veteran who satisfies both the current criteria and the legacy criteria is paid whichever of the two amounts is higher, per 38 CFR 71.40(c)(4)(i)(C), so qualifying under the current rules can never cost a legacy household money. And a legacy participant under 71.20(b) is paid not less than what the caregiver was eligible to receive the day before October 1, 2020, so long as the veteran still resides at the address on record with PCAFC on that date, per 38 CFR 71.40(c)(4)(i)(D). The legacy multiplier schedule runs for eight years beginning October 1, 2020, so it lapses October 1, 2028.2

What that means for New Jersey

New Jersey spans two OPM locality pay areas, the New York–Newark area (most of North and Central Jersey) and the Philadelphia–Camden area (most of South Jersey), so the exact stipend differs between, say, Bergen County and Camden County.

For 2026 the New York–Newark locality GS-4 step 1 annual rate is $42,907, which is a monthly base of about $3,576. Run against the four multipliers, a North or Central Jersey household in that locality lands at roughly:2

Read that table both ways before you budget. A legacy household rated 1 to 12 that assumed the 0.625 rate would be planning around roughly two and a half times the money it will actually receive. A legacy household rated 21 or higher that was told the self-sustain determination is the only route to the full rate would be underestimating by about 1.6 times, and might never ask for the amount it is already owed on the rating schedule alone.

South Jersey veterans in the Philadelphia–Camden area compute from a different GS-4 step 1 rate, so the figures above do not carry over. Because neither NJ DMAHS nor VA publishes a NJ-specific stipend table, compute your figure against the live VA stipend calculator using the veteran's exact ZIP code, and ask your Caregiver Support Coordinator to confirm which multiplier VA applied rather than assuming the 0.625 default.2

The legacy cohort cliff

VA's final rule at 90 FR 47891 (published September 29, 2025; effective September 30, 2025) extended the PCAFC legacy participants' transition period through September 30, 2028. Legacy participants are veterans who joined PCAFC before October 1, 2020, under the pre-2020 eligibility criteria. After September 30, 2028, legacy participants must satisfy the post-2020 PCAFC criteria or lose eligibility.

Until then, legacy status is not only an eligibility question, it also sets the stipend. As the schedule above shows, a legacy household's multiplier comes from the sum of the veteran's 2019 clinical ratings rather than from a self-sustain determination, and a legacy participant under 71.20(b) keeps the floor of what the caregiver was eligible to receive the day before October 1, 2020. So the 2028 reassessment can move the money as well as the eligibility. If your NJ veteran joined PCAFC before October 2020, start planning the 2027–2028 reassessment with the VA NJ Health Care System Caregiver Support Coordinator now, and ask what multiplier the household would land on under the current criteria.2

How to apply for PCAFC

Apply through the Caregiver Support Program at the veteran's VA medical center, online at caregiver.va.gov, or by calling the VA Caregiver Support Line at 1-855-260-3274. The application is VA Form 10-10CG; expect 30–90 days from a complete application to the first stipend.

Pathway 6: VA Veteran Directed Care (VDC)

VDC is administered jointly by the Administration for Community Living (ACL) and the VA at the federal level, with local administration by NJ Area Agencies on Aging or Centers for Independent Living in partnership with VA medical centers.1

VDC is a federal-funds pathway that can pay a spouse to be a caregiver. The veteran receives a monthly self-directed budget, the amount is set by the veteran's assessed need, not a published flat figure, and uses it to hire their own caregivers, including a spouse, adult children, friends, or in-laws.

Eligibility

• Veteran is 18+ and enrolled in VA health care.
• Veteran is clinically appropriate for HCBS, as assessed by their VA medical center's HCBS team.
• Veteran is willing and able to direct their own care, or designates a representative.

NJ VDC operational status

NJ VDC participation in 2026 should be confirmed by phone before relying on VDC as a pathway. NJ is listed by ACL as a participating state, but operational availability at individual VAMCs varies year-over-year. Call:

• VA NJ Health Care System, East Orange: 973-676-1000.
• VA NJ Health Care System, Lyons: 908-647-0180.
• Wilmington VAMC (for South Jersey veterans): reach via va.gov/wilmington-health-care.

Ask for the HCBS Coordinator and confirm VDC enrollment is open at that facility for the current fiscal year.

Stacking

VDC and PCAFC cannot both pay the same family member for the same hours, but a household can have one caregiver paid through PCAFC and a different caregiver paid through VDC. VDC and Aid & Attendance can stack: A&A is a pension supplement to the veteran; VDC is a caregiver wage paid via the Fiscal Intermediary.

Pathway 7: VA Improved Pension with Aid & Attendance (A&A)

A&A is not a family-caregiver wage program per se, it is a wartime pension supplement that gives the veteran or surviving spouse the income to afford a caregiver, who can be a family member. But it stacks cleanly with every other pathway in this guide.1

2026 Maximum Annual Pension Rates, effective Dec 1, 2025 – Nov 30, 2026

The VA publishes these as Maximum Annual Pension Rates only; the monthly column is the yearly rate divided by 12. Recompute against the live VA Pension Rates page (va.gov/pension/veterans-pension-rates/) before relying on them.1

Net-worth and look-back rules

The 2026 VA pension net-worth limit and look-back rules are set by federal regulation:1

• Net-worth limit (38 CFR § 3.274): $163,699 effective 12/1/2025 (annually indexed).
• Look-back (38 CFR § 3.276): 36 months from claim filing, with a penalty period (up to 5 years) for covered asset transfers.1

Who can help, and who can't

38 USC § 5905 prohibits unaccredited persons from charging a fee for assisting with VA pension claims. NJ has accredited Veteran Service Officers in all 21 counties through the NJ Department of Military and Veterans Affairs (DMAVA) and via the county VSO network. Use them, they're free and accredited. Avoid any "pension consultant" who charges to file your A&A claim.

NJ-only veteran resources

• NJ DMAVA Office of Veterans Services, veteran-benefits navigation and free accredited County Veteran Service Officers in all 21 counties (nj.gov/military).
• NJ Vet2Vet, the state's 24/7 veteran peer-support helpline (reach it through NJ DMAVA at nj.gov/military).
• Three NJ Veterans Memorial Homes, Menlo Park, Paramus, and Vineland, state-operated long-term care for NJ veterans (contact details at nj.gov/military).

Pathway adjacent to all of the above, NJ Family Leave Insurance (FLI)

NJ FLI is not a caregiver wage, it's a wage-replacement benefit for NJ-employed workers who need to take time off to care for a family member with a serious health condition. But it stacks with every Medicaid/VA pathway in this guide and is one of the most generous in the country.1

2026 figures

• Maximum benefit: $1,119/week (up from $1,081 in 2025).
• Wage replacement rate: 85% of average weekly wages.
• Maximum duration: 12 consecutive weeks in a 12-month period, OR 8 weeks (56 days) intermittently.
• 2026 FLI taxable wage base: $171,100.
• Funding: Employee contribution only in 2026 (employers do not pay into FLI).
• Apply at: myleavebenefits.nj.gov.1

NJ's broad family definition

NJ FLI's family definition is one of the broadest in the country. It includes:

• Parent, parent-in-law.
• Spouse, civil union partner, domestic partner.
• Child (biological, adopted, foster, stepchild, legal ward, and the equivalent for a domestic partner's child).
• Sibling.
• Grandparent and grandparent-in-law.
• Grandchild.
• Any other individual related by blood to the employee.
• "A person whose close association with the employee is the equivalent of a family relationship", the NJ-specific catch-all that covers "chosen family" relationships, friends, neighbors, and other functionally-family caregivers.

That last bullet is the rule that distinguishes NJ FLI from most other state programs. If you've been the primary caregiver for a longtime neighbor or close friend, NJ FLI covers that relationship.

Statutory authority

N.J.S.A. 43:21-25 et seq., as amended by P.L. 2019, c.37 (the 2019 expansion that increased the maximum to 12 weeks and the wage-replacement rate to 85%).1

NJ Earned Sick & Safe Days Act

Under the NJ Earned Sick & Safe Days Act (N.J.S.A. 34:11D-1 et seq.), effective October 29, 2018, all NJ employees regardless of employer size accrue 1 hour of paid sick leave per 30 hours worked, capped at 40 hours per benefit year, with up to 40 unused hours rolling into the next year.1

The leave may be used to care for a family member, defined broadly to include biological/adopted/foster/stepchildren, parent, sibling, spouse, domestic partner, civil-union partner, grandparent, grandchild, or "a person whose close association with the employee is the equivalent of a family relationship", the same catch-all as FLI.

For most NJ caregivers, the operational stack is:

1. Use Earned Sick Leave for short, urgent absences (medical appointments, hospitalizations).
2. Bridge with FLI for sustained leave (post-discharge weeks, end-of-life care).
3. Combine with PPP wages if the caregiver is also the paid PCA.

NJ Wounded Warrior Caregivers Credit (the only enacted state caregiver credit)

NJ has one enacted state tax credit specifically for caregivers: the Wounded Warrior Caregivers Credit, codified at P.L. 2017, c.67 (N.J.S.A. 54A:4-15).1

The credit

• The credit equals 100% of the qualifying veteran's federal disability compensation OR $675, whichever is less.
• The credit is refundable. That means even caregivers with no NJ income tax liability receive a refund check.
• Income limits: $100,000 (joint, head of household, qualifying widow/widower) or $50,000 (single, married filing separately).1

Who qualifies

The qualifying veteran must be:

• A US Armed Services member (active or veteran).
• With a service-connected disability arising from service on or after September 11, 2001.

The caregiver must be a NJ resident, not a paid commercial caregiver, and the qualifying veteran must live with the caregiver for more than half the year.

How to claim

• File Schedule NJ-WWC with your NJ-1040 if you have a NJ tax liability.
• Non-filers claim the refund on Form NJ-1040-HW.

Proposed but not yet enacted: CARE Act and broader Caregiver Tax Credit

Two broader caregiver tax credits remain proposed in the NJ Legislature as of 2026:1

CARE Act (A1581 / S2303)

The Caregiver Assistance Reimbursement and Empowerment Act (CARE Act) would create a non-refundable state credit for a share of qualified care expenses, capped at $675, with income limits mirroring the Wounded Warrior credit ($100,000 joint / $50,000 single). It has had committee referrals but no floor vote.1

Caregiver Tax Credit (A5776 / S4947)

A broader bill would create a $2,500 refundable Caregiver Tax Credit. The bill is in committee.1

Until either bill is signed, the only enacted NJ caregiver tax credit is the Wounded Warrior credit. Article framing must say "introduced, not enacted" until passage is confirmed.

Federal IRC § 131(c) and your New Jersey taxes

Taxes are the part most families dread, so take this slowly, it can put real money back in your pocket. This is one of the most consequential tax questions for NJ-paid family caregivers, and it's worth a few minutes even if tax rules usually make your eyes glaze over.1

The federal rule (in your favor)

IRS Notice 2014-7 (issued January 3, 2014) and IRC § 131(c) treat qualified Medicaid waiver payments to a live-in care provider as "difficulty-of-care" payments excludable from federal gross income. To qualify:

1. The payments must be made by a state Medicaid waiver program (or a certified Medicaid provider acting under a waiver). NJ FamilyCare PPP payments through PPL or Palco qualify as Medicaid waiver payments.
2. The PCA's home and the care recipient's home must be the same, the live-in test.

A NJ PPP PCA who lives with the participant typically reports no federal taxable wages in W-2 box 1 for those payments, even on a substantial gross paycheck, the difficulty-of-care exclusion zeroes out box 1.

The Tax Court in Feigh v. Commissioner, 152 T.C. 267 (2019), affirmed by the 9th Circuit in 2020, plus IRS Notice 2020-15 (March 2020), confirm that a taxpayer may elect to treat difficulty-of-care payments as earned income for purposes of the Earned Income Tax Credit and the Additional Child Tax Credit, even when the payments are excluded from gross income. For low- and moderate-income NJ caregivers with qualifying children, this election can add a meaningful federal EITC refund that the exclusion would otherwise cost them. Don't skip it, ask a tax preparer about the Notice 2020-15 election.

The NJ rule (uncertain, get a NJ CPA)

NJ Gross Income Tax conformity to IRC § 131(c) is unsettled. NJ does not automatically conform to the federal Internal Revenue Code; NJ GIT is a separate state-level scheme codified at N.J.S.A. 54A:1-1 et seq. NJ Division of Taxation has not issued a clear ruling on whether IRS Notice 2014-7's exclusion carries over to NJ GIT for live-in PPP PCAs.

Action item. Talk to a NJ-licensed CPA about your PPP wages before you file. Do not assume your federal § 131(c) exclusion automatically zeroes out your NJ tax. If your CPA concludes NJ does conform, document the position. If your CPA concludes NJ does not conform, budget for NJ Gross Income Tax at your applicable bracket.

NJ Earned Income Tax Credit

New Jersey has its own state Earned Income Tax Credit calculated as a percentage of the federal EITC (N.J.S.A. 54A:4-7). If you make the federal Feigh / Notice 2020-15 election to treat your excluded waiver payments as earned income for the federal EITC, that election typically carries into your NJ state EITC computation as well, adding to your refund.

How to become a paid family caregiver in New Jersey through PPP, step by step

If you're going to be paid as a family caregiver through NJ FamilyCare, this is your operational playbook.

A 30-day playbook for newly-diagnosed NJ families

Use this when a parent has just been diagnosed with a serious condition (dementia, stroke, advanced Parkinson's, terminal cancer) and you know you'll be the primary caregiver.1

Days 1–3. Call ADRC 1-877-222-3737 to be routed to your county Office on Aging. Schedule a free needs assessment. While on hold, write down: the care recipient's diagnoses, current medications, primary insurance(s), Medicare/Medicaid status, monthly income, and assets.

Days 4–7. Apply for NJ FamilyCare through your County Board of Social Services, even if you're not sure your loved one will qualify, the "deny" letter starts the appeal clock. Request the MLTSS clinical assessment in parallel. If the care recipient is 60+ and probably above the MLTSS income limit, also apply for JACC through the ADRC.

Days 8–14. Receive the assessment; receive the level-of-care determination. Pick an MCO. Tell your Care Manager at the first call that you want PPP.

Days 15–21. Fiscal Intermediary enrollment paperwork arrives. Identify your PCA (spouse OK; only exclusion is parent of a minor-child recipient). Begin background checks (CHRI, IdentoGO if required). Complete PCA orientation.

Days 22–28. First PCA shifts logged via EVV. First FI paycheck arrives within about 14 days of first time entry.

Days 29–30. If a wartime veteran, file for VA Aid & Attendance through your county VSO and screen for PCAFC eligibility at VA NJ Health Care System (East Orange or Lyons) or Wilmington VAMC. If you're employed in NJ and need extended leave, file for NJ Family Leave Insurance at myleavebenefits.nj.gov.

How New Jersey compares to New York, Pennsylvania, Ohio, and Maryland

NJ is on the more permissive end of the national distribution on family caregiver payment. Here is how it stacks up against neighboring and peer states.1

Two things stand out. First, NJ and NY are the two Northeast states where a spouse can be paid through the standard Medicaid pathway, Pennsylvania and Ohio cannot. Second, NJ's PPP is consumer-directed, so a family member is paid the wage directly rather than an agency keeping a cut.

NJ FIDE-SNPs and PACE, the Medicare-aligned options

For dual-eligibles (Medicare + NJ FamilyCare MLTSS), a Fully Integrated Dual-Eligible Special Needs Plan (FIDE-SNP) combines both programs in a single MCO, Aetna, Horizon, UnitedHealthcare, and Wellpoint each operate one in NJ in 2026. Caregiver supports (in-home support, respite, caregiver education) vary by plan and appear as Special Supplemental Benefits for the Chronically Ill (SSBCI) in each plan's Evidence of Coverage. FIDE-SNPs do not pay family caregivers directly; the paying pathway inside MLTSS is still PPP.1

The Program of All-Inclusive Care for the Elderly (PACE) is a fully capitated Medicare + Medicaid alternative for adults 55+ who meet a Nursing Facility Level of Care standard and live in a PACE service area. NJ expanded PACE to all 21 counties in January 2026. PACE itself does not pay family caregivers, it delivers comprehensive medical, social, and long-term care through an interdisciplinary team, so families seeking the "relative gets paid" model should route to PPP, not PACE. Find your nearest operator at njpaceassoc.org.1

Adult Family Care, what NJ does NOT have

NJ does not have a robust Medicaid-financed Adult Family Care program comparable to Massachusetts' AFC, Rhode Island's Shared Living, or Indiana's Structured Family Caregiving.1

NJ Adult Family Care Homes (AFCH) is a licensure category under N.J.S.A. 26:2H and N.J.A.C. 8:43H allowing an unrelated caregiver to provide home-based care to up to 3 adults in the caregiver's residence. This is a residential licensure category, not a Medicaid caregiver-pay program.

NJ families seeking the "live-in family caregiver gets paid by Medicaid" model should be routed to PPP, not AFC. PPP is the right pathway. AFC in NJ is licensure for non-related boarders, not a wage program for relatives.

Federal threats to NJ caregiver pay (2026–2028)

The One Big Beautiful Bill Act (OBBBA), Pub. L. 119-21, signed July 4, 2025, contains several provisions affecting NJ FamilyCare MLTSS and PPP economics. NJ DMAHS is publishing implementation guidance at nj.gov/humanservices/dmahs/obbba/medicaid-federal-changes.shtml.1

• Community-engagement (work) requirements. Beginning Fall 2026, ACA expansion-population adults aged 19–64 receiving Medicaid must demonstrate qualifying monthly activity hours (work, study, volunteering, job training) with statutory exemptions. NJ has a sizeable expansion population.
• Retroactive eligibility shortened. Reduces retroactive Medicaid eligibility to 60 days for non-expansion enrollees and 30 days for expansion enrollees.
• Provider-tax safe-harbor phasedown. The Medicaid provider-tax hold-harmless safe-harbor is scheduled to step down in ACA-expansion states between FY 2028 and FY 2034, which affects NJ MCO assessments and MLTSS capitation funding.
• Standalone HCBS waiver authority (the bright spot, 2028+). Beginning July 1, 2028, HHS may approve new 1915(c) HCBS waivers covering individuals who do not yet meet a nursing-facility level of care, an unprecedented expansion.

Article framing should remain "phased rollout beginning Fall 2026" rather than asserting specific operational impacts.

New Jersey helplines and where to call

Where to start today

1. Call ADRC 1-877-222-3737 and request a county Office on Aging assessment for both MLTSS screening and (if applicable) JACC eligibility.
2. Apply for NJ FamilyCare through your County Board of Social Services, even if you're not sure your loved one will qualify. The "deny" letter starts the appeal clock.1
3. If your loved one is a veteran, contact your county Veterans Service Officer (find them via NJ DMAVA at nj.gov/military) and ask a free VSO to file Aid & Attendance and screen for PCAFC.
4. Write down your loved one's diagnoses, medications, monthly income, and assets in one notebook. Take it to every appointment.
5. Talk to a NJ-licensed CPA who knows IRC § 131(c) federal/state interaction before you file.

Learn More

Find personalized help navigating New Jersey caregiver payment programs at brevy.com.

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.