How do I set up a care contract and quanitfy the value of the service provided?

I am trying to get some information about setting up a care contract for my sister who is the primary care giver for my two elderly parents.

I also need to know how to quantify the value of the work that she is doing. She provides 24/7 care and doesn't have another job or income. Her compensation is free room, board and spending money.

The eventual goal is to complete a Veterans Administration form for their Aid & Attendance Benefit. (Both parents are veterans)

To get the VA benefit we have to demonstrate that their unreimbursed medical expenses are greater than their income. As it is right now three people are living off of $34,000/year.

Is setting up a care contract and paying my sister from their limited resources the way to do that? Or is there a better way?
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Answers (2)

Laura Mcfarland-Taylor

Laura Mcfarland-Taylor

Contributor Level 8
A contract with your sister may or may not be the best way to handle the situation and you should really speak with an attorney that handles elder law.
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Stephen C. Jones

Stephen C. Jones

Contributor Level 3
Establishing a caregiver contract is a tool that is used for Medicaid planning. In this case you are talking about her compensation being free room, board and spending money. A caregiver contract may not be a good strategy if their is not a block of assets that you are looking to transfer out of your parents name. In fact the free room and board aspect of your caregiver agreement would result in taxable compensation without your sister receiving the money to actually pay the taxes.

You also make reference to seeking aid and attendance benefits. You will have trouble trying to use a caregiver agreement as unreimbursed medical costs in order to qualify. You may be better off actually having your parents pay for professional care so you clearly establish the unreimbursed medical expesens.

Finally, you do not have to wait until their unreimbusred medicla expenses exceed their income. Depending on what level of benefit they may qualify to recieve, you can file when their income is higher than the unreimbursed medical expenses and still receive a benefit that is reduced for the excess inome.

You really should consult with an elder law attorney on this matter. Dealing with Medicaid is very complicated. Dealing with Medicaid and VA benefits requires real expertise to balance the differing rules of the two programs.
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