Cash & Counseling Programs are financial and care assistance programs, usually but not always from Medicaid, which provide the beneficiary with cash assistance and with the flexibility to “consumer direct” or self-direct the spending of the cash on care providers of their choosing.
Most states have their own names for their Cash and Counseling Programs, typically associated with a specific Medicaid waiver. For example, in Arkansas, their program is called “IndependentChoices”, in California, “In Home Supportive Services” and in Michigan, the “Choice Waiver”. This site can help you get started on getting paid to be a family caregiver. Although the Cash and counseling programs are primarily for senior care, there are a number of “waiver programs” for special need youth.
Most states exclude spouses from being hired as caregivers, but twelve states permit spouses. Most programs do not exclude the adult children, in-laws or grandchildren. In addition, ex-spouses are typically not excluded leading to a rather absurd situation where couples get divorced in order to care for one another. The program has also extended for veterans which have far fewer exclusions.
In addition in those states that have consumer directed programs, the spouse can be part of the care team from the agency doing the case management.