How to Become a Paid Family Caregiver in New Jersey

To become a paid family caregiver in New Jersey, you enroll your relative in one of two state programs that let the care recipient hire their own worker, pass a clinical assessment showing they need nursing-facility level of care, and then get brought on as their paid caregiver through the program’s self-directed option. Which program you use depends on whether your family member qualifies for Medicaid.

Pick the Right Program First

Everything downstream — how you apply, what you’re paid, how your income is taxed — flows from which program your relative is enrolled in.

Personal Preference Program (PPP)

PPP is the self-directed option inside New Jersey’s Medicaid system. It’s for NJ FamilyCare members who qualify for Personal Care Assistant services and want to choose their own worker instead of using a home health agency. The care recipient acts as the employer: they pick the worker, set the schedule, and manage a care budget. The program explicitly allows hiring relatives, friends, and neighbors.¹ A fiscal intermediary handles payroll, withholding, and other employer paperwork, so you don’t run that yourself.

PPP sits within Managed Long-Term Services and Supports (MLTSS), which means the care recipient must be enrolled in NJ FamilyCare and meet MLTSS clinical criteria.²

Jersey Assistance for Community Caregiving (JACC)

JACC is a state-funded program for people who aren’t on Medicaid. It covers individuals 60 and older who meet the nursing-facility level of care and want to stay at home. Income can reach 365% of the federal poverty level, and assets can go up to $40,000 for an individual or $60,000 for a couple. JACC’s participant-employed provider option lets families hire their own workers, including relatives.³

If your relative has too much income for Medicaid but can’t afford full-time private home care, JACC is usually the right door.

One boundary worth knowing: if your family member is a veteran, the federal Program of Comprehensive Assistance for Family Caregivers pays a monthly stipend that runs separately from these New Jersey programs, and some families qualify for both.⁴

Does Your Family Member Qualify

Age

MLTSS and PPP require the care recipient to be 21 or older, and either 65-plus, or under 65 with a blind or disability determination from the Social Security Administration or the State of New Jersey.² JACC starts at age 60.³

Clinical Need

Both programs require nursing-facility level of care. That generally means hands-on help with at least three activities of daily living — bathing, dressing, toileting, eating, transferring, or moving around the home — or cognitive impairments that require supervision with those same activities.² A clinical assessment after you apply decides whether the threshold is met.

Finances

MLTSS eligibility runs through NJ FamilyCare’s Medicaid income and asset rules. JACC’s ceilings are much higher: income up to 365% of the federal poverty level, $40,000 in assets for an individual, $60,000 for a couple.³

Can You Be the Paid Caregiver

You need to be at least 18, a New Jersey resident, and able to demonstrate competence in the services you’ll provide. Both programs require caregivers to meet qualifications set by the Department of Human Services.³

Your relationship to the care recipient matters. Under federal Medicaid rules, payments to “legally responsible individuals” — a spouse, or the parent of a minor child — generally aren’t covered by federal funding for routine personal care. Federal guidance does allow states to pay these relatives for “extraordinary” care that goes beyond what a parent or spouse would ordinarily provide and is necessary to prevent institutionalization.⁵ In practice, a spouse or parent of a minor is more likely to be paid through JACC or the extraordinary-care exception than through standard MLTSS. Adult children, siblings, and other relatives face fewer restrictions and are routinely approved as paid caregivers through PPP.

Expect a criminal background check. New Jersey requires one for applicants seeking licensure as adult family care providers, including anyone who may act as a substitute caregiver and any non-client aged 18 or older living in the home.⁶ Even when formal licensure isn’t in play, the managed care organization or fiscal intermediary will run a screen before you start.

Applying

Pull these together before you start:

Driver’s license or state ID, Social Security numbers, and birth certificates for you and the care recipient
Proof of New Jersey residency (utility bill, lease, or mortgage statement)
The care recipient’s bank statements, income records (Social Security award letters, pension statements, tax returns), and asset details
Doctor’s orders, diagnosis records, hospital discharge summaries, and documentation of functional limitations
Power of attorney, guardianship papers, or health care proxy if applicable

For PPP, apply for NJ FamilyCare online, by phone at 1-800-701-0710, or in person at a County Social Services Agency or enrollment site.⁷ Online is fastest and lets you upload documents and track status.⁸ For JACC, contact your county’s Area Agency on Aging or Aging and Disability Resource Connection (ADRC).²

After the application is in, the care recipient goes through a clinical eligibility assessment that measures how much help they need with daily activities and whether they meet the nursing-facility standard.² You’ll get the decision by mail. Respond quickly to any request for additional documents; delays can stall or reset the process.

If You’re Denied

File an internal appeal with the health plan within 60 calendar days of the denial letter. The internal appeal must come first. If it’s denied, you have two paths: an external appeal with the NJ Department of Banking and Insurance within 60 days, or a Medicaid Fair Hearing within 120 calendar days of the internal appeal denial.⁹ If services are already in place and you want them to continue during the appeal, request continuation on or before the last day of the existing authorization or within 10 days of the denial letter, whichever is later.

What You’ll Be Paid

New Jersey’s minimum wage is $15.92 per hour as of January 1, 2026, and that’s the floor. Direct care staff in long-term care facilities have a higher minimum of $18.92 per hour, but that rate is for facility-based workers, not home caregivers.¹⁰ Actual pay through PPP or JACC depends on the care recipient’s approved budget and hours, and families often see rates in the $16 to $20 range depending on location and care intensity.

Your hours are capped by the clinical assessment. The managed care organization or JACC coordinator authorizes a set number of weekly hours, and you’re paid only for those authorized hours. If your relative’s condition changes, ask for a reassessment.

Caregiver wages count as earned income for federal benefit programs. If you receive SSI, the wages will reduce your SSI payment.¹¹ SNAP and other means-tested programs work the same way. Run the numbers before accepting paid status if you currently rely on those benefits.

Taxes on Caregiver Income

This is where families most often overpay. Under IRS Notice 2014-7, Medicaid waiver payments to a caregiver who lives in the same home as the care recipient are treated as “difficulty of care” payments and can be excluded from federal gross income.¹² The exclusion applies whether you’re related or not, but you have to share a home with the person you’re caring for. Live separately and the exclusion doesn’t apply.

The payments also have to come through a state Medicaid waiver program. PPP payments typically qualify. JACC payments may not, because JACC isn’t a Medicaid program. A tax professional familiar with Medicaid waiver programs can confirm your situation.

On payroll taxes, the care recipient is technically your employer under PPP, which triggers household employment rules. Social Security and Medicare taxes apply when a household employee earns $3,000 or more in cash wages during 2026.¹³ Wages paid to a spouse or a child under 21 are exempt from FICA regardless of amount.¹⁴ Under PPP, the fiscal intermediary handles withholding and filings.

What the Job Requires Day to Day

Electronic Visit Verification

Federal law requires states to use Electronic Visit Verification for all Medicaid-funded personal care services delivered in the home. Every visit captures six data points: service type, who received it, who provided it, where it was delivered, and start and end times.¹⁵ You’ll log in and out through a phone app or a toll-free number at the start and end of each shift.

Miss the clock-in or clock-out and the visit may not count toward your authorized hours, which means you don’t get paid for it. The fiscal intermediary will train you on the specific system. Keep your own notes on top of EVV; if a billing dispute or care-plan revision comes up, contemporaneous records hold up better than memory.

Wage and Hour Rules

Paid family caregivers are covered by federal and state labor laws. Covered domestic service workers under the Fair Labor Standards Act must receive at least the minimum wage for all hours worked and overtime at one and a half times their regular rate above 40 hours in a workweek. Live-in caregivers who reside permanently in the care recipient’s home may be exempt from overtime but still get minimum wage for every hour worked.¹⁶ New Jersey’s $15.92 minimum applies rather than the lower federal rate.¹⁰

Mandatory Reporting

New Jersey’s Mandatory Adult Abuse and Exploitation Reporting Law requires certain individuals to report suspected abuse, neglect, or exploitation of vulnerable adults. As a paid caregiver, if you see signs that the person in your care is being harmed, financially exploited, or neglected by anyone, you’re expected to report it to Adult Protective Services. Not reporting when required can carry its own legal consequences. Your county’s Area Agency on Aging or ADRC can explain what triggers the obligation.

1
Department of Human Services. Personal Preference Program (PPP)
2
Department of Human Services. Medicaid Managed Long Term Services and Supports (MLTSS)
3
NJ.gov. Jersey Assistance for Community Caregiving (JACC)
4
Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers Monthly Stipend for Primary Family Caregivers Fact Sheet
5
Medicaid. Leveraging Family Caregivers for Personal Care Services in 1915(c) Waiver Programs
6
Justia. New Jersey Revised Statutes 26:2Y-5 – Criminal History Record Background Check for Applicants for Licensure as Adult Family Caregiver
7
Department of Human Services. NJ FamilyCare/Medicaid
8
NJ FamilyCare. Need Help Enrolling?
9
NJ FamilyCare. The NJ FamilyCare Health Plan Appeal Process
10
Department of Labor & Workforce Development. New Jersey’s Minimum Wage
11
Social Security Administration. SSI Eligibility
12
Internal Revenue Service. Notice 2014-7
13
Internal Revenue Service. 2026 Publication 926
14
Internal Revenue Service. Topic No. 756, Employment Taxes for Household Employees
15
Medicaid. Leveraging Electronic Visit Verification (EVV) to Enhance Quality Monitoring and Oversight in 1915(c) Waiver Programs
16
U.S. Department of Labor. Fact Sheet 79B: Live-in Domestic Service Workers Under the Fair Labor Standards Act (FLSA)