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Easiest: Your SIL has some sort of monthly income, like her SS income or a pension. That is her $ and she can use it to pay for a caregiver. Ideally she gets an elder law attorney to review this, so that it meets standards should LTC Medicaid get file for her within next few years; atty draws it up and everyone signs off on it. It is taxable income paid to you and usually it’s easier to have a payroll company do this as it has required FICA reporting. She can pay you to do it at whatever is market rate for private pay agencies in your area. Like my mom had an agency for a bit after rotor cuff surgery and it was $18-22 hr with a 4 hr minimum & this was years ago.

Now if this is SIL wants the State of TX to pay, that’s a community based Medicaid program that will need to be filed for. It’s TX IHHS program and availability varies by county as TX does the placement primarily through home health agencies that participate in community Medicaid. There will be an outside assessment done on SIL to determine # of hours needed. Tend to be 20-28 hr a week at best. Could be only 12 hrs a week. State will NOT pay beyond the # of hours as per the assessment. By & large waiting lists to get an agency caregiver as contractually it is tied into TX minimum wage plus a % for what the caregivers are paid. Tx is $7.25 hr min wage - like most Southern States are - so hard to keep staff @ $8.00 hr as they can go to Target and work for $15 hr plus employee discounts and get a red wardrobe to boot.

whatever SIL decides to do make sure she keeps all paperwork and pays taxes and FiCA for whomever she pays especially if it’s family. Caregivers are household expenses as per IRS rules. If this isn’t done, and should she need LTC Medicaid to pay in her future, it could be looked at a gifting of $ to family which causes delays in her eligibility. It can become a hot mess to unthread at a difficult time.
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Very seldom do people get paid to care for a LO and if they do, its minimum wage and not many hours. Medicaid has an "in home" program. Call ur local Social Services to see how it works. Some States have deals with agencies where a person is trained by the agency, the agency hires them and then they are allowed to care for their LO.
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