Medicaid
10
min read

Structured Family Caregiving: Get Paid To Take Care Of Family

Explore how Structured Family Caregiving offers support, training, and compensation to family caregivers, ensuring consistent, quality care at home.
Published on
February 2, 2024
Presented by Givers
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Structured Family Caregiving (SFC) is a type of Medicaid program that allows family members to be compensated for their caregiving efforts and provides critical resources to make sure that care recipients receive the full support they need.

This program is different from informal or private caregiving, which usually provide no formal support, training, or payment. Informal caregivers often face the challenges of caring for someone alone, and private caregiving can be costly or lack the personal touch of SFC.

Ahead, learn how to become a paid caregiver through Structured Family Caregiving. We'll detail the benefits, eligibility requirements, and payment structures associated with these programs and how to navigate the journey effectively.

In this article:

Key Takeaways

  • Structured Family Caregiving allows family members to receive a tax-free stipend for caregiving through Medicaid, ensuring financial and emotional support.
  • Caregivers access ongoing training, respite care, and tailored resources to provide high-quality, personalized care at home.
  • Caregivers must meet age, residency, and background check standards, while care recipients must qualify for Medicaid and demonstrate a need for daily assistance.
  • Involves eligibility checks, case manager support, care plan development, and documentation submission for approval.
  • SFC programs vary by state, with differences in eligibility, caregiver roles (e.g., spousal participation), and reimbursement structures tailored to local needs.

What is Structured Family Caregiving?

Structured Family Caregiving (SFC) is a valuable Medicaid-funded program. It offers financial support and resources to family caregivers. These caregivers help individuals with disabilities or chronic health conditions at home.

SFC program highlights:

  • Tax-free stipend: Caregivers receive financial compensation without tax deductions.
  • Ongoing training: Family caregivers access continuous support and education.
  • Customized resources: Resources are tailored to address specific caregiving responsibilities.

For family caregivers, SFC offers much-needed support. Caregivers benefit from respite care and financial assistance to manage their caregiving duties effectively. By participating in SFC, families can ensure a higher level of care for their loved ones at home.

Benefits of Structured Family Caregiving programs

Structured Family Caregiving (SFC) programs offer many benefits for both caregivers and care recipients. These programs provide financial compensation through a tax-free stipend tailored to the level of care needed by the care recipient. Caregivers receive essential training, equipping them with skills like first aid, infection control, or emergency response.

Key benefits for care recipients include:

  • Receiving personalized and empathetic care in a familiar environment.
  • Enhanced emotional support, crucial for individuals with cognitive impairments.

For caregivers, the advantages are substantial:

  • Financial assistance reduces the caregiving burden.
  • Access to respite care options allows them necessary breaks.

SFC programs also offer societal benefits:

  • More cost-effective than traditional care models.
  • Decreased strain on healthcare facilities as more people receive at-home care.

Structured Family Caregiving enhances quality of life, promotes strong family relationships, and supports a healthier community.

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Eligibility criteria for SFC

When considering eligibility for Structured Family Caregiving, it's essential to understand the specific criteria set by your state. Though many requirements are shared nationwide, some states have unique rules. For instance, in some states, spouses may be restricted from serving as caregivers within the program framework. Always verify state-specific guidelines to ensure compliance.

Requirements for caregivers

To become a caregiver under the SFC program, several requirements must be met:

  • Age and residency: Primary caregivers must be at least 18 years old. They must also live with the care recipient in one of their homes.
  • Background check: A background check is mandatory. This ensures the caregiver is suitable for the role and can meet caregiving responsibilities effectively.
  • Employment restrictions: Caregivers must dedicate themselves fully to their roles. This means they cannot pursue outside employment or run a business from home while providing care.
  • Spousal restrictions: In some states, spouses are not allowed to serve as caregivers, which affects eligibility.

Requirements for care recipients

Care recipients have specific criteria to meet for participation in Structured Family Caregiving:

  • State residency and Medicaid eligibility: The individual must be a resident of the state and qualify for Medicaid.
  • Care needs: The care recipient must require help with at least three activities of daily living, such as bathing, dressing, and eating.
  • Medical or functional need: They must have a clear need for daily support and supervision. A case manager conducts a functional evaluation to determine the need for nursing facility-level care.
  • Living arrangement: Care recipients are required to live full-time with their caregiver.

These requirements ensure that care recipients receive the support they need in a structured family setting.

The application process for SFC

The Structured Family Caregiving (SFC) program supports family caregivers by providing financial assistance. To apply, both the caregiver and care recipient must first check their eligibility requirements. Eligibility typically includes the need for the recipient to require a specific level of care and for the caregiver to pass a background check.

Once eligibility is confirmed, applicants should work with a case manager who will guide them through the application process and assist in accessing necessary services. The process involves completing various paperwork, which varies by state and the specific Medicaid program offering SFC.

Steps in the SFC application:

  1. Complete the initial application to confirm eligibility for both the primary caregiver and care recipient. Use Givers free eligibility tool >>
  2. Connect with a case management agency for guidance.
  3. Complete functional assessment and develop a care plan.
  4. Submit the final application and wait for approval.

Following these steps, family caregivers can access financial compensation and other support through the SFC program.

How much can you get paid?

Caregivers receive a tax-free stipend based on the level of care the recipient requires. This exemption aligns with IRS Notice 2014-7, which excludes certain Medicaid waiver payments from gross income. The stipend is calculated per day and often increases with the intensity of care needed.

Factors influencing stipend amount:

  • Level of care requirement: A formal assessment evaluates the care recipient's needs, such as mobility and medical conditions.
  • Program guidelines: State programs have different guidelines that consider local cost of living and other factors.
  • Tax-free benefit: Stipends are usually not subject to federal income tax, making them more valuable to caregivers.

Payments in SFC programs are managed by a designated agency. This agency conducts assessments, provides training, and supports caregivers. Medicaid pays the managing agency a daily stipend, with 50-65% going to the caregivers.

Caregivers may need to submit documentation like daily notes or care logs to continue receiving payments. This ensures that care standards are maintained and transparency is upheld.

State-specific differences in SFC programs

Structured Family Caregiving (SFC) varies significantly across different states, each with its unique program name, eligibility criteria, and benefits.

States are free to tailor their programs to address the specific needs of their populations. Funding for SFC programs typically comes from a combination of sources, the most prominent being Medicaid. Many SFC programs operate under Medicaid waivers, allowing states to use federal funds to support innovative care models like SFC. Additionally, some states allocate specific budgetary funds for these programs, recognizing their importance in the broader healthcare and social support landscape.

Here's a brief overview:

Connecticut | Adult Family Living

Georgia | Structured Family Caregiving

  • Operates under the CCSP Waiver (Community Care Supports Program) and SOURCE Waiver program (Services Options Using Resources in Community Environments) (both under the GA Elderly and Disabled Waiver)
  • Serves persons who are aged or physically disabled
  • Spouse cannot serve as the paid caregiver

Indiana | Structured Family Caregiving

  • Service offered under three Medicaid waivers: IN Health & Wellness Waiver, IN PathWays for Aging Waiver, IN Community Integration and Habilitation
  • Serves persons who are aged or disabled
  • Spouse can serve as the paid caregiver

Louisiana | Monitored In-Home Caregiving (MIHC)

  • Operates under the LA Community Choices Waiver (CCW) and the LA New Opportunities Waiver (NOW)
  • Spouse can serve as the paid caregiver

Massachusetts | Adult Foster Care

  • Service offered under Massachusetts' regular state plan Medicaid program (MassHealth)
  • Serves people aged 16+ with a medical or mental condition
  • Spouse cannot serve as the paid caregiver

Missouri | Structured Family Caregiving

  • Operates under the Structured Family Caregiving Waiver (SFCW)
  • Serves people aged 21+ with Alzheimer's Disease or related dementia
  • Spouse can serve as the paid caregiver

Nevada | Structured Family Caregiving

North Carolina | Coordinated Caregiving

  • Operates under the NC Community Alternatives Program for Disabled Adults (CAP/DA) and NC Community Alternative Program for Children (CAP/C)
  • Serves developmental disability/medically fragile people (no age limit)
  • Spouse can serve as the paid caregiver

Ohio | Shared Living

  • Operates under the OH Individual Options Waiver
  • Serves developmental disability level of care (no age limit)
  • Spouse or parents cannot serve as the paid caregiver

Rhode Island | RIte @ Home - a Shared Living option

South Dakota | Structured Family Caregiving

  • Operates under the SD Home & Community Based Options and Person-Centered Excellence Waiver (HOPE Waiver)
  • Serves seniors and adults with disabilities
  • Spouse can serve as the paid caregiver

Each of these programs reflects the state's recognition of the need for structured support for family caregivers.

The variations in reimbursement rates, caregiver eligibility, and target populations indicate a tailored approach to meet each state's unique demographic and healthcare needs.

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Differences between Structured Family Caregiving and Personal Care Services

Structured Family Caregiving and Personal Care Services both offer opportunities for family caregivers to get paid for providing care, but they differ in their structure and requirements.

Structured Family Caregiving emphasizes the role of the family caregiver, allowing a family member to be paid for providing care. The primary benefit for the participant is receiving care from a trusted family member within a structured program, often with additional support and oversight.

Personal Care, on the other hand, focuses primarily on the participant, offering non-medical support to help with daily activities like bathing, dressing, and meal preparation. The primary benefit for the participant is the ability to receive care from external providers while maintaining their independence at home. PCS may be provided by family members but doesn't necessarily have the same level of program structure.

Learn more about Medicaid Personal Care Services >>

The availability and eligibility of these services vary depending on the specific Medicaid waiver, state regulations, and the participant's individual care needs.

How Givers helps

If you qualify for a Structured Family Caregiving program that Givers serves, we help you and your loved one with the administration involved in getting enrolled. Once you and your loved one are enrolled, you are required to work with a licensed agency to document your work, get support, and get paid as their caregiver. Givers can serve as your licensed agency in some states to help you easily meet all requirements.

Check your eligibility for free here>>

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