What is Structured Family Caregiving?
Structured Family Caregiving is a Medicaid home and community-based service for people who need daily help and live with a family caregiver. The caregiver provides personal care, supervision and household help around the clock, and a licensed SFC agency pays them a daily stipend and supports them with a care manager and a nurse or health coach.
It's sometimes shortened to structured family care or described as structured family home care, because the care happens in a shared home rather than in shifts. The idea is simple: a relative who is already doing the work full-time gets paid and supported to keep doing it, and the person receiving care avoids a nursing home.
SFC is different from hourly programs like CDPAP or IHSS. There are no timesheets for each hour. Instead, the agency checks in regularly and keeps daily notes on how your relative is doing.
How the Structured Family Caregiving program works
Every Structured Family Caregiving program follows the same basic pattern:
- Your relative qualifies for Medicaid and for the waiver that includes SFC — usually a nursing-home level of care.
- You live together. The caregiver and the person receiving care must share a home. It can be yours or theirs.
- You enroll with an approved SFC agency, which does a home visit and sets up a care plan.
- The agency pays you a daily stipend, usually weekly or twice a month, at a rate tied to your relative's care level.
- You get ongoing support — regular visits or calls from a care manager and nurse, training, and often a way to log daily notes.
The caregiver is usually not an employee of the agency; the stipend is a payment for care. That's one reason it's often treated as difficulty-of-care income rather than wages.
Day to day, the work is what you likely already do: helping with bathing and dressing, preparing meals, managing medications, getting your relative to appointments and keeping an eye on them overnight. The difference is that someone now checks in on how you're coping, helps you plan for bad weeks, and pays you for the time. That support is part of the service, not an extra, and it's especially useful when caring for someone with dementia.
Which states offer Structured Family Caregiving?
Six states offer a service called Structured Family Caregiving in their Medicaid programs:
| State | Program | Reported caregiver pay | Spouse can be caregiver? |
|---|---|---|---|
| Georgia | SFC through CCSP and SOURCE | ~$1,987–$2,400/month | No |
| Indiana | SFC in PathWays and Health & Wellness waivers | ~$46–$80/day | Yes |
| Ohio | SFC in PASSPORT and MyCare | ~$1,500–$3,000/month | Yes |
| Missouri | Structured Family Caregiving Waiver (dementia) | Daily stipend | Yes |
| Nevada | SFCG Waiver (dementia) | At least 65% of the daily rate | Yes |
| South Dakota | SFC in the HOPE Waiver | ~$392/week | Yes |
Several other states pay live-in family caregivers through the same kind of service under a different name: Connecticut's Adult Family Living, Massachusetts' Adult Foster Care, Louisiana's Monitored In-Home Caregiving and North Carolina's Coordinated Caregiving. Some national trackers count 11 states in total. If your state isn't listed, see Medicaid family caregiver programs by state for its hourly options.
Structured Family Caregiving Georgia
Georgia Structured Family Caregiving is the state's main way to pay a relative who lives with an older adult or a person with a disability. The daily stipend is reported at about $80 a day in 2026 — roughly $1,987 to $2,400 a month depending on the care tier — paid weekly and generally tax-free.
Who qualifies for the SFC program in Georgia
- The member must be on Georgia Medicaid and enrolled in CCSP (the Community Care Services Program) or SOURCE.
- The caregiver must live with the member and enroll through a licensed SFC provider agency.
- Spouses can't be the paid SFC caregiver, and parents of minor children are excluded. Adult children and other relatives can.
To start the SFC program Georgia offers, call your Area Agency on Aging for a CCSP or SOURCE screening, then choose an SFC provider agency. CCSP has capped slots and can have a waitlist; SOURCE, for people on SSI, generally doesn't. Families asking about Structured Family Caregiving Georgia in metro Atlanta can start at Fulton County, DeKalb County, Cobb County or Gwinnett County. See Georgia caregiver pay for rates.
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Structured Family Caregiving Indiana
Indiana has one of the most established programs. Structured Family Caregiving Indiana pays a daily rate to the SFC agency, which must pass at least 60% of it to the caregiver. Program rates effective July 1, 2025:
| Level | Daily program rate | Caregiver's share (60%+) |
|---|---|---|
| Level 1 | $77.54 | about $46.52 or more |
| Level 2 | $99.71 | about $59.83 or more |
| Level 3 | $133.44 | about $80.06 or more |
That's the source of the widely reported "$46 to $80 a day" range. The stipend is generally tax-free because caregiver and member live together.
Indiana is unusually open about who can be the caregiver: a live-in spouse can be paid through SFC, and parents, guardians and stepparents of minor children can provide SFC under the Health & Wellness waiver. The drawback is access. The PathWays and Health & Wellness waivers have had waitlists since 2024. Start with your Area Agency on Aging for intake. See the Indiana caregiver program, Indiana caregiver pay, Marion County and Lake County.
Ohio, Missouri, Nevada and South Dakota
Ohio offers SFC through PASSPORT and Next Generation MyCare, and spouses can be the paid caregiver. MyCare has no enrollment cap. See Franklin County and Cuyahoga County.
Missouri runs a small Structured Family Caregiving Waiver for people with a dementia diagnosis, capped at about 300 participants. Unlike Missouri's hourly program, it allows a spouse or legal guardian to be the paid live-in caregiver.
Nevada's SFCG Waiver also serves adults with dementia, with about 156 slots in 2026. The caregiver must receive at least 65% of the Medicaid daily rate, and a spouse can be the caregiver.
South Dakota offers SFC in the HOPE Waiver. Rates from July 1, 2026 run from $82.00 to $114.81 a day by tier, with at least 50% paid to the caregiver. Spouses can be paid.
The living-together requirement
SFC only works if you share a home. That usually means one of three things: your parent moves in with you, you move in with your parent, or you already live together as spouses or relatives.
Agencies check the living arrangement at enrollment and during home visits. If you move out, the stipend stops, though your relative may be able to switch to an hourly service.
Is the stipend taxable?
Often not. Under IRS Notice 2014-7, Medicaid waiver payments to a caregiver who lives in the same home as the person receiving care can be excluded from income as difficulty-of-care payments. Because SFC requires living together, most SFC stipends fall under this rule. Your circumstances matter, so confirm with a tax preparer.
That makes SFC pay worth more than it looks next to an hourly wage. Compare state by state in family caregiver pay rates.
Structured Family Caregiving vs. hourly paid family care
| Structured Family Caregiving | Hourly self-directed care | |
|---|---|---|
| Must live together | Yes | No |
| How you're paid | Daily stipend through an agency | Hourly wage through a payroll agency |
| Timesheets | Daily notes, no hourly logs | Hours logged each shift |
| Support | Care manager and nurse built in | Varies by state |
| Spouse | Allowed in most SFC states | Often barred |
If you're weighing both, the deciding points are usually whether you live together and whether the person you care for needs someone there most of the day. Read 24-hour home care for round-the-clock options.
How to apply
- Confirm your state offers SFC or a live-in equivalent (table above).
- Apply for Medicaid and request a long-term care assessment through the Area Agency on Aging or state agency.
- Ask specifically for Structured Family Caregiving when the waiver services are discussed.
- Choose an SFC agency and schedule the home visit.
- Start receiving the stipend once the care plan is approved.
Sunroom Care helps families with this paperwork at no cost to them. Check eligibility to see if SFC is available to you.
Where to go next
Frequently asked questions
What is Structured Family Caregiving?
A Medicaid waiver service that pays a family caregiver who lives with the person needing care a daily stipend, through an approved agency that also provides coaching and nurse support.
Do I have to live with my relative?
Yes. Sharing a home is the core requirement of Structured Family Caregiving.
How much does Structured Family Caregiving pay?
It depends on the state and care level. Indiana caregivers receive at least 60% of $77.54 to $133.44 a day, and Georgia reports about $1,987 to $2,400 a month.
Can a spouse be paid through Structured Family Caregiving?
In Indiana, Ohio, Missouri, Nevada and South Dakota, yes. In Georgia, no.
Is the SFC stipend taxable?
Often not. Under IRS Notice 2014-7, Medicaid waiver payments to a live-in caregiver can be excluded from income. Confirm with a tax preparer.
Is there a waitlist?
Often. Indiana's waivers, Georgia's CCSP and the capped waivers in Missouri, Nevada and South Dakota can all have waitlists. Ohio's MyCare has no cap.
Sources: IRS: certain Medicaid waiver payments may be excludable from income · Indiana FSSA: Structured Family Caregiving · Georgia Department of Community Health: CCSP and SOURCE · Medicaid Planning Assistance: Structured Family Caregiving by state. Program rules and rates change — always confirm with the program. Reviewed September 30, 2026.