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Structured Family Caregiving (SFC) is a Medicaid program in the United States where a family member or a close acquaintance is officially recognized and compensated for providing caregiving services to a relative or friend with health-related needs. SFC programs aim to reduce the need for institutional care by supporting home-based care options.
As life expectancy continues to rise, so does the proportion of older adults, many of whom will require some form of long-term care. [1] This demographic shift is accompanied by a rise in chronic conditions such as dementia, diabetes, and heart disease, further intensifying the need for continuous caregiving.
SFC programs operate under Medicaid waivers. To receive care under these programs, the recipient must be eligible for Medicaid. Eligibility for SFC requires a formal assessment to determine if the person's condition warrants the level of care provided by SFC programs, which is usually the same as the criteria for nursing home care or intensive in-home care. Some programs are designed to cater to specific groups, such as older adults, people with disabilities, or those with chronic conditions.
Many SFC programs have established guidelines regarding the qualifications of caregivers. While family members are often given priority, certain states allow non-family members with a significant personal relationship with the care recipient to be eligible. They may need to undergo training or certification to ensure that the caregiver can provide a high standard of care in a home setting. Usually, the caregiver and the care recipient must live together to qualify for the program.
The stipend paid in SFC programs is determined on a per-day basis and is directly linked to the care recipient's needs as outlined in their Individual Service Plan (ISP). A managing agency or organization is responsible for processing payments in most SFC programs. Caregivers must comply with specific program requirements to receive payments.
Medicaid pays provider agencies a daily stipend, with a percentage of this amount, usually between 50% and 65%, paid to the caregiver. [10] The exact amount varies depending on the state and the needs of the care recipient.