Structured Family Caregiving (SFC), also known as Caregiver Homes of Indiana, is a fairly new model of caregiving. It provides financial and supportive services for family (and non-family) caregivers. It empowers caregivers to care for seniors and those with disabilities who wish to remain at home, or in the home of an approved caregiver, rather than become institutionalized into a nursing home. It is not a standalone program. Rather, it is a benefit associated with Indiana’s Aged and Disability Medicaid Waiver or Indiana Programs of All-Inclusive Care for the Elderly (PACE).
Structured Family Caregiving works as follows: A caregiver either moves into the home of an elderly or disabled individual; or the reverse, the care recipient moves into the caregiver’s home. The care provider receives financial compensation for providing care to the elderly individual who would otherwise require nursing home level care, as well as ongoing educational support from a care team.
Under this program, the adult children of aging parents receive compensation for having their aging parent live with them and being their primary caregiver.
Caregivers can be related to the care recipients. Commonly, it is the adult children who become the paid caregivers. However, there is no requirement that care recipients and caregivers be related. Sometimes, a friend, in-law, or neighbor becomes the caregiver. In 2020, Indiana expanded SFC to allow spouses to take part in this program as compensated caregivers. And as of 2021, the program also includes legal guardians.
Administrators at local state agencies supervise and approve all SFC caregiver / care recipient matchings and are responsible for training and paying caregivers. There are also intermediary agencies who manage much of the eligibility and compliance process with the state. This frees caregivers to provide care. For their role, the intermediary agencies take a percentage of the caregiver compensation. Our estimate is this figure is generally between 40% and 60%. Thus, if you are considering working as a paid caregiver through this program, it is important to understand how much the agency takes and the services they provide.
Eligibility requirements apply to both the care recipient and the one applying to be the caregiver.
Care Recipient Requirements
To qualify under the SFC program, an applicant must be a resident of Indiana, be financially eligible for the Aged and Disability Medicaid Waiver, and meet the level of care for nursing facility placement as determined by a case manager. This generally means that the care recipient needs help with three personal care tasks per day. The eligible individual must also live full time with his or her caregiver.
The primary caregiver must be at least 18 years of age and be deemed physically and mentally capable of performing his or her caregiving responsibilities. He or she must be willing to complete a criminal background check.
A case manager and a registered nurse from the Structured Family Caregiving overseeing agency creates a service plan tailored to each individual applicant’s needs. Applicants are placed into one of three levels, which determine the amount of compensation the caregiver receives. Below, we estimate the monthly compensation caregivers receive as well as the amount the intermediary agency takes. The level of care is related to the amount of personal care needs that are required by the care recipient. The figures in the table below are current as of August 2022. Please note that the estimated monthly rate is based on a 30-day month. Thus, the monthly compensation will vary based on the number of days in a month.
|Care Level||Est. Monthly Caregiver Compensation||Est. Monthly Agency Compensation||Total State Payment|
|Level 1||$741.00 – $1,104.00||$741.00 – $1,104.00||$1,830.00|
|Level 2||$867.48 – $1,293.72||$867.48 – $1,293.72||$2,146.20|
|Level 3||$993.00 – $1,482.00||$993.00 – $1,482.00||$2,460.00|
Caregivers are expected to provide the majority of the care recipient’s personal care needs. This includes housekeeping, laundry, shopping, transportation, and assistance with activities of daily living, such as eating, dressing, and mobility. However, the case manager and registered nurse from SFC will continue to make regular home visits to offer support. Unskilled respite care, up to 15 days per year, is also available to relieve caregivers.
Care recipients can also continue to receive other services available via the Aged and Disabled Waiver. Most notably they can receive adult day care, transportation to and from adult day care and medical appointments, home delivered meals, personal emergency response systems, and limited financial assistance for home modifications that increase their home’s safety and accessibility.
For more information about the Structured Family Caregiving program, call the Indiana Division of Aging toll free at 1-888-673-0002. Persons wishing to apply for Medicaid or become eligible for the Indiana Aged and Disabled Waiver should contact their local Indiana Area Agency on Aging.