Ask GCDD Anything! Learn about Structured Family Caregiving

The Georgia Council on Developmental Disabilities (GCDD) invites you to ask our team questions about legislation, supports, services, or other topics that are related to individuals with intellectual or developmental disabilities (I/DD). The following is this month's question and answer.

The Question: A GCDD community member from Alpharetta asked: Please provide information about programs where an unemployed caretaker is paid for a caregiving role.

The Answer: Georgia operates programs that allow family members to get paid for providing care. Both programs are funded through the Medicaid waiver system and are for people who are actively enrolled in Medicaid.

Structured Family Caregiving (SFC)

The SFC program provides a tax-free daily stipend to primary caregivers who live in the same home as the person receiving care.

• The Benefit: Caregivers typically receive a daily stipend ranging from $65 to over $100, depending on the care recipient's level of need.
• Eligibility: Adult biological, adoptive, or step-relatives are eligible and can be paid. The caregiver must live in the same primary residence as the person they are caring for.
• Who CANNOT Be Paid: Legally responsible individuals are not eligible. This means that spouses and legal guardians (parents or other adults who are responsible for the care of a child) are strictly excluded from being paid under SFC.

Personal Support Services (PSS)

PSS pays family members directly for providing hands-on assistance to elderly, disabled, and medically fragile individuals. It is a program of Georgia's CCSP (Community Care Services Program) and SOURCE (Service Options Using Resources in a Community Environment) waivers.

• The Benefit: Caregivers are paid an hourly rate to help with activities of daily living (ADLs), such as bathing, dressing, meal preparation, and light housekeeping.
• Eligibility: To qualify for these programs, both the caregiver and the person receiving care must meet specific requirements. The requirements include income limits and an evaluation to prove that the person needs the same level of care as a person in a skilled nursing home. The person who needs care must be enrolled in either the CCSP or SOURCE waiver programs.
• Who CANNOT Be Paid: Spouses, parents of minor children, legal guardians, and conservators are not eligible to receive payment as caregivers.

Visit Georgia’s Aging and Disability Resource Connection web page for more information on this program.

Participant-Directed Services (NOW and COMP Waivers)

Participant Direction (also called Self-Direction) allows individuals with I/DD, or their representatives, to hire and supervise their own support staff. This often includes family members who can be paid. It is available through Georgia's NOW (New Options Waiver) and COMP (Comprehensive Supports Waiver Program). For adults with I/DD, this is usually the most significant Medicaid-funded option.

• The Benefit: Family members and other workers can be hired and paid to provide authorized support services. The individual or their representative directs care by choosing, hiring, and supervising their own staff, giving families greater control over who provides support and how.
• Eligibility: To qualify, the person receiving care must have either a NOW or COMP waiver, and the specific service must be authorized in their Individual Service Plan (ISP). A Financial Support Services provider handles payroll and taxes for the hired workers.
• Who CANNOT Be Paid: Not every family member is eligible. Legally responsible relatives are often restricted from being paid as caregivers in certain circumstances.

Learn more on Georgia’s Participant Direct website.

Georgia Pediatric Program (GAPP)

GAPP provides in-home nursing and personal care services for medically fragile children under Medicaid. Under certain circumstances, parents or family members may be paid as caregivers.

• The Benefit: Family members, and in some cases parents, may be paid to provide in-home care. Services primarily include skilled nursing and personal care delivered in the home.
• Eligibility: The child must be medically fragile and enrolled in Medicaid. They must also qualify for GAPP's nursing or personal care services. Eligibility for a parent or family member to be paid depends on the specific circumstances of the case.
• Who CANNOT Be Paid: Eligibility for paid family caregivers is based on the individual case and is not guaranteed. Specific restrictions on which relatives can be paid vary by case and program rules.

Visit the Georgia Pediatric Program website for additional details.

Caregiver Training

All programs require that caregivers meet state-mandated skill sets. The type of training, time commitment, and certifications differ between the programs.

Do you have a question for the GCDD team? Submit your question here.