What’s the difference?
Structured Family Caregiver (SFC) is a special program for live-in family caregivers who are unable to work due to taking care of a Medicaid member. With SFC, one primary caregiver is selected and only that person can receive stipend payments for taking care of the member. Switching to another family caregiver requires approval from the Case Manager and the SFC provider agency.
Family Hire (FH) is when a Medicaid member is approved to receive traditional home care services through CCSP, SOURCE, ICWP, NOW, or COMP. Normally, the personal care services are provided by non-related personal care aides, but with Family Hire, an immediate or extended family member can also be hired to work in the home, as long as that family member has onboarded with the home care provider agency in the same way that any other employee would.
SFC caregivers are not allowed to have a job or business, whereas FH caregivers can. SFC caregivers must live in the same home, but Family Hire caregivers do not have to live in the same home.
FH caregivers are just one of potentially multiple paid caregivers working in the home, whereas SFC can only have one paid primary caregiver at a time.
| Program Guidelines | Family Hire (FH) | Structured Family Caregiver (SFC) |
| Must be in the same house? | No | Yes |
| Can be spouse? | No | No |
| Can be the client’s guardian? | No | No |
| Can be parent of care recipient under age 18? | No | No |
| Allowed to work other jobs? | Yes | No |
| Must be at least a PCA | Yes | N/A |
| Schedule and mandatory EVV required? | Yes | No. *must submit daily tasks |
| Background check/fingerprints? | Yes | Yes |
| Payment type | Employee | Independent contractor, receives Stipend |
| Periodic in-services (training) required? | Yes | Yes |
| Travel allowed? | Yes, but only in the United States. Prior notification to DCH and Case Management is required for time out of the home (member and aide together) for vacation/family circumstance purposes. This is important in the event that a medical emergency occurs outside the state, insurance may not reimburse–leaving the member responsible for their own bills and possibly being kicked out the EDWP program as well. Providers are not responsible for travel costs. Out of Country travel with Medicaid is prohibited. | |
| What about non-related live-in caregivers? | Not allowed in CCSP / SOURCE, effective July 2023 in Medicaid. | Not allowed in the program. |
| Can other, non-related or related caregivers be scheduled to work shifts? | Yes | No. Only one designated SFC caregiver permitted at a time. Each one must be approved separately. |
