Can a Spouse Be Paid as a Caregiver in Georgia?

No. Georgia's Structured Family Caregiving (SFC) program does not pay a husband or wife to care for their spouse. Georgia treats a spouse as a legally responsible person. Under SFC, legally responsible people cannot be the paid caregiver.

That is a hard answer for many couples. But it is not the end of the road. Another relative may be able to serve as the paid caregiver. Medicaid can also send trained aides, cover adult day care, and give the spouse a break. If your partner is a veteran, VA has its own caregiver program that does include spouses.

Spouse caregiver pay in Georgia at a glance

• Can a spouse be the paid SFC caregiver? No
• Why not: spouses and legal guardians count as legally responsible individuals
• Who can be paid instead: an adult relative who lives in the same home
• Other Medicaid help: EDWP personal support, respite, adult day health and home-delivered meals
• Veterans: VA's family caregiver program can include spouses, if VA approves
• First step: Georgia's Aging and Disability Resource Connection, 866-552-4464

Who can be a paid family caregiver in Georgia instead of a spouse?

Georgia pays family caregivers through SFC, a service inside the Elderly and Disabled Waiver Program (EDWP). If a spouse cannot be paid, the next question is whether someone else in the family can. The Georgia Council on Developmental Disabilities explains that adult biological, adoptive or step-relatives can be paid SFC caregivers.

For another relative to be the paid caregiver, these points generally need to be true:

• The caregiver is an adult relative. For example, an adult son, daughter, grandchild, sibling, niece or nephew.
• The caregiver lives in the same primary home as the person who needs care.
• The person needing care has Georgia Medicaid and is enrolled in EDWP, through CCSP or SOURCE.
• The person needs a lot of daily help. DCH's SFC notice set the service for members assessed as needing at least five hours of personal support a day.
• The caregiver is not a legally responsible individual, such as a spouse or legal guardian.

Our Structured Family Care guide explains the rest of the program. You can also check your family's fit with our online eligibility form.

Why can't a spouse be the paid SFC caregiver?

The reason is legal responsibility. GCDD states plainly that legally responsible individuals are not eligible to be paid under SFC. In Georgia, that group includes spouses and legal guardians.

The same idea appears in wider Medicaid rules. Federal rules on Medicaid personal care services describe a family member as a "legally responsible relative." Those services must come from someone who is not that kind of family member. You can read the rule at 42 CFR 440.167.

What can a spouse do instead?

Most couples have more options than they expect. EDWP covers a range of services at home and in the community. The DCH EDWP fact sheet lists these and more.

• Another relative as SFC caregiver

  An adult relative who lives in the home may be paid through SFC

• Personal support aides

  Trained aides help with bathing, dressing and meals at home

• Adult day health

  Daytime care in a center, so the spouse can rest or work

• Respite care

  Short breaks for the spouse who gives care every day

• Home-delivered meals

  Meals brought to the door for the person who needs care

• Caregiver support

  Help for caregivers through Georgia's Area Agencies on Aging

If another relative moves in

SFC requires the paid caregiver to live in the same home. Some families plan for an adult child to move in. Talk with an SFC provider before anyone moves. The provider can explain the steps and the order to do them in.

Support for the unpaid spouse

Spouses who give care are still caregivers, even when they are not paid. The Georgia Division of Aging Services says all of Georgia's Area Agencies on Aging help caregivers. Services can include information and help, respite care, adult day care, legal help and telephone counseling. Call 866-552-4464 to reach your local agency.

Can a spouse be paid through VA if the partner is a veteran?

Possibly. This is the main exception families ask about. The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) is a federal VA program, not Georgia Medicaid. VA lists a spouse as someone who can be a family caregiver.

VA sets its own rules for the veteran. They include a VA disability rating at the level VA requires, enrollment in VA health care, and a need for at least six months of continuous, in-person personal care. The veteran and caregiver apply together on VA Form 10-10CG.

An approved Primary Family Caregiver may receive a monthly stipend from VA. They may also get training, respite care and, in some cases, health coverage through CHAMPVA. VA decides who qualifies and how much is paid.

Will a spouse's income and savings affect Medicaid?

Often this worries couples more than caregiver pay. When a married person applies for EDWP, Georgia looks at the couple's finances. The DCH EDWP fact sheet says the assets of a spouse who lives at home must be considered.

The rules also protect the spouse at home. Federal spousal impoverishment rules let the spouse at home keep a protected share of the couple's resources and a monthly income allowance. The EDWP fact sheet notes that some of the applicant's income may be set aside for the spouse at home. The amounts are updated each year, so check the current figures on the official pages.

Who can be paid to help a married Georgian at home?

Each Medicaid option in this table starts with EDWP. Georgia.gov explains how to apply, starting with a call to 866-552-4464.

How A1-GA Healthcare Agency helps

A1-GA Healthcare Agency is a Georgia DCH-approved Medicaid home care provider in Norcross, serving metro Atlanta. We have provided in-home care since 2008 and staffed caregivers since 2004. We offer Structured Family Caregiving and EDWP in-home services.

If a spouse cannot be paid, we help families look at the next options. We can explain whether another relative might qualify for SFC. We can also explain how EDWP personal support, respite and other services might fit. We give honest answers, even when SFC is not the right fit.

• Phone: 678-446-1832
• Hours: Monday to Friday, 8am to 6pm
• Email: [email protected]
• Office: 4505 Peachtree Industrial Blvd, Suite K, Norcross, GA 30092
• Check eligibility online: A1-GA eligibility form