How Is Structured Family Caregiving Pay Set in Georgia?

In Georgia, Structured Family Caregiving (SFC) pay is not set by the caregiver or by the agency. The Georgia Department of Community Health (DCH) sets the daily Medicaid rate for SFC. Medicaid pays that rate to an approved SFC provider agency. The agency then pays the family caregiver.

For families, the rule is simple. SFC caregivers are paid by direct deposit every two weeks; the amount is set by the loved one's assessed level of care. No one can tell you your amount before that assessment happens.

This guide explains who decides the rate, how the assessment fits in, how the money moves, and where to see the current official figure. We do not print a number here. Rates change, and the only reliable figure is the one in Georgia's own documents.

SFC pay at a glance

• Who pays: Georgia Medicaid, through the Elderly and Disabled Waiver Program (EDWP)
• Who sets the rate: the Georgia Department of Community Health
• How it is billed: as a daily service, by a DCH-approved SFC provider agency
• How the caregiver is paid: by direct deposit every two weeks; the amount is set by the loved one's assessed level of care
• What shapes the amount: the assessment of how much daily help your loved one needs
• Where to see current rates: Appendix R of Georgia's EDWP (CCSP and SOURCE) provider manual

Who qualifies for a paid SFC caregiver in Georgia?

Pay only comes into the picture once both people qualify. SFC is a service inside EDWP, so the loved one must be in that program first. The caregiver must also meet the program's rules.

When DCH added SFC to the waiver, its public notice described who the service is for. In plain terms, the basics are:

• The loved one is in EDWP. That means enrollment through CCSP or SOURCE, Georgia's two EDWP service paths.
• The loved one has Georgia Medicaid. SFC is a Medicaid service.
• The loved one needs a lot of daily help. DCH set SFC for members assessed as needing at least five hours of personal support a day.
• A family caregiver lives in the home. The DCH EDWP fact sheet describes SFC as support for a live-in family member.

Our guide to Structured Family Care covers the full caregiver rules, including who cannot be the paid caregiver. Not sure your family fits? Use our eligibility page or the online eligibility form.

Who sets the SFC pay rate in Georgia?

DCH sets the Medicaid rate for every EDWP service, including SFC. A provider agency cannot raise it. A family cannot negotiate it. Medicaid pays approved SFC providers the rate DCH publishes.

Rate changes follow a public process. DCH publishes a notice and invites public comment. The Board of Community Health then votes. Changes to the waiver itself also need approval from the federal Centers for Medicare & Medicaid Services (CMS).

You can see this process in DCH's own records. In March 2024, DCH issued a public notice proposing to adjust EDWP rates based on a rate study. SFC was on that list, billed as a daily unit. An earlier 2018 rate notice shows that some EDWP rate increases also depend on funding from the Georgia General Assembly.

How an SFC rate change happens

1. 1

   Review the rates

   DCH reviews costs, often through a rate study, or the legislature funds an increase.

2. 2

   Publish a notice

   DCH posts a public notice describing the proposed change.

3. 3

   Take public comment

   Providers, families and advocates can send written comments.

4. 4

   Board vote

   The Board of Community Health votes on the change.

5. 5

   Federal approval

   Changes to the waiver need CMS approval before they take effect.

How does the assessment affect SFC pay?

The assessment is the step that matters most for your family. A care coordinator reviews how much help your loved one needs with daily tasks. That review shapes the care plan and the level of care.

DCH designed SFC to replace agency aide hours, not add to them. Its notice says the SFC rate is "an offset to the equivalent number of hours of Personal Support Services." In other words, SFC stands in for the hands-on help an aide would otherwise give.

This is why the caregiver's amount follows the loved one's assessed level of care. It does not follow the caregiver's skills, hours worked, or household costs. If your loved one's needs change, the care plan can be reviewed.

How does SFC money get from Medicaid to the caregiver?

Families often ask why the agency is involved at all. The answer is that Georgia Medicaid pays approved providers, not individual relatives. Georgia's EDWP provider manual says SFC agencies provide coaching, support and a daily financial stipend to live-in family caregivers.

Part of what Medicaid pays the agency covers the support DCH requires around the caregiver. That includes a health coach who reviews the caregiver's daily notes.

Where can I see the current SFC rate?

Georgia publishes EDWP provider rates in its provider manual. Look for Appendix R, "Reimbursement Rates for CCSP and SOURCE," in the EDWP (CCSP and SOURCE) General Services manual. The manual is updated regularly, so always check the newest version on the Georgia Medicaid provider portal.

Keep one point in mind as you read it. Appendix R shows what Medicaid pays the provider agency. It is not the same as the caregiver's direct deposit.

Why do websites show different SFC pay amounts?

Search for SFC pay and you will see many different numbers. There are a few common reasons.

• Some pages quote the daily rate Medicaid pays the agency. Others quote what a caregiver receives.
• Some pages quote a daily amount, others a weekly or monthly one.
• Rates change after rate studies and budget decisions, and older pages are not always updated.
• Some figures are estimates made before any assessment.

The safest approach is to treat any number online as a rough guide only. Your family's amount depends on the assessment and the current DCH rate.

Is SFC pay taxable?

Taxes are a separate question from how pay is set. The IRS has issued Notice 2014-7, which covers certain Medicaid waiver payments to caregivers who live with the person they care for. Whether it applies to you depends on your situation. Please confirm with a tax professional.

What can change an SFC caregiver's pay?

• A new assessment or care plan review. If your loved one's level of care changes, the amount can change too.
• A DCH rate change. New rates take effect only after the public process and any needed approvals.
• A change in eligibility. SFC depends on your loved one staying in EDWP with Georgia Medicaid.
• A change in living arrangements. The caregiver must live in the same home as the loved one.

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.

We explain how SFC pay works for your family before you enroll. We handle the Medicaid billing, and we pay SFC caregivers by direct deposit every two weeks; the amount is set by the loved one's assessed level of care. If SFC is not the right fit, we will say so and explain other options.

• 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