Georgia Structured Family Caregiving (SFC) pays a live-in family caregiver a daily stipend of roughly $80 per day in 2026 to care for a Medicaid member, but Georgia Medicaid does not pay a spouse. SFC is a service offered under Georgia's Elderly and Disabled Waiver Program, delivered through the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE). A spouse, legal guardian, parent of a minor child, or conservator cannot be the paid SFC caregiver, so an adult child, sibling, grandchild, or in-law is the typical paid caregiver. This guide covers who qualifies, what SFC pays, the tax treatment under federal rules, and how to apply.

In This Guide

What Is Georgia Structured Family Caregiving?

Structured Family Caregiving (SFC) is a Medicaid home and community-based services (HCBS) model in which a family caregiver who lives with the care recipient receives a daily stipend for providing daily care. In Georgia, SFC is an authorized service inside the Elderly and Disabled Waiver Program (EDWP), which operates through two Section 1915(c) HCBS waivers: the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE). Both are administered by the Georgia Department of Community Health (DCH).

The "structured" part refers to the agency oversight that comes with the payment. SFC operates through a home care agency that contracts with the state, conducts an initial assessment, trains the caregiver, runs background checks, and provides ongoing case management, a registered nurse contact, and backup respite. The family caregiver provides the daily hands-on care.

Two rules trip up most families:

  • SFC is a service, not a program. You do not apply for SFC directly. The care recipient must first be enrolled in CCSP or SOURCE, which requires Georgia Medicaid eligibility and a nursing-facility level-of-care determination. SFC is then chosen as one of the waiver's services.
  • The caregiver must live in the home. Co-residence is required for SFC, and it is also the condition that makes the stipend tax-free under federal rules. A caregiver who does not live with the recipient cannot receive the SFC stipend.

Who Can Be Paid (and Who Cannot)

The single most important rule for a Georgia family is who the law lets you pay. A spouse, legal guardian, parent of a minor-child recipient, or conservator is not eligible to be the paid SFC caregiver. This exclusion is uniform across Georgia Medicaid's self-direction rails, not just SFC.,

Generally eligible to be the paid SFC caregiver:

  • Adult children of the care recipient
  • Adult grandchildren
  • Adult siblings
  • Adult in-law relatives (daughter-in-law, son-in-law, sister-in-law, brother-in-law)
  • Other adult relatives who are not the recipient's spouse, guardian, or conservator

Not eligible:

  • Spouses (spousal caregiving is treated as an expected part of marriage)
  • Legal guardians and conservators
  • Parents of a minor-child recipient

If the person who needs to be paid is a spouse, Georgia Medicaid is not the route. The only Georgia rails that can compensate a spouse are VA programs: the Program of Comprehensive Assistance for Family Caregivers (PCAFC), Veteran Directed Care, and VA Aid and Attendance (which a veteran can use to pay any family member privately).

What Georgia Structured Family Caregiving Pays

In 2026, the SFC stipend paid to the family caregiver runs roughly $80 per day, about $560 per week, or $1,987 to $2,400 per month. The caregiver typically receives 50 to 65 percent of the daily per-diem Medicaid pays the SFC agency; the agency retains the balance to fund nurse visits, monthly in-home coaching, 24/7 phone support, annual training, and backup respite. Care recipients with higher acuity, such as advanced dementia or significant behavioral-health needs, may carry higher amounts. Specific rates vary by agency, contract year, and assessment, so confirm the operative figure with your contracted agency.

The stipend is generally tax-free. Under federal Notice 2014-7, Medicaid HCBS payments to a caregiver who lives in the care recipient's home may be excluded from federal gross income as difficulty-of-care payments under Internal Revenue Code Section 131. The exclusion is what makes co-residence so consequential: it applies only when the caregiver lives in the recipient's home, and it fails the moment the caregiver does not. The agency issues tax documentation but reports the payments as excludable. State income tax treatment may vary, and SFC stipends are generally not subject to FICA withholding. Consult a tax professional for your situation.

Because the stipend is excluded from gross income rather than paid as taxable wages, the after-tax value is materially higher than equivalent W-2 wages, and the payment is generally not counted as earned income for the Social Security earnings test. The exact effect depends on your tax bracket and household situation.

How SFC Compares to Other Georgia Pathways

SFC is one of several ways a Georgia family member can be paid. The differences that matter are whether the caregiver must live in the home, whether the pay is a daily stipend or an hourly wage, and which population the program serves.

Pathway Who it serves Live-in required Pay structure Can a spouse be paid?
Structured Family Caregiving (SFC) CCSP or SOURCE members at nursing-facility level of care Yes Daily stipend, ~$80/day No
CCSP Personal Support Consumer Direction (PSCD) CCSP members No Hourly wage No
NOW and COMP Participant Direction People with intellectual or developmental disabilities No Hourly wage No
Independent Care Waiver Program (ICWP) self-direction Adults 21 to 64 with severe physical disability or TBI No Hourly wage No
VA programs (PCAFC, Veteran Directed Care, Aid and Attendance) Eligible veterans Varies Stipend or private pay Yes

A few distinctions are worth spelling out:

How to Apply in Georgia

Because SFC sits inside a waiver, the application starts with the waiver, not the SFC service.

1
Step 1

Apply for CCSP or SOURCE

For CCSP, contact your local Area Agency on Aging through the Georgia ADRC at 1-866-552-4464. For SOURCE, contact a SOURCE-enrolled provider. Medicaid eligibility is established through Georgia Gateway.

2
Step 2

Get a nursing-facility level-of-care determination

Georgia uses the Determination of Need-Revised (DON-R) assessment to evaluate the care recipient's functional needs.

3
Step 3

Enroll in the waiver

Enrollment requires Medicaid financial eligibility, the level-of-care determination, and an available waiver slot. CCSP commonly operates a waitlist when capacity is reached; SOURCE has historically had no waitlist.

4
Step 4

Choose SFC and select a contracted agency

Once enrolled, tell your case manager you want SFC, then select among DCH-contracted SFC agencies such as Careforth (formerly Seniorlink), Health Force of Georgia, Structured Family Caregiving of Georgia (Newnan), and Passion to Care HC.

5
Step 5

Complete assessment, background check, and training

The agency conducts a home assessment, builds the care plan, runs a criminal background check on the caregiver, and provides initial training. Stipend payments begin once the caregiver is approved.

The full process from waiver application to the first SFC payment commonly takes two to six months, depending on waitlist status and assessment scheduling.

Frequently Asked Questions

Can my spouse be my paid SFC caregiver in Georgia?

No. A spouse, legal guardian, parent of a minor-child recipient, or conservator cannot be the paid Structured Family Caregiving caregiver. This bar is uniform across Georgia Medicaid's self-direction rails. The only Georgia pathways that can pay a spouse are VA programs, which operate separately from Medicaid.

How much does SFC pay in Georgia in 2026?

The 2026 SFC stipend paid to the caregiver runs roughly $80 per day, about $560 per week, or $1,987 to $2,400 per month. The caregiver typically receives 50 to 65 percent of the daily per-diem Medicaid pays the agency; the agency keeps the rest for nurse visits, coaching, 24/7 support, training, and respite. Higher-acuity care plans may carry higher amounts. Confirm the figure with your contracted agency.

Is the SFC stipend taxable?

Generally no. Under federal Notice 2014-7, SFC stipends paid to a caregiver who lives in the recipient's home are typically excludable from federal gross income as difficulty-of-care payments under Internal Revenue Code Section 131. The exclusion depends on co-residence and fails if the caregiver does not live in the home. State tax treatment may vary, and the payments are generally not subject to FICA. Consult a tax professional.

Do I have to live with the care recipient?

Yes. Co-residence is required for SFC, and it is also what makes the stipend tax-free under federal rules. A caregiver who does not live with the recipient cannot receive the SFC stipend, though hourly options such as CCSP Personal Support Consumer Direction do not require co-residence.

Which Georgia Medicaid programs offer SFC?

SFC is offered under the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE), the two Section 1915(c) waivers that make up Georgia's Elderly and Disabled Waiver Program. It is not offered under ICWP, NOW, or COMP.

Which agencies provide SFC in Georgia?

Active SFC agencies in Georgia include Careforth (formerly Seniorlink), Health Force of Georgia, Structured Family Caregiving of Georgia (Newnan), and Passion to Care HC. The current contracted list can change, so confirm options with DCH or your CCSP or SOURCE case manager.

How do I apply for SFC in Georgia?

Apply for CCSP or SOURCE first, since SFC is a waiver service rather than a standalone program. Contact the Georgia ADRC at 1-866-552-4464 (for CCSP) or a SOURCE-enrolled provider, establish Medicaid eligibility through Georgia Gateway, complete a nursing-facility level-of-care determination, then choose SFC and a contracted agency once enrolled.

Can I work an outside job while receiving SFC?

SFC involves substantial daily care, often approaching full-time responsibility, so most SFC caregivers do not hold a full-time outside job. Limited part-time work may be possible if the care recipient's needs are still met with backup coverage. Discuss any outside work with your agency and case manager.

Learn More

MedicaidGeorgia CCSP WaiverGeorgia CCSP Waiver 2026: who qualifies for the Community Care Services Program, what it covers, and how to apply through your Area Agency on Aging. MedicaidGeorgia SOURCE WaiverHow the Georgia SOURCE waiver works in 2026: a delivery model inside the 1915(c) Elderly and Disabled Waiver Program, eligibility, sites, and how to apply. MedicaidGeorgia ICWP WaiverGeorgia's Independent Care Waiver Program (ICWP) funds home care for adults 21-64 with severe physical disabilities or TBI. Eligibility, services, how to apply. MedicaidGeorgia Medicaid Self-Directed ServicesGeorgia has not adopted Section 1915(j) standalone. Here are the Medicaid self-direction and family-caregiver-payment paths that actually exist in Georgia. MedicaidGeorgia HCBS WaiversGeorgia's five Medicaid HCBS waivers in 2026: who CCSP, SOURCE, ICWP, NOW, and COMP serve, the 300% SSI income rule, the planning list, and how to apply. CaregiverHow to Get Paid as a Family Caregiver in GeorgiaGeorgia pays family caregivers via Structured Family Caregiving (about $80/day, tax-free), CCSP, SOURCE, ICWP, NOW/COMP, and VA programs. A 2026 guide.

Find personalized help getting paid as a family caregiver in Georgia at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.