Georgia Structured Family Care
Questions & Answers

Structured Family Care is a program that is funded by GA Medicaid through the Elderly and Disabled Waiver. With this program a Caregiver related by blood or marriage (spouses and legal guardians do not qualify) can get paid a weekly stipend to care for a loved one.  

The purpose of this program is to pay family members to care for loved ones with a long-term chronic physical diagnosis instead of receiving care from someone outside the home. This will work to help keep these loved ones out of nursing homes, and assisted living facilities, and assure they will get the best and most loving care possible.

Examples of daily tasks for taking care of a family member include:

• Meal prep
• Feeding
• Bathing
• Dressing
• Getting in and out of bed
• Transportation to medical appointments
• Moving around the house

Step 1 – Telephone Call with our Structured Family Caregiving Advisor

The first step in the SFC approval process is to make sure the client (your loved one needing care) and the caregiver meet state of Georgia qualifications. A telephone call with our director of Structured Family Caregiving will help determine qualification status.

You can call us right now at (770) 458-8500 extension 709.

Basic Qualifications of Client (Loved One)

1. Must have GA Medicaid or be eligible.
2. Must have a long term physical diagnosis
3. Must live in same household as caregiver.
4. Must be 21 years of age or older.

Basic Qualifications of Structured Family Caregiver

1. Must live in same household as loved one.
2. Must be 18 years of age or older.
3. Must be able to pass a criminal background check.
4. Cannot be employed once enrolled in the program.

Health Force of Georgia will need the following information for your loved one to place the referral:

1. Name
2. DOB
3. Marital status
4. Address
5. Income amount and source (EX: $1000 from Social Security)
6. Main person of Contact, relationship to loved one, and phone number
7. Primary Physician and location of practice
8. Medical Diagnosis of Loved one
9. Obtain Medical Records (History and Physical)
10. Social Security Number
11. Medicaid ID number if actively enrolled in GA Medicaid

Step 2 – Referral to Your Area Agency on Aging

Once state of Georgia SFC qualifications in step 1 have been confirmed by your Health Force of Georgia specialist, we’ll put in a referral on your behalf to the Area Agency on Aging (AAA) office. The AAA administers screening and is responsible for ensuring the client is eligible for the next step in the SFC approval process. Each AAA location handles a geographic area of the state based on the county the client resides in.

Step 3 – Selection of the Case Management Company & RN Assessment

With a successful screening by the AAA, the next step in the SFC approval process is selection of the case management company by the client. The case management company works with the client to schedule an RN assessment and receives results of the assessment.

Step 4 – Application Sent to Alliant Health Solutions (AHS – GA Medicaid)

The case management company reviews the RN assessment and sends it to AHS for approval.

Step 5 – Paperwork Sent to DFCS (Georgia Division of Family and Children Services State Office)

Once approved by AHS, the case management company submits paperwork to DFCS to obtain the EDWP Medicaid Waiver (Elderly and Disabled Waiver Program). The EDWP Medicaid Waiver is necessary because it allows clients to receive services at home under the SFC program.

Step 6 – Client Becomes Active in EDWP Medicaid Waiver Services

Congratulations, you’ve made it! The case management company informs the client they are approved into the SFC program. The last step is to select a health coach company.

Step 7 – Selection of Health Force of Georgia as the Health Coach Company

The last step is to select Health Force of Georgia as the clients' health coach company. The caregiver becomes a contractor of Health Force of Georgia making them eligible to receive:

• Tax-free, financial stipend paid weekly and direct deposited for your caregiving support
• Coaching and guidance from our professional health coach
• Telephone and email access to directly connect you with your structured family care support team.
• After hours/weekend access for emergency support

No, unfortunately. Social Security is a federal program and does not pay a caregiver directly to take care of a family member. Only the Structured Family Caregiving Program under Georgia Medicaid pays the caregiver directly through an approved health coach company like Health Force of Georgia, an approved health coach company!

• To validate your referral you will need to obtain medical records from their physician.
• This physician will need to be the one who is most familiar with their care. In most cases, it is their primary care provider (PCP), but can also be a specialist (e.g. if the client is an Alzheimer’s patient, the physician that is most familiar with their case may be their neurologist).
• Ask their physician to fax a recent H&P (this stands for History and Physical) to our Fax at 770-458-9050 “Attention Intake”, this information should include:

1. 1. The patient’s diagnoses
   2. Current Medications
   3. A brief summary of their medical history

How recent to the records have to be?

Ideally within the past six months, but just ask them to send the most current H&P they have. Remember, this is just a starting point for case management. They can follow up with the doctors if they need additional information.

Can I just send them to you directly if I already have these documents on hand?

Yes, as long as all the elements from the list above are present. They can fax them like above, or they can also scan and email the documents to Intake@HealthForceGA.com

Can’t you just call the doctor’s office for me and do it?

Generally, no. This is because we would need a signed Release of Information from the patient for the doctor’s office to be able to release those records to us.