The Structured Family Caregiving Waiver (SFCW) is a program that enables family members (including spouses) or friends to care for their loved ones at home who suffer from Alzheimer’s or other dementia-related disorders. Similar to the Consumer Directed Services program but geared towards family members at home with individuals who have active Missouri Medicaid and suffer from dementia, this program will allow, for the first time, family members or others who reside in the same household to provide caring and companionship at home to their loved ones in need.

When did the program start?
The Structured Family Caregiving Waiver became effective on July 1st, 2021. The Missouri HealthNet Division (MHD) along with the Department of Health and Senior Services, Division of Senior and Disability Services (DSDS) implemented the Structured Family Caregiving Waiver (SFCW). SFCW is designed to provide an option for individuals ages 21 and older diagnosed with Alzheimer’s or a related disorder who wish to live at home in the community and would otherwise require institutionalization in a nursing facility to remain in the community. This waiver is unique in that it requires both the primary caregiver and participant to reside in the same home, whether it be the private home of the primary caregiver or the participant. Furthermore, the primary and substitute caregivers may be a non-family member, a family member, or a legal guardian, which includes spouses.

How does the program work?
Structured Family Caregiving Waiver (SFCW) services are inclusive of all homemaker and attendant care services outlined in the participant’s plan of care. Allowable activities include homemaker and attendant care services related to activities of daily living (ADLs) medication oversight, escorting to necessary appointments such as doctor appointments and community activities that are therapeutic in nature or assist with maintaining natural supports, and/or supportive and health-related attendant and homemaker services that substitute for the absence, loss, diminution or impairment of a physical or cognitive function. SFCW services also includes a qualified substitute caregiver chosen by the participant and employed by At Home Care to provide services at times when the paid primary caregiver is not available.

Eligibility Criteria
All Structured Family Caregiving Waiver (SFCW) participants must:

• Be 21 years of age and over;
• Be in active Medicaid status and have an appropriate Medicaid Eligibility (ME) code
• Be diagnosed with Alzheimer’s disease or a related disorder as defined by 172.800 RSMo
• Have a primary caregiver that resides in the same household;
• Have a qualified substitute caregiver selected by the participant and/or legal guardian
  * The participant may request the selected provider to provide a substitute caregiver. If the selected provider is unable to supply a substitute caregiver, the participant and/or legal guardian shall identify a substitute caregiver before proceeding further with the SFCW request.
• Agree to participate in a comprehensive face-to-face (re)assessment with DSDS or its designee.
• Meet Nursing Facility Level of Care (LOC);

Restrictions
Initial and continued enrollment in the Structured Family Caregiving Waiver (SFCW) are subject to the following restrictions:

• Shall not be enrolled in any other state plan or waiver service, as the intent of SFCW is to meet all care needs of the participant;
• Shall not reside in a facility of any kind;
• The hiring of more than one primary caregiver is not allowed.

How do I sign up to participate or find out more information?
To find out more about the Structured Family Caregiving Waiver or to sign up to participate in the program through At Home Care, please call our office at 1-866-AT-HOME-8.