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Indiana Structured Family Caregiving

Indiana Structured Family Caregiving (SFC) pays a live-in caregiver through an approved provider agency. The service is available through the Health and Wellness, PathWays for Aging, and Traumatic Brain Injury waivers. The participant needs waiver eligibility and an approved service plan.

A daily caregiver stipend, training, provider oversight, and access to a substitute caregiver. The caregiver and participant must live together. Service levels use an assessed-needs score. The agency receives the published daily rate; the caregiver payment depends on the provider agreement and allowable support costs.

Some details for this program are still being verified. Check the official source for the most current information.

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

  • Does the person receiving care live in Indiana? — Residency is usually the first thing a program checks.

What this record does not yet say

  • complete waiver and medicaid category paths
  • tbi diagnosis and alternative level of care rules
  • medicaid income and resource rules
  • immigration status rules and october 2026 change
  • family caregiver and extraordinary care conditions
  • cohabitation and training evaluator
  • complete conditional document checklist
  • full application decision timing
  • current provider and waiver capacity
  • caregiver net stipend by provider agreement
  • front door varies by waiver and enrollment

Services

A daily caregiver stipend, training, provider oversight, and access to a substitute caregiver. The caregiver and participant must live together. Service levels use an assessed-needs score. The agency receives the published daily rate; the caregiver payment depends on the provider agreement and allowable support costs.

How to apply

  • If enrolled in a waiver, ask your care manager to assess SFC needs, identify approved providers, and add approved services to your plan.
  • For a new Health and Wellness or Traumatic Brain Injury waiver application, contact the local Area Agency on Aging at 800-713-9023.
  • For a nursing-facility level-of-care assessment, call Indiana LCAR–Maximus at 833-597-2777. A PathWays member should contact the assigned managed care entity. A TBI applicant who does not meet nursing-facility level of care can be referred to BDS for an ICF/IID assessment.
  • The Division of Family Resources reviews Medicaid financial eligibility. Medicaid enrollment, waiver approval, an approved service plan, and a start date are separate steps.

Use the official program page for application details: official program page.

  • medicaid (depends_on): Care recipient must be Medicaid-eligible
  • hcbs-waivers (companion): SFC is available through Indiana HCBS waivers including Health & Wellness, TBI, and PathWays for Aging

Caregiver support and training

  • The agency must make at least one home visit per quarter and attend each separate quarterly case-management monitoring meeting. The caregiver must receive at least eight hours of training each year. Training can be virtual. The agency must arrange a backup plan and access to a qualified substitute caregiver as needed for up to 15 days per year. [Indiana FSSA]

Waiver eligibility needs a separate review

  • Health and Wellness serves people age 59 or younger with a disability. PathWays serves people age 60 or older. Its disability groups cover ages 60–64; disability verification is not required at age 65 or older. TBI requires a qualifying traumatic brain injury and nursing-facility or ICF/IID level of care. The typed rules do not fully represent TBI diagnosis, alternative level of care, or Medicaid category rules. [Indiana FSSA]

Medicaid status rules need review

  • U.S. citizenship is not the only qualifying status. DFR must review the applicable immigration category and other Medicaid requirements. Indiana has announced a change effective October 1, 2026. This record is due for review before that date. [Indiana FSSA]

Family caregiver conditions

  • A spouse or parent of a minor may be paid only under the waiver’s conditions. Legally responsible caregivers must provide extraordinary care and work through an approved agency. Relatives and legal guardians also need review under Appendices C-2-d and C-2-e. Family relationship alone does not establish eligibility. [Indiana FSSA]

Household and service limits

  • An SFC home normally serves no more than four waiver participants. The state can approve an exception for participants with a family relationship. Separate payment is not made for attendant care or home and community assistance. Assisted living and adult family care cannot be combined with SFC. TBI also lists home modifications and assessments and hourly residential habilitation among incompatible services. Ask the care manager to check the full service plan. [Indiana FSSA]

Check waiver capacity

  • Health and Wellness and PathWays use statewide waiting lists. An approved waiver or a listed SFC provider does not show that a place is available now. Ask the care manager or intake team about the applicable waiver, priority rules, and provider capacity. [Indiana FSSA]

Caregiver income treatment

  • Indiana excludes qualifying SFC income from the caregiver’s Medicaid budget. DFR needs proof of the provider agreement, work relationship, and applicable income-exclusion attestation. This does not remove the participant’s Medicaid financial eligibility review. [Indiana FSSA]

Assessment notice is a separate step

  • LCAR must send its level-of-care outcome letter within 10 business days after the determination. This is not a deadline for the full Medicaid or SFC application decision. [Indiana FSSA]