Structured Family Caregiving Requirements in Georgia:The Full Checklist

To qualify for Structured Family Caregiving (SFC) in Georgia, the person receiving care must be on Georgia Medicaid, enrolled in the Elderly and Disabled Waiver Program, and assessed as needing a lot of daily help, and the caregiver must be an adult relative who lives with them and passes a state fingerprint background check. Legally responsible relatives, such as a spouse or legal guardian, cannot be the paid caregiver.

This checklist goes one requirement at a time. It shows who must meet each rule, who checks it, and what paperwork backs it up. It also covers the part most guides skip: the background check, and what can disqualify a caregiver.

SFC requirements at a glance

• Requirements apply to two people: the Medicaid member who receives care, and the family caregiver
• The member must: have Georgia Medicaid, be enrolled in EDWP through CCSP or SOURCE, and need substantial daily personal support
• The caregiver must: be an adult relative, live in the same home, and not be legally responsible for the member
• Background check: fingerprint-based, run through Georgia's GCHEXS system before care starts
• Who checks the rules: the Area Agency on Aging, the care coordinator, DCH's Background Investigation Unit, and the SFC provider
• Official rules: Georgia DCH, in its EDWP fact sheet and provider manual

Does your loved one meet the SFC requirements?

Start with the person who needs care. If they do not meet these rules, the caregiver rules do not matter yet. Tick each one you can confirm.

• Age or disability. EDWP serves adults 21 and older who are elderly or functionally impaired, according to the DCH fact sheet.
• Nursing-home level of care. They need the intermediate level of care that would qualify them for a nursing home.
• Georgia Medicaid. They have Medicaid, or are likely to qualify after the financial review.
• Enrolled in EDWP. SFC is a service inside CCSP and SOURCE, the two paths of the waiver.
• A physician-approved care plan. DCH lists approval of the care plan by the member's doctor as a requirement.
• A choice of care at home. They prefer services in the community to a nursing facility.
• Enough daily need for SFC. DCH's SFC waiver notice set the service for members assessed as needing at least five hours of personal support each day.

The last item is decided by the assessment, not by the family. The assessment looks at how much hands-on help your loved one needs each day. Our guide to how SFC pay is set explains how that assessment also shapes the care plan.

Does the caregiver meet the SFC requirements?

Now check the family member who will give care. All of these must be true.

• An adult relative. The Georgia Council on Developmental Disabilities describes eligible caregivers as adult biological, adoptive or step-relatives.
• Lives with the member. DCH describes SFC as care by a live-in family caregiver. GCDD says the two must share the same primary residence.
• Not legally responsible for the member. GCDD lists spouses and legal guardians as excluded. For EDWP services, it also names parents of minor children and conservators.
• Passes the background check. DCH requires a fingerprint-based check before SFC care begins.
• Works with a health coach. The caregiver agrees to regular support from the provider's health coach and sends daily notes about the member's condition.

If a spouse is the main helper today, another relative in the home may still qualify. We cover that situation in Can a Spouse Be Paid as a Caregiver in Georgia?

Who checks each SFC requirement?

Families often wonder who decides. Different people check different rules.

What disqualifies you from being an SFC caregiver?

Some things rule a caregiver out completely. Others can be fixed.

Things that rule out a caregiver

• Being the member's spouse or legal guardian. Legally responsible relatives cannot be the paid SFC caregiver.
• Living somewhere else. SFC is built around a caregiver who lives in the home.
• Certain criminal records. The DCH provider manual bars anyone with a prior conviction for abuse, neglect, mistreatment or financial exploitation from direct member care. DCH's SFC instructions add that violent felonies and sexual offenses disqualify no matter how long ago they happened.

Things that can often be fixed

• The member is not on Medicaid yet. The DCH fact sheet says new applicants apply at their county DFCS office.
• The member is not enrolled in EDWP yet. The screening starts with a call to the Area Agency on Aging.
• A record error. DCH says applicants can challenge an inaccurate record with the arresting agency or court.
• A pending charge. DCH says a pending charge for a disqualifying offense leads to an unsatisfactory result, which can be appealed.

How does the SFC background check work?

The check runs through the Georgia Criminal History Check System, called GCHEXS. DCH's SFC applicant instructions set out the steps.

1. 1

   Register in the portal

   Create an account in the GCHEXS Application Background Check portal. Use the SFC provider code your provider gives you.

2. 2

   Enter your details

   Fill in your information. Your SFC provider then reviews and submits the application.

3. 3

   Book fingerprints

   You will get an email from IDEMIA with a number and a link to schedule fingerprints at a site near you.

4. 4

   Submit within the deadline

   DCH says fingerprints must be submitted within 90 days of the emails, or the application closes.

5. 5

   Watch for your result

   Your portal shows Satisfactory or Unsatisfactory. DCH may ask for more documents first.

A fee applies to fingerprinting. The GCHEXS email says whether your employer has paid it. If you were fingerprinted for an earlier job, GCHEXS decides whether you need new prints.

What if the result is unsatisfactory?

The applicant can appeal. DCH says the appeal goes to its Office of Inspector General within 10 days of the unsatisfactory letter. The provider cannot appeal for you. The Office of State Administrative Hearings hears the case. DCH's provider manual also says checks must be repeated every three years.

What paperwork proves the SFC requirements?

There are two sets of paperwork. One is for your loved one's EDWP and Medicaid eligibility. The other is for the caregiver.

For the person receiving care

Georgia.gov lists what the EDWP application asks for:

• Proof of income
• Proof of assets, such as bank accounts or property
• Proof of citizenship
• A doctor's approval for intermediate nursing home care
• A doctor's approval for a care plan

For the caregiver

• A completed GCHEXS application and fingerprints
• Any other documents your SFC provider asks for during intake

Ask your SFC provider for its document list in writing, so nothing is missed.

Do SFC requirements change after you are approved?

Yes, some do. The requirements must keep being met while care continues.

• Background checks are repeated. DCH's manual says SFC checks must be completed again every three years.
• The caregiver keeps living in the home. SFC depends on a live-in caregiver. Talk to your provider before any move.
• Daily notes continue. The caregiver keeps sending notes about the member's condition to the health coach.

For an overview of how SFC works day to day, see our guide to Structured Family Caregiving in Georgia. New to the waiver? Read What Is EDWP?

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. Our Structured Family Caregiving team walks families through this checklist before any paperwork starts.

We can help you see which requirements you already meet and which ones still need work. We also guide caregivers through the GCHEXS background check. If SFC is not the right fit, we will tell you early.

• Phone: 678-446-1832
• Hours: Monday to Friday, 8am to 6pm
• Email: info@gahac.com
• Office: 4505 Peachtree Industrial Blvd, Suite K, Norcross, GA 30092
• Quick check: fill in our eligibility form or visit our eligibility page