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How to Switch Structured Family Caregiving Provider Agencies

Learn how to evaluate and transition between Structured Family Caregiving providers to ensure optimal care and support for your care recipient.
Published on
April 12, 2024
Presented by Givers
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Structured Family Caregiving offers a unique and personalized approach to in-home care, allowing individuals receiving specific Medicaid waivers in some states to live comfortably in their own homes or with their caregivers. This model supports care recipients by providing necessary supervision and daily care tasks tailored to their needs and empowers family caregivers by offering training programs, financial compensation, and ongoing support. 

As recipients and caregivers navigate the complexities of care in a familiar and supportive environment, understanding how to manage and, when necessary, transition between provider agencies becomes crucial to maintaining the quality and continuity of care.

What is structured family caregiving?

The Structured Family Caregiving service offers recipients of specific Medicaid waivers the opportunity to reside with their caregiver in their own home or that of their caregiver. The goal is to provide necessary care and supervision for the care recipient while letting them stay in their community in the most integrated setting possible. 

Structured Family Caregiving programs enable a family member or a close acquaintance to take on the role of a caregiver, providing care in a familiar environment while earning a daily tax-free stipend for their work. Through structured family caregiving programs, caregivers receive training, financial compensation, and ongoing support to ensure they can offer the best care possible while addressing their needs and well-being.

Caregivers provide a range of essential daily tasks, including but not limited to personal care, supervision, meal preparation, household chores, and medication management, tailored to the individual's needs as outlined in their person-centered Individual Support Plan (ISP), a personalized electronic document outlining a consumer's service needs and preferences, developed collaboratively and finalized with informed consent.

Additionally, depending on the consumer's assessed requirements and reflected in their ISP, the state may authorize payment for additional services offered by third-party Medicaid Providers, such as nursing care, specialized medical equipment, or respite care. However, payment for activities like meals, homemaking, or chore services is not separately provided under Structured Family Caregiving, as these are considered inherent to the service. 

Structured family caregiving is accomplished through a cooperative relationship between the recipient, the caregiver, a case management agency, and a Medicaid-enrolled Structured Family Caregiving Provider agency: 

  1. Primary caregiver: The primary caregiver for the eligible participant. The primary caregiver provides routine intermittent personal care, supervision, cueing, meals, homemaker services, chore services, medication management (to the extent permitted under state law), and other instrumental activities of daily living like transportation for necessary appointments and community activities, shopping, managing finances, and phone use to the recipient. The primary caregiver receives a stipend from the Medicaid-enrolled Structured Family Caregiving Provider Agency. A primary caregiver is not an employee of the Medicaid-enrolled Structured Family Caregiving Provider Agency and is not subject to employee regulations such as wage/hour laws, workers' compensation, and unemployment. 
  2. Case management agency: This agency is responsible for reassessing the participant's needs and eligibility at least annually, facilitating the development of the ISP, calling annual and as-needed meetings to develop and approve changes to the ISP, authorizing additional services, and resolving any participant concerns. 
  3. Medicaid-enrolled Structured Family Caregiving Provider Agency: This agency oversees the Structured Family Caregiving service, providing coaching and support to the principal caregiver and passes through a portion of the Medicaid reimbursement to the primary caregiver. 

Who are you caring for?

Reasons for switching structured family caregiving providers

Reasons for switching structured family caregiving provider agencies can be varied and personal. Understanding these reasons can help ensure that the change aligns with the best interests of the care recipient and meets their evolving needs more effectively:

Dissatisfaction with current care 

Dissatisfaction with current care is often the primary motivator behind changing providers. Issues might include:

  • Inadequate attention to the care recipient's needs
  • Poor communication or responsiveness from the caregiver or agency
  • Frequent changes in assigned caregivers leading to inconsistency in care

Changes in care recipient's needs

As individuals age or their health conditions change, their care requirements also may change, necessitating a provider with different expertise or a higher level of care:

  • Increased medical needs that require specialized skills or certifications
  • Need for more intensive care or supervision than currently provided


Moving to a new geographical location can require finding a new provider closer to the new residence or better suited to the care networks available in that area.

Financial considerations

Changes in the family's financial situation or variations in the cost of care might prompt a switch. This could include:

  • Finding a provider who can pay a higher daily stipend
  • Adjusting to changes in insurance coverage or eligibility for subsidies

The ability to choose your own service provider is a key component of the Structured Family Caregiving service. This choice empowers caregivers to select or change providers for whatever reason they choose. 

How to search for a new structured family caregiving provider

When considering a switch, the first step is researching potential alternatives. 

Begin by communicating your concerns with your current provider to see if issues can be resolved internally. If a resolution isn't possible, inform your case management agency of your desire to change SFC provider agencies, specifying the reasons for your dissatisfaction. Your case manager can then provide a comprehensive list of alternative agencies, allowing you to compare and consider different agencies based on their services, responsiveness, and reputation.

Assess each potential agency's qualifications, how frequently they handle payroll, and their communication practices. Check references and reviews to gauge the experiences of other clients with the agencies. While your case manager cannot direct you to a specific provider, you may still want to ask about agencies with a reputation for being exceptionally responsive and cooperative.

Once you've identified the agency you want to go with, discuss facilitating the transition with your case manager. They will notify your current provider and manage the administrative aspects of changing to a new agency. This process can take a few days to a couple of weeks, depending on various factors. However, always remember that the choice to change providers rests entirely with you, allowing you to make monthly changes if necessary to find the right fit.


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Key factors to look for in a structured family caregiving provider

When searching for a new Structured Family Caregiving Provider Agency, it's essential to consider several key factors that ensure the agency is well-suited to meet the specific needs of the care recipient. 

Experience and training are fundamental. A well-qualified agency should have a robust training program that equips caregivers to handle their clients' varied and often complex needs. 

Personality fit and the agency's operational ethos are equally crucial. Trust your instincts about whether an agency values its clients. Agencies that are more client-focused typically spend more time understanding individual needs rather than rushing through the process. Look for signs that the agency is genuinely interested in building relationships, not just processing transactions. They should provide support during moments of need—such as a sudden change in the care recipient's condition or when the caregiver is under stress—offering reassurance and practical solutions. This level of support indicates that the agency views its role as more than just a facilitator of payments but as a crucial part of the caregiving team dedicated to the well-being of both the caregiver and the recipient.

How to approach the transition with your current agency

Transitioning from your current Structured Family Caregiving Provider Agency requires tact and professionalism to ensure a smooth and respectful changeover. 

Here are some steps to guide this process:

  • Communicate clearly and respectfully: Initiate a conversation with your current provider to explain your decision to switch agencies. Be honest but courteous, focusing on your needs and the care recipient's well-being rather than deficiencies in service. 
  • Review contractual obligations: Before announcing your decision to switch, review any contractual agreements with your current agency to understand any obligations or required notices to avoid penalties or disruptions in care. 
  • Provide adequate notice: Giving your current provider ample notice allows them to prepare for the end of your partnership and, if necessary, assist in transitioning to a new provider. 
  • Discuss transition plans: Engage both your current and future agencies in the transition, which may include transferring documents, medical records, and care plans to ensure continuity of care. A well-coordinated transfer can help minimize disruption for the care recipient.
  • Express gratitude: Regardless of why you leave, acknowledge any positive aspects or support your current agency provided. A thank-you note or a conversation expressing gratitude can go a long way in preserving the relationship and easing the transition process.

Handling the transition with care and respect can ensure a smoother changeover and maintain positive relationships within your caregiving network.

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