Question 1

What is Structured Family Caregiving?

Accepted Answer

Structured Family Caregiving (SFC) is an Indiana Medicaid program that pays family members and trusted loved ones to provide full-time care at home. If you're already helping a parent, spouse, sibling, or close friend with daily tasks (bathing, meals, medication, mobility, supervision), SFC compensates you for that work through a tax-free daily stipend. The program is funded by Indiana Medicaid and administered by the Indiana Family and Social Services Administration (FSSA). It runs through licensed provider agencies like Tender Home Care, who handle the paperwork, compliance, and payments so families don't have to. SFC is part of a national shift away from nursing facility care and toward keeping people at home: better outcomes, lower costs, and more dignity for everyone involved.

Question 2

Why does Indiana pay families to provide care at home?

Accepted Answer

It saves the state money. A nursing facility in Indiana costs Medicaid roughly $7,000 to $10,000 per month per resident. Keeping someone at home with a family caregiver costs a fraction of that, even after paying the caregiver a fair stipend and the provider agency for compliance work. It also produces better care. Family caregivers know their loved one's history, preferences, routines, and warning signs in a way that no rotating facility staff ever could. Studies consistently show that home-based care results in fewer hospitalizations, less depression, better medication adherence, and longer lifespans. So the program is a rare three-way win: the state spends less, the care recipient gets better support, and the family is compensated for work they were already doing.

Question 3

Does this cost me or my family anything?

Accepted Answer

No. There is no cost to the care recipient. No cost to the caregiver. No hidden fees. No sign-up fees. Nothing comes out of your pocket. Medicaid pays Tender Home Care directly for the program. We retain a portion to cover compliance, home visits, paperwork, and ongoing support, and we pass a generous percentage through to the caregiver as a tax-free weekly stipend. If anyone (another provider, an attorney, anyone) ever tries to charge you for enrollment in SFC, that's a red flag. The program is free to families by design.

Question 4

Is this the same as Consumer-Directed Attendant Care or hourly caregiving?

Accepted Answer

No. People often confuse the two, so it's worth clearing up. Structured Family Caregiving (SFC) is a live-in program. The caregiver lives with the care recipient and provides 24/7 support. Pay is a flat daily stipend, and it's typically tax-free under IRS rules for live-in caregivers. Consumer-Directed Attendant Care (CDAC, sometimes called Attendant Care or ATTC) is an hourly program. The caregiver does not need to live with the recipient. Pay is hourly and taxable like a regular job. Tender Home Care only operates in the SFC program. We made that choice deliberately so we can be excellent at one thing instead of average at several. If you need hourly care without a live-in arrangement, we'll point you toward a CDAC provider.

Question 5

Is Structured Family Caregiving a permanent program, or could it go away?

Accepted Answer

SFC is a permanent fixture of Indiana's Medicaid waiver system and has been for years. It's not a pilot, a grant, or a temporary initiative. That said, all Medicaid programs depend on federal and state funding decisions. The 2025 federal Medicaid changes have created some uncertainty about future funding levels, and Indiana has implemented waitlists for certain waivers in response. But the core SFC program continues to operate, and the political momentum is firmly behind home-based care over institutional care across both parties. We're transparent about this with every family: the program is solid today, demand continues to grow, and the trend lines favor it long-term. We'll always give you honest information about what we're seeing in the regulatory environment.

Question 6

Is this only for elderly care recipients?

Accepted Answer

No. Although a lot of SFC families are caring for aging parents, the program also serves younger adults with disabilities, people with traumatic brain injuries, and individuals with chronic conditions that prevent independent living. The eligibility requirement is medical, not age-based. The care recipient must need help with daily activities and meet Indiana's Nursing Facility Level of Care threshold. That can apply at any age. Different Medicaid waivers cover different populations: Pathways for Aging covers people 60 and older, Health & Wellness covers people under 60 with disabilities, and the Traumatic Brain Injury waiver covers TBI survivors. We'll help you figure out which one applies to your situation.

Question 7

Who can be a paid caregiver under SFC?

Accepted Answer

To be a paid SFC caregiver in Indiana, you must be at least 18 years old, live with the care recipient, pass a background check, and have a real relationship with them. Eligible relationships are broad: spouses, adult children, parents (of adult children only), siblings, grandchildren, nieces, nephews, cousins, in-laws, and close friends all qualify. The program is intentionally flexible because the goal is to support whoever is actually doing the caregiving. Indiana is one of the few states that allows spouses to serve as paid caregivers. Most states don't. If you've been caring for a husband or wife full-time, this is a significant opportunity.

Question 8

Can parents get paid to care for their adult disabled children?

Accepted Answer

Yes. Parents can be paid SFC caregivers for their adult children with disabilities (anyone 18 or older). However, as of July 2024, Indiana no longer allows parents of minor children to be paid through the Attendant Care program. Parents of minors can still be paid through SFC for adult children, and other family members and friends can be paid caregivers for minors in some cases. The rules around minor children are evolving. Reach out and we'll walk through your specific situation.

Question 9

What does the care recipient need to qualify?

Accepted Answer

The person receiving care must meet four conditions: live in Indiana, be enrolled in Indiana Medicaid (or eligible to enroll), need help with daily activities like bathing, dressing, eating, mobility, toileting, or medication, and meet Indiana's Nursing Facility Level of Care threshold. The Nursing Facility Level of Care requirement is the most misunderstood. It does not mean your loved one needs to actually be in a nursing home or want to be. It means their care needs would qualify them for nursing home placement if they chose it. A formal assessment by a Medicaid case manager determines this. If you think your loved one might be close to qualifying but you're not sure, reach out. We do free eligibility checks and we'll tell you honestly within the first conversation.

Question 10

What if my loved one isn't on Medicaid yet, or makes too much money?

Accepted Answer

Not a dealbreaker. Many families we work with start the SFC process before their loved one is enrolled in Medicaid. Indiana has income limits (in 2026, roughly $2,982 per month) and asset limits (about $2,000), but there are legal strategies that help people qualify even with higher income or savings. A Qualified Income Trust can help with income that's slightly above the limit. Spend-down strategies can reduce assets in ways that are legally protected. For complex cases, we recommend working with an elder law attorney or Medicaid planner. We can refer you to ones we trust. The eligibility numbers also change annually with inflation adjustments. If your loved one was over the limit a year or two ago, they may qualify now.

Question 11

Can I be a paid caregiver for more than one person at the same time?

Accepted Answer

In general, no. SFC is a 24/7 live-in program. The assumption is that one caregiver is providing full-time care for one person. The math of "live with someone full-time" doesn't usually work for multiple recipients. There are exceptions. If you have a spouse who also needs care, or if you're caring for two parents in the same household, talk to us. We've helped families navigate those situations. The rules around multiple care recipients are nuanced and depend on the specific waivers and household setup.

Question 12

How long does enrollment take?

Accepted Answer

For most families, the full process, from your first phone call to your first paycheck, takes about 6 weeks. Some families take longer, typically 2 to 4 months. The variables that slow things down are: which waiver applies (some have waitlists), how quickly the care recipient gets the Medicaid eligibility determination, and how fast documents come together. We can't control all of these, but we can manage them. We'll give you a realistic timeline at the first meeting based on your specific situation. If we run into delays, you'll hear from us, not the other way around. The single biggest complaint families have about competitors is feeling left in the dark. We don't do that.

Question 13

What if my loved one is on a waiver waitlist?

Accepted Answer

Indiana has implemented waitlists for certain Medicaid waivers in recent years due to state budget constraints. As of 2026, the Aged & Disabled waiver has a waitlist, while Pathways for Aging and Health & Wellness are actively accepting new applicants. If your loved one ends up on a waitlist, we don't disappear. We monitor your position with the state, prepare everything else in the background (care plans, documentation, caregiver background checks) so you're ready to enroll the day a slot opens. In the meantime, we stay in regular contact and update you whenever there's movement. Some families wait a few months. Others wait longer. We're upfront about timelines and we don't sugarcoat them.

Question 14

What documents will I need to enroll?

Accepted Answer

Don't worry about gathering anything before reaching out. We help families pull documents together one piece at a time. The main pieces, in rough order: photo ID for the caregiver and care recipient, proof of Indiana residency, the care recipient's Medicaid information (or income/asset documentation if applying), basic medical history and current medication list, a background check authorization for the caregiver, and direct deposit information for the caregiver's paychecks. We provide checklists, templates, and reminders. If something is missing or hard to find, tell us. There are usually workarounds.

Question 15

What is a Medicaid waiver and which one applies to my situation?

Accepted Answer

A Medicaid waiver is a special provision that lets Medicaid pay for services it wouldn't normally cover, like home-based care provided by a family member. Each waiver has its own population, eligibility rules, and benefits. For SFC, three waivers matter: Pathways for Aging is for Indiana residents age 60 and older. Launched in 2024 as Indiana's managed long-term services and supports program. Currently active and accepting applicants. Health & Wellness is for Indiana residents under 60 with disabilities. Currently active. Traumatic Brain Injury (TBI) is for people who have had a traumatic brain injury. The older Aged & Disabled (A&D) waiver is being transitioned into Pathways for Aging and has had a waitlist since April 2024. You don't need to figure out which waiver applies before reaching out. We'll determine the right one based on your loved one's age and circumstances.

Question 16

What happens during the in-home enrollment meeting?

Accepted Answer

We come to your home, your kitchen table, your living room, wherever you're comfortable. The meeting usually takes about an hour. We walk through the program in detail, answer every question you have, and start the paperwork together. We collect basic information about the care recipient and caregiver, explain what to expect during the waiver application, and set realistic expectations about the timeline. You won't be asked to commit to anything during this meeting. We're not high-pressure. The goal is for you to leave with a clear understanding of what SFC is, whether you qualify, and what the next steps look like. If you decide it's not for you, that's fine. If you decide to move forward, we begin the application immediately.

Question 17

How much does a paid caregiver earn through SFC?

Accepted Answer

Indiana sets three pay tiers based on the level of care your loved one needs. The tier is determined by a formal assessment, not by us or by you. Tender Home Care passes through a generous percentage of the state's daily rate to the caregiver, paid weekly by direct deposit every Friday. The exact amount depends on the tier. If you want a rough estimate before reaching out, our  walks you through the typical assessment questions in under two minutes. The final number from the official assessment may differ slightly, but the calculator gives a realistic ballpark.

Question 18

Is SFC pay taxable?

Accepted Answer

In most cases, no. SFC stipends typically fall under IRS Notice 2014-7, which classifies certain Medicaid waiver payments to live-in caregivers as excludable "difficulty of care" payments. That means the money doesn't show up as taxable income on your federal return. Tender Home Care files the appropriate tax forms (1099) at year-end, but the income reported is typically marked as non-taxable under 2014-7. Most caregivers receive their full stipend tax-free. There are exceptions. For example, if the caregiver doesn't live with the care recipient, or if the IRS rules change in the future. We always recommend confirming your specific situation with a tax professional. We can refer you to ones familiar with caregiver tax treatment.

Question 19

How and when do I get paid?

Accepted Answer

Every Friday, by direct deposit. We chose weekly pay because caregivers shouldn't have to wait two weeks or a month for income they've earned. The first paycheck arrives the Friday after your enrollment is fully complete and the state has authorized payment. After that, you receive weekly stipends consistently, every Friday, with no exceptions or delays. If a Friday falls on a federal holiday, payments may arrive the business day before or after. We notify you in advance whenever this happens.

Question 20

Will SFC pay affect my own Social Security, SSI, Medicaid, food stamps, or other benefits?

Accepted Answer

This is one of the most important questions, and the answer is "usually not, but it depends." Because most SFC payments are tax-free under IRS Notice 2014-7, they typically don't count as income for federal purposes. That means they usually don't affect Social Security retirement, Medicare, or your tax-based benefits. However, need-based programs like SSI, SNAP (food stamps), and your own Medicaid eligibility can be more sensitive. The treatment varies by program and by state. Some programs do count SFC payments as income; others don't. We strongly recommend talking to a benefits counselor before enrolling if you currently receive any need-based benefits. We can refer you to free counselors who specialize in this. Walking in with eyes open is always better than getting surprised by a benefits change.

Question 21

What happens to my pay if my loved one goes to the hospital, rehab, or a facility?

Accepted Answer

If the care recipient is hospitalized, your daily stipend pauses for the duration of the hospital stay and resumes when they return home. The same applies to short-term rehab stays. We handle the documentation with the state on our end. You focus on being with your loved one. The pause is automatic. You don't need to do anything to trigger it. If your loved one transitions to long-term facility care permanently, SFC ends because the program is for at-home care. We'll work with you through any transition. If they return home later, you can re-enroll. For extended hospital stays, we'll talk through your options. Many families have been through this and there are usually paths forward we can help with.

Question 22

What does a paid SFC caregiver actually do?

Accepted Answer

The day-to-day job is what you're probably already doing: helping your loved one with activities of daily living. That can include personal care (bathing, dressing, grooming, toileting), meal preparation, medication reminders, mobility assistance, transportation to appointments, light housekeeping related to the recipient, and general supervision and companionship. What you're not doing is anything medical that requires a licensed nurse, like wound care, injections, or skilled medical procedures. SFC is non-medical, supportive care. If your loved one needs medical procedures done at home, those are typically provided by a home health agency separately. The state doesn't require you to track every task you do. We provide a simple care log tool that takes minutes a week to keep current.

Question 23

What are the ongoing requirements after enrollment?

Accepted Answer

Three things are required, and we make all of them painless. A home visit every 6 weeks. A nurse or caregiver coach visits to check on your loved one, review the care plan, and make sure things are going well. We schedule around your availability. These visits are typically 30 to 60 minutes. A basic care log. A short record of the care you're providing. You can do it on your phone with the tool we provide. Realistically, this takes about 5 to 10 minutes per week. Care plan updates when needs change. If your loved one's health shifts, we update the care plan together. Sometimes this triggers a re-assessment and a tier change. We handle the paperwork; you provide the information. That's it. No state forms you need to file. No bureaucracy on your end. We absorb the compliance burden.

Question 24

Can I lose my spot in the program or get "fired"?

Accepted Answer

The program isn't designed to remove people. The vast majority of families who exit do so for life reasons, not for non-compliance: the care recipient is hospitalized long-term, moves into a facility, passes away, no longer meets medical eligibility, or the caregiver chooses to step away. You can be removed for serious cause: falsified documentation, abuse or neglect of the care recipient, failure to provide care, or failing background checks. These are rare and they're the kinds of things you'd never accidentally do. We work with you. If we see something that needs to change, we tell you directly and help you fix it. The goal is to keep families enrolled, not to push them out.

Question 25

What if I need a break or want to take a vacation?

Accepted Answer

Caregiver burnout is real and we take it seriously. SFC is a 24/7 commitment, so taking time away requires planning, but it's absolutely possible. For short breaks, another approved family member or friend can typically cover for you. We'll help you set up backup caregivers as part of the care plan. For longer absences, you can arrange for respite care (temporary care provided by another approved person) through the same Medicaid system. Some of the waivers include respite benefits. We also offer support resources for caregivers experiencing burnout: support groups, wellness check-ins, and connections to mental health resources. Caring for someone full-time is one of the hardest jobs in the world. You don't have to do it without support.

Question 26

What if my loved one has dementia or Alzheimer's?

Accepted Answer

SFC frequently serves families dealing with dementia and Alzheimer's. The care recipient's diagnosis is recognized by the state's care assessment, and dementia care typically qualifies for higher tier rates because of the supervision and behavioral support required. Our caregiver coach visits include guidance specific to dementia care: handling sundowning, communication strategies, managing wandering, navigating progressive decline. We connect families with dementia-specific resources in Indiana and provide training as needs change. If you're caring for someone with dementia, you're doing some of the hardest caregiving work there is. The program was built with situations like yours in mind.

Question 27

What does Tender Home Care actually do?

Accepted Answer

We handle everything between you and the state. Specifically: Before enrollment: Eligibility screening, Medicaid waiver application, coordination with your local Area Agency on Aging, caregiver background check, care plan development, and all enrollment documentation. After enrollment: Weekly payment to caregivers every Friday, mandatory home visits every 6 weeks, care plan updates as needs change, ongoing compliance reporting to the state, re-assessments when triggered, training and support for caregivers, and a direct line to us whenever you need it. You focus on caregiving. We handle the system. That's the deal.

Question 28

How is Tender Home Care different from other SFC providers in Indiana?

Accepted Answer

Four things set us apart, and we mean each of them honestly. This is all we do. SFC in Indiana, period. Not multi-state. Not multi-program. Every person and dollar at Tender is dedicated to making this one program excellent. Most competitors spread across attendant care, multiple states, or multiple programs. We come to you. In-person home visits, not just calls. We sit at your kitchen table for enrollment and we come back regularly. Technology is impersonal; presence isn't. Transparency. Honest timelines, clear communication about what caregivers earn, and no hidden fees. Our logo has a window in it for a reason. We tell you what to expect even when it's not what you want to hear. Community. We invest in the neighborhoods we serve through events, sponsorships, and a scholarship program for caregivers pursuing education. We're not extracting from Indiana. We're rooted here.

Question 29

Is Tender Home Care licensed and accredited?

Accepted Answer

Yes. Tender Home Care is a fully licensed Indiana Medicaid provider for the Structured Family Caregiving program. All required state licensure and certifications are in place. We're also Indiana-owned and Indiana-operated. We're not a franchise or a national chain. Our office is in Indiana, our staff is in Indiana, and our investments are in Indiana communities. If you ever want to verify our licensing status, the Indiana FSSA maintains public records of all licensed providers. We're listed there. If you have any concerns about our credentials, ask us directly and we'll show you the documentation.

Question 30

Can I switch from another SFC provider to Tender Home Care?

Accepted Answer

Yes. If you're currently enrolled with another SFC provider and want to switch to Tender Home Care, you can. There's no penalty from the state for switching providers, and you won't lose any of your existing pay rate or hours. Your tier carries over because it was assigned by the state, not by your current provider. The process is straightforward: you notify your current provider that you're switching, we coordinate with the state and your case manager to transfer your enrollment, and your care continues uninterrupted. Most switches complete within 2 to 4 weeks. We've helped families make this transition before. Families typically switch for one of three reasons: their current provider pays a lower percentage to the caregiver, response times and communication are poor, or they want a more local, personal experience. Whatever the reason, we'll talk you through it honestly, including whether switching actually makes sense for your situation. If we don't think it's worth it, we'll say so.

Question 31

What if I have a question that isn't answered here?

Accepted Answer

Ask us directly. The fastest ways: Use the chat in the bottom-right corner of any page on this site. Call us. We answer in person during business hours and return voicemails within 24 hours. Send a quick message through our . Schedule a 15-minute call if you'd rather book a specific time. There's no such thing as a dumb question with this program. The Medicaid system is intentionally complicated, and most families have questions that don't fit neatly into an FAQ. That's what we're here for.

Questions, Answered.

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