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Missouri Structured Family Caregiving

Missouri's Structured Family Caregiving program pays family caregivers a daily stipend through a Medicaid waiver to provide in-home care to individuals aged 21+ with Alzheimer's disease or a related dementia as an alternative to nursing facility placement. The caregiver must live with the care recipient. Spouses may serve as caregivers. A provider agency coordinates services, provides caregiver training, and conducts regular oversight visits.

Pays family caregivers a daily stipend for providing in-home care to Medicaid-eligible individuals aged 21+ with Alzheimer's disease or a related dementia who require a nursing facility level of care. Missouri's July 2026 HCBS Services Units and Rates appendix lists Structured Family Caregiver as S5126HB, one day, one unit/day, at $110.33. The SFCW policy says the unit is one day/24 hours, the provider may not receive more than 35% of the unit rate, and the provider must pay the primary and substitute caregivers for services rendered. The caregiver must live with the care recipient. Spouses, legal guardians, immediate family, other family, and non-family caregivers may serve when they meet program requirements. An enrolled SFCW provider develops and manages the person-centered care plan and must be selected through participant choice and provider availability. Income and resource eligibility are determined through Medicaid, not SFCW directly.

Eligibility

  • Asset limit of $6,068
  • U.S. citizenship or qualified immigrant status required
  • Care recipient must have a qualifying disability
  • Care recipient age: at least 21
  • Must live with care recipient

Services

Pays family caregivers a daily stipend for providing in-home care to Medicaid-eligible individuals aged 21+ with Alzheimer's disease or a related dementia who require a nursing facility level of care. Missouri's July 2026 HCBS Services Units and Rates appendix lists Structured Family Caregiver as S5126HB, one day, one unit/day, at $110.33. The SFCW policy says the unit is one day/24 hours, the provider may not receive more than 35% of the unit rate, and the provider must pay the primary and substitute caregivers for services rendered. The caregiver must live with the care recipient. Spouses, legal guardians, immediate family, other family, and non-family caregivers may serve when they meet program requirements. An enrolled SFCW provider develops and manages the person-centered care plan and must be selected through participant choice and provider availability. Income and resource eligibility are determined through Medicaid, not SFCW directly.

How to apply

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 the Missouri Structured Family Caregiving Waiver (SFCW)