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The Structured Family Caregiving Waiver (SFCW) is a Home and Community Based Services (HCBS) waiver service offered through the Division of Senior and Disability Services (DSDS) available to participants with a diagnosis of Alzheimer’s disease or related dementia disorders. The goal of the SFCW is to provide necessary care to participants in a home environment by fostering the participant’s independence while preserving dignity, self-respect, and privacy in a non-institutional setting.​

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All SFCW participants must meet the following eligibility criteria:

• Be 21 years of age and over at initial entry

• Diagnosed with Alzheimer's or related dementia disorders as defined by state statute 172.800 RSMo by a physician licensed in the State of Missouri

• Reside full time in the same household as the primary caregiver

• Have an established backup plan

• A qualified substitute caregiver familiar with the participant’s needs, chosen by the participant or legal guardian and employed by the provider, must be identified and available to provide services at times when the primary caregiver is not available. 

• Meet Nursing Facility Level of Care (LOC) • Have an appropriate Medicaid Eligibility (ME) code

• Have an appropriate Medicaid Eligibility (ME) code

• Be in active Medicaid status

  • Participants eligible for Medicaid on a spenddown basis may be authorized to receive SFCW during periods when spenddown liability is met.

  • When the participant has not met their monthly spenddown liability amount, the participant and provider may make a private arrangement for the continued delivery of services. In these instances, the participant is responsible for the cost of services received.

  • Authorization of the SFCW does not meet the requirements for an individual to be eligible for Home and Community Based (HCB) Medicaid.

  • Participants in a ‘Transfer of Property penalty’ are eligible for Medicaid funded SFCW

  • Participants who receive Medicaid due to eligibility for Blind Pension (BP) are not eligible for the SFCW.

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​RESTRICTIONS

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The SFCW has the following restrictions:

• The participant must not be enrolled in any other HCBS state plan or waiver service, regardless of which state agency administers the waiver

• Individuals who reside in a facility of any kind, group home, or boarding home are not eligible for the SFCW.

• The hiring of more than one primary caregiver is not allowed.

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​Allowable Services and Supports

These are supportive and health-related attendant and homemaker services that substitute for the absence, loss, reduction, or impairment of a physical or cognitive function. The following are services related to needed Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs) .

• Homemaker which includes general household tasks like cleaning and laundry.

• Attendant care to provide assistance with ADLs such as bathing, dressing, and other personal care tasks.

• Medication oversight to manage medications and doses (to the extent permitted under State law).

• Escorting for necessary appointments, whenever possible, such as transporting individuals to doctor appointments and community activities that are therapeutic in nature or assists with maintaining natural supports.​​​​​​​​​​