This article was written by Sue Gregg, the Midwest Regional Director for Caregiver Homes.

Community based services like Structured Family Caregiving become available to consumers when the state in which they reside opts to include those services in a Medicaid waiver. A waiver is a mechanism that enables a state to serve consumers in a new or different way from what federal guidelines originally required, and it allows a state to fulfill consumers' needs in the way that best suits them. Structured Family Caregiving is a new service that will become available in the State of Indiana in the summer of 2013 for elders and individuals with disabilities through the Aged and Disabled Waiver administered by the Indiana Division of Aging (pending final approval for elders in the near future). Structured Family Caregiving is currently offered in other states under different names (Adult Foster Care in Ohio; Enhanced Adult Foster Care in Mass; RIte @ Home in Rhode Island).

In September, 2012, the state of Indiana updated its policy and added Structured Family Caregiving to a waiver that provides choices for individuals with intellectual and developmental disabilities about how and where to receive service in the community. This summer Caregiver Homes will become a recognized provider of this type of service in that state.*

Indiana is the first state to use the name Structured Family Caregiving to describe a Home and Community Based Medicaid Waiver program that is usually referred to as Adult Foster Care. This is significant as it indicates Indiana's move to allow family members to become compensated caregivers and adopts Caregiver Homes' innovative model that supports full-time, live-in paid family caregivers through a professional team of nurses and care managers and uses technology to ensure compliance and improve outcomes. As a new provider in the state, Caregiver Homes will be available and will concentrate on raising awareness of this new type of service offering first in the Indianapolis- Marion County and Fort Wayne-Allen County regions of the state.

Caregiver Homes of Indiana is the second Midwest program for the Caregiver Homes Network and joins Caregiver Homes of Ohio which began to serve consumers in May, 2012. Caregiver Homes of Ohio provides Structured Family Caregiving to individuals with intellectual and developmental disabilities through the Ohio Department of Developmental Disabilities' Individual Options Waiver services: Adult Foster Care and Adult Family Living. It is anticipated that the program will grow to include elders and individuals with physical disabilities through participation in Ohio's Integrated Care Delivery System (ICDS) demonstration to service individuals that are both Medicare and Medicaid eligible.

Caregiver Homes of Ohio and Caregiver Homes of Indiana work with advocacy organizations within their states to be part of the conversations around public policy issues that impact consumers that we serve. An example would be the Arc of Ohio and the Arc of Indiana for consumers with intellectual and developmental disabilities. For elders and individuals with physical disabilities Caregiver Homes works with the Ohio and Indiana Area Agencies on Aging for through the Aging and Disability Resource Centers.

The expansion of Structured Family Caregiving (by all of its names) into the Midwest Region gives providers of Structured Family Caregiving, including Caregiver Homes, the opportunity to continue to build on best practices and incorporate quality standards across multiple states to further develop staff expertise in the fields of aging, behavioral health and developmental disabilities. For those of us who believe that no one can care for family like family, the expansion of Structured Family Caregiving is extremely positive, and I am delighted to be part of the ongoing effort to make it available to consumers in communities in more states over time.


*The Family and Social Services Administration (FSSA), through the Division of Disability and Rehabilitative Services (DDRS), Bureau of Developmental Disabilities Services (BDDS) included Structure Family Caregiving as a new service within the Community Integration and Habilitation Waiver for individuals with intellectual and developmental disabilities.