Personal Support Services Georgia Medicaid: SFC vs PSS Explained

Georgia Pays Family Caregivers Through Two Different Programs

Most families don't realize that Georgia Medicaid will pay a family member to care for an aging parent at home. The state operates two distinct paid caregiving pathways under the Elderly and Disabled Waiver Program (EDWP): Structured Family Caregiving (SFC) and Personal Support Services (PSS).

Both programs serve the same population — Medicaid-eligible seniors who meet a nursing facility level of care — but the compensation structure, living requirements, and tax implications are fundamentally different.

Structured Family Caregiving (SFC)

SFC pays a flat daily stipend to a family caregiver who lives with the care recipient. The payment is structured as a difficulty-of-care foster payment rather than a wage.

2026 pay rates: $67–$80 per day, which translates to roughly $1,987–$2,400 per month.

Tax treatment: The stipend is fully excludable from federal income tax under IRS Notice 2014-7. This is a significant financial advantage — a $2,400/month tax-free stipend has the same spending power as roughly $3,100–$3,400 in taxable wages, depending on the caregiver's tax bracket and state.

Key requirements:

• The caregiver must live in the same home as the care recipient — full-time cohabitation is mandatory
• No outside employment is permitted. The caregiver cannot hold a second job, work remotely, or freelance while receiving the SFC stipend
• Daily electronic care logging is required
• Monthly home visits by a registered nurse and a health coach for ongoing oversight
• Spouses, legal guardians, parents of minors, and court-appointed conservators are excluded from serving as SFC caregivers

Who typically qualifies: Adult children, siblings, grandchildren, nieces, nephews, and close family friends who are willing to move in with (or already live with) the care recipient and make caregiving their full-time occupation.

Personal Support Services (PSS)

PSS pays an hourly wage to a caregiver through a home care agency contracted under the Medicaid waiver. The caregiver is employed by the agency, not directly by the state.

2026 pay rates: Typically $12.50–$16.00 per hour, depending on the agency's pay scale and the region.

Tax treatment: Standard W-2 employment. Federal income tax, state income tax, Social Security, and Medicare (FICA) are all withheld. At $15/hour for 40 hours per week, gross monthly pay is approximately $2,600, but take-home pay after taxes is considerably less than the equivalent SFC stipend.

Key requirements:

• The caregiver does not need to live with the care recipient
• Outside employment is permitted, as long as work schedules don't conflict with caregiving shifts
• The caregiver works through a Medicaid-contracted home care agency, which handles payroll, scheduling, and basic oversight
• Family member exclusions are narrower — spouses and legal guardians are typically excluded, but most other family relationships are permitted

Side-by-Side Comparison

How to Decide Between SFC and PSS

Choose SFC if: The caregiver is willing to make full-time caregiving their sole occupation and can live with the parent. The tax-free stipend makes this the financially superior option in most cases — $2,400/month untaxed beats $2,600/month with 25–30% going to taxes. The trade-off is total commitment: no second job, no remote work, and structured daily documentation.

Choose PSS if: The caregiver needs to maintain outside employment, can't or doesn't want to live with the parent, or the family prefers a less rigid structure. PSS also works for situations where caregiving responsibilities are split among multiple family members working different shifts.

Note: A recipient cannot receive PSS or another in-home personal-care service at the same time as SFC. Ask the case manager which pathway applies to the care plan.

How to Enroll

Both programs require the care recipient to be enrolled in the CCSP or SOURCE waiver program first. The pathway:

1. Contact the Aging and Disability Resource Connection (ADRC) at 1-866-552-4464
2. Complete the clinical screening (DON-R assessment) to establish nursing facility level of care
3. Apply for Medicaid through DFCS if not already enrolled
4. Once waiver enrollment is confirmed, discuss SFC or PSS with the assigned case manager
5. For SFC: the care coordinator connects the family with an approved SFC provider agency that handles onboarding, training, and equipment
6. For PSS: the case manager identifies a Medicaid-contracted home care agency that accepts family member employees

Planning Caregiving as Part of the Bigger Picture

Getting paid to care for a parent solves one problem but opens others — tax planning, impact on the caregiver's own retirement contributions, and what happens if the parent's needs eventually exceed what a family caregiver can provide.

The Georgia Care Decision Guide covers both paid caregiving programs alongside the full care transition framework: evaluating care levels, navigating Medicaid eligibility, protecting family assets, and planning for the point when home care may no longer be enough.

See more Georgia guides →