North Carolina is one of 11 states with an official Structured Family Caregiving (SFC) program — sometimes marketed as "Coordinated Caregiving" by provider agencies — funded through the state's CAP/DA Medicaid waiver.
What Structured Family Caregiving is in North Carolina
SFC provides a personalized, in-home alternative to residential care for people needing supervision or help with daily activities. It's funded through North Carolina's Community Alternatives Program for Disabled Adults (CAP/DA) and delivered through approved SFC provider agencies.
Could your family member qualify?
- Must be enrolled in North Carolina Medicaid
- Must be eligible for the CAP/DA waiver (limited enrollment slots, may involve a waitlist)
- Must need daily supervision or assistance with activities of daily living. An independent assessment must find limited help needed with 3 of 5 ADLs, extensive help with 2 of 5, or full dependence with 2 of 5
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Check my eligibilityCan you be the paid caregiver?
- Generally lives with the care recipient
- Does not need to be related to the care recipient, though it's often an adult child
- Whether a spouse can be paid depends entirely on which track you use (see below)
Are you the spouse of the person receiving care?
Spousal rules vary a lot by state and by program — don't assume you're disqualified or automatically eligible.
See the spouse answer for this stateThe split inside the same waiver
North Carolina's CAP/DA waiver contains two different tracks, and they treat spouses in opposite ways:
- Consumer Direction — the Medicaid recipient hires and directs their own caregiver. This option excludes spouses. Other relatives can generally be hired.
- Coordinated Caregiving — North Carolina's Structured Family Caregiving model: a live-in caregiver paid a daily stipend through a provider agency. A spouse can be the paid caregiver under this track.
If you are a spouse, Coordinated Caregiving is the track to ask your CAP/DA case manager about.
How pay works
Payments have been described as up to roughly $1,100 per month, though this varies by provider agency and individual care plan.
Ready to apply? Here's where to start
- Confirm the care recipient's North Carolina Medicaid eligibility
- Confirm CAP/DA waiver eligibility and enrollment
- Choose an approved SFC provider agency, or ask your case manager about the Consumer-Directed option instead
- Complete required assessments and enrollment paperwork
- Begin receiving coaching support and payments once approved
Getting approved is only part of it. Family caregivers often need to keep track of care hours, documents, reassessment dates and other benefits — FeatherKeep helps keep that organized in one place.
See how FeatherKeep helpsWhat you'll need to keep track of once approved
- Documentation of care hours and tasks
- Ongoing care plan compliance records
- Payment/tax records from your provider agency
Keeping this organized
Whichever pathway applies to your family, staying on top of documentation is an ongoing responsibility. FeatherKeep organizes this automatically as you go.
Check our Medicaid Structured Family Caregiving checklist →
Check what else you may qualify for →
Related guides: US pillar page, Medicaid checklist tool, Indiana guide, Georgia guide
Disclaimer: General information only, not legal or financial advice. North Carolina's program details, spousal eligibility conditions, and payment amounts vary by provider agency and case, and change over time — confirm current details with NC Medicaid or your CAP/DA case manager before applying.