Adult Foster Care (AFC) is a community-based, non-institutional long-term care option for adults needing daily support with personal activities. This model provides housing and personalized assistance in a home-like setting, serving as an alternative to larger facilities like nursing homes or assisted living centers. AFC offers a supportive, intimate environment that promotes the recipient’s safety and well-being. It is designed for individuals who cannot live independently but do not require the continuous, intensive medical services of a hospital or skilled nursing facility.
The Residential Model
The Adult Foster Care model is characterized by its small scale and private residential setting, distinguishing it from larger commercial facilities. Care is typically provided in a single-family home where the caregiver or provider family also resides, creating a low resident-to-caregiver ratio. This structure allows for a high degree of personalized attention and a more natural, familiar atmosphere.
The number of residents permitted is strictly regulated, often limited to between two and six individuals, depending on state and local licensing classifications. This small capacity helps foster a cohesive, family-style environment beneficial for the residents’ emotional and social health. The physical setting offers residents private or semi-private bedrooms and shared common areas, closely mirroring a typical family household.
Eligibility for Placement and Provision
Eligibility for Adult Foster Care involves separate criteria for both the recipient seeking placement and the provider. A potential AFC resident must be an adult requiring daily hands-on help or supervision with at least one Activity of Daily Living (ADL), such as bathing, dressing, transferring, or eating. Individuals must have a relatively stable medical condition and cannot require continuous skilled nursing care, as the AFC setting is not equipped for intensive medical management.
The provider, often a family member or trained professional, must meet strict requirements for licensure. Caregivers must typically be over the age of 18 or 21 and live in the home to provide 24-hour supervision. A comprehensive background check is mandatory for all applicants and adult household members to ensure resident safety.
Providers must complete state-mandated training covering resident rights, medication management, and emergency procedures. The home must pass fire safety and health inspections, demonstrating a safe and supportive environment. While family members are often eligible to be providers, spouses and legal guardians are frequently excluded from receiving payment as caregivers under certain state programs.
Scope of Care and Limitations
The services provided within Adult Foster Care are comprehensive, focusing on personal support and daily living assistance. Caregivers routinely assist with Activities of Daily Living (ADLs), including personal hygiene, mobility assistance, and feeding, tailored to the resident’s individualized care plan. Beyond physical care, the scope includes preparing nutritious meals and arranging transportation to medical appointments.
A core function of the caregiver is the management and administration of medications. Despite the high level of personal care, AFC has clear boundaries regarding medical complexity. The model generally cannot accommodate individuals requiring continuous skilled nursing care, such as complex wound care or ventilator management. Furthermore, residents exhibiting severe behavioral issues that could endanger themselves or others may be deemed unsuitable for the small, non-clinical setting.
Funding and Regulatory Oversight
Funding for Adult Foster Care services comes from a combination of sources. Many recipients cover the cost of room and board through private pay, using personal savings, pensions, or long-term care insurance. For individuals with limited financial resources, AFC is often covered through Medicaid or specific Medicaid Home and Community-Based Services (HCBS) waivers.
Custodial care, which forms the basis of AFC, is typically not covered by general Medicare insurance. The regulatory framework for AFC is established and enforced at the state or county level, ensuring adherence to minimum standards. Licensing is mandatory for AFC homes and requires regular inspections and ongoing monitoring of the caregivers. Licensed case managers or social workers make periodic visits to the home to assess the resident’s well-being and the quality of care provided.