An Adult Foster Care (AFC) home is a community-based alternative for long-term support for individuals who require daily assistance. This model is designed for adults unable to live independently due to a physical, mental, or chronic condition, but who do not require the comprehensive medical services of a hospital or nursing home. The core philosophy centers on providing personalized care within a familiar, non-institutional environment, ensuring residents’ physical and emotional needs are met.
The Core Model of Adult Foster Care
AFC homes are small, residential, and family-like settings, often operating out of a private single-family house. They typically house between two and six residents, fostering an intimate and personalized atmosphere. This low capacity allows for a high staff-to-resident ratio, ensuring attentive and consistent support. In many models, the primary caregiver lives in the home, providing 24-hour non-medical supervision.
State-level licensing and regulations govern these homes, ensuring they meet minimum standards for safety and care provision. Although not medical institutions, the licensing process dictates the maximum number of residents and the operational structure. This small scale promotes a sense of community and allows care plans to be highly tailored to the preferences and daily habits of each resident.
Services and Support Provided to Residents
Support in an AFC home focuses primarily on assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ADLs include fundamental self-care tasks like bathing, dressing, grooming, and mobility. Caregivers also provide cueing and supervision for residents with cognitive impairments.
IADLs involve more complex tasks that support independent living. Primary services include:
- Meal preparation and dietary oversight.
- Medication administration, including managing prescriptions and providing reminders.
- Coordinating transportation for medical appointments and social outings.
- Facilitating social engagement opportunities to promote overall well-being.
Eligibility and Resident Profile
Placement is determined by the individual’s functional and medical needs. A person must require daily assistance, supervision, or cueing with at least one Activity of Daily Living due to a physical, cognitive, or chronic health condition. While many programs cater to older adults, some also include adults aged 18 and over with qualifying disabilities.
A primary limitation is that the individual must be medically stable and cannot require continuous skilled nursing care. High-level medical interventions, such as complex wound care, intravenous therapy, or ventilator support, disqualify a person from AFC placement. The ideal resident benefits from 24/7 supervision and personal care support but does not necessitate a clinical environment.
Differentiating AFC from Institutional Settings
AFC homes offer a middle ground between personal home care and larger institutional settings like Assisted Living Facilities (ALFs) and Skilled Nursing Facilities (SNFs). The primary contrast is size and environment. AFC homes are small, residential properties with a maximum of six residents, resulting in a much higher staff-to-resident ratio compared to larger, apartment-style ALFs.
Skilled Nursing Facilities (SNFs) represent the highest level of medical care, providing 24-hour access to licensed nurses for complex clinical needs, such as rehabilitation. AFC homes, conversely, provide non-medical personal care and supervision, making them unsuitable for individuals with unstable or complex medical conditions.
Funding models also differ. AFC is often covered through state Medicaid waivers for home and community-based services, while SNFs rely heavily on Medicare and Medicaid for their comprehensive medical services.