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Adult Foster Care

If you're a parent or guardian considering having your adult child continue to live at home or in their community after high school, either in the short or long term as they develop their skills, Adult Foster Care – also called Adult Family Care – could be a suitable option.

What is Adult Foster Care?

Adult Foster Care allows adults with disabilities to continue living with their family members or a community member and receive benefits and services that will help them to thrive. This is considered a long-term service and support that is offered under your state’s Regular State Plan Medicaid program.

Transition tip

Depending on where you live, your state’s Adult Foster Care Program might be called the Adult Family Care Program.

How does Adult Foster Care work?

The Adult Foster Care Program (AFC) connects adults living in private homes with a dedicated caregiver who’s on hand to provide continuous supervision, assist with personal care, and take care of homemaker tasks. This program is intended for state residents who require assistance due to an inability to independently bathe, groom, get themselves dressed, prepare a meal, get around by themselves, do laundry, and use the toilet. 

AFC programs are generally for adults 18+ but participants can be eligible as young as age 16, if determined through an in-person evaluation from a nurse and a caseworker. The program is directed to adults with physical limitations such as blindness, visual impairments or cognitive issues such as developmental and intellectual disabilities, and autism. Adult Foster Care participants are expected not to need around-the-clock skilled nursing care.

Who can be an Adult Foster caregiver?

Adult foster caregivers may be a family member or close friend. This includes an adult sibling or parent, but unfortunately, does not include a person legally responsible for the care of the individual. 

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Good to know

Guardians are explicitly prohibited from being adult foster caregivers.

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What is an Adult Foster Care home like?

AFC providers are usually parents in their own home or it can be someone else in their own home – often people who have worked in the human services field in another capacity.

Depending on the state you live in, up to three program participants can reside in an adult foster care home. The adult foster care home must also be a private home. Participants are allowed to stay home alone for up to 3 hours depending on their level of care. Legally, an individual receiving Adult Foster Care services cannot reside in a group home, nursing home or an assisted living residence.

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Good to know

Depending on the state you live in, participants are also allowed, and in some cases expected, to participate in adult day programming, which may include employment.

How much are AFC Caregivers paid?

Caregivers are employed and paid by Adult Foster Care provider agencies  that are contracted by your state’s Medicaid program. In most states Adult Foster Caregivers submit invoices to the provider agency for their care payment. The process for this differs state by state or even by the provider agency. The caregiver’s pay rate is based on the needs of the individual in their care.

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Good to know

While most state-based health care programs will cover the cost of care services in adult foster care, room and board will not be paid for.

What are some benefits of Adult Foster Care?

Whether you or someone else provides the caregiving, the following might be helpful benefits of having Adult Foster Care, or options to ask about when looking for AFC:

What you need to know before you apply for Adult Foster Care for your young adult

Applicants must be eligible for receiving Medicaid. The American Council on Aging offers a free Medicaid eligibility test to determine if one might meet Medicaid’s eligibility criteria. You can take the Medicaid Eligibility Test here.

When you apply, an AFC nurse will conduct an assessment to determine eligibility. The provider will have monthly visits by the provider agency in their home. As part of the application process, applicants will need to gather documentation for submission. Examples include copies of Social Security and Medicare cards, proof of income, previous bank statements, copies of life insurance policies, property deeds, and pre-need burial contracts. Unfortunately, missing or incomplete documentation or documentation not submitted in a timely manner are common reasons for delays in eligibility.

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Good to know

Have all of your documents ready and with you at your initial interview to expedite the process. Your application may be delayed if you don’t have these documents with you.

How do I become an Adult Foster caregiver?

In order to apply to become an Adult Foster Caregiver, the person you will be the caregiver for must be receiving Medicaid through your state (or must be eligible for Medicaid). When applying, you will need to work with a non-profit provider in your state who provides Adult Foster Care services. Once connected with a provider, you will be required to go through an application process to ensure you are qualified to be an adult foster caregiver and that the person you will be the caregiver for meets the necessary criteria for this program. Your application process will include a background Criminal Offender Record Information (CORI) check. You will work closely with the non-profit provider through this process and if you are approved to be a caregiver, you will go through a series of training sessions depending on your state’s training requirements. Training may include First Aid/CPR certification, medication management, and learning how to fill out the monthly caregiver reporting information.

Transition tip

If you’re thinking of becoming an Adult Foster caregiver, it may be helpful to know that AFC payments are funded by Medicaid and are non-taxable income.


Here’s a helpful article to learn more about Adult Foster Care in your state:

Ready for more? Read this.

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