Adult foster care programs are designed to offer crucial residential care and support services to adults. These programs operate within licensed homes, categorized as either family foster care or community residential settings (CRS). The hallmark of adult foster care is its personalized approach, with services tailored to meet the specific needs of each adult as detailed in their individual support plan. Understanding the guidelines and definitions surrounding these programs is essential for both caregivers and those seeking care.
Defining Adult Foster Care
At its core, adult foster care encompasses individual waiver services that provide ongoing residential care and supportive services to adults. These services are delivered within a home environment that is officially licensed either as family foster care or as a community residential setting. The services are not generic; instead, they are meticulously individualized. This means that the type and intensity of support provided are directly determined by the unique needs of the adult in care, as formally identified and documented in their support plan. This plan acts as a roadmap, ensuring that the care provided is both appropriate and effective for the individual.
Types of Adult Foster Care Settings
The landscape of adult foster care includes different types of settings, primarily categorized by the living arrangement and the nature of staffing.
Family Foster Care Setting
A family foster care setting is specifically defined as a licensed environment where the license holder also resides in the home. This model often evokes a more familial atmosphere, as care recipients live alongside the care provider in a shared home. The residential aspect is key here; it’s not just a service location, but also the primary residence of the caregiver.
Community Residential Setting (CRS)
In contrast, a Community Residential Setting (CRS) is a licensed residential facility that serves adults, but crucially, the license holder does not live at the premises. CRSs typically employ a shift-staff model, meaning that paid staff members work in shifts to provide 24-hour support. This structure is common in settings designed to support multiple individuals with varying needs. A defining characteristic of a CRS, in the context of HCBS waiver programs, is that at least one person living in the setting must be receiving foster care or supported living services funded by such a waiver.
Understanding the Term “Institution” in Context
For clarity within the realm of adult foster care guidelines, it’s important to understand what is classified as an “institution.” The term institution, in this context, specifically refers to:
- Nursing facility
- Hospital
- Intermediate care facility for persons with developmental disabilities (ICF/DD)
- Institution for mental disease (IMD)
These are traditional institutional settings that are distinct from the home-like environments of family foster care and CRSs.
Prong Settings: Location Relative to Institutions
To further refine the definition of appropriate settings for adult foster care, particularly in relation to institutions, the concept of “prong settings” is introduced. This helps delineate settings that might be physically connected or adjacent to larger institutions, which could influence the nature of care provided.
Prong 1 Setting
A Prong 1 setting is defined as a setting that is located within a publicly or privately owned institution. This is characterized by a direct physical connection or adjacency. Examples include scenarios where the waiver service setting and the institution share the same address, are separated by a common wall, or are connected via a walkway, skywalk, or another enclosed corridor. The key factor is the integrated or directly connected nature of the setting with the larger institution.
Prong 2 Setting
A Prong 2 setting refers to a situation where the waiver service setting is located adjacent to a publicly owned institution. Adjacency in this context means that the waiver service setting physically touches the institution or its property. Crucially, there is no intervening parcel of land separating the two. While not directly connected like a Prong 1 setting, the close physical proximity to a publicly owned institution is the defining feature.
Publicly Owned Institution
Finally, the term “publicly owned institution” is clarified as an institution that is financed and operated by a governmental body. This includes entities at the county, state, municipal, or other governmental unit level. It’s specifically noted that a privately owned nursing facility does not fall under the definition of a public institution, highlighting the distinction based on ownership and operational control.
Understanding these definitions and guidelines is crucial for navigating the landscape of adult foster care programs and ensuring that individuals receive care in the most appropriate and supportive setting.
