Adult Family Living (AFL)—also known as Caregiver Homes of Connecticut—is a program that helps frail elderly individuals to remain living in private homes instead of moving into assisted living communities or nursing homes. This program works by providing financial assistance and support for family members or friends that act as both primary in-home caregivers and hosts of an elderly individual. This program is akin to a type of foster care for adults.
The Connecticut Department of Social Services offers the AFL option under the Connecticut Home Care Program for Elders and the Personal Care Assistance Medicaid waiver programs. The eligibility is the same across these programs. However, the Personal Care Assistance program is strictly for adults 18-64 years old. The benefits offered through Adult Family Living are sufficiently different from the other services available through the waivers that we discuss AFL here as a separate program.
Under AFL, an elderly individual moves into the home of a family member or friend, or the family member or friend moves into the home of the elderly individual. An intermediary agency provides training, quality oversight, and support for the individual working as the caregiver. (To be clear, a spouse cannot serve as the caregiver). The Connecticut Department of Social Services must accredit the intermediary agency.
Care providers receive compensation for providing the elderly individuals with assistance completing their activities of daily living and instrumental activities of daily living. AFL has four levels of compensation for the care providers. The rates range from approximately $44 to $110 per day. However, the family caregiver must work through an agency acting as an intermediary. The agency takes a cut, estimated at 20% – 40% of the wage.
The AFL program is open to Connecticut residents statewide who are eligible for the Connecticut Home Care Program for Elders (CHCPE) or the Personal Care Assistance (PCA) program. Care recipients must have both a functional and financial need for care. For further eligibility information, one can read about the CHCPE eligibility criteria here and PCA eligibility criteria here.
Benefits of the AFL / Caregiver Homes program should be thought of on two levels: the benefits to the individual in need of care and the benefits received by his/her care provider.
Care recipients receive personal care, supervision, and assistance with day-to-day activities, such as eating, bathing, dressing and mobility. They can also receive assistance with the instrumental activities of daily living, such as transportation, shopping for essentials, and meal preparation. Elders also benefit by living in a family home with care being provided by someone with whom they are comfortable and familiar.
Care providers receive compensation for their caregiving efforts. In the case of family members, caregivers are paid for work that they would have likely provided for free. AFL offers four levels of compensation, depending on the care needs of the individual. However, as mentioned above, caregivers do not receive the full amounts listed below. They should expect between 60% and 80% of these amounts. The following levels are current as of March 2021. The compensation amount last increased in January 2019, which was the first time it was increased since January 2015.
Attention. If the family member who provides care works with an intermediary agency, he/she will not receive the full amount listed above. The agency takes a fee for facilitating the work and maintaining the care recipient’s eligibility.
For questions about the program or to apply, visit the website of the CHCPE Alternative Care Unit of the Connecticut Department of Social Services here.