A Community-Based Alternative to Nursing Homes or Assisted Living

Contributed by Carrie Hobbs Guiden, Director of Operations-Adult Foster Care, and Kate Terwanger, Program Manager, Indiana Mentor

With the expansion of Home and Community-Based Services (HCBS) in Indiana, greater numbers of older adults are able to see the dream of growing old in their own homes become a reality. Yet for many, there comes a time when more support is needed to maintain health and safety. In the past, older adults who required this level of support were placed into nursing homes, and more recently, assisted living. However, Adult Foster Care (AFC) allows an individual to live in a homelike setting that provides the necessary support and oversight for healthy living. 

Though relatively new in Indiana, other states including Oregon, Washington, Texas and Colorado have operated AFC programs for many years.

Models of Adult Foster Care
Some AFC homes are owned by the caregiver who is certified as a “provider.” It is not uncommon for the caregiver’s family to live there as well. 

Other AFC homes are owned by a homeowner and then staffed with caregivers for different shifts.  In these situations, the caregivers and the caregivers’ families do not typically live in the home.

A third model recently introduced in Indiana is a “host-home” model that is used by Indiana Mentor, a human services agency specializing in residential services. In this model, the agency sub-contracts with individuals who are both the homeowner and caregiver. Indiana Mentor then provides additional oversight, support and training to the caregiver. Indiana Mentor is the official “provider,” but the contractual relationship with the caregivers allows us to provide the client with services in a homelike environment.

Paying for AFC
AFC is a service on the Aged and Disabled (A&D) Waiver, which is funded through Medicaid. If an older adult is not eligible for the A&D Waiver, some of the AFC providers will accept private pay.  Rates are negotiated directly with that provider. 

To provide adult foster care through the A&D Waiver, providers must be certified by the Indiana Division of Aging. Certified AFC homes must meet certain qualifications. Caregivers working in these homes go through a variety of background checks and are required, at minimum, to have training in First Aid/CPR.  Currently, there are approximately 17 certified AFC locations throughout Indiana . AFC providers who accept only private pay do not undergo a certification process, as certification is related only to the funding source. Certification does not guarantee quality services nor does lack of certification indicate poor services.  

"The Next Best Thing"
In an ideal AFC living arrangement, the older adult should feel safe, respected, comfortable, and included in the activities of the home.  While nothing can take the place of living in your own home, the ideal AFC situation should be the “next best thing.”

For more information on Adult Foster Care services, contact the local Area Agency on Aging in your region or review the AFC information in the Indiana State Plan for Aging and In-Home Services http://www.in.gov/fssa/files/stateplan07-10.pdf, pages 27-28.

Aging Network News

The National Council on Patient Information and Education has launched Medication Use Safety Training for Seniors (MUST for Seniors), a national education awareness campaign to promote safe and appropriate medicine use among America's older adults. For more information, visit www.mustforseniors.org

National Center for Health Statistics - Power Point presentations on:

• Major trends and patterns in health and aging
• Major trends and patterns in diabetes for older Americans
• Major trends in medication spending by older Americans
• Major trends and patterns in supplemental health insurance coverage for Medicare beneficiaries

Mark your calendar

There is a Bridge - Don't miss this one-hour documentary featuring innovative communication treatments for Alzheimer’s patients that demonstrates that no degree of dementia isolates a person from human connection. There is a Bridge will air on WFYI-20 in Indianapolis on Saturday, November 17 at 5:00pm and on WTIU-30 in Bloomington on Sunday, November 18 at 3:00pm. To purchase a copy of the documentary, visit www.memorybridge.org.

The Indiana Collaborative Conference on Aging is just a little more than three months away, February 5-6, 2008! Watch for registration brochures and online registration to be available soon. In the meantime, check out www.inagingconference.com for more information.

Grants to go for

Brookdale Foundation Grants - The Brookdale Foundation Relatives as Parents Program (RAPP) has announced two grant opportunities. The Foundation will be providing seed grants to non-profit, 501(c)(3) programs across the country that want to create or expand services to grandparents and other relatives raising children.  In addition, the 2008 State RAPP Guidelines have also been released.  The State RAPP Initiative is open to state public agencies, in eligible states, who want to provide services to relative caregivers. www.brookdalefoundation.org.

Results-Based Management Training - The U.S. Department of Labor’s Center for Faith-Based and Community Initiatives is offering Results-Based Management Training to grassroots faith-based or community nonprofit organizations that help struggling people prepare for, obtain and retain employment. For more information and to apply, visit http://www.performance-results.net/dol/info.php or contact Christopher Stio at (202) 693-6450 or stio.christopher@dol.gov. I f selected, two staff from your local nonprofit organization will be invited to attend one of four three-day training conferences. There are several locations and dates to choose from: Indianapolis, IN (November 7-9); Dallas, TX (December 11-13); Chapel Hill, NC (January 15-17);and Los Angeles, CA (February 5-7).

Impact 100 Greater Indianapolis will be seeking Letters of Inquiry from nonprofit organizations in January 2008 for $100,000 grant opportunities. Proposals should be submitted in one of five interest areas: Arts and Culture, Education, Environment, Family, and Health and Wellness. For more information, visit www.impact100indy.org.