January 12, 2005
ADULT FOSTER CARE PROGRAM (ADULT FAMILY LIVING)
By: Helga Niesz, Principal Analyst
You asked what has happened to Connecticut's Adult Foster Care program (later known as Adult Family Living).
The Adult Family Living Program no longer accepts new applicants but continues to support four existing participants. The program, begun in 1993, was originally intended to be self-sustaining, but attracted very few participants despite outreach efforts and suffered from lack of funding, inadequate staff, and staff turnovers. The Department of Social Services (DSS) decided to end its efforts to find new applicants and just maintain the existing participants (currently there are only four) after a 2001 study concluded the program was not cost-effective.
In 1993, the legislature first required the DSS commissioner to establish an adult foster care program (PA 93-212, §§ 1 and 2). The program was aimed at elderly people who were inappropriately institutionalized or who might otherwise be placed in nursing homes. Disabled people over age 18 were also eligible. The program was voluntary and attempted to match these people with foster care homes. In return for a monthly stipend, the home was expected to provide room, board, and personal care services (CGS § 17b-424). However, due to liability concerns, DSS later interpreted the law as not allowing the foster family members to directly provide personal care. Consequently, DSS, often under the Connecticut Home Care Program for Elders, arranged for home health care aides for participants who needed hands-on personal care. Participants could also attend an adult day care center during the day and return to the foster home at night. The host family's duties include 24-hour supervision, daily nutritious meals and snacks, laundry services, housekeeping, supervision of health-related activities, transportation, and shopping assistance.
Over the years, DSS contracted with several agencies to run the program, including The Village for Families and Children, the Newington Senior and Disabled Center, the Town of Newington, and Sage Services. At first, the program was limited to the Hartford area but later it attempted statewide expansion. The contractors' duties included outreach, screening participants and foster families, matching them, and administering the program's financial aspects. Participating seniors paid $1,400 a month to the program and the contractor paid $1,000 to the foster families, with $400 going to the contractor for administration. Although the program screened as many as 15 potential participants and nine potential host families in its most active year (FY 2000), it never had more than six active matches in any year.
2001 STUDY OF PROGRAM'S COST EFFECTIVENESS RESULTS IN PROGRAM CLOSURE
In 2001, the DSS Elderly Services Division conducted a study (enclosed) to determine whether the program was cost effective. It decided the program was not cost effective because it did not have the participant level needed to sustain it (there were only five participants at that time). According to the study, the program's difficulties included finding funding to pay for people who could not pay privately (later legislation allowed the Connectcut Home Care Program and the State Supplement program to pay for adult family living for those low-income people who qualify for these programs). Other difficulties included inadequate program staffing and frequent staff turnovers, the strains of expanding to serve people statewide, and difficulties in performing associated financial functions.
The division decided to discontinue the program but continues to serve the remaining participants (of which there are currently four). The South Central Agency on Aging has assumed responsibility for them.