Texas Adult Care Homes


Texas Adult Care Homes: How to pay for, Laws and Regulations and Questions to ask…

Texas is a sought after destination for seniors. Retirees and our aging adult population enjoy the warm climate and low cost of living. Texas is also home to culturally thriving cities like Houston, Dallas, and Austin. Texas is a family friendly state, full of friendly neighborhoods, with many parks and entertainment venues fit for everyone. Some of the most diverse cuisine can be found in Texas. The state of Texas is home to more than 3.5 million senior citizens, and the number is growing with each passing year. As our seniors continue to age, it is likely that some will require care at some point. When most Americans think of housing and care for our aging population, they think of nursing homes, but this is not your only option. Aging adults deserve the best accommodations when it comes to care, and Texas has a variety of senior care and housing to fit the needs and preferences of everyone. An adult care home, commonly referred to as adult foster care homes in Texas, may be ideal for a senior who can no longer manage their health and safety in their own home; they may need care but still want to honor their independence as much as possible. Adult care homes are excellent for aging adults in need of some care because they offer private residencies in a home-like environment. Remember, these residences are not nursing homes.

Other terms you may hear to describe adult care homes in Texas

Adult care homes are found in normal residential neighborhoods. You may drive past an adult foster home each day on your commute. Texas law permits no more than three adult residents in an adult foster home, unless it is licensed by the state for additional residents. As you look for adult care homes in your community, it is good to know the other terms/names you may hear: 

  • Residential care home
  • Adult care home
  • Care Home
  • Adult family home 
  • Board and care home 
  • Adult foster home
  • Nursing Home (although this is an outdated and not an accurate term for this level of care)

Adult foster care homes in Texas

According to the Texas Department of Health and Human Services, the definition of Adult Foster Care (AFC) is: a 24-hour living arrangement with supervision in an adult foster home for people who are unable to continue living independently in their own homes because of physical, mental or emotional limitations. AFC providers and residents must live in the same household and share a common living area. With the exception of family members, no more than three adults may live in the foster home unless it is licensed by the state. The client pays the provider for room and board.

Similar to a nursing home, residents receive 24-hour care all in a single-family environment. Each home has an operator who may employ additional caregivers to support with the care of residents. Residences are licensed to house a smaller number of adults as opposed to larger assisted living communities. So they make ideal homes for loved ones who require individualized care while allowing residents the preferences and choices to honor their independence.

Licensing and regulations for adult foster care homes in Texas

All licenses for AFC is obtained through the Texas Department f Aging and Disability Services.

All administrators and healthcare professionals who work in the home must have an up to date and recognized license in the specialized services/tasks from the Texas Department of Health.

Texas law requires all providers/operators and residents live in the household and share a common living area. There may be no more than three adults (excluding the operator and family) in an AFC home unless authorized and licensed by the state of Texas. Texas Administrative Code

Caregivers in adult foster care homes may assist with activities of daily living and some additional care needs, including:

  • Personal care
  • Housekeeping
  • Activities
  • Group meals
  • Mobility
  • Behavior management
  • Eating
  • Dressing
  • Toileting
  • Personal hygiene
  • Cognitive support and redirection

How much does an adult foster care home cost in Texas?

Adult foster care homes are typically half the cost of a nursing home. Residency in an adult foster care home is typically between $2,000 to $4,000 per month, depending on the city or county where you are looking for care. The specific requirements and needs of a resident will also play a role in the cost. A nursing home in Texas is generally $7,000 per month or more. Assisted living in Texas is also more expensive than adult foster care homes.

Most often, the cost of adult foster care is a fixed monthly price. So when you find a home for your loved one, costs will stay fixed unless new care needs arise.

The cost for senior living and care is less expensive in the southern regions of the country (Texas) as well as some of the mid-western states. One advantage to looking for senior care in Texas is the vastness of the state. With so many regions and counties it is likely you may be able to discover care that fits your budget and needs.

Financial Assistance in Texas

Texas Community Care for Aged/Disabled (CCAD)

This program is designed to help seniors who are at risk of being moved into a nursing home to stay living at home or in the home of a caregiver, and to receive services and support in these locations. The intention is to help prevent costly Medicaid-funded institutionalization in a nursing home. The program offers personal care services in adult foster care homes and assisted living residences.

How to pay for adult foster care homes in Texas

You want to consider your payment options for assisted living, memory care, and care homes. For these services, Medicare is NOT an option for payment.

The most common payment for these services would be out of pocket Private Pay and assessing a combination of retirement funds, personal savings, and pension payments.

Medicaid can also be an option, be sure to see if you or a loved one qualifies.

Long-Term Care insurance is also a possible option in cases of chronic conditions, be sure to see if you or a loved one qualifies.

For our Veterans and spouses of veterans, be sure to assess Veteran Aid and your eligibility for these benefits.

Medicare – NO:

  • Medicare does NOT pay for Assisted Living.
  • People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
  • Coverage is meant for people in need of short-term care.

Private pay – YES:

  • Many families pay for assisted living with private funds.
  • Private pay can be a combination of retirement funds, personal savings, and pension payments.
  • Family members may contribute funds to pay for assisted living or other senior housing and care.

Medicaid – MAYBE:

  • Medicaid provides health coverage to millions of Americans. Eligible participants include: low-income adults, elderly adults and people with disabilities.
  • Medicaid is administered by state, according to federal requirements. The program is funded jointly by each state and the federal government.
  • Every state has their own individual Medicaid assistance program.
  • National guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines.
  • The state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
  • If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.

Long-term Care Insurance – MAYBE:

Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.

  • Long-term care insurance helps cover the costs of chronic medical conditions.
  • Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.

Veteran Aid and Assistance – MAYBE:

This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.

  • There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
  • A veteran with a sick spouse may be eligible for $1,600 per month.
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Questions to Ask

Finding an assisted living community can be overwhelming. Here are some tips on things to be observant of:

  • Make sure the facility is clean and well maintained. You can tell a lot about the operation by noting what is clean and maintained. Are doorknobs loose or damaged? Do you see any frayed carpet or trip hazards?
  • Visit during lunch hour to observe what the residents are eating. Ask questions about the nutrition program. Is there diversity in meals, healthy fruits and vegetables served at all meals, drink options?
  • Speak to residents and/or family members to learn their perspective.
  • Ask about staff and resident engagement. Get a feel for how staff interact with residents.
  • Ask about the life enrichment programs. Activities are crucial when it comes to quality of life and play a key role in care for older adults.
  • And finally (along with a plethora of more things to consider), get to know the leadership in the building. If you feel good around the Executive Director, Head Nurse, Lead Activities Director and even the Chef or Janitor, it is a good sign you can trust them with the care of your loved one.

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

The Texas Department of Health

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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