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A Comparison of Two Housing Models in Washington State

Adult Family Home vs. Shared Living in Washington State

Adult Family Home (AFH)Shared Living
Number of ResidentsUp to 6Flexible
Roommate SelectionCaregiver chooses roommatesFamilies choose roommates
Housing Choice Voucher (Section 8)Not permittedPermitted
Food benefitsNot permittedPermitted
Caregiver TrainingHCA + AFH administrationHCA
Caregiver Experience1,000 hoursNone
Physical StructureSingle family home (typically owned by caregiver)House or apartment (can be rental or owned by parents)
Separation of DutiesLandlord/caregiver can be the sameLandlord/caregiver must be separate
Parent InvolvementAdult Family Home-drivenParent-driven
Regulatory FeesInitial and annual license feesNone
Supervision24/7Parent-driven based on needs
Private PayNot permitted for Medicaid eligible residentsPermitted; varies based on Medicaid–funded personal care hours and desires of families
TimelineImmediate - based on availability of beds12-18 months to develop
Service PaymentDDA daily rateMedicaid-funded personal care hours and/or private pay
OversightDDA case manager/RCS licensorDDA/HCS case manager


  • DSHS – Department of Social and Health Services
  • DDA – Developmental Disabilities Administration of DSHS
  • RCS – Residential Care Services of DSHS
  • HCS – Homes & Community Services of DSHS
  • HCA – Home Care Aide