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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 Residents | Up to 6 | Flexible |
| Roommate Selection | Caregiver chooses roommates | Families choose roommates |
| Housing Choice Voucher (Section 8) | Not permitted | Permitted |
| Food benefits | Not permitted | Permitted |
| Caregiver Training | HCA + AFH administration | HCA |
| Caregiver Experience | 1,000 hours | None |
| Physical Structure | Single family home (typically owned by caregiver) | House or apartment (can be rental or owned by parents) |
| Separation of Duties | Landlord/caregiver can be the same | Landlord/caregiver must be separate |
| Parent Involvement | Adult Family Home-driven | Parent-driven |
| Regulatory Fees | Initial and annual license fees | None |
| Supervision | 24/7 | Parent-driven based on needs |
| Private Pay | Not permitted for Medicaid eligible residents | Permitted; varies based on Medicaid–funded personal care hours and desires of families |
| Timeline | Immediate - based on availability of beds | 12-18 months to develop |
| Service Payment | DDA daily rate | Medicaid-funded personal care hours and/or private pay |
| Licensing | RCS/DSHS | None |
| Oversight | DDA case manager/RCS licensor | DDA/HCS case manager |
Glossary:
- 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