4100, Adult Foster Care

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4110 Description

Revision 25-2; Effective March 31, 2025

Adult Foster Care (AFC) provides a 24-hour living arrangement in a Texas Health and Human Services Commission (HHSC) contracted foster home for people who, because of physical, mental or emotional limitations, cannot continue independent functioning in their own homes. Services may include meal preparation, housekeeping, minimal help with personal care, help with activities of daily living and provision of or arrangement for transportation. The unit of service is one day.

Providers of AFC must live in the household and share a common living area with the person. Detached living quarters do not constitute a common living area. The person enrolled to provide AFC must be the primary caregiver. Providers may serve up to three adult people in an HHSC enrolled AFC home without licensure as a personal care home.

4111 Four Bed Adult Foster Care Homes

Revision 25-2; Effective March 31, 2025

A Type C Assisted Living license is obtained if the provider wants to serve four people. The home cannot be approved for the fourth person until the provider has applied for and received the Type C license. After the enrollment is complete, the provider may apply for a Type C license from the Texas Health and Human Services Commission Regulatory Services Division. The license must be renewed yearly and requires an annual fee.

4112 Small Group Homes

Revision 25-2; Effective March 31, 2025

Adult Foster Care (AFC) may also be provided in a small group home licensed by the Texas Health and Human Services Commission (HHSC) as Assisted Living Type A, Small, under the Minimum Licensing Standards for Assisted Living. The provider must submit a copy of the Assisted Living license to contract management staff before enrollment and upon renewal thereafter. The provider must report to contract management staff any problem(s) identified by Regulatory Services. HHSC regional contract managers enroll small group homes and providers must meet all applicable requirements in the Minimum Standards for AFC. Providers must serve no more than eight adult people in an enrolled small group home.

AFC provided in small group homes is subject to two sets of regulations, HHSC minimum standards for AFC and Licensing Standards for Assisted Living Facilities. The stricter requirements apply when requirements conflict. Therefore, an enrolled AFC provider whose home is licensed as a small group home must comply with the requirement that an attendant is always present when residents are in the facility. This requirement applies regardless of the number of people currently living in the facility.

4113 Contract Manager and Case Worker Responsibilities

Revision 17-1; Effective March 15, 2017

4113.1 Contract Manager Responsibilities

Revision 25-2; Effective March 31, 2025

Texas Health and Human Services Commission regional contract managers are responsible for all requirements for adult foster care (AFC) providers and homes. The contract manager's responsibilities include:

  • recruiting adult foster homes;
  • processing AFC applications;
  • orientating and training the provider;
  • conducting fire and health inspections;
  • disenrolling adult foster homes;
  • approving private pay people;
  • conducting administrative reviews;
  • reassessing the provider and home; and
  • processing payments.

4113.2 Case Worker Responsibilities

Revision 25-2; Effective March 31, 2025

Texas Health and Human Services Commission (HHSC) caseworkers are responsible for all requirements for adult foster care (AFC) applicants and people. The caseworker's responsibilities include:

  • completing the AFC applicant intake and assessment process;
  • determining financial and functional eligibility for AFC;
  • assessing appropriateness for AFC;
  • providing information to interested applicants about potential adult foster homes and arranging visits to the homes;
  • developing a service plan and completing the person’s provider agreement;
  • authorizing AFC services;
  • monitoring the person; and
  • processing changes and conducting annual reassessments of the person.

4120 Eligibility

Revision 17-1; Effective March 15, 2017

4121 Basic Eligibility

Revision 25-2; Effective March 31, 2025

To be eligible for adult foster care (AFC), applicants and people must meet basic eligibility requirements for Community Care Services Eligibility services as well as specific requirements related to AFC. Find these requirements in 3000, Eligibility for Services.

4122 Appropriate Characteristics for Adult Foster Care

Revision 25-2; Effective March 31, 2025

Applicants and ongoing people in adult foster care (AFC) must display appropriate characteristics for AFC placement.

AFC placement is not appropriate for all people. Form 2330, Assessment and Service Plan Approval for Adult Foster Care, must be completed for all applicants. If any inappropriate characteristics are identified, the applicant or person is not appropriate for AFC and cannot be authorized for services.

A new Form 2330 must be completed at each annual review to ensure the person’s needs can be met within the foster care setting.

4123 Supervisory Approval

Revision 25-2; Effective March 31, 2025

It is the supervisor's responsibility to ensure that the applicant or person meets the appropriate characteristics, and their needs can be adequately met in adult foster care (AFC). The supervisor indicates on Form 2330, Assessment and Service Plan Approval for Adult Foster Care, if AFC is approved or disapproved. Supervisory approval is required before AFC is authorized or to reauthorize.

Review 3000, Eligibility for Services, for additional eligibility requirements.

4130 Adult Foster Care Intake and Assessment

Revision 25-2; Effective March 31, 2025

Adult Foster Care (AFC) is appropriate for people who, because of physical, mental or emotional limitations, cannot continue independent functioning in their own homes and who need and desire the support and security of family living. AFC is also appropriate for people who do not need institutional care but cannot resume independent living or have no relatives who are able to provide a home.

4131 Response to Request for Services

Revision 25-2; Effective March 31, 2025

Once an intake for adult foster care (AFC) is received, the caseworker arranges a home visit to conduct the assessment based on the intake priority. Refer to 2340, The Initial Interview and Application Process, for complete procedures. During the home visit, the caseworker assesses the applicant for financial eligibility and functional eligibility, using Form 2060, Needs Assessment Questionnaire and Task/Hour Guide. They also complete Form 2330, Assessment and Service Plan Approval for Adult Foster Care, to determine if the applicant is appropriate for AFC. Form 2330 lists the appropriate and inappropriate mental and physical characteristics for AFC people.

AFC is not appropriate and should not be authorized for a person who:

  • requires considerable help with personal care due to physical or mental conditions;
  • requires long-term care in a medical or psychiatric facility;
  • is a danger to themself or others; or
  • is bedfast.

4132 Person’s Rights and Responsibilities

Revision 25-2; Effective March 31, 2025

The caseworker must explain the room and board requirements in adult foster care (AFC) and ensure that the applicant understands that they must pay a portion of their monthly income for room and board. Review Form 2307, Rights and Responsibilities, and Attachment 2307-F, AFC Rights and Responsibilities, with the applicant. Make sure the person understands their responsibilities as a resident in an AFC home.

4133 Assessing Potential Adult Foster Care Homes

Revision 25-2; Effective March 31, 2025

If the applicant displays the appropriate characteristics and appears to meet eligibility criteria, the caseworker provides information about potential adult foster care (AFC) homes. The caseworker can arrange visits to appropriate AFC homes or if the applicant is capable or has family and supports available, they may make the arrangements to visit potential AFC homes. In some situations, the caseworker may need to help the applicant make the visit(s).

The visits to potential AFC homes lets the applicant assess the home and lets the AFC provider assess if the applicant will be appropriate in the foster home. The caseworker may contact the provider and share information about the applicant, including the applicant's particular needs and problems. This ensures that the potential provider is fully aware of the responsibilities involved in caring for the applicant and to prevent a potential mismatch of the applicant and provider.

4134 Placement on the Interest List

Revision 25-2; Effective March 31, 2025

If an intake is received for adult foster care (AFC) but no foster homes are available to provide care, place the person's name on the interest list. Determine if other services may be appropriate to meet the person's needs while waiting for placement in AFC. Refer to 2232, The Community Services Interest List System (CSIL), for interest list procedures. The application process for AFC begins when the person's name is released from the interest list.

4135 Adult Protective Services People in Adult Foster Care

Revision 25-2; Effective March 31, 2025

4135.1 Placement of Adult Protective Services People in Adult Foster Care

Revision 25-2; Effective March 31, 2025

In some areas, Adult Protective Services (APS) may use adult foster care (AFC) as a resource for placement of APS people. Approval by the contract manager is required before an APS person moves into a Texas Health and Human Services Commission enrolled AFC household. The purpose of the approval is to determine the:

  • appropriateness of the person's characteristics;
  • capacity of the foster home to meet the person's needs; and
  • compatibility of service delivery to the APS person and the delivery of services to the certified AFC people.

If it is determined by the contract manager that placement in foster care is inappropriate, the APS worker and the provider help the person make other living arrangements.

4135.2 Adult Protective Services Investigations of Adult Foster Care Providers

Revision 25-2; Effective March 31, 2025

Any time Texas Health and Human Services Commission (HHSC) staff suspect abuse, neglect or exploitation of an adult foster care (AFC) person in a foster home, a report must be made immediately to Adult Protective Services (APS).

If reports are made to APS from outside sources, HHSC staff may not be notified of individual allegations against a service provider until after those allegations have been validated. However, APS staff may ask Community Care Services Eligibility (CCSE) staff to help with the delivery of services during their investigation if the alleged mistreatment poses an immediate threat to the safety of AFC residents.

The contract manager assigned to the facility handles disenrollment and corrective actions against the foster home, as appropriate. If the caseworker cannot find a suitable residence for the person, the person is referred to APS for assistance in moving from the foster home.

A person who has the capacity to consent may decide not to move from the foster home, even though the allegation has been validated and the situation is likely to recur. In such an instance, the person's AFC services will be denied and payments to the home will terminate. However, the person may continue to live in the home by making private pay arrangements with the provider.

If a person who does not appear to have the capacity to consent refuses to move from a home operated by a person identified as the perpetrator in a case of validated abuse, neglect or exploitation, make a referral to APS.

4136 Private Pay People and Retroactive Payment Procedures

Revision 25-2; Effective March 31, 2025

4136.1 Private Pay People in Adult Foster Care

Revision 25-2; Effective March 31, 2025

Some adult foster care (AFC) providers may wish to take private pay people. Approval by the contract manager is required before the private pay person is accepted in the home. The AFC provider must contact the contract manager when considering admitting a private pay person. The contract manager will furnish Form 2330, Assessment and Service Plan Approval for Adult Foster Care, to the AFC provider. The AFC provider must complete Form 2330 and return it to the contract manager to approve or disapprove the private pay person. The purpose of the approval is to determine the:

  • appropriateness of the person's characteristics;
  • capacity of the foster home to meet the person's needs; and
  • compatibility of service delivery to the private pay person and the delivery of services to the certified AFC person.

If it is determined by the contract manager that placement in foster care is inappropriate, the AFC provider cannot accept the person.

Refer any issues about placements to the contract manager to resolve.

4136.2 Retroactive Payment Procedures

Revision 25-2; Effective March 31, 2025

If a private pay applicant already in the foster home applies for adult foster care (AFC) and meets all eligibility requirements, AFC can be approved retroactive to the date of intake.

AFC may be authorized retroactively with supervisory approval to the latter of the date of:

  • request for services intake date; or
  • entry into the foster home.

Supervisory approval is required in all situations. If an applicant does not meet eligibility requirements including appropriate characteristics, then AFC is not authorized. It is the person's responsibility to arrange for payment to the foster home or relocate.

4140 Adult Foster Care Case Worker Procedures

Revision 17-1; Effective March 15, 2017

4141 Eligibility Determination

Revision 25-2; Effective March 31, 2025

To determine eligibility for adult foster care (AFC), the caseworker must:

After eligibility is determined, the caseworker submits the person's case record to their supervisor for review and approval. Documentation in the case record must be complete to enable the supervisor to certify the person's need for care and the appropriateness or inappropriateness of the placement arrangement.

4142 Supervisory Approval

Revision 25-2; Effective March 31, 2025

Upon receipt of the case record, the supervisor reviews:

The supervisor may consult with the contract manager to evaluate the capacity of the foster care provider to meet the unique needs of the person in the foster home setting.

The supervisor decides if the foster home can meet the needs of the person and if the person is appropriate for adult foster care (AFC). If so, the supervisor approves AFC and the service plan by signing and dating Form 2330 or by giving verbal approval, which is documented by the caseworker. If the service is not approved, the supervisor confers with the caseworker about problems with the plan, as perceived through the record reviews. The caseworker must find a more suitable arrangement or resolve the potential problems with the person and the foster care provider to their supervisor's satisfaction. Refer the person to Adult Protective Services (APS) if there is reason to suspect abuse, neglect or exploitation.

4143 Service Planning

Revision 25-2; Effective March 31, 2025

Upon approval for adult foster care (AFC), the supervisor and caseworker discuss if the person has any special needs that require more monitoring in the foster home setting beyond the scheduled monitoring. If needed, a monitoring schedule is developed and documented in the case record.

The final care and monitoring plan for the person should address their functional, medical, social and emotional needs and how they might be met in the selected foster care home. Assess if other resources in the community should be used to meet specialized needs of the person. Use of those resources should be documented in the care plan.

If there are health concerns about the person, the regional nurse may be consulted. The nurse may make a recommendation for the person to have a physical or medical exam before moving into the AFC home.

Once the supervisor has approved the person and potential placement in AFC, the caseworker contacts the person and the AFC provider to arrange for the initial visit and a negotiated move-in date for the person.

4150 Finalizing the Care Plan – Required Initial Home Visit

Revision 25-2; Effective March 31, 2025

Program Standard: On or before the date the person moves into the adult foster care (AFC) home, a meeting with the person and the AFC provider is required to discuss the person's care plan and to complete Form 2327, Individual/Member and Provider Agreement.

The person's family members or responsible person may be included in the meeting. The meeting should preferably take place in the AFC home.

During the initial home visit, discuss the person's needs and care plan as indicated on Form 2060, Needs Assessment Questionnaire and Task/Hour Guide, and Form 2330, Assessment and Service Plan Approval for Adult Foster Care. Reach an agreement about how to meet person's needs through daily care and activities.

Discuss the person's care plan with the person and family members or responsible party and reach an understanding with them about how the foster care provider will meet their needs. This discussion should ensure that the person, their family or responsible party and the foster care provider are adequately prepared for a new person in the home and that adjustments occur smoothly. Document the care plan and any special needs of the person or special agreements between the person and provider on Form 2327.

4151 Person and Provider Agreement

Revision 25-2; Effective March 31, 2025

Document the service arrangements and the room and board payment agreement on Form 2327, Individual/Member and Provider Agreement, when meeting with the applicant and the adult foster care provider.

Review all the information on the agreement with the applicant, family or responsible person, and the provider. Cover all conditions of the agreement and the following topics in the discussion:

  • a full description of the care needs of the applicant, the services and the schedule of care, including if the applicant requires 24-hour supervision by the AFC provider;
  • the beginning and end date of the agreement;
  • a detailed description of the rights and responsibilities of the applicant and the provider;
  • an explanation of the applicant's right to privacy and confidentiality;
  • the monthly room and board amount the applicant agrees to pay the provider;
  • an inventory of the applicant’s personal effects;
  • the names, addresses and phone numbers of people to notify in an emergency, including the applicant's physician, family members or responsible person;
  • any special habits and needs of the applicant and any special arrangements or agreements between the applicant and the provider;
  • any other training needs of the provider and methods to get that training;
  • the responsibility of both the applicant and the provider to notify CCSE staff and the contract manager of problems, such as illnesses, hospitalizations, acts of violence, accidents, complaints about abuse, neglect or exploitation; and
  • other conditions that reflect changes in the applicant's condition and might affect the appropriateness of the foster home.

Discuss with the foster care provider the likelihood of problems arising after the applicant moves into the home, notification procedures and suitable actions to take to resolve problems. Also, discuss with the provider the impact of a new applicant on members of the foster care family and other people in the home. Anticipate problems that might arise and how to handle them. Outline the schedule of planned monitoring visits. The applicant and the provider must sign Form 2327 after discussing and agreeing to all the above topics.

4152 Personal Needs and Medical Expenses Allowance

Revision 25-4; Effective Sept. 1, 2025

Adult foster care people must be allowed to keep funds for personal needs and medical expenses.

  • People with Medicaid coverage must be allowed to keep at least $50 a month for personal needs.
  • People without Medicaid coverage must be allowed to keep at least $85 a month for personal needs and medical expenses.
  • All people must be allowed to keep at least one-half of any cost-of-living adjustment received on or after Jan. 1, 1993.

Make sure the person keeps sufficient funds each month for personal needs and medical expenses. The $50 and $85 amounts are minimum amounts. The person may need to keep more depending on their circumstances. Help the person decide how much they spend on prescription drugs and medical bills each month. When the room and board agreement is negotiated, also consider personal expenses such as replacement of clothing and toiletries.

Related Policy

26 Texas Administrative Code Section 271.161 

4153 Room and Board Agreement

Revision 25-2; Effective March 31, 2025

Ensure that the person and provider understand that the room and board arrangement with the provider is separate from the Texas Health and Human Services Commission (HHSC) payment for services. The person pays the provider for room and board. Help the provider and the person negotiate the room and board agreement. The amount paid may be influenced by prevailing rates in the community. The room and board agreement and any other monetary arrangements are entered on Form 2327, Individual/Member and Provider Agreement.

If the person is moving into the adult foster care home mid-month, prorate the amount of room and board for the month and advise the person and provider of the prorated amount. The ongoing amount of room and board is negotiated with the person and provider and both amounts are recorded on Form 2327.

4153.1 Changes in the Room and Board Agreement

Revision 25-2; Effective March 31, 2025

If the person has a change in income or expenses, they or the provider may request a change in the amount of room and board payment. Changes in the room and board payment are negotiated between the person and the provider. They are documented on Form 2327-A, Room and Board Amendment to the Individual/Member and Provider Agreement.

4154 Leave Away from the Foster Home and Charges

Revision 25-2; Effective March 31, 2025

Texas Health and Human Service Commission pays the daily rate for up to 14 days of leave for each 12-consecutive-month period when an authorized person is away from the foster home. Payment for leave over 14 days per year is the person’s responsibility. Any charges are between the person and provider because they have negotiated a monthly room and board agreement. However, charges may not exceed the daily room and board rate.

The adult foster care provider is responsible for notifying the caseworker by the next workday when a person is away from the foster home for personal leave or hospitalization.

During the initial home visit, the caseworker reviews the information about the person’s responsibility to pay a bed hold charge when away from the home. Ensure the person understands that if they use more than 14 days of leave during a 12-month period, they are responsible for paying the provider the full daily rate.

Related Policy

26 Texas Administrative Code Section 271.157(f)
26 Texas Administrative Code Section 271.157(g)

4155 Authorization of Adult Foster Care

Revision 25-2; Effective March 31, 2025

After all procedures are completed, the caseworker sends the person Form 2065-A, Notification of Community Care Services. The caseworker authorizes adult foster care on Form 2101, Authorization for Community Care Services, in the Service Authorization System wizards and sends the provider a copy of Form 2101.

4156 Adult Foster Care and Day Activity and Health Services

Revision 26-1; Effective June 1, 2026

Some services cannot be authorized at the same time as AFC. Refer to the chart in Appendix XX, Mutually Exclusive Services. Day Activity and Health Services (DAHS) may be authorized for AFC people under the following conditions. The AFC person:

  • requests to attend DAHS for socialization; or
  • has a medical need that cannot be met by the AFC provider.

Documentation in the case record must clearly specify that at least one of the above conditions is met. Review 4222 Medical Eligibility Criteria, for the DAHS eligibility requirements for a medical need.

DAHS may be authorized for the maximum of 10 units per week. However, the authorization must be related to the person's need and not authorized for the convenience of the AFC provider.

Per 26 Texas Administrative Code Section 278.113(a), Provider Responsibilities, the adult foster care provider must:

  • provide services to residents per the person’s service plan and the resident and provider agreement;
  • meet all requirements and conditions stated on the resident and provider agreement, approval of foster care and person’s service plan;
  • ensure that an approved substitute provider is present in the home if at least one resident remains when the provider plans to be absent from the home for more than three hours in a 24-hour period. Residents whose care plans specify the need for 24-hour supervision may not be left without the supervision of an approved substitute provider for any period.

If a person is authorized to attend DAHS but is ill or prefers not to attend on a particular day, the AFC provider must provide supervision in the AFC home for the person.

4160 Monitoring

Revision 25-2; Effective March 31, 2025

Program Standard: Monitoring contacts are required monthly for the first three months the person is in the foster home. Two of the monitoring contacts may be made by phone if appropriate for the person. At least one of the contacts must be a home visit to the person in the foster home and the person must be interviewed privately.

4161 30-Day, 60-Day and 90-Day Monitoring Contacts

Revision 25-2; Effective March 31, 2025

Monthly monitoring contacts must be completed during the first three months after the person is certified for adult foster care. Two of the monitoring contacts may be made by phone. At least one of the three monitoring contacts must be made face to face with the person in the foster home. The person must be seen alone so any problems with the provider or the home can be freely discussed. Help resolve any problems noted. Contact the contract manager if there are problems with the home or the provider.

4162 Six-Month Monitoring Contact

Revision 25-2; Effective March 31, 2025

After the first three months, the person must be monitored at regularly scheduled six-month intervals, unless the caseworker and supervisor have determined that the person requires more frequent monitoring. The first six-month monitoring contact occurs three months after the 90-day monitoring contact.

Regular monitoring visits should assess the person's needs and if the provider is addressing and meeting those needs. Report to the contract manager if the adult foster care provider is not addressing or meeting those needs. Carefully monitor the person's physical and medical condition to determine if initial problems are resolved and if new problems are arising due to decreased functional capacity or illness. Use regional nurses in this assessment and monitor process as needed.

All monitoring contacts must be recorded on Form 2314, Satisfaction and Service Monitoring, in the Service Authorization System monitoring wizard.

4170 Significant Changes

Revision 25-2; Effective March 31, 2025

It is the responsibility of the caseworker and the adult foster care (AFC) provider to ensure that the AFC person is in an appropriate setting to meet their needs. When the AFC person has a change in functional need, health problems or changes in behavior, it is the responsibility of the AFC provider to notify the caseworker.

Within 14 calendar days or sooner, as appropriate, the caseworker must follow-up with the person and provider to determine if changes to the care arrangement are needed. The caseworker may consult with the supervisor to determine how quickly a response is needed to the situation.

Give particular attention to people who reflect dramatic changes in functional need, medical problems or behaviors that are inappropriate for foster care. Alert family members, the responsible party or guardian to the situation. Discuss with them and the person the potential for the person to remain in the foster home. If a person has a guardian appointed by the courts, the guardian acts on the person's behalf. If the person has had a decline in their medical condition or functional ability, consult the regional nurse and request that the nurse make a visit to the person for a medical assessment.

4171 Changes in the Service Plan

Revision 25-2; Effective March 31, 2025

Document the changes in a person's condition on Form 2060, Needs Assessment Questionnaire and Task or Hour Guide, and Form 2330, Assessment and Service Plan Approval for Adult Foster Care, noting changes in the person's functional ability and appropriateness for adult foster care (AFC) placement. Discuss the changes with the supervisor, regional nurse if needed, AFC provider and family members. Refer to 2550, Identifying People at Risk, if the person’s health and safety are at risk and more service planning is needed. If AFC continues to be appropriate for the person, document the needed changes in the service plan on Form 2327, Individual/Member and Provider Agreement.

4172 Adult Foster Care No Longer Appropriate

Revision 25-2; Effective March 31, 2025

If after a review of Form 2060, Needs Assessment Questionnaire and Task or Hour Guide, and Form 2330, Assessment and Service Plan Approval for Adult Foster Care, the person's needs can no longer be met or the person is no longer appropriate for adult foster care, discuss alternative living arrangements with the person, family or responsible party. Long-range care plans should be discussed plainly with the person, family members and the foster care provider to ensure that all are aware of the capabilities and limitations of adult foster care services for people with deteriorating medical or functional conditions. People who become inappropriate for foster care must be advised of other available options. Help people and their family members in this decision process and with transfer activities when necessary. If the provider decides that the person is not appropriate for care in their home, the provider contacts the caseworker to request that the person be transferred to another placement. The caseworker is responsible for preparing the person for the move and transition.

4173 Termination of Adult Foster Care Services

Revision 25-2; Effective March 31, 2025

Once a person is identified as inappropriate for foster care, the caseworker must negotiate a time frame with the person, family or responsible party and the adult foster care (AFC) provider for the person to move. The time frame is determined on a case-by-case basis depending on the urgency and severity of the situation and how quickly an appropriate placement can be arranged. If the person has been a threat to the health and safety of other people or has displayed inappropriate behaviors so that the provider is asking the person to move immediately, then the caseworker must make every effort to locate another living arrangement as soon as possible. If other living arrangements are not readily available for the person, refer to Adult Protective Services (APS) to help locate appropriate placement for the person.

If the person will not be transferring to another AFC setting, send the person Form 2065-A, Notification of Community Care Services, with the negotiated move date as the end date of services. Unless the person's service is being terminated due to threat to health and safety, review 2811, Effective Dates. Give the person at least 12-calendar days' notice. Terminate AFC services on Form 2101, Authorization for Community Care Services.

If there is resistance to the move from the person, family or the provider, additional staffing with the person, family, responsible party and provider may be required to resolve the problem. Request that the supervisor and contract manager attend the staffing, if necessary. Advise the person and provider that AFC services will terminate on the date specified on Form 2065-A. The provider has the right to begin eviction proceedings as specified in the provider's resident rights and responsibilities. Ensure that the person and responsible party understand the consequences of eviction. If the provider must use eviction procedures and the person has refused to make other living arrangements, refer the person to APS.

If the person and provider decide that the person will remain in the home as a private pay person, then the contract manager must give approval. Make sure the person and provider understand that there are no case management services or payment arrangements from the Texas Health and Human Services Commission for a private pay person.

4180 Annual Reassessment

Revision 25-2; Effective March 31, 2025

Reassess the adult foster care (AFC) person every 12 months as outlined in 2660, Reassessments and Recertification Procedures. Form 2330, Assessment and Service Plan Approval for Adult Foster Care, must be completed annually and signed by the supervisor. Carefully review the appropriate and inappropriate characteristics on Form 2330. Be alert for changes that indicate the person is no longer appropriate for AFC or that their medical or functional needs can no longer be met. If the person's condition is deteriorating, but not to the point that AFC is currently inappropriate, discuss with the person that a move may be necessary in the future.

Reevaluate the service plan at each reassessment and update per the person's new or changed needs. Discuss changes in the person's need level and in the service plan with the foster care provider and get supervisory approval.

Reauthorize AFC on Form 2101, Authorization for Community Care Services.