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Host homes are a type of living arrangement where individuals with intellectual and developmental disabilities (I/DD) (and sometimes elderly adults), live in the private home of an individual or family and receive supportive services. These arrangements are also known as adult foster care, shared living, family living, etc. Support services are provided by the family members who share their home with the individual with I/DD. The supportive services provided can vary depending on the need of the individual; but, they generally include meal preparation, chore assistance, transportation to appointments, and assistance with other activities of daily living.

The host home model is built on the principles of shared living. Shared living is a concept, as opposed to a service model or setting. This approach is designed to enable people with supportive living needs to living in the community without the control of the formal service delivery system.

Room and board costs cannot be covered by Medicaid, and therefore, coverage of room and board is specific to the individual. Often a certain percentage of an individual’s SSI payments are used to cover the cost of room and board; in other cases the state department of developmental disabilities may pay the cost; in some situations, the host family may elect to not receive room and board payments; or the family of the individual may pay the cost.

41 states have host home arrangements for individuals with I/DD, and they use a variety of different names. How much these arrangements adhere to the concept of shared living depends on the state, and various states are more invested in the host home model than others.

This report includes state-specific information on the number of individuals living in host homes, the estimated number of host homes per state, states that cover host homes, and how they are funded. The report also explores how states reimburse and administer host home support services.

This report was updated on January 31, 2019 to reflect new information provided by the state of Tennessee. 

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