Mark Harvey - I want you to open an Adult Family Home

I am a Leo and an “only child” — explains a lot of things, doesn’t it?

I know, but the fact is that I want something from you and I’m pretty sure I deserve it. What do I want? I want you to open and run an “Adult Family Home” in Grays Harbor or Pacific County; preferably both! And you, of course, said (well, after you said, “I don’t care what you want…”), “Huh? What’s an Adult Family Home?” Fair enough.

It’s not unusual, when I’m talking to folks and/or families, for the subject of “residential options” to come up. The context is usually one in which someone just needs more care than someone else (or a whole bevy of “someone elses”) can continue to provide at home, so here’s what we cover: assisted living facilities, memory care/dementia communities, adult family homes and nursing homes.

Here’s what the State of Washington says an adult family home is:

“An adult family home (AFH) is licensed to provide housing and care services for up to six adults in a regular house located in a residential neighborhood. The AFH may be run by a family, single person, or business partners.”

Here’s what I say an adult family home is:

“It’s a regular house in a regular neighborhood where a person can get room, board and 24/7 care, and there can’t be more than 6 folks living there, getting care; so, it’s kinda like a little ‘mini-nursing home’, except without the institutional trappings and feel.”

This isn’t anything new — AFH’s have been around for a long time. The proverbial “good news” is that, by their nature, they tend to be more informal, flexible and home-like, where genuine relationships develop between residents and the folks providing the care. Is there “bad news?” Well, sure! It isn’t “home” (although, after a while — if things go well — it can begin to feel like “home”) and “bad care” or “bad players” can happen anywhere! Often, though, if there’s a good “match” between place and people, they can be a great compromise.

An adult family home is a HOME. It is — literally! Somebody’s house; oh, sure, they have to be licensed and inspected and have to be able to safely, sanely and respectfully accommodate “x” number of folks. Usually, folks have to be hired to come in and help provide the care and there’s paperwork and rules and regulations and and and…Well, I never said that this was going to be walk-in-the-park.

But when someone who genuinely cares about elders and folks with disabilities, and enjoys the day-to-dayness of doing that work, opens one of these, it’s one of the best not-“home”-but-darned-close-to-it options you’ll ever find.

The current “problem” is that we don’t have very many of these anymore, and very few of the ones we do have will accept Medicaid – Not Medicare, Medicaid! What does that mean? Well, it means that if Mom needs and wants this kind of help, and doesn’t have much money, she’s either going to end-up in some other kind of place OR have to go quite a ways away.

And why don’t more AFH operators accept Medicaid? Because the rates are lower than they ought to be AND they can get more money from “private pay.” Now, there’s nothing wrong with that, as far as it goes, but it doesn’t help Mom; in other words, if you’ve got the money, OK! If you don’t, guess where you’re likely to end up?


So, what I want you to do is attend a two-hour meeting a few days from today — Dec. 12 — from 1 to 3 p.m. at the Aberdeen “Home &Community Services” office at 415 W. Wishkah in Aberdeen, and learn about what it takes to open and run an Adult Family Home. THEN, I want you to actually go do it, and make a solemn vow to accept people on Medicaid, who don’t have a whole lot of choices. You can register by calling Dawn Okrasinski at 360-664-9144.

THEN, I want you to commit to being the BEST there is, and then I want you to get a tattoo on your wrist that says, “There, but for the grace of …” and conduct your business accordingly.

That’s it — that’s all it takes to make Mark happy: Go to one lousy meeting for two hours next Thursday, then change the world! Well, OK, you may have to learn the same thing that I had to learn a long time ago: I can’t “change the world,” but I can change my little piece of it.

So I will. And I’ll take all the help I can get.

Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information &Assistance.


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