What is Adult Foster Care (AFC)?
Adult Foster Care (AFC), also called Adult Family Care, is a program for frail elderly adults and adults with disabilities who cannot live alone safely. AFC adults live with trained paid caregivers who provide daily care. Caregivers may be family members (except legally responsible relatives), or non-family members.
The program is for adults who need daily help with personal care, but want to live in a family setting rather than in a nursing home or other facility. The caregiver provides meals, companionship, personal care assistance, and 24-hour supervision. Caregivers may be individuals, couples, or larger families.
Caregivers receive up to $18,000 per year from MassHealth to provide care to MassHealth members who otherwise would need institutional care. Service providers, including a social worker and registered nurse, train the caregiver and provide ongoing support.
Am I Eligible?
To be eligible for Adult Foster Care / Adult Family Care:
- you must be 16 years of age or older
- you must be unable to live alone because of a medical, physical, cognitive or mental condition
- you must need daily assistance with one or more activities of daily living (ADLs)
- you cannot require full-time skilled nursing care
- you must be willing to live with your caregiver
- you must be eligible for MassHealth or able to pay privately
- your caregiver cannot be your spouse or another relative legally responsible for you
(Note: For a minor child, the caregiver cannot be a parent)
- you must be approved for AFC by a physician and an Aging Services Access Point (ASAP)
Adult Foster Care / Adult Family Care offers two levels of care:
Level 1 is for people who need daily assistance with at least one of the following activities of daily living (ADL): bathing, dressing, toileting, transferring from one position to another, ambulating (walking or wheelchair assistance), or eating
Level 2 is for people who need assistance with three or more ADLs; or two or more ADLs, plus caregiver intervention for one or more of these behaviors: wandering, resisting care, being physically or verbally abusive, or socially inappropriate or disruptive behavior.
Who can be a Caregiver?
- Caregivers can be family members or non-family members. However, caregivers cannot be spouses, parents of minor children, or legally responsible relatives.
- Caregivers must be approved by the program (interview, references, CORI check), and be able to provide 24-hour supervision.
What benefits will I get?
- You can live in your caregiver's home, or your caregiver can move into your home.
- You will be treated like a member of the family by your caregiver. Your caregiver will:
- prepare meals and snacks
- assist you with personal care
- provide behavior interventions as needed
- provide medication reminders and assistance
- do shopping, laundry, and housekeeping
- provide transportation to medical appointments and social visits
- maintain a clean safe living space
- keep a caregiver log
The Adult Foster Care / Adult Family Care (AFC) agency provides:
- careful screening and training of your caregiver family
- case management and service coordination
- periodic visits by social workers and registered nurses to monitor medical conditions, evaluate caregiver services, and offer support and training
- 24-hour coverage for emergencies
- Your caregiver will receive:
- up to $1500 per month for caregiver services ($18,000 per year), depending on the level of care needed
- support and training
- home visits by social workers and registered nurses
- respite care (up to 14 days per year)
Your caregiver is not allowed to have more than three AFC clients at a time, and no more than two who require Level 2 care.
What are the costs?
- If you are eligible for MassHealth, MassHealth will pay for personal care services, service provider fees, and administration costs. Caregivers receive a tax-free stipend of $9000 per year for personal care services for Level 1, and about $18000 per year for Level 2.
- MassHealth also pays service providers and program administrators for their services.
- MassHealth does not pay for room and board. If you are living in your caregiver's home, your host family may charge you a monthly fee (like rent) for room and board. You and your caregiver decide on the amount you will pay for room and board. You will have a private or semi-private bedroom.
If you are not eligible for MassHealth, you must pay all of the costs yourself. The total cost without MassHealth depends on the level of service needed.
Medicare does not pay for this program.
How do I apply?
Regalis Health MA Inc. Adult Foster Care Program at:
270 Union St, Ste 303
Lynn MA 01901
Tel: 617-430-4716
Fax: 508-762-4215
You may apply for AFC if you already have a caregiver in mind (for example, a family member or friend), or if you want to be matched with a caregiver. If you are matched with a caregiver you do not already know, you and your caregiver will have a chance to meet each other before approving the match.
Regalis Health MA Inc. AFC staff will screen the caregiver and make sure the home where you will be living is safe, clean, and physically accessible.
You can also call MassHealth Customer Service at 1-800-841-2900 if you need to verify any information you have learnt on our website about the Adult Foster Care Program.
Thank you for requesting our services for your loved ones.