Adult Family Care Program
The Adult Family Care (AFC) Program (also known as Adult Foster Care Program) is a residential program for people age 16 and older who due to medical, physical, cognitive or psychiatric problems cannot safely live alone. Consumers either live in the homes of skilled caregivers called Care Providers, or a Care Provider moves into the consumer’s home.
The Care Provider provides assistance with activities of daily living (ADLs) such as bathing, toileting, mobility, dressing, and other elements of personal care; and instrumental activities of daily living (IADLs) such as house cleaning, laundry, grocery shopping and medication management. Consumers receive a private room, all meals and are assisted with transport to medical appointments.
Care Providers are provided initial and ongoing training by Springwell’s AFC staff. They receive a tax-exempt, monthly stipend and receive two weeks’ paid vacation a year.
Family members can apply to become Care Providers unless they are the parents of a minor child who would be the AFC consumer, the spouse of the consumer or a legally responsible relative (such as a guardian) of the consumer.
AFC consumers are individuals living with a variety of different medical diagnoses, but they all need help with their activities of daily living. Some consumers are frail elders who receive assistance from family members, while others are younger adults who have disabilities and may be involved with the Department of Mental Retardation (DMR) or the Department of Mental Health (DMH). Some consumers work, while others attend Adult Day Health programs.
Click here to read an AFC success story
A Springwell RN and Social Worker meet with consumers interested in receiving services through the AFC Program for a complete assessment of their needs. Consumer eligibility is determined for Level 1 or Level 2 service within the AFC Program. If the consumer is eligible a Comprehensive Care Plan is created.
Eligibility (Level I) :
Adult Family Care services are provided to MassHealth members who meet the clinical criteria for AFC:
- At least 16 years of age or older;
- A physician must write an order for AFC;
- The member must have a medical or mental condition that requires daily physical assistance or cueing and supervision during the task in order for the member to successfully complete at least one ADL;
- A member must be clinically approved for AFC services by MassHealth.
Eligibility (Level II ):
In addition to Level I AFC services, the MassHealth agency pays for AFC at Level II if a member requires:
- Physical assistance with three ADLs (bathing, dressing, toileting, transferring, ambulating and eating); or
- Physical assistance with two ADLs and management of behaviors that require caregiver intervention: i.e. wandering, verbally abusive behavioral symptoms, socially inappropriate or disruptive behavioral symptoms and resisting care.
Care Provider Requirements
A Springwell Social Worker will meet with potential Care Providers at his/her home to discuss the AFC Program and to assess whether the Care Provider meets the following requirements:
- Be a responsible person who is at least 18 years of age;
- Not abuse alcohol or drugs;
- Be able to devote appropriate time necessary to provide needed personal care to the member to ensure the consumer’s safety and well-being at all times;
- Have a physical and tuberculosis test within prior 12 months
- Meet all other requirements of the AFC regulations.
Certain relatives of a MassHealth member may serve as that member’s AFC Care Provider in a qualified setting. Excluded relatives are: a spouse, parent of a minor member, including adoptive parent, or any legally responsible relative of the member.
Care Provider Home Requirements
During the visit to the Care Provider Springwell’s AFC Social Worker will conduct an assessment of the home to ensure it meets all requirements including:
- A private residence located in Massachusetts; not subject to state licensure as another type of facility (e.g. group home);
- Physically accessible to meet specific needs of its residents;
- In good repair; compliant with local health, fire, occupancy and state building codes for residential dwellings; equipped with appropriate safety equipment; and
- Occupied by no more than three AFC consumer’s, no more than two of whom require Level II AFC services, regardless of type and payment source.
Matching Consumers w/ Care Providers
Springwell AFC staff will carefully match consumers with Care Providers according to availability. While a consumer interested in the AFC Program may have a specific Care Provider to appoint, many do not. If a consumer does not have an available Care Provider, introductory visits are made and if requested, a trial weekend stay is provided. Once both the consumer and Care Provider agree with a match the Springwell AFC staff assists with facilitating the consumer’s move into the Care Provider’s home.
The Springwell AFC RN and Social Worker are in regular contact with the consumer and Care Provider, visiting the home a minimum of one time per month. The staff provides on-going training to ensure that the needs of the consumer are being met.
Consumer only pays Care Provider room and board (approx. $420 per month).
Springwell pays the Care Provider $23.00 per day for caring for a consumer who is enrolled in Level 1 and $49.05 per day for caring for a consumer who is enrolled in Level 2.
All other services (including Adult Day Health, LifeLine and medical transport) are paid for by MassHealth (Medicaid) directly.
For more information, or to become a consumer or host family with AFC, please call (617) 926-4100, Monday through Friday 8 a.m. to 5 p.m.