In Massachusetts, there are a few ways that family members can be paid to care for an elderly or disabled person. In this post we will discuss a state program called Adult Foster Care (AFC) or Adult Family Care.
MassHealth has always focused on program options that preserve the Community First principle of allowing individuals to live in the community, if possible.
The Adult Foster Care is a community-based program began as a way to keep people in their homes and communities for as long as possible by having their care needs met by a trained and qualified caregiver who lives with them. AFC offers an alternative to residential care for members.
The AFC program is a MassHealth funded program that provides in-home support to qualified individuals. We deserve the freedom and comfort of living at home and being cared for by someone we know and trust.
Eligibility Criteria (Members)
- Currently has MassHealth (Standard or Common Health), One Care Options (Commonwealth Care Alliance or Network Health/Tufts) or Senior Care Options (SCO)( Fallon or Tufts)
- Is at least 16 years old
- Requires assistance to complete Activities of Daily Living (ADLs)
- Requires supervision at least 21 hours daily
- Has a medical condition or cognitive impairment that requires hands-on assistance or active supervision and coaching to successfully complete at least one of the following activities: (Bathing, Dressing, Toileting, Transferring, Mobility, or Eating)
- Be unable to live alone due to their medical or mental condition
- Must have a friend or family member who can take care of them
- Must live with the caregiver or be willing to move in with the caregiver (not a spouse or legal guardian)
AFC is a medical service that must be prescribed by the member’s PCP office.
Eligibility Criteria (Caregivers)
- Can be a member or non-family member of the person they are caring for
- Can NOT be a spouse, parent or guardian for the person they are caring for
- Can NOT be a parent or guardian for the child they are caring IF the child is under 18 years old
- Must be 18 years of age or older
- Must be able to pass Criminal Offender Record Information check
- Must have the ability to provide the medical care and physical assistance required to care for the potential member
- Must be able to provide references
- Must have a physical and TB test within the past 12 months
- Determined to be responsible and capable of making precise decisions
- All caregivers for members in the Adult Foster Care program are required to complete a minimum of eight hours of trainings per year
Through the AFC program, qualified caregivers are paid a MassHealth tax-free stipend. The member may pay room and board based on an individualized basis.
“When your friend or loved one relies on you to help them get through their days and nights, you shouldn’t have to struggle to provide support”
Mass Care Link
Adult Foster Care Team Services
A multidisciplinary team provides support, training, and coaching to AFC members and caregivers.
- Member assessments
- Care plan to identify goals and objectives to maximize care
- Nursing and care management support
- Individualized training and support
- Monthly visits by an RN and care manager
- Information on community resources and other local community programs
- Case managers can help caregivers understand MassHealth paperwork and requirements, ensuring caregivers receive their tax-free stipend to help offset the cost of providing personal care
- Help caregiver and member set up their living space so it complies with state regulations
- Provides education, support, and guidance
- Emergency Back-up Plan with caregiver input
- 24 hour on call system
How much is the tax-free stipend?
The MassHealth payment to caregivers is a tax-free stipend. Level I and Level II service payment is determined by the MDS evaluation and additional clinical assessments.
Adult Foster Care (Level I) $54.37
Adult Foster Care (Level II) $91.31
Mass Council for Adult Foster Care
Kris' PCA Services 
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