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Community Enterprises, Inc. |
| 441 Pleasant Street, Northampton, MA 01060 | |
| Telephone 413-584-1460 |
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Massachusetts ADULT FOSTER CARE (AFC)
I. Purpose:
To provide daily assistance with personal care services (Activities of Daily Living-ADL), Instrumental Activities of Daily Living (IADL) as needed, and case management services to elderly and/or disabled MassHealth members who meet the clinical criteria and member characteristics for the AFC program as set forth in the AFC Guidelines. AFC members reside in a family-like setting in the caregiver's home.
II. Provider Eligibility:
Provider enrollment for the AFC program is open to a wide variety of agencies that serve the elderly and physically compromised. Providers must meet the criteria and guidelines set forth by the Division of Medical Assistance (the Division). Providers must complete an Adult Foster Care Program Application following Instructions and a MassHealth Provider Enrollment and Credentialing Application to receive approval from the Division in order to receive reimbursement for AFC services.
PROGRAM FACT SHEET III. Host/Caregiver Home Requirements: A). Host/caregiver homes must not meet the definition of an institution or assisted living facility (i.e. no more than three unrelated people receiving care by the host family in the home). B). The host/caregiver home may not be subject to licensing requirements (i.e. rest home, DMR group home...). C). Host/caregiver homes must comply with all applicable local and state fire and safety codes, and must be in good repair and show adequate maintenance and upkeep. IV. Service Package: The service package includes physical and psycho-social oversight by a registered nurse and social worker respectively, and assistance with activities of daily living (ADL) such as bathing, dressing, grooming, toileting, transferring, and ambulating provided by the host/caregiver seven days per week. In addition, the following services and staff must be provided: A). Qualified program director:Multi-disciplinary Care Plan and Comprehensive Service Plan developed by the nurse and social worker in collaboration with the member. Daily personal care and 24-hour supervision; and professional staffing ratio of 3.5 hours per member per week. B). The host/caregiver family is also responsible for providing assistance with Instrumental Activities of Daily Living (IADL) such as meal preparation, laundry, shopping, housekeeping, and transportation to medical and other appointments as indicated by the member's functional ability and needs. V. Member Eligibility: A). Financial Eligibility: Financial categories of assistance are determined either in the MassHealth Enrollment Centers (MEC), or in the local Social Security Administration office which determines financial eligibility for Supplemental Security Income (SSI). MassHealth does not cover medical services provided prior to the effective date of financial eligibility. B). Clinical Eligibility: Physician certification must confirm that Adult Foster Care services are appropriate to meet the physical and psycho-social needs of the member. The member may be at risk of institutionalization; a chronic disabled or elderly individual who may require supervision; and requires daily assistance with at least one activity of daily living (ADL). Assistance is defined as physical assistance or supervision and cueing to complete the ADL task. Prior approval from the Division's designee, the Aging Services Access Points (ASAP), Coastline Elderly Services, Inc., as well as financial eligibility, must be received in order for payment to be made for AFC services. MassHealth does not cover medical services provided prior to clinical approval. SERVICES PROVIDED: Independent Living with Intensive Supports Home Sharing Housing & Support Services to Consumers of the Department of Mental Retardation Supported Employment Supported Living for people with disabilities who are homeless Self-Directed Community Support to people with dual diagnosis Support for Families of people with psychiatric disabilities
POPULATIONS SERVED:
Individuals with:
FUNDING SOURCES:
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