What is the Massachusetts group adult foster care program?

According to state audits, from 2010 through 2018, the cost of the Adult Foster Care and Group Adult Foster Care Programs almost doubled, showing the increasing demand for community-based care. This expansion highlights the critical role of programs like the What is the Massachusetts group adult foster care program?

Quick Summary

The Massachusetts Group Adult Foster Care (GAFC) program, funded by MassHealth, provides personal care and support services for eligible adults aged 22 or older who live in approved community housing or assisted living, helping them maintain independence and avoid institutionalization.

Key Points

• GAFC is a MassHealth Program: The Massachusetts Group Adult Foster Care (GAFC) program is a Medicaid-funded initiative providing essential personal and support services to eligible state residents aged 22 or older.

• Supports Independent Living: The program is designed to help elderly and disabled individuals remain independent in community-based settings, such as approved subsidized housing or assisted living residences.

• Covers Personal Care, Not Housing: GAFC funding covers personal care services and case management, but does not pay for room and board. Other financial assistance, like Supplemental Security Income (SSI-G), may help with housing costs.

• Eligibility Includes Financial and Clinical Criteria: To qualify, applicants must meet MassHealth income requirements and demonstrate a clinical need for assistance with one or more Activities of Daily Living (ADLs).

• Includes Nursing Oversight and Case Management: A multidisciplinary team, including a Registered Nurse and Case Manager, provides oversight and coordinates care plans to ensure comprehensive and ongoing support.

Understanding the Group Adult Foster Care (GAFC) Program

The Massachusetts Group Adult Foster Care (GAFC) program is a MassHealth-funded initiative providing community-based care for seniors and disabled adults. It offers personal care assistance and support services to promote independence and a better quality of life in a non-institutional setting, specifically in subsidized or assisted living residences.

How GAFC Differs from Other Care Options

GAFC distinguishes itself from other care options in Massachusetts by focusing on personal care within a group setting for MassHealth recipients.

• GAFC vs. Adult Foster Care (AFC): GAFC participants live in approved group settings, while AFC recipients reside with a live-in caregiver in a private home. GAFC aides are typically employed by a provider, whereas AFC caregivers can be family members.
• GAFC vs. Nursing Home Care: GAFC is for individuals needing daily help but not the 24/7 skilled nursing care provided in a nursing home. It serves as a more community-focused alternative.
• GAFC vs. Traditional Home Care: While home care occurs in a person's home, GAFC offers an integrated model in a group residential setting, including care management and nursing oversight alongside personal care.

Eligibility Requirements for GAFC

Eligibility for GAFC requires meeting clinical and financial criteria set by MassHealth. Key requirements include:

1. Age and Residency: Must be a Massachusetts resident at least 22 years old.
2. MassHealth Enrollment: Must be enrolled in MassHealth Standard, MassHealth CommonHealth, or a Senior Care Options (SCO) plan.
3. Clinical Need: Requires daily assistance or supervision with one or more Activities of Daily Living (ADLs) due to a medical, cognitive, or behavioral-health condition, certified by a physician.
4. Residence: Must live in a MassHealth-approved managed building, assisted living residence, or subsidized group housing.
5. Assessment: An in-person assessment confirms clinical need and suitability for the program.

What Services Are Provided Through GAFC?

GAFC provides comprehensive personal and support services delivered by trained aides and overseen by a multidisciplinary team. Services typically include:

• Personal Care: Assistance with ADLs like bathing, dressing, and grooming.
• Homemaking: Help with tasks such as light housekeeping, meal preparation, and laundry.
• Medication Management: Reminders and supervision for taking medications.
• Care Management and Coordination: A case manager develops and updates a personalized care plan.
• Nursing Oversight: A Registered Nurse conducts health assessments and coordinates medical services.
• Community Integration: Services are provided in a setting that supports social engagement.

The Application and Enrollment Process

The GAFC application process involves several steps:

1. MassHealth Enrollment: Be a MassHealth member.
2. Contacting a Provider: Contact a MassHealth-approved GAFC provider agency for guidance.
3. Initial Assessment: A provider conducts an in-person assessment of clinical needs and home safety.
4. Documentation: The provider assists in obtaining necessary physician certification.
5. Approval and Service Start: Services begin after MassHealth approves eligibility and the care plan.

GAFC vs. Other MA Senior Care Options

Feature	Group Adult Foster Care (GAFC)	Adult Foster Care (AFC)	Assisted Living (Private Pay)	Nursing Home (Medicaid)
Living Environment	Approved subsidized housing or assisted living	Caregiver's or participant's private residence	Private or semi-private apartment-like unit	Long-term care facility
Funding	MassHealth (pays for personal care services only)	MassHealth (pays for caregiving and oversight)	Out-of-pocket, long-term care insurance, or SSI-G	MassHealth/Medicaid (for qualifying individuals)
Daily Assistance	Daily visits from an aide for personal care and homemaking	24-hour supervision and personal care from a live-in caregiver	Staff provides assistance with ADLs on-demand	24-hour medical and personal care
Nursing Care	Regular oversight from a Registered Nurse	Regular oversight from a Registered Nurse	Available nursing staff for health management	24/7 skilled nursing care
Cost for Room & Board	Participant's responsibility, may be supplemented by SSI-G	Included in caregiver's private residence	Participant's responsibility	Included for eligible individuals

Finding a GAFC Provider

To find a GAFC provider in Massachusetts, residents can consult official state resources like the Massachusetts Executive Office of Health and Human Services (EOHHS) or local Aging Services Access Points (ASAPs) for lists of approved agencies. Many certified home care agencies also serve as GAFC providers and can assist with the application and setup process. Comparing providers is recommended to find the best fit.

Conclusion

The Massachusetts Group Adult Foster Care program provides essential, cost-effective community-based care for eligible seniors and disabled residents. By funding personal care and support through MassHealth, it removes financial barriers while offering vital nursing oversight and care management. GAFC empowers eligible individuals to live more independently and receive dignified care outside of an institution.

Learn more about MassHealth's Long-Term Services and Supports programs

Frequently Asked Questions

What is the primary purpose of the GAFC program in Massachusetts?

The main purpose of the Massachusetts GAFC program is to provide personal care and supportive services to eligible elderly and disabled adults who reside in approved community settings. The goal is to help them live with greater independence and prevent or delay institutionalization in a nursing home.

Who pays for the GAFC program?

The GAFC program is funded by MassHealth, which is Massachusetts' Medicaid program. It covers the cost of personal care services and care management for eligible members, but it does not pay for housing costs like rent and utilities.

What is the age requirement for the GAFC program?

Individuals must be at least 22 years old and a resident of Massachusetts to be eligible for the Group Adult Foster Care program.

Do I have to live in a specific type of housing to receive GAFC services?

Yes, GAFC services are provided to individuals living in approved group settings, such as subsidized housing for the elderly or disabled, or assisted living residences. This differs from the Adult Foster Care (AFC) program, where the caregiver lives with the member in a private home.

What is the difference between GAFC and AFC?

The primary difference lies in the living arrangement and caregiving model. GAFC involves an aide visiting a member in an approved group residential setting, while AFC involves a live-in caregiver providing 24/7 supervision in a private home setting.

Does GAFC cover assistance with Activities of Daily Living (ADLs)?

Yes, GAFC services include assistance with Activities of Daily Living (ADLs), such as bathing, dressing, eating, and personal hygiene. It also covers help with Instrumental Activities of Daily Living (IADLs) like meal preparation and housekeeping.

How do I apply for the GAFC program?

To apply, you must first be enrolled in MassHealth. Then, you can contact an approved GAFC provider agency or your local Aging Services Access Point (ASAP) to begin the assessment process.

What if my needs change after enrolling in GAFC?

Your care plan is reviewed regularly by a nurse and case manager. If your needs change, your care team will adjust the plan to ensure you continue to receive the appropriate level of support.