ADULT FOSTER CARE

Adult Foster Care (AFC) program is a MassHealth program that provides personal care services in either a community or assisted living setting to individuals who are elderly and/or disabled. AFC provides assistance with Activities of Daily Living (ADLs), nursing oversight and care management. Individuals must meet the criteria and guidelines set forth by MassHealth:

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MEMBER QUALIFICATIONS:

  • Must be age 22 years of age or older;
  • Must meet the financial criteria for MassHealth* (Standard of CommonHealth)
  • A physician’s summary confirming the appropriateness of AFC services;
  • Requires daily assistance with at least one ADL(e.g., bathing, dressing, eating, continence care, ambulation or transfer);
  • Requires clinical approval from the MassHealth designated clinical screening  agent, Coastline Elderly Services, Inc; and
  • Must reside in identified community housing for individuals who are elderly or disabled OR live in an assisted living residence.
  • Financial Eligibility for AFC
  • Financial eligibility for AFC in an assisted living setting is determined by the
  • Social Security Administration through the Supplemental Security Income Program

WHAT IS SSI-G?

Supplemental Security Income (SSI) is a Federal program administered by the Social Security Administration (SSA);
Massachusetts implemented the SSI State Supplemental Living Arrangement (L/A) Category G, Assisted Living, as of 1998 to assist individuals who clinically meet the criteria for GAFC in an effort to assist in the payment of Room and Board in assisted living facilities;
The Commonwealth of Massachusetts, depending and individual’s living arrangement (must live in a certified assisted living that participates in the GAFC program), supplements the Federal SSI payment;
The income guidelines for SSI-G change on an annual, calendar year basis; and
The 2009 income guideline for an individual is $1128.00 per month with assets of $2000. or less and for a member of a couple $846.00 per month with assets of $3000. or less. It is important to note that SSI applies a general $20.00 disregard of income.

QUALIFICATIONS

Requires clinical approval for AFC services from the MassHealth designated clinical screening agent, Coastline Elderly Services, Inc.;
Must file an SSI application with the local SSA Field Staff Office;
Must meet all other SSI requirements; and
Requires a Residence Verification form completed by the assisted living facility
        and Coastline Elderly Services, Inc., confirming residency at the assisted living facility

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