Massachusetts Caregiver Homes Program: Enhanced Adult Family Care


 Under this program, family members can receive payment for caring for elderly relatives in their homes.

In the last few years, a new type of MassHealth (Medicaid) program has emerged in Massachusetts. Instead of living in a nursing home or another institutional facility, elderly participants move into a caregiver's home or, alternatively, have a caregiver move into their home. Sometimes, the caregivers have more than one elder in their home at the same time.

Most commonly the caregivers are friends or family members of the care recipient, although it is not a requirement that the caregiver and care recipient be acquainted. The state pays the caregivers for the 24-hour personal care that they provide. Typically, personal care assistance includes the activities of daily living like bathing, toileting, grooming and other personal hygiene as well as the instrumental activities of daily living, such as meal preparation, housekeeping, and laundry.

The Caregiver Homes program does not pay for the individual's room and board, Care recipients are expected to pay around $400 - $500 per month to their caregivers for those costs. However, often when family members are providing the care, they cover those costs themselves.

Eligible family members that can be paid as caregivers include siblings, the adult children and other relatives but not the care recipient's spouse, parent of minors or legal guardian. It is unclear whether ex-spouses can be paid as caregivers.

 The Caregiver Homes program is also referred to by other names including Cash and Counseling, Paid Caregiver, Adult Foster Care, Adult Family Care, AFC, Enhanced Adult Family Care and EAFC.


Eligibility Guidelines

To qualify for the Caregiver Homes program, Massachusetts residents must be elderly or disabled and require assistance with their activities of daily living. They must also require 24-hour care. However, of course, the residents must not require a significant level of care that would be only available in a nursing home. In addition to the medical requirements, program participants must be financially eligible for MassHealth (Massachusetts' Medicaid program).

For 2017, the income limits are $1,005 per month for an individual or $1,354 per month for a couple. While these are limits, families should not be overly concerned if the candidate's income is more than these limits. Massachusetts has a Medically Needy Medicaid program in which individuals whose medical expenses are extraordinarily high can qualify even though their income is more than the limits. MassHealth financial planning advisers can help re-organize a candidate's income so that they become compliant.

MassHealth also considers the applicant's financial resources. Depending on the situation, the resource limits for an individual or a married couple where one spouse is an applicant range from $2,000 - $120,800. Many assets are considered exempt or can be considered exempt if they allocated appropriately.

Persons unsure of their financial eligibility should consult with a MassHealth planning expert. Any planning must be done prior to applying. Read more.


Benefits and Services

Care recipients receive 24-hour personal care services from their caregivers including assistance with bathing, dressing, meals, and getting up among other activities. They continue to receive nursing care in their place of residence or in the home of the caregiver from trained medical professionals.

Caregivers receive payment from MassHealth of between $8,000 - $18,000 annually. They also receive two weeks of respite care per year. Some caregivers also receive an addition $400 - $500 / month for room and board. However, the room and board payment comes from the care recipients directly and is not paid for by MassHealth.

If a family chooses to work with an intermediary agency that helps manage the process, provide training, backup caregivers and assist with paperwork, they should expect that the agency takes between 20 - 40 percent of the total of compensation. For some family caregivers focused on the needs of their loved one, an intermediary can make the difference between managing the program requirements and being able to receive the payments.


How to Apply / Learn More

The Caregiver Homes / Adult Foster Care Program is available in all counties in the state. Interested individuals can learn more about the program and apply by calling the Mass AgeLine at 1-800-243-4636 or contact their local Aging Services Access Point. While sometime there are long waiting times on the Mass AgeLine, one can leave a voice mail and have their call returned a by staff member.

Detailed PDFs about the program are available for download from at this link