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MOD hears from many people with disabilities and their family members who want to know what options exist for those who either need help to live at home or are seeking residential care. We thought it would be helpful to lay out and describe most of the major options in one place to make it easier to compare and navigate the various programs.

This is Part One of a two-part blog series on long-term home care and residential care programs for seniors and people with disabilities in Massachusetts. Part One will focus on Home Care options for people who need services to help them live at home and in their communities. Here are some options:

Adult Day Care

Adult Day Care programs provide care, supervision, and support services to persons 18 years of age or older who have physical, cognitive, or behavioral health impairments. These programs provide a structured day program in a group setting for seniors and adults with disabilities who return to their homes at the end of the day. Services include nursing, case management, social activities, and help with activities of daily living.  Programs accept private payments, MassHealth Standard, CommonHealth and long term care insurance. There are also programs funded by the state and Veteran’s Administration.  For more information on finding and applying for adult day care programs, contact your local Aging Services Access Point (ASAP).

Adult Foster Care (AFC)

Frail seniors and adults with disabilities in AFC live with professional caregivers. AFC allows individuals who need personal care to live in a family setting rather than in a nursing home or institutional facility. AFC caregivers provide meals, 24-hour supervision, companionship and personal care assistance. Caregivers are paid by MassHealth to care for MassHealth members. Family members (except legally responsible relatives) or non-family members may serve as caregivers to the individual. Caregivers may be individuals or entire families who receive training from a social worker, registered nurse, and other service providers. For more information on AFC and to apply, contact the ASAP that serves your area.

Group Adult Foster Care (GAFC)

GAFC is a MassHealth program that pays for personal care and medication management to seniors and individuals with disabilities who live in GAFC-approved housing. Residents must be eligible for MassHealth and require assistance with at least one activity of daily living such as bathing, toileting, or eating. There is no cost for GAFC for MassHealth members. Housing costs are not covered, only the supportive services. To apply, contact MassHealth.

Home Care Assistance Program

The Home Care Assistance Program (HCAP) provides homemaking services such as grocery shopping, meal preparation, laundry, chores and housekeeping for adults with disabilities under age 60. There is a waiting list for services. To apply, contact HCAP directly (617) 204-3853 or toll-free 1-800-223-2559. Homemaking services for individuals age 60 and over are administered through the ASAPs.

Elderly man with walker sits in foreground, woman in the background washing a bowl in a sink.

Home care allows seniors and people with disabilities to remain in their own home or in a family setting.

MassHealth Home Health

MassHealth pays for home health agency services to members who are home-bound and need skilled nursing/therapy services. Services include home health aide, personal care attendant, physical and occupational therapy, and speech/language therapy.   Home health services must be part of a doctor’s individual care plan for the member. Contact MassHealth for more information.

MassHealth Personal Care Attendant (PCA) Program

The MassHealth PCA Program provides funds to hire a PCA for MassHealth Standard or CommonHealth members with a chronic or permanent disability who require hands-on assistance with at least two of seven activities of daily living (ADLs) (mobility, bathing/grooming, dressing/undressing, passive range-of-motion exercises, taking medications, eating, and toileting) and have PCA services approval from a doctor. PCA Program consumers hire and manage their PCAs independently if they are able to do so. PCAs provide assistance with ADLs as well as other services such as laundry, shopping, housekeeping, meal preparation and transportation to medical appointments. To apply for the PCA program, applicants must contact a Personal Care Management Agency (PCMA) who will obtain an authorization from MassHealth for the applicant.  You can find a list of PCMAs in the PCA Consumer Handbook.

Come back for Part Two: Residential Care and Supportive Housing where we will cover options for individuals to receive support services in a residential rather than a home setting.



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