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In the latest edition of our Caregiving Chronicles Q&A series, we speak with Scott Dean, Adult Family Care Case Manager at BayPath Elder Services, Inc. in Marlborough. Dean discusses BayPath’s recently launched AFC Program and how it fits BayPath’s mission to provide services and programs to older adults, caregivers and persons with disabilities to support their independence and dignity.

The BayPath AFC Program serves all 14 towns and cities in BayPath’s coverage area – Ashland, Dover, Framingham, Holliston, Hopkinton, Hudson, Marlborough, Natick, Northborough, Sherborn, Southborough, Sudbury, Wayland and Westborough – as well as other surrounding communities, including MetroWest towns Medfield, Millis and Norfolk.

Other area ASAPs also have AFC programs. the coverage area for Springwell s AFC program includes Needham and Wellesley, while residents in Bellingham, Franklin, Medway, Mendon, Milford and Millis should contact Tri-Valley’s AFC program.

Caregiving MetroWest: What is the Adult Family Care Program?
The Adult Family (or Foster) Care Program is a well-established program that has been in Massachusetts since the 1960s. The original goal was to discharge consumers from nursing homes and rehabilitation facilities back to their own homes, while still receiving the care they required. The key element of the program supports the consumer living with a trusted caregiver of their choice who is responsible for assisting with Activities of Daily Living (ADLs), such as bathing and mobility assistance, and Instrumental Activities of Daily Living (IADLs), such as cooking and cleaning. In return this caregiver is paid a monthly, tax-free stipend, which does not affect their earned income level. The rate of the stipend is based on the consumer’s level of care, varying from $24.23 a day to $50.28 a day.

CGMW: Is there any difference between Adult Family Care and Adult Foster Care?
 These terms are used interchangeably; both referring to this program that allows a consumer to reside with a paid caregiver.

CGMW: Why did BayPath decide to start this program?
BayPath started the program to provide an additional continuum of care.  Since the implementation of the Personal Care Attendant (PCA) program at BayPath in 2008, we have served more than just the over-60 population. The AFC program provides an alternative option for consumers 16 and older to remain in their own homes and choose their own caregivers. The clinical qualifications for the AFC program also allow enrolling consumers that other BayPath programs may exclude. For example, behaviors interfering with consumer care and/or supervision needs are taken into consideration for AFC, where they may not be in other programs.

CGMW: How does someone qualify for the AFC Program?
 To qualify for the AFC Program, the consumer must:
•    Be on MassHealth Standard or CommonHealth
•    Must reside with their caregiver, who is at least 18 years old
•    Must have a permanent, chronic disability that requires hands-on, physical assistance with at least one personal care need.
•    Must be 16 years old or older.
•    Both the consumer and the caregiver must have the support of their personal care physicians to enroll in the program.

CGMW: What is BayPath’s role in the program?
BayPath staff is responsible for screening the consumer, the caregiver and the home environment to make sure that all meet the guidelines of the program. Once approved, the care team of a Case Manager and Program Nurse through BayPath will meet with the consumer and caregiver on a monthly basis to ensure that the ongoing medical and social needs of the consumer are being addressed. The case manager can assist with finding volunteer work, adult day health program, community involvement, learning and enrichment programs etc.

CGMW: How does the AFC Program differ from the PCA Program? How would prospective clients determine which program they should apply for?
 Our department handles referrals for both the PCA and AFC programs. The eligibility criteria differ, as well as the caregiver payment. In general, the PCA Program serves individuals who have similar needs to those in the AFC Program, but who live independently, rather than with their caregiver. Our staff assists all referrals in determining which program or combination of programs will best serve the consumer’s needs.

CGMW: Is there anything else that people should know about BayPath’s new AFC Program?
Many people are already in a living situation that meets the criteria for this program.  We receive many calls from caregivers who have had to leave their jobs to care for parents, relatives, or siblings with disabilities. The program is ideal in these circumstances.  It allows the consumer to remain in their home with care, while providing the caregiver with income. While the consumer needs are addressed with round the clock coverage, respite opportunities are built into the program to support the caregiver and prevent burn out.

CGMW: How do you apply for the AFC Program?
AFC referrals can be made by calling BayPath at 508-573-7272. A Case Manager will then contact you for more information and to schedule an appointment with the potential member and caregiver.  Please also feel free to contact me at 508-573-7298 or sdean@baypath.org with questions or concerns.

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