Understanding Group Adult Foster Care (GAFC) in Massachusetts

Group Adult Foster Care (GAFC) helps adults who can’t safely live entirely on their own get daily personal care in supportive housing—typically assisted living residences or designated senior housing—so they can stay in the community instead of moving to a nursing home. GAFC is funded by MassHealth (Medicaid in MA) and pairs hands-on help with Activities of Daily Living (ADLs) and ongoing care coordination.

GAFC at a glance

What it is: Daily personal care (e.g., bathing, dressing, toileting, meal support) provided in GAFC-approved housing with on-site support—not a live-in caregiver.
Who it’s for: MassHealth members (often seniors or adults with disabilities) who need at least one ADL daily with hands-on help or full cueing/supervision.
How it differs from AFC: AFC requires living with a trained caregiver and offers a non-taxable caregiver stipend; GAFC is delivered in supportive housing and does not pay a family caregiver stipend.

How GAFC works in Massachusetts

The core services

GAFC provides day-to-day personal care for ADLs, safety monitoring, meal support, and help coordinating health needs—delivered where the member lives (assisted living or designated senior housing). The goals are safety, dignity, and preserving independence at home.

Eligibility basics

To qualify for GAFC in Massachusetts, a person generally must:

Have MassHealth coverage (Standard or CommonHealth).
Be age 16+ (many participants are older adults, but adults with disabilities can qualify).
Need daily help with at least one ADL—either hands-on assistance or cueing/supervision throughout the entire activity.
Avoid duplicative services (e.g., cannot receive overlapping programs that deliver the same type of personal care).
Live in a GAFC-approved setting (assisted living or designated supportive senior housing).

Staff tip: A quick clinical screen looks for daily ADL assistance needs and confirms they’re met with either physical help or full cueing/supervision—not just occasional reminders.

GAFC vs. AFC (Adult Foster Care)

Setting:
- GAFC: Supportive housing with on-site staff; no live-in caregiver.
- AFC: Member resides with a trained caregiver at home.
Caregiver stipend:
- GAFC: No family stipend.
- AFC: Caregivers receive a non-taxable stipend (per IRS Notice 2014-7 “difficulty of care”).
Clinical thresholds:
- GAFC: At least 1 ADL daily with hands-on help or full cueing/supervision.
- AFC: Ranges by Level I/II, with higher ADL thresholds and/or behavioral supports when Level II.

The enrollment path (what families can expect)

At Clare Senior Care, the GAFC journey is designed to be simple and fast, with bilingual support throughout:

Consultation & eligibility check
We verify MassHealth coverage and do a quick ADL screen. If you’re not yet on MassHealth, we help you apply or renew.
Initial Intake
We collect IDs, review HIPAA consents, and explain the program in plain language.
Nursing/Case Management Assessment
A nurse evaluates ADLs, safety, medications, and risks; a care manager reviews psychosocial needs and housing fit.
Physician order & submission
We coordinate your PCP order and submit the required documentation through the appropriate channel (Clare handles the paperwork and follow-ups).
Approval & start of services
Once approved, GAFC services begin in your housing setting; ongoing visits from nursing/case management support you each month.

Note: Whether you’re in a SCO plan (Navicare/Fallon, Tufts, UHC, CCA, WellSense) or on MassHealth without SCO (managed locally via ASAP), GAFC connects through either pathway; Clare coordinates with your assigned case managers and nurse case managers.

What GAFC does not include

No live-in family caregiver stipend (that’s AFC, not GAFC).
No duplicative personal-care programs at the same time (e.g., overlapping PCA hours that mirror GAFC tasks).

If you need extras beyond GAFC—like more frequent nursing visits, medication management, or concierge support—Clare offers Private Home Health Services as an add-on or alternative.

Benefits of GAFC for families

Stay home, stay safe: Receive daily hands-on care in a familiar residence with staff nearby.
Coordinated care: Regular nurse/case-management check-ins to monitor conditions, prevent falls, and navigate appointments.
Language-inclusive support: Clare provides culturally sensitive, multilingual assistance for forms, renewals, and ongoing care.
MassHealth-funded: For eligible members, GAFC personal-care services are covered by MassHealth.

FAQ: Frequently Asked Question

▶Do I have to move into a facility?

No nursing facility move is required. GAFC serves people in GAFC-approved housing (assisted living or designated senior housing) with on-site support—helping you remain in the community.

▶What if I don’t qualify for GAFC?

Clare can still help—via Private Home Health Services, community referrals, or exploring AFC if you live with a caregiver and meet those criteria.

▶How fast is enrollment?

We move quickly: intake → assessment → PCP order → submission. Families complete forms; Clare handles the rest, including follow-ups and documentation.

▶Can I be in GAFC and other programs together?

You can combine GAFC with many services, but not with programs that duplicate the same personal-care tasks. We’ll check for conflicts and advise you.

How Clare Senior Care can help

Clare Senior Care specializes in AFC & GAFC enrollment and ongoing support, from MassHealth applications to monthly nursing and case-management visits. We work with SCO plans and local ASAPs and provide multilingual assistance for families across Massachusetts.

Call (888) 479-8354 or book a consultation to check GAFC eligibility and next steps.