Transitioning to Adult Foster Care: What Families Can Expect

Transitioning to Adult Foster Care does not mean moving a loved one into a facility. In Massachusetts, the member and caregiver live together in a qualified home while the caregiver provides daily assistance and receives support from an approved provider.

This guide focuses on what happens after a family begins the process, including assessments, authorization, placement, caregiver training, and the first weeks of services.

Before the Transition: Confirm the Program Fits

Adult Foster Care may be appropriate when an eligible MassHealth member needs daily physical assistance, or cueing and supervision, with at least one activity of daily living and lives with a qualified caregiver.

The caregiver must be at least 18 and cannot be the member’s spouse or court-appointed legal guardian. A parent cannot be paid through the program for a child under 18. The member generally needs MassHealth Standard or CommonHealth.

For the intake and document stages, read how to apply for Adult Foster Care in Massachusetts.

Step 1: Complete the Clinical and Home Assessments

Mass Care Link schedules nursing, psychosocial, and qualified-setting assessments. The team reviews the member’s health, daily abilities, caregiver support, current services, household, and home environment.

Use specific examples of what the caregiver does during a typical day. Explain whether the member needs hands-on help, step-by-step prompting, or supervision to complete personal care safely.

Step 2: Gather Remaining Medical Information

The team may need a current physical examination, primary care provider order, medication information, diagnoses, and other records. Missing or outdated information must be resolved before authorization.

Families can help by responding promptly, confirming provider contact information, and attending scheduled appointments.

Step 3: Review the Proposed Plan of Care

The plan of care translates assessment findings into clear responsibilities. It identifies the member’s daily needs, caregiver assistance, safety considerations, goals, professional oversight, and reporting expectations.

The member should participate in planning to the greatest extent possible. The caregiver should ask questions before agreeing to responsibilities that are unclear or feel unsafe.

Step 4: Complete Caregiver Screening and Training

Before placement, the caregiver completes required screening, forms, and initial training. Topics may include:

• Activities of daily living and the authorized care
• Safety and emergency procedures
• Medication-related responsibilities
• Daily documentation
• Reporting changes in condition
• Member rights, privacy, and professional boundaries
• Backup-care expectations
• Communication with the nurse and care manager

Training continues after placement as needs change or new requirements arise.

Step 5: Wait for Required Authorization

Adult Foster Care services and caregiver payment cannot begin based only on an intake or assessment. The required clinical review and MassHealth authorization must be completed.

Processing time varies. Medical records, coverage questions, scheduling, or requests for clarification may affect the timeline. Mass Care Link keeps the family informed about outstanding items.

Step 6: Prepare the Home and Backup Plan

Before placement, confirm that the home supports the member’s mobility, privacy, daily routine, and safety. Address obvious hazards and organize frequently used supplies.

The family should also identify a backup-care plan for caregiver illness, appointments, emergencies, or time away. The primary caregiver remains responsible for communicating changes to the provider.

Step 7: Attend the Placement Meeting

Placement is the formal beginning of services. The member and caregiver must be present. During placement, the team reviews and completes required approvals, the plan of care, caregiver responsibilities, documentation, contact information, and the visit schedule.

Ask who to contact during business hours, after hours, and in an emergency. Call 911 for emergencies rather than waiting for a routine provider response.

Step 8: Establish the First-Month Routine

The first several weeks are a period of adjustment. A simple routine helps the caregiver meet requirements consistently:

• Follow the plan of care each day.
• Complete documentation accurately and on time.
• Keep provider and appointment information organized.
• Report hospitalizations, falls, medication changes, and meaningful changes in daily abilities.
• Attend scheduled home visits and training.
• Ask questions before a small concern becomes a larger problem.

Our new caregiver checklist for the first 30 days offers additional organization and safety tips.

What Ongoing Support Includes

After placement, Mass Care Link’s nurses and care managers provide oversight, education, care-plan monitoring, and coordination. The team supports both the member and caregiver while maintaining the member’s preferences, dignity, and safety.

Adult Foster Care does not replace primary or specialty medical care. Caregivers should continue regular appointments and contact healthcare professionals with clinical questions.

Common Transition Delays

• Expired or missing physical examination
• Incomplete forms or signatures
• Difficulty verifying MassHealth coverage
• Missing primary care provider documentation
• Scheduling conflicts for assessments
• Questions about the caregiver relationship or household
• Current services that may duplicate Adult Foster Care
• Home-setting concerns that require clarification

Responding promptly and keeping one organized document folder can reduce avoidable delays, although no provider can guarantee an approval date.

Frequently Asked Questions

Does transitioning to Adult Foster Care require moving?

Not necessarily. The member and caregiver may already live together, or one may move into the other’s qualified home before services begin.

When does caregiver payment begin?

Payment begins according to the provider’s placement and payment procedures after required authorization and formal enrollment. Care provided before placement is not automatically payable through the program.

Can the member keep the same doctors?

Adult Foster Care does not replace the member’s medical providers. Provider networks and coverage should be reviewed with the member’s health plan.

What if the caregiver needs time away?

The caregiver should follow the approved backup-care plan and notify the care team as required. Do not leave the member without appropriate support.

What if the member’s needs increase?

Notify the nurse or care manager promptly. The provider may review the plan, obtain medical information, or conduct another assessment.

Begin the Transition With Mass Care Link

Review how to qualify or start an application with Mass Care Link. Our intake team will explain the next required step.

This article provides general educational information. Eligibility, authorization, placement, and service requirements depend on current MassHealth rules and individual circumstances.