The Massachusetts Council for Adult Foster Care (AFC) began a pilot program in the 1970’s to assist frail seniors in remaining in a home setting by matching them with a Caregiver. It operates on the fundamental belief that people have a right to remain at home in a community setting and has since expanded to include youth and adults with disabilities.

At that time, there were only a handful of member agencies contracted as providers to administer the program. It’s growth as a program was limited by several factors but perhaps the most difficult was the exclusion of family members as Caregivers. This requirement changed in 2007 allowing family members as Caregivers, provided they are not the legal guardian of the participant, and extending the eligibility to persons over the age of 16 with a need for assistance in prescribed Activities of Daily Living. This marked the beginning of major program growth. Referred to as Adult Family Care as well, AFC is a Mass Health funded program – referrals come via a variety of sources including but not limited to school systems, word of mouth and the Department of Developmental Services.

The AFC program has proven to be one of the most cost effective way of providing supports that keep families together and promote growth and meaningful community membership. People and families who have traditionally “fallen through the cracks” in other more restrictive and often more expensive service models have now been reached.

In 2010, The Arc of Greater Plymouth became an AFC provider agency. A service that began with one individual now serves over 100 people between the ages of 18 and 85, living in home settings in the community, with a mix of family and non-family Caregivers. The Arc provides interdisciplinary care via a team of nurses, social workers and case managers who develop thoughtful plans of care that meets each participant’s individual medical, physical, emotional, social and cultural needs. Other supports include ongoing training for Caregivers and safety inspections of the home.

Caregivers provide companionship, personal care assistance, supervision and community experiences for people who are aging and/or people with disabilities who need daily help to live in a traditional home setting in their community. Caregivers receive a daily stipend from The Arc of Greater Plymouth to provide care for people who might otherwise require institutional care. The program offers 14 days of respite care – with trained and vetted respite providers in the home, or in a certified Respite Caregiver home.

Mary is a 26 – year old woman with disabilities who lives with her parents. She is unable to live alone and requires support for her daily living needs. Mary’s Mom said “ The AFC program allows me to give Mary every opportunity available while I am still able to care for her at home. The case managers and nurses provide me with the latest health news, trainings, and vital information and help me resolve issues and problems that crop up. They also care so much for my daughter and it gives Mary other people in her life that care for her. I really don’t know what we would do without this support.”

Michael was living with his elderly mother in his family home.  As his mother grew older she began to experience significant physical challenges and it became clear that she was no longer able to support Michael on her own – it became necessary to move Michael into a new home as soon as possible. The Arc’s Family Support and AFC departments worked together to identify a family that was willing to provide AFC supports to Michael and to welcome him into their home.  Through the Adult Family Care program, Michael and his new Caregiver will continue to receive the supports they need to build successful, trusting relationships that will benefit Michael, his family and his Caregiver over time.

Potential funding cuts currently in discussion would significantly impact the quality of this critical program and thereby the quality of life of people like Mary and Michael, their families and their Caregivers.  Cutting administrative funding to agencies like the Arc will mean increased caseloads and fewer home visits and will impact vital trainings and enhanced medical oversight. For caregivers, this is not just a job it’s a life choice. A choice to mentor and support a person with disabilities or someone in fragile health in a nurturing family home; someone who might otherwise be forced into a more restrictive living situation or an institutional setting.

Laurie, a Caregiver for many years for an older gentleman describes the experience this way: “Edward became part of our family. My kids grew up with him and loved him without reservation and he in turn loved them. It was a help for us financially, allowed us to stay together and bring a new member into our family.”

Jim is his granddaughter’s Caregiver. Jim explains: “Michelle is non-verbal and sometimes that can be challenging when she is not feeling well as she cannot tell you what is wrong. To me it is a godsend to have a nurse and case manager from the AFC program that will visit our home and who I can call with any questions or concerns. They provide another ‘pair of eyes’ for my wife and I to ensure that we are doing everything possible for Michelle to thrive.”

The Arc of Greater Plymouth along with all our self- advocates, community sponsors and family members urge all stakeholders to carefully examine the proposed cuts to this essential program, to consider the stories of Mary, Michael, Edward, and Michelle and to join us in strongly advocating for legislative reversal of cuts scheduled to take place in March 2017.