Compassionate In-Home Care Services For Seniors And Individuals With Disabilities

Adult Foster Care (AFC)

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About AFC


Adult Family Care (AFC), also known as AFC, is a specialized program designed to support individuals who are 16 years or older and are facing challenges due to developmental, intellectual, physical, or mental disabilities or for elderly individuals who are no longer able to safely live on their own.

In the AFC program, individuals, known as “AFC Members,” reside with trained and compensated caregivers who offer round-the-clock assistance and care. These caregivers open their homes to provide a family-like living environment for AFC Members, as opposed to the traditional setting of nursing homes or other residential facilities.

Key features of Rivers of Hope's Adult Family Care program include:

  • Customized Care: AFC Members receive personalized care plans that address their needs. This can encompass daily tasks such as bathing, dressing, grooming, and other forms of assistance, supervision, or cueing as required.
  • Nutritious Meals and Companionship: Caregivers are responsible for providing nutritious meals, including three main meals and two healthy snacks each day. Additionally, AFC Members benefit from the companionship and emotional support provided by their caregivers.
  • 24-Hour Supervision: AFC Members receive continuous supervision and support from their caregivers, ensuring their safety and well-being around the clock.
  • Shared Living Arrangement: An essential component of AFC is that the caregiver and the AFC Member live together in the same household, creating a close-knit family environment.


  1. Be at least 16 years of age or older
  2. A licensed physician must order services
  3. Unable to live alone due to medical, physical, cognitive, or mental conditions
  4. Need daily assistance with one or more of the following:

    Activities of Daily Living (ADL), such as

    • Bathing, Ambulation
    • Dressing (upper and lower)
    • Eating
    • Toileting
    • Mobility, Transferring
  5. Member and Caregiver MUST live together
  6. Members cannot require continuous skilled nursing
  7. Caregivers cannot be the spouse or legal guardian of the members

Meeting these criteria ensures eligibility and making sure the member receives essential support and care to maintain their well-being and independence at home.

By choosing Rivers of Hope, you can expect the following benefits:

For Members and Their Families:

  1. Professional Oversight:
    • Members receive regular supervision and care assessments from healthcare professionals.
  2. Health and Wellness Monitoring:
    • Continuously monitor members’ health and wellness.
  3. Comfort of Home:
    • Offering a comfortable, familiar environment that enhances members’ well-being.
  4. Personalized Care Plans:
    • Every member receives a care plan tailored specifically to their individual needs, preferences, and health conditions, ensuring personalized attention and care.
  5. No Cost to Members or Families:
    • Not costing the members or their families, as it is covered under specific health plans and programs.

For Caregivers:

  1. Monthly Stipends:
    • Caregivers receive monthly stipends as compensation for their dedication and hard work, providing financial support for their invaluable service.
  2. Training and Support:
    • Rivers of Hope offers comprehensive training and ongoing support to caregivers. 
  3. Respite Care:
    • Rivers of Hope provides respite services to give caregivers


With Rivers of Hope, you can trust that you and your loved ones will receive high-quality, personalized care and support.


Eligibility Requirements

Potential AFC members should:​ - Have MassHealth Standard​ - Be at least 18 years old​ - Services must be ordered by a physician ​ - Require supervision, cueing or physical assistance with one or more activities of daily living; mobility, eating, dressing, bathing, toileting, or transferring.

Is there paperwork involved?

Yes. Caregiver log that need to be completed on a daily basis. Providing the company with annual physical documents and annual caregiver agreement documents.

My nonprofit is brand new. Can we apply for grants?

While it's challenging for new nonprofits to secure grants, there are exceptions. Most funders prefer organizations with a proven track record and may require financial records spanning three years. We encourage new nonprofits to consult with us to determine their readiness for grant applications and explore steps to become "grant ready."

What are the costs?

Rivers of Hope's AFC program (through MassHealth) pays the caregiver a monthly stipend for personal care services provider administrators. The AFC provider (through MassHealth) will also pay for 2 weeks respite for the caregiver per year. ​

The Benefits of AFC

The Adult Family Care agency will carefully screen and train your caregiver, make sure you are getting the services you need, provides monthly visits and/or as needed visits by Care Managers or RN's to monitor medical conditions and evaluate the caregiver services, offer support and provide 24-hour coverage for emergencies. Your caregiver will receive a monthly stipend.

Anything else?

Depending on the level of care monthly home visits are done with an RN and the AFC Care manager. These people are also available to help in anyway they can.

Caregiver Application

If you are currently taking care of a family member in your house, they might qualify for Adult Foster Care program. This service is a MassHealth funded program for individuals 16 years old and other in need of daily help to complete their ADL’s. To become the caregiver, you must live with this member already, provide healthy meals and snacks, companionship, personal care assistance, and 24 hour supervision.​ Upon enrollment, you will meet our multidisciplinary team that is consist of a Director, Register Nurses, Care Manager and our Administrative Support team. Our staff are well educated and are trained to serve your family needs. Our team speaks Haitian Creole, English, Russian, and Lithuanian.