In 1999 the United States Supreme Court ruled in the Olmstead v. L.C. case that the Americans with Disabilities Act may require states to provide services in the least restrictive setting possible (i.e. community-based services), rather than institutional placements for individuals with disabilities.
Justice Ginsberg said that states are required to place persons with disabilities in community settings rather than in institutions when:
- The state's treatment professionals have determined that community placement is appropriate.
- The transfer from institutional care to a less restrictive setting is not opposed by the affected individual.
- The placement can be reasonably accommodated, taking into account the resources available to the state.
The U.S. Department of Health and Human Services issued guidance to the states urging that they develop a plan for full compliance with the Olmstead decision.
One facet of Massachusetts's implementation is the MassHealth Adult Foster Care aka, Adult Family Care, program. The program is for adults who need daily help with personal care, are not able to live alone safely, and want to live in the home of a host family (which may be any size) that's willing to care for them instead of in a nursing home or other facility. The host caregiver provides a private bedroom, meals, companionship, personal care assistance, and 24-hour supervision. This arrangement is beneficial to the care-recipient adult, who gets to live in a family setting, and it is also beneficial to the state, as the less restrictive setting is less expensive. Both the care-recipient and the host family must meet certain requirements to participate in the AFC program, and the caregiver is provided with training and on-going support.
Most of the upcoming posts in the AFC category will be copies of emails sent Cc: to all of the following:
- The WestMass ElderCare Social Worker
- The WestMass ElderCare Registered Nurse
- The research analyst for Massachusetts State Senator Stephen Buoniconti
- Massachusetts State Representative James T. Welch
- MassHealth Customer Service
- The Massachusetts Attorney General's Office
- The Massachusetts Statewide Independent Living Council Coordinator
- National Family Caregivers Association
Note: In the interest of protecting anonymity, the names of individuals that are not "in the public eye" will appear as ********.
As will be explained in the following 2 posts, the author has experienced some difficulties with various public entities in the past. Although the urge to vent is great, every effort will be made to remain as objective as possible. It is hoped that this chronicle of continuing adventures may prove helpful to those readers interested in the AFC program.
