MassHealth Customer Service,
Thank you for your response and your continued patience.
Re: your answer,
"Please note there was no change to the Level I payment rate to AFC providers.",
I am aware that there has not yet been any change to the Level I payment rate. But because Transmittal Letter AFC-11 states:
"The regulations incorporate new standards that are consistent with other MassHealth covered community-based services",
and I know that Senator Buoniconti was working on increasing the payment rate last year, I have been wondering what this increase will be and when it will go into effect, that is, what other community-based services will the rate be consistent with?
Where can I find the regulations pertaining to the current Level I rate and the Level I rate in general?
Re; your answer,
"Regarding 'legal status as an AFC caregiver', it is recommended to speak to the AFC facility you are affiliated with for this information.",
I have spoken with the facilities Lawyer about this in the past, and was informed that the facility did not have the freedom to choose the Terms of it's Agreement, but is constrained by MassHealth regulations. So far, I have only been able to find 408.434(A)(4) - "employ or independently contract with an AFC caregiver:",
but have been unable to find any reference to "volunteer" in the
regulations. This is why I asked what MassHealth's opinion is regarding my status. Do the regulations now allow for AFC providers to contract with volunteers? Is this implied, if not explicitly stated, somewhere in the regulations? Or am I now considered an employee by MassHealth?
Please, what is MassHealth's opinion?
Thanks,
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4 Comments
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MassHealth Customer Service
You are not considered an employee by MassHealth. MassHealth does not make this determination, the AFC Provider does. The language is meant to give the AFC provider the flexibility to either hire a caregiver as an employee of the AFC provider, or to pay caregivers on an individual basis as a non-employee. The latter is typically what we see in the vast majority of AFC programs.
Are you considered the full time primary caregiver? Are you not paid at all by the AFC Provider?
Even if you are not paid by the AFC Provider, some form of an agreement is still necessary between the AFC Provider and the caregiver. The reason for the agreement in this circumstance is to solidify the responsibilities of the caregiver. Even though the caregiver may be unpaid, you are still bound to all the qualifications, and responsibilities in the regulations and outlined in the Member's care plan. You are still bound to these requirements because MassHealth is paying the AFC provider for MassHealth AFC services delivered to the Member. As a result the caregiver, home, and all AFC service delivered to the Member must continue to meet the requirements in the regulations.
If you are unpaid, then we would venture to guess that there is or must be a 'contract agreement' with the AFC provider. This agreement should state that you are unpaid and the reason why. Both the caregiver and the AFC provider would sign the agreement.
Please let us know if we can be of any further assistance.
MassHealth Customer Service