Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth

Table of Contents iv

Provider Manual Series

Transmittal Letter Date

Adult Foster Care Manual

AFC-20 04/26/24

4. Program Regulations

130 CMR 408.000: Adult Foster Care

408.401: Introduction ............................................................................................................ 4-1 408.402: Definitions ............................................................................................................. 4-1 408.403: Eligible Members .................................................................................................. 4-4 408.404: Provider Eligibility ................................................................................................ 4-4 (130 CMR 408.405 through 408.414 Reserved) 408.415: Scope of Adult Foster Care Services .................................................................... 4-6 408.416: Clinical Eligibility Criteria for AFC ...................................................................... 4-8 408.417: Clinical Assessment and Prior Authorization ........................................................ 4-9 408.418: Quality Management .............................................................................................. 4-10 408.419: Conditions for Payment ........................................................................................ 4-10 (130 CMR 408.420 through 408.429 Reserved) 408.430: Adult Foster Care Provider Responsibilities ........................................................ . 4-12 408.431: Preadmission and Admission Procedures ............................................................. 4-17 408.432: Discharge Procedures ............................................................................................ 4-18 408.433: Adult Foster Care Staff Qualifications and Responsibilities ................................ 4-19 408.434: Adult Foster Care Caregiver Qualifications and Responsibilities ......................... 4-24 408.435: Adult Foster Care Qualified Setting Requirements ............................................... 4-26 408.436: Emergency Services and Plans .............................................................................. 4-28 408.437: Non-covered Days ................................................................................................. 4-28 408.438: Withdrawal by an Adult Foster Care Provider from MassHealth .......................... 4-29 (130 CMR 408.439 through 408.501 Reserved) 408.502: Definitions ........................................................................................................... 4-31 408.503: GAFC Eligible Members ..................................................................................... 4-33 408.504: GAFC Provider Eligibility ................................................................................... 4-33 408.505: Scope of Group Adult Foster Care Services ........................................................ 4-34 408.506: GAFC Clinical Eligibility Criteria ....................................................................... 4-36 408.507: GAFC Clinical Assessment and Prior Authorization ........................................ 4-37 408.508: GAFC Quality Management ................................................................................ 4-38 408.509: GAFC Conditions for Payment ............................................................................ 4-38 (130 CMR 408.510 through 408.520 Reserved) 408.521: GAFC Provider Responsibilities .......................................................................... 4-40 408.522: GAFC Preadmission and Admission Procedures ................................................. 4-44 408.523: GAFC Discharge Procedures ............................................................................... 4-46 408.524: GAFC Staff Qualifications and Responsibilities ................................................. 4-46 408.525: GAFC Emergency Services and Plans ................................................................. 4-52 408.526: GAFC Non-covered Days .................................................................................... 4-52 408.527: Withdrawal by a GAFC Provider from MassHealth ............................................ 4-53

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-1

Provider Manual Series (130 CMR 408.000)

Transmittal Letter Date

Adult Foster Care Manual

AFC-21 09/12/25