9C Cuts Threaten to Erode Vital Family Caregiver Supports

Adult Foster Care (AFC) helps more than 10,000 people in the Bay State receive vital care at home—but recent 9C cuts threaten to erode the quality of this innovative and highly effective program.

Funded through MassHealth, AFC supports the live-in caregivers who meet the daily needs of older adults and people with disabilities who can no longer live alone.

The AFC program at Somerville-Cambridge Elder Services (SCES) provides help for more than 250 families across the greater Boston area. In addition to providing a tax-free stipend for caregivers, we provide vital training and respite, all with the goal of providing the best possible in-home care.

Jeanne Leyden is Director of Adult Family Care, a non-profit Adult Foster Care provider that serves much of the Greater Boston Area
Jeanne Leyden is Director of Adult Family Care, a non-profit Adult Foster Care provider that serves much of the Greater Boston Area

It’s a wonderful program, but recent activity at Beacon Hill has us concerned about its prospects going forward.

Citing an anticipated budget shortfall, Governor Charlie Baker invoked Section 9C of Mass General Law to slash $98 million from the state budget in early December—a move that eliminated $5.6 million from statewide AFC programs.

House Speaker Robert DeLeo responded by telling the Boston Globe the cuts were premature, saying tax revenues are in line with projections. DeLeo subsequently Tweeted that, depending on the numbers, a supplemental budget could restore some of the 9C cuts—adding the focus would be on helping those with the greatest need.

How significant are these cuts? In a recent release, the Massachusetts Council for Adult Foster Care—an umbrella organization that supports providers—termed the cuts “decimating and unprecedented,” predicting it would result in a drastic reduction of nurse and social worker home visits, and generally undermine the support system that allows the Commonwealth to provide quality care at home.

The Council for Adult Foster Care also pointed out that AFC costs MassHealth $50 to $85 per member, per day—compared to $125 to $250 for nursing home care. The program’s efficiency was also noted by the Provider’s Council—a statewide association of health and human service agencies– in a recent letter to House leadership.

“From 2000 to 2015 nursing facility patient days paid for by MassHealth have fallen 37 percent, in part because of community-based alternatives like Adult Foster Care,” said the letter.

And perhaps most importantly: studies have repeatedly indicated the vast majority of people prefer to receive care in-home. AFC meets that need for more than 10,000 older adults and people with disabilities, and we think it’s a wise and caring investment of state resources.

If you agree that’s a cause worth supporting, please contact your legislators at Beacon Hill to voice your support. By working together hopefully we can ensure that AFC remains viable support network that helps family caregivers succeed.

Nathan Lamb is Director of Outreach and Community Relations for Somerville-Cambridge Elder Services (SCES). Jeanne Leyden is Director of Adult Family Care, a non-profit program at SCES that provides Adult Foster Care across the Greater Boston, North Shore, and Merrimack Valley areas. For more information, visit adultfamilycare.org or call 617-628-2601.