Adult Foster Care Caregiver Qualifications and Responsibilities

(A) General Requirements. The AFC provider must (1) uniformly administer an evaluation of all prospective AFC caregivers to ensure that the individuals meet all of the necessary qualifications defined in 130 CMR 408.434(B); (2) conduct a Criminal Offender Records Information (CORI) check and determine whether any offender records may disqualify the individual from performing as an AFC caregiver; (3) conduct a Sex Offender Registry Information (SORI) check; (4) conduct Office of Inspector General (OIG) check; (5) ensure that each AFC caregiver has received a tuberculosis screening within the prior 12 months, and thereafter every two years in accordance with current guidelines issued by the Centers for Disease Control and Prevention (CDC) and Massachusetts Department of Public Health; (6) ensure that the AFC caregiver is not serving more than a total of three persons, no more than two of whom are authorized for AFC level II service payment, in the qualified setting regardless of service provided or payer source; (7) ensure that all AFC caregivers are appropriately trained and managed; and (8) ensure that the AFC caregiver is in the qualified setting to provide the appropriate amount of necessary care to meet the member’s needs. (B) Qualifications. Each AFC caregiver must (1) be a responsible person who is at least 18 years old, with the ability to make mature and accurate judgments and with no mental, physical, or other impairments that would interfere with the adequate performance of the duties and responsibilities of an AFC caregiver; (2) not suffer from alcohol or substance use disorder; (3) be able to devote appropriate time necessary to provide needed personal care to the member to ensure the member’s safety and well-being at all times; (4) not be a family member, as defined in 130 CMR 408.402; (5) not serve in another role within a member’s MDT (e.g., cannot be a member’s AFC care manager and also the member’s AFC caregiver); and (6) meet all other requirements established by the AFC provider for an AFC caregiver. (C) Responsibilities. The AFC caregiver must (1) supervise and assist with ADLs and IADLs of a member that is necessary for the member’s health and well-being; (2) monitor and report any nonurgent or nonemergency changes in the member’s medical condition to the member’s AFC provider. In cases of emergency, the AFC caregiver must report directly to the most appropriate provider and follow up with the AFC provider; (3) maintain of the qualified setting consistent with the requirements of 130 CMR 408.435; (4) complete a caregiver log; (5) send the completed caregiver log at the end of each month to the program’s registered nurse where it is maintained as part of the member’s file; (6) provide ongoing supervision to the member of health-related activities, such as: (a) issuing reminders to the member about prescribed medications; (b) timely refilling of the member’s prescriptions; (c) assisting with or arranging for member transportation to medical and other appointments; (d) assisting the member to comply with healthcare instructions from healthcare providers; and (e) promptly arranging for medical care that the member needs; (7) notify the AFC provider of the need for alternative care of the member; and (8) immediately notify the AFC provider when any of the following events occur: (a) death of a member; (b) a medical emergency or any significant change in a member’s health or level of functioning; (c) a fire, accident, injury, or contraction of a serious communicable disease by the member or AFC caregiver; (d) any planned or unexpected departure from the residence by a member or AFC caregiver; and (e) all other member or caregiver incidents or accidents. (D) AFC Caregiver Training Requirements. (1) AFC providers must provide AFC caregivers a minimum of eight hours of in-service training per year on topics that complement or reinforce the topics listed in 130 CMR 408.434(D)(2) with at least one hour of training on recognizing, responding to, communicating, and reporting changes in condition, critical incidences, emergencies, and knowledge of emergency procedures, including the AFC provider’s fire, safety, and disaster plans. Records of completed training must be kept on file and updated regularly by AFC providers. (2) The initial orientation training sessions must include the following topics: (a) techniques of providing safe delivery of ADLs and IADLs and good body mechanics; (b) delivery of AFC by the AFC provider; (c) written policies and procedures of the AFC provider; (d) the requirements of 130 CMR 408.000; (e) the roles and responsibilities of AFC provider staff and AFC caregivers; (f) caring for people with disabilities, elders, individuals with Alzheimer’s disease and related disorders, behavioral health issues and cognitive impairments, including behavioral interventions, behavior acceptance, and accommodations; (g) observation, reporting and documentation of the member’s status and the care provided including AFC caregiver log entries; (h) basic first aid, cardiopulmonary resuscitation (CPR), and emergency procedures, including the Heimlich maneuver; (i) universal precautions and infection control and practices; (j) information about local health, fire, safety, and building codes; (k) privacy and confidentiality; (l) communication and interpersonal skills; (m) advance directives; (n) prevention of, and reporting of, abuse, neglect, mistreatment and misappropriation/financial exploitation; (o) completing and filing critical incident reports; (p) human rights, nondiscrimination and cultural sensitivity; (q) recognizing the physical, emotional, and developmental needs of the individuals in their care and working in a manner that respects them, their privacy and their property; (r) recognizing, responding to, communicating, and reporting change in condition, critical incidences, emergencies, and knowledge of emergency procedures, including the AFC provider’s fire, safety, and disaster plans; and (s) relevant provisions of the Health Insurance Portability and Accountability Act of 1996.