Personal Care

The PCA Program is a MassHealth self-directed service that lets you hire your own personal care attendants (PCAs) to help with daily activities.

• Bathing, grooming, dressing, toileting, mobility.
• Meal preparation, light housekeeping, shopping.
• Transportation to medical appointments.

• You are the employer—you recruit, train, schedule, and supervise your PCAs.
• If needed, a surrogate can take on these responsibilities for you.
• A Personal Care Management (PCM) agency completes your assessment and helps you apply to MassHealth.
• A Fiscal Intermediary (FI) handles payroll, timesheets, and taxes.

• MassHealth Standard, CommonHealth, SCO, or PACE enrollment.
• Chronic or permanent disability that makes it hard to perform daily tasks.
• Need physical assistance with at least two activities of daily living.
• Doctor or nurse practitioner authorization.

Helpful tip: Use the Mass PCA Directory to search for attendants in your area.

The AFC program is a service that pairs adults who cannot live alone safely with trained caregivers. The participant usually lives in the caregiver’s home (or a family member’s), receiving regular supervision and support.

• Help with bathing, dressing, toileting, eating, mobility.
• Medication reminders.
• Emergency backup planning.
• Care team oversight from a nurse and case manager.

• Caregivers receive training and professional support from an AFC agency.
• A nurse and care manager provide regular visits and oversight.
• The participant gains the stability of living in a supportive family environment.

• Age 16 or older.
• Cannot live alone safely due to physical, medical, cognitive, or mental health limitations.
• Need help with at least one activity of daily living.
• Caregiver must pass screening, training, and application requirements (cannot be spouse or legal guardian).
• MassHealth may cover cost for eligible MassHealth members.

GAFC is a service provided by a certified agency that provides limited personal care services for adults who need daily support.

• Assistance with bathing, dressing, toileting, mobility.
• Help with meal preparation, laundry, and light housekeeping.
• Ongoing nursing oversight and care management.
• Development and review of a personalized care plan.

• Personal care staff provide cueing and supervision, and/or hands-on support each day.
• A nurse and case manager meet regularly with residents to monitor and adjust care plans.

• Age 22 or older.
• Need assistance with one or more activities of daily living, or require cueing/supervision.
• Reside in a GAFC-approved facility or housing program.
• Must meet MassHealth medical necessity criteria and obtain prior authorization.
• MassHealth may cover cost for eligible MassHealth members (Standard, CommonHealth, or other qualifying coverage).

Home Care Agencies are private organizations that provide a wide range of in-home support services. Services can be paid for privately, or in some cases through state contracts if the agency partners with an Aging Services Access Point (ASAP).

• Personal care and homemaker services.
• Companionship and supervision.
• Chore assistance and errands.
• Skilled nursing, therapy, or specialized dementia care (depending on agency).

• Families or individuals choose an agency directly.
• Services are arranged privately, and costs depend on the agency’s hourly or daily rates.
• Some agencies also contract with state programs (like the Home Care Program or GAFC) to serve eligible individuals at reduced or no-cost.

• No age or income restrictions for private pay.
• Costs vary widely, so it’s important to compare options and ask about payment sources (private pay, or state subsidized programs).

The Home Care Program is a state-subsidized program that helps older adults and people with disabilities remain at home. It is overseen by the Executive Office of Aging & Independence (AGE) and administered by local Aging Services Access Points (ASAPs).

• Personal care, homemaker, and chore services.
• Care management and safety checks.
• Respite for caregivers.
• Specialized dementia services for people under 60 with Alzheimer’s or related conditions.
• Other services available in the Home Care Program, such as meals, medication management, companion, adult day health, supportive day care, assistive technology, and transportation.

• Contact your local Aging Services Access Point (ASAP) to request an in-home assessment.
• A care manager assesses to determine eligibility and develops a personalized needs-based care plan, and offers recommendations and referrals for community resources.
• Services are delivered by contracted providers and coordinated by the ASAP.
• Costs are sliding-scale—potentially free or subsidized based on income.

• Age 60+, or under 60 with Alzheimer’s or related dementia.
• Qualifying assessed functional need for assistance with daily living tasks and acceptance of service(s).
• Applicants for the Home Care Program must be living at home within Massachusetts, not in a nursing facility, assisted living or group home.
• Financial eligibility determines the level of subsidy (some participants pay a share of the cost).

Free training available in different languages for anyone who is interested in becoming a home care aide or learning how to care for an individual or a family member, including skills to safely support older adults and people with disabilities in their homes, such as personal care and homemaking. This training helps build the paid and unpaid workforce and offers a great starting point for new caregivers.

PHCAST also provides free, self-paced Informal Caregivers Training designed for anyone providing unpaid support to an older adult, person with a disability, or family member. This course is ideal for individuals serving in a volunteer capacity—whether helping inside or outside the home. Learners can take all eleven modules or select specific topics of interest. Those who complete all modules, knowledge checks, and score 80% or higher on the assessments will receive a Certificate of Completion.