Posted by Ellen Lash

I gave testimony this week at a MassHealth public hearing that was held to give Group Adult Foster Care providers, like JF&CS, an opportunity to respond to a proposed rate cut. So, what is Group Adult Foster Care anyway?

Group Adult Foster Care (GAFC) is a MassHealth-funded long-term care community option that provides elderly and disabled clients with daily personal care assistance. Personal care assistance includes assistance with bathing, dressing, meal preparation, and other activities of daily living. Each client's care is overseen by a registered nurse and a case manager. The goal of the GAFC program is to allow clients to avoid nursing home placement and stay in their homes safely, and with dignity, for as long as possible. JF&CS has been a Group Adult Foster Care provider since 1999.

It goes without saying that cuts to MassHealth reimbursement rates will have a serious negative impact on the amount of nursing and case manager oversight that we are able to provide. However, while utilization and cost data are certainly important, the issue is about the people in need of important services. For that reason, I would like to tell you about Fanya and Zalman, whose story I shared at the hearing.

A couple in their eighties, both Fanya and Zalman have multiple long standing medical conditions and have lived in the same apartment in Brighton for many years. They came to the United States from the former Soviet Union 20 years ago. Their son came with them but shortly thereafter returned to Russia, leaving them with no close family or friends in this country. Fanya has been in a wheelchair for many years and her lack of mobility, coupled with Zalman's chronic illness, has contributed to their social isolation. Fanya and Zalman began to receive GAFC services from JF&CS in 2005, easing both the physical strain and the couple's social isolation. Sadly, Zalman passed away last year after his long battle with cancer. Now Fanya is really alone. Her son wants her to return to Russia, but she won't leave her husband's final resting place. She will tell you that she is depressed, but she loves America, she loves her apartment, she loves her GAFC worker, and she feels dread at the thought of going to a nursing home. GAFC is keeping her safe and in her home, healing her both physically and emotionally.

Group Adult Foster Care services were vital to decreasing a sense of social isolation for this couple and increasing their connection to their community. Professional oversight and daily personal care are vital to keeping clients like Fanya and Zalman in a cost-effective long-term community setting. The same professional oversight is vital to preventing avoidable and costly hospitalizations. The proposed rate cut will put oversight at levels that not only threaten the safety of our clients, but threaten to increase health care expenditures in an already burdened system.

Ellen Lash, who received her BA in Healthcare Administration from Stonehill College, has worked in the healthcare industry for more than thirty years. Her particular expertise is in home care administration, with experience in both the for-profit and nonprofit sectors. She has been with JF&CS since 1995 and has been the director of our home health and home care programs since 2005.