Differences Between AFC & PCA Programs

senior man reading a book with his coffee


Choosing the right care program for yourself or an elderly or disabled loved one is crucial; you want the best care options available. Adult Foster Care (AFC) and the Personal Care Attendants Program (PCA) are two programs in Massachusetts that provide essential care services.

This blog post will explore these programs and highlight why AFC is often the preferred choice for many families.

Adult Foster Care (AFC):
Providing a Caring Home Environment

Adult Foster Care (AFC): Adult Foster Care, often called AFC or Adult Family Care, is a MassHealth-funded program designed for elderly or disabled individuals who cannot live alone safely. Under AFC, individuals live with eligible caregivers and receive assistance with personal care, supervision, and help with daily household activities.

AFC participants are assigned a Registered Nurse and a Case Manager to oversee their care and create customized care plans.

AFC Eligibility (Receiving Care): Individuals must require 24-hour cueing/supervision or assistance with one or more Activities of Daily Living (ADLs) to qualify for AFC. They must also be at least 16 years of age and have or be eligible for MassHealth coverage.

AFC Eligibility (Caregiver): AFC caregivers must be at least 18 years old, live with the person needing care, pass a background check, and follow AFC care guidelines.


  1. Tax-Free Payment: Caregivers receive tax-free payments via check, direct deposit, or a VITRA Debit Card, offering significant financial assistance.
  2. Caregiver Education: AFC provides resources and education for caregivers, ensuring they are well-prepared to provide quality care.
  3. Customized Care Plans: Each client receives personalized care plans tailored to their needs.
  4. Assigned Registered Nurse & Case Manager: AFC participants benefit from professional oversight and support from a Registered Nurse and Case Manager.
  5. Client Remains at Home: AFC enables clients to stay in the comfort of their homes, avoiding long-term care facilities.
  6. Insurance Support: The program helps with insurance-related matters.
  7. Bilingual Staff: Bilingual services are available to cater to diverse communities.
  8. Paid Time Off: Caregivers receive 14 days of paid time off.
  9. Regular RN/CM Visits: Clients have the advantage of one monthly visit with a Registered Nurse and Case Manager.

Personal Care Attendants Program (PCA)

Personal Care Attendants Program (PCA): The Personal Care Attendants Program, or PCA, is a MassHealth-funded program designed to provide home care services to older adults and people with disabilities who live in their own homes or communities.

PCA helps individuals maintain their independence by providing funds to hire personal care attendants (PCAs).

PCA Eligibility (Receiving Care): To qualify for PCA, individuals must need daily cueing/supervision or assistance with two or more Activities of Daily Living (ADLs). They must have a permanent or chronic disability or illness and receive approval from their doctor.

PCA Eligibility (Caregiver): PCA caregivers must be legally eligible to work in the United States, understand and carry out instructions of the PCA Consumer-employer, and meet certain age requirements.


  1. Provider Choice: PCA participants have the flexibility to choose their care providers.
  2. Scheduling Responsibility: Participants are responsible for managing their caregivers’ schedules.
  3. Hiring and Training: PCA consumer employers recruit, hire, train, and may discharge caregivers if needed.
  4. Income Guidelines: MassHealth will pay for PCA services if participants qualify and meet income guidelines.


While Adult Foster Care (AFC) and the Personal Care Attendants Program (PCA) offer essential services, AFC often emerges as the preferred choice due to its holistic approach. AFC provides financial assistance, a caring home environment, professional support, and a range of benefits that prioritize the well-being of both caregivers and recipients.

Ultimately, the choice between AFC and PCA should align with your loved one’s unique needs and preferences, but AFC’s comprehensive support and compassionate approach make it a standout option.

Could you be a Caregiver?

    Are you caring for someone in your home? Do you visit a friend to care for them?

    We would be delighted to tell you more about Adult Foster Care and guide you through the application process.

    You could receive a payment twice a month for the care that you provide every day