Downloads Adult Foster Care Regulations (PDF 312.58 KB) Programs for adults with intellectual and developmental disabilities: Adult Day Care, Adult Day Programs, Residential Services, Recreational Programs Home Ownership Meal preparation, shopping and transportation. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Please limit your input to 500 characters. We will use this information to improve this page. Adult Foster Care is a federally funded MassHealth program that is designed to provide living alternatives to individuals who are elderly or disabled. Please do not include personal or contact information. . This section contains the codes adult foster care providers need to bill MassHealth for their services. A lock icon ( If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. Its services allow seniors and persons with disabilities who need assistance with personal care tasks to remain in a home and in the community with a qualified and approved caregiver. These generally include an applicants primary home, household furnishings and appliances, personal effects, and a vehicle. Medicaid planning strategies should ideally only be implemented with careful planning and well in advance of the need for long-term care. In addition to help with these tasks, nursing oversight and assistance with homemaker tasks, such as laundry and housecleaning is provided. . Copyright 2023 All rights reserved. Full-time Weekend availability + 3 However, there are some workarounds, and Medicaid planners are aware of them. Adult Foster Care (AFC) is a special MassHealth program for frail elders and adults with disabilities who cannot live alone. Please let us know how we can improve this page. In-Home Services . The Medicaid Program in MA is called MassHealth, and the program specific to the elderly (65+) is MassHealth Standard. Please do not include personal or contact information. Adult foster care. Transforming Lives To apply for MassHealth, seniors must complete the Application for Health Coverage for Seniors and People Needing Long-Term Care Services, which can be found here. Assets Updated Staff Surveillance Testing for COVID-19 - State Operated Facilities and Congregate Care Sites (added May 7, 2021) MassHealth published two home health agency provider bulletins and two hospice provider bulletins yesterday that extend provisions of bulletins issued in January. The Medicaid Program in MA is called MassHealth. Fortunately, for eligibility purposes, Massachusetts Medicaid considers the home exempt (non-countable) in the following circumstances. The Massachusetts' Group Adult Foster Care (GAFC) Program provides care assistance in a congregate (group) setting, commonly an assisted living residence, for persons 22+ years old who are at risk of nursing home placement. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Home; Our Services; Employment; Resources; About Us; Events Calendar; Set an . Additional eligibility criteria follows and is relevant for seniors 65+ years of age. Program regulations cover matters that apply specifically to the type of provider for which the manual was prepared. Applying when over the income and / or asset limit(s) will be cause for denial of benefits. ADLs include bathing, grooming, dressing, eating, mobility, and toiletry. Program participants must live in a congregate setting that is contracted by MassHealth to provide GAFC. Adult Foster Care jobs in Lowell, MA Sort by: relevance - date 661 jobs $2000 SIGN ON BONUS - DIRECT SUPPORT STAFF - ADULT RESIDENTIAL The Minute Man Arc for Human Services Inc Concord, MA 01742 $18 an hour Employer est. You skipped the table of contents section. To qualify for the Adult Foster Care program, Massachusetts' residents must be elderly or disabled (and age 16 or over). Having income and / or assets over Medicaids limit(s) does not mean an applicant cannot still qualify for MA Medicaid / MassHealth. MA 01604; Office No: 508-926-8848 508-365-5500 Fax No: 508-926-8858; Email: info@royalecareinc.com ; NAVIGATION. Nursing Oversight Group adult foster care includes assisted living care, provided the GAFC Program has approved the residence. We''ve made this our mission for more than 50 years. An official website of the Commonwealth of Massachusetts, This page, 130 CMR 408.000: Adult Foster Care, is. Affable Adult Foster Care Llc is a provider established in Newton, Massachusetts operating as a Foster Care Agency. 857-598-4774 Please limit your input to 500 characters. If the application is not properly completed, or required documentation is missing, the application process will be delayed even further. Prior to submitting an application for the Group Adult Foster Care Program, applicants need to ensure they meet the eligibility criteria for MA Medicaid. THE MASSACHUSETTS ADULT FOSTER CARE PROGRAM Adult Foster Care is a program that provides services for individuals who need caregiver assistance with activities of daily living (ADL) and Instrumental Activities of daily living (IADL) in their home to maintain and improve their daily life. The Department of Children & Families (DCF) first tries to place children with relatives. When persons have assets over the limits, Irrevocable Funeral Trusts (IFTs) are an option. Use of this content by websites or commercial organizations without written permission is prohibited. Up to three program participants can reside in an adult foster care home. Share sensitive information only on official, secure websites. Transportation. The home in which the program participant resides must be a private home. This section explains to MassHealth providers how to determine eligibility, submit prior authorizations, and file claims. Transforming Lives Adult foster care homes (AFC) are single-family homes which house, feed and care for adult residents on a daily basis. The Massachusetts Group Adult Foster Care (GAFC) Program provides care assistance in a congregate (group) setting, commonly an assisted living residence, for persons 22+ years old who are at risk of nursing home placement. That said, there is a Social Security Administration program called SSI-G (Supplemental Security Income Category G), which provides supplemental income to help cover the costs of GAFC room and board for low-income persons living in assisted living residences. An official website of the Commonwealth of Massachusetts, This page, Adult Foster Care Manual for MassHealth Providers, is, Adult Foster Care Manual for MassHealth Providers, The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. Also known as a spend-down program, applicants are permitted to spend excess income on medical expenses and health care premiums, such as Medicare Part B, in order to meet Medicaids income limit. RN Case Manager- Adult Foster Care. A .mass.gov website belongs to an official government organization in Massachusetts. for Guidelines for Medical Necessity Determination for Adult Foster Care (AFC). Below are the most common. Based on law, Medicaid offices have up to 45 days to complete this process (up to 90 days for disability applications). Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. Maximum annual FCP is $6,400. Providers serving members enrolled in a MassHealth-contracted accountable care partnership plan (ACPP), managed care organization (MCO), integrated care organization (ICO), senior care organization (SCO), or program of all-inclusive care for the elderly (PACE) should refer to the ACPPs, MCOs, ICOs, SCOs or PACEs medical policies for covered services. These Guidelines for Medical Necessity Determination (Guidelines) identify the clinical informationthat MassHealth uses to determine medical necessity for adult foster care (AFC). Please limit your input to 500 characters. Funded by MassHealth (Medicaid), Adult Foster Care allows a family member or friend to provide 24-hour care for qualified members in their own homes. Research salary, company info, career paths, and top skills for Community Support Specialist As a provider of adult foster care services and mental health counseling, MA, we are committed to delivering quality services and programs. The applicant lives in the home or has intent to return to the home and his / her home equity interest is no greater than $955,000 in 2022. The provider is registered as an organization and their NPI record was last . There are many other options when the applicant has assets exceeding the limit. Adult Foster Care services through MassHealth could be the solution for adults unable to live on their own who would like to retain the dignity and freedom of living at home. Applicants applying for home care at no cost: You deserve the freedom and comfort of living at home and being cared for by someone you know and trust. The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. While MassHealth covers the cost of care services in adult foster care, MassHealth will not pay for room and board. Assets 24-7 On-Call Access We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. Leomister. If you need assistance, please contact the MassHealth. For married couples, the asset limit is slightly higher at $3,000. Please do not include personal or contact information. The GAFC Program provides the following benefits. Providing ongoing training to AFC caregivers on health and aging. However, there must be an available bed in a GAFC-approved assisted living residence or group home. It is not an official statement of the regulations. The Adult Foster Care is a state-funded program that transforms lives. Amy's commitment to safely aging in place and advocacy for our members is a priority in . Independent Care Other adult foster homes are reported to cost this amount. However, there is another MassHealth program, the Group Adult Foster Care (GAFC) Program, which allows program participants to reside in assisted living residences. For GAFC, the Minimum Data Set (MDS) Version 2.0 form is used. The fax number and addresses can be found on the application. You skipped the table of contents section. (Adult Foster Care Services and Licensure) Minnesota Statutes, 245A.03 (Who Must Be Licensed) Minnesota Statutes, 148.171 - 148.285 (Public Health Occupations) Minnesota Rules, 9575.0010 - 9575.1580 (Merit System) Royale Care, Inc. provides Home Health Services in Worcester, Massachusetts. Home Health Agency Provider Bulletin 63 and Hospice . If you need assistance, please contact the MassHealth. In 2010 Tempus Unlimited, formerly Cerebral Palsy of Massachusetts, opened our Adult Foster Care program. Some page levels are currently hidden. A lock icon ( Mass.gov is a registered service mark of the Commonwealth of Massachusetts. As part of the application process, applicants will need to gather documentation for submission. MassHealth pays qualified AFC caregivers to provide in-home care to elder and disabled MassHealth recipients who would otherwise be in a long-term care facility. Massachusetts Updated Date 21-05-2021; Minnesota Updated Date 21-05 . ) or https:// means youve safely connected to the official website. Contact information for ASAPs can be found here. Please let us know how we can improve this page. Apply to Registered Nurse, Case Manager, Recruiting Specialist and more! Our targeted array of services include residential treatment, group living, community residences, children and adult foster care . ) or https:// means youve safely connected to the official website. If you need assistance, please contact the MassHealth. Group Adult Foster Care (GAFC) is a Personal Care Assistance Program sponsored and paid for by MassHealth (Massachusetts Medicaid.) Caregivers can receive up to $1,500 per month plus room and board, per client, depending on the . Licensed by the State of Massachusetts 1-508-583-1157. Providers serving members enrolled in a MassHealth-contracted accountable care partnership plan (ACPP), managed care organization (MCO), integrated care organization (ICO), senior care organization (SCO), or program of all-inclusive care for the elderly (PACE) should refer to the ACPPs, MCOs, ICOs, SCOs or PACEs medical policies for covered services. . By using our website, you agree to our terms of use and privacy policy. Adult Foster Care jobs in Massachusetts All New Filter 195 jobs Create alert All New Adult Foster Care Social Worker/Case Manager Save. Cognitive limitations, commonly seen in persons with dementia, often results in the need for assistance with daily living activities. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve. Learn how we help adult foster care recipients, or members, like you get the care they deserve. Caregivers receive up to $1,500 a month per client plus room and board. A Homes for the Aged (HFA) provides 24-hour room, board, and supervised personal care to: 21 or more unrelated, non-transient individuals 55 years of age or older. Members Only Area >, Adult Foster Care Manual for Mass Health Providers. Membership > Massachusetts has a Medically Needy Medicaid Program for Medicaid applicants who have high medical expenses relative to their income. There are all kinds of foster parents. These rate regulations for adult foster care services. To apply for MassHealth, seniors must complete the Application for Health Coverage for Seniors and People Needing Long-Term Care Services, which can be found here. The Benefits: Living at home allows members to stick to their routines and participate in their community. Use this button to show and access all levels. You can also call our main number at 508-872-0038 or send us an email at advgafc@advancedcarellc.com. This holds true whether one or both spouses are applicants. The Adult Foster Care caregiver: When your friend or loved one relies on you to help them get through their days and nights, you shouldnt have to struggle to provide support. For example, with the VA medical foster homes for seniors, the cost is $1,500 to $3,000 a month depending on the level of care and monthly income received by the veteran. While the MassHealth 60-month look back rule does not apply to the Group Adult Foster Care Program, it does apply to nursing home Medicaid and the Frail Elder Waiver, either of which might become necessary for an individual in the future. A functional (clinical) needs assessment is completed to determine if one meets this criteria. For more information, call us today! Amy plays a leading role in business development, contracting and finance for WeCare 365. Director's Corner MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging, Overview of the Adult Foster Care Program, Benefits of the Adult Foster Care Program, Eligibility Requirements for MassHealth Adult Foster Care Program, Financial Criteria: Income, Assets & Home Ownership, How to Apply for MassHealth Adult Foster Care Program, What is the Medicaid Estate Recovery Program. Prior to submitting an application for the Adult Foster Care Program, applicants need to ensure they meet the eligibility criteria for MA Medicaid. Full Time position. These individuals usually require assistance while performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Request Services Or call 866-797-2333 You deserve care, too Choosing us gives you 130 CMR 409.00: Durable medical equipment services. Laundry As part of the application process, applicants will need to gather documentation for submission. Springfield, MA Group health and dental insurance, 403(b) with matching and discretionary contributions, agency-paid life insurance, 12 paid holidays, generous vacation and . . Medication Management / Reminders This appendix describes who is eligible, the types of copayments, deductibles, and coinsurance amounts that are covered, and how to bill for these services. Individual provider logins are required to access specific services like: Prior Authorization, agency infor, ***Interested parties looking to become an AFC Provider must contact Mass Health LTSS***. ) or https:// means youve safely connected to the official website. Nursing Oversight provided by a registered nurse Areas of consideration are mobility, toileting, bathing/personal hygiene, dressing, transferring (moving to another position), and eating. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Requirements for provider agencies and participants are both spelled out in the MassHealth Adult Foster Care manual. The applicant income limit is equivalent to 100% of the Federal Poverty Level (FPL). These generally include an applicants primary home, household furnishings and appliances, personal effects, and a vehicle. To be eligible, member organizations must: To qualify for the services of an Adult Foster Care provider, a potential participant must receive a physician's order detailing the participant's specific daily needs. This site is for information purposes; it is not a substitute for professional legal advice. We will use this information to improve this page. Aging Services of North Central Massachusetts (Formerly Montachusett Home Care Corporation) 680 Mechanic Street. Top-requested sites to log in to services provided by the state. The applicant has a child under 21 years old living in the home. Please remove any contact information or personal data from your feedback. Program participants require assistance to complete their activities of daily living (ADLs). The Adult Foster Care Manual guides AFC and GAFC providers to the regulations, administrative and billing instructions, and service codes they need. Please let us know how we can improve this page. They must have a physical, medical, mental, or cognitive issue that prevents them from living independently due to a need for assistance with daily living activities. Especially beneficial for those with evolving health conditions such as diabetes or Alzheimers disease. A .mass.gov website belongs to an official government organization in Massachusetts. Foster parents are paid in arrears, so your check will cover the two weeks that have just passed. You can be single or married, own a home or rent one. Membership > Across Massachusetts, Provider List > Please limit your input to 500 characters. Adult home care or adult foster care offers an alternative to residential care for recipients, or members who require supervision or physical help with bathing, hygiene, walking, transferring, eating, or dressing. Adult Foster Care caregivers must meet certain requirements to be eligible to care for their family member or friend. Transferring Behaviors, such as wandering, resisting care, and being disruptive, which are seen in persons with Alzheimers disease or another related dementia, are also taken into consideration. A spouse lives in the home. 600 Washington St., 6th Floor, Boston , MA 02111. Adult Foster Care (AFC) provides a 24-hour living arrangement with supervision in an adult foster home for people who are unable to continue living independently in their own homes because of physical, mental or emotional limitations. Persons can also contact the MassHealth Customer Service Center at 1-800-841-2900 or MassOptions at 1-800-243-4636. This means the state does not limit the number of persons who can receive adult foster care services. Home equity interest is the current value of the home minus any outstanding mortgage. Just contact our GAFC Program Manager: Denise Rodriguez. Use this button to show and access all levels. By using our website, you agree to our terms of use and privacy policy. Housecleaning However, despite the law, applications are sometimes delayed even further. Share sensitive information only on official, secure websites. Meal Preparation / Clean Up Approval Process & Timing Licensed foster parents in Massachusetts are reimbursed on a biweekly basis. Top-requested sites to log in to services provided by the state. MassHealth reviews requests for PA on the basis ofmedical necessity. The caregiver: Must be 18 or older. Adult Foster Care (AFC) Program for persons 16+ with disabilities AFC is a program for persons age 16 and older with physical or developmental disabilities who cannot live alone safely. Boston, MA 02111. The most cost efficient locations are Barnstable Town and Pittsfield, where the average daily cost is $65 - $66. Use of this content by websites or commercial organizations without written permission is prohibited. Massachusetts foster parents receive a biweekly allowance for caring for children in the foster care system, based primarily on the age of the children. Top-requested sites to log in to services provided by the state. Adult Foster Care Manual for MassHealth Providers The Adult Foster Care Manual guides AFC and GAFC providers to the regulations, administrative and billing instructions, and service codes they need. Share sensitive information only on official, secure websites. The applicant income limit is equivalent to 100% of the Federal Poverty Level (FPL), which increases on an annual basis in January. If you need assistance, please contact the Massachusetts Department of Children & Families. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. In addition to providing shared living through our Host Home program, we also offer Adult Foster Care (AFC). Care Management Across Massachusetts. Meal Preparation / Clean Up An AFC program participant cannot reside in a rest home, an assisted living residence, or a group home. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Participants and caregivers are assessed for eligibility according to MassHealth regulations but key components are as follows. Use this button to show and access all levels. Eating Greater Springfield Senior Services, Inc. Healthier You Wellness Nutrition Partners of Greater Boston, Old Colony Elder Services (Adult Foster Care Program), Opportunities for Inclusion (formerly GWArc), Tempus Unlimited (Formerly the Options Program of CPMA), The Arc of Opportunity in North Central Massachusetts, United Cerebral Palsy Association of Berkshire County, Viability- (Springfield, Holyoke, Worcester, Gloucester, Pittsfield). There are many other options when the applicant has assets exceeding the limit. Take the Medicaid eligibility test. But it is not easy. This page is located more than 3 levels deep within a topic. in Communities For the purposes of this article, adult foster care refers to care provided to persons of adult age in a home-like environment. Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of MassHealth benefits. Share sensitive information only on official, secure websites. Eating If MassHealth approves the request, payment is still subject to all general conditionsof MassHealth, including member eligibility, other insurance, MassHealths administrative and billingregulations and guidance, and MassHealths AFC program regulations and guidance. The residences included in this program tend to be smaller group homes. These individuals usually require assistance while performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Learn more. A .mass.gov website belongs to an official government organization in Massachusetts. Helpful Resources Gabriel Care provides individuals in Massachusetts with an alternative to assisted living care. The Adult Foster Care Program may also be called the Adult Family Care Program. This page is located more than 3 levels deep within a topic. See how Adult Foster Care compares to other care options below: Living at home allows members to stick to their routines and participate in their community. Fax: (617) 261-7435. This includes an adult child, grandchild, niece / nephew, or sibling, but unfortunately, does not include a spouse or a person legally responsible for the care recipient. Massachusetts Court System This is a part of: 130 CMR Regulation 130 CMR 408.00: Adult foster care 130 CMR 408.000 governs MassHealth providers of adult foster care services and provides program requirements and conditions of payment for the provision of adult foster care services. This site is for information purposes; it is not a substitute for professional legal advice. We at the Massachusetts Council for Adult Foster Care offer professional support to the agencies across the state that provide this valuable program. Be an agency that delivers health and human services to seniors or disabled populations. Fortunately, for eligibility purposes, Massachusetts Medicaid considers the home exempt (non-countable) in the following circumstances. Caregivers are employed and paid by Adult Foster Care providers that are contracted by MassHealth. Additional eligibility criteria are as follows and is only relevant for seniors 65+ years of age. Find a Medicaid planner. Adult Family/Foster Care is a MassHealth funded program for adults with disabilities or chronic illnesses who require assistance with personal care and various daily living activities; AFC participants live with an approved AFC caregiver in a family setting rather than a group home or nursing facility This is a 35-hour, Monday thru Friday position. Greater Springfield Senior Services. Unlike with many Medicaid long-term care programs, a nursing facility level of care (NFLOC) is not required. We will use this information to improve this page. Home; Contact Us; Careers; Employee Links; Locations; The functional need for group adult foster care must be authorized by ones doctor. Some assets are not counted towards Medicaids asset limit. If the application is not properly completed, or required documentation is missing, the application process will be delayed even further. The feedback will only be used for improving the website. Dedham MA, 02026 p. 781.329.0909 f. 781.320.9136 English. ) or https:// means youve safely connected to the official website. To qualify for Adult Foster Care through Mass Care Link, members must also meet certain requirements. Note, adult day care centers commonly bill in half-day increments. Administrative regulations and billing regulations apply to all providers and are contained in 130 CMR 450.000. CBSM - Adult foster care Adult foster care Effective Jan. 1, 2022, DHS updated this page to include only EW policy. The completed application can be mailed, faxed, or dropped off at the MassHealth Enrollment Center. Examples include copies of Social Security and Medicare cards, proof of income, previous bank statements, copies of life insurance policies, property deeds, and pre-need burial contracts. Assure high quality supports by providing direction and supervision in all aspects of the program. For these reasons, it is highly suggested one consult a Medicaid planner for assistance in qualifying for Medicaid when over the income and / or asset limit(s). Learn More Wellness Coaching Diabetes Prevention and Support Obesity Prevention and Support Cancer Prevention and Support Integrative Nutrition Scholarship Learn More Financial Assistance For Caregivers Many of our Adult Foster Care clients These rate regulations for adult foster care services and group adult foster care services may be found in 101 CMR 351.00. Bathing includes grooming and personal hygiene However, there are some workarounds, and Medicaid planners are aware of them. Caregivers receive a tax-free payment for their services, to help with the burden of care. Income RESOURCES. All-at-Home Health Care services provides Group Adult Foster Care in cities and towns throughout Massachusetts. Prior Authorization for MassHealth Providers, Guidelines for Medical Necessity Determination for Adult Foster Care (AFC). Listed on 2023-01-13. Transforming Lives in Communities Across Massachusetts What We Do The Adult Foster Care is a state-funded program that transforms lives. The live-in caregiver may move into the home of the program participant or the program participant can live in the caregivers home. An official website of the Commonwealth of Massachusetts, This page, 130 CMR 408.00: Adult foster care, is. Transportation to appointments. Massachusetts Executive Office of Health and Human Services (EOHHS) administers the Group Adult Foster Care Program. Personalized care is especially beneficial for those with evolving health conditions such as diabetes or Alzheimers disease. Download 130 CMR 408 Framingham, MA 01701. The completed application can be mailed, faxed, or dropped off at the MassHealth Enrollment Center. Home equity interest is the current value of the home minus any outstanding mortgage. This appendix lists the services required under the Early and Periodic Screening, Diagnosis and Treatment (EPDST) Program, and the ages at which those services must be provided. The feedback will only be used for improving the website. Based on law, Medicaid offices have up to 45 days to complete this process (up to 90 days for disability applications). If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. Persons can also contact the MassHealth Customer Service Center at 1-800-841-2900 or MassOptions at 1-800-243-4636. Children are sometimes temporarily placed in foster care because their parents arent able to give them the care that they need. This appendix lists covered codes for children who are eligible for the Childrens Medical Security Plan (CMSP). Thank you for your website feedback! Whether you need a single errand completed or the presence of a personal assistant in your home at night, you can depend on Rivers Of Hope AFC. At 1-800-841-2900 or MassOptions at 1-800-243-4636 a home or rent one an option team... To 45 days to complete their activities of daily living ( ADLs ) and activities! The GAFC program Manager: Denise Rodriguez it takes one several weeks to complete this process ( up to 1,500! Call our main number at 508-872-0038 or send us an Email at advgafc @ advancedcarellc.com their and. ; it is not required our services ; Employment ; Resources ; About us ; Events Calendar ; an... Used for improving the website ( EOHHS ) administers the group Adult Care... Email: info @ royalecareinc.com ; NAVIGATION Massachusetts Executive Office of Health and Human services EOHHS. Billing regulations apply to registered Nurse, Case Manager, Recruiting Specialist and more 508-365-5500 Fax No 508-926-8848... Official website of the supportive documentation ineligible to become eligible made this our mission for more than 3 levels within... Advgafc @ advancedcarellc.com spouses are applicants Central Massachusetts ( formerly Montachusett home Care Corporation ) 680 Mechanic.!, 6th Floor, Boston, MA 02111 21-05-2021 ; Minnesota Updated Date.. The live-in caregiver may move into the home minus any outstanding mortgage Mass.gov, our! 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