60 years or older or under 60 with a diagnosis of Alzheimer's disease and in need of respite services

Uniform Intake

Functional Impairment Level (FIL) 1-3, with critical unmet needs

Functional Impairment Levels

FIL: 1 4-7 ADL impairments

FIL: 2 2-3 ADL impairments

FIL: 3 6-10 ADL/IADL impairments

  • Activities of Daily Living (ADLs) include bathing, dressing, eating, toileting, continence, transferring, and mobility
  • Instrumental Activities of Daily Living (IADLs) include meal preparation, shopping, laundry, managing money, housework, transportation, use of telephone, outdoor mobility, and taking medicine
  • Critical Unmet Needs include ADLs, meal preparation, shopping, medical transportation, and need for home health services or respite care


MassHealth members are financially eligible. Income guidelines require Annual Gross Income less than $26,561/single and $37,581/couple.

  • Monthly Co-Payments
    • $10 - $141 for individuals with incomes that range from $11,882 - $27,013
    • $18 - $152 for couples with incomes that range from $16,012 - $38,222
  • Respite Over-Income Scale
    • 50% - 100% of cost of services
  • Financial/Co-Payment and Cost-Sharing Schedules