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Overview of the Adult Foster Home Program for Adults who are Older and Adults with Physical Disabilities

What is adult foster home care in Oregon?

When elderly people or adults with physical disabilities are no longer able to care for themselves in their own homes, adult foster care may be an option. Adult foster homes are single-family residences that offer 24-hour care in a home-like setting. The goal of an adult foster home licensee is to provide care and services to residents while supporting their independence, choice and right to make decisions.

Adult foster home licensees provide meals (including special medical-related diets), provide or arrange transportation to appointments and other activities, laundry, medication administration, and help with eating, dressing, bowel and bladder care, personal care, walking and/or getting out of a bed or a chair, and behavioral issues, as needed. They also provide friendship and the opportunity for residents to reside in a safe and caring environment.

A wide variety of residents are served in adult foster homes, from those needing only room, board and minimal personal assistance to those residents needing full personal care, or skilled nursing care with the help of community-based registered nurses.

Does the state oversee Oregon's adult foster homes?

Yes. Adult foster homes in Oregon are inspected and licensed, both before the licensee can accept residents and then at least annually as long as the licensee stays in business. If there is a complaint about the care provided to the residents or the condition of the facility itself, staff from the Oregon Department of Human Services (DHS), Aging and People with Disabilities (APD), or the Area Agency on Aging (AAA) office will investigate.

What does it take to become an adult foster home licensee in Oregon?

Every potential adult foster home licensee must meet certain standards in order to obtain a license to operate an adult foster home. Minimum requirements to become licensed as an adult foster home provider in Oregon include:

  • Being of good character;
  • Passing the department's background check;
  • Being at least 21 years of age;
  • Having a home that meets the structural and safety requirements of the adult foster home program;
  • Having the financial resources required to open and maintain an adult foster home business;
  • Being literate in the English language;
  • Being mentally able to provide care to up to five residents;
  • Guaranteeing that the licensed licensee or a resident manager lives in the adult foster home;
  • Completing an adult foster home licensee basic training course and passing an exam, based on that course; and
  • Being physically fit and able to provide care to five or fewer seniors or adults with physical disabilities.

What are the disadvantages of becoming an adult foster home licensee?

Adult foster home licensees may face some or all of the following challenges:

  • Loss of privacy with additional people living in the home;
  • The death of people they are very attached to and love;
  • May lift, move or care for people who are immobile; who fall easily, have problems eating or become incontinent; and have conditions that may not improve; or
  • Having to make complex care decisions for residents while respectfully and mindfully working with families, professionals and possibly the resident him or herself, who may have competing interests.

For those who become adult foster home licensees, the advantages far outweigh the challenges.

What are the benefits of becoming an adult foster home licensee?

Adult foster care allows the licensee to:

  • Make a difference in the lives of others while making a living in his/her own home;
  • Have the satisfaction of operating his/her own business;
  • Gain tax benefits that are available to licensees who: 1) live in the adult foster home; 2) sign a Medicaid contract; and 3) provide care to Medicaid residents; and
  • Gain personal and financial benefits as the licensee and his/her family experience the joys of a multi-generational household.

Providing adult foster care is ideal for those who wish to work from home, own their own business and provide personal care and services outside of an institutional setting.

Who do I contact to learn more about becoming an adult foster home licensee in Oregon?

To receive an application, or for more information about providing adult foster care in Oregon, please contact your local adult foster home licensing office​.

What are the three classifications of adult foster homes?

Adult foster home classifications in Oregon are primarily based on the experience and/or training of the licensee. In each classification, the licensee may only admit residents with a certain number of impairments. These impairments are defined according to six major activities of daily living (ADLs), including: eating/nutrition, dressing, personal hygiene, mobility, toileting and behavior management. Each of these ADLs is described in a bit more detail below:

  • Eating/nutrition: The ability to eat with or without special equipment;
  • Dressing: The ability to dress and undress; to comb one's hair; to file nails, and to use makeup, etc;
  • Personal hygiene: The ability to bathe, wash hair, shave and care for teeth;
  • Toileting: The ability to get to and from the toilet, to wash afterward and to adjust clothing;
  • Mobility: The ability to get around, both inside and outside of the home, using items like canes and wheelchairs, if needed, in addition to the ability to transfer from bed or wheelchair; and
  • Behavior management: The ability to understand one's needs in areas such as health and safety. Issues with confusion, disorientation, forgetfulness or wandering may be considered behavior management needs.

Adult foster home classifications are then based on the level of care that potential residents might need and the experience and training of the licensee and resident manager or shift caregivers, as applicable.

Class 1: A class 1 license authorizes the licensee to admit residents who may need assistance with up to four of their ADLs. The applicant must and pass the Division's Basic Training course and examination.

Class 2: A class 2 license may be issued if the applicant has two or more years' experience providing care to adults who are elderly or physically disabled. This AFH may admit residents who require assistance in all ADLs but require full assistance in no more than three ADLs. In addition, the applicant must complete and pass the Division's Basic Training course for AFH potential licensees; or

Class 3: A class 3 license may be issued if the applicant is a currently licensed health care professional in Oregon or if the applicant possesses the following qualifications:

  • Has at least three years of experience providing care to adults who are elderly or physically disabled and require full assistance in four or more of their ADLs.
  • Has satisfactory references from at least two licensed health care professionals who have direct knowledge of the applicant's ability and experience as a caregiver.

In addition, the applicant must complete and pass the Department's Basic Training course for potential AFH providers.

Staff from the Oregon Department of Human Services (DHS), Aging and People with Disabilities (APD), or the Area Agency on Aging (AAA) offices verify the qualifications of the caregiver and then determine the classification of the adult foster home. Representatives from this staff also conduct annual licensing inspections in the adult foster homes, and investigate complaints and concerns if they arise.

How much are adult foster home licensees paid?

Adult foster home licensees in Oregon are independent business owners. They are not employees of the State of Oregon. There are two payment options for these types of businesses. One option is private pay, where the resident has a contract with the licensee to pay a certain amount of money each month in return for specific care and services. The contract between the resident and the licensee should include the basic monthly rate** which includes the following:

  • Room;
  • Meals;
  • Laundry; and
  • Specified basic services.

Additional fees may be assessed for care and services** in addition to the basic rate, such as:

  • Incontinence care;
  • Assistance with eating;
  • Diabetic monitoring;
  • Special diets;
  • Transportation;
  • Mobility and transfers;
  • Skilled nursing tasks;
  • Night-time care; and
  • Dementia care.

**These services and costs vary between homes and must be explicit in the contract.

The other payment option is for licensees who agree to care for residents who are eligible for Medicaid. Medicaid provides health care insurance for low-income residents through a federal and state partnership.

If the potential resident is eligible for Medicaid assistance, the local DHS office in the licensee's town/city will determine the total amount the licensee will be paid for the potential resident's care. This determination will be based on the resident's care needs. The licensee must accept that amount as payment in full and cannot ask the resident or any other person for additional compensation.

Can residents do anything they want when living in my home?

No. However, when a person becomes a resident in an adult foster home, he/she does not give up any of his/her civil rights or any rights as an Oregon citizen. All care providers in adult foster homes must respect the residents' rights of privacy, dignity, independence and the right to make independent choices. Each adult foster home must post the Division's Residents' Bill of Rights in the adult foster home and discuss those rights with each new resident at the time of admission

Each adult foster home licensee develops "House Policies" pertaining to his/her home. House Policies include any restrictions or limitations on the use of the adult foster home by residents such as use of tobacco or alcohol, use of telephones, use of medical marijuana, guidelines around visitors, etc.