What is adult foster home care in Oregon?
Adult foster Homes are single-family residences that offer 24-hour care in a home-like setting that is safe and secure. AFH-DD homes serve five or fewer individuals. The goal of the AFH-DD is to provide necessary care while emphasizing the individual's independence. The goal is reached through a cooperative relationship between the provider; the individual; his/her guardian, if applicable; and the CDDP (Community Developmental Disabilities Program) service coordinator. The AFH-DD provides a setting that protects and encourages the individual's independence, dignity, choice and decision-making, allowing the individual to function at the highest level of independence possible.
Adult foster home providers provide meals, transportation to appointments and other activities, medication management, assistance with activities of daily living, personal care, mobility, and household activities. Support is also provided for behavioral challenges, implementation of nursing care, behavior support and individual support plans. Foster providers offer companionship and the opportunity for individuals to participate in social activities in the community.
The AFH-DD program supports individuals just turning 18 to those facing end of life decisions. The range of support needs is widely varied, and individual plans are developed to address the specific needs of the individuals in care.
Does the state oversee Oregon's adult foster homes?
AFH-DD homes in Oregon are inspected and licensed prior to receiving individuals for care and then annually to maintain licensure. The CDDP licensing staff works closely with the licensed provider to assure these activities are completed. CDDP licensing staff works with SPD to assure that all aspects of licensing are complete and to provide technical assistance as needed. Licenses are issued by SPD. Oregon Administrative Rule (Chapter 411 Division 360) governs the operation of the AFH-DD.
What does it take to become an adult foster home licensee in Oregon?
Every applicant for an AFH-DD license must meet certain standards in order to operate a AFH-DD.
Minimum requirements to become a licensed provider include:
- Being of good character;
- Passing a Criminal Records check;
- Being 21 years of age;
- Living in a home that meets the structural and safety requirements of the AFH-DD program;
- Having the financial resources required to open and operate the AFH-DD;
- Not being related to the resident(s) by birth, marriage or adoption;
- Being literate and capable of communicating orally and in writing to resident's physicians, therapists, etc.;
- Being mentally and physically capable of providing care;
- Successfully completing the Basic Training Course and first aid/CPR;
- Not having been found responsible for founded or substantiated abuse in the past; and
- Having one year experience working with people with developmental disabilities.
In addition to meeting the minimum requirements listed above, additional requirements are needed to become a 2B (behavioral) or 2M (medical) AFH-DD provider. Requirements include:
Additional 2B requirements:
- Having two years full time experience working with individuals with challenging behaviors; and
- Having completed the OIS (Oregon Intervention Systems) - G (general), OIS-IF (individual focus) or OIS-C (crisis) certification by a state approved OIS trainer.
Additional 2M requirements:
- Being a health care professional, such as an RN or LPN or having the equivalent of two years full-time experience providing care and supports to individuals who have serious medical conditions that could be life threatening.
What are the steps to becoming an AFH-DD provider?
- Contact the local CDDP program licensing staff;
- Complete an AFH-DD orientation as scheduled and provided by the local office;
- Complete initial application packet and submit with licensing fee of $20 per licensed capacity;
- Complete inspection of the home;
- Make corrections as required on the initial inspection; and
- Submit completed application materials to SPD, who approves the license.
What are the benefits of becoming an AFH-DD provider?
- Making the difference in the lives of others, while making a living in your own home;
- Having the satisfaction of operating your own business;
- Participating in training opportunities to assist you in personal career development and successful supports for individuals with developmental disabilities;
- Seeing the success of your efforts and the positive impact on another individual's life;
- Gaining tax benefits that are available to providers who live in the AFH-DD;
- Receiving room and board from the individuals as well as a service payment for the care provided; and
- Networking with county agencies, medical and mental health professionals to coordinate quality care.
What are the challenges of becoming an AFH-DD provider?
- Losing some privacy as individuals reside in the home of the provider;
- Experiencing medical and behavioral challenges or crises that may result in injury or death of the individual;
- Needing to physically assist individuals;
- Criminal records may prohibit some individuals from having access to your home, or employment in your home, regardless of existing relationship;
- Documentation requirements that include maintaining and keeping up to date medical, financial, personnel and individual client records; and
- Ability to support individuals may be limited based on the number of other individuals in the home who require care, including children or adult family members.
What are the classifications of AFH-DD?
Level-one AFH-DD homes must meet minimum qualifications and support individuals who have support needs in the areas of personal care, transportation, medication management and activities of daily living. Most individuals served in level-one AFH-DD homes also participate in day programs such as employment, alternatives to employment or school. Level-one homes may serve one individual with significant medical or behavioral challenges as approved by the CDDP. A provider intending to serve more than one individual with significant medical or behavioral challenges is required to obtain a 2B or 2M license.
2B homes support more than one individual with significant behavioral challenges. Challenges may stem from co-occurring mental health conditions, the type of disability the individual experiences, or criminal activity.
2M homes support more than one individual with significant medical conditions that may be life threatening. Many individuals in these settings require ongoing nursing care plans and frequent visits to the physician.
Additionally, a limited license may be granted to an applicant who has a long-term relationship with an individual who is identified as the only AFH resident in the home. Individuals with this license may not accept other individuals into the home.
Provisional (60) licenses may be granted in an emergency situation if a licensed provider is no longer able to provide care in an AFH-DD.
How much are adult foster home licensees paid?
Prior to placement, an individual's service payments are determined by a Support Needs Assessment Profile (SNAP). The assessment bases the service payment on the individual's specific needs, as determined by the profile. If an individual is entering a home under crisis circumstances, the local regional diversion program and/or county office will determine a short-term service payment until the assessment can be completed. SNAP rates are not negotiable.
Individuals who are not Medicaid eligible may pay privately, as approved by the CDDP, with a written contract between the AFH-DD provider and the individual, or his/her legal representative. An AFH-DD provider may not accept any individual into care without the approval of the local CDDP.
Even if a person is referred on a crisis basis, the provider has the right to decline the referral and should do so if the individual's needs exceed the provider's ability to provide care as stated in the Oregon Administrative Rules.
Can I choose who I want to live in my home?
Yes. Prior to entry into a foster care home, you should receive referral information from the local CDDP service coordinator. The AFH-DD provider should review this material prior to setting up a screening, or meeting, designed to introduce the individual and ask questions about level of care. The AFH-DD provider can also show the individual around the AFH-DD residence at this time. Should the provider and individual, and/or his or her legal representative, agree to placement, an entry meeting will be scheduled and transition activities should begin.
Even if a person is referred on a crisis basis, the provider has the right to decline the referral and should do so if the individual's needs exceed the provider's ability to provide care, as stated in the Oregon Administrative Rules.
Can I become an AFH-DD provider to support my family member with a developmental disability?
No. AFH-DD providers provide care to individuals who are not related to them. If you have a family member who requires support, contact your local CDDP to inquire about other services that may be available.
How do the Oregon Administrative Rules (OARs) Affect Me?
Every AFH-DD provider should obtain a copy of the Oregon Administrative Rules at the time of orientation. Copies may also be found on this website under AFH-DD Laws & Rules. Click on the AFH Administrative Rules link. The rules are derived from Oregon Revised Statutes (or laws) that govern adult foster care. They inform the provider of the expectations of care, facility requirements, provider qualifications, documentation requirements, and grievance and investigation procedures. Home inspections are based on the OARs, so it is best to always be familiar with the expectations. Lack of compliance with the OARs can result in administrative sanctions that include conditions on a license; civil penalties; or denial, suspension or revocation of a license.
How often will someone come to my AFH-DD for oversight?
CDDP service coordinators should visit the home on a monthly basis if five individual are served in the home, less if there are fewer individuals. The site visits are opportunities to review the operations of the home, meet with the provider and individuals and provide technical assistance. Licensing staff will visit at least once per year for licensing inspections, but may have follow-up meetings to assist in the correction of violations and/or provide technical assistance. AFH-DD providers must comply with the inspection.
What happens if there is a complaint or allegation of abuse in my AFH-DD?
Complaints are directed to the local CDDP where there is a process by which complaints are addressed and resolved. If unable to be resolved at the local level, there is a process to move the complaint along to higher levels of authority. If a complaint indicates a protective service action, an investigation may be opened with the local office. You must comply with all investigation activities. Substantiated allegations may result in administrative sanctions that can be anything from additional provider training, to denial, suspension or revocation of a license. Should this occur, the AFH-DD provider has the right to a hearing to appeal the decision. All AFH-DD providers and caregivers are mandatory abuse reporters and must report to the CDDP any instances of suspected abuse or neglect.
Can I operate more than one AFH-DD?
Yes; however the second and any subsequent home(s) require a resident manager to oversee the site. AFH-DDs with resident managers do not have the same tax benefits as an AFH-DD in which the licensed provider resides. New providers typically open one home and demonstrate the ability to support the individuals in that home before pursuing a second license.