What is adult foster home care in Oregon?
Adult foster homes are:
- Adult foster homes are for adults with intellectual or developmental disabilities (AFH-IDD)
- 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.
- Single-family residences that offer 24-hour care in a home-like setting that is safe and secure.
- Homes serve five or fewer individuals.
Goal of the AFH-IDD
The goal of the AFH-IDD 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 legal representative, if applicable; and the Community Developmental Disabilities Program (CDDP) service coordinator.
The AFH-IDD 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.
The AFH-IDD provider role
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.
Does the state oversee Oregon's adult foster homes?
AFH-IDD 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 the Department of Human Services (DHS) to assure that all aspects of licensing are complete and to provide technical assistance as needed. Licenses are issued by DHS. Oregon Administrative Rule (Chapter 411 Division 360) governs the operation of the AFH-IDD.
What does it take to become an adult foster home licensee in Oregon?
Every applicant for an AFH-IDD license must meet certain standards in order to operate an AFH-IDD.
Minimum requirements to become a licensed provider include:
- Being of good character;
- Passing an abuse and criminal background check;
- Being 21 years of age;
- Living in a home that meets the structural and safety requirements of the AFH-IDD Oregon Administrative Rule;
- Having the financial resources required to open and operate the AFH-IDD;
- 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;
- Having one year experience working with people with developmental disabilities.
In addition to meeting the minimum requirements listed above, further requirements are needed to become a 2B (behavioral) or 2M (medical) AFH-IDD 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-IDD provider?
- Contact the local Community Developmental Disabilities Program (CDDP) program licensing staff in the county where the adult foster home will be located;
- Complete an AFH-IDD orientation as scheduled and provided by the CDDP 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 DHS, who approves the license.
What are the challenges of becoming an AFH-IDD 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 background 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-IDD?
Level-one AFH-IDD 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-IDD 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.
Limited license may be granted to an applicant who has a long-term relationship with an individual who is identified as the only resident in the adult foster home. Individuals with this license may not accept other individuals into the home.
Provisional (60 days) licenses may be granted in an emergency situation if a licensed provider is no longer able to provide care in an AFH-IDD.
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.
Individuals who are not Medicaid eligible may pay privately with a written contract between the AFH-IDD provider and the individual, or his/her legal representative.
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-IDD 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-IDD provider can also show the individual around the AFH-IDD 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.
Can I become an AFH-IDD provider to support my family member with a developmental disability?
No. AFH-IDD providers can receive payment to provide care to individuals who are not related to them.
How do the Oregon Administrative Rules (OARs) affect me?
Every AFH-IDD provider should obtain a copy of the Oregon Administrative Rules (OAR) at the time of orientation.
The rules come from Oregon Revised Statutes (or laws) that govern adult foster care. They tell the provider about 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-IDD 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-IDD providers must comply with the inspection.
What happens if there is a complaint or allegation of abuse in my AFH-IDD?
Complaints are directed to the local CDDP. There, complaints are addressed and resolved. If they can’t 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. If this happens, the AFH-IDD provider has the right to a hearing to appeal the decision.
All AFH-IDD 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-IDD?
Yes. However the second and any subsequent home(s) require a resident manager to oversee the site. AFH-IDDs with resident managers do not have the same tax benefits as an AFH-IDD 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.