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Adult Foster Homes For Persons With Developmental Disabilities


Published: 2015

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The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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DEPARTMENT OF HUMAN SERVICES,

AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES




 

DIVISION 360
ADULT FOSTER HOMES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES

411-360-0010
Statement of Purpose
(1) The rules in OAR chapter 411, division
360 prescribe the standards and procedures for the licensure of adult foster homes
for individuals with intellectual or developmental disabilities (AFH-DD) and the
provision of care and services to support individuals with intellectual or developmental
disabilities in a homelike environment that is safe and secure.
(2) An AFH-DD supports individuals
by providing necessary care and services through a cooperative relationship between
the AFH-DD provider, the individual, the individual’s legal representative
(if applicable), and the community developmental disability program.
(3) An AFH-DD protects and
encourages an individual's independence, dignity, choice, and decision making while
addressing an individual's needs in a manner that supports and enables the individual
to maximize his or her ability to function at the highest level of independence
possible.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0020
Definitions
Unless the context indicates otherwise,
the following definitions and the definitions in OAR 411-317-0000 apply to the rules
in OAR chapter 411, division 360:
(1) "Abuse" means:
(a) Abuse of a child as defined
in ORS 419B.005; and
(b) Abuse of an adult as
defined in OAR 407-045-0260.
(2) "Abuse Investigation"
means the reporting and investigation activities as required by OAR 407-045-0300
and any subsequent services or supports necessary to prevent further abuse as required
by 407-045-0310.
(3) "Adult" means an individual
who is18 years or older with an intellectual or developmental disability.
(4) "Adult Foster Home (AFH)"
means any family home or facility licensed by the Department in which residential
care and services are provided in a home-like environment for compensation to five
or fewer adults who are not related to the provider by blood, marriage, or adoption.
An adult foster home does not include any house, institution, hotel, or other similar
living situation that supplies room or board only, if no individual thereof requires
any element of care.
(5) "Adult Foster Home for
Individuals with Intellectual or Developmental Disabilities (AFH-DD)" means an adult
foster home licensed by the Department to provide residential care and services
to support individuals with intellectual or developmental disabilities.
(6) "Advance Directive" or
"Advance Directive for Health Care" means the legal document signed by an individual
or the legal representative of the individual that provides health care instructions
in the event the individual is no longer able to give directions regarding his or
her wishes. The Advance Directive gives the individual the means to control his
or her own health care in any circumstance. An Advance Directive for Health Care
does not include Physician Orders for Life-Sustaining Treatment (POLST).
(7) "Advocate" means a person
other than a paid caregiver who has been selected by an individual or the legal
representative of the individual to help the individual understand and make choices
in matters relating to identification of needs and choices of services, especially
when rights are at risk or have been violated.
(8) "AFH" means "adult foster
home" as defined in this rule.
(9) "AFH-DD" means an "adult
foster home for individuals with intellectual or developmental disabilities" as
defined in this rule.
(10) "Aids to Physical Functioning"
means any special equipment prescribed for an individual by a physician, therapist,
or dietician that maintains or enhances the physical functioning of the individual.
(11) "Applicant" means a
person who completes an application for an adult foster home license who is also
the owner of the business or a person who completes an application to become a resident
manager. The term applicant includes a co-applicant (if applicable).
(12) "Background Check" means
a criminal records check and abuse check as defined in OAR 407-007-0210 (Criminal
Records and Abuse Check for Providers).
(13) "Bill of Rights" means
civil, legal, or human rights afforded to individuals in an adult foster home that
are in accordance with those rights afforded to all other U.S. citizens including,
but not limited to, those rights delineated in the Adult Foster Home Bill of Rights
for individuals with intellectual or developmental disabilities described in OAR
411-360-0170.
(14) "Brokerage" means "Brokerage"
as defined in OAR 411-340-0020.
(15) "Care" means supportive
services that encourage maximum individual independence and enhance the quality
of life for an individual including, but not limited to:
(a) Provision of 24-hour
supervision, being aware of the whereabouts of the individual, and ensuring the
health, safety, and welfare of the individual;
(b) Assistance with activities
of daily living as defined in OAR 411-317-0000;
(c) Assistance with instrumental
activities of daily living as defined in OAR 411-317-0000;
(d) Assistance with quality
of life activities, such as socialization and recreation; and
(e) Monitoring the activities
of the individual to ensure the health, safety, and welfare of the individual.
(16) "Career Development
Plan" means the part of an ISP that identifies:
(a) The employment goals
and objectives for an individual;
(b) The services and supports
needed to achieve those goals;
(c) The people, agencies,
and providers assigned to assist the individual to attain those goals;
(d) The obstacles to the
individual working in an individualized job in an integrated employment setting;
and
(e) The services and supports
necessary to overcome those obstacles.
(17) "Caregiver" means any
person responsible for providing care and services to support individuals. A caregiver
includes a provider, resident manager, and any temporary, substitute, or supplemental
caregiver or other person designated to provide care and service to support individuals
in an adult foster home for individuals with intellectual or developmental disabilities.
(18) "Centers for Medicare
and Medicaid Services (CMS)" means the federal agency within the United States Department
of Health and Human Services responsible for the administration of Medicaid and
the Health Insurance Portability and Accountability Act (HIPAA) and overseeing Medicaid
programs administered by the states through survey and certification.
(19) "CDDP means "Community
Developmental Disability Program" as defined in OAR 411-320-0020.
(20) "Chemical Restraint"
means the use of a psychotropic drug or other drugs for punishment or to modify
behavior in place of a meaningful behavior or treatment plan.
(21) "Choice" means the expression
of preference, opportunity for, and active role of an individual in decision-making
related to services received and from whom including, but not limited to, case management,
providers, services, and service settings. Individuals are supported in opportunities
to make changes when so expressed. Choice may be communicated through a variety
of methods, including orally, through sign language, or by other communication methods.
(22) "CMS" means "Centers
for Medicare and Medicaid Services".
(23) "Community Nursing Services"
mean the nursing services that focus on the chronic and ongoing health and safety
needs of an individual. Community nursing services include an assessment, monitoring,
delegation, training, and coordination of services. Community nursing services are
provided according to the rules in OAR chapter 411, division 048 and the Oregon
State Board of Nursing rules in OAR chapter 851.
(24) "Compensation" means
monetary or in-kind payments by or on behalf of an individual to a provider in exchange
for room and board, care, and services as indicated in the ISP. Compensation does
not include the voluntary sharing of expenses between or among roommates.
(25) "Complaint" means an
allegation that a licensee or caregiver has violated these rules or an expression
of dissatisfaction with a provider, the services provided, or the condition of an
adult foster home.
(26) "Complaint Investigation"
means the investigation of any complaint that has been made to a proper authority
that is not covered by an abuse investigation.
(27) "Condition" means a
provision attached to a new or existing license that limits or restricts the scope
of the license or imposes additional requirements on the licensee.
(28) "Controlled Substance"
means any drug classified as schedules one through five under the Federal Controlled
Substance Act.
(29) "Crisis" means "crisis"
as defined in OAR 411-320-0020.
(30) "Day Care" means care,
assistance, and supervision of an individual who does not stay overnight. Individuals
receiving day care services are included in the licensed capacity of a home as described
in OAR 411-360-0060.
(31) "Delegation" is the
process by which a registered nurse authorizes a provider, resident manager, or
substitute caregiver to perform nursing tasks in selected situations and confirms
that authorization in writing. Delegation may only occur after a registered nurse
follows all steps of the delegation process as outlined in OAR chapter 851, division
047.
(32) "Denial" means the refusal
of the Department to issue a license to operate an adult foster home for individuals
with intellectual or developmental disabilities because the Department has determined
that an applicant or the home is not in compliance with one or more of these rules.
(33) "Department" means the
Department of Human Services or the designee of the Department.
(34) "Developmental Disability"
means "developmental disability" as defined in OAR 411-320-0020 and described in
OAR 411-320-0080.
(35) "Direct Nursing Services"
means the provision of individual-specific advice, plans, or interventions by a
nurse at a home based on the nursing process as outlined by the Oregon State Board
of Nursing. Direct nursing service differs from administrative nursing services.
Administrative nursing services include non-individual-specific services, such as
quality assurance reviews, authoring health-related agency policies and procedures,
or providing general training for caregivers.
(36) "Director" means the
Director of the Department of Human Services, Office of Developmental Disability
Services or Office of Licensing and Regulatory Oversight, or the designee of the
Director.
(37) "Disaster" means an
occurrence beyond the control of a licensee, whether natural, technological, or
man-made that renders a home uninhabitable on a temporary, extended, or permanent
basis.
(38) "Domestic Animals" mean
the animals domesticated so as to live and breed in a tame condition, such as dogs,
cats, and domesticated farm stock.
(39) "Enjoin" means to prohibit
by judicial order.
(40) "Entity" means a person,
a trust or estate, a partnership, a corporation (including associations, joint stock
companies, and insurance companies), a state, or a political subdivision or instrumentality,
including a municipal corporation.
(41) "Entry" means admission
to a licensed adult foster home for individuals with intellectual or developmental
disabilities.
(42) "Exempt Area" means
a county where there is a county agency that provides similar programs for licensing
and inspection of adult foster homes that the Director finds are equal to or superior
to the requirements of ORS 443.705 to 443.825 and that the Director has exempted
from the license, inspection, and fee provisions described in ORS 443.705 to 443.825.
Exempt area county licensing rules require review and approval by the Director prior
to implementation.
(43) "Exit" means termination
or discontinuance of a Department-funded developmental disability service by a Department
licensed or certified provider.
(44) "Facility" means the
physical structure of an adult foster home for individuals with intellectual or
developmental disabilities.
(45) "Founded Report" means
the determination by the Department or Law Enforcement Authority (LEA), based on
the evidence, that there is reasonable cause to believe that conduct in violation
of the child abuse statutes or rules has occurred and such conduct is attributable
to a person alleged to have engaged in the conduct.
(46) "Functional Needs Assessment":
(a) Means the comprehensive
assessment or re-assessment that:
(A) Documents physical, mental,
and social functioning;
(B) Identifies risk factors
and support needs; and
(C) Determines the service
level.
(b) The functional needs
assessment for an individual residing in an adult foster home for individuals with
intellectual or developmental disabilities is known as the Support Needs Assessment
Profile (SNAP). The Department incorporates the SNAP into these rules by this reference.
The SNAP is maintained by the Department at http://www.oregon.gov/dhs/dd/rebar/pages/assess-afc.aspx.
A printed copy may be obtained by calling (503) 945-6398 or writing the Department
of Human Services, Developmental Disabilities, ATTN: Rules Coordinator, 500 Summer
Street NE, E-48, Salem, OR 97301.
(47) "Guardian" means the
parent for an individual less than 18 years of age or the person or agency appointed
and authorized by a court to make decisions about services for an individual. A
paid provider for an individual may not be the guardian of the individual.
(48) "Hearing" means a contested
case hearing subject to OAR 137-003-0501 to 137-003-0070, which results in a Final
Order.
(49) "Home" means the physical
structure of an adult foster home for individuals with intellectual or developmental
disabilities.
(50) "Homelike" means an
environment that promotes the dignity, security, and comfort of individuals through
the provision of personalized care and services to support and encourage independence,
choice, and decision making by the individuals.
(51) "House Rules" means
the written and posted statements governing house activities in an adult foster
home that do not conflict with the Adult Foster Home Bill of Rights.
(52) "Incident Report" means
the written report of any injury, accident, act of physical aggression, use of protective
physical intervention, or unusual incident involving an individual.
(53) "Independence" means
the extent to which an individual exerts control and choice over his or her own
life.
(54) "Indirect Ownership
Interest" means an ownership interest in an entity that has an ownership interest
in the disclosing entity.
(55) "Individual" means an
adult residing in an adult foster home for individuals with intellectual or developmental
disabilities, regardless of source of compensation.
(56) "Individualized Education
Program" means the written plan of instructional goals and objectives developed
in conference with an individual less than 21 years of age, the parent or legal
representative of the individual (as applicable), teacher, and a representative
of the public school district.
(57) "Intellectual Disability"
means "intellectual disability" as defined in OAR 411-320-0020 and described in
411-320-0080.
(58) "Involuntary Transfer"
means a provider has made the decision to transfer an individual without prior approval
from the individual.
(59) "ISP" means "Individual
Support Plan". An ISP includes the written details of the supports, activities,
and resources required for an individual to achieve and maintain personal goals
and health and safety. The ISP is developed at least annually to reflect decisions
and agreements made during a person-centered process of planning and information
gathering that is driven by the individual. The ISP reflects services and supports
that are important for the individual to meet the needs of the individual identified
through a functional needs assessment as well as the preferences of the individual
for providers, delivery, and frequency of services and supports. The ISP is the
plan of care for Medicaid purposes and reflects whether services are provided through
a waiver, the Community First Choice state plan, natural supports, or alternative
resources. The ISP includes the Career Development Plan.
(60) "ISP Team" means a team
composed of an individual receiving services and the legal representative of the
individual, services coordinator or personal agent, and others chosen by the individual,
or as applicable the legal representative of the individual, such as providers or
family members.
(61) "Legal Representative"
means a person who has the legal authority to act for an individual. The term "legal
representative" includes the guardian of an individual, as well as:
(a) For health care decisions,
a court-appointed guardian, a health care representative under an Advance Directive
for Health Care, or a power of attorney for health care.
(b) For financial decisions,
a court-appointed conservator, an agent under a power of attorney, or a representative
payee.
(62) "License" means a document
granted by the Department to an applicant who is in compliance with the requirements
of these rules.
(63) "Licensee" means the
person who is issued a license, whose name is on the license, and who is responsible
for the operation of an adult foster home. The licensee of an adult foster home
does not include the owner or lessor of the building in which the adult foster home
is situated unless the owner or lessor of the building is the provider.
(64) "Limited License" means
a license is issued to a licensee who intends to provide care and services for compensation
to a specific individual who is unrelated to the licensee but with whom the licensee
has an established relationship of no less than one year.
(65) "Liquid Resource" means
cash or those assets that may readily be converted to cash, such as a life insurance
policy that has a cash value, stock certificates, or a guaranteed line of credit
from a financial institution.
(66) "Mandatory Reporter":
(a) Means any public or private
official as defined in OAR 407-045-0260 who:
(A) Is a provider, resident
manager, caregiver, or volunteer who, while acting in an official capacity, comes
in contact with an adult with an intellectual or developmental disability and has
reasonable cause to believe the adult has suffered abuse, or comes in contact with
any person whom the public or private official has reasonable cause to believe abused
the adult.
(B) Is a provider, resident
manager, caregiver, or volunteer who comes in contact with a child with or without
an intellectual or developmental disability and has reasonable cause to believe
the child has suffered abuse, or comes in contact with any person whom the public
or private official has reasonable cause to believe abused the child, regardless
of whether or not the knowledge of the abuse was gained in the official capacity
of the public or private official.
(b) Nothing contained in
ORS 40.225 to 40.295 affects the duty to report imposed by this definition, except
that a psychiatrist, psychologist, clergy, attorney, or guardian ad litem appointed
under 419B.231 is not required to report if the communication is privileged under
ORS 40.225 to 40.295.
(67) "Marijuana" means all
parts of the plant Cannabis family Moraceae, whether growing or not, the resin extracted
from any part of the plant, and every compound, manufacture, salt derivative, mixture,
or preparation of the plant or its resin. Marijuana does not include the mature
stalks of the plant, fiber produced from the stalks, oil or cake made from the seeds
of the plant, any other compound, manufacture, salt, derivative, mixture, or preparation
of the mature stalks (except the resin extracted there from), fiber, oil, or cake,
or the sterilized seed of the plant which is incapable of germination. "Legal medical
marijuana" refers to the use of marijuana authorized under the Oregon Medical Marijuana
Act (OMMA), ORS 475.300 to 475.346.
(68) "Mechanical Restraint"
means any mechanical device, material, object, or equipment attached or adjacent
to the body that cannot be easily removed or easily negotiated around that restricts
freedom of movement or access to the body.
(69) "Mental Health Assessment"
means the assessment used to determine the need for mental health services by interviewing
an individual and obtaining all pertinent biopsychosocial information as identified
by the individual, the family of the individual, and collateral sources. A mental
health assessment:
(a) Addresses the condition
presented by the individual;
(b) Determines a diagnosis;
and
(c) Provides treatment direction
and individualized services and supports.
(70) "Modified Diet" means
the texture or consistency of food or drink is altered or limited, such as no nuts
or raw vegetables, thickened fluids, mechanical soft, finely chopped, pureed, or
bread only soaked in milk.
(71) "Monitoring" means the
periodic review of the implementation of services and supports identified in an
Individual Support Plan and the quality of services delivered by other organizations.
(72) "Natural Supports" mean
the voluntary resources available to an individual from the relatives, friends,
significant others, neighbors, roommates, and the community of the individual that
are not paid for by the Department.
(73) "Nursing Service Plan"
means the plan that is developed by a registered nurse based on an initial nursing
assessment, reassessment, or an update made to a nursing assessment as the result
of a monitoring visit.
(a) The Nursing Service Plan
is specific to an individual and identifies the diagnoses and health needs of the
individual and any service coordination, teaching, or delegation activities.
(b) The Nursing Service Plan
is separate from the ISP as well as any service plans developed by other health
professionals.
(74) "Occupant" means any
person residing in or using the facilities of an adult foster home including the
individuals, licensee, resident manager, friends, family members, a person receiving
day care services, and room and board tenants.
(75) "OHP Plus" means only
the Medicaid benefit packages provided under OAR 410-120-1210(4)(a) and (b). This
excludes individuals receiving Title XXI benefits.
(76) "OIS" means the "Oregon
Intervention System". OIS is the system of providing training of elements of positive
behavior support and non-aversive behavior intervention. OIS uses principles of
pro-active support and describes approved protective physical intervention techniques
that are used to maintain health and safety.
(77) "OSIPM" means "Oregon
Supplemental Income Program-Medical" as described in OAR 461-001-0030. OSIPM is
Oregon Medicaid insurance coverage for individuals who meets the eligibility criteria
described in OAR chapter 461.
(78) "Over the Counter Topical"
means a medication that is purchased without a prescription and is applied to the
skin and not in an orifice.
(79) "Ownership Interest"
means the possession of equity in the capital, stock, or profits of an adult foster
home. A person with an ownership or control interest means a person or corporation
that:
(a) Has an ownership interest
totaling 5 percent or more in a disclosing entity;
(b) Has an indirect ownership
interest equal to 5 percent or more in a disclosing entity;
(c) Has a combination of
direct and indirect ownership interests equal to 5 percent or more in a disclosing
entity;
(d) Owns an interest of 5
percent or more in any mortgage, deed of trust, note, or other obligation secured
by the disclosing entity if that interest equals at least 5 percent of the value
of the property or assets of the disclosing entity;
(e) Is an officer or director
of a disclosing entity that is organized as a corporation; or
(f) Is a partner in a disclosing
entity that is organized as a partnership.
(80) "Person-Centered Planning":
(a) Means a timely and formal
or informal process driven by an individual, includes people chosen by the individual,
ensures the individual directs the process to the maximum extent possible, and the
individual is enabled to make informed choices and decisions consistent with 42
CFR 441.540.
(b) Person-centered planning
includes gathering and organizing information to reflect what is important to and
for the individual and to help:
(A) Determine and describe
choices about personal goals, activities, services, providers, service settings,
and lifestyle preferences;
(B) Design strategies and
networks of support to achieve goals and a preferred lifestyle using individual
strengths, relationships, and resources; and
(C) Identify, use, and strengthen
naturally occurring opportunities for support at home and in the community.
(c) The methods for gathering
information vary, but all are consistent with the cultural considerations, needs,
and preferences of the individual.
(81) "Personal Agent" means
"personal agent" as defined in OAR 411-340-0020.
(82) "Protection" means the
necessary actions offered to an individual as soon as possible to prevent subsequent
abuse or exploitation of an individual, to prevent self-destructive acts, or to
safeguard the person, property, and funds of the individual.
(83) "Protective Physical
Intervention" means any manual physical holding of, or contact with, an individual
that restricts freedom of movement.
(84) "Provider" means any
person operating an adult foster home, such as a licensee or resident manager. "Provider"
does not include caregivers or the owner or lessor of the building in which an adult
foster is situated unless the owner or lessor of the building is also the operator
of the adult foster home.
(85) "Provider Enrollment"
means an agreement between the Department and a Medicaid provider to provide room
and board and care and services for compensation to support a Medicaid eligible
individual in an adult foster home.
(86) "Provisional License"
means a 60-day license issued in an emergency situation when a licensed provider
is no longer overseeing the operation of an adult foster home. A provisional license
is issued to a qualified person who meets the standards of OAR 411-360-0070 and
OAR 411-360-0110.
(87) "Psychotropic Medication"
means a medication the prescribed intent of which is to affect or alter thought
processes, mood, or behavior including, but not limited to, anti-psychotic, antidepressant,
anxiolytic (anti-anxiety), and behavior medications. The classification of a medication
depends upon its stated, intended effect when prescribed.
(88) "Qualified Entity Initiator
(QEI)" has the meaning set forth in OAR 407-007-0210 (Criminal Records and Abuse
Checks for Providers).
(89) "Qualified Mental Health
Professional" means a licensed medical practitioner or any other person meeting
the qualifications specified in OAR 309-019-0125.
(90) "Relief Care" means
the intermittent services that are provided on a periodic basis for the relief of,
or due to the temporary absence of, a person normally providing care and services
to support an individual. Relief care may include 24-hour relief care or hourly
relief care. Individuals receiving relief care are included in the licensed capacity
of a home as described in OAR 411-360-0060.
(91) "Reside" means for a
person to live in an adult foster home for a permanent or extended period of time.
For the purpose of a background check, a person is considered to reside in a home
if the visit of the person is for four consecutive weeks or greater.
(92) "Resident Manager" means
an employee of a licensee approved by the Department, who resides in an adult foster
home and is directly responsible for the care and services to support individuals
on a day-to-day basis.
(93) "Respite" means "relief
care" as defined in this rule.
(94) "Revocation" means the
action taken by the Department to rescind an adult foster home license after the
Department has determined that the provider is not in compliance with one or more
of these rules.
(95) "Room and Board" means
receiving compensation for the provision of meals, a place to sleep, laundry, basic
utilities, and housekeeping to a person that does not need assistance with activities
of daily living. Room and board facilities for two or more people are required to
register with the Department as described in OAR chapter 411, division 68, unless
registered with the local authority having jurisdiction. Room and board does not
include provision of care.
(96) "Self-Preservation"
in relation to fire and life safety means the ability of an individual to respond
to an alarm without additional cues and reach a point of safety without assistance.
(97) "Services" mean the
activities and supports that assist an individual to develop appropriate skills
to increase or maintain his or her level of functioning. Services available in the
community and arranged for by the provider may include mental health services, rehabilitation
services, social services, activities of daily living, medical, dental, other health
care services, educational services, financial management services, legal services,
vocational services, transportation, and other services required to meet the needs
of the individual as described in the ISP for the individual.
(98) "Services Coordinator"
means "services coordinator" as defined in OAR 411-320-0020.
(99) "Special Diet" means
the specially prepared food or particular types of food that are specific to the
medical condition or diagnosis of an individual and in support of an evidence-based
treatment regimen. Examples include, but are not limited to, low calorie, high fiber,
diabetic, low salt, lactose free, or low fat diets. A special diet does not include
a diet where extra or additional food is offered without the order of a physician
or licensed health care provider but may not be eaten, such as offering prunes each
morning at breakfast or including fresh fruit with each meal.
(100) "Subject Individual"
means:
(a) Any person 16 years of
age or older, including:
(A) A licensed adult foster
home provider and provider applicant;
(B) A person intending to
work in or currently working in an adult foster home, including but not limited
to a substitute caregiver and a potential substitute caregiver in training;
(C) A volunteer if allowed
unsupervised access to an individual; and
(D) An occupant, excluding
an individual, residing in or on the premises of a proposed or currently licensed
adult foster home, including:
(i) A member of the household;
(ii) A room and board tenant;
and
(iii) A person visiting for
four consecutive weeks or greater.
(b) Subject individual does
not apply to:
(A) An individual of the
adult foster home or a visitor of an individual;
(B) A person who resides
or works in an adult foster home who does not have:
(i) Regular access to the
home for meals;
(ii) Regular use of the appliances
or facilities of the adult foster home; or
(iii) Unsupervised access
to an individual or the personal property of an individual.
(C) A person providing services
to an individual that is employed by a private business not regulated by the Department.
(101) "Substantiated" means
an abuse investigation has been completed by the Department or the designee of the
Department and the preponderance of the evidence establishes the abuse occurred.
(102) "Substitute Caregiver"
means any person who provides care and services in an adult foster home under the
jurisdiction of the Department that is left in charge of the individuals for any
period of time and has access to the individuals' records.
(103) "Support" means the
assistance that an individual requires, solely because of the effects of an intellectual
or developmental disability, to maintain or increase independence, achieve community
presence and participation, and improve productivity. Support is subject to change
with time and circumstances.
(104) "Suspension" means
an immediate, temporary withdrawal of the approval to operate an adult foster home
after the Department determines a provider or home is not in compliance with one
or more of these rules or there is a threat to the health, safety, or welfare of
individuals.
(105) "Tenant" means an individual
who resides in an adult foster home and receives services, such as meal preparation,
laundry, and housekeeping.
(106) "These Rules" mean
the rules in OAR chapter 411, division 360.
(107) "Transfer" means movement
of an individual from one home to another home administered or operated by the same
provider.
(108) "Transition Plan" means
the ISP describing necessary services and supports for an individual upon entry
to a new service setting. The Transition Plan is approved by a services coordinator
and includes a summary of the services necessary to facilitate adjustment to the
services offered, the supports necessary to ensure health and safety, and the assessments
and consultations necessary for further ISP development.
(109) "Unusual Incident"
means any incident involving an individual that includes an act of physical aggression,
serious illness or an accident, injury or illness requiring inpatient or emergency
hospitalization, a suicide attempt, death, when an individual contacts the police
or is contacted by the police, a fire requiring the services of a fire department,
or any incident requiring an abuse investigation.
(110) "Urgent Medical Need"
means the onset of psychiatric or medical symptoms requiring attention within 48
hours to prevent a serious deterioration in the mental or physical condition of
an individual.
(111) "Variance" means the
temporary exception from a regulation or provision of these rules that may be granted
by the Department upon written application by the provider.
(112) "Young Adult" means
a young individual age 18 through 21 who resides in an adult foster home under the
custody of the Department, voluntarily, or under guardianship. A young adult may
include an individual who is less than 18 years of age.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13;
APD 28-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 47-2014, f. 12-26-14,
cert. ef. 12-28-14
411-360-0030
Variance
(1) A provider or applicant may apply
to the Department for a variance from a provision of these rules. The provider must
justify to the Department that such a variance does not jeopardize the health, safety,
or welfare of the individuals or violate state or federal laws. If the variance
applies to the care and services for an individual, the provider must provide evidence
that the variance is consistent with the currently approved ISP for the individual.
(2) A variance is granted
in writing on a Department-approved form. A variance granted to one AFH-DD provider
does not constitute a precedent for any other AFH-DD provider. A variance is specific
to a licensed site.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005 f. 1-10-05
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13; APD 47-2014, f. 12-26-14, cert. ef. 12-28-14
411-360-0040
License Required
(1) Any home that meets the definition
of an AFH-DD as defined in OAR 411-360-0020 must first apply for and obtain a license
from the Department or an exempt area county before providing care and services
for compensation to an individual.
(2) A person or entity may
not represent themselves as operating an AFH-DD or accept placement of an individual
without being licensed as an AFH-DD.
(3) No person, employed and
requiring a background check may be a provider, resident manager, substitute caregiver,
or otherwise be in training, employed by the provider, a volunteer for the AFH-DD,
or reside in or on the property of an AFH-DD who --
(a) Has been convicted of
any of the disqualifying crimes listed in OAR 407-007-0275;
(b) Has not complied with
Department rules for review of background checks in accordance with OAR 407-007-0200
to 407-007-0370; or
(c) Has been disapproved
to work based on current Department policy and procedures for background checks
in accordance with OAR 407-007-0200 to 407-007-0370.
(4) Section (3) of this rule
does not apply to individual service recipients of the AFH-DD.
(5) Section (3)(a) of this
rule does not apply to employees hired prior to July 28, 2009.
(6) LIMITED LICENSE. Any
home that meets the definition of a limited license AFH-DD as defined in OAR 411-360-0020
must apply for and obtain a license from the Department before providing care and
services to an individual for compensation.
(a) To qualify for a limited
license and for compensation from the Department, the provider must:
(A) Submit a completed provider
enrollment agreement, application for a limited license, appropriate licensing fee,
physician's statement, and a background check in regards to criminal records, founded
abuse of children, and substantiated abuse of an adult;
(B) Demonstrate a clear understanding
of the individual's care, service, and support needs;
(C) Acquire any additional
training necessary to meet the specific care, service, and support needs of the
individual;
(D) Meet the standards of
an AFH-DD;
(E) Meet minimal fire safety
compliance including the installation of smoke alarms, carbon monoxide alarms, and
fire extinguishers; and
(F) Obtain any training deemed
necessary by the Department to provide adequate care and services to support the
individual.
(b) A limited license is
limited to the care and services of the individual named on the license only and
may not be transferred to another individual.
(7) PROVISIONAL LICENSE.
Any AFH-DD that meets the definition of a provisional license, due to an emergency
situation in which the licensed provider is no longer able to oversee the operation
of the AFH-DD, must be licensed by the Department. The applicant for the provisional
license must meet the standards in OAR 411-360-0070 and 411-360-0110.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 2-2010(Temp), f. & cert. ef. 3-18-10 thru 6-30-10; SPD 13-2010, f. 6-30-10,
cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0050
License Application and Fees
(1) An applicant for an AFH-DD license
must complete a written application on forms supplied by the Department and submit
the application to the Department with the non-refundable fee.
(a) The application is not
complete until the required information is submitted to the Department with the
required non-refundable fee. Incomplete applications are void after 60 days from
the date the application form is received by the Department.
(b) Failure to provide accurate
information may result in the denial of the application.
(2) A separate application
is required for each location where an AFH-DD is to be operated.
(3) An application for an
AFH-DD that has a resident manager must include a completed application for the
resident manager on the form supplied by the Department.
(4) The application for an
AFH-DD license must include:
(a) The maximum capacity
as described in OAR 411-360-0060;
(b) A list of all persons
that reside in the home that receive care including family members that reside in
the home that require care and persons receiving respite and day care services;
(c) A list of all other occupants
that reside in the home or on the home's property including family members, friends,
and room and board tenants;
(d) A physician's statement
on the form supplied by the Department regarding the applicant’s ability to
provide care and services;
(e) Financial information
including:
(A) A completed Financial
Information Sheet on the form supplied by the Department;
(i) An applicant must have
the financial ability and maintain sufficient liquid resources to pay the operating
costs of an AFH-DD for at least two months without solely relying on potential income
from individuals and room and board payments.
(ii) If an applicant is applying
to operate more than one AFH-DD, the applicant must demonstrate the financial ability
and maintain sufficient liquid resources to pay the operating costs of all the homes
for at least two months without solely relying on potential income from individuals
and room and board payments.
(iii) If an applicant is
unable to demonstrate the financial ability and resources required by this section
of this rule, the Department may require the applicant to furnish a financial guarantee
such as a line of credit or guaranteed loan to fulfill the requirements of this
rule.
(B) Documentation of all
unsatisfied judgments, liens, and pending lawsuits in which a claim for money or
property is made against the applicant;
(C) Documentation of all
bankruptcy filings by the applicant;
(D) Documentation of all
unpaid taxes due from the applicant including but not limited to, property taxes,
employment taxes, and state and federal income taxes;
(E) Copies of bank statements
from the last three months demonstrating banking activity in both checking and savings
accounts as applicable or demonstration of cash on hand may be requested; and
(F) A copy of a complete
and current credit report for the applicant may be requested.
(f) If the home is leased
or rented, a copy of the signed and dated lease or rental agreement. The agreement
must be a standard lease or rental agreement for residential use and include the
following:
(A) The owner and landlord’s
name;
(B) Verification that the
rent is a flat rate; and
(C) Signatures and date signed
by the landlord and applicant;
(g) If the applicant is purchasing
or owns the home, verification of purchase or ownership;
(h) A current and accurate
floor plan for the home that indicates:
(A) The size of the rooms;
(B) The size of the windows;
(C) Which bedrooms are to
be used by individuals, the licensee, caregivers, room and board tenants (as applicable),
and for day care and respite services;
(D) The location of all the
exits on each level of the home including emergency exits such as windows;
(E) The location of any wheelchair
ramps;
(F) The location of all fire
extinguishers, smoke alarms, and carbon monoxide alarms;
(G) Planned evacuation routes;
and
(H) Any designated smoking
areas in or on the premises of the home.
(i) If requesting a license
to operate more than one AFH-DD, a plan covering administrative responsibilities
and staffing qualifications for each home;
(j) Three personal references
for the applicant. The personal references may not be family members, current or
potential licensees, or co-workers of current or potential licensees;
(k) A written description
of the daily operation of the AFH-DD including:
(A) The schedule of the provider,
resident manager, and substitute caregivers; and
(B) A plan of coverage for
the absence of the provider, resident manager, and substitute caregivers.
(l) Written information describing
the operational plan for the AFH-DD including:
(A) The use of a substitute
caregiver, if applicable; and
(B) A plan of coverage for
the absence of the resident manager, if applicable;
(m) A signed background check
and if needed, the mitigating information and fitness determination form for each
person who is to have regular contact with the individuals, including the provider,
the resident manager, caregivers, and other occupants of the home over the age of
16 (excluding individual service recipients);
(n) A signed consent form
for a background check with regards to abuse of children;
(o) Founded reports of child
abuse or substantiated abuse allegations with dates, locations, and resolutions
of those reports for all persons that reside in the home, as well as all applicant
or provider employees, independent contractors, and volunteers;
(p) The classification being
requested with information and supporting documentation regarding qualifications,
relevant work experience, and training of caregivers as required by the Department;
(q) A $20.00 per bed non-refundable
fee for each individual service recipient (includes all private pay and publicly
funded individuals, but does not include day care and family members);
(r) A copy of the house rules
for the AFH-DD; and
(s) A mailing address if
different from the address of the home and a business address for electronic mail.
(5) After receipt of the
completed application materials, including the non-refundable fee, the Department
investigates the information submitted and inspects the home. Compliance with these
rules is determined upon submission and completion of the application and the process
described.
(a) The applicant is given
a copy of the inspection form identifying any areas of noncompliance and specifying
a timeframe for correction, but no later than 60 days from the date of inspection.
(b) Deficiencies noted during
an inspection of the home must be corrected in the timeframe specified by the Department.
Applicants must be in compliance with these rules before a license is issued. An
application is denied if cited deficiencies are not corrected within the timeframes
specified by the Department.
(6) Applicants must attend
a local orientation offered by the local CDDP prior to being licensed.
(7) An applicant may withdraw
a new or renewal application at any time during the application process by notifying
the Department in writing.
(8) An applicant whose license
has been revoked, non-renewed, or voluntarily surrendered during a revocation or
non-renewal process, or whose application has been denied, may not be permitted
to make a new application for one year from the date that the action is final, or
for a longer period of time if specified in the final order.
(9) All monies collected
under these rules are to be paid to the Quality of Care Fund.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0055
Provider Enrollment Agreements and Contracts
(1) MEDICAID PROVIDER ENROLLMENT AGREEMENT.
(a) An applicant or licensee
who intends to provide care and services to support individuals who are or become
eligible for Medicaid services must enter into a Medicaid Provider Enrollment Agreement
with the Department, follow Department rules, and abide by the terms of the Agreement.
A Medicaid Provider Enrollment Agreement is not approved unless the Department has
determined that the applicant, licensee, co-licensee, or any owner or officer of
the corporation, as applicable, is not listed on the Office of Inspector General's
or the U.S. General Services Administration's (System for Award Management) Exclusion
Lists.
(b) An approved Medicaid
Provider Enrollment Agreement does not guarantee the placement of individuals eligible
for Medicaid services in an AFH-DD.
(c) An approved Medicaid
Provider Enrollment Agreement is valid for the length of the license unless earlier
terminated by the licensee or the Department. A Medicaid Provider Enrollment Agreement
must be completed, submitted, approved, and renewed with each licensing cycle.
(d) An individual eligible
for Medicaid services may not be admitted into an AFH-DD unless and until the Department
has approved a Medicaid Provider Enrollment Agreement. Medicaid payment is not issued
to a licensee without a current license and an approved Medicaid Provider Enrollment
Agreement in place.
(e) The rate of compensation
established by the Department is considered payment in full. The licensee may not
request or accept additional funds or in-kind payment from any source.
(f) The Department does not
issue payment for the date of the exit of an individual or for any time period thereafter.
(g) The licensee or the Department
may terminate a Medicaid Provider Enrollment Agreement according to the terms of
the Agreement.
(h) The Department may terminate
a Medicaid Provider Enrollment Agreement under the following circumstances:
(A) The licensee fails to
maintain substantial compliance with all related federal, state, and local laws,
ordinances, and regulations; or
(B) The license to operate
the AFH-DD has been voluntarily surrendered, revoked, or not renewed.
(i) The Department must terminate
a Medicaid Provider Enrollment Agreement under the following circumstances:
(A) The licensee fails to
permit access by the Department or CMS to any AFH-DD licensed to and operated by
the licensee;
(B) The licensee submits
false or inaccurate information;
(C) Any person with five
percent or greater direct or indirect ownership in the AFH-DD did not submit timely
and accurate information on the Medicaid Provider Enrollment Agreement form or fails
to submit fingerprints if required under the background check rules in OAR 407-007-0200
to 407-007-0370;
(D) Any person with five
percent or greater direct or indirect ownership interest in the AFH-DD has been
convicted of a criminal offense related to the person’s involvement with Medicare,
Medicaid, or Title XXI programs in the last 10 years; or
(E) Any person with an ownership
or control interest, or who is an agent or managing employee of the AFH-DD fails
to submit timely and accurate information on the Medicaid Provider Enrollment Agreement
form.
(j) If a licensee submits
notice of termination of the Medicaid Provider Enrollment Agreement, the licensee
must concurrently issue a Notice of Involuntary Move or Transfer to each individual
eligible for Medicaid services residing in the licensee's AFH-DD.
(k) If either a licensee
or the Department terminates the Medicaid Provider Enrollment Agreement, the licensee
may not re-apply for a new Medicaid Provider Enrollment Agreement for a period of
no less than 180 days from the date the licensee or the Department terminated the
Agreement.
(l) A licensee must forward
all of the personal incidental funds (PIF) of an individual who is a recipient of
Medicaid services within 10 business days of the death of the individual to the
Estate Administration Unit, PO Box 14021, Salem, Oregon 97309-5024.
(2) PRIVATE CONTRACT. A licensee
who provides care and services to support individuals who pay with private funds
or individuals receiving only day care services must enter into a written contract
with the individual or the person paying for the individual's care and services.
The written contract is the admission agreement. The written contract must be signed
by all parties prior to the admission of the individual and updated as needed. A
copy of the contract is subject to review by the Department prior to licensure and
prior to the implementation of any changes to the contract.
(a) The contract must include
but not be limited to:
(A) An Individual Support
Plan;
(B) A schedule of rates;
and
(C) Conditions under which
the rates may be changed.
(b) The provider must give
a copy of the signed contract to the individual or the individual’s legal
representative and retain the original contract in the individual’s record.
(c) The licensee must give
written notice to a private pay individual or the person paying for the individual's
care and services 30 days prior to any general rate increases, additions, or other
modifications of the rates unless the change is due to a medical emergency resulting
in a greater level of care in which case the notice must be given within 10 days
of the change.
Stat. Auth.: ORS 409.050, & 410.070,
443.725, 443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775,
& 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0060
Capacity
(1) The maximum capacity of an AFH-DD
is limited to five individuals who require care and services who are unrelated to
the provider by blood, marriage, or adoption.
(2) The number of individuals
permitted to reside in an AFH-DD is determined by the ability of the caregiver to
meet the care, service, and support needs of the individuals, fire safety standards,
physical structure standards, and the standards of these rules.
(a) Determination of maximum
capacity includes consideration of total household composition including all children,
adult relatives, and older adults.
(b) In determining maximum
capacity, consideration is given to whether children over the age of 5 have a bedroom
separate from their parents and the number and age of children or others that reside
in the AFH-DD requiring care.
(3) Children under the age
of 10 living in the AFH-DD, individuals receiving respite services, and individuals
receiving day care services are included in the licensed capacity of the AFH-DD.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0070
Classification
A provisional, limited, level 1, level
2B, or level 2M license may be issued by the Department only if the qualifications
of the applicant, resident manager (if applicable), and substitute caregiver fulfills
the requirements of these rules.
(1) PROVISIONAL LICENSE.
(a) A provisional license
may be issued by the Department if:
(A) There is an emergency
situation where the current licensed provider is no longer overseeing the operation
of the AFH-DD; and
(B) An applicant meets the
qualifications described in OAR 411-360-0110(1)(a–f)(h–m).
(b) A provisional license
is valid for 60 days from the date of issue and is not renewable.
(2) LIMITED LICENSE.
(a) A limited license may
be issued by the Department if:
(A) An applicant intends
to provide care and services to a specific individual who is unrelated to the applicant
but with whom the applicant has an established relationship of no less than one
year;
(B) The applicant meets the
qualifications described in OAR 411-360-0110(1);
(C) The home meets the facility
standards described in OAR 411-360-0130; and
(D) The applicant acquires
any additional training necessary to meet the specific needs of the individual.
(b) The license is limited
to only the care of the individual named on the license.
(3) LEVEL 1 LICENSE. A Level
1 license may be issued by the Department if:
(a) The home and applicant
are in compliance with OAR 411-360-0080; and
(b) An applicant and resident
manager (if applicable):
(A) Meets the qualifications
described in OAR 411-360-0110;
(B) Complete the training
requirements described in OAR 411-360-0120;
(C) Has the equivalent of
one year of full-time experience in providing direct care and services to support
individuals with intellectual or developmental disabilities; and
(D) Has current CPR and First
Aid certification.
(i) Accepted CPR and First
Aid courses must be provided or endorsed by the American Heart Association, the
American Red Cross, the American Safety and Health Institute, or MEDIC First Aid.
(ii) CPR or First Aid courses
conducted online are only accepted by the Department when an in-person skills competency
check is conducted by a qualified instructor endorsed by the American Heart Association,
the American Red Cross, the American Safety and Health Institute, or MEDIC First
Aid.
(4) LEVEL 2B LICENSE.
(a) A provider must be licensed
as a Level 2B AFH-DD if the provider serves or intends to serve more than one individual
who exhibits behavior that poses a significant danger to the individual or others.
Examples of behaviors that may pose a significant danger to the individual or others
include but are not limited to:
(A) Acts or history of acts
that have caused injury to self or others requiring medical treatment;
(B) Use of fire or items
to threaten injury to persons or damage to property;
(C) Acts that cause significant
damage to homes, vehicles, or other properties; or
(D) Actively searching for
opportunities to act out thoughts that involve harm to others.
(b) A Level 2B license may
be issued by the Department only if the applicant and resident manager (if applicable)
has met the requirements described in section (3) of this rule for a Level 1 license
and meets the following additional criteria:
(A) Has two years of full
time experience providing care and services to support individuals who exhibit the
behavior described in subsection (a) of this section that poses significant risk
to the individual or others;
(B) Has completed OIS-G,
OIS-IF, or OIS-C certification by a state approved OIS trainer; and
(C) If available from the
Department, has completed additional hours of advanced behavior intervention training
per year based on the support needs of the individual.
(c) A provider of a Level
2B AFH-DD must have a Transition Plan for each individual upon entry that addresses
the individual’s support and service needs.
(d) A Behavior Support Plan,
if needed, must be implemented within 120 days of the individual's placement that:
(A) Emphasizes the development
of functional, alternative, and positive approaches to behavior intervention;
(B) Uses the least intervention
possible;
(C) Ensures that abusive
or demeaning intervention is never used; and
(D) Is evaluated by an ISP
Team through review of specific data at least every six months to assess the effectiveness
of the Plan.
(e) A provider of a Level
2B AFH-DD may not employ a resident manager or substitute caregiver who does not
meet or exceed the qualifications and training standards described in subsection
(b) of this section.
(f) A provider of a Level
2B AFH-DD may not admit an individual whose care and service needs exceed the licensed
classification of the Level 2B AFH-DD and may not admit an individual without prior
approval of the CDDP.
(5) LEVEL 2M LICENSE.
(a) A provider must be licensed
as a Level 2M AFH-DD if the provider serves or intends to serve more than one individual
who has a medical condition that is serious and may be life threatening. Examples
of medical conditions that are serious and may be life threatening include but are
not limited to:
(A) Brittle diabetes or diabetes
not controlled through medical or physical interventions;
(B) Significant risk of choking
or aspiration;
(C) Physical, intellectual,
or mental limitations that render the individual totally dependent on others for
access to food or fluids;
(D) Mental health or alcohol
or drug problems that are not responsive to treatment interventions; or
(E) A terminal illness that
requires hospice care.
(b) A Level 2M license may
be issued by the Department only if the applicant and resident manager (if applicable)
has met the requirements described in section (3) of this rule for a Level 1 license
and meets the following additional criteria:
(A) Is a licensed health
care provider such as a registered nurse or licensed practical nurse or has the
equivalent of two years of full-time experience providing care and services to support
individuals who have a medical condition described in subsection (a) of this section
that is serious and may be life-threatening;
(B) Has current satisfactory
references from at least two licensed health care providers, such as a physician,
physician’s assistant, nurse practitioner, or registered nurse, who have direct
knowledge of the applicant's ability and past experiences as a caregiver; and
(C) Has fulfilled a minimum
6 of the 12 hours of annual training requirements in specific medical training.
(c) A provider of a Level
2M AFH-DD must have a Transition Plan for each individual upon entry that addresses
the individual’s support and service needs.
(d) A provider must develop,
with an individual's ISP Team, a Medical Support Plan within 30 days of the individual's
placement or whenever there is a change in the individual's health status.
(e) A provider of a Level
2M AFH-DD may not employ a resident manager or substitute caregiver who does not
meet or exceed the qualification and training standards described in subsection
(b) of this section.
(f) A provider of a Level
2M AFH-DD may not admit an individual whose care and service needs exceed the licensed
classification of the Level 2M AFH-DD and may not admit an individual without prior
approval of the CDDP.
Stat. Auth.: ORS 410.070 & 409.050
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 22-2010(Temp), f.
& cert. ef. 8-27-10 thru 2-22-11; SPD 29-2010, f. 12-29-10, cert. ef. 1-1-11;
SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0080
Issuance of a License
(1) The Department issues a license
within 60 days after the Department has received the completed application materials,
if the home and applicant are found to be in compliance with these rules. The license
specifies the type of license and includes the name of the licensee and resident
manager (if applicable), address of the premises to which the license applies, the
maximum capacity, expiration date, and classification level. The licensee must visibly
post the license in the AFH-DD and the license must be available for inspection
at all times.
(2) LIMITED LICENSE. A limited
license is issued to a provider for the care of a specific individual. A provider
with a limited license may not accept other placements. A provider with a limited
license must meet the standards of an AFH-DD and acquire any additional training
necessary to meet the specific support needs of the individual and may be subject
to the requirements of:
(a) OAR 411-360-0140, Standards
and Practices for Health Care;
(b) OAR 411-360-0160, Behavior
Supports;
(c) OAR 411-360-0170, Documentation
and Record Requirements;
(d) OAR 411-360-0180, General
Practices; and
(e) OAR 411-360-0190, Standards
for Admission, Transfers, Respite, Crisis Placements, Exits, and Closure.
(3) PROVISIONAL LICENSE.
(a) The Department may issue
a 60-day provisional license to a qualified person if the Department determines
that an emergency situation exists after being notified that the licensed provider
is no longer overseeing the operation of the AFH-DD. A person is considered qualified
if he or she is at least 21 years of age and meets the qualifications of a provider
described in OAR 411-360-0110(1)(a-f)(h-m).
(b) A provisional license
may be extended one time for a period of 30 days if an applicant has demonstrated
a good faith effort to complete the application process and obtain the required
qualifications and trainings.
(4) The Department may attach
conditions to a license that limit, restrict, or specify other criteria for operation
of the AFH-DD. The conditions must be posted with the license in the AFH-DD and
be available for inspection at all times.
(5) A condition may be attached
to a license that restricts admissions to the AFH-DD.
(6) A license for an AFH-DD
is not transferable or applicable to any location or persons other than those specified
on the license.
(7) When an AFH-DD is to
be sold or otherwise transferred, the new provider must apply for, and obtain, a
license prior to the transfer of operation of the AFH-DD.
(8) A license is valid for
one year unless revoked or suspended.
(9) The Department does not
issue a license to operate an additional AFH-DD to a provider who has failed to
achieve and maintain substantial compliance with the rules and regulations while
operating any existing home or homes.
(10) The Department does
not issue an initial license unless:
(a) An applicant and home
are in compliance with ORS 443.705 to 443.825 and these rules;
(b) The Department has completed
an inspection of the home;
(c) The Department has completed
a background check on the applicant, resident manager (if applicable), and any subject
individual as defined in OAR 411-360-0020;
(d) The Department has determined
that the applicant has the financial ability and maintains sufficient liquid resources
to pay the operating costs of the home for at least two months without solely relying
on potential income from individuals and room and board payments;
(e) The Department has checked
the record of sanctions available from the Department's files, including the list
of nursing assistants who have been found responsible for abuse and whose names
have been added to the registry pursuant to ORS 441.678; and
(f) The Department has conducted
a background check of the provider or resident manager with regard to founded abuse
of children or substantiated abuse of adults.
(11) CHANGE OF RESIDENT MANAGER.
If a resident manager changes during the period of time the license covers, the
provider must notify the Department within 24 hours and identify who is to be providing
care.
(a) The provider must submit
a request for a change of resident manager to the Department with:
(A) A completed application
for the resident manager applicant on the form supplied by the Department;
(B) A background check and
a current consent form to conduct a background check for child abuse for the resident
manager applicant; and
(C) A non-refundable payment
fee of $10.00.
(b) A revised licensed with
the name of the new resident manager is issued upon the Department's determination
that the applicant meets the requirements of a resident manager and the applicant
has received the Department's required AFH-DD training and passed the test.
(12) In seeking an initial
license, the burden of proof to establish compliance with ORS 443.705 to 443.825
and these rules is upon the applicant.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0090
Renewal of a License
(1) The licensee must submit a renewal
application and fee prior to the expiration date of the current license to keep
the license in effect until a new license or a final order of non-renewal is issued
by the Department. If the renewal application and fee are not submitted prior to
the expiration date of the current license, the AFH-DD is treated as an unlicensed
home subject to administrative sanctions.
(2) The renewal application
must include the same information and fee as described in OAR 411-360-0050. A physician's
statement, financial information, house rules, and floor plan are not required if
the Department reasonably determines that the information has not changed.
(3) The Department may investigate
any information in the renewal application and is to conduct an inspection of the
home.
(a) The licensee is given
a copy of the inspection form citing any deficiencies and a timeframe for correction,
but no longer than 30 days from the date of inspection.
(b) The Department may require
the AFH-DD to correct deficiencies prior to issuing a license renewal. The Department
may deny a renewal application if cited deficiencies are not corrected within the
timeframe specified by the Department.
(4) The Department does not
renew a license unless:
(a) The provider and the
home are in compliance with ORS 443.705 to 443.825 and these rules;
(b) The Department has completed
an inspection of the home; and
(c) The Department has completed
an annual background check as required by ORS 181.534 and 443.735 on the provider,
resident manager (if applicable), and any subject individual as defined in OAR 411-360-0050.
(5) In seeking the renewal
of a license when an AFH-DD has been licensed for less than 24 months, the burden
of proof to establish compliance with ORS 443.705 to 443.825 and these rules is
upon the licensee.
(6) In proceedings for renewal
of a license when an AFH-DD has been licensed for at least 24 continuous months,
the burden of proof to establish noncompliance with ORS 443.705 to 443.825 and these
rules is upon the Department.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 2-2010(Temp), f. & cert. ef. 3-18-10 thru 6-30-10; SPD 13-2010, f. 6-30-10,
cert. ef. 7-1-10; SPD 5-2013(Temp), f. & cert. ef. 4-1-13 thru 9-27-13; SPD
34-2013, f. & cert. ef. 9-27-13
411-360-0110
Qualifications for Providers, Resident
Managers, and Caregivers
(1) PROVIDER QUALIFICATIONS. An AFH-DD
provider must meet the level requirements of the AFH-DD license as described in
OAR 411-360-0070 and the following qualifications:
(a) Be at least 21 years
of age;
(b) Reside in the home that
is to be licensed as the AFH-DD or if the provider does not reside in the home there
must be a resident manager who resides in the home. A provider or resident manager
resides in the home when the provider or resident manager sleeps in the home four
nights per week;
(c) Provide evidence satisfactory
to the Department regarding experience, training, knowledge, interest, and concern
in providing care and services to support individuals with intellectual or developmental
disabilities. Such evidence may include but not be limited to:
(A) Certified nurse's aide
training;
(B) Nursing home, hospital,
or institutional work experience;
(C) Licensed practical nurse
or registered nurse training and experience;
(D) Training approved by
the Department; or
(E) Experience providing
care and services and home management skills to individuals with intellectual or
developmental disabilities.
(d) Possess the physical
health, mental health, good judgment, and good personal character determined necessary
by the Department to provide 24-hour care and services to support individuals with
intellectual or developmental disabilities. A provider must have a statement from
a physician, on a form provided by the Department, indicating that the provider
is physically and mentally capable of providing care and services. A provider with
a documented history or substantiated complaints of substance abuse or mental illness
must provide evidence satisfactory to the Department of successful treatment and
rehabilitation and references regarding current condition;
(e) Have an approved background
check annually as required in section (2) of this rule and maintain that approval
as required;
(f) Have no founded reports
of child abuse or a substantiated abuse allegation;
(g) Have the financial ability
and maintain sufficient liquid resources to pay the operating costs of the AFH-DD
for at least two months without solely relying on potential income from individuals
and room and board payments. If a provider operates more than one AFH-DD, the provider
must have the financial ability and maintain sufficient liquid resources to pay
the operating costs of all the AFH-DDs for at least two months without solely relying
on potential income from individuals and room and board payments;
(A) Upon application, documentation
of the following must be provided to the Department:
(i) All unsatisfied judgments,
liens, and pending lawsuits in which a claim for money or property is made against
the applicant;
(ii) All bankruptcy filings
by the applicant; and
(iii) All unpaid taxes due
from the applicant including but not limited to property taxes, employment taxes,
and state and federal income taxes.
(B) The Department may require
or permit the applicant to provide a current credit report to satisfy this financial
requirement.
(C) The Department may not
issue an initial license to an applicant who has been adjudged bankrupt more than
once.
(D) If an applicant has any
unpaid judgments (other than a current judgment for support), pending lawsuits,
liens, or unpaid taxes, proof that the applicant has the amount of resources necessary
to pay those claims must be provided to the Department as required.
(E) If an applicant is unable
to demonstrate the financial ability and resources as required, the Department may
require the applicant to furnish a financial guarantee such as a line of credit
or guaranteed loan as a condition of initial licensure.
(h) Be literate in the English
language and demonstrate the ability to comprehend and communicate in English orally
and in writing with the individuals, licensed health care providers, services coordinators,
and others involved in the care of the individuals;
(i) Be able to respond appropriately
to emergency situations at all times;
(j) If transporting individuals
by motorized conveyance, have a current driver's license in compliance with the
laws of the Department of Motor Vehicles and vehicle insurance as required by the
state of Oregon;
(k) Document annual review
of responsibility for mandatory reporting of abuse or neglect of an individual on
forms provided by the Department;
(l) Have a clear understanding
of the job responsibilities, knowledge of the individuals' ISPs, and the ability
to provide the care and services specified for each individual; and
(m) Not be listed on the
Office of Inspector General’s or General Services Administration’s Exclusion
lists.
(2) BACKGROUND CHECKS.
(a) In accordance with OAR
407-007-0200 to 407-007-0370 and under ORS 181.534, all subject individuals as defined
in OAR 411-360-0020 must have an approved background check prior to operating, working,
training in, or residing in an AFH-DD:
(A) Annually;
(B) Prior to a subject individual’s
change in position (i.e. changing from a caregiver to resident manager); and
(C) Prior to working in another
AFH-DD regardless of whether the employer is the same or not unless subsection (b)
of this section applies.
(b) PORTABILITY OF BACKGROUND
CHECK APPROVAL. A subject individual, excluding licensees, may be approved to work
in multiple homes within a county only when the subject individual is working in
the same employment role. The indication of worksite location must be included by
a qualified entity initiator for each subject individual to show the subject individual's
intent to work at various AFH-DDs within the licensing jurisdiction of the county.
(c) Effective July 28, 2009,
public funds may not be used to support, in whole or in part, a provider, a resident
manager, providers’ employees, alternate caregivers, volunteers, or any other
subject individual under OAR 407-007-0200 to 407-007-0370 who is subject to background
checks, who has been convicted of any of the disqualifying crimes listed in OAR
407-007-0275. This rule does not apply to caregivers of the AFH-DD hired prior to
July 28, 2009.
(d) Effective July 28, 2009,
a person may not be authorized as a provider or meet qualifications as described
in this rule if the person is subject to background checks and has been convicted
of any of the disqualifying crimes listed in OAR 407-007-0275. This rule does not
apply to caregivers of the AFH-DD hired prior to July 28, 2009.
(e) A weighing test is applied
to background checks for occupants who do not provide care in the AFH-DD but require
a background check on or after July 28, 2009 for approval purposes.
(3) RESIDENT MANAGER REQUIREMENTS.
A resident manager must meet the provider qualifications listed in section (1) of
this rule and the level requirements of the AFH-DD license as described in OAR 411-360-0070.
(4) SUBSTITUTE CAREGIVER
REQUIREMENTS. A substitute caregiver must meet the level requirements of the AFH-DD
license as described in OAR 411-360-0070 and the following qualifications:
(a) Be at least 18 years
of age;
(b) Have an approved background
check annually as required in section (2) of this rule and maintain that approval
as required. A person may not be authorized as a substitute caregiver or meet qualifications
as described in this rule if the person has been hired on or after July 28, 2009,
or is subject to a background check beginning July 28, 2009 as required by administrative
rule, and the person has been convicted of any of the disqualifying crimes listed
in OAR 407-007-0275;
(c) Be notified annually
of the substitute caregiver's responsibility as a mandatory reporter of abuse or
neglect. Annual mandatory reporter notification must be documented on forms provided
by the Department;
(d) Be literate in the English
language and demonstrate the ability to comprehend and communicate in English orally
and in writing with the individuals, licensed health care providers, services coordinators,
and others involved in the care of the individuals;
(e) Be able to respond appropriately
to emergency situations at all times;
(f) Know fire safety and
emergency procedures;
(g) Have a clear understanding
of the job responsibilities, knowledge of the individuals' ISPs, and the ability
to provide the care and services specified for each individual's needs;
(h) Be able to meet the qualifications
of a resident manager described in section (4) of this rule when left in charge
of an AFH-DD for 30 days or longer;
(i) Not be an individual
service recipient of the AFH-DD;
(j) If transporting individuals
by motorized conveyance, have a current driver's license in compliance with the
laws of the Department of Motor Vehicles and vehicle insurance as required by the
state of Oregon;
(k) Possess the physical
health, mental health, good judgment, and good personal character determined necessary
by the Department to provide care and services to support individuals with intellectual
or developmental disabilities. A substitute caregiver with a documented history
or substantiated complaints of substance abuse or mental illness must provide evidence
satisfactory to the Department of successful treatment and rehabilitation and references
regarding current condition;
(l) Must meet the training
requirements of the level of the AFH-DD license in OAR 411-360-0120; and
(m) Must disclose on an application
for employment if they have been found to have committed abuse,
(5) A licensee may not hire
or continue to employ a resident manager or substitute caregiver that does not meet
the requirements stated in this rule.
(6) The licensee is responsible
for the operation of the AFH-DD and the quality of care and services rendered in
the AFH-DD.
(7) The licensee is responsible
for the supervision and training of resident managers and substitute caregivers
and their general conduct when acting within the scope of their employment or duties.
(8) A licensee, resident
manager, caregiver, volunteer, or other subject individual must self report any
potentially disqualifying condition as described in OAR 407-007-0280 and 407-007-0290.
The person must notify the Department within 24 hours.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 2-2010(Temp), f. & cert. ef. 3-18-10 thru 6-30-10; SPD 13-2010, f. 6-30-10,
cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0120
Training Requirements for Providers
(1) A provider must complete the Department's
Basic Training Course that includes but is not limited to taking and passing an
examination on course work and necessary skills. Failure to obtain a passing score
on the Basic Training Examination may result in the denial or non-renewal of a license
pursuant to OAR 411-360-0270. If an applicant fails the first Examination, a second
Examination may be taken. If the applicant fails the second Examination, the application
may be denied.
(2) All resident manager
applicants must complete the Department's Basic Training Course and pass the Basic
Training Examination prior to becoming a resident manager. If the applicant fails
the first Examination, a second Examination may be taken. If the applicant fails
the second Examination, the application may be denied.
(3) All substitute caregivers
must complete the Department's Basic Training Course and pass the Basic Training
Examination prior to providing care and services. If a substitute caregiver fails
the first Examination, a second Examination may be taken. If the substitute caregiver
fails the second Examination, the substitute caregiver must wait 14 days to retake
the Examination. Each subsequent test failure requires a 14-day waiting period until
the substitute caregiver passes the Examination.
(4) The provider or resident
manager must keep documentation of the completion of the Department's Basic Training
Course and annual training of substitute caregivers including the date of the training,
subject content, name of the agency or organization providing the training, and
the number of training hours.
(5) Prior to placement of
individuals in an AFH-DD, the provider must complete an AFH-DD orientation provided
by the local CDDP that at a minimum covers the requirements of the rules governing
AFH-DD services.
(6) Prior to providing care
and services to any individual, a resident manager and substitute caregiver must
be oriented to the AFH-DD and to the individuals by the provider. Orientation must
be clearly documented in the AFH-DD records. Orientation includes but is not limited
to:
(a) The location of the fire
extinguishers;
(b) Demonstration of evacuation
procedures;
(c) Instruction on the emergency
preparedness plan;
(d) Location of the individuals'
records;
(e) Location of telephone
numbers for the individuals' physicians, the provider, and other emergency contacts;
(f) Location of medication
and key for medication cabinet;
(g) Introduction to individuals;
(h) Instructions for caring
for each individual;
(i) Delegation by a registered
nurse for nursing tasks if applicable; and
(j) Instructions related
to any Advance Directives.
(7) All provider and resident
manager applicants must have current certification in first aid and CPR by a training
agency approved by the Department.
(a) Accepted CPR and First
Aid courses must be provided or endorsed by the American Heart Association, the
American Red Cross, the American Safety and Health Institute, or MEDIC First Aid.
(b) CPR or First Aid courses
conducted online are only accepted by the Department when an in-person skills competency
check is conducted by a qualified instructor endorsed by the American Heart Association,
the American Red Cross, the American Safety and Health Institute, or MEDIC First
Aid.
(8) The Department requires
at least 12 hours of Department-approved training annually for the provider, resident
manager, and substitute caregivers. Training must be documented in the records of
the AFH-DD.
(9) If a provider, resident
manager, or substitute caregiver is not in compliance with these rules, the Department
may require additional training in the deficient area, whether or not the 12-hour
approved annual training requirement has already been met.
(10) Providers, resident
managers, or substitute caregivers who perform tasks of care that are delegated
by a registered nurse or taught by a physician must receive appropriate training
and monitoring from a registered nurse or physician on performance and implementation
of the task of care. The delegated tasks of care must be addressed as part of an
individual's ISP.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0130
Facility Standards
In order to qualify for or renew a license,
an AFH-DD must meet the following provisions.
(1) GENERAL CONDITIONS.
(a) Each AFH-DD must maintain
up-to-date documentation verifying the AFH-DD meets applicable local business license,
zoning, building, and housing codes, and state and local fire and safety regulations
for a single-family residence. General buildings must be of sound construction and
meet all applicable state and local fire and safety regulations in effect at the
time of construction. It is the duty of the provider to check with local government
to be sure all applicable local codes have been met. A current floor plan of the
house must be on file with the local CDDP.
(b) Mobile homes must have
been built since 1976 and designed for use as a home rather than a travel trailer.
The mobile home must have the label from the manufacturer permanently affixed to
the home that states the mobile home meets the requirements of the Department of
Housing and Urban Development (HUD) or authority having jurisdiction.
(c) The building, patios,
decks, walkways, and furnishings must be clean and in good repair. The interior
and exterior must be well maintained and accessible according to the needs of the
individuals. Walls, ceilings, and floors must be of such character to permit frequent
washing, cleaning, or painting, as appropriate. There must be no accumulation of
garbage, debris, rubbish, or offensive odors.
(d) Stairways (interior and
exterior) must have handrails and be adequately lighted. Yard and exterior steps
must be accessible and appropriate to the needs of the individuals.
(e) Adequate lighting must
be provided in each room, internal and external stairways, and internal and external
exit ways. Incandescent light bulbs and florescent tubes must be protected and installed
per the directions of the manufacturer.
(f) The heating system must
be in working order. Areas of the AFH-DD used by individuals must be maintained
at a comfortable temperature. Minimum temperatures during the day (when individuals
are home) must be no less than 68 degrees F and no less than 60 degrees at night
when individuals are sleeping. During times of extreme summer heat, the provider
must make every reasonable effort to make the individuals comfortable and safe using
ventilation, fans, or air conditioners. The temperature may not exceed 85 degrees
in the house.
(g) There must be at least
150 square feet of common space and sufficient comfortable furniture in the AFH-DD
to accommodate the recreational and socialization needs of the occupants at one
time. Common space may not be located in the basement or in garages unless such
space was constructed for that purpose or has otherwise been legalized under permit.
Additional space may be required if wheelchairs are to be accommodated.
(h) Providers must not permit
individuals to access or use swimming or other pools, hot tubs, saunas, or spas
on the AFH-DD premise without supervision. Swimming pools, hot tubs, spas, or saunas
must be equipped with sufficient safety barriers or devices designed to prevent
accidental injury or unsupervised access.
(i) Hallways and exit ways
must be at least 36 inches wide or as approved by the authority having jurisdiction.
Interior doorways used by individuals must be wide enough to accommodate wheelchairs
and walkers if used by individuals.
(j) Only ambulatory individuals
capable of self-preservation may be housed on a second floor or in a basement.
(k) Split level homes must
be evaluated according to accessibility, emergency egress, and evacuation capability
of the individuals.
(l) Ladders, rope, chain
ladders, and other devices may not be used as a secondary means of egress.
(m) Marijuana must not be
grown in or on the premises of the AFH-DD. Individuals with Oregon Medical Marijuana
Program (OMMP) registry cards must arrange for and obtain their own supply of medical
marijuana from a designated grower as authorized by OMMP. The licensed provider,
the caregiver, other employee, or any occupant in or on the premises of the AFH-DD
must not be designated as the grower for and individual and must not deliver marijuana
from the supplier.
(2) SANITATION.
(a) A public water supply
must be utilized if available. If a non-municipal water source is used, the water
source must be tested for coliform bacteria by a certified agent yearly and records
must be retained for two years. Corrective action must be taken to ensure potability.
(b) If a septic tank or other
non-municipal sewage disposal system is used, it must be in good working order.
(c) Garbage and refuse must
be suitably stored in readily cleanable, rodent proof, covered containers, pending
weekly removal.
(d) Prior to laundering,
soiled linens and clothing must be stored in containers in an area separate from
food storage, kitchen, and dining area. Special pre-wash attention must be given
to soiled and wet bed linens.
(e) Sanitation for household
pets and other domestic animals must be adequate to prevent health hazards. Proof
of rabies or other vaccinations as required by a licensed veterinarian must be maintained
on the premises of the AFH-DD for household pets. Pets not confined in enclosures
must be under control and must not present a danger to individuals or guests.
(f) There must be adequate
control of insects and rodents, including screens in good repair on doors and windows
used for ventilation.
(g) Universal precautions
for infection control must be followed in care to individuals. Hands and other skin
surfaces must be washed immediately and thoroughly if contaminated with blood or
other body fluids.
(h) All caregivers must take
precautions to prevent injuries caused by needles and other sharp instruments or
devices during procedures. After they are used, disposable syringes and needles
and other sharp items must be placed in puncture-resistant containers for disposal.
The puncture-resistant containers must be located as close as practical to the use
area. Disposal must be according to local regulations and resources (ORS 459.386
to 459.405).
(3) BATHROOMS. Bathrooms
must:
(a) Provide for individual
privacy and have a finished interior, a mirror, a window capable of being opened
or other means of ventilation, and a window covering. No person must have to walk
through the bedroom of another person to access a bathroom;
(b) Be clean and free of
objectionable odors;
(c) Have tubs or showers,
toilets, and sinks in good repair. A sink must be located near each toilet. A toilet
and sink must be provided on each floor where rooms of non-ambulatory individuals
or individuals with limited mobility are located. There must be at least one toilet,
one sink, and one tub or shower for each six household occupants, including the
provider and the family of the provider;
(d) Have hot and cold water
in sufficient supply to meet the needs of the individuals for personal hygiene.
Hot water temperature sources for bathing areas may not exceed 120 degrees F;
(e) Have shower enclosures
with nonporous surfaces. Glass shower doors must be tempered safety glass. Shower
curtains must be clean and in good condition. Non-slip floor surfaces must be provided
in tubs and showers;
(f) Have grab bars for toilets,
tubs, and showers for the safety of individuals as required by the disabilities
of the individuals;
(g) Have barrier-free access
to toilet and bathing facilities with appropriate fixtures if there are non-ambulatory
individuals in the AFH-DD. Alternative arrangements for non-ambulatory individuals
must be appropriate to individual needs for maintaining good personal hygiene;
(h) Have adequate supplies
of toilet paper for each toilet and soap for each sink; and
(i) Individuals must be provided
with individual towels and wash cloths that are laundered in hot water at least
weekly or more often if necessary. Individuals must have appropriate racks or hooks
for drying bath linens. If individual hand towels are not provided, individuals
must be provided with individually dispensed paper towels.
(4) BEDROOMS.
(a) Bedrooms for all household
occupants must:
(A) Have been constructed
as a bedroom when the home was built or remodeled under permit;
(B) Be finished with walls
or partitions of standard construction that go from floor to ceiling and a door
that opens directly to a hallway or common use room without passage through another
bedroom or common bathroom;
(C) Be adequately ventilated,
heated, and lighted with at least one window capable of being opened that meets
the fire regulations described in subsection (h) of this section;
(D) Have at least 70 square
feet of usable floor space for each individual or 120 square feet of usable floor
space for two individuals; and
(E) Have no more than two
persons per room.
(b) Providers, resident managers,
or their family members must not sleep in areas designated as common use living
areas or share bedrooms with individuals.
(c) There must be a bed for
each individual. The bed must include a frame unless otherwise documented by an
ISP Team decision. The bed must include a clean and comfortable mattress, a waterproof
mattress cover if an individual is incontinent, and a pillow.
(d) Each bedroom must have
sufficient, separate, private dresser and closet space for the clothing and personal
effects for each individual, including hygiene and grooming supplies. Individuals
must be allowed to keep and use reasonable amounts of personal belongings and to
have private, secure storage space.
(e) Drapes or shades for
windows must be in good condition and allow privacy for individuals.
(f) Bedrooms must be on ground
level for individuals who are non-ambulatory or have impaired mobility.
(g) Individual bedrooms must
be in close enough proximity to the provider to alert the provider to nighttime
needs or emergencies, or be equipped with an intercom or audio monitor as approved
by an ISP team.
(h) Bedrooms must have at
least one window or exterior door that readily opens from the inside without special
tools and that provides a clear opening of not less than 821 square inches (5.7
sq. ft.), with the least dimensions not less than 22 inches in height or 20 inches
in width. Sill height must not be more than 44 inches from the floor level or there
must be approved steps or other aids to window egress that may be used by individuals.
Windows with a clear opening of not less than 5.0 square feet or 720 square inches
with sill heights of 48 inches may be accepted when approved by the State Fire Marshal
or the designee of the State Fire Marshal.
(5) MEALS.
(a) Three nutritious meals
must be served daily at times consistent with those in the community.
(A) Each daily menu must
include food from the four basic food groups and fresh fruit and vegetables in season
unless otherwise specified in writing by a physician.
(B) There must be no more
than a 14-hour span between the evening meal and breakfast unless snacks and liquids
are served as supplements.
(C) Food preparation must
include consideration of cultural and ethnic backgrounds, as well as, the food preferences
of individuals. Special consideration must be given to individuals with chewing
difficulties and other eating limitations.
(D) Food may not be used
as an inducement to control the behavior of an individual.
(b) Menus for the coming
week that consider individual preferences must be prepared and posted weekly in
a location that is accessible to individuals and the families of the individuals.
Menu substitutions in compliance with subsection (a) of this section are acceptable.
(c) MODIFIED OR SPECIAL DIETS.
For individuals with modified or special diets ordered by a physician or licensed
health care provider, the provider must:
(A) Have menus for the current
week that provide food and beverages that consider the preferences of the individual
and are appropriate to the modified or special diet; and
(B) Maintain documentation
that identifies how modified or special diets are prepared and served to individuals.
(d) Adequate storage must
be available to maintain food at a proper temperature, including a properly working
refrigerator. Food storage must be such that food is protected from dirt and contamination
and maintained at proper temperatures to prevent spoilage.
(e) Utensils, dishes, glassware,
and food supplies must not be stored in bedrooms, bathrooms, or living areas.
(f) Meals must be prepared
and served in the AFH-DD where individuals reside. Payment for meals eaten away
from the AFH-DD for the convenience of the provider (e.g. restaurants, senior meal
sites) is the responsibility of the provider. Meals and snacks as part of an individual
recreational outing are the responsibility of the individual.
(g) Utensils, dishes, and
glassware must be washed in hot soapy water, rinsed, and stored to prevent contamination.
(h) Food storage and preparation
areas and equipment must be clean, free of objectionable odors, and in good repair.
(i) Home-canned foods must
be processed according to the guidelines of the Oregon Extension Service. Freezing
is the most acceptable method of food preservation. Milk must be pasteurized.
(6) TELEPHONE.
(a) A telephone must be provided
in the AFH-DD that is available and accessible for the use of the individuals for
incoming and outgoing calls. Telephone lines must be unblocked to allow for access.
(b) Emergency telephone numbers
for the local CDDP, police, fire, medical if not served by 911, an emergency number
to reach a provider who does not reside in the AFH-DD, and any emergency physician
and additional persons to be contacted in the case of an emergency, must be posted
in close proximity to all phones utilized by the licensee, resident manager, individuals,
and caregivers.
(c) Telephone numbers for
making complaints or a report of alleged abuse to the Department, the local CDDP,
and Disability Rights Oregon must also be posted.
(d) Limitations on the use
of the telephone by individuals are to be specified in the written house rules.
Individual restrictions must be specified in the ISP. In all cases, a telephone
must be accessible to individuals for outgoing calls (emergencies) 24 hours a day.
(e) AFH-DD telephone numbers
must be listed in the local telephone directory.
(f) The licensee must notify
the Department, individuals, and as applicable the families, legal representatives,
and service coordinators of the individuals of any change in the AFH-DDs telephone
number within 24 hours of the change.
(7) SAFETY.
(a) Buildings must meet all
applicable state and local building, mechanical, and housing codes for fire and
life safety. The AFH-DD may be inspected for fire safety by the Office of the State
Fire Marshal at the request of the Department using the standards in these rules
as appropriate.
(b) Heating in accordance
with the specifications of the manufacturer and electrical equipment, including
wood stoves, must be installed in accordance with all applicable fire and life safety
codes. Such equipment must be used and maintained properly and be in good repair.
(A) Providers who do not
have a permit verifying proper installation of an existing wood stove must have
the wood stove inspected by a qualified inspector, Certified Oregon Chimney Sweep
Association member, or Oregon Hearth Products Association member and follow the
recommended maintenance schedule.
(B) Fireplaces must have
protective glass screens or metal mesh curtains attached to the top and bottom of
the fireplace.
(C) The installation of a
non-combustible heat resistant safety barrier may be required to be installed 36
inches around wood stoves to prevent individuals with ambulation or confusion problems
from coming in contact with the stove.
(D) Un-vented portable oil,
gas, or kerosene heaters are prohibited. Sealed electric transfer heaters or electric
space heaters with tip-over shut-off capability may be used when approved by the
authority having jurisdiction.
(c) Extension cord wiring
and multi-plug adaptors must not be used in place of permanent wiring. UL-approved,
re-locatable power tabs (RPTs) with circuit breaker protection are permitted for
indoor use only and must be installed and used in accordance with the manufacturer’s
instructions. If RPTs are used, the RPTs must be directly connected to an electrical
outlet, never connected to another RPT (known as daisy-chaining or piggy-backing),
and never connected to an extension cord.
(d) All exit doors and interior
doors used for exit purposes must have simple hardware that cannot be locked against
exit and must have an obvious method of single action operation. Hasps, sliding
bolts, hooks and eyes, and double key deadbolts are not permitted. Homes with one
or more individuals who have impaired judgment and are known to wander away from
their place of residence must have a functional and activated alarm system to alert
a caregiver of an unsupervised exit by the individual.
(e) CARBON MONOXIDE ALARMS.
Carbon monoxide alarms must be listed as complying with ANSI/UL 2034 and must be
installed and maintained in accordance with the instructions of the manufacturer.
Carbon monoxide alarms must be installed within 15 feet of each bedroom at the height
recommended by the manufacturer.
(A) Carbon monoxide alarms
may be hard wired, plug-in, or battery operated. Hard wired and plug-in alarms must
be equipped with battery back-up. Battery operated alarms must be equipped with
a device that warns of a low battery.
(B) Bedrooms used by hearing-impaired
occupants who may not hear the sound of a regular carbon monoxide alarm must be
equipped with an additional carbon monoxide alarm that has visual or vibrating capacity.
(f) SMOKE ALARMS. Smoke alarms
must be installed in accordance with the instructions of the manufacturer in each
bedroom, hallways or access areas that adjoin bedrooms, the family room or main
living area where occupants congregate, laundry rooms, office rooms, and basements.
In addition, smoke alarms must be installed at the top of all stairways in multi-level
homes.
(A) Ceiling placement of
smoke alarms is recommended. If wall mounted, smoke alarms must be between 6 inches
and 12 inches from the ceiling and not within 12 inches of a corner.
(B) Smoke alarms must be
equipped with a device that warns of low battery when battery operated or with a
battery back-up if hard wired.
(C) Smoke alarms when activated
must be audible in all sleeping rooms.
(D) Bedrooms used by hearing-impaired
occupants who may not hear the sound of a regular smoke alarm must be equipped with
an additional smoke alarm that has visual or vibrating capacity.
(g) All carbon monoxide alarms
and smoke alarms must contain a sounding device or be interconnected to other alarms
to provide, when actuated, an alarm that is audible in all sleeping rooms. The alarms
must be loud enough to wake occupants when all bedroom doors are closed.
(h) The licensee must test
all carbon monoxide alarms and smoke alarms in accordance with the instructions
of the manufacturer at least monthly (per NFPA 72). Testing must be documented in
the AFH-DD records.
(i) FIRE EXTINGUISHERS. At
least one 2A-10BC rated fire extinguisher must be in a visible and readily accessible
location on each floor, including basements. Fire extinguishers must be inspected
at least once a year by a qualified person that is well versed in fire extinguisher
maintenance. All recharging and hydrostatic testing must be completed by a qualified
agency properly trained and equipped for this purpose and documentation must be
maintained in the AFH-DD records.
(j) The licensee must maintain
carbon monoxide alarms, smoke alarms, and fire extinguishers in functional condition.
If there are more than two violations in maintaining battery operated alarms in
working condition, the Department may require the licensee to hard wire the alarms
into the electrical system.
(8) EMERGENCY PROCEDURES
AND PLANNING.
(a) EVACUATION DRILLS.
(A) The provider must conduct
unannounced evacuation drills when individuals are present, once every quarter with
at least one drill per year occurring during the hours of sleep. Drills must occur
at different times of the day, evening, and night, with exit routes being varied
based on the location of a simulated fire. All occupants must participate in the
evacuation drills.
(B) Written documentation
must be made at the time of the drill and kept by the provider for at least two
years following the drill. Evacuation drill documentation must include:
(i) The date and time of
the drill or simulated drill;
(ii) The location of the
simulated fire and exit route;
(iii) The last names of all
individuals, the provider, caregivers, and all other occupants present on the premises
at the time of the drill;
(iv) The type of evacuation
assistance provided by the provider to individuals;
(v) The amount of time required
by each individual to evacuate; and
(vi) The signature of the
provider or caregiver conducting the drill.
(b) The provider must document
that, within 24 hours of arrival, each new individual receives an orientation to
basic safety and is shown how to respond to a fire and carbon monoxide alarm and
how to exit from the AFH-DD in an emergency.
(c) The provider must demonstrate
the ability to evacuate all individuals from the AFH-DD within three minutes. If
there are problems in demonstrating this evacuation time, the Department may apply
conditions to the license that include, but are not limited to, reduction of individuals
under care, additional staffing, increased fire protection, or revocation of the
license.
(d) The provider must provide,
post, and keep up to date, a floor plan on each floor. The floor plan must contain
room sizes, the location of the bed for each individual, windows, exit doors, the
sleeping rooms for the resident manager or provider, smoke and carbon monoxide alarms,
fire extinguishers, escape routes, and wheelchair ramps. A copy of the floor plan
must be updated to reflect any change and a copy of the updated floor plan must
be submitted to the Department.
(e) There must be at least
one plug-in rechargeable flashlight available for emergency lighting in a readily
accessible area on each floor including the basement.
(f) If an individual accesses
the community independently, the provider must provide the individual information
about appropriate steps to take in an emergency, such as emergency contact telephone
numbers, contacting police or fire personnel, or other strategies to obtain assistance.
(g) WRITTEN EMERGENCY PLAN.
Providers must develop, maintain, update, and implement a written Emergency Plan
for the protection of all the individuals in the event of an emergency or disaster.
The Emergency Plan must:
(A) Be practiced at least
annually. The Emergency Plan practice may consist of a walk-through of the duties
or a discussion exercise dealing with a hypothetical event, commonly known as a
tabletop exercise;
(B) Consider the needs of
the individuals being served and address all natural and human-caused events identified
as a significant risk for the AFH-DD, such as a pandemic or an earthquake;
(C) Include provisions and
sufficient supplies, such as sanitation and food supplies, to shelter in place,
when unable to relocate, for at least three days under the following conditions:
(i) Extended utility outage;
(ii) No running water;
(iii) Inability to replace
food supplies; and
(iv) Caregivers unable to
report as scheduled.
(D) Include provisions for
evacuation and relocation that Identifies:
(i) The duties of caregivers
during evacuation, transporting, and housing of individuals including instructions
to caregivers to notify the Department and local CDDP of the plan to evacuate or
the evacuation of the AFH-DD as soon as the emergency or disaster reasonably allows;
(ii) The method and source
of transportation;
(iii) Planned relocation
sites that are reasonably anticipated to meet the needs of the individuals in the
AFH-DD;
(iv) A method that provides
persons unknown to the individual the ability to identify each individual by name,
and to identify the name of the supporting provider for the individual; and
(v) A method for tracking
and reporting to the Department and the local CDDP the physical location of each
individual until a different entity resumes responsibility for the individual.
(E) Address the needs of
the individuals including provisions to provide:
(i) Immediate and continued
access to medical treatment with the evacuation of the individual summary sheet
and the emergency information identified in OAR 411-360-0170, and other information
necessary to obtain care, treatment, food, and fluids for individuals;
(ii) Continued access to
life sustaining pharmaceuticals, medical supplies, and equipment during and after
an evacuation and relocation;
(iii) Behavior support needs
anticipated during an emergency; and
(iv) Adequate staffing to
meet the life-sustaining and safety needs of the individuals.
(F) Providers must instruct
and provide training to all caregivers about the duties and responsibilities of
the caregivers for implementing the Emergency Plan.
(i) Documentation of caregiver
training must be kept on record by the provider.
(ii) The provider must re-evaluate
the Emergency Plan at least annually or when there is a significant change in the
AFH-DD.
(G) Applicable parts of the
Emergency Plan must coordinate with each applicable employment provider or day program
provider to address the possibility of an emergency or disaster during day time
hours.
(9) SPECIAL HAZARDS.
(a) Flammable and combustible
liquids and hazardous materials must be safely and properly stored in original,
properly labeled containers or safety containers, and secured to prevent tampering
by individuals and vandals.
(b) Oxygen and other gas
cylinders in service or in storage must be adequately secured to prevent cylinders
from falling or being knocked over. No smoking signs must be visibly posted where
oxygen or other gas cylinders are present. Oxygen and other gas cylinders may not
be used or stored in rooms where a wood stove, fireplace, or open flames are located.
(c) To protect the safety
of an individual in an AFH-DD, the provider must store hunting equipment and weapons
in a safe and secure manner inaccessible to the individuals in the AFH-DD. Ammunition
must be secured in a locked area separate from the firearms.
(d) For AFH-DDs with one
or more employees, smoking regulations in compliance with the Indoor Clean Air Act
must be adopted to allow smoking only in outdoor designated areas. Signs must be
posted prohibiting smoking in the workplace per OAR 333-015-0040.
(e) Smoking is prohibited
in sleeping rooms. Ashtrays of noncombustible material and safe design must be provided
in areas where smoking is permitted. Designated smoking areas must be at least 10
feet from any entrance, exit, window that opens, ventilation intake, or accessibility
ramp. Smoking is prohibited in vehicles when individuals or employees occupy the
vehicle.
(f) Cleaning supplies, poisons,
and insecticides must be properly stored in original, properly labeled containers
in a safe area away from food, food preparation and storage, dining areas, and medications
and in a manner to prevent tampering by individuals.
[Publications: Publications referenced
are available from the agency.]
Stat. Auth.: ORS 409.050,
410.070, 443.725, 443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767,
443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 25-2011(Temp), f.
& cert. ef. 12-1-11 thru 5-29-12; SPD 5-2012, f. & cert. ef. 5-29-12; SPD
34-2013, f. & cert. ef. 9-27-13; APD 47-2014, f. 12-26-14, cert. ef. 12-28-14
411-360-0140
Standards and Practices for Health Care
(1) INDIVIDUAL HEALTH CARE. An individual
must receive care and services that supports and promotes the health and well-being
of the individual as follows:
(a) The AFH-DD must ensure
each individual has a primary physician or primary licensed health care provider
whom the individual or the legal representative of the individual has chosen from
among qualified providers.
(b) The AFH-DD must ensure
each individual receives a medical evaluation by a licensed health care provider
no less than every two years or as recommended by the licensed health care provider.
(c) The AFH-DD must monitor
the health status and physical conditions of each individual and take action in
a timely manner in response to identified changes or conditions that may lead to
deterioration or harm.
(d) A written and signed
order from a physician or licensed health care provider is required prior to the
use or implementation of any of the following:
(A) Prescription medications;
(B) Non-prescription medications
except over the counter topicals;
(C) Treatments other than
basic first aid;
(D) Modified or special diets;
(E) Adaptive equipment; and
(F) Aids to physical functioning.
(e) The provider must implement
the order of a physician or licensed health care provider.
(f) Injections may be self-administered
by the individual or administered by a relative of the individual, a currently licensed
registered nurse, a licensed practical nurse under registered nurse supervision,
or the provider, resident manager, or substitute caregiver who has been trained
and is monitored by a physician or delegated by a registered nurse in accordance
with the rules of the Board of Nursing in OAR chapter 851, division 047. Documentation
regarding the training or delegation must be maintained in the record for the individual.
(2) REQUIRED DOCUMENTATION.
(a) A provider must maintain
and keep current records on each individual to aid physicians, licensed health care
providers, the CDDP, and the Department in understanding the medical history of
the individual. Such documentation must include:
(A) A list of known health
conditions, medical diagnoses, any known allergies, immunizations, Hepatitis B status,
previous TB tests, incidents or injuries affecting the health, safety, or emotional
well-being of the individual, and history of emotional or mental health status that
may be pertinent to current care and services;
(B) A record of visits and
appointments to licensed health care providers that includes documentation of the
consultation, any treatment provided, and any follow-up reports provided to the
provider;
(C) A record of known hospitalizations
and surgeries;
(D) Current signed orders
for all medications, treatments, therapies, special diets, and adaptive equipment;
(E) Medication administration
records (MARs);
(F) Documentation of the
consent from the legal representative of the individual for medical treatment that
is not routine including surgery and anesthesia; and
(G) Copies of previous mental
health assessments and assessment updates, including multi-axial DSM diagnosis,
treatment recommendations, and progress records for mental health treatment services.
(b) When requested, copies
of medical records and MARs must be provided to the legal guardian, Department caseworker,
or services coordinator.
(3) MEDICATION PROCUREMENT
AND STORAGE. All medications must be:
(a) Kept in the original
containers;
(b) Labeled by the dispensing
pharmacy, product manufacturer, or physician, as specified by the written order
of a physician or licensed health care provider; and
(c) Kept in a secured, locked
container and stored as indicated by the product manufacturer.
(4) MEDICATION ADMINISTRATION.
(a) All medications and treatments
must be recorded on an individualized MAR. The MAR must include:
(A) The name of the individual;
(B) A transcription of the
written order of the physician or licensed health care provider including the brand
or generic name of the medication, prescribed dosage, frequency, and method of administration;
(C) For over the counter
topical medications without a written order from a physician or licensed health
care provider, a transcription of the printed instructions from the topical medication
package;
(D) Times and dates of administration
or self-administration of the medication;
(E) Signature of the person
administering the medication or the person monitoring the self-administration of
the medication;
(F) Method of administration;
(G) An explanation of why
a PRN (as needed) medication was administered;
(H) Documented effectiveness
of any PRN (as needed) medication administration;
(I) An explanation of all
medication administration or documentation irregularities; and
(J) Documentation of any
known allergy or adverse drug reaction.
(b) Any errors in the MAR
must be corrected with a circle of the error and the initials of the person making
the correction.
(5) SELF-ADMINISTRATION OF
MEDICATION.
(a) For individuals who independently
self-administer medications, there must be a plan as determined by the ISP team
for the periodic monitoring and review of the self-administration of medications.
(b) The AFH-DD must ensure
that individuals able to self-administer medications keep the medications in a place
unavailable to other individuals residing in the AFH-DD and store the medications
as recommended by the product manufacturer.
(6) USE OF MEDICAL MARIJUANA.
(a) Prior to using medical
marijuana in an AFH-DD, an individual must:
(A) Possess a valid OMMP
registry card. A copy of the current OMMP registry card for the individual must
be made available to the provider and maintained in the individual’s record;
(B) Provide a copy of the
written statement by the physician that indicates medical marijuana may mitigate
the symptoms of the qualifying condition of the individual and includes instructions
for the use of medical marijuana;
(C) Be responsible for obtaining
the marijuana from an OMMP approved third party grower who is not the provider,
caregiver, resident manager, or any other occupant in or on the premises of the
AFH-DD; and
(D) Sign an agreement that
the individual understands that:
(i) Marijuana is not allowed
to be grown by any person in or on the premises of the AFH-DD;
(ii) A participant in the
OMMP may not possess more than one ounce of marijuana at any one time while in or
on the premises of the AFH-DD;
(iii) Medical marijuana may
only be administered by ingesting it with food and by a vaporizer. If assistance
with administration is necessary, the individual must agree to arrange for a "designated
primary caregiver". The designated primary caregiver must be authorized by the OMMP
and identified on the OMMP registry card for the individual;
(iv) A provider, caregiver,
resident manager, or any occupants of the AFH-DD cannot be designated as the OMMP-approved
designated primary caregiver of the individual and identified on the OMMP registry
card for the individual;
(v) A provider, caregiver,
resident manager, or any occupants of the AFH-DD cannot assist with the preparation,
administration, or delivery of medical marijuana;
(vi) The individual must
maintain any equipment used to administer marijuana;
(vii) Marijuana must be kept
in locked storage in the bedroom of the individual when not being administered;
(viii) The individual must
immediately notify the OMMP of any change in status, such as a change in address,
designated primary caregiver, or person responsible for the marijuana grow site.
A copy of the updated OMMP registry card for the individual must be made available
to the provider for the record of the individual; and
(ix) Failure to comply with
Oregon laws, Oregon rules, or the house rules of the AFH-DD may result in additional
action.
(b) An individual must comply
with the Oregon Medical Marijuana Act, the rules for the OMMP in OAR chapter 333,
division 008, these rules, and any other requirements for the OMMP.
(c) An individual must self-administer
medical marijuana by ingesting the marijuana or inhaling the marijuana with a vaporizer.
Smoking marijuana in or on the premises of the AFH-DD is prohibited. Marijuana must
be administered privately in a room that is not shared with another person. The
individual may not have visitors, other individuals, or any other person in this
private space while self-administering the marijuana.
(d) An individual must designate
a grower to provide the marijuana as necessary. The grower must not be the provider,
resident manager, caregiver, or any occupant in or on the premises of the AFH-DD.
The grower designated by the individual must be authorized by OMMP and identified
on the OMMP registry card for the individual.
(A) The designated grower
for individuals being served in the foster care system must accommodate the specific
needs related to the dispensation and tracking of the controlled substance. Not
more than 28 grams at a time may be stored on the property of the AFH-DD per card
holder. The remainder of the OMMP card holder’s marijuana must be stored at
the site of the grower.
(B) Each 28 grams, as needed,
must be packaged in an airtight container clearly dated and labeled as to the total
amount in grams with the name of the OMMP card holder. The container must be stored
in a locked cabinet as is done with all controlled medications. Each administration
must be tracked on the individual's MAR as to dosage in grams as weighed on a scale,
date, and time of day.
(e) A provider, caregiver,
resident manager, or any other occupants in or on the premises of the AFH-DD must
not prepare or in any way assist with the administration or procurement of an individual’s
marijuana. The provider must monitor the individual’s usage of medical marijuana
to ensure safety and to document that the individual's use of medical marijuana
is in compliance with the physician’s instructions for using marijuana as
documented in the individual’s ISP.
(f) If a provider, resident
manager, or caregiver also has an OMMP card for medical purposes, a substitute caregiver
must be available to support the individuals when the provider, resident manager,
or caregiver is under the influence of the medical marijuana. Any OMMP card holder
in or on the premises of the AFH-DD must not smoke marijuana in or on the premises
of the AFH-DD but may ingest the marijuana or inhale the marijuana with a vaporizer.
(7) PSYCHOTROPIC MEDICATIONS.
(a) Psychotropic medications
and medications for behavior must be:
(A) Prescribed by a physician
or licensed health care provider through a written order; and
(B) Monitored by the prescribing
physician, licensed health care provider, ISP team, and provider for desired responses
and adverse consequences.
(b) A provider, resident
manager, or any caregiver may not discontinue, change, or otherwise alter the prescribed
administration of a psychotropic medication for an individual without direction
from a licensed health care provider.
(c) A provider, resident
manager, or any caregiver may not use alternative medications intended to alter
or affect mood or behavior, such as herbals or homeopathic remedies, without direction
and supervision of a licensed health care provider.
(d) PRN (as needed) psychotropic
medication orders are not allowed.
(e) PSYCHOTROPIC MEDICATIONS
FOR YOUNG ADULTS. A qualified mental health professional or a licensed health care
provider must provide a mental health assessment prior to any young adult being
prescribed one or more psychotropic medications or any antipsychotic medication.
(A) A mental health assessment
is not required in the following situations:
(i) In case of urgent medical
need;
(ii) For a change in the
delivery system of the same medication;
(iii) For a change in medication
within the same classification;
(iv) A one-time medication
order given prior to a medical procedure; or
(v) An anti-epileptic medication
prescribed for a seizure disorder.
(B) When a mental health
assessment is required, the provider must notify and inform the following of the
need for a mental health assessment:
(i) The legal guardian of
the young adult, or the caseworker of the Department when the Department is the
legal guardian of the young adult; and
(ii) The services coordinator.
(C) The required mental health
assessment:
(i) Must be completed within
three months prior to the prescription of a psychotropic medication; or
(ii) May be an update of
a prior mental health assessment that focuses on a new or acute problem.
(D) Information from the
mental health assessment must be provided to the licensed health care provider prior
to the issuance of a prescription for a psychotropic medication.
(E) Within one business day
after receiving a new prescription or knowledge of a new prescription for a psychotropic
medication for the young adult, the provider must notify:
(i) The legal guardian of
the young adult, or the caseworker of the Department when the Department is the
legal guardian of the young adult; and
(ii) The services coordinator.
(F) The notification described
in subsection (E) of this section must contain:
(i) The name of the prescribing
physician or licensed health care provider;
(ii) The name of the medication;
(iii) The dosage, any change
of dosage, or suspension or discontinuation of the current psychotropic medication;
(iv) The dosage administration
schedule prescribed; and
(v) The reason the medication
was prescribed.
(G) The provider must get
a written informed consent from one of the following prior to filling a prescription
for any new psychotropic medication, except in case of urgent medical need:
(i) The legal guardian of
the young adult; or
(ii) The Department when
the Department is the legal guardian of the young adult.
(H) When a young adult has
more than two prescriptions for psychotropic medications, an annual review of the
psychotropic medications must occur by a licensed health care provider or a qualified
mental health professional who has the authority to prescribe drugs, such as the
Oregon Medicaid Drug Use Review Program.
(f) BALANCING TEST. When
a psychotropic medication is first prescribed and annually thereafter, the provider
must obtain a signed balancing test from the prescribing licensed health care provider
using the Balancing Test Form (form SDS 4110), or by inserting the required form
content into a form maintained by the provider.
(A) The provider must present
the physician or licensed health care provider with a full and clear description
of the behavior and symptoms to be addressed, as well as any side effects observed;
and
(B) The provider must keep
signed copies of the balancing test in the medical record for the individual for
seven years.
(8) MEDICATION SAFEGUARDS.
(a) Safeguards to prevent
adverse effects or medication reactions must be utilized and include:
(A) Whenever possible, obtaining
all prescription medication for an individual, except samples provided by the licensed
health care provider, from a single pharmacy that maintains a medication profile
for the individual;
(B) Maintaining information
about each desired effects and side effects of the medication; and
(C) Ensuring that medications
prescribed for one individual are not administered to, or self-administered by,
another individual or caregiver.
(b) An individual's record
must include documentation of the reason when all medications are not provided through
a single pharmacy.
(9) MEDICATION DISPOSAL.
All unused, discontinued, outdated, recalled, and contaminated medications including
over-the-counter medications may not be kept in the AFH-DD and must be disposed
of within 10 days of expiration, discontinuation, or the knowledge of the provider
of recall or contamination. A provider may contact the local DEQ waste management
company in the area for instructions on proper disposal of medications. Disposal
of all controlled medications must be documented and witnessed by at least one other
person who is 18 years of age or older. A written record of the disposal of the
medication must be maintained that includes documentation of:
(a) Date of disposal;
(b) Description of the medication,
including dosage, strength, and amount being disposed;
(c) Name of the individual
for whom the medication was prescribed;
(d) Reason for disposal;
(e) Method of disposal;
(f) Signature of the person
disposing of the medication; and
(g) For controlled medications,
the signature of a witness to the disposal.
(10) DIRECT NURSING SERVICES.
When direct nursing services are provided to an individual the provider must:
(a) Coordinate with the registered
nurse and the ISP team to ensure that the nursing services being provided are sufficient
to meet the health needs of the individual; and
(b) Implement the Nursing
Service Plan, or appropriate portions therein, as agreed upon by the ISP team and
registered nurse.
(11) COMMUNITY NURSING SERVICES.
(a) Community nursing services
include:
(A) Nursing assessments,
including medication reviews;
(B) Care coordination;
(C) Monitoring;
(D) Delegation and training
of nursing tasks to a provider, resident manager, or substitute caregiver;
(E) Teaching and education
of the provider and identifying supports that minimize health risks while promoting
the autonomy of an individual and self-management of healthcare; and
(F) Collateral contact with
a services coordinator regarding the community health status of an individual to
assist in monitoring safety and well-being and to address needed changes to the
ISP for the individual.
(b) After an initial nursing
assessment, a nursing reassessment must be completed every six months or sooner
if a change in medical condition requires an update to the Nursing Service Plan.
(c) Community nursing services
exclude direct nursing care.
(d) A Nursing Service Plan
must be present when Department funds are used for community nursing services. A
services coordinator must authorize the provision of community nursing services
as identified in an ISP.
(e) When community nursing
services are provided to an individual the provider must:
(A) Coordinate with the registered
nurse and the ISP team to ensure that the nursing services being provided are sufficient
to meet the health needs of the individual; and
(B) Implement the Nursing
Service Plan, or appropriate portions therein, as agreed upon by the ISP team and
registered nurse.
(f) A registered nurse providing
community nursing services must comply with:
(A) Provider record and documentation
requirements referenced in OAR chapter 411, division 048 for financial, clinical,
and other records including the Provider Enrollment Agreement and electronic billing
procedures;
(B) Department direct contracts
(if applicable); and
(C) Service record requirements
outlined in this rule.
(12) DELEGATION AND SUPERVISION
OF NURSING TASKS. Nursing tasks must be delegated by a registered nurse to a provider,
resident manager, and a substitute caregiver in accordance with the rules of the
Oregon State Board of Nursing in OAR chapter 851, division 047.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD
47-2014, f. 12-26-14, cert. ef. 12-28-14
411-360-0160
Behavior Support
(1) A decision to develop a plan to
alter an individual’s behavior must be made by the individual's ISP team.
The provider must maintain documentation of the ISP team's decision.
(2) FUNCTIONAL BEHAVIORAL
ASSESSMENT. Prior to the development of a formal Behavior Support Plan, as agreed
to by an individual's ISP team, a functional behavioral assessment must be conducted.
The functional behavioral assessment must be based upon information provided by
one or more persons who know the individual and include:
(a) A clear, measurable description
of the behavior including (as applicable) frequency, duration, and intensity of
the behavior;
(b) A clear description and
justification of the need to alter the behavior;
(c) An assessment of the
meaning of the behavior including the possibility that the behavior is one or more
of the following:
(A) An effort to communicate;
(B) The result of a medical
condition;
(C) The result of a psychiatric
conditions; or
(D) The result of environmental
causes or other factors.
(d) A description of the
context in which the behavior occurs; and
(e) A description of what
currently maintains the behavior.
(3) BEHAVIOR SUPPORT PLAN.
(a) A Behavior Support Plan
must include:
(A) An individualized summary
of the individual's needs, preferences, and relationships;
(B) A summary of the function
of the behavior (as derived from the functional behavioral assessment);
(C) Strategies that are related
to the function of the behavior and are expected to be effective in reducing challenging
behaviors;
(D) Prevention strategies
including environmental modifications and arrangements;
(E) Early warning signals
or predictors that may indicate a potential behavioral episode and a clearly defined
plan of response;
(F) A general crisis response
plan that is consistent with OIS;
(G) A plan to address post
crisis issues;
(H) A procedure for evaluating
the effectiveness of the Behavior Support Plan including a method of collecting
and reviewing data on frequency, duration, and intensity of the behavior;
(I) Specific instructions
for caregivers who provide support to follow regarding the implementation of the
Behavior Support Plan; and
(J) Positive behavior supports
that includes the least intrusive intervention possible.
(b) A provider must maintain
written evidence that an individual, the individual’s legal representative
(if applicable), and the individual's ISP team are aware of the development of a
Behavior Support Plan and any objections or concerns must be documented.
(4) PROTECTIVE PHYSICAL INTERVENTION.
(a) The AFH-DD must only
employ protective physical intervention techniques that are included in the current
approved OIS curriculum or as approved by the OIS Steering Committee.
(b) Protective physical intervention
techniques must only be applied:
(A) When the health and safety
of an individual or others is at risk and the individual's ISP team has authorized
the procedures as documented by the ISP team's decision, the procedures are documented
in the individual's ISP, and the procedures are intended to lead to less restrictive
intervention strategies;
(B) As an emergency measure,
if absolutely necessary to protect the individual or others from immediate injury;
or
(C) As a health related protection
prescribed by a physician if absolutely necessary during the conduct of a specific
medical or surgical procedure or for the individual's protection during the time
that a medical condition exists.
(c) TRAINING. Providers,
resident managers, and substitute caregivers who support individuals who have behavior
support needs that may require the application of protective physical intervention
must be trained by an instructor certified in OIS when an ISP team has determined
that there is probable cause for future application of protective physical intervention.
Documentation verifying OIS training must be maintained in the personnel file of
the provider, resident manager, and substitute caregiver.
(d) MODIFICATION OF TECHNIQUES.
A provider must obtain the approval of the OIS Steering Committee for any modification
of standard OIS protective physical intervention techniques. The request for modification
of protective physical intervention techniques must be submitted to the OIS Steering
Committee and must be approved in writing by the OIS Steering Committee prior to
the implementation of the modification. The provider must maintain documentation
of the OIS Steering Committee's approval in the individual's record.
(e) USE IN EMERGENCY SITUATIONS.
(A) Use of protective physical
intervention techniques in emergency situations that are not part of an approved
Behavior Support Plan must:
(i) Be reviewed by the provider,
resident manager, or designee within one hour of application; and
(ii) Be used only until the
individual is no longer an immediate threat to self or others.
(B) No later than one working
day after the use of protective physical intervention techniques in an emergency
situation, an incident report as described in subsection (f) of this section must
be submitted to the services coordinator, personal agent (if applicable), or other
Department designee.
(C) An individual's ISP must
meet if an emergency protective physical intervention is used more than three times
in a six-month period.
(f) INCIDENT REPORT.
(A) Any use of protective
physical intervention must be documented in an incident report. The report must
include:
(i) The name of the individual
to whom the protective physical intervention was applied;
(ii) The date, type, and
length of time the protective physical intervention was applied;
(iii) A description of the
incident precipitating the need for the use of the protective physical intervention;
(iv) Documentation of any
injury;
(v) The name and position
of the caregiver applying the protective physical intervention;
(vi) The name and position
of the caregivers witnessing the protective physical intervention; and
(vii) The name and position
of the person conducting the review of the incident that includes the follow-up
to be taken to prevent a recurrence of the incident.
(B) Within five working days
of the incident, a copy of the incident report must be forwarded to the services
coordinator or other Department designee (if applicable).
(C) If the protective physical
intervention results in an injury, a copy of the incident report must be forwarded
within one working day of the incident to the services coordinator or other Department
designee (if applicable).
(D) A copy of an incident
report not associated with a protective service investigation must be provided to
the individual's personal agent (if applicable) and the individual’s legal
representative (if applicable) within the timeframes specified in this rule.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0170
Documentation and Record Requirements
(1) INDIVIDUAL RECORDS. A record must
be developed, kept current, and available on the premises of the AFH-DD for each
individual admitted to the AFH-DD.
(a) The provider must maintain
a summary sheet for each individual in the AFH-DD. The summary sheet must include:
(A) The name of the individual,
current and previous address, date of entry into the AFH-DD, date of birth, gender,
marital status, religious preference, preferred hospital, Medicaid prime and private
insurance number (if applicable), and guardianship status; and
(B) The name, address, and
telephone number of:
(i) The legal representative,
family, advocate, or other significant person;
(ii) The primary licensed
health care provider and designated back up licensed health care provider or clinic
preferred by the individual;
(iii) The dentist preferred
by the individual;
(iv) The day program or employer
(if applicable);
(v) The services coordinator;
and
(vi) Other representatives
providing care and services to the individual.
(b) EMERGENCY INFORMATION.
The provider must maintain emergency information for each individual receiving care
and services in the AFH-DD in addition to the individual summary sheet identified
in subsection (a) of this section. The emergency information must be kept current
and must include:
(A) The name of the individual;
(B) The name, address, and
telephone number of the provider;
(C) The address and telephone
number of the AFH-DD where the individual resides if different from that of the
provider;
(D) The physical description
of the individual, which may include a picture of the individual with the date the
picture was taken, and identification of:
(i) The race, gender, height,
weight range, hair, and eye color of the individual; and
(ii) Any other identifying
characteristics that may assist in identifying the individual, such as marks or
scars, tattoos, or body piercings.
(E) Information on the abilities
and characteristics of the individual including:
(i) How the individual communicates;
(ii) The language the individual
uses and understands;
(iii) The ability of the
individual to know how to take care of bodily functions; and
(iv) Any additional information
that may assist a person not familiar with the individual to understand what the
individual can do for him or herself.
(F) The health support needs
of the individual including:
(i) Diagnosis;
(ii) Allergies or adverse
drug reactions;
(iii) Health issues that
a person needs to know when taking care of the individual;
(iv) Special dietary or nutritional
needs, such as requirements around textures or consistency of foods and fluids;
(v) Food or fluid limitations
due to allergies, diagnosis, or medications the individual is taking that may be
an aspiration risk or other risk for the individual;
(vi) Additional special requirements
the individual has related to eating or drinking, such as special positional needs
or a specific way foods or fluids are given to the individual;
(vii) Physical limitations
that may affect the ability of the individual to communicate, respond to instructions,
or follow directions; and
(viii) Specialized equipment
needed for mobility, positioning, or other health-related needs.
(G) The emotional and behavioral
support needs of the individual including:
(i) Mental health or behavioral
diagnosis and the behaviors displayed by the individual; and
(ii) Approaches to use when
dealing with the individual to minimize emotional and physical outbursts.
(H) Any court ordered or
guardian authorized contacts or limitations;
(I) The supervision requirements
of the individual and why; and
(J) Any additional pertinent
information the provider has that may assist in the care and services to support
the individual if a natural or man-made disaster occurs.
(c) Individual records must
be made available to representatives of the Department conducting inspections or
investigations as well as to individuals to whom the information pertains, the legal
representative of the individual, or other legally authorized people.
(d) Individual records must
be kept by the provider for a period of at least three years. When an individual
moves or an AFH-DD closes, copies of pertinent information must be transferred to
the new place of residence for the individual.
(e) Providers must comply
with ORS 179.505 in all other matters pertaining to confidential records and release
of information.
(2) INDIVIDUAL ACCOUNT RECORDS.
For those individuals not yet capable of managing money as determined by the ISP
team or legal representative of the individual, the provider must prepare, maintain,
and keep current a separate and accurate written record of all money received or
disbursed on behalf of or by the individual.
(a) The account record must
include:
(A) The date, amount, and
source of income received;
(B) The date, amount, and
purpose of funds disbursed; and
(C) The signature of the
provider or caregiver making each entry.
(b) Purchases of $10.00 or
more made on behalf of an individual must be documented by receipts unless an alternate
amount is otherwise specified by the ISP team.
(c) Personal Incidental Funds
(PIF) are to be used at the discretion of the individual for things, such as clothing,
video games, and snacks (not part of daily diet) as addressed in the ISP for the
individual.
(d) Each account record must
include the disposition of the room and board fee that the individual pays to the
provider at the beginning of each month.
(e) REIMBURSEMENT TO INDIVIDUAL.
The provider must reimburse the individual any funds that are missing due to theft
or mismanagement on the part of the provider, resident manager, or caregiver of
the AFH-DD, or for any funds within the custody of the provider that are missing.
Such reimbursement must be made within 10 business days of the verification that
funds are missing.
(f) Financial records must
be maintained for at least seven years.
(3) PERSONAL PROPERTY RECORD.
A provider must prepare and maintain an accurate individual written record of personal
property that has significant emotional or monetary value to each individual as
determined by a documented ISP team or legal representative decision. The personal
property record must include:
(a) The description and identifying
number (if any):
(b) Date of inclusion in
the record;
(c) Date and reason for removal
from record;
(d) Signature of provider
making each entry; and
(e) A signed and dated annual
review of the personal property record for accuracy.
(4) INDIVIDUAL SUPPORT PLAN.
A health and safety transition plan must be developed for an individual at the time
of entry for the first 60 days of care and services. An updated ISP must be developed
by the end of 60 days. The ISP must be updated at least annually and more often
when the support needs of the individual change.
(a) A completed ISP must
be documented on the Department-mandated ISP Form and include the following:
(A) What is most important
to the individual and what works and doesn't work;
(B) The care, services, and
support needs as identified by a functional needs assessment;
(C) The type and frequency
of care, services, and supports to be provided; and
(D) The person responsible
for carrying out the care, services, and supports.
(b) As of July 1, 2014, a
Career Development Plan must be attached to the ISP of an adult in accordance with
OAR 411-345-0160.
(c) For an individual in
employment services or other Department-funded day services, a copy of the plan
maintained by the provider for employment services or other Department-funded day
services must be integrated or attached to the ISP for the individual.
(d) The ISP must include
at least six hours of activities each week that are of interest to the individual
that do not include television or movies made available by the provider. Activities
are those available in the community and made available or offered by the provider
or the CDDP.
(A) Activities may include:
(i) Recreational and leisure
activities; and
(ii) Other activities required
to meet the needs of an individual as described in the ISP for the individual.
(B) Activities may not include:
(i) Rehabilitation;
(ii) Educational services;
or
(iii) Employment services.
(5) HOUSE RULES.
(a) A provider must establish
house rules regarding hours, visitors, designated smoking areas, alcohol, use and
presence of medical marijuana, meal times, use of telephones and kitchen, monthly
charges and services to be provided, and policies on refunds in case of departure,
hospitalization, or death. The house rules must also include:
(A) House rules specific
to the immediate notification of substantiated abuse as described in OAR 411-360-0210;
and
(B) Any restrictions the
AFH-DD may have on the use and presence of alcohol, tobacco, medical marijuana (if
applicable), pets, visiting hours, dietary restrictions, or religious preference.
(i) Use of tobacco must be
in compliance with the Oregon Indoor Clean Air Act and OAR 411-360-0130.
(ii) Use and presence of
medical marijuana must be in compliance with the Oregon Medical Marijuana Act and
OAR 411-360-0140. The house rules for medical marijuana must be reviewed and approved
by the Department. If an individual intends to use medical marijuana in the AFH-DD,
the house rules for medical marijuana must be signed and dated by the individual
or the legal representative of the individual and included in the record for the
individual.
(b) House rules may not violate
the rights of an individual as stated in ORS 430.210, ORS 443.739, OAR 411-318-0010,
and described in section (9) of this rule.
(c) House rules may not be
in conflict with the family atmosphere of the AFH-DD or any of these rules.
(d) House rules are subject
to review and approval by the Department prior to the issuance of a license and
prior to implementing changes.
(e) A provider must discuss
and provide a copy of the house rules to each individual and the legal representative
of the individual at the time of entry and annually or as changes occur. The provider
must document in the file for the individual that a copy of the house rules was
provided.
(f) House rules must be posted
in a conspicuous location in the AFH-DD that is accessible to individuals and visitors.
(6) UNUSUAL INCIDENTS. A
written report of all unusual incidents relating to an individual must be sent to
the CDDP within five business days of the incident. The report must include how
and when the incident occurred, who was involved, what action was taken by the provider
or caregiver, the outcome to the individual, and what action is being taken to prevent
the reoccurrence of the incident.
(7) GENERAL INFORMATION.
The provider must maintain all other information or correspondence pertaining to
the individual.
(8) MONTHLY PROGRESS NOTES.
The provider must maintain and keep current monthly progress notes for each individual
residing in the AFH-DD that include, at a minimum, the progress of the ISP supports,
any medical, behavioral, or safety issues, or any other events that are significant
to the individual.
(9) BILL OF RIGHTS FOR INDIVIDUALS.
(a) The provider must abide
by the Bill of Rights for individuals.
(b) The Bill of Rights must
be posted in a conspicuous location in the AFH-DD that is accessible to individuals
and the legal representatives of the individuals. The Bill of Rights must include
the name and phone number of the office to call in order to report a complaint.
(c) The provider must explain
and provide a copy of the Bill of Rights along with a description of how to exercise
these rights to each individual and the legal representative of the individual at
the time of entry and document in the file for the individual that a copy of the
Bill of Rights was provided.
(d) The provider must review
the Bill of Rights with each individual and the legal representative of the individual
annually or as changes occur.
(e) The Bill of Rights states
each individual has the right to:
(A) Be treated as an adult
with respect and dignity;
(B) Be free from abuse and
neglect;
(C) Be encouraged and assisted
to exercise constitutional and legal rights as a citizen including the right to
vote;
(D) Receive appropriate care
and services and prompt health care as needed;
(E) Have adequate personal
privacy and privacy to associate and communicate privately with any person of choice,
such as family members, friends, advocates, and legal, social service, and medical
professionals;
(F) Send and receive personal
mail unopened and engage in telephone conversations as explained in OAR 411-360-0130;
(G) Have access to and participate
in activities of social, religious, and community groups;
(H) Be able to keep and use
personal clothing and possessions as space permits;
(I) Be free of discrimination
in regard to race, color, national origin, gender, sexual orientation, or religion;
(J) Manage his or her financial
affairs unless determined unable by the ISP team or legally restricted;
(K) Have a safe and secure
environment;
(L) Have a written agreement
regarding the services to be provided;
(M) Voice grievance without
fear of retaliation;
(N) Have freedom from training,
treatment, chemical restraint, or protective physical interventions except as agreed
to, in writing, in the ISP for an individual;
(O) Have freedom from mechanical
restraint, except as approved by the Department;
(P) Be allowed and encouraged
to learn new skills, to act on his or her own behalf to his or her maximum ability
and to relate to others in an age appropriate manner;
(Q) Have an opportunity to
exercise choices including such areas as food selection, personal spending, friends,
personal schedule, leisure activities, and place of residence;
(R) Be free from punishment.
Behavior intervention programs must be approved in writing in the ISP for an individual;
(S) Have the opportunity
to contribute to the maintenance and normal activities of the household;
(T) Have access and opportunity
to interact with people with or without disabilities; and
(U) Have the right to not
be transferred or moved without advance notice as provided in ORS 443.739(18) and
OAR 411-088-0070 and the opportunity for a hearing as provided in ORS 443.738(11)(c)
and OAR 411-088-0080.
(10) AFH-DD records must
be kept current and maintained by the provider and be available for inspection upon
request.
(11) EMPLOYMENT RECORDS.
AFH-DD records must include proof that the provider, resident manager, and any other
caregivers have met the minimum qualifications as required by OAR 411-360-0110.
The following documentation must be included in the AFH-DD record and made available
for review upon request:
(a) Completed employment
applications including the names, addresses, and telephone numbers of all caregivers
employed by the provider. An application for employment in any capacity in an AFH-DD
must include a question asking whether the person applying for employment has ever
been found to have committed abuse;
(b) Proof that the provider
has the approval from the Department for each subject individual, as defined in
OAR 411-360-0020, to have contact with older adults, adults with disabilities, or
adults with intellectual or developmental disabilities as a result of a background
check as defined in OAR 407-007-0210;
(c) Proof of required training
according to OAR 411-360-0120. Documentation must include the date of each training,
subject matter, name of agency or organization providing the training, and number
of training hours;
(d) A certificate to document
completion of the Department's Basic Training Course for the provider, resident
manager, and substitute caregivers;
(e) Proof of mandatory abuse
report training for the provider, resident manager, and substitute caregivers;
(f) Proof of any additional
training required for the specific classification of an AFH-DD or the provider,
resident manager, and all caregivers; and
(g) Documentation of caregiver
orientation to the AFH-DD, training of emergency procedures, training on the ISPs
for individuals, and training on behavior supports and the Nursing Service Plan
(if applicable).
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 25-2011(Temp), f.
& cert. ef. 12-1-11 thru 5-29-12; SPD 29-2011(Temp), f. & cert. ef. 12-30-11
thru 5-29-12; SPD 5-2012, f. & cert. ef. 5-29-12; SPD 34-2013, f. & cert.
ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 47-2014,
f. 12-26-14, cert. ef. 12-28-14
411-360-0180
General Practices
The provider must:
(1) Post the license for
the AFH-DD in a conspicuous location in the AFH-DD that is accessible to individuals
and visitors;
(2) Cooperate with Department
personnel in complaint investigation procedures, abuse investigations and protective
services, planning for individual care and services, application procedures, and
other necessary activities, and allow access of Department personnel to the AFH-DD,
the individuals, and all records;
(3) Give care and services
as appropriate to the age and condition of the individuals and as identified in
the individuals' ISP. The provider must be responsible for ensuring that physician
orders and those of other medical or health professionals are followed and that
the individual's physicians and other health professionals are informed of changes
in health status and if the individual refuses care and services;
(4) In the provider's absence,
have a substitute caregiver on the premises that is capable of providing care and
services as required by the age and condition of the individuals. An AFH-DD service
recipient may not be a substitute caregiver. For provider absences beyond 72 hours,
the CDDP must be notified of the name of the substitute caregiver and the plan of
operation in the provider’s absence;
(5) A provider, resident
manager, or caregiver must be present in the AFH-DD at all times individuals are
present, unless specifically stated in an individual's ISP and granted as a variance
by the Department;
(6) Allow individuals to
exercise all civil and human rights accorded to other citizens;
(7) Not allow or tolerate
physical, sexual, or emotional abuse or punishment, exploitation, or neglect of
individuals;
(8) Provide care and services
as agreed to in an individual's ISP;
(9) Keep information related
to individuals confidential as required under ORS 179.505;
(10) Assure that the number
of individuals requiring nursing care does not exceed the provider's capability
as determined by the Department;
(11) Not admit individuals
without developmental or intellectual disabilities prior to the express permission
of the Department. The provider must notify the CDDP prior to admitting an individual
not referred for placement by the CDDP;
(12) Exercise reasonable
precautions against any conditions that may threaten the health, safety, or welfare
of individuals;
(13) Immediately notify the
appropriate ISP team members (in particular the services coordinator and an individual's
legal representative) of any unusual incidents that include the following:
(a) Any significant change
in medical status;
(b) An unexplained or unanticipated
absence from the AFH-DD;
(c) Any alleged or actual
abuse of the individual;
(d) Any major behavioral
incident, accident, illness, or hospitalization;
(e) If the individual contacts
or is contacted by the police; or
(f) The individual dies.
(14) Write an incident report
for any unusual incident and forward a copy of the incident report to the CDDP within
five working days of the incident unless the incident must be referred immediately
for a protective services investigation. Copies of incident reports not involving
a protective services investigation must be provided to the individual's legal representative
or personal agent, when applicable; and
(15) Notify the Department
within 24 hours upon a change in the business address for electronic mail and the
telephone number for the provider and the AFH-DD.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 5-2012, f. &
cert. ef. 5-29-12; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0190
Standards for Admission, Transfers, Respite,
Crisis Placements, Exit, and Closures
(1) NON-DISCRIMINATION. An individual
considered for Department-funded services may not be discriminated against because
of race, color, creed, age, disability, gender, sexual orientation, national origin,
duration of Oregon residence, method of payment, or other forms of discrimination
under applicable state or federal law.
(2) QUALIFICATIONS FOR DEPARTMENT-FUNDED
SERVICES. An individual who enters an AFH-DD is subject to eligibility as described
in this section.
(a) To become a Department-funded
resident of an AFH-DD, an individual must:
(A) Be an Oregon resident;
(B) Be eligible for OHP Plus;
(C) Be determined eligible
for developmental disability services by the CDDP of the county of origin as described
in OAR 411-320-0080;
(D) Meet the level of care
as defined in OAR 411-320-0020; and
(E) Be an individual who
is not receiving other Department-funded in-home or other funded comprehensive residential
services.
(b) To be eligible for Department-funded
relief care in an AFH-DD, an individual must:
(A) Meet the criteria in
subsection (2)(a)(A-D) of this section;
(B) Be referred by a CDDP
or Brokerage; and
(C) Not be receiving services
in a 24-hour residential setting as described in OAR chapter 411, division 325 or
a supported living setting as described in OAR chapter 411, division 328.
(c) TRANSFER OF ASSETS.
(A) As of October 1, 2014,
an individual receiving medical benefits under OAR chapter 410, division 200 requesting
Medicaid coverage for services in a nonstandard living arrangement (see OAR 461-001-0000)
is subject to the requirements of the rules regarding transfer of assets (see OAR
461-140-0210 to 461-140-0300) in the same manner as if the individual was requesting
these services under OSIPM. This includes, but is not limited to, the following
assets:
(i) An annuity evaluated
according to OAR 461-145-0022;
(ii) A transfer of property
when an individual retains a life estate evaluated according to OAR 461-145-0310;
(iii) A loan evaluated according
to OAR 461-145-0330; or
(iv) An irrevocable trust
evaluated according to OAR 461-145-0540;
(B) When an individual is
considered ineligible due to a disqualifying transfer of assets, the individual
must receive a notice meeting the requirements of OAR 461-175-0310 in the same manner
as if the individual was requesting services under OSIPM.
(3) ENTRY. All individuals
considered for entry into the AFH-DD must:
(a) Be referred by the CDDP
or have prior written approval of the CDDP or Department if the services for the
individual are paid for by the Department; or
(b) Be placed with the agreement
of the CDDP if the individual is either private pay or not eligible for developmental
disability services.
(4) DOCUMENTATION UPON ENTRY.
(a) At the time of a referral
from the CDDP, a provider must be given:
(A) A copy of the eligibility
determination document for an individual;
(B) A statement indicating
the safety skills of the individual including the ability of the individual to evacuate
from a building when warned by a signal device and adjust water temperature for
bathing and washing;
(C) A brief written history
of any behavioral challenges of the individual including supervision and support
needs;
(D) The medical history of
the individual and information on health care support that includes when available:
(i) The results of the most
recent physical exam;
(ii) The results of any dental
evaluation;
(iii) A record of immunizations;
(iv) A record of known communicable
diseases and allergies; and
(v) A record of major illnesses
and hospitalizations.
(E) A written record of the
current or recommended medications, treatments, diets, and aids to physical functioning
for the individual;
(F) Copies of documents relating
to the guardianship or conservatorship of the individual, health care representation
of the individual, or any other legal restrictions on the rights of the individual
(if applicable);
(G) A copy of the most recent
Behavior Support Plan and assessment, ISP, Nursing Service Plan, and Individualized
Education Program (if applicable); and
(H) Copies of protocols,
risk tracking record, and any support documentation (if available).
(b) If an individual is being
admitted from the family home of the individual and the information required in
subsection (a) of this section is not available, the provider must assess the individual
upon entry for issues of immediate health or safety and document a plan to secure
the remaining information no later than 30 days after entry. The plan must include
a written justification as to why the information is not available.
(5) ENTRY MEETING. An ISP
team meeting must be conducted prior to an individual entering an AFH-DD. The findings
of the ISP team meeting must be recorded in the file for the individual and include,
at a minimum:
(a) The name of the individual
proposed for services;
(b) The date of the meeting
and the date determined to be the date of entry for the individual;
(c) Documentation of the
participants included in the meeting;
(d) Documentation of the
pre-entry information required by section (4) of this rule;
(e) Documentation of the
decision to serve the individual requesting services; and
(f) A written Transition
Plan for no longer than 60 days after entry that includes all medical, behavior,
and safety supports needed by the individual.
(6) The provider retains
the right to deny the entry of any individual if the provider feels the support
needs of the individual may not be met by the provider or for any other reason specifically
prohibited by these rules.
(7) An AFH-DD may not be
used as a site for foster care for children, adults from other agencies, or any
other type of shelter or day care without the written approval of the Department.
(8) TRANSFERS.
(a) An individual may not
be transferred by a provider to another AFH-DD or moved out of the AFH-DD without
30 days advance written notice to the individual, the legal representative of the
individual, and the CDDP stating reasons for the transfer as provided in ORS 443.739(18)
and OAR 411-088-0070, and the right of the individual to a hearing as provided in
ORS 443.738(11)(c) and OAR 411-088-0080, except for a medical emergency or to protect
the welfare of the individual or other individuals. Individuals may only be transferred
by a provider for the following reasons:
(A) Behavior that poses a
significant danger to the individual or others;
(B) Failure to make payment
for care and services;
(C) The license for the AFH-DD
has been suspended, revoked, not renewed, or the provider voluntarily surrendered
the license;
(D) The care and service
needs of the individual exceed the ability of the provider; or
(E) There is a mutual decision
made by the individual, the legal representative of the individual, and the ISP
team that a transfer is in the best interest of the individual and all ISP team
members agree.
(b) Individuals who object
to the transfer by the AFH-DD provider must be given the opportunity for a hearing
as provided in ORS 443.738(11)(c) and OAR 411-088-0080. Participants may include
the individual and at the request of the individual, the provider, a family member,
and the CDDP. If a hearing is requested to appeal a transfer, the individual must
continue to receive the same services until the appeal is resolved.
(9) RELIEF CARE.
(a) Relief care may be provided
to one or more individuals if the addition of the individual receiving relief care
in the AFH-DD does not cause the capacity of the AFH-DD as determined by OAR 411-360-0060
to exceed five. Relief care may not be provided for longer than 14 days duration
without prior approval from the Department. A provider may exceed the licensed capacity
of the AFH-DD by one or more individuals receiving relief care if:
(A) Approved by the Department;
(B) The capacity of the AFH-DD
as determined by OAR 411-360-0060 does not exceed five; and
(C) There is adequate bedroom
and living space available in the AFH-DD for the individuals receiving relief care.
(b) The provider must have
information sufficient to provide for the health and safety of an individual receiving
relief care that includes the following:
(A) Medications provided
in a container labeled from a pharmacy or in the original container labeled from
the manufacturer;
(B) A list of medications,
administration times, and self-administration information as needed. Administration
of medication must be documented on a MAR;
(C) Basic summary sheet for
the individual that includes the following:
(i) The name of the physician
of the individual and the phone number for the physician;
(ii) The name of the emergency
contact person of the individual and the phone number for the emergency contact;
(iii) List of supports related
to food and drink (textures, special diets, allergies, preferences);
(iv) List of supports related
to health supports;
(v) List of supports related
to safety including ability to adjust water temperature; and
(vi) List of supports related
to challenging behaviors.
(c) On the first relief care
visit of an individual, the provider must practice and document a fire drill immediately
upon the arrival of the individual. For subsequent relief care visits, the provider
must review the fire evacuation procedures with the individual and document the
review.
(d) No use of PRN (as needed)
psychotropic medications is allowed.
(10) CRISIS SERVICES.
(a) All individuals considered
for crisis services received in an AFH-DD must:
(A) Be referred by the CDDP
or Department;
(B) Be determined eligible
for developmental disability services by the CDDP of the county of origin as described
in OAR 411-320-0080; and
(C) Have a written Crisis
Plan developed by the CDDP or Regional Crisis Diversion Program that serves as the
justification for, and the authorization of, care, services and supports, and expenditures
pertaining to an individual receiving crisis services provided under this rule.
(b) An individual receiving
support services under OAR chapter 411, division 340 and receiving crisis services
in an AFH-DD must have a Support Services ISP and a Support Services Brokerage Crisis
Addendum upon the entry of the individual to the AFH-DD.
(c) Individuals not enrolled
in support services receiving services to avert a crisis situation for less than
90 days must have a Transition Plan at the time of entry that addresses any critical
information relevant to the health and safety of the individual including the current
orders of a physician.
(d) An entry meeting as described
in section (5) of this rule is required for an individual receiving crisis services
in an AFH-DD.
(e) An exit meeting as described
in section (11) of this rule is required for an individual receiving crisis services
in an AFH-DD when the individual exits the AFH-DD.
(f) An individual receiving
crisis services in an AFH-DD does not have appeal rights regarding exit upon completion
of the Crisis Plan for the individual.
(11) IMMEDIATE EXIT.
(a) An individual who was
admitted on or after July 1, 2014 may be moved without advance notice if all of
the following are met:
(A) The AFH-DD provider was
not notified prior to the entry of the individual to the AFH-DD that the individual
is on probation, parole, or post-prison supervision after being convicted of a sex
crime; and
(B) The AFH-DD provider learns
that the individual is on probation, parole, or post-prison supervision after being
convicted of a sex crime; and
(C) The individual presents
a current risk of harm to another individual, staff, or visitor in the AFH-DD as
evidenced by:
(i) Current or recent sexual
inappropriateness, aggressive behavior of a sexual nature, or verbal threats of
a sexual nature; or
(ii) Current communication
from the State Board of Parole and Post-Prison Supervision, Department of Corrections,
or community corrections agency parole or probation officer that the Static 99 score
for the individual or other assessment indicates a probable sexual re-offense risk
to others in the AFH-DD.
(b) Prior to the move, the
AFH-DD provider must contact the Central Office of the Department by telephone to
review the criteria in subsection (a) of this section. The Department shall respond
within one business day of contact by the AFH-DD. The parole or probation officer
of the Department of Corrections must be included in the review, if available. The
Department shall advise the AFH-DD provider if rule criteria for immediate exit
are not met. The Department shall assist in locating placement options.
(c) A written move-out notice
must be completed on form number SDS 0719DD. The form must be filled out in its
entirety and a copy of the notice must be delivered in person to the individual
or if applicable the legal representative of the individual. Where an individual
lacks capacity and there is no legal representative, a copy of the notice to move-out
must be immediately faxed to the State Long Term Care Ombudsman.
(d) Prior to the move, the
AFH-DD licensee must orally review the notice and the right to object with the individual,
or as applicable the legal representative of the individual, and determine if a
hearing is requested. A request for hearing does not delay the exit. The AFH-DD
must immediately telephone the Central Office of the Department when a hearing is
requested. The hearing must be held within five business days of the exit of the
individual. An informal conference may not be held prior to the hearing.
(12) EXIT.
(a) A provider may only exit
an individual for valid reasons equivalent to those for transfers as described in
section (8)(a) of this rule or for an immediate exit as described in section (11)
of this rule.
(b) The provider must give
at least 30 days written notice to an individual, the services coordinator, and
the Department before termination of residency, unless an immediate exit as described
in section (11) of this rule or where undue delay might jeopardize the health, safety,
or well-being of the individual or others. If an individual requests a hearing to
appeal an exit from an AFH-DD, the individual must receive the same services until
the appeal is resolved. This does not apply to an immediate exit as described in
section (11) of this rule.
(c) The provider must promptly
notify the CDDP in writing if an individual gives notice or plans to leave the AFH-DD
or if an individual abruptly leaves. An individual is not required to give notice
to an AFH-DD provider if the individual chooses to exit the AFH-DD.
(13) EXIT MEETING. An ISP
team must meet before any decision to exit is made. Findings of such a meeting must
be recorded in the file for an individual and include, at a minimum:
(a) The name of the individual
considered for exit;
(b) The date of the exit
meeting;
(c) Documentation of the
participants included in the meeting;
(d) Documentation of the
circumstances leading to the proposed exit;
(e) Documentation of the
discussion of strategies to prevent the exit of the individual from the AFH-DD (unless
the individual or the legal representative of the individual is requesting the exit
or the individual must exit immediately as described in section (11) of this rule);
(f) Documentation of the
decision regarding the exit of the individual, including verification of the voluntary
decision to exit or a copy of the Notice of Involuntary Transfer or Exit; and
(g) Documentation of the
proposed plan for services for the individual after the exit.
(14) WAIVER OF EXIT MEETING.
Requirements for an exit meeting may be waived if an individual is immediately removed
from the AFH-DD under the following conditions:
(a) The individual or the
legal representative of an individual requests an immediate move from the AFH-DD;
or
(b) The individual is removed
by legal authority acting pursuant to civil or criminal proceedings.
(15) CLOSURE. Providers must
notify the Department and CDDP in writing prior to announcing a voluntary closure
of the AFH-DD to individuals and the legal representatives of the individuals.
(a) The provider must give
each individual, the legal representative of the individual, and the CDDP 30 days
written notice of the planned closure, except in circumstances where undue delay
might jeopardize the health, safety, or welfare of the individuals, provider, or
caregivers.
(b) If a provider has more
than one AFH-DD, the individuals may not be shifted from one AFH-DD to another AFH-DD
without providing each individual, the legal representative of the individual, and
the CDDP 30 days written notice of the planned closure, unless prior approval is
given and agreement obtained from the individuals, the legal representative of the
individuals, and the CDDP or when undue delay might jeopardize the health, safety,
or well-being of the individuals, provider, or caregivers.
(c) A provider must return
the AFH-DD license to the Department if the AFH-DD closes prior to the expiration
of the license.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 25-2011(Temp), f.
& cert. ef. 12-1-11 thru 5-29-12; SPD 29-2011(Temp), f. & cert. ef. 12-30-11
thru 5-29-12; SPD 5-2012, f. & cert. ef. 5-29-12; SPD 34-2013, f. & cert.
ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 47-2014,
f. 12-26-14, cert. ef. 12-28-14
411-360-0200
Adjustment, Suspension or Termination of
Payment
(1) The Department may adjust, suspend,
or terminate payment to a provider when any of the following conditions occur:
(a) The provider's AFH-DD
license is revoked, suspended, or terminated;
(b) Upon finding that the
provider is failing to deliver any care or service as agreed to in an individual's
ISP;
(c) When funding, laws, regulations,
or the Department's priorities change such that funding is no longer available,
redirected to other purposes, or reduced;
(d) An individual's care
and service needs change;
(e) An individual is absent
without providing notice to the provider for five or more consecutive days;
(f) An individual is determined
to be ineligible for services; or
(g) An individual moves,
with or without notice, from the AFH-DD. The provider is paid only through the last
night the individual slept in the AFH-DD.
(2) The Department is under
no obligation to maintain the AFH-DD at its licensed capacity or to provide payments
to potential providers.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0210
Inspections and Abuse Investigations
(1) The Department conducts an inspection
of an AFH-DD:
(a) Prior to the issuance
of an AFH-DD license;
(b) Prior to the annual renewal
of an AFH-DD license;
(c) Upon receipt of an oral
or written complaint of violations that threaten the health, safety, or welfare
of individuals; or
(d) Anytime the Department
has probable cause to believe that an AFH-DD violated a regulation or provision
of these rules or is operating without an AFH-DD license.
(2) The Department may conduct
inspections of an AFH-DD:
(a) Anytime inspections are
authorized by these rules and any other time the Department considers an inspection
necessary to determine if an AFH-DD is in compliance with these rules or with conditions
placed upon the license of the AFH-DD;
(b) To determine if cited
deficiencies have been corrected; and
(c) For the purpose of monitoring
an individuals' care and services.
(3) State or local fire inspectors
must be permitted access to inspect an AFH-DD for fire safety upon request of the
Department.
(4) Department staff must
have full access and authority to:
(a) Examine the physical
premises of the AFH-DD including the buildings, grounds, equipment, and any vehicles;
and
(b) Examine and copy facility,
individual, and account records (as applicable).
(5) Department staff has
authority to interview the provider, resident manager, caregivers, and individuals.
Interviews are conducted in private and are confidential except as considered public
record under ORS 430.763.
(6) Providers must authorize
resident managers and substitute caregivers to permit entrance by Department staff
for the purpose of inspection and investigation.
(7) Department staff has
authority to conduct inspections with or without advance notice to the provider,
substitute caregiver, or an individual of the AFH-DD. The Department may not give
advance notice of any inspection if the Department believes that advance notice
may obstruct or seriously diminish the effectiveness of the inspection or enforcement
of these rules.
(8) The inspector must respect
the private possessions and living area of individuals, providers, and caregivers
while conducting an inspection.
(9) A copy of the inspection
report must be given to the licensee within 10 working days of completion of the
final report.
(10) Completed reports on
inspections, except for confidential information, are available to the public during
business hours, upon request of the Department.
(11) ABUSE INVESTIGATIONS.
(a) The Department investigates
allegations of abuse as defined in OAR 407-045-0260 for individuals receiving services
authorized or funded by the Department.
(b) When abuse is alleged
or death of an individual has occurred and a law enforcement agency or the Department
has determined to initiate an abuse investigation, the provider may not conduct
an internal investigation without prior authorization from the Department. For the
purpose of this section, an internal investigation is defined as:
(A) Conducting interviews
of the alleged victim, witness, the accused person, or any other person who may
have knowledge of the facts of the abuse allegation or related circumstances;
(B) Reviewing evidence relevant
to the abuse allegation other than the initial report; or
(C) Any other actions beyond
the initial actions of determining:
(i) If there is reasonable
cause to believe that abuse has occurred;
(ii) If the alleged victim
is in danger or in need of immediate protective services;
(iii) If there is reason
to believe that a crime has been committed; and
(iv) What, if any, immediate
personnel actions must be taken.
(c) When an abuse investigation
has been initiated, the Department must provide notice to the provider according
to OAR 407-045-0290.
(d) The Department conducts
investigations as described in OAR 407-045-0250 to 407-045-0360.
(e) When an abuse investigation
has been completed, the outcome of the Abuse Investigation and Protective Services
Report is provided by the Department according to OAR 407-045-0320.
(f) NOTIFICATION OF SUBSTANTIATED
ABUSE.
(A) When a provider receives
notification of a substantiated allegation of abuse, the provider must provide immediate
written notification:
(i) To the person found to
have committed abuse;
(ii) Each individual of the
AFH-DD;
(iii) Each individual's services
coordinator; and
(iv) Each individual's legal
representative.
(B) The provider's written
notification of a substantiated allegation of abuse must include:
(i) The type of abuse as
defined in OAR 407-045-0260;
(ii) When the allegation
was substantiated; and
(iii) How to request a copy
of the Abuse Investigation and Protective Services Report.
(g) When a provider has been
notified of the completion of the abuse investigation, a provider may conduct an
internal investigation to determine if any other personnel actions are necessary.
(h) According to OAR 407-045-0330,
the sections of the Abuse Investigation and Protective Services Report that are
public records and not exempt from disclosure under the public records law must
be provided to the provider upon completion of the Report. The provider must implement
the actions necessary within the deadlines listed to prevent further abuse as stated
in the Report.
(i) RETALIATION. A provider
may not retaliate against any person who reports in good faith suspected abuse,
or against the individual with respect to the report. An accused person may not
self-report solely for the purpose of claiming retaliation.
(A) According to ORS 430.755,
any provider who retaliates against any person because of a report of suspected
abuse or neglect is liable in a private action to that person for actual damages
and, in addition, is subject to a penalty up to $1,000, not withstanding any other
remedy provided by law.
(B) Any adverse action creates
a presumption of retaliation if taken within 90 days of a report of abuse. For the
purpose of this section, "adverse action" means any action taken by a community
facility, community program, or person involved in a report of suspected abuse against
the person making the report or against the individual because of the report. Adverse
action may include but is not limited to:
(i) Discharge or transfer
from the AFH-DD, except for clinical reasons;
(ii) Discharge from or termination
of employment;
(iii) Demotion or reduction
in remuneration for services; or
(iv) Restriction or prohibition
of access to the AFH-DD or the individuals served by the AFH-DD.
(C) Adverse action may also
be evidence of retaliation after 90 days even though the presumption of retaliation
no longer applies.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0220
Complaints
(1) The Department furnishes each AFH-DD
with a Complaint Notice. The Complaint Notice must be posted in a conspicuous location
in the AFH-DD, stating the telephone number of the Department and the CDDP, and
the procedure for making complaints.
(2) Any person who believes
these rules have been violated may file a complaint with the Department or CDDP.
(3) The Department investigates
any complaint regarding the AFH-DD.
(4) Copies of all AFH-DD
complaints are maintained by the Department. All complaints and action taken on
the complaint, indexed by the name of the provider, must:
(a) Be placed into the public
file at the Department. (Information regarding the investigation of the complaint
may not be filed in the public file until the investigation has been completed);
(b) Protect the privacy of
the complainant and the individual; and
(c) Treat the names of the
witnesses as confidential information.
(5) Providers who receive
substantiated complaints pertaining to the health, safety, or welfare of individuals
may have their AFH-DD licenses suspended, revoked, or not renewed, or may have conditions
placed on the AFH-DD license.
(6) The provider, resident
manager, or caregiver must not retaliate in any way against any individual after
a complaint has been filed with the Department. Retaliation may include but is not
limited to:
(a) Increasing charges;
(b) Decreasing care or services,
rights, or privileges;
(c) Threatening to increase
charges or decrease care or services, rights, or privileges;
(d) Taking or threatening
to take any action to coerce or compel the individual to leave the AFH-DD; or
(e) Abusing, harassing, or
threatening to harass or abuse an individual in any manner.
(7) A complainant, witness,
or caregiver of an AFH-DD must not be subject to retaliation by a provider or resident
manager for making a report, being interviewed about a complaint, or being a witness.
Retaliation may include but is not limited to caregiver dismissal or harassment
or restriction of access to either the AFH-DD or an individual.
(8) Any person has the right
to inspect and receive a photocopy of the public complaint files, including protective
services files, maintained by the Department upon request subject to the Department's
procedures, ORS 192.410 through 192.505, and photocopy charges for public record
requests subject to federal and state confidentiality laws.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0230
Procedures for Correction of Violations
(1) If an inspection or investigation
results in a violation of these rules other than abuse, the Department notifies
the provider in writing of violations of these rules.
(2) The notice of violation
includes the following:
(a) A description of each
conduct or condition that constitutes a violation;
(b) Each rule that has been
violated; and
(c) A specific timeframe
for correction, not to exceed 30 calendar days after receipt of the notice of violations.
(A) The Department may approve
a reasonable timeframe in excess of 30 calendar days if correction of the violation
within that timeframe is not practical.
(B) If the licensee requests
more than 30 calendar days to correct the violation, such time must be specified
in the licensee’s plan of correction and must be found acceptable by the Department.
(3) The provider must notify
the Department in writing of the correction of violations no later than the date
specified in the notice of violation.
(4) The Department may conduct
a re-inspection of the AFH-DD after the date the Department receives the report
of compliance or after the date by which violations must be corrected as specified
in the notice of violation.
(5) For violations that present
an imminent danger to the health, safety, or welfare of individuals, the licensee
must correct the violations and abate the conditions no later than 24 hours after
receipt of the notice of violation. The Department inspects the AFH-DD after the
24-hour period to determine if the violations are corrected as specified in the
notice of violation.
(6) If individuals are in
immediate danger, the AFH-DD license may be suspended immediately and arrangements
made to move the individuals.
(7) If, after inspection
of the AFH-DD, the violations have not been corrected by the date specified in the
notice of violation or if the Department has not received a report of compliance,
the Department may institute one or more of the following actions:
(a) Imposition of an administrative
sanction; or
(b) Filing of a criminal
complaint.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0240
Administrative Sanction
(1) An administrative sanction may be
imposed for non-compliance with these rules. An administrative sanction may include
one or more of the following actions:
(a) Attachment of conditions
to an AFH-DD license;
(b) Civil penalties;
(c) Denial, suspension, revocation,
or non-renewal of the AFH-DD license; or
(d) Reclassification of the
AFH-DD license.
(2) If the Department imposes
an administrative sanction, the notice of administrative sanction is served upon
the licensee either personally or by certified mail.
(3) The notice of administrative
sanction includes:
(a) Each sanction imposed;
(b) A reference to the particular
sections of the statute, rule, standard, or order involved;
(c) A short and plain statement
of each condition or act that constitutes a violation;
(d) A statement of the administrative
sanction imposed;
(e) A statement of the licensee's
right to a contested case hearing;
(f) A statement of the authority
and jurisdiction under which the contested case hearing is to be held;
(g) A statement that the
Department's files on the subject of the contested case automatically become part
of the contested case record upon default for the purpose of proving a prima facie
case; and
(h) A statement that the
Department’s notice of administrative sanction serves as the final order by
default if the licensee fails to request a contested case hearing within the specified
time or fails to appear for a contested case hearing.
(4) The licensee must comply
with the final order of the Department.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0250
Conditions
(1) The Department may attach conditions
to a license that take effect immediately upon notification by the Department or
the delivery of the notice of condition whichever is sooner. The type of conditions
attached to an AFH-DD license must directly relate to a risk of harm or potential
risk of harm to individuals. The Department may attach a condition to a license
upon a finding that:
(a) Information on the application
or initial inspection requires a condition to protect the health, safety, or welfare
of individuals;
(b) A threat to the health,
safety, or welfare of an individual exists;
(c) There is evidence of
abuse, neglect, or exploitation; or
(d) The AFH-DD is not being
operated in compliance with these rules.
(2) Conditions that the Department
may impose on a license include, but are not limited to:
(a) Restricting the total
number of individuals in the AFH-DD based upon the ability of the licensee to meet
the health and safety needs of the individuals;
(b) Restricting the total
number and impairment level of individuals in the AFH-DD based upon the capacity
of the caregivers to meet the health and safety needs of all individuals;
(c) Requiring additional
caregivers to meet the needs of the individuals;
(d) Requiring additional
qualifications or training of the licensee and caregivers to meet specific individual
care and service needs;
(e) Requiring additional
documentation;
(f) Restricting a provider
from opening an additional AFH-DD;
(g) Restricting entry:
(A) When there is a threat
of harm to the individuals of the AFH-DD and admitting new individuals compounds
that threat; or
(B) When the Department has
issued a notice of intent to revoke or not renew the license; and
(h) Restricting a licensee
from allowing a person on the premises who may be a threat to the health, safety,
or welfare of an individual.
(3) The Department issues
a written notice to the provider when the Department imposes conditions to a license.
The written notice of conditions includes the conditions imposed by the Department,
the reason for the conditions, and the opportunity to request a hearing under ORS
chapter 183.
(4) The licensee may request
a hearing in accordance with ORS Chapter 183 and this rule upon written notice of
the imposition of conditions.
(a) The licensee must request
a hearing within 21 days from the receipt of the written notice of conditions. Conditions
take effect immediately upon issuance of the written notice of conditions and are
a Final Order of the Department unless later rescinded through the hearings process.
(b) In addition to, or in
lieu of a hearing, a licensee may request an administrative review by the Director
of the Department. The administrative review does not diminish the right of the
licensee to a hearing.
(5) Conditions imposed remain
in effect until the Department has sufficient cause to believe the situation that
warranted the condition has been remedied. The licensee may send a written request
to the Department to remove a condition if the licensee believes the situation that
warranted the condition has been remedied.
(6) Conditions must be posted
with the AFH-DD license in a prominent location in the AFH-DD and be available for
inspection at all times.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 5-2012, f. &
cert. ef. 5-29-12; SPD 34-2013, f. & cert. ef. 9-27-13; APD 29-2014(Temp), f.
& cert. ef. 7-1-14 thru 12-28-14; APD 47-2014, f. 12-26-14, cert. ef. 12-28-14
411-360-0260
Civil Penalties
(1) A civil penalty of not less than
$100 and not more than $250 per violation, except as otherwise provided in this
rule, is imposed on a licensee for a general violation of these rules.
(2) A civil penalty of up
to $500, unless otherwise required by law, is imposed for falsifying individual
or AFH-DD records or causing another to falsify individual or AFH-DD records.
(3) A civil penalty of $250
is imposed on a licensee for failure to have either the provider, resident manager,
or other qualified caregiver on duty 24 hours per day in the AFH-DD per ORS 443.725(3),
unless permitted under OAR 411-360-0180(7).
(4) A civil penalty of $250
is imposed for dismantling or removing the battery from any required smoke alarm
or failing to install any required smoke alarm.
(5) A civil penalty of not
less than $250 and not more than $500, unless otherwise required by law, is imposed
on a licensee who admits knowing that an individual's care or service needs exceed
the license classification of the AFH-DD if the admission places the individual
or other individuals at grave risk of harm.
(6) Civil penalties of up
to $1,000 per occurrence may be assessed for substantiated abuse.
(7) If the Department conducts
an abuse investigation and the substantiated abuse resulted in the death, serious
injury, rape, or sexual abuse of an individual, a civil penalty of not less than
$2,500 is imposed for each violation.
(a) To impose the civil penalty
in section (7) of this rule, the Department must establish that:
(A) The abuse arose from
deliberate or other than accidental action or inaction;
(B) The conduct resulting
in the abuse was likely to cause death, serious injury, rape, or sexual abuse of
an individual; and
(C) The person with the substantiated
finding of abuse had a duty of care and services toward the individual.
(b) For the purpose of the
civil penalty in section (7) of this rule, the following definitions apply:
(A) "Serious injury" means
a physical injury that creates a substantial risk of death or that causes serious
disfigurement, prolonged impairment of health, or prolonged loss or impairment of
the function of any bodily organ.
(B) "Rape" means rape in
the first, second, or third degree as described in ORS 163.355, 163.365, and 163.375.
(C) "Sexual abuse" means
any form of nonconsensual sexual contact including but not limited to unwanted or
inappropriate touching, sodomy, sexual coercion, sexually explicit photographing,
or sexual harassment. The sexual contact must be in the form of any touching of
the sexual or other intimate parts of a person or causing such person to touch the
sexual or other intimate parts of the actor for the purpose of arousing or gratifying
the sexual desire of either party.
(D) "Other than accidental"
means failure on the part of the licensee, or the licensee's employees, agents,
or volunteers for whose conduct licensee is responsible, to comply with applicable
Oregon Administrative Rules.
(8) In addition to any other
liability or penalty, the Department may impose a civil penalty for any of the following:
(a) Operating the AFH-DD
without a license;
(b) The number of individuals
exceeds the licensed capacity for the AFH-DD;
(c) The licensee fails to
achieve satisfactory compliance with the requirements of these rules within the
time specified or fails to maintain such compliance;
(d) The AFH-DD is unable
to provide an adequate level of care and services to support individuals in the
AFH-DD;
(e) There is retaliation
or discrimination against an individual, family member, employee, or any other person
for making a complaint against the AFH-DD;
(f) The licensee fails to
cooperate with the Department, physician, registered nurse, or other health care
professional in carrying out an individual's ISP;
(g) The licensee fails to
obtain an approved background check from the Department on a subject individual
as defined in OAR 411-360-0020 prior to the subject individual operating, working,
training in, or residing in an AFH-DD;
(h) Violations are found
on two consecutive inspections of an AFH-DD after a reasonable amount of time prescribed
for elimination of the violations has passed; or
(i) Violations other than
those involving the health, safety, or welfare of an individual if the licensee
fails to correct the violation as required when a reasonable timeframe for correction
was given.
(9) In imposing a civil penalty
pursuant to this rule, except for a civil penalty imposed pursuant to section (7)
of this rule, the following factors are considered by the Department:
(a) The past history of the
licensee incurring a civil penalty in taking all feasible steps or procedures necessary
or appropriate to correct any violation;
(b) Any prior violations
of statutes or rules pertaining to AFH-DD;
(c) The economic and financial
conditions of the licensee incurring the civil penalty; and
(d) The immediacy and extent
to which the violation threatens or threatened the health, safety, and welfare of
the individuals.
(10) The notice of civil
penalty is delivered in person or sent by registered or certified mail and includes:
(a) A reference to the particular
sections of the statute, rule, standard, or order involved;
(b) A short and plain statement
of the matter asserted or charged;
(c) A statement of the amount
of the civil penalty or penalties imposed; and
(d) A statement of the licensee's
right to request a contested case hearing.
(11) The licensee has10 calendar
days after the receipt of the notice of civil penalty in which to make a written
application for a contested case hearing before the Department. A final order by
default is issued by the Department if a written request for a contested case hearing
is not timely received.
(12) All contested case hearings
are conducted pursuant to the applicable provisions of ORS Chapter 183.
(13) Except as may be prohibited
by state law, a civil penalty imposed under ORS 443.455 or 441.710 may be remitted
or reduced upon such terms and conditions as the Director of the Department considers
proper and consistent with individual health and safety.
(14) If a final order is
not appealed, the amount of the civil penalty is payable within 10 days after the
final order is entered. If the final order is appealed and is sustained, the amount
of the civil penalty is payable within 10 days after the court decision. The final
order, if not appealed or sustained on appeal, constitutes a judgment and may be
filed in accordance with provisions of ORS Chapter 18. Execution may be issued upon
the order in the same manner as execution upon a judgment of a court of record.
(15) A violation of any general
order or final order pertaining to an AFH-DD issued by the Department is subject
to a civil penalty in the amount of not less than $5 and not more than $500 for
each and every violation.
(16) Judicial review of civil
penalties imposed under ORS 441.710 is provided under ORS 183.480, except that the
court may, in its discretion, reduce the amount of the penalty.
(17) All penalties recovered
under ORS 443.455 and 441.710 to 441.740 are to be paid into the Quality Care Fund.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef. 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 5-2012, f. &
cert. ef. 5-29-12; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0270
Denial, Revocation or Non-renewal of License
(1) The Department denies, revokes,
or refuses to renew a license where it finds:
(a) There has been imminent
danger to the health or safety of individuals or substantial failure to comply with
these rules;
(b) There is substantial
non-compliance with local codes and ordinances, or any other state or federal law
or rule applicable to the health and safety of individuals in an AFH-DD;
(c) The Department has conducted
a background check and determined the applicant or licensee is not approved in accordance
with OAR 411-360-0110;
(d) The applicant or licensee
is listed on the Office of Inspector General's or the U.S. General Services Administration's
(System for Award Management) Exclusion Lists;
(e) The licensee allows a
caregiver, or any other subject individual as defined in OAR 411-360-0020, excluding
individuals who are receiving care and services in the AFH-DD, to operate, work,
train in, or reside in the AFH-DD that:
(A) Have been convicted of
any of the disqualifying crimes listed in OAR 407-007-0275;
(B) Are not approved by the
Department as the result of a background check; or
(C) Refused to cooperate
with the Department for a background check in accordance with OAR 407-007-0200 to
407-007-0370;
(f) The applicant or licensee
falsely represents that he or she has not been convicted of a crime;
(g) The licensee fails to
implement a plan of correction or comply with a final order of the Department imposing
an administrative sanction;
(h) When a background check
is required on or after July 28, 2009, a subject individual as defined in OAR 411-360-0020
has been convicted of any of the disqualifying crimes listed in OAR 407-007-0275;
(i) The Department of Revenue
has sent the Department a notice in accordance with ORS 305.385;
(j) The applicant or licensee
has had a previous certificate or license to operate a foster home, or any other
setting involving residential care, denied, suspended, revoked, or not renewed within
three years preceding the present action or is associated with a person whose certificate
or license was denied, suspended, revoked, or not renewed within three years preceding
the present action due to the abuse of an individual or failure to possess the physical
or mental health, or good personal character necessary, unless the applicant or
licensee demonstrates to the Department by clear and convincing evidence that the
applicant or licensee, or the person associated with the applicant or licensee,
does not pose a threat to the individuals.
(A) For the purpose of this
subsection, an applicant or licensee is "associated with" a person as described
above, if the applicant or licensee:
(i) Resides with the person;
(ii) Employs the person in
the AFH-DD;
(iii) Receives financial
backing from the person for the benefit of the AFH-DD;
(iv) Receives managerial
assistance from the person for the benefit of the AFH-DD; or
(v) Allows the person to
have access to the AFH-DD.
(B) For the purpose of this
subsection only, "present action" means the date of the notice of denial, suspension,
revocation, or refusal to renew.
(2) The Department may deny,
revoke, or refuse to renew an AFH-DD license if the applicant or licensee:
(a) Has a history of, or
demonstrates financial insolvency, such as filing for bankruptcy, foreclosure, eviction
due to failure to pay rent, or disruption of utility services due to failure to
pay bills;
(b) Has threatened the health,
safety, or welfare of any individual;
(c) Has a founded report
of abuse of a child or has a substantiated finding of abuse of an individual;
(d) Has a medical or psychiatric
problem that interferes with the applicant's or licensee's ability to provide care
and services;
(e) Has had a previous certificate
or license to operate a foster home, or any other setting involving residential
care, denied, suspended, revoked, or not renewed more than three years from the
present action or the licensee or applicant is associated with a person whose certificate
or license was denied, suspended, revoked, or not renewed more than three years
from the present action due to the abuse of an individual or failure to possess
the physical or mental health, or good personal character necessary, unless the
applicant or licensee demonstrates to the Department by clear and convincing evidence
that the applicant or licensee, or the person associated with the applicant or licensee,
does not pose a threat to the individuals.
(A) For the purpose of this
subsection, an applicant or licensee is "associated with" a person as described
above, if the applicant or licensee:
(i) Resides with the person;
(ii) Employs the person in
the AFH-DD;
(iii) Receives financial
backing from the person for the benefit of the AFH-DD;
(iv) Receives managerial
assistance from the person for the benefit of the AFH-DD; or
(v) Allows the person to
have access to the AFH-DD.
(B) For the purpose of this
subsection only, "present action" means the date of the notice of denial, suspension,
revocation, or refusal to renew.
(f) Has failed to pass the
second AFH-DD Basic Training Examination;
(g) Has failed to disclose
requested information on the application or submits untrue information to the Department;
(h) Has previously been cited
for the operation of an unlicensed AFH;
(i) Does not possess the
good judgment or character deemed necessary by the Department;
(j) Fails to correct a violation
within the specified timeframe allowed;
(k) Refuses to allow access
to the AFH-DD and inspection of the AFH-DD;
(l) Fails to comply with
a final order of the Department to correct a violation of the rules for which an
administrative sanction has been imposed, such as a license condition;
(m) Fails to obtain an approved
background check for subject individuals according to OAR 411-360-0110; or
(n) Fails to operate any
AFH-DD licensed to the licensee in substantial compliance with ORS 443.705 to 443.825
and these rules.
(3) DENIAL. When the Department
denies an applicant an AFH-DD license, the applicant has 60 calendar days after
receipt of the notice of denial to make a written application for a contested case
hearing before the Department.
(4) NON-RENEWAL. When an
administrative sanction is to not renew an AFH-DD license, the licensee has 21 calendar
days after the receipt of the notice of administrative sanction to make a written
application for a contested case hearing before the Department.
(5) REVOCATION. When an administrative
sanction is to revoke a license, the licensee has 10 calendar days after the receipt
of the notice of administrative sanction to make a written application for a contested
case hearing before the Department.
(6) All hearings are conducted
pursuant to the applicable provisions of ORS chapter 183.
(7) If the applicant or licensee
fails to request a contested case hearing within the timeframe specified in the
notice of denial, refusal to renew, or revocation, a default order may be entered
by the Department.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 2-2010(Temp), f. & cert. ef. 3-18-10 thru 6-30-10; SPD 13-2010, f. 6-30-10,
cert. ef. 7-1-10; SPD 34-2013, f. & cert. ef. 9-27-13
411-360-0275
Suspension
(1) The Department may suspend a license
for reasons of abuse, neglect, or exploitation of an individual if:
(a) An immediate threat to
the health, safety, or welfare of any individual exists;
(b) There is evidence of
abuse, neglect, or exploitation of any individual;
(c) The AFH-DD is not operated
in compliance with ORS 443.705 to 443.825 or the rules adopted there under; or
(d) The provider has been
found to have been convicted of a crime that would have resulted in a denied fitness
determination of a background check.
(2) The licensee may request
an administrative review of the decision of the Department to suspend an AFH-DD
license. The Department must receive a written request for an administrative review
within10 days from the receipt of the notice and order of suspension.
(a) Within 10 days from the
receipt of the request for an administrative review from the licensee, all material
relating to the allegation of abuse, neglect, or exploitation and the suspension
of the AFH-DD license, including any written documentation submitted by the licensee
within that timeframe, is reviewed by the Director of the Department. Based on review
of the material, the Director determines whether to sustain the decision to suspend
the AFH-DD license.
(b) A suspension is rescinded
immediately if the Director does not sustain the decision to suspend the AFH-DD
license.
(c) The decision of the Director
is subject to a hearing under ORS Chapter 183 if requested within 90 days from the
date of the decision of the administrative review.
(3) In the event the license
to maintain an AFH-DD is ordered immediately suspended, the Department withholds
service payments until the license is reinstated.
(4) For the protection of
the individuals, the Department arranges for the individuals in the AFH-DD to move
when the AFH-DD license is suspended.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD
47-2014, f. 12-26-14, cert. ef. 12-28-14
411-360-0280
Criminal Penalties
(1) Operating an AFH-DD without a license
is punishable as a Class C misdemeanor pursuant to ORS 443.991(5).
(2) Refusing to allow the
Department access and inspection to the AFH-DD or access to the AFH-DD regarding
fire safety by state and local fire inspector, is punishable as a Class B misdemeanor
pursuant ORS 443.991(6).
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0290
Enjoinment of Operation
The Department may commence an action
to enjoin operation of an AFH pursuant to ORS 443.775(8):
(1) When an AFH-DD is operated
without a valid license; or
(2) After notice of revocation
or suspension has been given, a reasonable time for placement of individuals in
other homes has been allowed, and such placement has not been accomplished.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0300
Zoning
An AFH-DD is a residential use of property
for zoning purposes. An AFH-DD is a permitted use in any residential zone, including
a residential zone that allows a single family dwelling, and in any commercial zone
that allows a single-family dwelling. No city or county may impose any zoning requirement
on the establishment and maintenance of an AFH-DD in these zones that is more restrictive
than a single-family dwelling in the same zone.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13
411-360-0310
Public Information
(1) The Department maintains current
information on all licensed AFH-DD's and makes that information available to prospective
individuals, the individuals' families, and other interested members of the public.
(2) The information includes:
(a) The location of the AFH-DD;
(b) A brief description of
the physical characteristics of the AFH-DD;
(c) The name and mailing
address of the provider;
(d) The license classification
of the AFH-DD and the date the provider was first licensed to operate the AFH-DD;
(e) The date of the last
inspection of the AFH-DD, the name and telephone number of the office that performed
the inspection, and a summary of the findings of the inspection;
(f) Copies of all complaint
investigations involving the AFH-DD, together with the findings of and actions taken
by the Department;
(g) Any license conditions,
suspensions, denials, revocations, civil penalties, exceptions, or other actions
taken by the Department involving the AFH-DD; and
(h) Whether care and services
are provided primarily by the provider, a resident manager, or other arrangement.
(3) Any list of adult foster
homes maintained or distributed by the Department includes notification to the reader
of the availability of public records concerning the AFH-DD's.
Stat. Auth.: ORS 409.050, 410.070, 443.725,
443.730, 443.735, 443.738, 443.742, 443.760, 443.765, 443.767, 443.775, & 443.790
Stats. Implemented: ORS 443.705
- 443.825
Hist.: SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 34-2013, f. &
cert. ef. 9-27-13

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