DOCUMENTO DE TRABAJO DE LOS SERVICIOS DE LA COMISIÓN RESUMEN DE LA EVALUACIÓN DE IMPACTO

BACKGROUND

The Office of Child and Family Services certifies and monitors family-type homes that provide long-term residential care, room, board, housekeeping, supervision, or personal care to four or fewer adults unrelated to the operator. The program began in 1944 to address the needs of older adults who could no longer live by themselves in the

community. New York licenses 500 homes with a capacity to serve 1,500 older adults. The supply has declined over time as providers have aged out of the business. The state is making efforts to expand the supply through active public awareness and recruitment strategies. The state sees adult family care as a cost-effective way to provide personal care/supervision in a family atmosphere for vulnerable adults.

The department coordinates with local districts to assist providers with the needs of their residents who receive Supplemental Security Income, additional state payments, or home relief.

Web Site Content

http://www.nyhealth.gov/nysdoh/phforum/nycrr18.htm Rules (Title 18: Part 489)

DEFINITION

An adult care facility (ACF) for family-type homes is an establishment operated for the purpose of providing long-term residential care, room and board, personal care, and supervision for four or fewer adult persons unrelated to the operator.

ADMISSION/RETENTION CRITERIA

An operator may not accept or retain a person who needs continuous medical or nursing care or supervision; suffers from a serious mental disability; requires mental or health services that are not available or cannot be provided safely by local service providers; is likely to cause danger to self or others; has an unstable medical condition; refuses to comply with the proscribed treatment plan; is chronically bedfast or chairfast, or requires physical assistance to walk, climb, or descend; has unmanaged bowel or urinary

incontinence; is unable to communicate with the operator in a common language; or refuses to inform the operator of changes in medications or other elements of medical evaluation.

The operator must determine that the home can support the person’s needs before admitting him or her.

ASSESSMENT AND CARE PLANNING PROCESS

Operators must determine that the home can support the physical and psychosocial needs of a resident before admitting him or her. The determination is based on a medical evaluation (completed 30 days before the admission date) and an interview between the operator and the resident or the resident’s representative. The home co-coordinators can arrange for professional evaluations, obtain required health and mental health

information, establish link with community resources, and, if necessary, arrange for the transfer of a resident to an appropriate level of care.

Services are determined on the basis of a written agreement following an assessment. The assessment addresses specific information regarding the applicant, including medical history; care needs and preferences; prescribed medications; medical diagnosis; significant behaviors or symptoms; history of depression, anxiety, or mental illness; functional and cognitive abilities; and activities preferences. The assessor prepares a preliminary service plan that describes the needs for services and a plan to meet them. Within 30 days of admission, a specific plan is negotiated on the basis of the resident’s needs and preferences. The facility will notify the resident or the resident’s legal representative of any health changes that affect the service plan.

SERVICES

The operator is responsible for providing room and board, laundry services, supervision, personal care, and social support. Supervision includes monitoring residents’ mental, behavioral, and physical conditions, as well as their attendance at meals and maintenance of personal hygiene; arranging medical services; and protecting residents from harm. Personal care services include grooming, bathing, toileting, walking, eating, recording weight, and assisting with the self-administration of medications. Operators include residents in ongoing activities in the home, such as mealtime and family activities.

MEDICATIONS

Residents who self-administer medications must be able to read and understand the medication label; open the container; follow instructions for measuring or preparing; and correctly ingest, inject, or apply the medication. Operators must periodically verify the resident’s ability to self-administer. Operators may provide assistance and supervision in any of the above activities. A medication record must be maintained for residents who need supervision or assistance. Operators may only inject medications if they hold a New York State license to administer injectable medications.

RESIDENT AGREEMENT/CONTRACT/DISCLOSURE

The resident agreement discloses the services provided and the costs for additional activities, services, or items. The provider and resident negotiate the rate for room and board; this rate must be specified in the agreement, as well as the facility’s policies on discharge, transfer, medical leave, liability, and refunds. The agreement must also specify the resident’s need for personal care services and items, planned activity programs, and meal preferences.

PUBLIC FINANCING

SSI residents receive a state supplement of $266.48 a month in New York City and in Nassau, Rockland, Suffolk, and Westchester counties, and $228.48 elsewhere. The state is considering increasing its SSI supplement to attract more providers.

STAFFING

The operator must live in the home; be at least 21 years old; be of good character; be able to speak, read, and write English; and be physically and mentally capable of operating a

home. The operator must not rely on the income from residents to meet household expenses. Operators must have sufficient income from other sources to maintain and support their household.

TRAINING

The local departments must provide orientation to providers and help the operator develop procedures to link residents with community resources, maintain accurate recordkeeping, and obtain health information regarding residents and prospective residents.

OVERSIGHT AND MONITORING

The local social service areas are responsible for conducting inspections and providing oversight of family-type homes. Each year, the local department must conduct an

unannounced inspection of each home. The local departments are also required to arrange for professional evaluations of residents and transfer a resident to a higher level of care if needed. The Office of Child and Family Services and local districts investigate

complaints. The ombudsman may also visit homes to address resident’s rights and protection.