Adult Foster Care

What is adult foster care?

Adult foster care providers offer a family-centered living situation in their home in which 24 hour supervision, personal care, assistance and protection are given as well as room, board, and laundry services. Adult foster care provides people with a community living alternative which includes the normal supports of every day life - family, friends, job or training activities, recreational opportunities, and the privacy and comfort of a home setting.

Adult foster care helps people to help themselves. It is a program created out of the belief that people are happiest living active and purposeful lives in their own community.

Who is it for?

People living in adult foster care homes are men and women, 18 years of age and older, who, because of mental or physical disability, cannot manage on their own anymore. This living arrangement is intended for single persons or husband and wife, with no more than four such persons in a single-family home. The care may be provided by single or married people over the age of 21 who meet the qualifications and criteria established for providers of adult foster care.

People living in adult foster care homes need support remaining within or to return to the community from an institutional setting. As individuals, their needs and abilities may vary, but, remaining in the community is a common goal.

How does the program work?

Prior to placement in an adult foster home, the Rice County Social Services agency is responsible for ensuring an assessment is completed to determine if adult foster care is appropriate for the individual. The assessment may be completed in many different forms.

If foster care is deemed inappropriate for an individual, she/he may discuss alternative living arrangements with his/her social worker.

If foster care is appropriate, the county foster care licensor is notified. The licensor will then check into the availability and willingness of foster care homes to accept a new resident.

At this time, a pre-placement visit to the prospective foster care home is arranged. The purpose of the visit is two-fold: 1) for the prospective resident to see the house and surrounding community; and 2) for the resident and provider to meet and get to know each other, as well as any roommates to see if this living arrangement would work out.

If everyone agrees the arrangement is acceptable, plans for placement are initiated. If either party declines, other plans are made. No arrangement is necessarily permanent and either party may terminate the agreement should the need develop.

Cost

The basic rate for adult foster care is established by the Minnesota Department of Human Services. This rate covers the basic needs to be provided in the adult foster home.

In addition to the base rate, an additional Difficulty of Care (DOC) payment may be paid based on a resident's physial, emotional, or behavioral needs.  This payment will be determined through the use of a Difficulty of Care rating form for adult foster care.

Licensing Criteria

All adult foster care homes in Rice County must be licensed by Rice County Social Services.

The foster care homes must meet and enforce the Minnesota Uniform Fire Code. A state fire marshal will complete initial and subsequent inspections to ensure fire safety.

Caregivers and household members must have a medical exam and be free from communicable diseases (this also holds true to residents upon entering the home). Each caregiver or family members, over the age of 13, must also submit to a criminal background check for the disclosure of arrest, conviction, and criminal history records.

Adult foster care homes are expected to comply with sanitation and health standards. This assures that the residence will be clean, and free from accumulations of dirt and other dirt-producing substances.

Caregivers of adult foster care must complete an orientation provided by Rice County Social Services. In addition to the orientation, the caregiver must also receive additional training as required by the Adult Foster Care Rule.

Every home shall have a living room to which the residents have free access. The resident will also have their own bedroom unless they have mutually consented, in writing, to share a bedroom with another resident. No more than two residents may share one bedroom that will be provided with:

• A separate, adult-size single bed or larger with a clean mattress in good repair.
• Clean bedding appropriate for the season for each resident.
• An individual dresser and closet for storage of personal possessions and clothing.
• A mirror for grooming.

When possible, a resident shall be allowed to have items of furniture that she/he personally owns in the home as pre-arranged with the caregiver.

All foster care residents are protected by the Minnesota Statute 626.557 - the Vulnerable Adults Act. The Vulnerable Adults act states that anyone over the age of 18 years who cannot report abuse or neglect without help from someone is considered to be a Vulnerable Adult. Anyone living in an Adult Foster Home is considered to be a Vulnerable Adult. The adult foster care provider is required to protect each resident from abuse and neglect.

Methods of payment

There are various methods of payment for adult foster care services. These include:

• Private funds
• Earnings
• Income from a pension
• Minnesota Supplemental Aid (must meet eligibility criteria. Apply at Rice County Social Services).
• General Assistance (must meet eligibility criteria. Apply at Rice County Social Services).

There is a growing need for a sensitive and creative alternative in the community for adults who cannot live alone. The adult foster care program provides this alternative and gives the individual a sense of dignity and self-worth.

What Is "Family" Adult Foster Care vs. "Corporate" Adult Foster Care?

A "family' foster home is the personal residence of the license-holder. A "corporate" foster home is a home where the license-holder does not reside, and where staff are hired to care for the residents. In both cases, licensing standards are essentially the same.

What Type of People Are Placed in Adult Foster Homes?

Individuals placed in adult foster homes have varying diagnoses, and in fact may have a combination of diagnoses. Foster homes can serve individuals who are developmentally disabled, mentally ill, physically disabled, elderly and sometimes persons who are chemically dependent (if they have maintained a significant period of sobriety). These individuals must have a social worker/case manager involved in their lives who will assess the need for placement, structure the terms of placement, and follow-up to determine if the placement is suitable.

What Services Do Adult Foster Homes Offer?

In addition to room and board, an adult foster home provides services as stipulated in the Individual Resident Placement Agreement. Overnight supervision is perhaps the most critical feature of adult foster care, which distinguishes it from other residential settings in the community. Depending on the vulnerable adult's particular needs, other negotiable services typically include the following: medication administration or monitoring; assistance with activities of daily living, prompts for personal hygiene, assistance with managing cash resources, arranging for medical appointments, transportation, meal preparation, shared dining, etc. Adult foster care licensers and case managers carefully match residents with providers whose skills and/or willingness to provide various services are in keeping with the resident's needs.

How Does Payment Work for Adult Foster Care Placements?

The State of Minnesota legislates that rates paid for adult foster care through Group Residential Housing (GRH) funds must not exceed the rate paid by an individual not receiving a GRH rate. Essentially, no individual placed in adult foster care (whether public or private pay) can pay less than the State-established base rate, also known as "room-and-board". The actual reimbursement for the care of a resident is set on a case-by-case situation (in family homes), or facility costs (in corporate homes). Some individuals pay privately, if their assets do not allow them to qualify for public funding. More commonly, residents qualify for public funding--at least in part. Some residents receive multiple sources of public funding which supports their placement (i.e. GRH, SSI, Social Security Survivor's Benefits, RSDI, etc.). Some residents have employment income or other assets that are evaluated in order to determine whether they qualify for public funding, or whether they must either "spend-down" or contribute partial payment from these other sources of income/assets.

Some residents also qualify for "waivered services" funding under the federal Medicaid program. Examples of such waivers include: Home-and-Community-Based Waivers for Persons with Developmental Disabilities (HCBW), Community Alternatives for Disabled Individuals (CADI) Waiver, Elderly Waiver (EW), Alternative Care (AC) Waiver, and Traumatic Brain Injury (TBI) Waiver. Waivered services funding pays for services to the individual resident.

What Other Placement Options Exist for Vulnerable Adults?

Aside from Adult Foster Care, there are several other housing options for vulnerable adults. Such settings include, but are not limited to, the following:

Board & Lodge: room-and-board (with meals); some facilities offer 24-hour staffing and services--others do not,

Board & Care: room-and-board (with meals); some medical services provided;

Assisted Living Settings: with meals, homemaker and/or personal care services available;

Apartment Training Programs: specialized housing and services for persons with different disabilities.

Semi-Independent Living Services (SILS) Programs: apartment programs for developmentally disabled individuals; individuals who reside in these settings tend to be higher functioning than those who reside in adult foster homes.

Who Should You Contact for More Information on Adult Foster Care, or to Refer Someone for Placement in an Adult Foster Home?

The State of Minnesota has designated county agents to carry out the licensing function for Adult Foster Homes. County social service departments throughout the State therefore are available to provide you with further information on Adult Foster Care and to assist you in finding an appropriate placement setting. County licensers are aware that the array of placement options available for vulnerable adults can be confusing and overwhelming. For that reason, licensers are available to help you sort through the options. Now that you are aware of Adult Foster Care and its diversity of services, which are tailored to individual needs, you will view it as an excellent placement alternative for vulnerable adults. We look forward to hearing from you!

MAGIC Mission Statement

All persons are entitled to independence regarding their quality and style of life. Vulnerable individuals, however, may require assistance with decision making while respecting their dignity, autonomy, and well-being.

The Minnesota Association for Guardianship and Conservatorship (MAGIC), is a membership organization to explore substitute decision-making. MAGIC brings

Together and supports professionals who are committed to insuring that the appropriate level of quality substitute decision making is applied

Consistently. The organization provides education and communication for those interested in guardianship or less restrictive services.

JOURNAL OF THE MINNESOTA ASSOCIATION FOR GUARDIANSHIP & CONSERVATORSHIP is published by MAGiC: Minnesota Association for Guardianship & Conservatorship for professional people who are substitute decision-makers. Questions, comments, or requests to be added to the mailing list may be made by calling: (651) 292-9131 or in writing to MAGiC, P.O. Box 14246, St. Paul, MN 55114, Anita Raymond, Editor Mary Ferris Jensen, Associate Editor Mary Watson, Associate Editor Vickie Berg, Associate Editor Lori Guzman, Associate Editor Bruce Myers, Advertising

@ Copyright 2000 by Minnesota Association for Guardianship & Conservatorship.

Rice County has a well-developed adult foster care program, with 96 licensed adult foster care homes serving individuals with developmental disabilities, mental health issues, and frail elderly. If you are interested in providing adult foster care or utilizing adult foster home services, please contact Kate Hanson, Adult Foster Care Licensor, 507-332-6255 or khanson@co.rice.mn.us for information.