State Assisted Living Policy: 1998. Georgia

06/01/1998

Citation

Personal Care Homes. Georgia Code Annotated §s 31-2-4 et seq.; 31-7-2.1 et seq.; Georgia Comp R and Regulations § 290-5-35.07 et seq.

General Approach

A Medicaid waiver provides reimbursement for group homes. The maximum size of group homes was increased from 15 to 24 or fewer clients in February 1998.

Definition

"Any dwelling, whether operated for profit or not, which undertakes through its ownership or management to provide or arrange for the provision of housing, food services, and one or more personal services for two or more adults who are not related to the owner or administrator by blood or marriage."

Unit Requirements

Bedrooms must have at least 80 square feet of usable floor space per resident. There may be no more than four residents per bedroom. Spouses may be permitted, but not required to share a bedroom. Both the occupant and the administrator or on-site manager must be provided with keys for rooms with lockable doors.

Tenant Policy

Personal Care Homes serve people 18 and older who meet the personal care definition of "ambulatory" - "a resident who has the ability to move from place to place by walking, either unaided or aided by prosthesis, brace, cane, crutches, walker or hand rails, or by propelling a wheelchair; who can respond to an emergency condition ... and escape with minimal human assistance ..." Personal Care Homes cannot admit or retain persons who need physical or chemical restraints, isolation, or confinement for behavioral control. Residents may not be bedbound or require continuous medical or nursing care and treatment.

If short term medical, nursing, health or supportive services are necessary, the resident (or representative) is responsible for purchasing them from licensed providers that are managed independently of the home. The home may assist in the arrangement for such services, but not the provision of those services. Applicants requiring continuous medical or nursing services shall not be admitted or retained.

Services

Room, meals, and personal services which include but are not limited to individual assistance with, or supervision of, self-administered medication, assistance with ambulation and transfer, and essential activities of daily living. Homes are responsible 24-hours a day for the well-being of residents.

Financing

A Medicaid HCBS waiver reimburses two models of personal care homes, group homes serving 7-24 people and the family homes serving 2-6 people. Group homes are reimbursed at $24.66 per day. The SSI payment for room and board is $494 less a personal needs allowance of $86 a month. Family homes are reimbursed by a provider agency that contracts with the Medicaid agency. Medicaid pays $23.49 to the provider agency which must then pay at least $11.52 to the family home subcontractor. In 1997, there were 117 group homes and 1,154 beneficiaries participating in the waiver and 30 family homes serving 788 beneficiaries.

Staffing

At least one administrator, on-site manager, or a responsible staff person must be on the premises 24-hours per day. The minimum on-site staff to resident ratio is one staff person per fifteen residents during waking hours and one staff person per 25 residents during non-waking hours.

Training

All employees must receive work-related training acceptable to the Department within the first 60 days of employment. This training must include: current certification in emergency first aid, except where the staff person is a currently licensed health care professional; current certification in CPR; emergency evacuation procedures; medical and social needs and characteristics of the resident population; residents' rights; and a copy of the Long Term Care Abuse Reporting Act.

Direct care staff are required to complete 16 hours of continuing education a year in courses approved by the department covering but not limited to: Working with the elderly; working with residents with Alzheimer's disease; working with the mentally retarded, mentally ill and developmentally disabled; social and recreational activities; legal issues; physical maintenance and fire safety; housekeeping; or topics as needed or determined by the department.

Background Check

All employees must obtain a satisfactory criminal records check determination from the Department. The Administrator and on-site manager must obtain a satisfactory fingerprint records check determination from the Department.

Monitoring

The Office of Regulatory Services (ORS) investigates complaints and the Division of Public Health conducts an annual inspection. Inspections may be conducted on an announced and unannounced basis. ORS is planning to hire 14 new staff in order to conduct annual reviews.

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