State Assisted Living Policy: 1998. Michigan

06/01/1998

Citation

Homes for the aged: Michigan Comp. Law § 333.20106(3); 333.21301 et seq.; Michigan administrative code r.325.1801 et seq.

Adult foster care: Large group homes R400.15101 et seq.

General Approach

The state licenses homes for the aged and adult foster care homes. In 1995, a work group established by the Directors of Human Services Agencies and headed by the Department on Aging reviewed current trends in assisted living and supported updating and combining existing regulations in a single category of assisted living. Following a reorganization of state agencies in 1996, responsibility for licensing was shifted to the Department of Consumer and Industry Services. The Department formed a 40 member assisted living task force in the fall of 1997. The task force is examining issues in four areas: consumer information and protection, fire and safety protections, services and affordability. A report is expected in the summer of 1998.

Medicaid HCBS waiver will pilot test coverage of care in assisted living facilities in one county as long as services are delivered by community agencies rather than the facility's staff. Thus far one provider is participating and 4 beneficiaries are being served.

Definition

Homes for the aged "A supervised personal care facility, other than a hotel, adult foster care facility, hospital, nursing home, or county medical care facility, that provides room, board, and supervised personal care to 21 or more unrelated, non-transient, individuals 60 years of age or older. Home for the aged includes a supervised personal care facility for 20 or fewer individuals 60 years of age or older if the facility is operated in conjunction with and as a distinct part of a licensed nursing home."

Adult foster homes There are two levels of adult foster homes, those that serve 12 or fewer and those that serve between 13 and 20 residents. An adult foster care facility is a governmental or non-governmental establishment that provides foster care to adults. Adult foster care facilities include facilities and foster care family homes for adults who are aged, mentally ill, developmentally disabled, or physically handicapped who require supervision on an ongoing basis but who do not require continuous nursing care.

Unit Requirements

Homes for the aged Homes constructed, converted or expanded after 1981 must provide 100 square feet of usable space for single rooms and 80 square feet per resident in shared rooms. Rooms may not be shared by more than four people. Homes licensed prior to 1981 must offer at least 80 square feet of usable floor space for single rooms while shared rooms must provide 70 square feet per resident. The regulations do not limit the number of residents that may share a room. Toilet facilities are required for every eight residents per floor and bathing facilities for every 15 residents.

Adult foster homes A single bedroom must have at least 80 square feet of usable floor space; a multi-bed room must have at least 65 square feet of usable floor space per bed. A maximum of two beds are allowed per bedroom unless the facility has been continuously licensed since the effective date of the rules or unless the resident (or the resident's representative) has agreed to reside in the multi-occupancy room, the home is in compliance with all state fire safety and environmental standards, and the bedroom provides no less than 70 square feet (65 square feet from homes licensed on or before December 31, 1976) of usable floor space per bed.

Tenant Policy

Homes for the aged Residents requiring nursing care that cannot be provided by a home health agency may not be admitted. Residents requiring 24-hour nursing care or intensive nursing care may not be retained. Physicians must certify that new residents are free from communicable diseases. Residents with a mental condition disturbing to others may not be admitted or retained.

Adult foster homes may not accept, retain, or care for residents who require continuous nursing care. This does not preclude the accommodation of a resident who becomes temporarily ill while in the home, but who does not require continuous nursing care. All residents must be assessed by the facility as to the amount and type of services required by the resident. Facilities may not accept or retain residents who require isolation or restraint.

Services

Homes for the aged provide personal care. The rules require that residents wash their hands before meals and receive a bath or shower at least once a week.

Services in adult foster homes include supervision, protection, personal care, medication administration, social activities, and assistance with instrumental activities of daily living. Homes must arrange for transportation services.

Medications

No provisions.

Staffing

Homes for the aged A sufficient number of attendants are required for each shift to assist residents with personal care under direction from a supervisor.

Adult foster homes The ratio of direct care staff in facilities for between 13 and 20 residents must be no less than one staff to 15 residents during waking hours and one staff to 20 residents during normal sleeping hours. The ratio for facilities for 12 or fewer residents must be no less than one staff per 12 residents. In all facilities there must be sufficient direct care staff on duty at all times for the supervision, personal care, and protection of residents and to provide the services specified in the resident's care agreement and assessment plan.

Training

In adult foster homes, administrators must have at least one year of experience working with persons who are mentally ill, developmentally disabled, physically handicapped, or aged. Both the licensee of the home and the administrator must complete either 16 hours of training approved by the Department of Social Services or six credit hours at an accredited college or university in an area approved by the Family Independence Agency. Direct care staff must be at least 18 years old. The licensee or administrator must provide in-service training or make training available through other sources for direct care staff in the following areas: reporting requirements, first aid, CPR, personal care, supervision, protection, resident rights, safety and fire prevention, and prevention and containment of communicable disease.

Staff

Homes for the aged A licensee or administrator shall provide in-service training or make training available through other sources to direct care staff. Direct care staff shall be competent before performing assigned tasks, which shall include being competent in all of the following areas: reporting requirements; first aid; cardiopulmonary resuscitation; personal care, supervision and protection; resident rights; safety and fire prevention; and prevention and containment of communicable diseases.

Adult foster homes (Large Group Homes) Before a license is issued, an applicant and an administrator shall be competent in all of the following areas: nutrition, first aid, CPR, foster care, safety and fire prevention, financial and administrative management, needs of the population to be served, resident rights, and prevention and containment of communicable diseases. A licensee and an administrator shall annually participate in, and successfully complete, 16 hours of training designed or approved by the department that is relevant to the licensee's admission policy and program statement.

Background Check

Homes for the aged No provision.

Adult foster care Large group homes must submit to the licensing agency the name of employee or volunteer who is on a court-supervised probation or parole or who has been convicted of a felony.

Monitoring

Adult foster care homes are inspected by the Family Independence Agency or the Department of Consumer and Industry Services or a local health department at the request of the Family Independence Agency.

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