AGING AND DISABILITY SERVICES ADMINISTRATION
February 9, 2001
AASA: AFH #2001-004
RE: NOTICE OF WITHDRAWAL FROM PILOT RULEMAKING
CLOSURE OF THE AFH SECURED ENVIRONMENT PILOT PROJECT
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Dear Adult Family Home Provider:
There has been management review recently of the Secured Environment Pilot Project that has been operating with four homes (two providers) since November 1999 via the pilot rule making process.? It has been determined that the rules tested in the pilot project are not going to become rules.? The primary reason is that current WAC adequately addresses the use of locked gates to meet the needs of individual residents and meet resident right requirements.? A locked gate is defined as any device on an outdoor gate that impedes or prohibits the access or egress of residents.
Current licensing requirements permit the use of locked gates for residents who are assessed to require such to ensure the resident?s health and safety.? Key regulation and law to consider and review in your home if you use locked gates are:
- Resident Rights
- Admission Agreements
- Resident Assessment
- Negotiated Care Plan
- Staff Competence and Availability
- Fire Safety and Emergency Preparedness
- A resident always has the right to choose to be in an adult family home with or without a locked gate.
- The admission agreement should disclose that the home utilizes locked gates and the type of locked gates available in the same way it lists other available services.? Providing this information prior to admission gives the resident and/or surrogate decision maker a basis for an informed decision regarding this service.
- The resident?s current assessment must identify specifically the resident?s needs, usually exhibited through behavior(s), the resident?s history, and the resident?s preferences that would best be met by the use of a locked gate.
- The evaluation of the cognitive status would also determine if the resident is capable of making an informed decision related to this service or would need a decision made by a surrogate decision maker.? Consent to use of a locked gate by a legal representative or family member may not contradict a resident?s right to choose to live in a home without a locked gate.
- The negotiated care plan must specify the type of locked gate and the provider?s method of using the gate to meet the individual resident?s needs.
- Staff must be trained on current best practice in the use of outdoor space and activity and how that information relates to the care plan for a specific resident and the strategies and techniques as outlined in the negotiated care plan specific to each resident.
- Locked gates cannot be used as a convenience to staff, or an alternative to sufficient staff available to meet the needs of the residents.
- Emergency preparedness and fire evacuation plans must adequately address the safe egress of residents and access of emergency personnel during emergencies and/or fire.? Staff must be trained on these plans and have knowledge of all related procedures.
Applicable Regulation:
WAC 388-76-60070 What Are Some Of The Other Resident Rights That Must Be Considered?
(4) The provider must not require or ask the resident or resident?s representative to sign any?contract or agreement that waives any rights of the resident or waives potential liability for loss of personal property.
WAC 388-76-60000 What Are Resident Rights?
(3)? Long-term care residents should receive appropriate services, be treated with?courtesy, and continue to enjoy their basic civil right and legal rights. (see chapter 70.129 RCW)
WAC 388-76-60050 What Information Is The Provider Required To Supply To Potential Residents And Current Residents?
At a minimum, information supplied to the resident prior to admission must include:
- House rules and policies, including:
- A description of services, items, and activities regularly available in the home or arranged for by the home;
- Types of care that can and cannot be offered:
- a description of what the adult family home will try to do to make adjustments to a resident?s foreseeable or likely increasing care needs for the kinds of residents served by the home;
(4)?Significant known behaviors or symptoms that may cause concern or require?special care;
(5) Evaluation of cognitive status in order to determine the individual?s current level of??functioning. This must include an evaluation of disorientation, memory impairment, and? impaired judgment;
WAC 388-76-61500 What Is A Negotiated Care Plan???????????
A negotiated care plan is a written plan developed between the provider and resident, or the resident?s representative, if the resident has a representative. The provider is responsible to make sure the plan is written and signed. The plan identifies:
- The care and services to be provided;
- When and how the care and services will be provided;
WAC 388-76-655 General Management and Administration.
(2)? The provider shall ensure all of the following:
- That staff are competent, and receive necessary training to perform assigned tasks;
- The home employs sufficient staff to meet the needs of the residents
WAC 388-76-670 Disaster and Emergency Preparedness.
(1) The provider shall develop written plans and procedures to meet potential emergencies??and disasters, such as fires, earthquakes, and floods.
(2) The provider shall ensure that all staff are trained in those emergency procedures when? they begin work at the home.
(3) The provider shall periodically review disaster and emergency procedures with staff, caregivers, and residents.
WAC 388-76-765 Fire Safety.
(11)? An adult family home shall have posted, a written plan for evacuation to safe areas in the event of fire. All staff, caregivers and residents shall be instructed in?? emergency evacuation procedures.
If you have any questions about this letter, please contact your Field Manager.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
