AGING AND DISABILITY SERVICES ADMINISTRATION

2006 AFH "Dear Provider" Letters

February 20, 2006

ADSA: AFH #2006-002
Transfer/Discharge

Dear Adult Family Home Provider:

This letter replaces ADSA: AFH #2006-002, dated February 3, 2006.

In the past few months, concerns about the transfer and discharge of residents have been raised. The purpose of this letter is to remind you of some of the adult family home’s responsibilities related to transfer/discharge.

State requirements related to transfer and discharge can be found in RCW 70.129.030, RCW 70.129.110, and WAC 388-76-61010. It is your responsibility to be familiar with these requirements.

Some of the issues that have been brought to my attention are concerns about:

1. The failure of adult family homes to explain what they mean when they discharge a resident because the home is “unable to meet the resident’s needs;”
2. The steps the adult family home has or has not taken to reasonably accommodate the resident, before deciding that they cannot meet the resident’s needs; and
3. Whether the adult family homes’ transfer or discharge notice includes the location to which the resident will be discharged or transferred.

Remember that you are only allowed to admit and keep those residents whose needs you can meet with available resources (RCW 70.129.030). If you discharge a resident because the adult family home is “unable to meet the resident’s needs”, you must be able to show specifically why you cannot meet those needs.

Before you discharge a resident, you must try to reasonably accommodate the resident’s needs. Reasonable accommodation will be different for each resident and will be dependent upon the facts of the case.

Notice of involuntary transfer or discharge

As you know, you must notify residents when the transfer/discharge process is started by you. Under most circumstances the adult family home must give the resident a minimum of thirty days notice of the transfer/discharge (RCW 70.129.110). You may use any transfer or discharge notice form that includes all of the required elements in RCW 70.129.110 (5) including the location to which the resident will be discharged or transferred.

Here are some highlights of the adult family home transfer/discharge requirements:

The provider may only admit or continue services for a person when:

1. The adult family home can meet the person's assessed needs with current staff or through reasonable accommodations.
2. The person's admission will not adversely affect the provider's ability to meet the needs of other residents in the home or endanger the safety of other residents; and
3. All residents and household members can be safely evacuated in an emergency.

The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless:

1. The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;
2. The safety of individuals in the facility is endangered;
3. The health of individuals in the facility would otherwise be endangered;
4. The resident has failed to make the required payment for his or her stay; or
5. The facility ceases to operate.

Before a long-term care facility transfers or discharges a resident, the facility must:

1. First attempt through reasonable accommodations to avoid the transfer or discharge, unless agreed to by the resident;
2. Notify the resident and representative and make a reasonable effort to notify, if known, an interested family member of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand;
3. Record the reasons in the resident's record; and
4. Include in the notice the items described in RCW 70.129.110 subsection (5).

When the resident's relocation occurs due to the adult family home's voluntary license relinquishment:

1. The provider shall send written notification, thirty days before ceasing operation, to the appropriate adult family home area manager and to all residents except when shorter notice is required due to emergency circumstances;
2. The provider shall provide appropriate discharge planning and coordination for all residents.

If you have any questions on the discharge and transfer requirements, please feel free to contact your local RCS Field Manager.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services