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HomeMy WebLinkAboutMHIDD-304 Personal Care Homes1 FRANKLIN/FULTON COUNTY MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL DISABILITIES/EARLY INTERVENTION 425 Franklin Farm Lane Chambersburg, PA 17202 (717) 264-5387 MH/IDD/EI PROCEDURE STATEMENT PROCEDURE SUBJECT: Personal Care Homes PROCEDURE NUMBER: MHIDD-304 Effective Date: April 4, 2007 Date Revised: January 24, 2022 Reference: 55 PA Code 2600 Regulations OMHSAS Personal Care Home Policy (8-18-09) PURPOSE: The purpose of this policy is to establish a procedure for case management staff to follow when they refer an individual to a Personal Care Home (PCH). It also establishes a procedure that applies when MH/IDD/EI staff become aware of, or suspect the operation of an unlicensed personal care home in Franklin or Fulton County. Although MH/IDD/EI does not have authority over unlicensed personal care homes, it does have the ethical responsibility to notify those agencies that do have authority. MH/IDD/EI is committed to developing integrated and varied housing options that allow individuals to live in home-like settings that embrace Office of Mental Health and Substance Abuse Services (OMHSAS) recovery principles and Office of Developmental Programs (ODP) Everyday Lives principles. In the event that an individual determines that he/she would like to live in a Personal Care Home, MH/IDD/EI is also committed to supporting the OMHSAS/ODP guidelines for this level of care. DEFINITIONS: Activities of Daily Living (ADLs) - The term includes eating, drinking, ambulating, transferring in and out of a bed or chair, toileting, bladder and bowel management, personal hygiene, securing health care, managing health care, self-administering medication and proper turning and positioning in a bed or chair. Appropriate Assessment Agency - An organization serving adults who are older or adults with disabilities, such as a county mental health/intellectual disability agency, a drug and alcohol 2 agency, an area agency on aging or another human service agency, or an individual in an occupation maintaining contact with adults who are older and adults with disabilities, such as medicine, nursing or rehabilitative therapies. Community Support Plan (CSP) (MH only) - Is a "living" document which can be created/updated while a person is either a patient in a state hospital or in an extended acute care facility or living in the community. This document contains a significant amount of information including community-based supports which would enable an individual to pursue their own recovery. The group which develops/updates this document (of which the individual is an essential member) should be composed of persons who are known to the individual or who bring pertinent support/information to the process. Integrated Housing - Permanent, safe, secure and affordable housing where an individual holds a lease or other occupancy agreement and where receiving services is not a condition of residence. License - A certificate of compliance issued by the Department of Human Services (DHS) permitting the operation of a personal care home, at a given location, for a specific period of time and for a period exceeding 24 hours, for three (3) or more adults who are not relatives of the operator, who do not require the services in or of a licensed long-term facility, but who do require assistance or supervision in ADLs (per an MA51 packet completed by a primary care physician). Area Agency on Aging will be providing the assessment for this level of care. Special Consideration - Any time there are three (3) or more unrelated individuals in an unlicensed facility and one (1) or more of these individuals has a diagnosis of Intellectual & Developmental Disabilities and requires 30 hours or more of direct supervision per week, the home must be licensed by the Office of Developmental Programs (ODP). PROCEDURE: Referrals: 1. On a monthly basis, the MH/IDD/EI Administrative Assistant (AA) will check the DHS licensing website to monitor PCH licenses. If any home is placed on a provisional license, the AA will notify the Program Specialists. 2. Prior to an individual being referred to a PCH, the Case Management Unit/Supports Coordination Organization will notify the Program Specialists of the referral so that the status of the license will be reviewed by a Program Specialist via the DHS licensing website. If a home is on a provisional license, MH/IDD/EI staff will consult with OMHSAS/ODP staff and inform the Case Manager/Supports Coordinator prior to making a referral to that home. 3. When an individual is in need of housing, their Case Manager/Supports Coordinator will review the options available to them in the community and assist the individual in touring as many of these options as possible. Only those PCHs with full or provisional licenses (per the DHS website) will be offered to the individual as options. 3 4. If the individual expresses interest in a PCH, the Case Manager/Supports Coordinator will contact the Area Agency on Aging to coordinate an options assessment and the individual’s primary care physician to schedule an appointment to have the MA-51 completed in order to determine if that level of care is appropriate. If this assessment process indicates that another level of care is more appropriate, the individual’s Case Manager/Supports Coordinator will present those options for consideration. 5. At the recommendation of OMHSAS, MH/IDD/EI will allow an exception to the 16-bed rule, when all of the following exist:  This is where the person wants to live  No other housing options are available or viable for the individual  The individual does not want to move to another County  The PCH and community supports meet the person’s needs as documented in the CSP, and  Without making an exception the person would not be able to be discharged from the state hospital. 6. ODP guidelines do not allow an individual enrolled in the waiver to move into a personal care home with more than eight (8) beds, but in the event that a PCH with more than eight (8) beds is determined to be the most appropriate placement option for an individual with a mental health and/or intellectual & developmental disability diagnosis, MH/IDD/EI will closely follow the OMHSAS policy related to referring people to a home of this size. This would include:  Ensuring that the individual has the opportunity to tour at least two (2) alternative housing options, other than the large PCH.  If it is determined that a PCH larger than 16 beds is the most appropriate option, a Community Support Plan (CSP) will be developed for any individual who is being discharged from a State hospital, following the OMHSAS policy guidelines, prior to the referral being made. The purpose of the CSP development process would be to fully understand the housing and support needs of the individual from their perspective. The completed CSP will need to clearly indicate the rationale (including the individual’s reason for this informed choice) behind the referral to a PCH larger than 16 beds.  Prior to the CSP being approved, the MH/IDD/EI Administrator must sign off on the exception request, which would be submitted to OMHSAS. 7. If an individual is referred to a PCH that has in-house services, the individual has the right to seek those same services outside of the home. Unlicensed Homes: 1. In the event that MH/IDD/EI staff become aware of or suspect an unlicensed residence housing three (3) or more unrelated individuals, regardless of age, where one (1) or more of the individuals require assistance with ADLs, the agency staff person will immediately gather as much information about the site and the residents as possible, including but not limited to:  Location of the residence,  Total number of individuals living in the residence, 4  Total number and names of anyone 60 years of age or over, if possible,  Total number of residents who require assistance with ADLs,  Total number of residents who are related to the owner of the residence or not, and  Source(s) of information. 2. The MH/IDD/EI Program Specialist will present the gathered information to the MH/IDD/EI Administrator. 3. The MH/IDD/EI Program Specialist and Administrator will present the information to the Case Management Unit/Supports Coordination Organization Case Management Director. The Case Management Director and/or MH/IDD/EI Administrator may ask the reporting staff member to gather additional information. 4. If it is determined that the gathered information is sufficient for a referral to the appropriate assessment agency or DHS Licensing, the referral will be made by MH/IDD/EI. The information must adequately show reasonable doubt that policy and regulations are not being followed, leading to potential endangerment of residents, before a referral is made so as not to impede an individual’s right to earn a living.