In prior columns we have discussed various living arrangements both in and out of your home. But what if you cannot live alone and need 24 hour personal care, protection or supervision, but do not need the care provided by a nursing home? Adult Foster Care (“AFC”) homes and Homes for the Aged (“HFAs”) offer non-nursing home options for you.
Both AFC homes and HFAs provide care for persons who are aged, mentally ill or impaired, developmentally disabled, physically disabled or have Alzheimer’s disease or other dementia related disorders. The main differences between them are the number of residents and the ages of residents.
AFC homes are generally limited to no more than twenty adults of any age. Some AFC homes are limited to six or twelve residents. HFAs on the other hand, generally have more than twenty residents who must be at least sixty years old.
AFC homes and HFAs are licensed by the Michigan Department of Human Services, Bureau of Child and Adult Licensing (“BCAL”). As part of their licensing requirements and for your protection, AFC homes and HFAs must perform criminal background checks for all the workers in the home who have direct access to you or your property, financial information, medical records, treatment information or any other identifying information.
The care provided by AFC homes and HFAs is typically help with activities of daily living. This may include assistance with bathing, grooming, dressing, eating, transferring, walking, toileting or dispensing of medication.
There are various levels of services that these homes can provide. There are some homes that provide only minimal assistance and require residents to be fully mobile. There are other homes that offer more intensive care and supervision and may provide all the non-medical services that are typically provided by a nursing home.
But how do you choose a facility? Well, one of the things that you can do first is get a list of the licensed AFC homes in your area by going online at HYPERLINK “http://www.michigan.gov/dhs” www.michigan.gov/dhs and clicking on “Doing Business with DHS.” Click on “Licensing” and then click on “Adult Foster Care & Homes for the Aged.” Scroll down to “License Lookups” and click on “Adult Foster Care/Homes for the Aged Facilities.” You can then search by zip code, county, etc. You can also view recent complaint investigative reports for each of the homes.
You can also ask for referrals from people you know who have had family members in these homes. Check with local senior agencies who may also offer some referrals.
When choosing a home, make sure the home has a process for addressing concerns and complaints about the staff or the administration and a procedure to resolve conflicts. You do have certain rights when you are in an AFC home or an HFA and those rights include:
- be free from discrimination because of race, religion, national origin, sex, age, handicap, marital status, or source of payment.
- exercise constitutional rights, including the right to vote, to practice the religion of your choice, etc.
- to send and to receive unopened and uncensored mail.
- participate in social, religious and community activities, as well as the right to not participate.
- contacts with relatives and friends, and to receive visitors in the home at a reasonable time.
- private communications and consultations with a physician, attorney, or any person of your choice.
- choose a physician, psychiatrist, or dentist for needed services.
- refuse treatment and services, and to be told of the possible consequences of that refusal.
- private use of a telephone every day.
- access to your own room at your discretion.
- voice complaints and make recommendations for change without fear of retaliation.
- be treated with consideration and respect, with recognition of personal dignity, individuality and the need for privacy.
- nutritious, appetizing meals, be free from harm and punishment by restraint, isolation, personal humiliation, or by having food, water, or clothing/personal items withheld.
- review and discuss your records with the home’s staff, including the assessment and care plans.
- use the services of advocacy agencies and to attend other community services.
- request and receive assistance form a responsible agency to relocate to another living situation.
If you have an issue with the home, you can file a complaint with BCAL who will investigate the complaint and can require the home to prepare a plan of correction, fine the home, suspend, modify or revoke the facility’s license.
At the time of admission to one of these homes, you should be completing a residential care agreement with the home. The agreement must be reviewed at least annually, but can be reviewed anytime there is a concern about or a change in your care.
AFC homes and HFAs are generally private businesses or non-profits that set their own rates. You are typically responsible for privately paying your monthly cost of care. There are also certain long-term care policies that will provide reimbursement for your care in licensed facilities, such as AFC homes or HFAs.
The cost of an AFC home or HFA is generally less than nursing home care. I have seen some of these homes with monthly rates less than $1,500. Others were over $4,500 per month with everything in between. The costs vary depending upon location of the home and the level of care provided.
You have a lot of options for non-nursing home care. Those options include AFC homes and HFAs. With the options available, you can choose the facility that is right for you depending upon the level of care you need and what would best fit your budget.
By: Matthew M. Wallace, CPA, JD
Published edited November 14, 2010 in The Times Herald newspaper, Port Huron, Michigan as: Options are available when you can’t live alone