INDIVIDUAL RECORDS. A record must be
developed, kept current, and available on the premises of the AFH-DD for each
individual admitted to the AFH-DD.
provider must maintain a summary sheet for each individual in the AFH-DD. The
summary sheet must include the following:
The name of the individual, current and previous address (when current address
is less than six months old), date of entry into the AFH-DD, date of birth,
gender, marital status, religious preference, preferred hospital, Medicaid
prime and private insurance number (if applicable), and guardianship
The name, address, and
telephone number of the following (as applicable):
(i) The individual's legal representative,
family, advocate, or other significant person.
(ii) The primary physician or licensed health
care provider and designated back up physician or licensed health care provider
or clinic preferred by the individual.
(iii) The dentist preferred by the
(iv) The individual's
day program or employer.
individual's services coordinator.
(vi) Other representatives delivering care
and services to the individual.
EMERGENCY INFORMATION. A provider must
maintain emergency information for each individual receiving care and services
in the AFH-DD, in addition to the individual summary sheet identified in
subsection (a) of this section. The emergency information must be kept current
and must include the following:
provider's name, address, and telephone number.
(C) The address and telephone number of the
AFH-DD where the individual resides if different from the provider.
The individual's physical description,
which may include a picture of the individual with the date the picture was
taken, and identification of the following:
(i) Race, gender, height, weight range, and
color of hair and eyes.
other identifying characteristics that may assist in identifying the
individual, such as marks or scars, tattoos, or body piercings.
Information on the
individual's abilities and characteristics including, but not limited to, the
(i) How the individual
(ii) The language the
individual uses or understands.
(iii) The individual's ability to know how to
take care of bodily functions.
Any additional information that may assist a person not familiar with the
individual to understand what the individual can do for himself or
individual's health support needs including, but not limited to, the following:
(ii) Allergies or adverse drug
(iii) Health issues a
person needs to know when taking care of the individual.
(iv) Special dietary or nutritional needs,
such as requirements around textures or consistency of foods and
(v) Food or fluid
limitations due to allergies, diagnosis, or medications the individual is
taking that may be an aspiration risk or other risk.
(vi) Additional special requirements the
individual has related to eating or drinking, such as special positional needs
or a specific way foods or fluids are given to the individual.
(vii) Physical limitations that may affect
the individual's ability to communicate, respond to instructions, or follow
equipment needed for mobility, positioning, or other health-related
individual's emotional and behavioral support needs including, but not limited
to, the following:
(i) Mental health or
behavioral diagnosis and the behaviors displayed by the individual.
(ii) Approaches to use when supporting the
individual to minimize emotional and physical outbursts.
(H) Any court ordered or guardian authorized
contacts or limitations.
individual's supervision requirements and why.
(J) Any additional information the provider
has that may assist in the individual's care and support if a natural or
man-made disaster occurs.
(c) Individual records must be made available
to representatives of the Department conducting inspections or investigations
as well as to individuals to whom the information pertains, the individual's
legal representative, or other legally authorized people.
(d) Individual records must be kept by a
provider for a period of at least three years. When an individual moves or an
AFH-DD closes, copies of the individual's records must be transferred to the
individual's new residence.
provider must comply with ORS
in all other matters pertaining to confidential records and release of
INDIVIDUAL ACCOUNT RECORDS. For an individual not yet capable of managing money
as determined by their ISP team or legal representative, a provider must
prepare, maintain, and keep current a separate and accurate written record of
all money received or disbursed on behalf of or by the individual.
The account record must include the
(A) Date, amount, and source of
(B) Date, amount,
and purpose of funds disbursed.
Signature of the provider or caregiver making the entry.
(b) Purchases of $10.00 or more made on an
individual's behalf must be documented by receipts unless an alternate amount
is otherwise specified by the individual's ISP team.
(c) An individual's Personal Incidental Funds
(PIF) are to be used at the discretion of the individual for things such as
clothing, video games, and snacks (not part of daily diet) as addressed in
(d) Each account record
must include the disposition of the room and board fee the individual pays to
the foster care provider at the beginning of each month.
(e) REIMBURSEMENT TO INDIVIDUAL. A provider
must reimburse an individual for any missing funds within the custody of the
provider or due to theft or mismanagement on the part of the provider, resident
manager, or caregiver. Reimbursement must be made within 10 business days from
the date of verification the funds are missing.
(f) Financial records must be maintained for
at least seven years.
PERSONAL PROPERTY RECORD. A provider must
prepare and maintain an accurate individual written record of personal property
that has significant emotional or monetary value to each individual as
determined by a documented ISP team or legal representative decision. The
personal property record must include the following:
(a) A description and identifying number (if
(b) Date of inclusion in the
(c) Date and reason for
removal from record.
of person making the entry.
signed and dated annual review of the personal property record for
A provider must collect and
summarize the following information prior to an individual's ISP meeting:
(A) One-page profile reflecting, at a
minimum, information gathered by the provider;
(B) Person-centered information reflecting,
at a minimum, information gathered by the provider; and
(C) Information about known, identified
following information must be developed by a provider and shared with an
individual's services coordinator and the individual, or if applicable the
individual's legal or designated representative, as directed by the Services
(A) Implementation strategies,
such as action plans, for desired outcomes or goals.
(B) Necessary protocols or plans that address
health, behavioral, safety, and financial supports.
(C) A summary of the provider's risk
management strategies in place, including title of document, date, and where
the document is located.
Nursing Service Plan, if applicable.
(E) Other documents required by the ISP
(c) When desired
by an individual, a provider must participate in the individual's ISP team
(d) A provider must agree
in writing to implement the portion of an individual's ISP for which the
provider is responsible for implementing. Agreement may be recorded by the
provider's signature on the individual's ISP or Service Agreement.
(e) A provider must maintain a copy of an
individual's ISP or Service Agreement provided by the CDDP.
(f) A provider must maintain documentation of
implementation of each support and services specified in subsection (b) of this
section. The documentation must be kept current and be available for review by
the individual, the individual's legal representative, CDDP, and Department
provider may not place any limitations to the following freedoms without an
and freedom to access the individual's personal food at any time.
(B) Visitors of the individual's choosing at
(C) A lock on the
individual's bedroom, lockable by the individual.
(D) Choice of a roommate, if sharing a
(E) Freedom to furnish and
decorate the individual's bedroom as the individual chooses in accordance with
their Residency Agreement.
Freedom and support to control the individual's schedule and
(G) Freedom from
restraint, except in accordance with the standards for developmental
disabilities services set forth in ORS
chapter 411, or the relevant Title XIX Medicaid-funding authority.
When an individual's freedom
in subsection (a) of this section may not be met due to a threat to the health
and safety of the individual or others, an individually-based limitation must
be authorized and documented in the individual's ISP in accordance with OAR
A provider is
responsible for the following:
Maintaining a copy of the completed and signed form documenting an individual's
consent to the appropriate individually-based limitation. The form must be
signed by the individual or the individual's legal representative, if
(B) Regular collection
and review of data to measure the ongoing effectiveness of, and the continued
need for, the individually-based limitation.
(C) Requesting a review of the
individually-based limitation when a new individually-based limitation is
indicated, or change or removal of an individually-based limitation is
(a) House rules must be
submitted to the Department prior to implementation and as changes occur and
may be subject to review and approval by the Department.
(b) House rules must be posted in a
conspicuous location in the AFH-DD accessible to individuals and
House rules may not
violate the rights of an individual as stated in ORS
, and described in section (11) of this rule.
(d) House rules may not be in conflict with
these rules or the home and community-based services and settings rules in OAR
chapter 411, division 004.
provider must review and provide a copy of the house rules to each individual,
and as applicable the individual's legal representative, at the time of entry
and annually or as changes occur. The reviews must be documented by having the
individual, or as applicable the individual's legal representative, sign and
date a copy of the house rules. A copy of the signed and dated house rules must
be maintained in the individual's record.
RESIDENCY AGREEMENTS. A provider must
maintain a Residency Agreement with each individual as described in OAR
, and if applicable, specialized contracts with the Department, and
tenancy agreements with room and board tenants.
(8) GENERAL INFORMATION. A provider must
maintain all other information or correspondence pertaining to an
(9) MONTHLY PROGRESS
NOTES. A provider must maintain and keep current monthly progress notes for
each individual that include, at a minimum, the progress of the supports
identified in an individual's ISP or Service Agreement, any medical,
behavioral, or safety issues, or any other events significant to the
(10) POSITIVE BEHAVIOR
SUPPORT PLAN DATA. A provider and caregivers must document, track, and maintain
behavioral data specified in an approved Positive Behavior Support Plan for
BILL OF RIGHTS.
As stated in ORS
individual residing in an AFH-DD has the right to the following:
(A) Be treated as an adult, with respect and
(B) Be informed of all
rights and all house rules.
encouraged and assisted to exercise legal rights, including the right to
(D) Be informed of his or her
medical condition and the right to consent to or refuse treatment.
(E) Receive appropriate care and services,
and prompt medical care as needed.
(F) A safe and secure environment.
(G) Be free from mental and physical
Be free from restraints,
except as described in OAR 411-360-0160
(I) Complete privacy when receiving treatment
or personal care.
(J) Associate and
communicate privately with any person the individual chooses.
(K) Send and receive personal mail
(L) Participate in
activities of social, religious, and community groups.
(M) Have medical and personal information
(N) Keep and use
a reasonable amount of personal clothing and belongings, and to have a
reasonable amount of private, secure storage space.
(O) Manage the individual's own money and
financial affairs unless legally restricted.
(P) Be free from financial exploitation. A
provider may not charge or ask for application fees or nonrefundable deposits
and may not solicit, accept, or receive money or property from an individual
other than the amount agreed to for services.
(Q) A written agreement regarding the
services to be provided and the rate schedule to be charged. A provider must
give written notice 30 calendar days prior to any change in the rates or the
ownership of the AFH-DD.
(R) Not be
transferred or moved out of the AFH-DD without written notice 30 calendar days
in advance and an opportunity for a hearing. A provider may transfer or
discharge an individual only for medical reasons including a medical emergency
described in ORS
or for the welfare of the individual or other individuals residing in the
AFH-DD, or for nonpayment.
free of discrimination on the basis of race, color, religion, sex, sexual
orientation, national origin, marital status, age, disability, source of
income, duration of Oregon residence, or other protected classes under federal
and Oregon Civil Rights laws.
Make suggestions and complaints without fear of retaliation.
(U) Be encouraged and assisted in exercising
all legal, civil, and human rights accorded to other citizens of the same age,
except when limited by a court order.
(b) A provider must guarantee these rights
and help individuals exercise them.
(c) A provider must post a copy of the Bill
of Rights in the entry or other equally prominent place in the AFH-DD. The Bill
of Rights must include the name and phone number of the office to call to
report a complaint.
(d) A provider
must explain and provide a copy of the Bill of Rights along with a description
of how to exercise the rights to each individual and the individual's legal
representative at the time of entry and document in the individual's file that
a copy of the Bill of Rights was provided.
(e) A provider must review the Bill of Rights
with each individual and the individual's legal representative annually or as
In addition to
the rights described in subsection (11)(a) of this section, individuals
receiving home and community-based services in residential and non-residential
home and community-based settings have the right to home and community-based
settings with the qualities described in OAR 411-004-0020
In addition to the rights described in
subsections (11)(a) of this section, individuals receiving home and
community-based services in provider owned, controlled, or operated residential
settings have the right to provider owned, controlled, or operated residential
settings with the qualities described in OAR 411-004-0020
(12) AFH-DD records must be kept
current and maintained by the provider and be available for inspection upon
AFH-DD records must include proof the provider, resident manager, and any other
caregivers have met the minimum qualifications as required by OAR 411-360-0110
The following documentation must be included in the AFH-DD record and made
available for review upon request:
Completed employment applications including the names, addresses, and telephone
numbers of all caregivers employed by the provider. An application for
employment in any capacity in an AFH-DD must include a question asking whether
the person applying for employment has ever been found to have committed
Proof the provider has
an approved background check from the Department in accordance with OAR
, for each subject individual as defined in OAR 411-360-0020
(A) The provider must maintain documentation
of preliminary and final fitness determinations in accordance with these rules
and the background check rules in OAR chapter 407, division 007.
(B) Verification may include printed or
Verification must be readily accessible upon request.
Proof of required training according to
. Documentation must include the date of each training, subject
matter, name of agency or organization providing the training, and number of
(d) A certificate
to document completion of the Department's Basic Training Course for the
provider, resident manager, and substitute caregivers, as applicable.
(e) Proof of mandatory abuse report training
for the provider, resident manager, and substitute caregivers, as
(f) Proof of any
additional training required for the specific classification of an AFH-DD or
the provider, resident manager, and all caregivers, as applicable.
(g) Documentation of caregiver orientation to
the AFH-DD, training of emergency procedures, training on the ISPs or Service
Agreements for individuals, and training on behavior supports and the Nursing
Service Plan (if applicable).
For each person implementing the behavior supports identified in an
individual's Positive Behavior Support Plan, documentation of training on the
individual's Positive Behavior Support Plan and, if applicable, certification
in an ODDS-approved behavior intervention curriculum.
Or. Admin. R.
SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 25-2011(Temp),
f. & cert. ef. 12-1-11 thru 5-29-12; SPD 29-2011(Temp), f. & cert. ef.
12-30-11 thru 5-29-12; SPD 5-2012, f. & cert. ef. 5-29-12; SPD 34-2013, f.
& cert. ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru
47-2014, f. 12-26-14, cert. ef.
12/28/2014; APD 30-2015(Temp), f. 12-31-15,
cert. ef. 1-1-16 thru 6-28-16;
21-2016, f. & cert. ef.
29-2017, amend filed 11/30/2017, effective
30-2018, amend filed 08/09/2018, effective
Statutory/Other Authority: ORS
Statutes/Other Implemented: ORS
443.705-443.825, 443.875 & 443.991