Foster Care Manual: Mental Retardation
This information has been excerpted from materials specific to one state. Be sure to check with your Foster Care Specialist for details in your state, county, or province.
Provider homes that provide services to individuals (referred to clients or children in other programs) who are placed through county mental retardation programs are licensed as Family Living and Community Homes. Family Living homes can provide services for up to two individuals. Community Homes can provide services for three or more individuals. Both programs receive licensure through the State Office of Mental Metardation.
Provider Parent Training
Family Living Provider Parents - Both parents must have at least 24 hours of pre-service training, as well as, 24 hours of training on an annual basis. Both parents must receive training by a certified trainer in first aid, CPR, and Heimlich techniques prior to an individual living in the home.
Community Homes Provider Parents and Staff - Anyone that works with an individual (staff) in a Community Home must receive pre-service training, as well as, 24 hours of training on an annual basis. Both parents and anyone that works with an individual must receive training by a certified trainer in first aid, CPR, and Heimlich techniques prior to an individual living in the home. Also, provider parents and staff all must have pre-service general fire-safety training, as well as, fire safety training by an expert on a yearly basis.
Respites
Individuals in the Family Living and Community Homes programs are able to choose to visit in the homes of family and friends. The homes that they stay in need not necessarily be licensed for the individual to stay over night. This is to promote the individual being able to freely socialize and visit with others. Still, whenever the provider parent is arranging a respite for an individual, it is hoped that as often as possible the individual can be placed into a provider home with this Agency. This usually assures greater safety, consistency, and ease of monitoring by the family living and program specialist.
Physical Site Regulations
Family Living and Community Homes - Many of the different regulations regarding the specific site regulations are the same as those in other programs. Still, there are some exceptions. When the home serves physically disabled individuals there must be appropriate accommodations made to promote the safety and reasonable access of the individual. Hot water temperature in the home must not exceed 120 degrees F. All interior stairs and outside steps must have a non-skid surface (e.g. carpeting, rubber strips, rough finished concrete, etc). All landings must be at least as wide as stairs leading to those landings. Individual bedrooms cannot be in basements unless there is a standard door leading from the level directly outside to grade level. Each individual sharing a bedroom must have a minimum of 50 square feet of living space, and an individual occupying a single bedroom must have a minimum of 80 square feet of space. Each individual who uses a wheelchair must have a minimum of 100 square feet of bedroom space.
One additional regulation for Community Homes is that there cannot be either ammunition or firearms present in the home unless the Office of Mental Retardation has granted that home a waiver for this regulation.
Fire Regulations
Family Living Homes - Furnaces must be cleaned annually. Cleaning is not required for gas or electric furnaces (except to change the filters). Portable space heaters may never be used while the individual is in the home. Wood and coal burning stoves must first be inspected and approved for safe installation by a fire safety expert before being used. Wood and coal burning stoves, including chimneys and flues, must be cleaned at least every year if used more frequently than once per week during the winter season. Fire drills must be held at least every 3 months. A fire drill must be held during sleeping hours at least once every 12 months. Alternate exit routes must be used during fire drills. Fire drills must be held on different days of the week and at different times of the day and night. All family members and individuals must be trained in fire safety within 31 days of an individual living in the home and retrained annually. Fire extinguishers must be checked annually to ensure operation.
Community Homes
The fire safety regulations described above for Family Living Homes also apply to Community Homes with the following exceptions. There must be written notification to the local fire department of the address of the home and the exact location of the bedrooms of individuals who need assistance evacuating in the event of an actual fire. Furnaces must be inspected and cleaned at least annually by a professional cleaning company. The inspection/cleaning must be documented. Inspections must be done for all furnaces including gas and electric furnaces. Cleaning is not required for gas and electric furnaces (except to change the filters). Portable space heaters cannot be used in the home. If the home serves four or more individuals, or if the home has three or more stories including the basement and attic, there must be at least one smoke detector, interconnected and audible throughout the home, or an automatic fire alarm system that is audible throughout the home. If a smoke detector or fire alarm is inoperative, notification for repair must be made within 24 hours and repairs must be completed within 48 hours of the time the detector or alarm was found to be inoperative. A fire safety expert must inspect and approve all fire extinguishers on an annual basis. Fire drills must be held at least once per month. A fire drill must be held at least once per every 6 months during sleeping hours. All provider parents and staff must be trained annually by a fire safety expert. Individuals must be also trained on an annual basis in fire safety (in areas as specified by regulation), unless they are medically or functionally unable.
Restrictive Procedures
Restrictive procedures are defined as practices that limit an individual’s movement, activity, or function. Also, they are practices that interfere with an individual’s ability to acquire positive reinforcement. All provider parents and staff will receive training and information in regard to restrictive procedures.
One thing to remember is that punishments (i.e. Time Out) and reward systems that may be appropriately used in other programs, may be considered a restrictive procedure if used with a mentally retarded individual. Certain necessary restrictive procedures can be used, but only when attention is given to following the procedures promulgated by the regulations for Family Living and Community Homes programs.
Provider Parent Health
Family Living Homes - All family members must have physicals before accepting an individual into the home. This physical must include a tuberculin skin test by Mantoux method. If a tuberculin skin test is positive then an initial chest x-ray is required. Physical forms are available from the Family Living Specialist. It is important that these forms be used as they contain the necessary component areas.
Community Homes - All family members and staff must have general physicals (including tuberculin skin test by Mantoux method) before working with individuals and every 2 years thereafter. If a tuberculin skin test is positive then an initial chest x-ray is required. Physical forms are available from the Program Specialist. It is important that these forms be used as they contain the necessary component areas.
Individual Health
All individuals in Family Living and Community Homes must have a physical examination within 12 months prior to admission and annually thereafter. This physical must include tuberculin skin testing by Mantoux method. If a tuberculin skin test is positive then an initial chest x-ray is required. Physical forms are available from the Program Specialist. It is important that these forms are used as they contain the necessary component areas.
All individuals 17 years of age and younger must have a dental examination (including teeth cleaning or checking gums and dentures) on a semiannual basis. All individuals 18 years and older must have a dental examination (including teeth cleaning or checking gums and dentures) on an annual basis. All follow-up dental work as indicated by the examination must be completed.
Medication Administration
It is important that all provider parents and staff be trained and proficient in the administration of medication to individuals. This training is available from the Program Specialist or Family Living Specialist in your home, as well as, through regular group trainings provided through the Family Care Services yearly training schedule. In addition, Community Home Provider parents and staff must complete and pass a Medication Administration Course (and annual practicum) before being able to administer any medications to individuals in the home.
Incidents and Unusual Incidents
An incident is any occurrence in the home that results in an injury or a change in the usual status or behavior of an individual. Any time that a provider parent or staff observes any such incident, it should be reported to the Family Living or Program Specialist so that an incident report may be written and filed.
An unusual incident is abuse or suspected abuse of an individual; injury, trauma, or illness of an individual requiring inpatient hospitalization; suicide attempt by an individual; violation or alleged violation of an individual’s rights; an individual who is missing more than 24 hours or who could be in jeopardy if missing at all; alleged misuse of individual funds or property; outbreak of a serious communicable disease; an incident requiring the services of a fire department or law enforcement agency; and any condition that results in closure of a home for more than one day. Any unusual incidents must be immediately reported to the Program Specialist or Family Living Specialist for your home so that an unusual incident report can be written and filed.
Client Funds
Individuals in our MR programs who receive Supplemental Security Income (SSI) have their room & board, clothing, and other expenses paid from these funds by their representative payee who may be a provider parent or a natural family member. When a provider parent or natural family member is representative payee, that individual pays a monthly room and board bill to this Agency and makes the client’s funds available for clothing, spending money, and other expenses. The representative payee is accountable to the Social Security Administration for the client’s funds. Provider parents must maintain detailed records of the sources and uses of client funds held as representative payee or as temporary custodian.
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