Standards for private organizations

2020 Edition

Adult Foster Care (AFC) 8: Placement Monitoring and Reassessment

Placement monitoring ensures continuity of service and care and timely adjustments to the placement when challenges arise.
2020 Edition

Currently viewing: ADULT FOSTER CARE (AFC)

VIEW THE STANDARDS

Purpose

 Adult Foster Care (AFC) programs support community-based living arrangements for adults in need of long term-services and supports, matching them with in-home caregivers.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for placement monitoring and reassessment
  • Procedures for responding to complaints or problems
  • Tools for placement monitoring and reassessment
  • Schedule of home visits
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 
Fundamental Practice

AFC 8.01

Placement monitoring procedures include: 
  1. a frequency schedule of in-person visits made to the home;
  2. assignment of responsibility for ensuring services are being accessed and are appropriate and satisfactory;
  3. annual health status reports, either provided by the qualified personnel or documentation by the caregiver’s and service recipient’s primary care physicians;
  4. documentation to be provided by the caregiver, and
  5. responsiveness to any complaints or problems that may develop.

Interpretation

Regarding element (c) health status reports should be completed annually, on a schedule, and after every medical emergency or significant change in functioning.

 

AFC 8.02

Qualified personnel meet with the caregiver and service recipient at least annually to conduct formal placement reassessments and: 
  1. within five working days of a precipitating event;
  2. when there is a significant change in the individual’s status or circumstances, or a new issue arises; and
  3. within 48 hours of notification when a hospital or institutional discharge is imminent.

 

AFC 8.03

Placement reassessment includes: 
  1. conditions of the home environment;
  2. changes in baseline functioning status of the service recipient, including increased needs;
  3. community integration, including frequency of the individual engaging in community activities and ability to access community activities independently; and
  4. changes in the household make up.

 

AFC 8.04

Caregivers and case workers develop a system of documentation and communication regarding: 
  1. completion of ADLs and IADLs;
  2. the service recipients physical, mental, and emotional status within the household;
  3. medication; and
  4. services utilized.

 
Fundamental Practice

AFC 8.05

Case workers regularly monitor the placement and: 
  1. have a schedule of caregiver documentation review; and
  2. communicate with other service providers to assess service participation and effectiveness.