MALA Annual Conference
Lansing Center
Lansing, MI
Wednesday May 17, 2017, 10:30 a.m.
Licensing Update from AFC & Camps
Licensing Division
Grant Sutton, AFC Consultant, Grand Rapids
Jay Calewarts, Director, AFC & Camps Licensing
Division
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
LARA/Bureau Overview
• Shelly Edgerton, LARA Director
• Larry Horvath, Bureau Director
• Currently there are 4 Divisions:
–
–
–
–
AFC and Camps Division (includes AFC, HFA and camps)
Child Care Licensing Division
Federal Survey and Certification Division
Health Facilities Licensing, Permits & Support Division
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Bureau of Community and Health
Systems (BCHS) Org Chart
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
AFC & Camps Org Chart
27 new consultants in last 2 years!
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
HFA Inspection Cycle
• MCL333.20155. (1) …the department shall make at
least 1 visit to each licensed health facility or agency
every 3 years for survey and evaluation for the
purpose of licensure.
– Reduces regulatory burden on providers
– More time for staff to focus on initial applications and
complaints
• Changed in October of 2015
• License renewal still required annually
• Policy is to inspect every other year unless get
manager approval to go earlier or extend.
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
HFA TB screening
• Requirement for screening of residents and staff at
an HFA changing
• New testing/screening requirements based on CDC
guidelines and risk assessment
• Anticipated that new requirements will be
approved in upcoming months (JCAR currently
reviewing)
• Working on similar language for AFC
• See link for proposed HFA rule revisions
–
http://w3.lara.state.mi.us/orr/Rules.aspx?type=Number&id=R 325.1901
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Inspection Model
• Move from Interview and Observation to full
inspection model for renewals
– Because of increasing complaints/serious violations
– June or July of 2017
– Still have interview and observation as part of
inspection
– Hope to catch issues early and get it corrected before
someone is seriously hurt
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
AFC Council Rule Review
• MCL 400.710(5) The rules shall be reviewed by the
council not less than once every 5 years.
• Have begun to review rules as required by law
• Currently reviewing special certification rules
• Hope to have draft AFC rule changes for special
certification ready for public comment before end of
summer
• Once complete with special certification will move to
other AFC rule sets
• Any proposed rule changes you may have, please
send to me at [email protected]
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Referrals to APS
• Have heard comments about increased APS visits
• Likely because of a 2015 and 2016 audit by OAG
where they found AFC Licensing was not referring all
instances as required to APS
• As a result of the audit, LARA is now referring
everything that may be considered abuse, neglect or
exploitation upon receiving complaint
• Continue to work with APS to try and decrease
unnecessary referrals to APS
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Environmental Inspections
• Policy revised environmental inspections by
local health department on June 1, 2016
• Will request local health departments to
inspect AFC’s with private well or private
sewage disposal system initially and upon
renewal (including Family Homes)
• Could be requested in other instances as
needed
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Assessment Plan and
Individual Plan of Service
• Make sure that you and your staff know the
assessment plan and individual plan of service
• Review resident history and ask the placing
agency questions if things are missing from
plan of service
• You as a licensee are responsible to ensure
that the resident is safe and free from harm
• If not in the placing agencies plan, it is not a
free pass
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
AFC Definition
Definition of foster care (Act 218)…
“The provision of supervision, personal care and
protection in addition to room and board for 24 hours
a day, 5 or more days a week and for 2 or more
consecutive weeks for compensation.”
Definition of adult foster care facility
“a governmental or nongovernmental establishment
that provides foster care to adults.”…
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Is a License Required? (AFC)
•
•
•
•
•
•
•
Provision of supervision
Provision of personal care
Provision of protection
Provision of room and board
Twenty-four hours a day
Five or more days a week
Two or more consecutive weeks for
compensation
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
HFA Definition
Definition of Home for the Aged per MCL
333.20106 (3)
“A supervised personal care facility…that
provides room, board, and supervised personal
care to 21 or more unrelated nontransient,
individuals 60 years of age or older.”
Note that it goes on to say that it can be less
than 20 individuals if in a distinct part of a
nursing home.
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Is a License Required?
• Investigating unlicensed providers is complaint
driven
• 195 unlicensed investigations in 2016, 56 in 2017
however some are still ongoing
• 9 substantiated unlicensed providers to date in
2017; 49 in 2016, 36 in 2015 and 41 in 2014
• Work with unlicensed provider to achieve
compliance
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Is a License Required?
• Workgroup was formed over a year ago to discuss
LARA’s interpretation of the law
• Members include a representative from MALA,
Leading Age, MCAL, The Arc Michigan, MPAS, AFC
Advisory Council, State LTC Ombudsman and LARA.
• Discussions originally focused on AFC but were not
able to come to a consensus.
• HFA became focus as we felt that we could come to
a consensus
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
SB 378 HFA Amendments
• Senator Knollenberg is expected to introduce a bill
to revise the Public Health Code for Homes for the
Aged. It is believed that this bill would include:
– Board and Care model for Fire Safety review for existing
facilities
– More clearly defines “supervised personal care”
– Attestation that room and care parties are unrelated
– 55 years old or older
– Cap background checks
– Add a claw back clause that the department can revoke
an exemption for systematic care issues that cause
serious injury, death or mental anguish
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Fire Separation-Group Home
• Rule 511. (1) If the heating plant is located in
the basement of a small group home,
standard building material may be used for
the floor separation. Floor separation shall
also include at least 1 3/4-inch solid core
wood door or equivalent to create a floor
separation between the basement and the
first floor.
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Fire Separation-Group Home
Rule 511. (2) Heating plants and other flameproducing equipment located on the same level
as the residents shall be enclosed in a room that
is constructed of material which has a 1-hourfire-resistance rating, and the door shall be
made of 1 3/4-inch solid core wood. The door
shall be hung in a fully stopped wood or steel
frame and shall be equipped with an automatic
self-closing device and positive-latching
hardware.
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Fire Separation-Group Home
Rule 40. (6) Heat-producing equipment located
in a basement shall be separated from the
remainder of the home by means of a floor
separation. Standard building material shall be
sufficient for the floor separation …
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.
Questions & Answers
Email: [email protected]
[email protected]
Lansing Office Address:
611 W. Ottawa Street
Ottawa Building, 1st Floor
PO Box 30664
Lansing MI, 48909
C U S T O M E R D R I V E N.
B U S I N E S S M I N D E D.