Foster care for adults

Adult foster care provides residential care for people age 18 and over who need supportive housing and services due to physical, emotional, developmental or mental health reasons. Providers of adult foster care are responsible for residents' food, lodging, protection, supervision and household services. Providers must be licensed. The county evaluates prospective homes and recommends licenses for those that meet state standards, monitors providers for compliance, and supports quality foster homes for adults.

Client needs and choices drive placement decisions.

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Prospective providers

Thank you for your interest in the adult foster care at Hennepin County. Licenses fall into two categories.

Corporate adult foster care providers

The State of Minnesota has a moratorium on new corporate adult foster care facilities, and has capped the number of homes allowed. Counties cannot grant licenses for corporate applicants unless those providers plan to serve specific clients who meet certain criteria.

You can find information on the moratorium exception process and exception-eligible client development. Learn more about the moratorium and related processes.

The county has no information about when the state will lift the moratorium. It would require new action by the state legislature. Occasionally, the county will issue a request for interest for providing corporate adult foster care. These are usually posted on the county's contracting page.

Family adult foster care providers

In family adult foster care, the license applicant opens the home where they reside to an adult with special needs. The county currently has a waiting list for new family adult foster care providers. To receive an application and be placed on the waiting list, potential providers must attend an orientation session. Information and registration for an orientation session may be obtained by contacting familyadultfostercare@hennepin.us.

If you currently meet any of the following criteria, county licensors will meet with you individually and provide you with an application:

If you have an existing adult foster care license in another county and plan to move with your residents to Hennepin County
If you are taking over the duties of an existing Hennepin County provider who is retiring
If a child in foster care is aging out and the child/guardian choose to remain in your home, which requires you to become licensed for adult foster care

Operating an adult foster care home involves regulation and attention to business detail that require time and organization. Requirements include learning and following laws, rules and policies, and completing forms. County licensing staff work with you in the licensing process, but the license itself is issued by the State of Minnesota. County licensing staff can help you understand state licensing requirements but it is ultimately your responsibility to operate your home in compliance with the rules of your license.

Licensing requirements

The home must be in Hennepin County.
The applicant must be at least 18 to live in the home.
The applicant must pay for a fire marshal inspection and pass the inspection. Your licensor prepares the request form.
If renting, the applicant must get permission from the landlord to have a fire inspection. The landlord must make any fire safety-related corrections at their own expense, including to any adjoining units in a multi-unit dwelling. Licensors have the form needed to document landlord permission for the fire marshal.
The applicant must pay for a criminal background check for themselves, every household member 13 and older and all substitute caregivers they intend to use. Everyone must pass the background check.
All household members must cooperate with a social history interview and submit a written autobiography.
Provide three references from non-relatives.
No more than four foster residents can be admitted; five are allowed if they’re all elderly residents over 55, none of whom have a primary diagnosis of mental illness or development delay.
Have bedroom space for each resident. Single occupancy bedrooms must have at least 80 square feet of floor space with a 7 ½ foot ceiling. Double occupancy rooms must have at least 120 square feet of floor space with a 7 ½ foot ceiling. Expecting foster residents to share a bedroom might severely limit the number of people interested in your home.
Complete a site visit and home study with a county licensor.
Complete at least three hours of orientation including training in vulnerable adult law.
Agree to abide by state laws and county policies regulating adult foster care including accepting placements only through a county licensor.

How providers are paid

All providers receive base payment for the room, board and supervision they provide residents. Providers receive additional payment for other services they provide each resident (often referred to as the difficulty of care rate). Providers can also receive payment from the residents themselves, when residents receive earned income or public assistance. Residents can keep a personal needs allowance, and the rest goes to the cost of their care.

As of July 1, 2015, the base rate is $891/month. The maximum supplemental rate set by the state is $482.84.

Some adult foster care providers can receive payments for specific services through waivered services programs instead of the supplemental rate. If you intend to serve disabled persons under 55 who are on a waiver, you would apply to the Minnesota Department of Human Services for a Home and Community-Based Services (also known as HCBS or 245D) program license. There is a fee for this license set by the state. If you intend to serve vulnerable adults over 55, you would enroll as a provider to accept elderly waiver supplemental funding through the Minnesota Department of Health.

After you're licensed

Providers maintain their license by working with the county to:

Maintain safety and certain physical conditions in the home.
Complete required paperwork.
Cooperate in making sure residents are a good match for the home.
As needed, ask for support and participate in problem-solving.
Cooperate with investigations of alleged license violations.
Follow and learn relevant rules and laws governing adult foster care services.
Follow orders of the State of Minnesota, including orders for correcting license problems or violations.
Learn and follow changes to adult foster care rules and procedures.

Licensing process

If you believe you can meet the above criteria, contact the licensing intake at 612-348-2816.
Receive basic information, an application, and some biographical information forms to complete and return.
County licensing will contact the three references you have listed.
Complete an intake interview with a county licensor in your home.
Complete state background studies and receive clearance letters (there is a cost for this)
Have an inspection by a fire marshal in your home (approximately $50).
Complete the writing of required policies and procedures for your home.
Complete a three-hour orientation.
County licensing staff makes a recommendation to the state whether to issue a license.
The state makes the final licensing decision.
Licenses are generally issued for two year periods, after the first year of licensing.

The application process generally takes four to six months.

Current family adult foster care providers

The security, consistency and warmth of your setting allow vulnerable adults to live and participate in the community. The county values your work.

Meeting your business responsibilities

Operating an adult foster care home involves regulation and attention to business details spelled out in state statute or rule. County licensing staff can help you understand the requirements, but you have the ultimate responsibility to operate your home according to the rules of your license.

Training for family adult foster care homes

Annually for the first five years of your license, you must receive 12 hours of training. After that, each year you must have six hours of training. In addition, every year a review of vulnerable adult mistreatment reporting is required. Family members or substitutes who provide care for more than eight hours per week or more than 30 days per year must also document their training hours. Additional training requirements apply to license holders of 245D home and community-based services.

Access online training for all vulnerable adult mistreatment reporting.

Training and support group opportunities

The Family AFC Support Group will meet Tuesday, November 3 from 10 a.m. to noon at the Brookdale library building, 6125 Shingle Creek Parkway, Conference Rooms A and B, Brooklyn Center. The training room is to the left of the Library entrance.

The training topic will be Vulnerable Adult Maltreatment Reporting followed by an open support session. This session will meet your annual requirement to review Vulnerable Adult Law. RSVP to Darlene Lanning: 612-247-0416.

Newsletters

The Hennepin County adult family foster care newsletter goes out periodically to all providers and is free.
The national Adult Family Caregiver Network Newsletter is available with a paid subscription, and you can get a price break through the county. Your licensor will notify you in April or May during annual renewal.

Forms

As a licensed adult foster care provider, you must obtain and annually update certain records about each resident in your care. You must keep these records for at least five years after each placement ends.

Resident records

Resident information
Guardianship/conservatorship court papers (updated as needed)
Individual resident placement agreement (original and most recent)
Resident's medication permissions and log
Individual abuse prevention plan (original and most recent)
Mobility assessment (original and most recent)
Documentation of medical equipment training
Signed notification of a communicable/contagious disease (if applicable)
Difficulty of care rating sheet
Cash resources record
Foster care resident's rights and vulnerable adult law information (from within 72 hours of original placement)
Incident report forms
Resident progress notes

Home records of policies and procedures

You must have written policies and procedures, review these every two years and update them as needed.

You must provide copies to your county licensing worker:

Forms you must provide at re-licensing

Financial information

Group residential housing funds

Base rate for July 1, 2015 to June 30, 2016 is $891/month
Supplemental rate (difficulty of care) maximum is $482.84
Minimum to be spent on food per resident is $194/month
Each resident’s personal needs allowance for 2015 is $97/month
GRH agreement renewals are sent out each spring for signatures

Waiver

Residents may qualify for waiver funding to receive services, if they’re at risk of placement in a nursing home. To receive waiver payment for the additional services you provide, you must apply separately for a home and community-based services license through the state. Consult with your county licensor for more information.

If you already have a 245D-HCBS license to bill the state for waivered services, email questions to the state at DHS.245Dlicensehelp@state.mn.us or call 651-431-6624.

Licensing look-up

This tool allows you to look up the status of your license by your name, county or by your license number. Look up your license.

Required reporting

You must report the following to your county licensing worker:

Within five calendar days of any change in the regular membership of the household or caregiver's employment status
Within 24 hours after a fire, storm or other damage
Within 24 hours of the start of repair or remodeling that requires a building permit
Immediately after any serious injury or death of a resident. Serious injury means an injury that requires treatment by a doctor
Within 24 hours of a change in health status of a caregiver that could affect the ability of the caregiver to care for a resident
Immediately after a resident, caregiver or household member is diagnosed with a communicable disease
At least 30 days before the involuntary discharge of a resident who does not have an individual service plan
Within seven days after the transfer or voluntary discharge of a resident

Mistreatment and serious injury/death reporting

If you witness or suspect that a resident is being maltreated, (abused or neglected), you must call the state reporting line at 844-880-1574. Also, complete an incident report form.

If a resident is developmentally delayed, mentally ill or elderly, you must report any serious injury or death to the Department of Human Services-Office of the Ombudsman (1-800-657-3591), as well as the case manager, guardian and your county licensor.

Statutes and rules for family adult foster care providers

Referring case managers

Adult foster care allows people who need supportive housing services an opportunity to live and participate in the community in a residential setting with overnight supervision and support. County and state philosophy emphasize that people who need this type of care have choices in their housing and that the services they receive are person-centered. The state defines minimum standards of care, placement documentation, and oversight. The state also requires that people seeking adult foster care as a housing option meet eligibility criteria.

There are two options in adult foster care settings: family or corporate.

Corporate adult foster care

Corporate homes are residential settings where the license holder does not reside in the home. Residents can receive services either from the corporation licensed to operate the home, or from another licensed service provider. Most Hennepin County residents in corporate adult foster care have pre-qualified for waivered services funding to pay for residential support services.

How to find vacancies

HB101 Places is a tool that can be used to search for housing vacancies, including corporate adult foster care homes. Check this site for updates. Currently, those interested in corporate adult foster care housing options must contact individual providers to ask about vacancies. For information on licensed providers, visit the DHS licensing information lookup.

Due to the moratorium on new corporate foster care development, people interested in corporate adult foster care may find information on alternative housing options by visiting Minnesota health care facilities programs.

New corporate development

The state has imposed a moratorium on the growth of corporate foster care. The moratorium created a statewide cap on beds and created a process that allows for new corporate adult foster care homes for individuals who meet specific eligibility criteria.

If you are interested in developing new corporate foster care beds, the clients you plan to house must meet one of these criteria:

Individuals with a hospital level of care (CAC or BI-NB waivers)
Settings that require MN Statute 144D housing with services registration (80 percent or more of the residents are age 55 or older)
Closure of a nursing facility, ICF/DD, regional treatment center, or due to restructuring of state-operated facilities and closure plans in place
Those transitioning out of Minnesota State Security Hospital
Those transitioning out of Anoka Regional Treatment Center

For more information on the moratorium and exceptions, please visit the State Department of Human Services.

How to refer residents for placement

Hennepin County licensors are not involved in screening or matching referrals to corporate adult foster care homes. Providers screen and match referrals to their own homes. Once you have selected a home that meets your or your client's housing needs and choices, contact the provider directly.

Case manager responsibilities

Work with the person you serve, their team and the provider to determine appropriateness of placement, client choice, payment logistics and paperwork.

Post-placement concerns or complaints

Hennepin County seeks input on how corporate adult foster care homes are performing and can assist with complaints and concerns. If you do not know the licensor for a specific corporate adult foster care home and would like to reach them, contact the county at 612-348-2816.

Family adult foster care

In family homes, the license holder lives in the home and is the primary caregiver. Most adults in family adult foster care in Hennepin County qualify for either group residential housing funds or pay with private funds. Some family providers hold an additional license to accept waiver payments.

Placement in a family’s home brings additional considerations in matching the needs and choices of the individual served with the provider.

People generally appropriate for family adult foster care

Able to benefit from living in a family setting
Able to maintain activities of daily living, under supervision
Willing to accept services, follow a treatment plan and cooperate with the placement agreement
Are involved in day programming, school, are employed, or engaged in some other kind of meaningful daytime activity
Function at the moderate, mild, or borderline level of developmental disability
Have emotional or mental health problems for which they are receiving appropriate treatment but are not acute at time of placement
Be an elderly person unsafe in their own home
Have physical limitations or impairments that require limited physical assistance with activities of daily living
Need and accept some supervision in basic living skills such as hygiene, cooking, or budgeting
Cooperate with taking prescribed medication
Agree to have background information shared with the adult foster care provider
Are recovering from chemical dependency but have had one year or greater of sobriety and consistently follow their recovery plan

People generally inappropriate for family adult foster care

Have a history of fire setting
Have a history of committing sexual abuse
Have a recent or significant history of assaulting others
Have a legal history of endangering others in a home environment
Are unable or unwilling to accept the expectations of a family environment, including respecting household rules, family members' privacy and refraining from verbal abuse, lying, stealing or excessive complaints
Need close round-the-clock monitoring including providers who are awake at night
Refuse to work with service professionals as determined by their placement agreement
Are unwilling to make required or agreed-upon payments to the foster care provider
Are currently considered chemically dependent and not participating in a treatment or recovery plan.

People who might be a match for family adult foster care

Resist attending to personal hygiene
Smoke – most of the county’s adult foster care homes are non-smoking
Engage in self harm
Require some nursing care
Are without a day program
Have a physical condition that requires extensive assistance or home modifications
Have disruptive sleeping habits
Have failed in previous placements
Have made a suicide attempt in the past year
Have less than one year of sobriety and are following their recovery plan
Have very limited or no background information available

Finding vacancies in family adult foster care

Note that county licensing staff must approve all family placements prior to move-in.

Complete a placement request form.
Email the form to familyadultfostercare@hennepin.us. They will review your referral for a possible match and get back to you within two business days.

New development in family adult foster care

See potential provider section for more information.

Referring to family adult foster care

Once you identify a potential home, you must interview the provider and visit the home to determine if the provider can meet the client’s needs.

Considerations before placement

Case managers must arrange for the client to have a physical exam, within 30 days prior or three days after placement. The exam must document that your client is free of communicable/contagious disease. If coming from a health care facility, a physical transfer summary satisfies this requirement.
Case managers must ensure that foster care providers are aware of and arrange for training in the use of needed medical equipment.

Required forms for family adult foster care

The case manager must have these documents completed on or before the date the resident moves in and make sure they're updated at least yearly. Licensors can answer questions about the forms and participate in pre-placement meetings.

Individual resident placement agreement and ISP or CSSP (if available)
Individual abuse prevention plan (IAPP)
Vulnerable adult law information form
APS reporting vulnerable adult maltreatment
Information form
Client medical
Mobility access assessment
Resident’s medication record
Cash record form
Client sign-off on rights form

Paying for family adult foster care

Before placement, the case manager establishes the payment sources and how payments will be made. Most clients have some portion of their foster care paid through group residential housing (GRH) funds. Application for those funds must be made by the date of placement.
The case manager is responsible for communicating all financial information and requirements to the client or client’s representative.
Make sure the client understands what their share of the cost of care will be, whether the source of payment is public or private.
Make alternate payment arrangements if the client has trouble making timely or complete payments.
Check that the foster provider has a 245D HCBS license for clients whose service rate will be paid by a disability waiver program.
Complete the difficulty-of-care (DOC) process for non-waiver clients to establish a service rate to be paid by group residential housing funding.
The case manager should facilitate getting the Shelter Verification Form to the provider and assist in completion and submission as needed.

Follow-up case manager responsibilities

Follow-up with your client and the provider within 30-days of placement to evaluate the appropriateness of placement and modify the placement plans if needed.
Meet with the provider and client in the foster home annually, or more frequently if needed, to review and sign the placement records and modify them as needed.
Call the foster provider periodically to discuss placement issues and case planning.
Call the county licensor if you have concerns about your client’s care in a particular foster home.
Complete the county’s provider evaluation form

Post-placement concerns or complaints

County licensors seek case manager input on how homes are performing and can assist with complaints and concerns. Send your complaints or concerns to familyadultfostercare@hennepin.us.

Considering family adult foster care

Choosing family adult foster care allows a person to become part of a family in a family home. This allows residents to participate in family and community life. In family adult foster care, the primary caregiver remains the same for as long as a resident lives in the home, allowing the family to get to know the resident as a whole person.

Persons generally appropriate for family adult foster care

Able to benefit from living in a family setting
Able to maintain activities of daily living, under supervision
Willing to accept services, follow a treatment plan and cooperate with the placement agreement
Are involved in day programming, school, are employed, or engaged in some other kind of meaningful daytime activity
Function at the moderate, mild, or borderline level of developmental disability
Have emotional or mental health problems for which the person is receiving appropriate treatment but are not acute at time of placement
Be an elderly person unsafe in their own home
Have physical limitations or impairments that require limited physical assistance with activities of daily living
Need and accept some supervision in basic living skills such as hygiene, cooking, or budgeting
Cooperate with taking prescribed medication
Agree to have background information shared with the adult foster care provider
Are recovering from chemical dependency but have had one year or greater of sobriety and consistently follow their recovery plan

Persons generally inappropriate

Have a history of fire setting
Have a history of committing sexual abuse
Have a recent or significant history of assaulting others
Have a legal history of endangering others in a home environment
Are unable or unwilling to accept the expectations of a family environment, including respecting household rules, family members' privacy and refraining from verbal abuse, lying, stealing or excessive complaints
Need close round-the-clock monitoring including providers who are awake at night
Refuse to work with service professionals as determined by their placement agreement
Are unwilling to make required or agreed-upon payments to the foster care provider
Are currently considered chemically dependent and not participating in a recovery plan

Persons who might be a match

Resist attending to personal hygiene
Smoke — most of the county’s adult foster care homes are non-smoking
Engage in self harm
Require some nursing care
Are without a day program
Have a physical condition that requires extensive assistance or home modifications
Have disruptive sleeping habits
Have failed in previous placements
Have made a suicide attempt in the past year
Have less than one year of sobriety and are participating in a recovery plan
Have very limited or no background information available

Required referral to live in an adult foster care home

To live in an adult foster care home, a resident must get a referral from an assessor or case manager. If a resident doesn't have one, call county staff at 612-348-4111.

Community members with concerns

Responsibilities of adult foster care providers

Adult foster care consists of qualified caregivers providing housing, meals, supervision and services based on the individual needs of a resident. Adults who live in adult foster care have chosen this kind of housing due to physical, emotional, developmental or mental health reasons. State law protects these adults from any type of mistreatment.

Anyone with a concern about a currently-licensed home

If you witness or suspect that a resident of a licensed adult foster home in Hennepin County is being abused or neglected, call 844-880-1574 (toll free).

If you are concerned about something other than mistreatment, call 612-348-2816. Be prepared to give the address of the home and, if you have it, the name of the person who operates the adult foster care home.

You can also look up the status of an adult foster care license license (type of license, expiration date, and any negative action against the license holder) by entering the license holder’s name, address, city or county.

Visit the state licensing lookup.

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