Or. Admin. Code § 411-346-0190

Current through Register Vol. 63, No. 12, December 1, 2024

Section 411-346-0190 - Standards and Practices for Care and Services

(1) A foster provider is responsible for supervision and must:

(a) Provide structure and daily activities designed to promote a child's physical, social, intellectual, cultural, spiritual, and emotional development.

(b) Provide playthings and activities in the child foster home, including games, recreational and educational materials, and books, appropriate to a child's chronological age, culture, and developmental level.

(c) In accordance with a child's ISP and as defined in an ODHS-CW Case Plan (if applicable), encourage the child to participate in age-appropriate and developmentally-appropriate activities including, but not limited to, extracurricular, enrichment, cultural, and social activities, and support the child's participation in such activities with the child's family, friends, and on the child's own when appropriate.

(d) Promote a child's independence and self-sufficiency by encouraging and assisting the child to develop new skills and perform age-appropriate tasks.

(e) In accordance with a child's ISP and as defined in an ODHS-CW Case Plan (if applicable), ask the child to participate in household chores appropriate to the child's age and ability that are commensurate with household chores expected of the foster provider's children.

(f) Provide a child with reasonable access to a telephone and to writing materials.

(g) In accordance with a child's ISP and as defined in an ODHS-CW Case Plan (if applicable), permit and encourage the child to have visits with the child's family and friends.

(h) Allow a child regular contact and private visits or phone calls with their CDDP services coordinator and ODHS-CW case worker (if applicable).

(i) Not allow a child in foster care to baby-sit in the child foster home or elsewhere without the permission of their CDDP services coordinator and guardian.

(j) When appropriate, allow a child's parent or guardian to attend to their child in the foster home when prior approval from the Department has been granted.

(A) The foster home provider must request Department approval using the "Child Foster Home Parent/Guardian Attending to Child Request for Approval" form.

(B) The CDDP managing the child's case must submit the form to the Department for review.

(C) If Department approval is granted, the foster provider shall continue to serve as the primary person responsible for the child's supervision.

(2) RIGHTS OF A CHILD. The rights of a child are described in OAR 411-318-0010.

(3) INDIVIDUALLY-BASED LIMITATIONS.

(a) A foster provider may not place any limitations on a child's home and community-based freedoms described in OAR 411-004-0020 without an individually-based limitation consistent with OAR 411-415-0070(3), except when all of the following conditions have been met:

(A) The child is under the age of 18.

(B) The limitation is consistent with community parenting standards for children of the same age who do not experience disabilities.

(C) The foster provider, child's parent or legal guardian, and the ISP team identify and agree upon the limitation appropriate for the child.

(b) A foster provider may not place limitations on a child's freedom from restraint, except in accordance with the standards for developmental disabilities services set forth in OAR chapter 411, the relevant Title XIX Medicaid-funding authority, or OAR 411-346-0195(2).

(c) Prior to implementation, an individually-based limitation must be authorized and documented in the child's ISP in accordance with OAR 411-415-0070.

(d) When an individually-based limitation is implemented for a child, a foster provider is responsible for all of the following:

(A) Maintaining a copy of the completed and signed form documenting informed consent to the individually-based limitation.

(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 change or removal of the individually-based limitation is needed.

(4) RELIGIOUS, ETHNIC, AND CULTURAL HERITAGE.

(a) A foster provider must recognize, respect, and support a child's race, spiritual beliefs, sexual orientation, gender identity and gender expression, national origin, and cultural identities, and provide opportunities to enhance the positive self-concept and understanding of the child's heritage.

(b) In accordance with a child's ISP and the preferences of their guardian, a foster provider must participate with the child's ISP team to arrange transportation and appropriate supervision during religious services or ethnic events for a child whose beliefs and practices are different from those of the foster provider.

(c) A foster provider may not require a child to participate in religious activities or ethnic events contrary to the child's beliefs.

(5) PUBLIC EDUCATION. A foster provider:

(a) Must enroll each school-age child in public school within five school days of their placement and arrange for the child's transportation to school.

(b) Must comply with any Alternative Educational Plan described in a child's Individualized Education Program.

(c) Must be actively involved in a child's school program and must participate in the development of the child's Individualized Education Program. A foster provider may apply to be a child's educational surrogate if requested by the child's parent or guardian.

(d) Must consult with school personnel when there are issues with a child in school and report to the child's guardian and CDDP services coordinator any serious situations that may require Department involvement.

(e) Must support a child in the child's school or educational placement.

(f) Must assure a child regularly attends school or educational placement and monitor the child's educational progress.

(g) May sign consent to any of the following school-related activities:

(A) School field trips within Oregon.

(B) Routine social events.

(C) Sporting events.

(D) Cultural events.

(E) School pictures for personal use only, unless prohibited by the court or a child's guardian.

(h) Must support the involvement of a child's parent (unless limited by court order) and CDDP services coordinator in the child's public education decision-making process.

(6) ALTERNATE CAREGIVERS.

(a) A foster provider must arrange for safe and responsible alternate care.

(b) A child care plan for a child in foster care must be approved by the Department, the CDDP, or ODHS-CW, before the child care plan may be implemented. When a child is cared for by a child care provider or child care center, the child care provider or child care center must be certified as required by the State Child Care Division (ORS 329A.280) or be a certified foster provider.

(c) A foster provider must have a Relief Care Plan approved by a certifying agency or the Department when using alternate caregivers.

(d) A foster provider must assure alternate caregivers, consultants, and volunteers meet the following requirements:

(A) 18 years of age or older.

(B) Capable of assuming foster care responsibilities.

(C) Present in the home.

(D) Physically and mentally capable to perform the duties of the foster provider as described in these rules.

(E) Cleared by a background check as described in OAR 411-346-0150, including an ODHS-CW background check.

(F) Able to communicate with the child, agencies delivering services to the child, the CDDP services coordinator, and appropriate others.

(G) Trained on fire safety and emergency procedures.

(H) Trained on the child's ISP, Positive Behavior Support Plan, and any related protocols.

(I) Able to provide the care needed for the child.

(J) Trained on the required documentation for the child's health, safety, and behavioral needs.

(K) A driver's license and vehicle insurance in compliance with the laws of the Driver and Motor Vehicle Services Division when transporting a child by motorized vehicle.

(L) Not be a person who requires care in a foster care or group home.

(M) Not be the child's parent or guardian.

(N) Complete mandatory reporter training prior to caring for a child.

(e) When a foster provider uses an alternate caregiver and a child is staying at the alternate caregiver's home, the foster provider must assure the alternate caregiver's home meets the child's necessary health, safety, and environmental needs.

(f) When a foster provider arranges for a child's social activities for less than 24 hours, including an overnight arrangement, the foster provider must assure the person is responsible and capable of assuming child care responsibilities and is present at all times. The foster provider still maintains primary responsibility for the child.

(7) FOOD AND NUTRITION.

(a) A foster provider must offer three nutritious meals daily at times consistent with those in the community.

(A) Daily meals must include food from the four basic food groups, including fresh fruits and vegetables in season, unless otherwise specified in writing by a health care provider.

(B) There must be no more than a 14-hour span between the evening meal and breakfast, unless snacks and liquids are served as supplements.

(C) Consideration must be given to cultural and ethnic background in food preparation.

(b) A child must be permitted to acquire, store, and access personal food in the child foster home in a manner consistent with age-typical practices for children living in the community and in accordance with the child's ISP.

(c) Any home canned food used must be processed according to the guidelines of Oregon State University extension services (http://extension.oregonstate.edu/fch/food-preservation).

(d) All food items must be used prior to their expiration date.

(e) A foster provider must implement special diets only as prescribed in writing by a health care provider.

(f) A foster provider must prepare and serve meals in the child foster home. Payment for meals eaten away from the child foster home for the convenience of the foster provider (for example, meals from a restaurant), is a foster provider's responsibility.

(g) When serving milk, a foster provider must only use pasteurized liquid or powdered milk for consumption by a child in foster care.

(h) A child who must be bottle-fed and cannot hold the bottle, or is 11 months or younger, must be held during bottle-feeding.

(8) CLOTHING AND PERSONAL BELONGINGS.

(a) A foster provider must assure each child has their own clean, well-fitting, seasonal clothing appropriate to, the child's individual needs.

(b) A foster provider must support a school-age child's participation in selecting their own clothing that supports the child's personal choice, style, and culture.

(c) A foster provider must allow a child to bring and acquire appropriate personal belongings.

(d) A foster provider must assure when a child leaves their child foster home, the child's belongings, including all personal funds, medications, and personal items, remain with the child. This includes all items brought with the child and obtained while living in the child foster home.

(9) BEHAVIOR SUPPORT PRACTICES.

(a) A foster provider must teach and support a child with respect, kindness, and understanding, using positive behavior theory and practice. Behavior support practices must not include any of the following:

(A) Physical force, spanking, or threat of physical force inflicted in any manner upon a child.

(B) Verbal abuse, including derogatory remarks about a child or their family that undermine the child's self-respect.

(C) Denial of food, clothing, or shelter.

(D) Denial of visits or contacts with family members, except when otherwise indicated in the child's ISP or the ODHS-CW Case Plan (if applicable).

(E) Assignment of extremely strenuous exercise or work.

(F) Threatened or unauthorized use of safeguarding intervention.

(G) Use or threatened use of mechanical restraints.

(H) Punishment for bed-wetting or punishment related to toilet training.

(I) Delegating or permitting punishment of a child by another child.

(J) Threat of removal from the child foster home as a punishment

(K) Use of shower as punishment.

(L) Group punishment for misbehavior of one child.

(M) Locking a child in a room or area inside or outside of the child foster home.

(N) Involuntary seclusion or isolation of a child from others.

(O) Punishing a child by intentionally inflicting emotional or physical pain or suffering.

(P) Use or threatened use of a prone restraint.

(Q) Use or threatened use of a supine restraint.

(R) Use of practices that are abusive, aversive, coercive, disciplinary, demeaning, retaliatory, or for convenience.

(S) Denying or withholding the personal funds of a child.

(b) A foster provider must set clear expectations, limits, and consequences of behavior in a non-punitive manner.

(c) A foster provider may use a time-out only for the purpose of giving a child a short break for the child to regain control. If a foster provider uses time-out, all of the following conditions apply:

(A) Use of time-out must be approved by the child's ISP team and documented in their ISP.

(B) Only common-use living areas of the home are to be used for time-out.

(C) Time-out is to be used for short duration and frequency as approved by the child's ISP team. The duration must be appropriate to the child's chronological age, emotional condition, and developmental level.

(d) POSITIVE BEHAVIOR SUPPORT PLAN. For a child who has demonstrated a serious threat to self, others, or property and for whom it has been decided a Positive Behavior Support Plan is needed, the Positive Behavior Support Plan must be developed by a behavior professional in accordance with OAR chapter 411, division 304 with the approval of the child's ISP team.

(10) SAFEGUARDING INTERVENTIONS AND SAFEGUARDING EQUIPMENT. For the purpose of this rule, a designated person is the person implementing the behavior supports identified in a child's Positive Behavior Support Plan.

(a) A safeguarding intervention must meet the requirements of OAR 411-346-0195.

(b) A designated person must only use a safeguarding intervention or safeguarding equipment according to OAR 411-346-0195.

(c) Prior to the use of a safeguarding intervention or safeguarding equipment, a foster provider must have a copy of a completed and signed form documenting informed consent for an individually-based limitation in accordance with OAR 411-415-0070(3) and section (3) of this rule.

(d) Prior to using a safeguarding intervention or safeguarding equipment, a designated person must be trained.

(A) For a safeguarding intervention, the designated person must be trained in intervention techniques using an ODDS-approved behavior intervention curriculum and trained to the child's specific needs. Training must be conducted by a person who is appropriately certified in an ODDS-approved behavior intervention curriculum.

(B) For safeguarding equipment, the designated person must be trained on the use of the identified safeguarding equipment.

(e) A designated person must not use any safeguarding intervention or safeguarding equipment not meeting the standards set forth in this rule or OAR 411-346-0195 even when the use is directed by the child or the child's parent, guardian, or representative, regardless of the child's age.

(11) RESTRAINT. The use of a restraint must meet the requirements in OAR 411-346-0195.

(12) MEDICAL AND DENTAL CARE. A foster provider must:

(a) Provide care and services as appropriate to a child's chronological age, developmental level, and condition, and as identified in the child's ISP.

(b) Assure the orders of a health care provider are implemented as written.

(c) Inform health care providers of a child's current medications, changes in health status, and if the child refuses care, treatments, or medications.

(d) Inform the guardian and CDDP services coordinator of any changes in a child's health status, except as otherwise indicated in the ODHS-CW Permanent Foster Care contract agreement and as agreed upon in the child's ISP.

(e) Obtain the necessary medical, dental, therapies, and other treatments of care including, but not limited to, all of the following:

(A) Making appointments.

(B) Arranging for or providing transportation to appointments.

(C) Obtaining emergency medical care.

(f) Have prior consent from a child's guardian for medical treatment that is not routine, including surgery and anesthesia, except in cases where an ODHS-CW Permanent Foster Care contract agreement exists.

(g) Keep current medical records. The records must include all of the following, when applicable:

(A) Any history of physical, emotional, and medical problems, illnesses, and mental health status.

(B) Current orders for all medications, treatments, therapies, use of safeguarding intervention, safeguarding equipment, special diets, adaptive equipment, and any known food or medication allergies.

(C) Completed medication administration record (MAR) from previous months.

(D) Pertinent medical and behavioral information, such as hospitalizations, accidents, immunization records, including Hepatitis B status and previous TB tests, and incidents or injuries affecting the child's health, safety, or emotional well-being.

(E) Documentation or other notations of guardian consent for medical treatment that is not routine, including surgery and anesthesia.

(F) Record of medical appointments.

(G) Medical appointment follow-up reports provided to the foster provider.

(H) Copies of previous mental health assessments, assessment updates including multi-axial DSM diagnosis and treatment recommendations, and progress records from mental health treatment services.

(h) Provide, when requested, copies of medical records and medication administration records to the child's guardian, CDDP services coordinator, and ODHS-CW caseworker.

(i) Provide copies, as applicable, of the medical records described in subsection (g)(H) of this section to a licensed health care provider prior to a medical appointment or no later than the time of the appointment.

(j) Support the involvement of the child's parent (unless limited by court order) and CDDP services coordinator in the child's medical and dental care coordination.

(13) MEDICATIONS AND MEDICAL ORDERS.

(a) An authorization by a licensed health care provider must be in a child's file prior to the usage of, or implementation of, any of the following:

(A) All prescription medications.

(B) Nonprescription medications except over the counter topicals.

(C) Treatments other than basic first aid.

(D) Therapies and use of safeguarding equipment as a health and safety related protection.

(E) Modified or special diets.

(F) Prescribed adaptive equipment.

(G) Aids to physical functioning.

(b) A foster provider must have any of the following:

(A) A copy of the authorization in the format of a written order signed by a licensed health care provider.

(B) Documentation of a telephone order by a licensed health care provider with changes clearly documented on the MAR, including the name of the person giving the order, the date and time, and the name of the person receiving the telephone order.

(C) A current prescription or label from the manufacturer as specified by the order of a licensed health care provider on file with the pharmacy.

(c) A foster provider or alternate caregiver must carry out orders as prescribed by a licensed health care provider. Changes may not be made without the authorization of a licensed health care provider.

(d) Each medication for a child, including refrigerated medication, must be clearly labeled with the label of the pharmacist or in the originally labeled container from the manufacturer and kept in a locked location or stored in a manner that prevents access by children.

(e) Unused, outdated, or recalled medications may not be kept in the child foster home and must be disposed of in a manner that prevents illegal diversion into the possession of people other than for which the medication was prescribed.

(f) A foster provider must keep a MAR for each child. The MAR must be kept for all medications administered by the foster provider or alternate caregiver to that child, including over the counter medications and medications ordered by licensed health care providers and administered as needed (PRN) for the child.

(g) The MAR must include all of the following:

(A) The name of the child in foster care.

(B) A transcription of the written order of the licensed health care provider, including the brand or generic name of the medication, prescribed dosage, frequency, and method of administration.

(C) A transcription of the printed instructions from the package for topical medications and treatments without an order from a licensed health care provider.

(D) Times and dates of administration or self-administration of the medication.

(E) Signature of the person administering the medication or the person monitoring the self-administration of the medication.

(F) Method of administration.

(G) An explanation of why a PRN medication was administered.

(H) Documented effectiveness of any PRN medication administration.

(I) An explanation of all medication administration or documentation irregularities.

(J) Any known allergy or adverse drug reactions and procedures that maintain and protect the child's physical health.

(h) Any errors in the MAR must be corrected by circling the error and then writing on the back of the MAR what the error was and why.

(i) Treatments, medication, therapies, and special diets must be documented on the MAR when not used or applied according to the order of licensed health care provider.

(j) SELF-ADMINISTRATION OF MEDICATION. For any child who is self-administering medication, a foster provider must:

(A) Have documentation that a training program was initiated with approval of the child's ISP team or that training for the child was unnecessary;

(B) Have a training program that provides for retraining when there is a change in dosage, medication, and time of delivery;

(C) Provide for an annual review, at least as part of the ISP process, upon completion of the training program;

(D) Assure the child is able to handle the child's own medication regime;

(E) Keep medications stored in a locked area inaccessible to others; and

(F) Maintain written documentation of all training in the child's medical record.

(k) A foster provider may not use alternative medications intended to alter or affect mood or behavior, such as herbals or homeopathic remedies, without direction and supervision of a licensed health care provider.

(l) Any medication used with the intent to alter a child's behavior must be documented in the child's ISP.

(m) BALANCING TEST. When a psychotropic medication is first prescribed and annually thereafter, a foster provider must obtain a signed balancing test from the prescribing health care provider using the Balancing Test Form (form 4110). A foster provider must present the licensed health care provider with a full and clear description of the behavior and symptoms to be addressed as well as any side effects observed.

(n) PRN prescribed psychotropic medication is prohibited.

(o) A mental health assessment by a qualified mental health professional or licensed medical practitioner must be completed, except as noted in subparagraph (A) of this subsection, prior to the administration of a new medication for more than one psychotropic or any antipsychotic medication to a child in foster care.

(A) A mental health assessment is not required in any of the following situations:

(i) In a case of urgent medical need.

(ii) For a substitution of a current medication within the same class.

(iii) A medication order given prior to a medical procedure.

(B) When a mental health assessment is required, a foster provider:

(i) Must notify the ODHS-CW caseworker when a child is in legal custody of ODHS-CW; or

(ii) Must arrange for a mental health assessment when a child is a voluntary care placement.

(C) The mental health assessment:

(i) Must have been completed within three months prior to the prescription; or

(ii) May be an update of a prior mental health assessment that focuses on a new or acute problem.

(D) Whenever possible, information from the mental health assessment must be communicated to the licensed health care provider prior to the issuance of a prescription for psychotropic medication.

(p) Within one business day after receiving a new prescription or knowledge of a new prescription for psychotropic medication for a child in foster care, a foster provider must notify:

(A) The CDDP services coordinator; and

(B) The child's parent when the parent retains legal guardianship or the child's guardian; or

(C) ODHS-CW when ODHS-CW is the child's guardian.

(q) A foster provider's notification to a child's parent or guardian and their CDDP services coordinator must contain all of the following:

(A) Name of the prescribing licensed health care provider.

(B) Name of the medication.

(C) Dosage, any change of dosage, suspension, or discontinuation of the current psychotropic medication.

(D) Dosage administration schedule prescribed.

(E) Reason the medication was prescribed.

(r) A foster provider must get a written informed consent prior to filling a prescription for any new psychotropic medication except in a case of urgent medical need from ODHS-CW when ODHS-CW is a child's guardian.

(s) A foster provider must cooperate as requested when a review of psychotropic medications is indicated.

(14) NURSING SERVICES. When nursing services are provided to a child, a foster provider must:

(a) Coordinate with a registered nurse and the child's ISP team to ensure the nursing services being delivered are sufficient to meet the child's health needs; and

(b) Implement the child's Nursing Service Plan, or appropriate portions therein, as agreed upon by the ISP team and the registered nurse.

(15) COMMUNITY NURSING SERVICES.

(a) Community nursing services include all of the following:

(A) Nursing assessments, including medication reviews.

(B) Care coordination.

(C) Monitoring.

(D) Development of a Nursing Service Plan.

(E) Delegation and training of nursing tasks to a foster provider or alternate caregiver.

(F) Teaching and education of a foster provider and identifying supports that minimize health risks while promoting a child's autonomy and self-management of healthcare.

(G) Collateral contact with a CDDP services coordinator regarding the community health status of a child to assist in monitoring safety and well-being and to address needed changes to the child's ISP.

(b) Community nursing services exclude direct nursing services.

(c) When Department funds are used for community nursing services, prior authorization for community nursing services must be in accordance with OAR 411-048-0180.

(d) After an initial nursing assessment, a nursing reassessment must be completed every six months or sooner if a change in medical condition requires an update to a Nursing Service Plan.

(e) When community nursing services are provided to a child, a foster provider must:

(A) Coordinate with a registered nurse and the child's ISP team to ensure the nursing services being delivered are sufficient to meet the child's health needs; and

(B) Implement the Nursing Service Plan, or appropriate portions therein, as agreed upon by the child's ISP team and registered nurse.

(f) A registered nurse providing community nursing services must:

(A) Be enrolled in the Long Term Care Community Nursing Program as described in OAR chapter 411, division 048;

(B) Meet the qualifications described in OAR 411-048-0210; and

(C) Submit a resume to the CDDP indicating the education, skills, and abilities necessary to provide nursing services in accordance with Oregon law, including at least one year of experience with individuals with intellectual or developmental disabilities.

(g) A registered nurse providing community nursing services must comply with:

(A) Provider record and documentation requirements referenced in OAR 407-120-0100 through 407-120-1505 for financial, clinical, and other records including the Provider Enrollment Agreement and electronic billing procedures;

(B) Department direct contracts (if applicable); and

(C) Service record requirements outlined in this rule.

(16) PRIVATE DUTY NURSING. As defined in OAR chapter 410, division 132 and the Medicaid State Plan, a child or young adult aged 0 through 20 that resides in a child foster home may receive private duty nursing services in accordance with OAR 411-300-0150.

(a) When private duty nursing services are provided, a foster provider must:

(A) Coordinate with a registered nurse and a child's ISP team to ensure the nursing services being provided are sufficient to meet the child's health needs; and

(B) Implement the Nursing Service Plan, or appropriate portions therein, as agreed upon by the ISP team and registered nurse.

(b) A nurse providing private duty nursing services must be an enrolled Medicaid Provider as described in OAR 410-132-0200.

(17) DELEGATION AND SUPERVISION OF NURSING TASKS. Nursing tasks must be delegated by a registered nurse to a foster provider or alternate caregiver in accordance with the rules of the Oregon State Board of Nursing in OAR chapter 851, division 047.

(18) CHILD RECORDS.

(a) GENERAL INFORMATION OR SUMMARY RECORD. A foster provider must maintain a record for each child receiving foster care services in their child foster home. The record must include all of the following:

(A) Child's name, date of entry into the child foster home, date of birth, gender, religious preference, and guardianship status.

(B) Names, addresses, and telephone numbers of the child's guardian, family, or other significant person.

(C) Name, address, and telephone number of the child's preferred primary health care provider, designated back up health care provider and clinic, dentist, preferred hospital, medical card number and any private insurance information, and Oregon Health Plan choice.

(D) Name, address, and telephone number of the child's school program.

(E) Name, address, and telephone number of the child's CDDP services coordinator and representatives of other agencies providing services to the child.

(b) EMERGENCY INFORMATION. A foster provider must maintain emergency information for each child receiving foster care services in their child foster home. The emergency information must be kept current and must include all of the following:

(A) The child's name.

(B) The child's address and telephone number.

(C) The child's physical description, which may include a picture and the date it was taken, and identification of the following:

(i) Race, gender, height, weight range, and color of hair and eyes.

(ii) Any other identifying characteristics that may assist in identifying the child if the need arises, such as marks or scars, tattoos, or body piercing.

(D) Information on the child's abilities and characteristics including, but not limited to, the following:

(i) How the child communicates.

(ii) The language the child uses or understands.

(iii) The child's ability to know how to take care of bodily functions.

(iv) Any additional information that may assist a person not familiar with the child to understand what the child may do for himself or herself.

(E) The child's health support needs including, but not limited to the following:

(i) Diagnosis.

(ii) Allergies or adverse drug reactions.

(iii) Health issues that a person needs to know when taking care of the child.

(iv) Special dietary or nutritional needs, such as requirements around textures or consistency of foods and fluids.

(v) Food or fluid limitations due to allergies, diagnosis, or medications the child is taking that may be an aspiration risk or other risk.

(vi) Additional special requirements the child has related to eating or drinking, such as special positional needs or a specific way foods or fluids are given to the child.

(vii) Physical limitations that may affect the child's ability to communicate, respond to instructions, or follow directions.

(viii) Specialized equipment needed for mobility, positioning, or other health-related needs.

(ix) The child'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 child.

(II) Approaches to use when supporting the child to minimize emotional and physical outbursts.

(x) Any court ordered or guardian authorized contacts or limitations.

(xi) The child's supervision requirements and why.

(xii) Any additional pertinent information the foster provider has that may assist in the child's care and support if a natural or man-made disaster occurs.

(c) EMERGENCY PLANNING. A foster provider must post emergency telephone numbers in close proximity to all phones used by the foster provider or alternate caregivers. The posted emergency telephone numbers must include, but not be limited to, all of the following:

(A) Telephone numbers of the local fire, police department, and ambulance service if not served by 911 emergency services.

(B) The telephone number of any emergency health care providers and additional people to be contacted in the case of an emergency.

(d) WRITTEN EMERGENCY PLAN. A foster provider must:

(A) Develop, maintain, update, and implement a written Emergency Plan for the protection of all children in foster care in the event of an emergency or disaster. The Emergency Plan must:

(i) Be practiced at least annually. The Emergency Plan practice may consist of a walk-through of the responsibilities of the foster provider and alternative caregiver.

(ii) Consider a child's needs and address all natural and human-caused events identified as a significant risk for the child foster home, such as a pandemic or an earthquake.

(iii) Include provisions and sufficient supplies, such as sanitation and food supplies, to shelter in place when unable to relocate for at least three calendar days under the following conditions:

(I) Extended utility outage.

(II) No running water.

(III) Inability to replace food supplies.

(IV) An alternate caregiver is unable to provide relief care or additional support and care.

(iv) Include provisions for evacuation and relocation that identifies all of the following:

(I) The duties during evacuation, transporting, and housing of a child, including instructions to notify the child's parent or guardian, the Department or the Department's designee, the CDDP services coordinator, and ODHS-CW as applicable, of the plan to evacuate or the evacuation of the child foster home as soon as the emergency or disaster reasonably allows.

(II) The method and source of transportation.

(III) Planned relocation sites that are reasonably anticipated to meet a child's needs.

(IV) A method that provides people unknown to the child the ability to identify each child by name and to identify the name of the child's supporting provider.

(V) A method for tracking and reporting to the Department or the Department's designee and the local CDDP, the physical location of each child in foster care until a different entity resumes responsibility for the child.

(v) Address a child's needs including provisions for all of the following:

(I) Immediate and continued access to medical treatment, information necessary to obtain care, treatment, food, and fluids for the child during and after an evacuation and relocation.

(II) Continued access to life-sustaining pharmaceuticals, medical supplies, and equipment during and after an evacuation and relocation.

(III) Behavior support needs anticipated during an emergency.

(IV) The supports needed to meet a child's life-sustaining and safety needs.

(B) Provide and document all training to alternate caregivers regarding the alternate caregiver's responsibilities for implementing the Emergency Plan.

(C) Re-evaluate and revise the Emergency Plan at least annually or when there is a significant change in the child foster home.

(e) INDIVIDUAL SUPPORT PLAN (ISP). Within 60 calendar days of placement, the ISP for a child must be prepared and updated at least annually.

(A) If requested by a child or the child's guardian, a foster provider must participate with an ISP team in the development and implementation of the child's ISP to address the child's behavior, medical, social, financial, safety, and other support needs.

(B) Prior to, or upon entry to, or exit from a child foster home, a foster provider must participate in the development and implementation of a Transition Plan for the child.

(i) The Transition Plan must include a summary of the services necessary to facilitate a child's adjustment to the child foster home or after care plan; and

(ii) Identify the supports necessary to ensure the child's health, safety, and any assessments and consultations needed for ISP development.

(f) FINANCIAL RECORDS.

(A) A foster provider must maintain a separate financial record for each child in foster care. Errors must be corrected with a single strike through and initialed by the person making the correction. The child's financial record must include all of the following:

(i) Date, amount, and source of all income received on the child's behalf.

(ii) Room and board fee paid to the foster provider at the beginning of each month.

(iii) Date, amount, and purpose of funds disbursed on the child's behalf.

(iv) Signature of the person making the entry.

(B) Any single transaction more than $25 purchased with a child's personal funds, unless otherwise indicated in the child's ISP, must be documented in the child's financial record and include the receipt.

(C) A child's ISP team may address how the personal spending money of a child is managed.

(D) If a child has a separate commercial bank account, records from the account must be maintained with the child's financial record.

(E) A child's personal funds must be maintained in a safe manner and separate from the funds of other members of the household.

(F) Misuse of funds may be cause for suspension, revocation, or denial of renewal of a certificate.

(g) PERSONAL PROPERTY RECORD.

(A) A foster provider must maintain a written record of a child's property with a monetary value of more than $25 or that has significant personal value to the child, parent, or guardian, or as determined by the ISP team. Errors must be corrected with a single strike through and initialed by the person making the correction.

(B) Personal property records are not required for a child who has a court approved ODHS-CW Permanent Foster Care contract agreement, unless requested by the child's guardian.

(C) The personal property record must include all of the following:

(i) A description and identifying number, if any.

(ii) The date the personal property was brought into the child foster home or purchased.

(iii) The date and reason for the removal of a child's personal property from the record.

(iv) The signature of the person making the entry.

(h) EDUCATIONAL RECORDS. A foster provider must maintain the following educational records when available:

(A) A child's report cards.

(B) Any reports received from a child's teacher or the school.

(C) Any evaluations received as a result of educational testing or assessment.

(D) A child's disciplinary reports.

(i) Child records must be available to representatives of the Department, the certifying agency, and ODHS-CW conducting inspections or investigations, as well as to the child, if appropriate, and the child's guardian or other legally authorized people.

(j) Child records must be kept for a period of three years. If a child moves or the child foster home closes, copies of pertinent information must be transferred to the new home of the child.

(19) COVID-19. A foster provider must implement all directives related to a child foster home to reduce the spread of the Coronavirus (COVID-19) issued by any of the following:

(a) Governor's Executive Order.

(b) Written instruction to the foster provider from the Local Public Health Authority or the Oregon Health Authority Public Health Division.

(c) Written guidance directed at the foster provider through Department policy.

Or. Admin. Code § 411-346-0190

MHD 15-2000(Temp), f. & cert. ef. 11-30-00 thru 5-28-01; MHD 3-2001, f. 5-25-01, cert. ef. 5-28-01; Renumbered from 309-046-0190, SPD 34-2004, f. 11-30-04, cert. ef. 1-1-05; SPD 10-2007, f. 6-27-07, cert. ef. 7-5-07; SPD 7-2010, f. 6-29-10, cert. ef. 7-1-10; SDP 6-2011(Temp), f. & cert. ef. 2-10-11 thru 8-1-11; SPD 15-2011, f. & cert. ef. 7-1-11; SPD 62-2013, f. 12-27-13, cert. ef. 12-28-13; APD 28-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 46-2014, f. 12-26-14, cert. ef. 12/28/2014; APD 1-2016(Temp), f. & cert. ef. 2-23-16 thru 8-20-16; APD 30-2016, f. 8-18-16, cert. ef. 8/20/2016; APD 29-2017, amend filed 11/30/2017, effective12/1/2017; APD 4-2018, temporary amend filed 02/20/2018, effective 02/20/2018 through 08/18/2018; APD 33-2018, temporary amend filed 08/23/2018, effective 08/23/2018 through 02/15/2019; APD 12-2019, amend filed 02/14/2019, effective 2/15/2019; APD 40-2019, amend filed 10/29/2019, effective 11/1/2019; APD 31-2020, temporary amend filed 07/22/2020, effective 07/23/2020 through 01/18/2021; APD 55-2020, amend filed 12/30/2020, effective 1/1/2021; APD 20-2022, amend filed 04/13/2022, effective 4/15/2022; APD 24-2024, amend filed 05/31/2024, effective 6/1/2024; APD 66-2024, amend filed 11/27/2024, effective 12/1/2024

Statutory/Other Authority: ORS 409.050, 427.104, 430.662 & 443.835

Statutes/Other Implemented: ORS 409.010, 418.519-418.523, 427.007, 427.101, 427.104, 430.215, 430.610, 430.662 & 443.830-443.836