AGING AND DISABILITY SERVICES ADMINISTRATION

December 23, 2004

ADSA: AFH #2004-009
Use of emergency medical services

Dear Adult Family Home Provider:

The Department has become aware of situations in which adult family homes have inappropriately used the local fire department/emergency medical services (911) to pick up residents who have fallen when there are no injuries. If an adult family home (AFH) chooses to admit or retain a resident who has a significant history of falling, or is assessed to be a high risk for falling, the adult family home must have systems and staff in place to be able to respond to non-emergent falls without calling 911.

The following laws and rules apply:

• RCW 70.129.030(3) requires an AFH to admit or retain only those residents whose needs it can safely and appropriately serve in the facility with appropriate available staff.
• WAC 388-76-655(1) prohibits an AFH from admitting or retaining an individual if the home cannot meet the individual’s needs.
• WAC 388-76-655(2) requires an AFH to employ competent and sufficient staff to meet the needs of the residents.
• WAC 388-76-61020 requires an AFH to assess the resident’s needs.
• WAC 388-76-61500 requires an AFH to develop a plan to meet the needs of resident, including appropriate emergency interventions or identified risks.

Adult family homes that choose to admit a resident with a risk of falling must have available staff who are capable of 1) evaluating the resident’s condition after a fall, and 2) assisting the resident back to the pre-fall position, if there is no indication of injuries. The same requirement applies if the AFH chooses to retain a resident who is identified as being at risk for falling after admission.

This letter should not be construed to mean that it is never appropriate to call 911. Clearly, there are occasions when an evaluation reveals the resident may have a medical emergency and calling 911 is appropriate and required. It is not appropriate, however, for adult family homes to routinely call 911 as a primary plan for responding to all resident falls.

Please contact your local Residential Care Services Field Manager if you have further questions regarding this matter.

Sincerely,

Patricia K. Lashway, Director
Residential Care Services