Information for Adult Family Home Providers | DSHS

Announcements

AFH Online License Application
Instructions:
Written | Audio | Video

Informal Dispute Resolution

AFH License Application process informational slideshow

Reporting Abuse and Neglect in Adult Family Homes Webinar (May 7, 2024 Recording)

AFH online license application note: There are certain symbols that can create errors or prevent submission in the completed application. Do not use the following symbols &, =, +, or #. Instead, use the following terms: (and) (equals) (plus) (number sign), spelling out the words, with parentheses on either side. See the updated Instructions for the license application for details. We are researching a permanent fix to this issue and will advise you of any changes.

Background checks during and after licensure:

For new license applications
For change of ownership

If you have any questions regarding the Adult Family Home (AFH) application process, please contact the Business Analysis and Applications Unit at baau@dshs.wa.gov. If you have general questions about opening an AFH, please reach out to Resource Support and Development at resourcedevelopment@dshs.wa.gov.

AFH Information

Disaster Preparedness Rulemaking

Provider Letters and Rule Changes

Dear Provider Letters
Updates to Chapter 388-76 WAC Webinar | PowerPoint
AFH Rule Filings
- DSHS Rule-making Process
- CR 101 - Proposed Rulemaking - Chapter 388-76 WAC (Medication Transfer and Disposal)
- CR 101 - Proposed Rulemaking - Chapter 388-76 WAC (ESHB 1120 - Licensing Inspection Timelines)
- CR 103P - Permanent Rules - Chapter 388-76 WAC
  - Concise Explanatory Statement / Summary of Changes
- CR 101 – Proposed Rulemaking – 388-76 WAC (8 bed capacity & liability insurance)
- CR 101 – Proposed Rulemaking - Chapter 388-76 WAC (TB Testing)
  - View CR 101
- CR 101 – Proposed Rulemaking - Chapter 388-76 WAC (Background Checks)
  - View CR 101
- CR 101 – Proposed Rulemaking Chapter 388-76 WAC (ESHB 1120 Licensing Inspection Timelines)

Do my caregivers need the Home Care Aide certification?

Yes, they will have to be Home Care Aide certified unless they meet one of the following exemptions:

RNs, LPNs, and certified nursing assistants (NA- C/CNA) or persons in an approved CNA training program;
Medicare certified home health aides;
Person with special education training and an endorsement granted by the Superintendent of Public Instruction; or
Employed as a LTC worker sometime between 1/1/2011 and 1/6/2012 AND who completed the training requirements in effect at the time. Must have proof of that employment meeting the requirements of DOH WAC 246-980-070. Long-Term Care Employment Verification form (DOH 675-006)

Forms

AFH Applicant Attestation - Household Members & Background Check Requirements (DSHS 27-252)
AFH Information Changes Form (DSHS 10-585) Word / PDF
AFH Personnel Changes (DSHS 02-709)
AFH IDR Request Form (DSHS 27-179)
Caregiving Experience Attestation (CEA) Form (DSHS 10-417)
Disclosure of Charges Form Word / PDF (DSHS 15-449)
Disclosure of Services Form Word / PDF (DSHS 10-508)
Instructions for Completing and Submitting Disclosure Forms
AFH Incident Log (DSHS 13-645)
Notice of Transfer & Discharge (DSHS 15-458)
Request for AFH Application Fee Waiver (DSHS 15-436)
Request Licensed Bed Capacity Increase (DSHS 06-168) Word / PDF
Request Licensed Bed Capacity Decrease (DSHS 06-169) Word / PDF
Search DSHS Forms
Sample AFH Evacuation Drill Word/PDF
Adult Family Home Management Agreement: Attestation Information and Attachments (DSHS 27-226)
AFH Negotiated Care Plan Sample Template (updated 04/2024)

Health care and health care decision making

Nurse Delegation in Community Based Settings
Medication Assistance
69.41 – Legend Drugs – Prescription Drugs
Medicaid Rates for Contracted Home & Community Residential Care Services
FDA Recalls
Department Of Health (DOH)
Flu Information
Advance Directives & Informed Consent Fact Sheet (Word)
DOH POLST Information
RCS/DOH Medical Test Site Waiver Regulatory Requirements Materials
- Provider Letter AFH #2024-047
- Video
- PPT Slides
- MTSW Webinar Q&A
- MTSW Readiness Checklist
Required Reportable Diseases and Conditions
Side Rail Safety

How do I contact RCS and what can I expect during/after inspections?

How do I protect vulnerable adults?

Resources

AFH Information Sheets
AFH Annual License Fee
AFH Sample Contracts
CareLearn Washington
CHOW (Change of Ownership)
Emergency Evacuations Reporting Reminder
In the event of a facility/home evacuation, you must report it to RCS. Report online or call 1-800-562-6078. Include the information in the list at this link in your report.
Infection Control Essentials for Community Programs – PowerPoint Presentation
Opioid Abuse: Facts & Prevention Tips
RCS Standard Operating Procedures Manual
Resident Rights & Alternate Decision-Makers
IRS Notice 2014-7, Difficulty of Care Payments
Home and Community Based Services (HCBS) & New Federal Rules
Significant Change Frequently Asked Questions
Tax Exclusion
Do you qualify for this potential earned income tax exclusion?

What are the laws and regulations for operating an AFH?

What are the training requirements?

Approved Instructors for AFH Training Classes
Training Information for AFH
- Instructor and Curriculum Alert
Adult Family Homes Food Safety & Food Worker Card
Caregiving Experience Attestation (CEA) form (DSHS 10-417)

Where do I find background check information?