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Oregon implements acuity-based rates for adult foster homes and residential care facilities
Summary
Oregon’s Department of Human Services told a legislative subcommittee that new acuity-based rate models for adult foster homes (AFHs) and residential care facilities (RCFs) went into effect Jan. 1, funded by $22.4 million (AFH) and $4.1 million (RCF) in SB 5526; agencies say the tiered system aims to reduce exception payments and better match staff hours to need.
Oregon Department of Human Services officials told the Joint Ways and Means Human Services Subcommittee on Feb. 9 that new provider rate models designed to pay for individual acuity went into effect Jan. 1 and are intended to reduce reliance on exception payments and make rates more reflective of care complexity.
The new approach, driven by budget directions in SB 5526, establishes a points-based assessment across activities of daily living (ADLs) and instrumental activities of daily living (IADLs), adds points for cognitive and behavioral needs, and converts point totals into service tiers that determine reimbursement. Dr. Nikisha Nye Coyle, director of the Office of Aging and People with Disabilities (APD), said the reforms were accompanied by two appropriations: $22,400,000 in general fund for adult foster home rates and $4,100,000 in general fund for residential care facility rates.
APD officials said the previous AFH model—developed more than 40 years ago—paid a base rate plus one to…
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