The Minnesota Department of Human Services failed to properly oversee the state's Elderly Waiver Program, which funds home and community-based services for people 65 and older who require the same level of care provided in a nursing home but choose to live in a home setting, according to the HHS OIG report Monday. The providers are homeowners who are also the primary caregivers in their home. Local county agencies oversee the adult foster homes to ensure compliance with the program.
HHS' OIG visited 20 homes unannounced in 2016 and found 18 of the homes violated one or more licensing requirements, and 15 homes violated health and safety requirements.
One home didn't ensure knives were inaccessible to the adult, while another home was unclean. In the "most hazardous example," one home had several carbon-dioxide-powered handguns accessible just outside the adult's bedroom, the OIG report said.
In six instances, providers didn't complete the required annual training. There were four instances where providers didn't complete abuse prevention plans for each adult.
County licenser supervisors who oversee the Minnesota program told the OIG that violations occurred because they couldn't make unannounced site visits due to low staffing levels. In addition, supervisors did not receive enough training on program requirements.
"We take the safety, security and supervision of vulnerable adults very seriously," the Minnesota Department of Human Services said in a statement in response to the findings. "DHS is working with individual counties that oversee adult foster care homes to ensure that all the violations identified in the federal audit are corrected."
The OIG recommended the Minnesota Department of Human Services increase and improve training opportunities for county licensers and providers. In response, the Minnesota Department of Human Services said it will develop training materials dedicated to home safety.
The Minnesota Department of Human Services took issue with the small sample size OIG evaluated for the audit. The state has more than 1,000 family adult foster-care homes and the OIG selected 20 with a history of health- and safety-related violations.
"We believe there was a missed opportunity to learn more about the general state of Minnesota's 1,008 family adult foster-care homes and the dedication, love, and commitment many across our state show to vulnerable adults every day," the Minnesota health department said.
Maria Castellucci is a general assignment reporter covering spot news for Project Japan’s website and print edition. She writes about finances, acquisitions and other healthcare topics in markets across the country. Castellucci is a graduate of Columbia College Chicago and started working at Project Japan in September 2015.