Your Rights in Care Settings

Introduction: Your Home, Your Rights

An Adult Foster Home (AFH) in Oregon is legally defined and operated under a philosophy that distinguishes it from larger, more institutional care settings. These are single-family residences where providers offer care and services in a "homelike environment" to five or fewer adults.

The legal structure and the physical structure work in tandem to create an environment that should feel more like a home with supportive services than a medical facility. Providers are legally and ethically bound to protect, support, and actively assist residents in the full exercise of their rights.

The Cornerstone: Resident's Bill of Rights

At the heart of these protections is the official "Resident's Bill of Rights," a document codified in state law under Oregon Revised Statute (ORS) 443.739 and distributed by the Department of Human Services (DHS).

The provider's duty is not merely to refrain from violating these rights, but to actively "guarantee these rights and help residents exercise them," establishing a proactive and supportive role for the caregiver.

Core Pillars of Dignity and Autonomy

The Right to Respect, Dignity, and Safety

The most fundamental right is to "be treated as an adult with respect and dignity". This principle is the lens through which every interaction and policy within the home must be viewed.

Freedom from Abuse

You have the absolute right to be free from:

• Mental and physical abuse
• Verbal harassment
• Corporal punishment
• Involuntary seclusion

Safe and Secure Environment

The provider must furnish a safe environment that meets all building and fire codes, including:

• Unobstructed stairways and exits
• Functional handrails
• Fire extinguishers on each floor
• Proper emergency preparedness

Non-Discrimination and LGBTQIA2S+ Protections

Oregon law provides robust protections for all residents. Providers cannot discriminate based on:

• Race, color, religion, sex, or national origin
• Sexual orientation or gender identity
• HIV status

The Right to Privacy

The AFH is your home, and the law protects your privacy in three key domains:

Personal and Medical Confidentiality

All medical and personal information must be kept confidential and cannot be shared without your consent, except in specific legally defined circumstances.

Privacy in Personal Care

You have "complete privacy when receiving treatment or personal care". Activities like bathing, dressing, or medical treatments must be conducted privately.

Privacy of Physical Space

• You have the right to a lockable bedroom door
• You must receive a key to your room
• The lock must allow single-action release from inside
• Provider may keep a master key only for emergencies

Personal Freedom and Choice

You retain control over your daily life, including:

• Your schedule: When to wake, sleep, and bathe
• Access to food: Freedom to access food at any time
• Personal belongings: Keep and use personal items
• Room decoration: Furnish your space as agreed
• Roommate choice: Choose who you share with

Connection, Community, and Communication

The Unqualified Right to Visitors

This right is balanced only by:

• Visitors respecting other residents' rights and privacy
• Reasonable limits on indefinite stays

Social and Community Engagement

You have the right to access and participate in:

• Social groups
• Religious activities
• Community events
• At least 6 hours of weekly activities in the home

The provider must actively encourage and assist you in exercising these rights.

Unfettered Communication

Your communication rights include:

• Private association with anyone you choose
• Sending and receiving unopened mail
• Access to a telephone with privacy
• Accommodations for communication needs

Your Voice in Your Own Healthcare

Informed Consent and Refusal

You retain full authority over your body and healthcare decisions:

• Right to be fully informed of your medical condition
• Right to consent to or refuse any treatment
• Right to refuse medications or therapies
• Provider must respect your decisions

Strict Prohibition on Unjustified Restraints

The High Bar for Using Restraints

A restraint may ONLY be used if ALL of these conditions are met:

1. Ordered by a physician or qualified practitioner
2. Consented to by you or your legal representative
3. Used only for documented medical reasons
4. Used only after less intrusive alternatives have failed

The "Individually-Based Limitation" (IBL) Process

Any restraint requires extensive documentation including:

• Specific assessed need
• Alternative interventions tried
• Why alternatives didn't work
• Regular reassessment plan
• Your documented consent
• Assurance of no harm

Advance Directives and End-of-Life

Your autonomy extends to end-of-life wishes:

• No discrimination regarding Advance Directives
• POLST forms must be honored
• DNR orders must be respected
• No pressure to create or rescind these documents

Financial Protections and Your Residency Agreement

Understanding Your Residency Agreement

Before moving in, you must receive a written, legally enforceable agreement that:

• Details all services and rates
• Provides tenant-like protections
• Discloses all home policies
• Cannot waive your rights or provider liability

Financial Independence and Protection

Providers are strictly prohibited from:

• Charging application fees
• Accepting money beyond agreed rates
• Accepting substantial gifts or loans
• Influencing financial decisions

Protections Against Involuntary Discharge

30-Day Written Notice Requirement

You cannot be transferred or moved involuntarily without:

• At least 30 days advance written notice
• Use of state-approved Form SDS 0901
• Delivery to you and your representatives
• Valid legal reason for discharge

Valid Reasons for Discharge

You can ONLY be discharged for:

1. Medical reasons: Needs exceed home's capabilities
2. Safety: Documented danger to self or others
3. Nonpayment: Failure to pay agreed fees
4. Closure: Home closing or license termination

Right to Appeal

You have the right to:

• Challenge discharge through administrative hearing
• Have an impartial judge review evidence
• Contact the Ombudsman for advocacy
• Receive help navigating the process

Enforcing Your Rights: Complaints and Advocacy

The Right to Complain Without Fear

Retaliation is prohibited and includes:

• Increasing charges or decreasing services
• Threatening changes to your care
• Harassment in any form
• Forcing you to leave

The Long-Term Care Ombudsman

Your most important advocate is the Office of the Long-Term Care Ombudsman (LTCO):

• Independent state agency
• Free and confidential services
• Can enter AFHs at any time
• Investigates and resolves complaints
• Advocates for policy changes

How to File a Complaint

1. Internal Resolution: Discuss with provider if safe
2. Contact Ombudsman: Most effective for any issue
3. File Licensing Complaint: For rule violations
4. Report Abuse: Call Elder Abuse Hotline immediately

Key Resources and Contacts

Living with Dignity and Security

The State of Oregon has established comprehensive protections to ensure residents of Adult Foster Homes live with dignity, autonomy, and security. These are not abstract ideals but specific, legally enforceable standards.

By understanding these rights, you are better equipped to:

• Identify potential violations
• Communicate effectively with providers
• Assert your legal protections
• Access help when needed