PL. 94-566, known as the Keys Amendment, became effective October 1, 1977. The Keys Amendment requires each state to establish and enforce standards for residential facilities where a significant number of Supplemental Security Income (SSI) recipients reside or are likely to reside.
This statute requires each state to make available for public review certain information about the standards and their enforcement. In accordance with the regulations 45 CFR Part 1397 that implement the Keys Amendment, the following is a summary of licensing standards along with the names and addresses of designated agencies which establish and enforce standards for non-medical residential facilities in which SSI recipients are likely to reside.
All programs and services providing care to more than two individuals with a developmental disability are subject to licensing requirements by the North Dakota Department of Health and Human Services unless the facility is a family boarding home (as defined in North Dakota Century Code 15.1-34-01) or a health care facility (as defined in North Dakota Century Code section 23-17.2-02) other than an intermediate care facility for the developmentally disabled.
Intermediate Care Facilities must have a minimum of four individuals with a developmental disability residing in the facility to be in compliance with certification and licensing requirements.
Standards for the program and services include location requirements, fire and safety, water supply, facility construction or remodeling, appeals process for determinations, staff requirements, admissions policies, insurance, civil rights protection, recreational activities, rate payment requirements, provider assessments, and basic program requirements.
All programs and services providing care to more than two individuals with a developmental disability are subject to licensing requirements by the North Dakota Department of Health and Human Services unless the facility is a family boarding home (as defined in North Dakota Century Code 15.1-34-01) or is a health care facility (as defined in North Dakota Century Code section 23-17.2-02) other than an intermediate care facility for the developmentally disabled.
Standards for the program and services include settings for care, zoning, billing and rate requirements, licensure requirements, whether residential habilitation is to be provided in an agency foster home for adults or in a private residence, such as fire and safety, staff requirements, admissions policies, insurance, civil rights protection, recording and reporting abuse, neglect, exploitation, and use of restraint, documentation and data reporting requirements, and other basic program requirements.
All residential facilities that provide room and board to five or more individuals who are not related by blood or marriage to the owner or manager of the residence and who, because of impaired capacity for independent living require health, social, or personal care services, but do not require regular twenty-four-hour medical or nursing services and:
A. makes response staff available at all times to meet the twenty-four hour per day scheduled and unscheduled needs of the individual;
B. is kept, used, maintained, advertised, or held out to the public as an Alzheimer’s dementia, or special memory care facility; or
C. is attached to a nursing home or assisted living facility, and its staff are available to meet the needs of all residents and comply with state and federal regulations
are subject to licensing requirements by the North Dakota Department of Health and Human Services unless the facility is a medical hospital (as established in North Dakota Century Code 23-16).
Standards for basic care facilities address subject areas relating to definitions, issuance of license, plans of correction, enforcement actions, appeals, governing body, fire safety, education programs, resident assessments and care plans, resident records, personal care services, pharmacy and medication administration services, social services, nursing services, dietary services, activity services, housekeeping and laundry services, adult day care services, end-of life services, and optional Alzheimer’s dementia, special memory care, or traumatic brain injury facility or unit services.
A person providing for the provision of food, shelter, security, safety, guidance, and comfort on a twenty-four hour per day basis in the residential home of a caregiver or agency to an individual age eighteen or older who is unable, neglects, or refuses to provide for the individual’s own care to more than one individual or for more than two adults who are related to each other are subject to licensing requirements by the North Dakota Department of Health and Human Services.
Standards for adult foster care address subject areas relating to licensure, zoning, fire and safety, health (including medical reports), criminal history record checks, insurance, record keeping, general building requirements, confidentiality of records of facilities pertaining to adults receiving services, meals and nutrition, emergency plans, critical incident reporting, standards for construction and equipment, and provider qualifications.
Separate standards and licenses relate to foster home for adults and agency foster home for adults. All of the facilities are governed by a specific, unique set of licensing regulations and law.
A person providing for the provision of substitute parental child care for those children who are in need of care for which the child’s parent, guardian, or custodian is unable, neglects, or refuses to provide, and includes the provision of food, shelter, security and safety, guidance, and comfort on a twenty-four-hour basis, to one or more children under twenty-one years of age to safeguard the child’s growth and development and to minimize and counteract hazards to the child’s emotional health inherent in the separation from the child’s family in a licensed, certified, or approved family foster home for children, supervised independent living program, or qualified residential treatment program for more than thirty days during a calendar year are subject to licensing requirements by the North Dakota Department of Health and Human Services.
A person is exempt from licensing if the care is provided in the home of an identified relative, the home of a kinship relative, a home or institution under the management and control of the state or political subdivision, or a home or facility furnishing room and board primarily to accommodate the child’s educational or career and technical education needs.
Standards for youth foster care address subject areas relating to fire and safety, building standards, health (including medical reports), licensure, record keeping, confidentiality of records pertaining to minors receiving services, criminal history records checks, qualifications for individuals residing in the home, critical incident reporting, discipline, and documentation requirements.
Separate standards and licenses relate to family foster care for children, certified family foster home for children, supervised independent living program, or qualified residential treatment program for children. All of the facilities are governed by a specific, unique set of licensing regulations and law.
A person who owns or leases an institution or district part of an institution to provide health care under the supervision of a licensed health care practitioner and continuous nursing care for twenty-four or more consecutive hours to two or more residents who are not related to the licensee by marriage, blood, or adoption, and who do not require care in a hospital setting are subject to licensing requirements by the North Dakota Department of Health and Human Services.
Standards for Skilled Nursing Facilities address definitions, application for and issuance of a license, access and surveillance by Department, plan of correction, bed capacity, governing body, physical environment, emergency plan, quality improvement program, education programs, medical services, nursing services, infection control, resident assessment and care plan, dietary services, resident records, pharmaceutical services, social services, activity services, specialized rehabilitative services, housekeeping, maintenance, and laundry, secured units, and adult day care.
The above-named facilities are licensed by the North Dakota Department of Health and Human Services, State Capitol, 600 East Boulevard, Bismarck, North Dakota 58505-0250.
The Life Skills and Transition Center serves as a specialty care and support resource for eligible individuals with developmental disabilities who are experiencing crisis or would benefit from stabilization.
Standards relate to eligibility requirements, residential and nonresidential service standards, client discharge and placement procedures, accreditation standards, rates for services provided, maintenance of an internal quality assurance review committee, confidentiality of treatment records, program management, fire inspection, qualifications of the superintendent, and other basic program requirements.
Life Skills and Transition Center is accredited by the Council on Quality and Leadership, 100 West Road, Suite 300, Towson, Maryland 21204.