47 Trial Lawyer • Fall 2023 Blair Townsend By Blair Townsend OTLA Guardian Brandon was born with severe autism and grew up non-verbal, visually impaired and deaf. His doctors suggested Brandon’s mental aptitude would remain that of a 3-year-old but his family disagreed. Growing up, Brandon was smart, loving, active, mischievous and incredibly teachable. His family engaged teachers, the community and educational modules to help Brandon find his voice. He was able to communicate with his family using a communication board and limited sign language to express his needs and desires. As we all know (or hope), a parent’s love is not predicated on or measured by a child’s abilities or independence. Brandon grew up in a loving and supportive family with a mother who retired to become Brandon’s sole caregiver. However, as Brandon grew and entered puberty (with its attendant hormones and growing muscles), it became increasingly difficult for Brandon’s mother to manage her son’s care on her own. Children and adults with Brandon’s diagnoses are more likely to develop anxiety, strong emotional responses and physical outbursts that can cause injury to themselves or others, particularly as they get older. By the time Brandon was 21, he was significantly taller and stronger than his mother and she, alone, could not safely manage his care. Brandon’s family looked into the cost of private care but the cost was prohibitive. What does a parent do in this impossible situation? Go bankrupt or potentially create a harmful home environment for themselves and Brandon? Of course not. They turn to residential care facilities, sometimes referred to colloquially (and inaccurately) as adult foster homes. Regulatory scheme Residential care facilities (RCF) offer long-term services and supports to older adults and people with disabilities who wish to remain in the community but need assistance with personal care and health-related tasks. Often, each resident with disabilities, like Brandon, requires one-on-one or two-on-one supervision and caregivers are (supposed to be) trained on providing essential care for a resident’s activities of daily living such as dressing, mobility, hygiene, bathing, toileting and medication management. In conjunction with the resident’s families and the public entities, discussed below, detailed care plans are created to address and provide the specific supporting services for a resident’s activities of daily life. They are often enumerated in an individual support plan and a behavioral support plan. RCFs are highly regulated. RCFs are licensed to operate and conduct business through the state Department of Human Services (DHS). The services offered by an RCF to residents like Brandon are coordinated, regulated, supervised and partly paid for by the applicable county and the state by and through DHS. In conjunction with DHS and the applicable Oregon Administrative Rules, the county also licenses and supervises RCFs, under the, for instance, Multnomah County Administrative Rules and the Adult Care Home Program. Both public entities have the obligation and power to take immediate actions to protect the health, safety and welfare of residents. When examining these cases, be aware of this overlapping regulatory jurisdiction. Essentially, when a potential case comes in, you need to be aware of the potential parties in the case and whether Giving A Voice to Those Silenced Residential Care Facility Abuse See Residential Care Facility p 48
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