BISMARCK – Jessica Nelson is worried about burnout. Working a 24-hour job with a break equivalent to a day and half per week, the adult foster home provider pleaded with North Dakota legislators Tuesday for a little more time off.

Nelson, of rural Towner, worked with District 6 legislators to introduce House Bill 1460, which adjusts the amount of respite or substitute caregiving allowed in adult foster homes. The House Human Services Committee heard the bill Tuesday.

Nelson, who worked in the long-term care industry for several years before opening an adult foster home, specializes in residents with dementia. Licensed for four residents, she said she currently has two full-time residents and a third resident who comes periodically. She finds and funds her own respite and substitute caregivers as she receives no public money.

Caring for individuals with dementia is a 24-hour job, Nelson said.

“The state allows an adult foster care home provider to only have 96 days off a year. That is equivalent to about a day and a half a week. Anything over eight hours is considered a day off,” said Nelson, who listed her average work week at 120 hours.

The bill proposes a “calendar day” be 12 hours of caregiving rather than eight hours and that respite or substitute caregivers be allowed to provide an adult foster home operator with 136 days off a year rather than 96 days.

Because time off is so limited, she has to weigh taking time to attend her daughter’s basketball games against taking a week’s summer vacation, Nelson said.

“It’s burning me out, and it’s taking away from my kids. But I love my job. I love helping people, and I think there’s a need for adult foster homes,” she said. “I’m willing to share what I can do – my cares – but please don’t make it to where I have to neglect my family to do so, because I think it could really be done beautifully together.”

Bill sponsor Rep. Dick Anderson, R-Willow City, said North Dakota needs more facilities like Nelson’s because residents in rural communities often don’t have many options for long-term care.

Rep. Paul Thomas, R-Velva, a co-sponsor, said care also can be provided at a reduced cost compared to a nursing home, resulting in savings to families and the state.

He called HB 1460 “one small change to try and assist people that are doing this foster care to better be able to comply with the law and then also allow them to provide those services.”

North Dakota has 11 licensed adult foster care homes, according to the North Dakota Department of Health and Human Services.

Thomas also stressed the importance of the bill’s inclusion of an interim study on adult foster home licensing. The study would consider the barriers to receiving services for older adults and adults with disabilities; regulatory restrictions that create challenges for facilities, providers and caregivers; and funding or reimbursement limitations in federal and state law.

“There’s a lot of things in the Century Code when it comes to adult foster homes that definitely are confusing, and it doesn’t feel like it is necessarily looking at the caregiver in any aspect,” Nelson said.

Elements of state law also can be unworkable, such as requiring spontaneous family visits at any time, she said. In caring for residents who need assistance in every aspect, having a schedule is essential to ensuring everyone’s needs are met, she explained.

The committee requested Nelson and the bill’s sponsors provide as much information as possible related to the scope of the study so any bill amendments can be added to better direct the interim work.

Nelson suggested the Legislature investigate adult foster care in other states.

“The way that they’re modeled in different states is actually really neat, and I think they’re worth looking into,” she said.