Background:

Caregivers in an adult family home or assisted living facility must meet training standards in three areas: orientation, basic training, and continuing education. Caregivers must receive special training if they work in a setting with residents who have special needs, such as dementia, developmental disabilities, or mental illness.

Nursing homes must have a staff development program to ensure that each employee receives initial orientation training and appropriate inservice education to help residents maintain the highest practicable level of physical, mental, and psychosocial well-being. To accomplish this, nursing homes must assess the training needs of each employee and determine the special needs of the resident population that may require additional emphasis in training. One method of determining the needs of nursing home residents is through the federally required Minimum Data Set. The Minimum Data Set is a clinical assessment tool that evaluates the physical, psychological, and psychosocial capabilities of nursing home residents for developing an individual care plan.

Nursing homes must also meet certain staffing level requirements. The standards require that nursing homes maintain levels of direct care staff that are adequate to provide at least 3.4 hours of direct care per resident per day. Nursing homes may include geriatric behavioral health workers when calculating their minimum staffing requirements. To be considered a geriatric behavioral health worker, an employee must: (1) have at least three years of experience caring for persons with chronic mental health issues, dementia, or intellectual and developmental disabilities; (2) have advanced practical knowledge in aging, disability, mental illness, Alzheimer's disease, and developmental disabilities; and (3) if he or she holds less than a master's degree in social work, be directly supervised by an employee who has a master's degree in social work or a registered nurse.

Summary:

The Department of Social and Health Services must adopt minimum competencies and standards for approving curricula for: (1) facility-based caregivers serving persons with behavioral health needs; and (2) geriatric behavioral health workers. The curricula must be at least 30 hours in length and cover the diagnosis, care, and crisis management of residents with a mental health disorder, traumatic brain injury, or dementia. The curricula must be outcome-based and a caregiver's competency must be measured through an examination.

The completion of the behavioral health curriculum by a nursing home employee may substitute for the experience requirement for becoming recognized as a geriatric behavioral health worker. The requirement that a geriatric behavioral health worker have either a bachelor's or master's degree in social work is removed.

The recognition of hours worked by geriatric behavioral health workers as counting toward minimum staffing requirements is limited to total hours as adjusted by the proportion of resident days of clients at the nursing home with a behavioral health condition. "Behavioral health conditions" are defined as one or more behavioral symptoms specified in Section E of the Minimum Data Set.

Votes on Final Passage:

House	98	0
Senate	48	0