WSR 03-22-091

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed November 5, 2003, 10:58 a.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 03-19-117.

     Title of Rule: WAC 388-71-05640 through 388-71-05952 Individual provider and home care agency provider qualifications.

     Purpose:

•     Incorporating nurse delegation core training in in-home settings, as required by HB 1753 (chapter 140, Laws of 2003).

•     Rules are reorganized for clarity and to allow for future revisions.

     See Explanation of Rule for a list of proposed new rules.

     Statutory Authority for Adoption: RCW 74.39A.050, chapters 18.79 and 18.88A RCW.

     Statute Being Implemented: RCW 74.39A.050, chapters 18.79 and 18.88A RCW, chapter 140, Laws of 2003.

     Summary: Incorporating nurse delegation core training requirements in in-home settings and reorganizing rules for clarity and to allow for future revisions.

     Reasons Supporting Proposal: To meet requirements of HB 1753 (chapter 140, Laws of 2003).

     Name of Agency Personnel Responsible for Drafting: Barbara Hanneman, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2540; Implementation and Enforcement: Kay Kramer Sievers, 3906 172nd Street N.E., Suite 101, Arlington, WA 98223, (360) 651-6828.

     Name of Proponent: Department of Social and Health Services, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: Incorporating nurse delegation core training in in-home settings, as required by HB 1753 (chapter 140, Laws of 2003). Existing rules are reorganized for clarity and to allow for future revisions.

     This rule making includes adoption of proposed new sections WAC 388-71-05805 What is nurse delegation core training?, 388-71-05810 What knowledge and skills must nurse delegation core training include?, 388-71-05815 Is competency testing required for nurse delegation core training?, 388-71-05820 Is there a challenge test for nurse delegation core training?, 388-71-05825 What documentation is required for successful completion of nurse delegation core training?, 388-71-05830 Who is required to complete nurse delegation core training?, and 388-71-05895 What additional qualifications are required for instructors of nurse delegation core training?

     Proposal Changes the Following Existing Rules: Existing WAC 388-71-05800 through 388-71-05952 will be renumbered ("recodified") to allow for future revisions of this chapter. See the list of current (listed as "old") WAC numbers and their corresponding new WAC numbers at the end of the accompanying WAC text. Minor clarifying changes and WAC references have also been made to existing rules.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the rules and concluded that no new costs will be imposed on the businesses.

     RCW 34.05.328 applies to this rule adoption. The department has determined that the rules meet the definition of a "significant legislative rule." A cost benefit analysis was completed and is available upon request from Tiffany Sevruk, Home and Community Services Division, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2538, fax (360) 407-7582, e-mail sevruta@dshs.wa.gov.

     Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on December 9, 2003, at 10:00 a.m.

     Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by December 2, 2003, phone (360) 664-6094, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.

     Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, mail to P.O. Box 45850, Olympia, WA 98504-5850, deliver to 4500 10th Avenue S.E., Lacey, WA, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., December 9, 2003.

     Date of Intended Adoption: Not sooner than December 10, 2003.

October 30, 2003

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3311.6
AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-0520   Are there training requirements for an individual provider or a home care agency provider of an adult client?   An individual provider or a home care agency provider for an adult client must meet the training requirements in WAC ((388-71-05910)) 388-71-05665 through ((388-71-05952)) 388-71-05909.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-0520, filed 4/30/02, effective 5/31/02. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. 00-03-043, § 388-71-0520, filed 1/13/00, effective 2/13/00.]

NURSE DELEGATION CORE TRAINING
NEW SECTION
WAC 388-71-05805   What is nurse delegation core training?   Nurse delegation core training is required before a nursing assistant may be delegated a nursing task. DSHS approves instructors for nurse delegation core training.

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NEW SECTION
WAC 388-71-05810   What knowledge and skills must nurse delegation core training include?   Only the curricula developed by DSHS may be used for nurse delegation core training.

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NEW SECTION
WAC 388-71-05815   Is competency testing required for nurse delegation core training?   Passing the DSHS competency test is required for successful completion of nurse delegation core training, as provided under WAC 388-71-05835 through 388-71-05865.

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NEW SECTION
WAC 388-71-05820   Is there a challenge test for nurse delegation core training?   There is no challenge test for nurse delegation core training.

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NEW SECTION
WAC 388-71-05825   What documentation is required for successful completion of nurse delegation core training?   (1) Nurse delegation core training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes:

     (a) The name of the trainee;

     (b) The name of the training;

     (c) The name of the training entity giving the training;

     (d) The instructor's name and signature; and

     (e) The date(s) of training.

     (2) The trainee must be given an original certificate. Home care agencies must keep a copy of the certificate on file.

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NEW SECTION
WAC 388-71-05830   Who is required to complete nurse delegation core training, and when?   Before performing any delegated nursing task, individual providers and home care agency providers must:

     (1) Successfully complete DSHS-designated nurse delegation core training;

     (2) Be a nursing assistant registered or certified under chapter 18.88A RCW; and

     (3) If a nursing assistant registered, successfully complete basic training.

[]


NEW SECTION
WAC 388-71-05895   What additional qualifications are required for instructors of nurse delegation core training?   An instructor for nurse delegation core training must have a current RN license in good standing.

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AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05910   What definitions apply to WAC ((388-71-05911)) 388-71-05670 through ((388-71-05952)) 388-71-05909?   "Client" means an individual age eighteen or older, receiving in-home services through Medicaid personal care, COPES, or Chore programs. As applicable, the term client also means the client's legal guardian or other surrogate decision maker.

     "Competency" means the minimum level of information and skill trainees are required to know and be able to demonstrate.

     "DSHS" refers to the department of social and health services.

     "Learning outcomes" means the specific information, skills and behaviors desired of the learner as a result of a specific unit of instruction, such as what they would learn by the end of a single class or an entire course. Learning outcomes are generally identified with a specific lesson plan or curriculum.

     "Routine interaction" means contact with clients that happens regularly.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05910, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05918   Is there an alternative to the basic training for some health care workers?   Certain health care workers may complete the modified basic training instead of basic training if they meet the requirements in WAC ((388-71-05929)) 388-71-05760.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05918, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05919   What core knowledge and skills must be taught in basic training?   The basic training knowledge and skills must include all of the learning outcomes and competencies published by the department for the following core knowledge and skills:

     (1) Understanding and using effective interpersonal and problem solving skills with clients, family members, and other care team members;

     (2) Taking appropriate action to promote and protect client rights, dignity, and independence;

     (3) Taking appropriate action to promote and protect the health and safety of the client and the caregiver;

     (4) Correctly performing required personal care tasks while incorporating client preferences, maintaining the client's privacy and dignity, and creating opportunities that encourage client independence;

     (5) Adhering to basic job standards and expectations.

The basic training learning outcomes and competencies may be obtained from the DSHS aging and ((Adult)) disability services administration.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05919, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05920   Is competency testing required for basic training?   Competency testing is required for basic training as provided under WAC ((388-71-05938)) 388-71-05835 through ((388-71-05944)) 388-71-05865.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05920, filed 4/30/02, effective 5/31/02.]

MODIFIED BASIC TRAINING
AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05924   What is modified basic training?   Modified basic training is a subset of the basic training curriculum designed for certain health care workers defined in WAC ((388-71-05929)) 388-71-05760, whose previous training includes many of the competencies taught in the full basic training. Only the training curriculum developed by DSHS may be used for modified basic training.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05924, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05925   What knowledge and skills must be included in modified basic training?   Modified basic training must include all of the learning outcomes and competencies published by DSHS for the following core knowledge and skills:

     (1) Client rights, including mandatory reporting requirements;

     (2) Medication assistance regulations;

     (3) Nurse delegation regulations;

     (4) Assessment and observations in home and community settings;

     (5) Documentation in home and community settings;

     (6) Service planning in home and community care settings;

     (7) Resource information, including information on continuing education; and

     (8) Self-directed care regulations.

     The modified basic learning outcomes and competencies may be obtained from the DSHS aging and ((adult)) disability services administration.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05925, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05926   Is competency testing required for modified basic training?   Competency testing is required for modified basic training as provided under WAC ((388-71-05938)) 388-71-05835 through ((388-71-05944)) 388-71-05865.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05926, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05941   What training must include the DSHS-developed competency test?   Basic ((and)) training, modified basic training, and nurse delegation core training must include the DSHS-developed competency test.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05941, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05943   What form of identification must providers show a tester before taking a competency or challenge test?   Providers must show a tester photo identification before taking a competency test (or challenge test, when applicable) for basic ((or)) training, modified basic training, or nurse delegation core training.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05943, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05946   Must instructors be approved by DSHS or an AAA?   (1) DSHS must approve any instructor under contract with DSHS to conduct basic ((or)) training, modified basic training, or nurse delegation core training classes using the training curricula developed by DSHS. DSHS may select contracted instructors using any applicable contracting procedures. Contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through the contracting procedure.

     (2) DSHS contracts with area agencies on aging (AAA) or other entities to conduct orientation, basic, modified basic, nurse delegation core training, and continuing education training programs for individual providers and home care agency providers. The training entity must approve any instructor under contract with the entity to conduct training programs. The entity's contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through the entity's contracting procedures.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05946, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05947   Can DSHS or the AAA deny or terminate a ((contact)) contract with an instructor or training entity?   (1) DSHS or an area agency on aging (AAA), as applicable, may determine not to accept an offer by a person or organization seeking a contract with DSHS or the AAA to conduct training programs. No administrative remedies are available to dispute DSHS' or the AAA's decision not to accept an offer, except as may be provided through the contracting process.

     (2) DSHS or the AAA may terminate any training contract in accordance with the terms of the contract. The contractor's administrative remedies shall be limited to those specified in the contract.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05947, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-15-064, filed 7/11/02, effective 8/11/02)

WAC 388-71-05949   What are the minimum qualifications for an instructor for basic ((or)), modified basic or nurse delegation core training?   An instructor for basic ((or)), modified basic, or nurse delegation core training must meet the following minimum qualifications:

     (1) General qualifications:

     (a) Twenty-one years of age;

     (b) Has not had a professional health care or social services license or certification revoked in Washington state (however, no license or certification is required).

     (2) Education and work experience:

     (a) Upon initial approval or hire, must have:

     (i) A high school diploma and one year of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD per chapter 388-820 WAC, or home care setting; or

     (ii) An associate degree in a health field and six months of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD per chapter 388-820 WAC, or home care setting.

     (3) Teaching experience:

     (a) Must have one hundred hours of experience teaching adults on topics directly related to the basic training; or

     (b) Must have forty hours of teaching while being mentored by an instructor who meets these qualifications, and must attend a class on adult education that meets the requirements of WAC ((388-71-05951)) 388-71-05899.

     (4) The instructor must be experienced in caregiving practices and capable of demonstrating competency with respect to the course content or units being taught;

     (5) Instructors who will administer tests must have experience or training in assessment and competency testing; and

     (6) If required under WAC ((388-71-05923)) 388-71-05730 or ((388-71-05929)) 388-71-05760, instructors must successfully complete basic or modified basic training prior to beginning to train others.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-15-064, § 388-71-05949, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05951   What physical resources are required for basic ((or)), modified basic, or nurse delegation core classroom training and testing?   (1) Classroom facilities used for basic ((or)), modified basic, or nurse delegation core classroom training must be accessible to trainees and provide adequate space for learning activities, comfort, lighting, lack of disturbance, and tools for effective teaching and learning such as white boards and flip charts. Appropriate supplies and equipment must be provided for teaching and practice of caregiving skills in the class being taught.

     (2) Testing sites must provide adequate space for testing, comfort, lighting, and lack of disturbance appropriate for the written or skills test being conducted. Appropriate supplies and equipment necessary for the particular test must be provided.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05951, filed 4/30/02, effective 5/31/02.]


AMENDATORY SECTION(Amending WSR 02-10-117, filed 4/30/02, effective 5/31/02)

WAC 388-71-05952   What standard training practices must be maintained for basic ((or)), modified basic, or nurse delegation core classroom training and testing?   The following training standards must be maintained for basic ((or)), modified basic, or nurse delegation core classroom training and testing:

     (1) Training, including all breaks, must not exceed eight hours within one day;

     (2) Training provided in short time segments must include an entire unit, skill or concept;

     (3) Training must include regular breaks; and

     (4) Students attending a classroom training must not be expected to leave the class to attend to job duties, except in an emergency.

[Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-05952, filed 4/30/02, effective 5/31/02.]


NEW SECTION

     The following sections of the Washington Administrative Code, as amended, are recodified as follows:

    
Old WAC Number New WAC Number
388-71-05910 388-71-05665
388-71-05918 388-71-05705
388-71-05919 388-71-05710
388-71-05920 388-71-05715
388-71-05924 388-71-05735
388-71-05925 388-71-05740
388-71-05926 388-71-05745
388-71-05941 388-71-05850
388-71-05943 388-71-05860
388-71-05946 388-71-05875
388-71-05947 388-71-05880
388-71-05949 388-71-05890
388-71-05951 388-71-05905
388-71-05952 388-71-05909

NEW SECTION

     The following sections of the Washington Administrative Code are recodified as follows:

    
Old WAC Number New WAC Number
388-71-0580 388-71-05640
388-71-05911 388-71-05670
388-71-05912 388-71-05675
388-71-05913 388-71-05680
388-71-05914 388-71-05685
388-71-05915 388-71-05690
388-71-05916 388-71-05695
388-71-05917 388-71-05700
388-71-05921 388-71-05720
388-71-05922 388-71-05725
388-71-05923 388-71-05730
388-71-05927 388-71-05750
388-71-05928 388-71-05755
388-71-05929 388-71-05760
388-71-05930 388-71-05765
388-71-05931 388-71-05770
388-71-05932 388-71-05775
388-71-05933 388-71-05780
388-71-05934 388-71-05785
388-71-05935 388-71-05790
388-71-05936 388-71-05795
388-71-05937 388-71-05799
388-71-05938 388-71-05835
388-71-05939 388-71-05840
388-71-05940 388-71-05845
388-71-05942 388-71-05855
388-71-05944 388-71-05865
388-71-05945 388-71-05870
388-71-05948 388-71-05885
388-71-05950 388-71-05899

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