WSR 05-21-099

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)

[ Filed October 18, 2005, 1:43 p.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 05-16-080.

     Title of Rule and Other Identifying Information: Chapter 388-112 WAC, Residential long-term care services -- Training.

     Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane, behind Goodyear Tire. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on November 22, 2005, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than November 23, 2005.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., November 22, 2005.

     Assistance for Persons with Disabilities: Contact Stephanie Schiller, DSHS Rules Consultant, by November 18, 2005, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at schilse@dshs.wa.gov.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of the new language in WAC 388-112-0020, 388-112-0060, 388-112-0090, 388-112-0210, 388-112-0245, and 388-112-0315, is to clarify standards and expectations regarding the integration of safe food handling training into the required training and continuing education, as required by SHB 1591, chapter 505, Laws of 2005. The statute requires that:

• The department's curricula meet the standards established by the State Board of Health pursuant to chapter 69.06 RCW. This includes the addition of a separate section of safe food handling questions be a part of the basic and modified training competency testing.
• Caregivers working in adult family homes receive information on safe food handling practices from the employer before providing food handling service for clients.
• The addition of .5 hours per year of safe food handling continuing education for adult family home caregivers in order to maintain food handling and safety training.
     The purpose of new language in WAC 388-112-0255 and 388-112-0260 is to add content requirements for first-aid training.

     Reasons Supporting Proposal: See above.

     Statutory Authority for Adoption: RCW 18.20.090, 70.128.040, 70.128.230.

     Statute Being Implemented: RCW 18.20.090, 70.128.040, 70.128.230.

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

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

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Barbara Hanneman, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2540.

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

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Tiffany Sevruk, Home and Community Services, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2538, fax (360) 407-7582, e-mail sevruta@dshs.wa.gov.

October 13, 2005

Andy Fernando, Manager

Rules and Policies Assistance Unit

3608.2
AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0020   What content must be included in an orientation?   Orientation may include the use of videotapes, audiotapes, and other media if the person overseeing the orientation is available to answer questions or concerns for the person(s) receiving the orientation. Orientation must include introductory information in the following areas:

     (1) The care setting;

     (2) The characteristics and special needs of the population served;

     (3) Fire and life safety, including:

     (a) Emergency communication (including phone system if one exists);

     (b) Evacuation planning (including fire alarms and fire extinguishers where they exist);

     (c) Ways to handle resident injuries and falls or other accidents;

     (d) Potential risks to residents or staff (for instance, aggressive resident behaviors and how to handle them); and

     (e) The location of home policies and procedures.

     (4) Communication skills and information, including:

     (a) Methods for supporting effective communication among the resident/guardian, staff, and family members;

     (b) Use of verbal and nonverbal communication;

     (c) Review of written communications and/or documentation required for the job, including the resident's service plan;

     (d) Expectations about communication with other home staff; and

     (e) Whom to contact about problems and concerns.

     (5) Universal precautions and infection control, including:

     (a) Proper hand washing techniques;

     (b) Protection from exposure to blood and other body fluids;

     (c) Appropriate disposal of contaminated/hazardous articles;

     (d) Reporting exposure to contaminated articles, blood, or other body fluids; and

     (e) What staff should do if they are ill.

     (6) Resident rights, including:

     (a) The resident's right to confidentiality of information about the resident;

     (b) The resident's right to participate in making decisions about the resident's care, and to refuse care;

     (c) Staff's duty to protect and promote the rights of each resident, and assist the resident to exercise his or her rights;

     (d) How and to whom staff should report any concerns they may have about a resident's decision concerning the resident's care;

     (e) Staff's duty to report any suspected abuse, abandonment, neglect, or exploitation of a resident;

     (f) Advocates that are available to help residents (LTC ombudsmen, organizations); and

     (g) Complaint lines, hot lines, and resident grievance procedures.

     (7) In Adult Family Homes, safe food handling practices information must be provided to all staff, prior to handling food for residents.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, § 388-112-0020, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0060   Is competency testing required for basic training?   Passing the DSHS competency test is required for successful completion of basic training as provided under WAC 388-112-0290 through 388-112-0315.

     For licensed adult family home providers and employees, successfully completing basic training includes passing the safe food handling section or obtaining a valid food handler permit.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, § 388-112-0060, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0090   Is competency testing required for modified basic training?   Passing the DSHS competency test is required for successful completion of modified basic training as provided in WAC 388-112-0290 through 388-112-0315.

     For licensed adult family home providers and employees, successfully completing modified basic training includes passing the safe food handling section or obtaining a valid food handler permit.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, § 388-112-0090, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0210   What kinds of training topics are required for continuing education?   Continuing education must be on a topic relevant to the care setting and care needs of residents, including but not limited to:

     (1) Resident rights;

     (2) Personal care (such as transfers or skin care);

     (3) Mental illness;

     (4) Dementia;

     (5) Developmental disabilities;

     (6) Depression;

     (7) Medication assistance;

     (8) Communication skills;

     (9) Positive resident behavior support;

     (10) Developing or improving resident centered activities;

     (11) Dealing with wandering or aggressive resident behaviors; ((and))

     (12) Medical conditions; and

     (13) Safe food handling.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0210, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0245   Who is required to complete continuing education training, and when?   Adult Family Homes

     (1) Adult family home providers (including entity representatives as defined under chapter 388-76 WAC), resident managers, and caregivers must complete ten hours of continuing education each calendar year (January 1 through December 31) after the year in which they successfully complete basic or modified basic training.

     (2) Continuing education must be on a topic relevant to the care setting and care needs of residents in adult family homes.

     (3) Continuing education must include 0.5 hours per year on safe food handling.

     Boarding Homes

     (((3))) (4) Boarding home administrators (or their designees) and caregivers must complete ten hours of continuing education each calendar year (January 1 through December 31) after the year in which they successfully complete basic or modified basic training. A boarding home administrator with a current nursing home administrator license is exempt from this requirement.

     (((4))) (5) Continuing education must be on a topic relevant to the care setting and care needs of residents in boarding homes.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0245, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0255   What is first-aid training?   First-aid training is training that ((meets the content requirements in WAC 296-800-15010)) meets the guidelines established by the Occupational Safety and Health Administration and listed at www.osha.gov. Topics include:

     (1) General program elements, including:

     (a) Responding to a health emergency;

     (b) Surveying the scene;

     (c) Basic Cardiopulmonary Resuscitation (CPR);

     (d) Basic First Aid intervention;

     (e) Standard Precautions;

     (f) First aid supplies; and

     (g) Trainee assessments.

     (2) Type of injury training, including:

     (a) Shock;

     (b) Bleeding;

     (c) Poisoning;

     (d) Burns;

     (e) Temperature Extremes;

     (f) Musculoskeletal injuries;

     (g) Bites and stings;

     (h) Confined spaces; and

     (i) Medical emergencies; including heart attack, stroke, asthma attack, diabetes, seizures, and pregnancy.

     (3) Site of injury training, including:

     (a) Head and neck;

     (b) Eye;

     (c) Nose;

     (d) Mouth and teeth;

     (e) Chest;

     (f) Abdomen; and

     (g) Hand, finger and foot.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0255, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0260   What are the CPR and first-aid training requirements?   Adult Family Homes

     (1) Adult family home providers and resident managers must possess a valid CPR and first-aid card or certificate prior to providing care for residents, and must maintain valid cards or certificates.

     (2) Adult family home caregivers must obtain a valid CPR and first-aid card or certificate:

     (a) Within thirty days of beginning to provide care for residents, if the provision of care for residents is directly supervised by a fully qualified caregiver who has a valid first-aid and CPR card or certificate; or

     (b) Before providing care for residents, if the provision of care for residents is not directly supervised by a fully qualified caregiver who has a valid first-aid and CPR card or certificate.

     (3) Adult family home caregivers must maintain valid CPR and first-aid cards or certificates.

     (4) Licensed nurses working in adult family homes must possess a valid CPR card or certificate within thirty days of employment and must maintain a valid card or certificate. If the licensed nurse is an adult family home provider or resident manager, the valid CPR card or certificate must be obtained prior to providing care for residents.

     Boarding Homes

     (((4))) (5) Boarding home administrators who provide direct care, and caregivers must possess a valid CPR and first-aid card or certificate within thirty days of employment, and must maintain valid cards or certificates. ((Boarding home)) Licensed nurses working in boarding homes must possess a valid CPR card or certificate within thirty days of employment, and must maintain a valid card or certificate.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0260, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0315   How many times may a competency test be taken?   (1) A competency test that is part of a course may be taken twice. If the test is failed a second time, the person must retake the course before any additional tests are administered. Licensed adult family providers and employees who fail the food handling section of the basic training competency test a second time, must obtain a valid food worker permit.

     (2) If a challenge test is available for a course, it may be taken only once. If the test is failed, the person must take the classroom course.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0315, filed 7/11/02, effective 8/11/02.]

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