WSR 08-22-053

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed November 3, 2008, 12:30 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 08-15-135.

Title of Rule and Other Identifying Information: The department is amending chapter 388-71 WAC, Home and community services and programs and chapter 388-112 WAC, Residential long-term care services.

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. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on December 9, 2008, at 10:00 a.m.

Date of Intended Adoption: Not earlier than December 10, 2008.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by

5 p.m. on December 9, 2008.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by November 25, 2008, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Chapter 146, Laws of 2008 (ESSHB [E2SHB] 2668) requires that all nursing assistants who will be delegated the task of insulin injections complete a specialized diabetes nurse delegation training. The new language in chapters 388-71 and 388-112 WAC add this requirement.

The purpose of new rules in WAC 388-112-02605 through 388-112-02630 is to add content requirements for the existing HIV/AIDS training requirement.

New language in WAC 388-112-0250 clarifies that the existing CPR training requirement must include skills demonstration tests.

WAC 388-112-0180 is amended to correct a WAC reference.

Statutory Authority for Adoption: Chapter 146, Laws of 2008 (ESSHB [E2SHB] 2668), RCW 18.20.090, 74.08.090, chapter 70.128 RCW.

Statute Being Implemented: Chapter 146, Laws of 2008 (ESSHB [E2SHB] 2668), RCW 18.20.090, 74.08.090, chapter 70.128 RCW.

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 rules and determined that no more than minor costs will be imposed on small businesses or nonprofit organizations.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Barbara Hanneman, Home and Community Services, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2540, fax (360) 725-2646, e-mail HanneBJ@dshs.wa.gov.

October 29, 2008

Stephanie E. Schiller

Rules Coordinator

4042.2
AMENDATORY SECTION(Amending WSR 05-11-082, filed 5/17/05, effective 6/17/05)

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 388-71-05665 through 388-71-05865 and WAC 388-71-0801 through 388-71-0826.

[Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-71-0520, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.39A.050, 2003 c 140, chapters 18.79, 18.88A RCW. 04-02-001, 388-71-0520, filed 12/24/03, effective 1/24/04. 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.]


AMENDATORY SECTION(Amending WSR 04-02-001, filed 12/24/03, effective 1/24/04)

WAC 388-71-05810   What knowledge and skills must nurse delegation core training include?   Only the ((curricula)) curriculum developed by DSHS ((may be used)), "Nurse Delegation for Nursing Assistants", meets the training requirement for nurse delegation core training.

[Statutory Authority: RCW 74.39A.050, 2003 c 140, chapters 18.79, 18.88A RCW. 04-02-001, 388-71-05810, filed 12/24/03, effective 1/24/04.]


AMENDATORY SECTION(Amending WSR 04-02-001, filed 12/24/03, effective 1/24/04)

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

[Statutory Authority: RCW 74.39A.050, 2003 c 140, chapters 18.79, 18.88A RCW. 04-02-001, 388-71-05895, filed 12/24/03, effective 1/24/04.]


NEW SECTION
WAC 388-71-0801   What is specialized diabetes nurse delegation training?   Specialized diabetes nurse delegation training is the required training for nursing assistants, certified or registered, who will be delegated the task of insulin injections. DSHS approves the instructors for the specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-71-0806   What knowledge and skills must specialized diabetes nurse delegation training include?   Specialized diabetes nurse delegation training consists of three modules on diabetes, insulin, and injections. Only the curriculum developed by DSHS, "Nurse Delegation for Nursing Assistants: Special Focus on Diabetes", may be used for the specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-71-0811   Is competency testing required for the specialized diabetes nurse delegation training?   Passing the DSHS competency test is required for successful completion of specialized diabetes nurse delegation training, as provided under WAC 388-71-05835 through 388-71-05865.

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NEW SECTION
WAC 388-71-0816   Is there a challenge test for specialized diabetes nurse delegation training?   There is no challenge test for specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-71-0821   What documentation is required for successful completion of specialized diabetes nurse delegation training?   (1) Specialized diabetes nurse delegation 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.

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NEW SECTION
WAC 388-71-0826   Who is required to complete the specialized diabetes nurse delegation training, and when?   Specialized diabetes nurse delegation training is required before a nursing assistant, certified or registered, who meets the qualifications in WAC 388-71-05830, may be delegated the task of insulin injections.

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4041.2
AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0175   What knowledge and skills must nurse delegation core training include?   Only the curriculum developed by DSHS ((may be used)), "Nurse Delegation for Nursing Assistants", meets the training requirement for nurse delegation core training.

[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, 388-112-0175, filed 7/11/02, effective 8/11/02.]


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

WAC 388-112-0180   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 ((388-112-0265)) 388-112-0290 through ((388-112-0295)) 388-112-0315.

[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, 388-112-0180, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0196   What is specialized diabetes nurse delegation training?   Specialized diabetes nurse delegation training is the required training for nursing assistants, certified or registered, who will be delegated the task of insulin injections. DSHS approves the instructors for specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-112-01961   What knowledge and skills must specialized diabetes nurse delegation training include?   Specialized diabetes nurse delegation training consists of three modules on diabetes, insulin, and injections. Only the curriculum developed by DSHS, "Nurse Delegation for Nursing Assistants: Special Focus on Diabetes", may be used for the specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-112-01962   Is competency testing required for the specialized diabetes nurse delegation training?   Passing the DSHS competency test is required for successful completion of the specialized diabetes nurse delegation training, as provided under WAC 388-112-0290 through 388-112-0315.

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NEW SECTION
WAC 388-112-01963   Is there a challenge test for specialized diabetes nurse delegation training?   There is no challenge test for specialized diabetes nurse delegation training.

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NEW SECTION
WAC 388-112-01964   What documentation is required for successful completion of specialized diabetes nurse delegation training?   (1) Specialized diabetes nurse delegation 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. Adult family homes and boarding homes must keep a copy of the certificate on file.

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NEW SECTION
WAC 388-112-01965   Who is required to complete the specialized diabetes nurse delegation training, and when?   Specialized diabetes nurse delegation training is required before a nursing assistant, certified or registered, who meets the qualifications in WAC 388-112-0195, may be delegated the task of insulin injections.

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AMENDATORY SECTION(Amending WSR 06-16-072, filed 7/28/06, effective 8/28/06)

WAC 388-112-0250   What is CPR training?   Cardiopulmonary resuscitation (CPR) training is training provided by an authorized CPR instructor. Trainees must successfully complete the written and skills demonstrations tests.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230. 06-16-072, 388-112-0250, filed 7/28/06, effective 8/28/06. 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, 388-112-0250, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-02610   What is HIV/AIDS training?   It is recommended that the HIV/AIDS training be taught in classroom style by an expert instructor who can answer technical questions. The Washington state department of health's "KNOW HIV Prevention Education for Health Care Facility Employees" manual is the state model, designed as a complete training. HIV/AIDS training must be based on this curriculum, be a minimum of two to three hours, and include the following topics:

(1) Causes of HIV and how it is spread, including:

(a) Reported cases in the United States and Washington state; and

(b) Risk groups and risky behaviors.

(2) Transmission and infection control, including:

(a) Infection control precautions;

(b) Factors affecting the risk for transmission; and

(c) Risks for transmission to health care workers.

(3) Legal and ethical issues, including:

(a) Confidentiality;

(b) Informed consent;

(c) Legal reporting requirements;

(d) Ethical issues; and

(e) Civil rights.

(4) Psychosocial issues, including:

(a) Personal impact of HIV continuum;

(b) The human response to death and dying;

(c) Issues for care providers;

(d) Family issues; and

(e) Special populations.

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NEW SECTION
WAC 388-112-02615   Is competency testing required for HIV/AIDS training?   No competency testing is required for HIV/AIDS training.

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NEW SECTION
WAC 388-112-02620   Is there a challenge test for HIV/AIDS training?   There is no challenge test for HIV/AIDS training.

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NEW SECTION
WAC 388-112-02625   What documentation is required for completion of HIV/AIDS training?   HIV/AIDS training must be documented by:

(1) Proof of registration, certification or licensure from the department of health; or

(2) A certificate of completion of the state developed twenty-eight hour revised fundamentals of caregiving, completed after December 19, 2003; or

(3) A certificate of completion of HIV/AIDS training issued by the instructor or training entity that includes:

(a) The name of the trainee;

(b) The name of the training curriculum;

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

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

(e) The date(s) of the training session(s).

(4) The trainee must be given an original certificate. The facility or entity must keep a copy of the certificate on file.

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NEW SECTION
WAC 388-112-02630   Who is required to complete HIV/AIDS training, and when?   Adult family home and boarding home staff who have potential exposure to bodily fluids must complete HIV/AIDS training before having routine interaction with residents.

(1) Licensed, certified or registered staff meet the HIV/AIDS training requirements for their specific department of health license, certification or registration.

(2) All other adult family home and boarding home staff must complete the HIV/AIDS training, as defined in WAC 388-112-02610.

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Washington State Code Reviser's Office