Original Notice.

     Preproposal statement of inquiry was filed as WSR 09-04-087.

     Title of Rule and Other Identifying Information: Chapter 388-71 WAC, Home and community services and programs; chapter 388-112 WAC, Residential training; chapter 388-829A WAC, Alternative living; and chapter 388-829C WAC, Companion homes.

     Hearing Location(s): Office Building 2, Auditorium, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html or by calling (360) 664-6094), on July 6, 2010, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than July 7, 2010.

     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 July 6, 2010.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by June 22, 2010, 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 74.39A RCW requires training for long-term care workers which includes seventy-five hours of entry-level training before a long-term care worker is eligible to provide care and also requires federal and state criminal history background checks for all long-term care workers. This law increases the basic training hour requirements for long-term care workers from thirty-two hours to seventy-five hours and increases their continuing education hour requirement from ten to twelve hours annually.

     The purpose of the new language in chapters 388-71, 388-112, 388-829A, and 388-829C WAC is to implement and clarify the training requirements and the criminal history background check requirements.

     Reasons Supporting Proposal: See above.

     Statutory Authority for Adoption: RCW 74.08.090, 74.39A.360.

     Statute Being Implemented: RCW 74.39A.360.

     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: Nancy Brubaker, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2540.

     A small business economic impact statement has been prepared under chapter 19.85 RCW.

     SUMMARY OF PROPOSED RULES: In 2007, the legislature passed RCW 74.39A.360 creating the Taft-Hartley Training Trust (trust) to operate a training partnership. The training partnership is a nonprofit 501(c)3 formed to train and develop professional long-term care workers to deliver high quality care and support to older adults and people with disabilities. RCW 74.39A.360 also increased continuing education requirements for long-term care workers from ten to twelve hours, added twelve hours optional peer mentoring, and mandated the department to offer sixty-five hours of optional advanced training. In addition, it expanded the definition of "long-term care worker" to include most caregivers who work in home and community-based services settings, including:

o     Individual providers of home care services,

o     Direct care employees of home care agencies,

o     Providers of home care services to persons with developmental disabilities under Title 71 RCW, and

o     All direct care workers in state-licensed:

     ▪     Boarding homes.

     ♦     Adult family homes.

o     Respite care providers,

o     Community residential service providers, and

o     Any other direct care worker providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

     In 2008, an initiative increasing basic training from thirty-two hours to seventy-five hours was placed on the ballot for consideration by Washington voters. It stated "current procedures to train and educate long-term care workers and to protect the elderly are insufficient." In November 2008, Initiative 1029 was voted on and approved by Washington state voters.

     With the implementation of 1029, the department of social and health services (DSHS) is amending and adopting new rules in chapters 388-112 and 388-71 WAC to conform to E2SHB 2284 and Initiative 1029 as follows:

o     Increase basic training hour requirements from thirty-two hours to seventy-five hours.

o     Increase continuing education hour requirement from ten to twelve hours annually.

     SMALL BUSINESS ECONOMIC IMPACT STATEMENT: Chapter 19.85 RCW, The Regulatory Fairness Act, requires that the economic impact of proposed regulations be analyzed in relation to small businesses. The statute defines small businesses as those business entities that employ fifty or fewer people and are independently owned and operated.

     With some exceptions, preparation of an SBEIS is required when a proposed rule has the potential of placing a disproportionate economic impact on small businesses. The statute outlines information that must be included in an SBEIS.

     Though an SBEIS is not required for adoption of these rules, pursuant to RCW 19.85.025(3) and 34.05.310 (4)(e), for informational purposes the department has analyzed the proposed rule amendments and has determined that small businesses will be impacted by these changes, with some costs considered "more than minor" and disproportionate to small businesses. However, these costs primarily result from the increased training requirements brought about by E2SHB 2284 and Initiative 1029, not from these conforming amendments to the department's training rules.

     Though not required for adoption of these rules, the department has analyzed the probable costs and probable benefits of the proposed amendments, taking into account both the qualitative and quantitative benefits and costs. The department's analysis shows the costs and benefits of the proposed rules to those impacted by the rules. Again, these costs primarily result from the increased training requirements brought about by E2SHB 2284 and Initiative 1029, not from these conforming amendments to the department's training rules. Impacted groups include:

•     Adult family home providers.

•     Boarding homes with fewer than fifty employees.

•     Home care agencies with fewer than fifty employees.

     INDUSTRY ANALYSIS: The department keeps a current internal data base that identifies all affected small businesses. Using this data base gives more accurate information about impacted small businesses for this analysis than the four-digit NAICS codes.

     The department has determined that there are approximately three thousand three hundred ninety-six existing agencies that meet the criteria for small businesses under RCW 19.85.020. These proposed rules impact:

•     Adult family home providers.

•     Boarding homes with fewer than fifty employees.

•     Home care agencies with fewer than fifty employees.

     INVOLVEMENT OF SMALL BUSINESSES: Many small businesses have been involved in writing the proposed rules and in ascertaining the costs associated with proposed rule changes. The department engaged assistance of external stakeholders, which included representation from small businesses, and met and talked several times with a number of small businesses to consider costs that would impact their businesses. In addition, a survey was mailed to a twenty-five percent random sampling of the three thousand three hundred ninety-six businesses across the state of Washington impacted by the changes. Data was reviewed and analyzed for the purposes of completing the cost-benefit analysis (CBA) and SBEIS.

     There are currently two thousand eight hundred forty-two adult family homes in Washington state. The department completed a random sample mailing to twenty-five percent of these homes and received a seventeen percent response rate. Of the seventeen percent who responded to the survey, seventy-three percent met the definition of "small businesses" within the meaning of RCW 19.85.011.

     There are currently five hundred fifty-four boarding homes in Washington state. The department completed a random sample survey mailing to twenty-five percent of these homes and received a twenty-six percent response rate. Of the twenty-six percent who responded, seventy-two percent met the definition of "small businesses" within the meaning of RCW 19.85.011.

     There are currently three hundred eighty-one home care agencies in Washington state. The department completed a random sample mailing to twenty-eight percent of these agencies and received a twenty-seven percent response rate. Of the twenty-seven percent who responded, forty-eight percent met the definition of "small business" within the meaning of RCW 19.85.011.

     EVALUATION OF PROBABLE COSTS AND PROBABLE BENEFITS: Since the proposed amendments "make significant amendments to a policy or regulatory program" (see RCW 34.05.328 (5)(c)(iii)), the department has determined the proposed rules to be "significant" as defined by the legislature. Nevertheless, because the content of these rules is explicitly and specifically dictated by statute, a[n] evaluation of the costs and benefits of these rules is not required pursuant to RCW 34.05.328 (5)(b)(v).

     For informational purposes, the department has analyzed the probable costs and probable benefits of the proposed amendments, taking into account both the qualitative and quantitative benefits and costs. The businesses impacted by these rules are adult family homes, boarding homes and home care agencies.

     COST OF COMPLIANCE: To consider costs of compliance, the department considered costs of training long-term care workers prior to the implementation of Initiative 1029 and after the rule implementation related to Initiative 1029. This is because:

•	Long-term care workers drive the businesses that provide direct care. In these businesses, there is a high turnover rate. This requires ongoing costs of training long-term care workers. Using the cost of training before and after implementation of Initiative 1029 is a more accurate depiction of costs than costs per employee;
•	Business decisions and planning are based on the number of long-term care workers needed to meet the needs of the clients served; and,
•	The increase of hours in required training for long-term care workers influences the most significant proposed changes in cost.

     Cost of Long-Term Care Training: The major cost anticipated by small businesses for proposed rule changes is the new requirement that increases long-term care training from its current thirty-two hours to seventy-five hours. This requirement has been added to improve training for long-term care workers and improve client outcomes since decisions about quality patient care will be based on outcomes derived from this training.

     Currently, training of long-term care workers occurs within a one hundred twenty day period of time after initial hire. As of January 2011, all new long-term care workers must complete seventy-five hours of training within the one hundred twenty days and complete a certification examination administered by the department of health within one hundred fifty days of hire. This becomes the baseline requirement.

     Additionally, there is minor cost anticipated by small business for proposed rule changes that increase continuing education from ten hours per calendar year, to twelve hours per calendar year.

     The small business owners determine the ways to meet these requirements for training. There are currently several ways in which training of long-term care workers can be accomplished. Providers have the following options:

•	In-house instruction by instructors that have met DSHS instructor qualifications and have been approved by DSHS to teach the training.
•	Utilizing a DSHS approved community educator (fee based).
•	Utilizing a DSHS approved community college (fee based).
•	Training partnership (after January 1, 2011, this will be fee based).

     Currently, forty-five percent of these small businesses provide in-house instruction and will reportedly continue to do so in the future. The remaining sixty percent pay for training through various venues and plan to continue to do so in the future. The cost of providing for the increase in training hours will reportedly increase for seventy-seven percent of respondents. Of these respondents, fifty-seven percent anticipate an increase in costs from the current cost of less than $500.00 per employee per year, to a projected range of $501.00 to $2500.00 per employee per year.

     In addition, forty-eight percent of respondents report that this will affect their ability to provide services, while twenty-six percent are unsure of the impact of the costs on services. Lastly, forty-five percent of respondents report that the changes in these rules will result in job loss, while fifty-three percent question whether they will be able to continue their businesses.

     BENEFITS: There are benefits to the changes in these rules: Programmatic, long-term care worker training, and client care. The major benefits are listed below:

•	Ensure that long-term care workers receive additional and enhanced training that will prepare them for work with diverse clients.
•	Ensure that long-term care workers are well trained and prepared for work across diverse care settings.
•	Provide in-depth coverage of key content that will enhance quality of care.
•	Provide on-the-job support and career development services for workers across the spectrum of long-term care.
•	Provide oversight and consistency in continuing education for long-term care workers.

     DISPROPORTIONATE ECONOMIC IMPACT ANALYSIS: When there are more than minor costs to small businesses as a result of proposed rule changes, the Regulatory Fairness Act requires an analysis to be done comparing these expenses between small businesses and ten percent of the largest businesses. The costs identified with the increase in training requirements for long-term care workers for small businesses would be considered by the department to be "more than minor." Small businesses have expressed the most concern over this added requirement of all the other proposed rule changes submitted.

     The department looked at the possible disproportionate impact of this requirement on small businesses, as compared to ten percent of the largest businesses. Given cost information the department compiled on both small and large business[es], the department determined that there is a disproportionate impact on small businesses.

     The department recognizes that the cost of additional training will impact all agencies and entities that employ long-term care workers.

     MITIGATING EXPENSES FOR LONG-TERM CARE WORKER TRAINING: The department has proposed plans to mitigate expenses for small businesses. The department will use one or more of the following to help small businesses meet the requirement for increased training of long-term care workers:

•	The department will develop policies and procedures that more formally enable small businesses and training entities to authorize on-the-job training as a component of the seventy-five hour long-term care worker basic training. This minimizes the number of hours that long-term care workers will have to be trained outside of the agency and will lessen worker replacement costs.
•	The department will provide curriculum materials for use by small businesses at cost for copying.
•	The department will engage in instructor development through routine regional trainings and provide train the trainer programs to assist small businesses in meeting the instructor requirements enabling them to conduct their own training.
•	The department will be available for consultation and technical assistance as small businesses identify creative approaches for implementing the training requirements.

     CONCLUSION: The department has given careful consideration to the impact on small businesses of proposed rules in chapters 388-12 and 388-71 WAC, training requirements for long-term care workers. The department has analyzed impacts on small businesses and proposed ways to mitigate those costs associated with this legislatively mandated increase in training requirements.

     A copy of the statement may be obtained by contacting Kristi Knudsen, Home and Community Services, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-3213, fax (360) 407-7582, e-mail Kristi.Knudsen@dshs.wa.gov.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kristi Knudsen, Home and Community Services, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-3213, fax (360) 407-7582, e-mail Kristi.Knudsen@dshs.wa.gov.

April 30, 2010

Katherine I. Vasquez

Rules Coordinator

     (1) Qualifications of an individual provider, as defined in WAC 388-106-0010;

     (2) Qualifications of a caregiver from a home care agency ((provider)), as defined in WAC 388-106-0010 and chapter 246-336 WAC;

     (3) Conditions under which the department or the area agency on aging (AAA) will pay for the services of an individual provider or a home care agency ((provider)) caregiver;

     (4) Training requirements for an individual provider and home care agency ((provider)) caregiver.

     A participant, as described in WAC 388-71-0836 eligible to receive long-term care services, or his/her legal representative on the participant's behalf, may choose to receive personal care services in the participant's home from an individual provider or a caregiver from a home care agency. If the participant chooses to receive services from a home care agency, the agency will assign a caregiver employed by the agency to provide services to the participant. Individual providers and home care agency caregivers are "long-term care workers" as defined in RCW 74.39A.009 and are subject to background checks under RCW 74.39A.055 and 43.20.710.

[Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-71-0500, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.39A.090. 02-21-098, § 388-71-0500, filed 10/21/02, effective 11/21/02. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-0500, 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, 74.39.095. 01-11-019, § 388-71-0500, filed 5/4/01, effective 6/4/01. 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, § 388-71-0500, filed 1/13/00, effective 2/13/00.]

     (1) Has the primary responsibility for locating, screening, hiring, supervising, and terminating an individual provider;

     (2) Establishes an employer/employee relationship with the individual provider; and

     (3) May receive assistance from the social worker/case manager or other resources in this process.

[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, 74.39.095. 01-11-019, § 388-71-0505, filed 5/4/01, effective 6/4/01. 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, § 388-71-0505, filed 1/13/00, effective 2/13/00.]

     (1) Be eighteen years of age or older;

     (2) Provide the social worker/case manager/designee with:

     (a) A valid Washington state driver's license or other valid picture identification; and either

     (b) A Social Security card; or

     (c) Proof of authorization to work in the United States as required on the employment verification form.

     (3) ((Complete and submit to the social worker/case manager/designee)) Prior to January 1, 2012, be screened through the department's ((criminal conviction)) background ((inquiry application, unless the provider is also the parent of the adult DDD client and exempted, per chapter 74.15 RCW;)) check process:

     (a) Preliminary results may require a thumb print for identification purposes;

     (b) ((An FBI)) A fingerprint-based background check is required if:

     (i) The person has lived in the state of Washington less than three consecutive years immediately before the date of the background check; or

     (ii) The department has reasonable cause to believe the person has a conviction, pending charges, and/or negative actions in another state.

     (4) Effective January 1, 2012, be screened through the department's fingerprint-based background check, as required by RCW 74.39A.055. As provided in RCW 43.20A.710, results of the background check are provided to the department and employer for the purpose of determining:

     (a) Whether the person is disqualified based on a disqualifying crime or negative action; or

     (b) Whether the person should or should not be employed as an individual provider based on his or her character, competence, and/or suitability.

     (c) Disqualifying crimes and negative actions are those listed in WAC 388-71-0540 (4), (5), and (6).

     (5) Sign a home and community-based service provider contract/agreement to provide services to a COPES, MNIW, PACE, WMIP, or medicaid personal care ((client)) participant, or sign a contract as an individual provider to provide services to a New Freedom waiver, WMIP, or PACE participant under chapter 388-106 WAC.

[Statutory Authority: 2004 c 276 § 206 (6)(b) and Townsend vs. DSHS, U.S. District Court, Western District of Washington, No. C 00-0944Z. 04-16-029, § 388-71-0510, filed 7/26/04, effective 8/26/04. 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, 74.39.095. 01-11-019, § 388-71-0510, filed 5/4/01, effective 6/4/01. 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, § 388-71-0510, filed 1/13/00, effective 2/13/00.]

     (1) Records contained in databases maintained by the Washington state patrol and the Federal Bureau of Investigation, including records of:

     (a) Pending charges; and

     (b) criminal conviction.

     (2) Records maintained:

     (a) In the national sex offenders registry;

     (b) By the Washington state department of corrections;

     (c) By Washington courts; and

     (d) In the justice information system.

     (3) Records of negative actions, final findings, or civil adjudication proceedings of any agency or subagency including, but not limited to:

     (a) DSHS adult protective services;

     (b) DSHS residential care services;

     (c) DSHS children's protective services;

     (d) The Washington state department of health;

     (e) The nursing assistant registry; and

     (f) Any pending charge, criminal conviction, civil adjudicative proceeding and/or negative action disclosed by the applicant.

     (4) Any "civil adjudication proceeding", which is a judicial or administrative adjudicative proceeding that results in a finding of, or upholds any agency finding of, domestic violence, abuse, sexual abuse, exploitation, financial exploitation, neglect, abandonment, violation of a child or vulnerable adult under any provision of law, including but not limited to chapters 13.34, 26.44, or 74.34 RCW or rules adopted under chapters 18.51 and 74.42 RCW. "Civil adjudication proceeding" also includes judicial or administrative findings that become final due to the failure of the alleged perpetrator to timely exercise a legal right to administratively challenge such findings.

     (5) Negative actions which include the denial, suspension, revocation, or termination of a license, certification, or contract for the care of children, as defined in RCW 26.44.020, or vulnerable adults, as defined in RCW 74.34.020, for noncompliance with any state or federal regulation.

     (6) Except as prohibited by federal law, results are shared with the employer or prospective employer and with the department of health as authorized.

[]

     (1) Prior to January 1, 2012, be screened through the department's ((criminal conviction)) background ((inquiry application, which is submitted by the agency to the department. This includes an FBI fingerprint-based background check if the home care agency provider has lived in the state of Washington less than three years)) check process:

     (a) Preliminary results may require a thumb print for identification purposes; and

     (b) A fingerprint-based background check is required if the home care agency caregiver has lived in the state of Washington for less than three consecutive years immediately before the date of the background check.

     (2) Effective January 1, 2012, be screened through the department's fingerprint-based background check, as required by RCW 74.39A.055. As provided by RCW 43.20A.710, results are provided to the department and home care agency for the purpose of determining:

     (a) Whether the person is disqualified from being a home care agency caregiver based on a disqualifying crime, civil adjudication proceeding, or negative action as defined under WAC 388-71-0512; and

     (b) Whether the person should or should not be employed as a home care agency caregiver based on his or her character, competence, and/or suitability. Except as prohibited by federal law, results are shared with the employer or prospective employer and the department of health for purposes of making this determination.

     (3) Disqualifying crimes, civil adjudicative proceedings, and negative actions are listed in WAC 388-71-0540.

[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, 74.39.095. 01-11-019, § 388-71-0513, filed 5/4/01, effective 6/4/01.]

[]

     (1) Understand the ((client's)) participant's plan of care that is signed by the ((client)) participant or legal representative ((and social worker/case manager)), and which may be translated or interpreted, as necessary, for the ((client)) participant and the provider;

     (2) Provide the services as outlined on the ((client's)) participant's plan of care, as ((defined)) described in WAC 388-106-0010;

     (3) Accommodate ((client's)) the participant's individual preferences and ((differences)) unique needs in providing care;

     (4) Contact the ((client's)) participant's representative and case manager when there are changes ((which)) that affect the personal care and other tasks listed on the plan of care;

     (5) Observe ((the client for)) and consult with the participant or representative, regarding change(s) in health, take appropriate action, and respond to emergencies;

     (6) Notify the case manager immediately when the ((client)) participant enters a hospital, or moves to another setting;

     (7) Notify the case manager immediately ((if)) in the event of the ((client dies)) participant's death;

     (8) Notify the department or AAA immediately when unable to staff/serve the ((client)) participant; and

     (9) Notify the department/AAA when the individual provider or home care agency will no longer provide services. ((Notification to the client/legal guardian)) The individual provider or agency must:

     (a) Give at least two weeks' notice, and

     (b) ((Be)) Notify the participant or legal guardian in writing.

     (10) Complete and keep accurate time sheets that are accessible to the social worker/case manager; and

     (11) Comply with all applicable laws and regulations.

     (12) A home care agency ((must not bill the department for in-home medicaid funded personal care or DDD respite services when the agency employee providing care is a family member of the client served, unless approved to do so through an exception to rule under WAC 388-440-0001. For purposes of this section, family member means related by blood, marriage, adoption, or registered domestic partnership)) caregiver may meet his or her responsibilities under subsections (5), (6), (7) and (8) by notifying an appropriate individual within the home care agency, who shall be responsible for consulting with the participant or representative or notifying the case manager, AAA, or the department, as required.

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 571, and Washington state 2009-11 budget, section 206(17). 10-06-112, § 388-71-0515, filed 3/3/10, effective 4/3/10. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-71-0515, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.39A.090. 02-21-098, § 388-71-0515, filed 10/21/02, effective 11/21/02. 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, 74.39.095. 01-11-019, § 388-71-0515, filed 5/4/01, effective 6/4/01. 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, § 388-71-0515, filed 1/13/00, effective 2/13/00.]

[]

[Statutory Authority: 2008 c 146, RCW 18.20.090, 74.08.090, chapter 70.128 RCW. 09-03-066, § 388-71-0520, filed 1/14/09, effective 2/14/09. 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.]

     (1) When the services are provided by ((an employee of the)) a home care agency ((who is)) employee that is a family member, as described under RCW 74.39A.326, of the participant, including individuals related by blood, marriage, adoption, or registered domestic partnership to the ((client.

     The department, AAA, or department designee will deny payment for the services of an individual provider or home care agency provider who:

     (1))) participant, except in circumstances described in RCW 74.39A.326 (1)(b);

     (2) Who is the ((client's)) participant's spouse((, per)) in accordance with 42 C.F.R. 441.360(g), except in the case of an individual provider for a chore services client. Note: For chore spousal providers, the department pays a rate not to exceed the amount of a one-person standard for a ((continuing general assistance)) disability lifeline grant, per WAC 388-478-0030;

     (((2))) (3) Who is the natural/step/adoptive parent of a minor ((client)) participant aged seventeen or younger receiving services under medicaid personal care;

     (((3))) (4) Who is a foster parent providing personal care to a child residing in ((their)) the foster parent's licensed foster home;

     (((4) Has been convicted of a disqualifying crime, under RCW 43.43.830 and 43.43.842 or of a crime relating to drugs as defined in RCW 43.43.830;))

     (5) With any of the pending or disqualifying convictions, history, or findings, described below:

     (a) A history of noncompliance with federal or state laws or regulations in the provision of care or services to children or vulnerable adults;

     (b) A conviction for a crime in federal court or in any other state, and the department determines that the crime is equivalent to a crime under subsections (5)(c) through (g) of this section;

     (c) A conviction for a "crime against children or other persons" as described under RCW 43.43.830, unless the crime is simple assault, assault in the fourth degree, or prostitution and more than three years has passed since conviction;

     (d) A conviction for "crimes related to financial exploitation" as described under RCW 43.43.830, unless the crime is theft in the third degree and more than three years have passed since conviction, or unless the crime was forgery or theft in the second degree and more than five years have passed since conviction;

     (e) Has been convicted of:

     (i) Violation of the imitation controlled substances act (VISCA);

     (ii) Violation of the uniform controlled substances act (VUCSA);

     (iii) Violation of the uniform legend drug act (VULDA); or

     (iv) Violation of the uniform precursor drug act (VUPDA).

     (f) Has been convicted of sending or bringing into the state depictions of a minor engaged in sexually explicit conduct;

     (g) Has been convicted of criminal mistreatment;

     (h) Has been found to have abused, neglected, abandoned, or financially exploited a minor or vulnerable adult by court of law or a disciplining authority, ((as defined in)) including the department of health. Examples of legal proceedings in which such findings could be made include juvenile court proceedings under chapter 13.34 RCW, domestic relations proceedings under title 26 RCW, and vulnerable adult protection proceedings under chapter 74.34 RCW;

     (i) Has a finding of abuse or neglect of a child, per RCW 26.44.020 and chapter 388-15 WAC that is:

     (A) Listed on the department's background check central unit (BCCU) report; or

     (B) Disclosed by the individual, except for findings made before December, 1998. Findings made before December, 1998, require a character, competence and suitability determination.

     (j) Has a finding of abuse, neglect, financial exploitation, or abandonment of a vulnerable adult that is:

     (i) Listed on any registry, including the department's registry;

     (ii) Listed on the department's background check central unit (BCCU) report; or

     (iii) Disclosed by the individual, except for adult protective services findings made before October, 2003. Findings made before October, 2003, require a character, competence, and suitability determination.

     (6) Has had a ((license, certification, or a contract for the care of children or vulnerable adults denied, suspended, revoked, or terminated for noncompliance with state and/or federal regulations)) medicaid or medicare provider agreement or any other contract for the care and treatment of children or vulnerable adults terminated, cancelled, suspended, revoked, or not renewed by any public agency, including a state medicaid agency;

     (7) Who does not successfully complete the training requirements, if exempt from certification, within the time limits required in WAC ((388-71-05665)) 388-71-0836 through ((388-71-05865)) 388-71-1006;

     (8) ((Is already meeting)) Who does not successfully complete the certification or recertification requirements as described under WAC 388-71-0975;

     (9) Who has had a home care aide certification denied, suspended, or revoked and is not eligible to work until his or her certification has been reissued;

     (10) When the ((client's)) participant's needs are already being met on an informal basis, and the ((client's)) participant's assessment or reassessment does not identify any unmet need; and/or

     (((9))) (11) Who is terminated by the ((client)) participant (in the case of an individual provider) or by the home care agency (in the case of ((an)) a home care agency ((provider)) caregiver).

     (12) In addition, the department, AAA, or department designee may deny payment to or terminate the contract of an individual provider as provided under WAC 388-71-0543, 388-71-0546, and 388-71-0551((, and 388-71-0556)).

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 571, and Washington state 2009-11 budget, section 206(17). 10-06-112, § 388-71-0540, filed 3/3/10, effective 4/3/10. Statutory Authority: RCW 74.08.090, 74.09.520. 07-24-026, § 388-71-0540, filed 11/28/07, effective 1/1/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, § 388-71-0540, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-71-0540, filed 5/17/05, effective 6/17/05. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-0540, 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, 74.39.095. 01-11-019, § 388-71-0540, filed 5/4/01, effective 6/4/01. 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, § 388-71-0540, filed 1/13/00, effective 2/13/00.]

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-71-0543   When may the department, AAA, or department designee deny payment for the services of an individual provider or home care agency caregiver?   The department, AAA, or department designee may deny payment for the services of an individual provider or home care agency caregiver:

     (1) Who has been convicted of:

     (a) Simple assault, theft in third degree, assault in the fourth degree, or prostitution and more than three years has passed since conviction;

     (b) Forgery or theft in the second degree and more than five years has passed since conviction;

     (c) Any conviction that the department determines is reasonably related to the competency of the person to provide care to a participant; or

     (d) A crime involving a firearm used in commission of a felony or in any act of violence against a person.

     (2) Has engaged in the illegal use of drugs, or excessive use of alcohol or drugs without the evidence of rehabilitation;

     (3) Has committed an act of domestic violence toward a family or household member;

     (4) Has been found in any final decision of a federal or state agency to have abandoned, neglected, abused or financially exploited a vulnerable adult, unless such decision requires a denial of payment under this chapter;

     (5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, terminated, or not renewed;

     (6) Has had any health care provider license, certification or contract denied, suspended, revoked, terminated, even though the license was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a caregiver who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

     (7) Has had any residential care facility or health care facility license, certification, contract denied, suspended, revoked, terminated, even though the license, certification or contract was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a caregiver who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

     (8) Has been enjoined from operating a facility for the care and services of children or adults;

     (9) Has been the subject of a sanction or corrective or remedial action taken by federal, state, county, or municipal officials or safety officials related to the care or treatment of children or vulnerable adults;

     (10) Has obtained or attempted to obtain a license, certification or contract by fraudulent means or misrepresentation;

     (11) Knowingly, or with reason to know, made a false statement of material fact on his or her application for a license, certification, contract or any data attached to the application, or in any matter involving the department;

     (12) Willfully prevented or interfered with or failed to cooperate with any inspection, investigation, or monitoring visit made by the department, including refusal to permit authorized department representatives to interview participants or have access to their records.

[]

     (1) Evidence of alcohol or drug abuse;

     (2) A reported history of domestic violence committed by the individual provider, no-contact orders entered against the individual provider, or criminal conduct committed by the individual provider (whether or not the conduct is disqualifying under ((RCW 43.43.830 and 43.43.842)) WAC 388-71-0540);

     (3) A report from ((the client's health care provider or other)) any knowledgeable person that the ((requested)) individual provider lacks the ability or willingness to provide adequate care;

     (4) The individual provider has other employment or responsibilities that prevent or interfere with the provision of required services;

     (5) Excessive commuting distance that would make it impractical for the individual provider to provide services as they are needed and outlined in ((the client's)) your service plan.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, § 388-71-0546, filed 2/6/06, effective 3/9/06. 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, 74.39.095. 01-11-019, § 388-71-0546, filed 5/4/01, effective 6/4/01.]

     (2) Inadequate performance or inability to deliver quality care is jeopardizing the ((client's)) participant's health, safety, or well-being.

     (3) The department, AAA, or ((managed care entity)) department designee may summarily suspend the contract pending a hearing based on a reasonable, good faith belief that the ((client's)) participant's health, safety, or well-being is in imminent jeopardy. Examples of circumstances indicating jeopardy to the ((client could)) participant include, ((without limitation)) but are not limited to:

     (((1))) (a) The individual provider has committed domestic violence or abuse, neglect, abandonment, or exploitation of a ((minor)) child, as defined in RCW 26.44.020 or a vulnerable adult, as defined in RCW 74.34.020;

     (((2) Using or being)) (b) The individual provider uses or is under the influence of alcohol or illegal drugs during working hours;

     (((3))) (c) The individual provider engages in other behavior directed toward the ((client)) participant or other persons involved in the ((client's)) participant's life that places the client at risk of harm;

     (((4))) (d) A report from the ((client's)) participant's health care provider that the ((client's)) participant's health is negatively affected by inadequate care being provided by the individual provider;

     (((5))) (e) A complaint from the ((client or client's)) participant or participant's representative that the ((client)) participant is not receiving adequate care from the individual provider;

     (((6))) (f) The ((absence of)) individual provider's failure to engage in essential interventions identified in the service plan, such as medications or medical supplies; and/or

     (((7))) (g) The individual provider's failure to respond appropriately to emergencies.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, § 388-71-0551, filed 2/6/06, effective 3/9/06. 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, 74.39.095. 01-11-019, § 388-71-0551, filed 5/4/01, effective 6/4/01.]

     (((1) A fair)) (a) An administrative hearing to appeal the decision, ((per)) under chapter 388-02 WAC, and

     (((2))) (b) Receive services from another currently contracted individual provider or home care agency ((provider)) caregiver, or ((other options)) to receive services through other programs the ((client)) participant is eligible for((, if a contract is summarily suspended)).

     (((3))) (2) The hearing rights ((afforded)) provided under this section are those of the ((client)) participant, not the individual provider's rights.

[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, 74.39.095. 01-11-019, § 388-71-0560, filed 5/4/01, effective 6/4/01. 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, § 388-71-0560, filed 1/13/00, effective 2/13/00.]

     (a) Who has not been certified by the department of health as a home care aide; or

     (b) If exempted from certification, has not completed required training within the required timeframe.

     (2) An individual provider has an administrative hearing right when the department terminates the individual provider's contract, or takes other enforcement measures:

     (a) When the individual provider's certification as a home care aide has been revoked by the department of health; or

     (b) If exempted from certification, has not completed training requirements within the required timeframe.

     (3) In an administrative hearing challenging DSHS action to deny payment to an individual provider or to terminate the contract of an individual provider, the individual provider may not challenge the action by the department of health affecting the individual provider's certification. Action by the department of health affecting the individual provider's certification must be challenged in a department of health hearing, as provided in department of health rules.

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     "Certified home care aide" means a long-term care worker who has obtained and maintains a home care aide certification through the department of health.

     "Competency" defines the integrated knowledge, skills, or behavior expected of a long-term care worker after completing training in a required topic area. Learning objectives are associated with each competency.

     "DDD" refers to the division of developmental disabilities.

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

     "Hands-on care" means providing personal care services.

     "Individual provider" means a person who has contracted with the department to provide personal care or respite care services to persons with functional disabilities under medicaid personal care, community options program entry system (COPES), chore services, or respite care program, or to provide respite care or residential services and supports to person with developmental disabilities under chapter 71A.12 RCW or to provide respite care as defined in RCW 74.13.270.

     "Learning objectives" are measurable, written statements that clearly describe what a long-term care worker must minimally learn to meet each competency. Learning objectives are identified for each competency. Learning objectives provide consistent, common language and a framework for curriculum designers, the curriculum approval process, and testing. Curriculum developers have the flexibility to determine how learning objectives are met and may include additional content deemed necessary to best meet the competency in a particular setting.

     "Long-term care worker" includes all persons providing personal care for the elderly or persons with disabilities, including individual providers, direct care employees of home care agencies, providers of home care services to persons with developmental disabilities under Title 71 RCW, all direct care workers in state-licensed boarding homes, and adult family homes, respite care providers, and supported living providers.

     Long-term care workers do not include persons providing personal care services in nursing homes subject to chapter 18.51 RCW; hospitals or other acute care settings; residential habilitation centers under chapter 71A.20 RCW; facilities certified under 42 CFR, Part 483; hospice agencies subject to chapter 70.127 RCW; adult day centers; adult day health centers; persons who are otherwise licensed to provide health care services, such as nurses and certified nursing assistants; and individuals providing personal care on an independent basis to private-pay consumers. This last instance would occur when personal care services are provided directly to an individual who pays for the services out-of-pocket without assistance from DSHS.

     "Participant" means the individual receiving in-home services.

     "Personal care services" means physical or verbal assistance with activities of daily living and instrumental activities of daily living, as defined in WAC 388-106-0010, provided because of a person's functional limitations.

     "Training partnership" means a joint partnership or trust that includes the office of the governor and the exclusive bargaining representative of individual providers under RCW 74.39A.270 with the capacity to provide training, peer mentoring, and workforce development, or other services to individual providers.

[]

     (2) Orientation must be provided by a qualified instructor of:

     (a) The training partnership for individual providers; or

     (b) Appropriate agency staff for home care agency caregivers.

     (3) The department must pre-approve orientation curriculum.

[]

     (1) The care setting and the characteristics and special needs of the population served;

     (2) Basic job responsibilities and performance expectations;

     (3) The care plan, including what it is and how to use it;

     (4) The care team;

     (5) Process, policies, and procedures for observation, documentation and reporting problems and concerns;

     (6) Participant rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care;

     (7) Mandatory reporter law and worker responsibilities; and

     (8) Communication methods and techniques that can be used during the first weeks working with a participant or guardian, other care team members, and a participant's family and/or friends.

     One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training. The instructor must establish a way for the student to ask the instructor questions.

[]

     (2) Safety training must be provided by a qualified instructor of:

     (a) The training partnership for individual providers;

     (b) Appropriate agency staff for home care agency caregivers; or

     (c) Other DSHS contracted community instructors or training entities.

     (3) The department must approve safety training curriculums.

[]

     (1) Safety planning and accident prevention, including but not limited to:

     (a) Proper body mechanics;

     (b) Fall prevention;

     (c) Fire safety;

     (d) In-home hazards;

     (e) Long-term care worker safety; and

     (f) Emergency and disaster preparedness.

     (2) Standard precautions and infection control, including but not limited to:

     (a) Proper hand washing;

     (b) When to wear gloves and how to correctly put them on and take them off;

     (c) Basic methods to stop the spread of infection;

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

     (e) Appropriate disposal of contaminated/hazardous articles;

     (f) Reporting exposure to contaminated articles; and

     (g) What to do when sick or injured, including whom to report this to.

     (3) Basic emergency procedures, including but not limited to:

     (a) Evacuation preparedness;

     (b) When and where to call for help in an emergency;

     (c) What to do when a participant is falling or falls;

     (d) Location of any advanced directives and when they are given; and

     (e) Basic fire emergency procedures.

     One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training. The instructor must establish a way for the student to ask the instructor questions.

[]

[]

     (a) Core competencies; and

     (b) Population specific competencies.

     (2) All basic training curriculum and instructors must be pre-approved by DSHS.

     (3) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of training.

[]

     (1) The date of hire for home care agency caregivers; or

     (2) From the begin date of the authorization to provide department-paid in-home services for a participant for individual providers.

[]

     (1) An individual provider caring only for his or her biological, step, or adoptive child or parent; and

     (2) Until January 1, 2014, an individual provider who provides care to only one person for twenty hours or less in any calendar month.

     The individual providers described in this section may choose to complete the seventy hour basic training at their own expense.

[]

[]

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     (1) Medicaid personal care;

     (2) Assessments completed by the division of developmental disabilities;

     (3) Community resources;

     (4) State and federal benefits; and

     (5) Networking.

[]

     (2) A person employed as a long-term care worker on December 31, 2010, who completes within one hundred twenty days of hire, all of the training requirements in effect on the date of his or her hire;

     (3) A person previously employed as a long-term care worker prior to December 31, 2010, who completed prior to January 1, 2011, all the training requirements in effect on the date of his or her hire, and was employed as a long-term care worker at some point during the calendar year 2010;

     (4) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW;

     (5) Nursing assistants-certified under chapter 18.88A RCW;

     (6) Certified counselors under chapter 18.19 RCW;

     (7) Speech language pathologists or audiologists under chapter 18.35 RCW;

     (8) Occupational therapists under chapter 18.59 RCW;

     (9) Physical therapists under chapter 18.74 RCW;

     (10) A home health aide who is employed by a medicare-certified home health agency and has met the requirements of 42 CFR, Part 483.35;

     (11) An individual with special education training and an endorsement granted by the superintendent of public instruction as described in RCW 28A.300.010;

     (12) Parent providers as described in WAC 388-71-0890; and

     (13) Until January 1, 2014, an individual provider who provides care to only one person for twenty hours or less in any calendar month.

     A long term-care worker exempted by this section from the training requirements contained in RCW 74.39A.073 may not be prohibited from enrolling in the training and attending at their own expense.

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     (1) Communication skills;

     (2) Long-term care worker self-care;

     (3) Problem solving;

     (4) Participant rights and maintaining dignity;

     (5) Abuse, abandonment, neglect, financial exploitation and mandatory reporting;

     (6) Participant directed care;

     (7) Cultural sensitivity;

     (8) Body mechanics;

     (9) Fall prevention;

     (10) Skin and body care;

     (11) Long-term care worker roles and boundaries;

     (12) Supporting activities of daily living;

     (13) Food preparation and handling;

     (14) Medication assistance;

     (15) Infection control, blood-borne pathogens, HIV/AIDS; and

     (16) Grief and loss.

[]

     (1) Regarding communication, communicate effectively and in a respectful and appropriate manner with participants, family members, and other care team members:

     (a) Recognize how verbal and nonverbal cues impact communication with the participant and care team;

     (b) Engage and respect the participant through verbal and nonverbal communication;

     (c) Listen attentively and ensure that the participant understands what has been communicated;

     (d) Recognize and acknowledge participants' communication for indicators of pain, confusion, or misunderstanding;

     (e) Utilize communication strategies to deal with difficult situations; and

     (f) Recognize common barriers to effective communication and identify how to eliminate them.

     (2) Regarding long-term care worker self-care, take appropriate action to reduce stress and avoid burnout:

     (a) Identify behaviors, practices and resources to reduce stress and avoid burnout;

     (b) Recognize common barriers to self-care and ways to overcome them; and

     (c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout; and the importance of taking action to practice self-care to avoid burnout.

     (3) Regarding the competency of effective problem solving, use effective problem solving skills:

     (a) Explain why it is necessary to understand and utilize a problem solving method;

     (b) Implement a problem solving process/method; and

     (c) Identify obstacles to effective problem solving and ways to overcome them.

     (4) Regarding the competency of participant rights and dignity, take appropriate action to promote and protect a participant's legal and human rights:

     (a) Identify participant rights that are protected by federal and Washington state laws;

     (b) Protect a participant's confidentiality;

     (c) Promote dignity, privacy, and encourage a participant's maximum independence when providing care; and

     (d) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use.

     (5) Regarding the competency of abuse and mandatory reporting, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:

     (a) Describe long-term care workers' responsibilities as a mandatory reporter as defined in RCW 74.34.020 through 74.34.040; and

     (b) Identify common signs and symptoms of abuse, abandonment, neglect, and financial exploitation.

     (6) Regarding the competency of participant directed care, encourage the participant to direct his or her care:

     (a) Explain the importance of participant directed care;

     (b) Use problem solving skills that balance a participant's choice with safety; and

     (c) Report concerns when a participant refuses care or makes choices that present a possible safety concern.

     (7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:

     (a) Describe how cultural background, lifestyle practices, and traditions can impact care; and

     (b) Utilize methods to determine and ensure a participant's beliefs are respected and considered when providing care.

     (8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the care plan.

     (9) Regarding the competency on fall prevention, prevent or reduce the risk of falls:

     (a) Identify fall risk factors and take action to reduce fall risks for a participant; and

     (b) Take proper steps to assist when a participant is falling or has fallen and is on the floor.

     (10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:

     (a) Explain the importance of observing a participant's skin, when to observe it and what to look for including common signs and symptoms of skin breakdown;

     (b) Identify risk factors of skin breakdown;

     (c) Observe skin at pressure point locations and report any concerns;

     (d) Describe what a pressure ulcer is, what it looks like, and what to do if a participant develops a pressure ulcer;

     (e) Identify when to report skin concerns and to whom;

     (f) Describe personal care practices to protect and maintain a participant's skin integrity including how often a participant must change position when sitting or lying for extended periods, proper positioning and transfers; and

     (g) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility.

     (11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:

     (a) Identify when, where, how, and why to obtain information about a participant's condition or disease for which they are receiving services and use this information to provide appropriate, individualized care;

     (b) Describe a participant's baseline based on information provided in the care plan and explain why it is important to know a participant's baseline;

     (c) Identify changes in a participant's physical, mental, and emotional state;

     (d) Report changes from baseline and/or concerns to the appropriate care team member;

     (e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to a participant's safety and well-being;

     (f) Explain the purpose of a care plan and describe how it is created and modified;

     (g) Use a participant's care plan to direct a worker's job tasks and any participant directed care tasks;

     (h) Identify what is required of a long-term care worker, as described in WAC 388-71-0946, prior to performing a nurse-delegated task;

     (i) Describe the role of a care team and a long-term care worker's role in it;

     (j) Describe professional boundaries and the importance of maintaining them; and

     (k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them.

     (12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

     (a) Demonstrate, in the presence of a qualified instructor, all critical steps required for the following personal care tasks:

     (i) Helping an individual walk;

     (ii) Transferring an individual from bed to wheelchair;

     (iii) Turning and repositioning an individual in bed;

     (iv) Providing mouth care;

     (v) Cleaning and storing dentures;

     (vi) Shaving a face;

     (vii) Providing fingernail care;

     (viii) Providing foot care;

     (ix) Providing a bed bath;

     (x) Assisting an individual with a weak arm to dress;

     (xi) Putting knee-high elastic stockings on an individual;

     (xii) Providing passive range of motion for one shoulder;

     (xiii) Providing passive range of motion for one knee and ankle;

     (xiv) Assisting an individual to eat;

     (xv) Assisting with peri-care;

     (xvi) Assisting with the use of a bedpan;

     (xvii) Assisting with catheter care;

     (xviii) Assisting with condom catheter care; and

     (xix) Providing medication assistance.

     (b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate participant preferences, maintain privacy and dignity, encourage independence, and assure comfort and safety;

     (c) Appropriately utilize assistive device(s) specified in the care plan;

     (d) Describe any safety concerns related to each task and how to address the concerns;

     (e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

     (f) Identify the importance of knowing a participant's bowel and bladder functioning baseline and when to report concerns.

     (13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:

     (a) Describe how nutrition and hydration can impact a participant's health;

     (b) Plan, shop, and prepare meals for a participant according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the care plan and participant preferences;

     (c) Describe common signs of poor nutrition and hydration, and when to report concerns and to whom;

     (d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a participant;

     (e) Recognize when a participant's food choices vary from specifications on the care plan, describe when and to whom to report concerns;

     (f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

     (g) Describe appropriate food handling practices, including: avoiding cross contamination from one food to another, safe storage requirements for cooling of leftover foods, including depth, types of containers, and temperatures, the need to maintain food at proper temperatures to limit bacterial growth and what are the safe food storage and holding temperatures for both cold and hot foods, best practices for thawing and re-heating food, and using clean gloves and utensils when preparing food;

     (h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

     (i) Describe why a long-term care worker with certain types of illnesses and/or symptoms must not prepare food.

     Long-term care workers who complete DSHS approved basic training meet the training requirements for adult family homes in RCW 70.128.250.

     (14) Regarding the competency of medication assistance, appropriately assist with medications:

     (a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications as described under in chapter 246-888 WAC;

     (b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;

     (c) Identify common symptoms of medication side effects and when and to whom to report concerns;

     (d) Store medications according to safe practices;

     (e) Describe, in the proper sequence, each of the five rights of medication assistance; and

     (f) Identify what to do for medication-related concerns, including describing ways to work with a participant who refuses to take medications, identifying when and to whom to report when a participant refuses medication or there are other medication-related concerns, and identifying what is considered a medication error and when and to whom it must be reported.

     (15) Regarding the competency of infection control, blood borne pathogens and HIV/AIDS, implement best practices to prevent and control the spread of infections:

     (a) Identify common infections, ways that infections are spread, and symptoms of infections;

     (b) Describe the purpose, benefit and proper implementation of standard precautions in infection control;

     (c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;

     (d) Demonstrate proper hand washing and putting on and taking off gloves;

     (e) Identify immunizations that any adult needs to reduce the spread of viruses and bacteria;

     (f) Describe laundry and housekeeping measures that help in controlling the spread of infection;

     (g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;

     (h) Describe what blood-borne (BB) pathogens are and how they are transmitted;

     (i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;

     (j) Identify measures to take to prevent BB diseases;

     (k) Describe what to do if exposed to BB pathogens and how to report an exposure;

     (l) Describe how HIV works in the body;

     (m) Explain that testing and counseling for HIV/AIDS is available;

     (n) Describe the common symptoms of HIV/AIDS;

     (o) Explain the legal and ethical issues related to HIV including required reporting, confidentiality and nondiscrimination; and

     (p) Explain the importance of emotional issues and support for participants and long-term care workers.

     Long-term care workers who complete DSHS-approved basic training meet the four hours of AIDS education as required by the department of health in WAC 246-980-040.

     (16) Regarding the competency on grief and loss, support yourself and the participant in the grieving process:

     (a) Define grief and loss;

     (b) Describe common losses a participant or long-term care worker may experience;

     (c) Identify common symptoms associated with grief and loss;

     (d) Describe why self-care is important during the grieving process; and

     (e) Identify beneficial ways and resources to work through feelings of grief and loss.

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     (1) Dementia;

     (2) Mental health;

     (3) Developmental disabilities;

     (4) Young adults with physical disabilities;

     (5) Aging and older adults;

     (6) Communication; and

     (7) Dealing with challenging behaviors.

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     (1) Regarding the competency on dementia, work effectively with participants who have dementia based upon a basic understanding of dementia:

     (a) Identify basic information on dementia, including causes and treatments;

     (b) Describe how dementia affects a person's needs and behaviors;

     (c) List typical behaviors and symptoms a person with dementia would most likely experience; and

     (d) Describe the differences the long-term care worker might see based on the type of dementia a person has.

     (2) Regarding the competency on mental health, work effectively with participants with a mental disorder based upon a basic understanding of mental disorders:

     (a) Define and describe main symptoms of major mood and thought disorders, including depression, bipolar disorder, schizophrenia, and anxiety disorder, and list possible treatment options;

     (b) Describe the progression of mental disorders;

     (c) Identify common myths and misinformation about mental disorders;

     (d) Define stigma and identify how stigma can impact caregiving;

     (e) Identify if, and list signs that, a person is possibly suicidal;

     (f) Describe how to respond appropriately to a person experiencing suicidal thoughts, including how, where, and when to refer someone who is experiencing suicidal thoughts and/or planning, and methods to keep a suicidal person safe and ensure safety for others; and

     (g) Describe strategies to help cope with a participant's suicide.

     (3) Regarding the competency on developmental disabilities, work effectively with individuals who have a developmental disability based upon a basic understanding of developmental disabilities:

     (a) Define developmental disability and describe the following conditions, including mental retardation, cerebral palsy, epilepsy, and autism;

     (b) Identify common myths and misconceptions about developmental disabilities;

     (c) Describe the negative effects of using labels such as "retarded" or "handicapped" to represent people and positive alternatives; and

     (d) Differentiate between developmental disabilities and mental disorders.

     (4) Regarding the competency on young adults with physical disabilities, work effectively with young adults with physical disabilities based on a basic understanding of physical disabilities:

     (a) Identify basic information regarding physical disabilities, injuries and illnesses that are more common in younger adults;

     (b) Describe the impact of changing and fluctuating abilities;

     (c) Identify stereotypes, biases and misconceptions regarding perception of adults with disabilities;

     (d) Describe how biases, stereotypes and misconceptions can influence care to adults with disabilities;

     (e) Identify and explain the Americans with Disabilities Act and rights for adults with physical disabilities; and

     (f) Describe the value of personalizing care and supporting the specific person with a disability.

     (5) Regarding the competency on aging and older adults, work effectively with older adults based on a basic understanding of aging:

     (a) Describe basic information on the aging process, including the difference between age-related changes and disease process;

     (b) List typical changes that occur with aging;

     (c) Identify common stereotypes, biases and misconceptions regarding aging, "ageism" and older adults;

     (d) Describe how "ageism", biases, myths and misconceptions can influence care to older participants;

     (e) Describe how aging affects the participant's needs and behaviors; and

     (f) Describe the value of adapting caregiving to the age-related concerns of the person.

     (6) Regarding the competency on communication, communicate respectfully and appropriately with participants who have dementia, a mental disorder, or a developmental disability:

     (a) Explore and discuss how dementia-caused cognitive losses, mental disorders, and developmental disabilities affect communication;

     (b) Demonstrate appropriate and inappropriate communication skills;

     (c) Discuss how effective communication impacts a participant's behavior;

     (d) Demonstrate how to effectively initiate and conduct a conversation with a participant who has dementia; and

     (e) List tips for communicating with individuals with dementia, mental disorders, and developmental disabilities.

     (7) Regarding the competency on dealing with challenging behaviors, use a problem-solving approach when dealing with challenging behaviors:

     (a) Identify some challenging behaviors and explore their causes;

     (b) Review and demonstrate the use of a problem-solving method to intervene in challenging behaviors or situations;

     (c) Describe strategies for dealing with challenging behaviors; and

     (d) Demonstrate how to respond appropriately to a participant who is expressing a challenging behavior.

     Population specific training on dementia may be used to meet the introduction to dementia as described under WAC 388-112-0132(1); the population specific training on mental health may be used to meet the introduction to mental health as described under WAC 388-112-0142(1); the population specific training on developmental disabilities may be used to meet the introduction to developmental disabilities as described under WAC 388-112-0122(1).

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     (2) Nurse delegation specialized diabetes training; and

     (3) Peer mentoring and/or on-the-job training after July 1, 2011. Only up to twelve hours may be applied in any combination of peer mentoring or on-the-job training.

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     (2) Only the curriculum developed by DSHS, "Nurse Delegation for Nursing Assistants" meets the training requirement for nurse delegation core training.

     (3) DSHS must approve the instructors for nurse delegation core training prior to an instructor offering a course.

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     (2) The specialized diabetes nurse delegation training consists of three modules which are diabetes, insulin, and injections.

     (3) 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.

     (4) DSHS approves the instructors for the specialized diabetes nurse delegation training prior to an instructor offering a course.

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     (1) Be a:

     (a) Certified home care aide and nursing assistant registered; or

     (b) Nursing assistant certified under chapter 18.88A RCW; or

     (c) If exempt from the home care aide certification, become a nursing assistant registered and complete the basic training core competencies.

     (2) Successfully complete "Nurse Delegation for Nursing Assistants" training.

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     (2) Peer mentoring is provided by a long-term care worker who has completed twelve hours of peer mentor training and is mentoring no more than ten long-term care workers at any given time.

     (3) Participant consent must be obtained prior to providing or receiving peer mentoring.

     (4) Effective July 1, 2011, for the person receiving mentoring, the hours spent in mentoring may count for up to twelve hours toward the completion of basic training requirements.

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     (1) Documentation of on-the-job training must include the number of hours and verification of the demonstrated skills.

     (2) For the person receiving on the job training, the hours spent in on-the-job training may count for up to twelve hours toward the completion of basic training requirements.

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     (1) The name of the trainee;

     (2) The name of the training;

     (3) The number of hours of the training;

     (4) The name of the approved training entity and/or identification number;

     (5) The instructor's name and/or identification number;

     (6) The instructor's signature or an authorized signature from the training entity the qualified instructor is training on behalf of; and

     (7) The completion date of the training.

     The long-term care worker must retain the original certificate or transcript. A home care agency must keep a copy of the certificate or transcript on file.

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     (2) An approved instructor or approved training entity issuing and signing a DSHS seventy-five hour training certificate must verify that the long-term care worker has the certificates or transcript required documenting two hours of DSHS-approved orientation, three hours of approved safety training, and seventy hours of DSHS-approved basic training, as described in this chapter. Only a DSHS or training partnership seventy-five hour training certificate can be submitted by a long-term care worker applying to the department of health for a home care aide certification.

     (3) For home care aide recertification, successful completion of twelve hours of DSHS-approved continuing education training must be documented on a DSHS certificate issued by an approved instructor or approved training entity who has provided all twelve hours of continuing education training. If all twelve hours of continuing education were not provided by the same instructor or training entity, then an approved instructor or approved training entity must verify that the certified home care aide has certificates or transcripts that add up to twelve hours of DSHS-approved continuing education. Only a DSHS or training partnership twelve-hour continuing education certificate can be submitted by a certified home care aide applying to the department of health for recertification.

     (4) The long-term care worker and certified home care aide must retain the original seventy-five hour training certificate and any twelve-hour continuing education training certificates. Training entities must keep a copy of these certificates on file.

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     (2) DSHS must approve continuing education curricula and instructors.

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     (2) Effective July 1, 2011, all certified home care aides must complete twelve hours of continuing education each year as described in department of health WAC 246-980-110.

     (3) If exempt from certification, all long-term care workers, must complete twelve hours of continuing education per calendar year unless exempt from continuing education as described in WAC 388-71-1001.

     (4) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of continuing education. The instructor must establish a way for the student to ask the instructor questions.

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     (1) Individual providers caring only for his or her biological, step, or adoptive son or daughter; and

     (2) Before June 30, 2014, an individual provider who provides twenty hours or less of care for one person in any calendar month.

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     (1) Participant rights;

     (2) Personal care services;

     (3) Mental disorders;

     (4) Dementia;

     (5) Developmental disabilities;

     (6) Depression;

     (7) Medication assistance;

     (8) Communication skills;

     (9) Positive participant behavior support;

     (10) Developing or improving participant-centered activities;

     (11) Dealing with wandering;

     (12) Dealing with aggressive participant behaviors;

     (13) Medical conditions; and

     (14) Nurse delegation core and specialized diabetes.

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     (2) The nurse delegation core and diabetes training must use only the DSHS curriculum.

     (3) A curriculum requiring approval must be approved before it is used. Approval will be based on curriculum review, as described under WAC 388-71-1026 through 388-71-1033.

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     (1) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives are located in the curriculum for core competencies and learning objectives, as described under WAC 388-71-0911 and the population specific competencies and learning objectives, as described under in WAC 388-71-0921;

     (2) Any materials students will receive such as a textbook or student manual, handouts, and any audio-visual materials;

     (3) The table of contents or outline of the curriculum with the allotted time for each section;

     (4) The personal care tasks, described in WAC 388-71-0911 (12)(a) and (b), and infection control skills (hand washing and putting on and taking off gloves) demonstration checklists;

     (5) The teacher's guide or manual that includes for each section of the curriculum:

     (a) Goals and objectives;

     (b) How that section will be taught including teaching methods and learning activities that incorporate adult learning principles;

     (c) Methods instructors will use to determine whether each long-term care worker understands the material covered and can demonstrate all skills;

     (d) A list of sources or references, if any, used to develop the curriculum;

     (e) Methods of teaching and how accommodations will be made for long-term care workers with limited English proficiency and/or learning disabilities; and

     (f) Description and proof of how input from consumers and long-term care worker representatives was obtained in the development of the curriculum.

     (6) In addition, for curricula being submitted for the core competency section of the basic training as described in WAC 388-71-0911, the curriculum must include how much time long-term care workers will be given to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill.

     Substantial changes to a previously-approved curriculum must be approved before they are used.

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     (2) If the curriculum is not approved, a revised curriculum may be submitted to DSHS for another review. If the reasons why the curriculum is not approved cannot be resolved, the submitter may seek review of the nonapproval decision from the assistant secretary of aging and disability services administration. The assistant secretary's review decision shall be the final decision of DSHS; no other administrative review is available to the submitter.

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     (2) Effective July 1, 2011, in order to be approved for any continuing education training, submit DSHS form 16-228 and class syllabus at least forty-five days in advance of delivery of the training.

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     (1) Coordinating and teaching classes;

     (2) Assuring that the curriculum used is DSHS-approved and taught as designed;

     (3) Selecting and monitoring qualified guest speakers, where applicable;

     (4) Administering or overseeing the administration of the DSHS competency tests for nurse delegation core and specialized diabetes trainings;

     (5) Maintaining training records including student tests and attendance records for a minimum of six years;

     (6) Reporting training data to DSHS in DSHS-identified timeframes; and

     (7) Issuing or reissuing training certificates to students.

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     (1) DSHS must approve and/or contract with an instructor to conduct orientation, safety, basic training (core and population specific training), nurse delegation core training and nurse delegation specialized diabetes training, and continuing education. DSHS may contract with instructors using any applicable contracting procedures.

     (2) The training partnership must ensure that all instructors meet the minimum qualifications under this chapter.

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     (1) General qualifications:

     (a) Twenty-one years of age; and

     (b) Has not had a professional health care, adult family home, boarding home, or social services license or certification revoked in Washington state.

     (2) Education and work experience:

     (a) Upon initial approval or hire, an instructor must:

     (i) Be a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting; or

     (ii) Have 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 388-101 WAC, or home care setting; or

     (iii) Have a high school diploma, or equivalent, 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 388-101 WAC, or home care setting.

     (3) Teaching experience:

     (a) Must have one hundred hours of 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 in WAC 388-71-1066.

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

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

     (6) If required under WAC 388-71-0875, instructors must successfully complete basic training and obtain home care aide certification prior to beginning to train others; and

     (7) An instructor for nurse delegation core and specialized diabetes trainings must have a current Washington state RN license in good standing without practice restrictions.

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     (1) Adult education theory and practice principles;

     (2) Instructor facilitation techniques;

     (3) Facilitating learning activities for adults;

     (4) Administering competency testing; and

     (5) Working with adults with special training needs (for example, English as a second language or learning or literacy issues).

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     (a) May only teach a specific subject in which he or she has expertise, background, and experience that establishes his or her expertise on that specific topic;

     (b) May not teach the entire course;

     (c) Must not supplant the primary teaching responsibilities of the instructor; and

     (d) Must cover the DSHS competencies and learning objectives for the topic he or she is teaching.

     (2) The approved instructor:

     (a) Must ensure the guest speaker meets these minimum qualifications;

     (b) Maintain documentation of the guest speaker's qualifications and background;

     (c) Supervise and monitor the guest speaker's performance; and

     (d) Is responsible for ensuring the required content is taught.

     (3) DSHS does not approve guest speakers.

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     (a) Verify, document, keep on file, and make available to the department upon request, that all instructors meet the minimum instructor qualifications in WAC 388-71-1055 for the course they plan to teach;

     (b) Teach using a DSHS approved curriculum;

     (c) Notify DSHS in writing when changing training plans, including:

     (i) Name and schedule of training(s) the partnership will conduct;

     (ii) Name of approved curriculum(s) the partnership will use; and

     (iii) Name of the instructor.

     (d) Ensure that DSHS competency tests are administered when conducting nurse delegation core or specialized diabetes training;

     (e) Keep a copy of long-term care worker certificates on file for six years and give the original certificate to the trainee;

     (f) Keep attendance records and testing records of long-term care workers trained and tested on file for six years; and

     (g) Report training data to DSHS when requested by the department.

     (2) The department may conduct a random audit at any time to review instructor qualifications.

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

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

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     (1) Skills demonstration of ability to perform and/or implement specific caregiving approaches, and/or activities as appropriate to the training;

     (2) Written evaluation to show knowledge of the learning objectives included in the training; and

     (3) A scoring guide for the tester with clearly stated scoring criteria and minimum proficiency standards.

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     (1) An instructor for the course who meets all minimum qualifications for the course he or she teaches must oversee all testing; and

     (2) The tester must follow the DSHS guidelines for:

     (a) The maximum length of time allowed for the testing;

     (b) The amount and nature of instruction given students before beginning a test;

     (c) The amount of assistance to students allowed during testing;

     (d) The accommodation guidelines for students with disabilities; and

     (e) Accessibility guidelines for students with limited English proficiency.

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     The following sections of the Washington Administrative Code are repealed:

WAC 388-71-05665	What definitions apply to WAC 388-71-05670 through 388-71-05909?
WAC 388-71-05670	What is orientation?
WAC 388-71-05675	What content must be included in an orientation?
WAC 388-71-05680	Is competency testing required for orientation?
WAC 388-71-05685	Is there a challenge test for orientation?
WAC 388-71-05690	What documentation is required for orientation?
WAC 388-71-05695	Who is required to complete orientation, and when must it be completed?
WAC 388-71-05700	What is basic training?
WAC 388-71-05705	Is there an alternative to the basic training for some health care workers?
WAC 388-71-05710	What core knowledge and skills must be taught in basic training?
WAC 388-71-05715	Is competency testing required for basic training?
WAC 388-71-05720	Is there a challenge test for basic training?
WAC 388-71-05725	What documentation is required for successful completion of basic training?
WAC 388-71-05730	Who is required to complete basic training, and when?
WAC 388-71-05735	What is modified basic training?
WAC 388-71-05740	What knowledge and skills must be included in modified basic training?
WAC 388-71-05745	Is competency testing required for modified basic training?
WAC 388-71-05750	Is there a challenge test for modified basic training?
WAC 388-71-05755	What documentation is required for successful completion of modified basic training?
WAC 388-71-05760	Who may take modified basic training instead of the full basic training?
WAC 388-71-05765	What are the training requirements and exemptions for parents who are individual providers for their adult children receiving services through DDD?
WAC 388-71-05770	What are the training requirements and exemptions for parents who are individual providers for their adult children who do not receive services through DDD?
WAC 388-71-05775	What is continuing education?
WAC 388-71-05780	How many hours of continuing education are required each year?
WAC 388-71-05785	What kinds of training topics are required for continuing education?
WAC 388-71-05790	Is competency testing required for continuing education?
WAC 388-71-05795	May basic or modified basic training be completed a second time and used to meet the continuing education requirement?
WAC 388-71-05799	What are the documentation requirements for continuing education?
WAC 388-71-05805	What is nurse delegation core training?
WAC 388-71-05810	What knowledge and skills must nurse delegation core training include?
WAC 388-71-05815	Is competency testing required for nurse delegation core training?
WAC 388-71-05820	Is there a challenge test for nurse delegation core training?
WAC 388-71-05825	What documentation is required for successful completion of nurse delegation core training?
WAC 388-71-05830	Who is required to complete nurse delegation core training, and when?
WAC 388-71-05832	What is safety training?
WAC 388-71-05835	What is competency testing?
WAC 388-71-05840	What components must competency testing include?
WAC 388-71-05845	What experience or training must individuals have to be able to perform competency testing?
WAC 388-71-05850	What training must include the DSHS-developed competency test?
WAC 388-71-05855	How must competency test administration be standardized?
WAC 388-71-05860	What form of identification must providers show a tester before taking a competency or challenge test?
WAC 388-71-05865	How many times may a competency test be taken?
WAC 388-71-05870	What are an instructor's or training entity's responsibilities?
WAC 388-71-05875	Must instructors be approved by DSHS?
WAC 388-71-05880	Can DSHS deny or terminate a contract with an instructor or training entity?
WAC 388-71-05885	What is a guest speaker, and what are the minimum qualifications to be a guest speaker for basic training?
WAC 388-71-05890	What are the minimum qualifications for an instructor for basic, modified basic or nurse delegation core and specialized diabetes training?
WAC 388-71-05895	What additional qualifications are required for instructors of nurse delegation core training and specialized diabetes nurse delegation training?
WAC 388-71-05899	What must be included in a class on adult education?
WAC 388-71-05905	What physical resources are required for basic, modified basic, or nurse delegation core classroom training and testing?
WAC 388-71-05909	What standard training practices must be maintained for basic, modified basic, or nurse delegation core classroom training and testing?
WAC 388-71-0801	What is specialized diabetes nurse delegation training?
WAC 388-71-0806	What knowledge and skills must specialized diabetes nurse delegation training include?
WAC 388-71-0811	Is competency testing required for the specialized diabetes nurse delegation training?
WAC 388-71-0816	Is there a challenge test for specialized diabetes nurse delegation training?
WAC 388-71-0821	What documentation is required for successful completion of specialized diabetes nurse delegation training?
WAC 388-71-0826	Who is required to complete the specialized diabetes nurse delegation training, and when?

4201.3
AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0001   What is the purpose of this chapter?   The purpose of this chapter is to describe the residential long-term care training requirements ((under this chapter)) that apply to:

     (1) All long-term care workers:

     (a) Providing direct care in adult family homes licensed under chapter 70.128 RCW and chapter 388-76 WAC; ((and))

     (((2) All)) (b) Providing direct care in boarding homes licensed under chapter 18.20 RCW and chapter 388-78A WAC; and

     (c) Providing instruction and support care in the supported living program certified under chapter 71A.12 RCW and chapter 388-101 WAC.

     (2) Applicants for an adult family home to be licensed under chapter 70.128 RCW;

     (3) Entity representatives for adult family homes licensed under chapter 70.128 RCW;

     (4) Resident managers for adult family homes licensed under chapter 70.128 RCW;

     (5) Applicants for supported living certification under chapter 71A.12 RCW;

     (6) Administrators for supported living under chapter 71A.12 RCW; and

     (7) Administrators or designee for boarding homes licensed under chapter 18.20 RCW.

[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, § 388-112-0001, filed 7/11/02, effective 8/11/02.]

     (("Caregiver" means anyone providing hands-on personal care to another person including but not limited to cuing, reminding, or supervision of residents, on behalf of an adult family home or boarding home, except volunteers who are directly supervised.))

     "Care team" includes the individual and everyone involved in his or her care. The care team can include family, friends, doctors, nurses, caregivers, social workers and case managers. The role of the care team is to support the well-being of the individual, however, the individual directs the service plan.

     "Certified home care aide" means a person who has obtained and maintains a home care aide certification through the department of health.

     (("Challenge test" means a competency test taken without first taking the class for which the test is designed.))

     "Competency" ((means the minimum level of information and skill trainees are required to know and be able to demonstrate)) defines the integrated knowledge, skills, or behavior expected of a long-term care worker after completing the training in a required topic area. Learning objectives are associated with each competency.

     "DDD" refers to the division of developmental disabilities.

     "Designee" means a person in a boarding home who supervises ((caregivers)) long-term care workers and who is designated by a boarding home administrator to take the trainings in this chapter required of the boarding home administrator. A boarding home administrator may have more than one designee.

     "Direct care worker" means a paid long-term care worker who provides direct, hands-on, personal care services to individuals with disabilities or the elderly requiring long-term care services.

     "Direct supervision" means oversight by a person who has demonstrated competency in the basic training (and specialty training if required), or who has been exempted from the basic training requirements, is on the premises, and is quickly and easily available to the ((caregiver)) long-term care worker.

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

     "Entity representative" means the individual designated by an adult family home provider who is or will be responsible for the daily operations of an adult family home.

     "Hands-on care" means providing personal care services.

     "Home" refers to adult family homes and boarding homes.

     "Indirect supervision" means oversight by a person who has demonstrated competency in the basic training (and specialty training if required), or who has been exempted from the basic training requirements, and who is quickly and easily available to the ((caregiver)) long-term care worker, but not necessarily on-site.

     "Individual" means a resident, as described under RCW 70.129.005, or person receiving long-term care services from a boarding home, adult family home, or supported living provider.

     "Instruction and support services staff" are staff of supported living providers whose job function is the provision of instruction and support services to individuals. Instruction and support services staff shall also include employees of the contractor whose job function is the supervision of instruction and support services staff. In addition, applicants, prior to initial supported living certification, and administrators, prior to assuming duties, who may provide instruction and support to individuals or who directly supervise instruction and support staff, shall be considered instruction and support staff for the purposes of the applicable training requirements of this chapter.

     "Learning ((outcomes)) objectives" ((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)) are measurable, written statements that clearly describe what a long-term care worker must minimally learn to meet each competency. Learning objectives are identified for each competency. Learning objectives provide consistent, common language and a framework for curriculum designers, the curriculum approval process, and testing. Curriculum designers have the flexibility to determine how learning objectives are met and may include additional content deemed necessary to best meet the competency in a particular setting.

     "Long-term care worker" includes all persons providing personal care for the elderly or persons with disabilities, including individual providers of home care services, direct care employees of home care agencies, providers of home care services to persons with developmental disabilities under title 71A RCW, all direct care workers in state-licensed boarding homes, adult family homes, respite care providers, and supported living providers.

     Long-term care workers do not include persons providing personal care services in nursing homes subject to chapter 18.51 RCW; hospitals or other acute care settings; residential habilitation centers under chapter 71A.20 RCW; facilities certified under 42 CFR, Part 483; hospice agencies subject to chapter 70.127 RCW; adult day centers; adult day health centers; persons who are otherwise licensed to provide health care services, such as nurses and certified nursing assistants; and those people providing personal care on an independent basis to private-pay consumers. This last instance would occur when personal care services are provided directly to an individual who pays for the services out-of-pocket without assistance from DSHS

     "Personal care services" means physical or verbal assistance with activities of daily living and instrumental activities of daily living, as described under WAC 388-106-0010, provided because of a person's functional limitations.

     "Provider" means any person who is licensed by the department to operate an adult family home and meets the requirements of chapter 388-76 WAC and this chapter or any corporation, partnership, or limited liability company that is licensed under chapter 388-76 WAC to operate an adult family home and meets the requirements of this chapter.

     (("Resident" means a person residing and receiving long-term care services at a boarding home or adult family home. As applicable, the term resident also means the resident's legal guardian or other surrogate decision maker.))

     "Resident manager" means a person employed or designated by the provider to manage the adult family home who meets the requirements in chapter 388-76 WAC and this chapter.

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

     "Service provider" means a person or entity certified by the department to deliver services and supports to meet the identified needs of the individual receiving services under chapter 71A.12 RCW. The term includes the state operated living alternative (SOLA) program.

     "Supported living provider" means providers offering instruction and support services. These providers include state operated living alternatives (SOLA), supported living, group training homes, alternative living, companion homes, licensed staff residential, and children's group facilities that have a contract with the department.

[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, § 388-112-0005, filed 7/11/02, effective 8/11/02.]

     (2) Existing adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who on September 1, 2002, have not successfully completed the training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130 and this chapter. Existing adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who have not successfully completed the training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130 are subject to all applicable requirements of this chapter. However, until September 1, 2002, nothing in this chapter affects the current training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130)) apply to long-term care workers hired on or after January 1, 2011, unless exempt under RCW 18.88B.040. The requirements also apply to applicants for licenses or certifications in accordance with chapters 388-76, 388-78A, and 388-101 WAC.

[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, § 388-112-0010, filed 7/11/02, effective 8/11/02.]

     (2) The department ((does not)) must pre-approve ((specific)) orientation ((programs, materials, or trainers for homes)) curricula and instructors.

     (3) No test is required for orientation.

     (4) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of 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, § 388-112-0015, filed 7/11/02, effective 8/11/02.]

     (2) The department must approve safety training curricula and instructors.

     (3) No test is required for safety training.

     (4) One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training.

[]

     (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)) individuals or staff (for instance, aggressive ((resident)) individuals' behaviors and how to handle them); and

     (e) The location of a home's or service provider's policies and procedures.

     (4) Communication skills and information, including:

     (a) Methods for supporting effective communication among the ((resident/)) individual, 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)) individual's service plan;

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

     (e) Whom to contact about problems and concerns.

     (5) ((Universal)) Standard precautions and infection control, including:

     (a) Proper hand washing techniques;

     (b) When to wear gloves and how to correctly put them on and take them off;

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

     (((c))) (d) Appropriate disposal of contaminated/hazardous articles;

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

     (((e))) (f) What staff should do if they are ill or injured, including whom to report this to.

     (6) ((Resident)) Individual rights, including:

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

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

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

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

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

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

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

     (7) In adult family homes, safe food handling information must be provided to all staff, prior to handling food for ((residents)) individuals.

     (8) Orientation and safety training may include the use of videotapes, audiotapes, and other electronic media if the person overseeing the orientation is available to answer the questions or concerns of the person(s) receiving the orientation.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0020, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, § 388-112-0020, filed 7/11/02, effective 8/11/02.]

     (1) The trainee's name;

     (2) A list of the specific information taught;

     (3) The number of hours of the training;

     (4) The signature of the person overseeing orientation((, indicating completion of the required information)) and safety training;

     (((4))) (5) The trainee's date of employment;

     (((5))) (6) The name of the home or service provider giving the orientation and safety training; and

     (((6))) (7) The date(s) of orientation and safety 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, § 388-112-0035, filed 7/11/02, effective 8/11/02.]

     (((1))) All ((paid or volunteer staff in adult family homes who begin work September 1, 2002 or later)) long-term care workers must complete orientation and safety training before ((having routine interaction with residents)) providing care to individuals. Orientation and safety training must be provided by ((appropriate)) department-approved adult family home, boarding home, or supported living staff.

     ((Boarding home

     (2) Boarding home administrators (or their designees), caregivers, and all paid or volunteer staff who begin work September 1, 2002 or later must complete orientation before having routine interaction with residents. Orientation must be provided by appropriate staff.))

[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, § 388-112-0040, filed 7/11/02, effective 8/11/02.]

     (a) The core ((knowledge)) competencies and skills that ((caregivers)) long-term care workers need in order to provide personal care services effectively and safely;

     (b) Practice and demonstration of skills;

     (c) Population specific competencies.

     (2) DSHS must pre-approve basic training curricula.

     (3) For instruction and support services staff, orientation, safety training, and basic training are all included in the developmental disabilities supported living providers training.

     (4) Effective July 1, 2011, only up to sixteen hours may be applied in any combination of peer mentoring or on-the-job training;

     (5) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of 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, § 388-112-0045, filed 7/11/02, effective 8/11/02.]

     (1) Communication skills;

     (2) Long-term care worker self-care;

     (3) Problem solving;

     (4) Participant rights and maintaining dignity;

     (5) Abuse, abandonment, neglect, financial exploitation and mandatory reporting;

     (6) Participant directed care;

     (7) Cultural sensitivity;

     (8) Body mechanics;

     (9) Fall prevention;

     (10) Skin and body care;

     (11) Long-term care worker roles and boundaries;

     (12) Supporting activities of daily living;

     (13) Food preparation and handling;

     (14) Medication assistance;

     (15) Infection control, blood-borne pathogens, HIV/AIDS; and

     (16) Grief and loss.

[]

     (2) The basic training learning outcomes and competencies may be obtained from the DSHS aging and adult services administration)) core competencies describe the behavior and skills that a long-term care worker must exhibit when working with individuals. Learning objectives are associated with each competency.

     (1) Regarding communication, communicate effectively and in a respectful and appropriate manner with individuals, family members, and other care team members:

     (a) Recognize how verbal and non-verbal cues impact communication with the participant and care team;

     (b) Engage and respect the participant through verbal and non-verbal communication;

     (c) Listen attentively and ensure that the participant understands what has been communicated;

     (d) Recognize and acknowledge individuals' communication for indicators of pain, confusion, or misunderstanding;

     (e) Utilize communication strategies to deal with difficult situations; and

     (f) Recognize common barriers to effective communication and identify how to eliminate them.

     (2) Regarding long-term care worker self-care, take appropriate action to reduce stress and avoid burnout:

     (a) Identify behaviors, practices and resources to reduce stress and avoid burnout;

     (b) Recognize common barriers to self-care and ways to overcome them; and

     (c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout; and the importance of taking action to practice self-care to avoid burnout.

     (3) Regarding the competency of effective problem solving, use effective problem solving skills:

     (a) Explain why it is necessary to understand and utilize a problem solving method;

     (b) Implement a problem solving process/method; and

     (c) Identify obstacles to effective problem solving and ways to overcome them.

     (4) Regarding the competency of participant rights and dignity, take appropriate action to promote and protect an individual's legal and human rights:

     (a) Identify participant rights that are protected by federal and Washington state laws;

     (b) Protect an individual's confidentiality;

     (c) Promote dignity, privacy, and encourage an individual's maximum independence when providing care; and

     (d) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use.

     (5) Regarding the competency of abuse and mandatory reporting, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:

     (a) Describe long-term care workers' responsibilities as a mandatory reporter as described under RCW 74.34.020 through 74.34.040; and

     (b) Identify common symptoms of abuse, abandonment, neglect, and financial exploitation.

     (6) Regarding the competency of participant directed care, encourage the participant to direct his or her care:

     (a) Explain the importance of participant directed care;

     (b) Use problem solving skills that balance an individual's choice with safety; and

     (c) Report concerns when an individual refuses care or makes choices that present a possible safety concern.

     (7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:

     (a) Describe how cultural background, lifestyle practices, and traditions can impact care; and

     (b) Utilize methods to determine and ensure an individual's beliefs are respected and considered when providing care.

     (8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the service plan.

     (9) Regarding the competency on fall prevention, prevent or reduce the risk of falls:

     (a) Identify fall risk factors and take action to reduce fall risks for an individual; and

     (b) Take proper steps to assist an individual who is falling or has fallen and is on the floor.

     (10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:

     (a) Explain the importance of observing an individual's skin, when to observe it and what to look for including common signs and symptoms of skin breakdown;

     (b) Identify risk factors of skin breakdown;

     (c) Observe skin at pressure point locations and report any concerns;

     (d) Describe what a pressure ulcer is, what it looks like, and what to do if an individual develops a pressure ulcer;

     (e) Identify when to report skin concerns and to whom;

     (f) Describe personal care practices to protect and maintain an individual's skin integrity including how often an individual must change position when sitting or lying for extended periods, proper positioning and transfers; and

     (g) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility.

     (11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:

     (a) Identify when, where, how, and why to obtain information about an individual's condition or disease for which they are receiving services and use this information to provide appropriate, individualized care;

     (b) Describe an individual's baseline based on information provided in the service plan and explain why it is important to know an individual's baseline;

     (c) Identify changes in an individual's physical, mental, and emotional state through observation;

     (d) Report changes from baseline and/or concerns to the appropriate care team member;

     (e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to an individual's safety and well-being;

     (f) Explain the purpose of a service plan and describe how it is created and modified;

     (g) Use an individual's service plan to direct a worker's job tasks and any participant directed care tasks;

     (h) Identify what is required of a long-term care worker, as described in WAC 388-112-0195, prior to performing a nurse-delegated task;

     (i) Describe the role of a care team and a long-term care worker's role in it;

     (j) Describe professional boundaries and the importance of maintaining them; and

     (k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them.

     (12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

     (a) Demonstrate, in the presence of a qualified instructor, all critical steps required for the following personal care tasks:

     (i) Helping an individual walk;

     (ii) Transferring an individual from a bed to a wheelchair;

     (iii) Turning and repositioning an individual in bed;

     (iv) Providing mouth care;

     (v) Cleaning and storing dentures;

     (vi) Shaving a face;

     (vii) Providing fingernail care;

     (viii) Providing foot care;

     (ix) Providing a bed bath;

     (x) Assisting an individual with a weak arm to dress;

     (xi) Putting knee-high elastic stockings on an individual;

     (xii) Providing passive range of motion for one shoulder;

     (xiii) Providing passive range of motion for one knee and ankle;

     (xiv) Assisting an individual to eat;

     (xv) Assisting with peri-care;

     (xvi) Assisting with the use of a bedpan;

     (xvii) Assisting with catheter care;

     (xviii) Assisting with condom catheter care; and

     (xix) Providing medication assistance.

     (b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate participant preferences, maintain privacy and dignity, encourage independence, and assure comfort and safety;

     (c) Appropriately utilize assistive device(s) specified on the service plan;

     (d) Describe any safety concerns related to each task and how to address the concerns;

     (e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

     (f) Identify the importance of knowing an individual's bowel and bladder functioning baseline and when to report concerns.

     (13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:

     (a) Describe how nutrition and hydration can impact an individual's health;

     (b) Plan, shop, and prepare meals for an individual according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the service plan and participant preferences;

     (c) Describe common signs of poor nutrition and hydration, and when to report concerns and to whom;

     (d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for an individual;

     (e) Recognize when an individual's food choices vary from specifications on the care plan, describe when and to whom to report concerns;

     (f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

     (g) Describe appropriate food handling practices, including: avoiding cross contamination from one food to another, safe storage requirements for cooling of leftover foods, including depth, types of containers, and temperatures, the need to maintain food at proper temperatures to limit bacterial growth and what are the safe food storage and holding temperatures for both cold and hot foods, best practices for thawing and re-heating food, and using clean gloves and utensils when preparing food;

     (h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

     (i) Describe why a long-term care worker with certain types of illnesses and/or symptoms must not prepare food.

     Long-term care workers who complete a DSHS-approved basic training meet the training requirements for adult family homes in RCW 70.128.250.

     (14) Regarding the competency of medication assistance, appropriately assist with medications:

     (a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications as described under chapter 246-888 WAC;

     (b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;

     (c) Identify common symptoms of medication side effects and when and to whom to report concerns;

     (d) Store medications according to safe practices;

     (e) Describe, in the proper sequence, each of the five rights of medication assistance; and

     (f) Identify what to do for medication-related concerns, including describing ways to work with an individual who refuses to take medications, identifying when and to whom to report when an individual refuses medication or there are other medication-related concerns, and identifying what is considered a medication error and when and to whom it must be reported.

     (15) Regarding the competency of infection control, blood borne pathogens and HIV/AIDS, implement best practices to prevent and control the spread of infections:

     (a) Identify common infections, ways that infections are spread, and symptoms of infections;

     (b) Describe the purpose, benefit and proper implementation of standard precautions in infection control;

     (c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;

     (d) Demonstrate proper hand washing and putting on and taking off gloves;

     (e) Identify immunizations that any adult needs to reduce the spread of viruses and bacteria;

     (f) Describe laundry and housekeeping measures that help in controlling the spread of infection;

     (g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;

     (h) Describe what BB pathogens are and how they are transmitted;

     (i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;

     (j) Identify measures to take to prevent BB diseases;

     (k) Describe what to do if exposed to BB pathogens and how to report an exposure;

     (l) Describe how HIV works in the body;

     (m) Explain that testing and counseling for HIV/AIDS is available;

     (n) Describe the common symptoms of HIV/AIDS;

     (o) Explain the legal and ethical issues related to HIV including required reporting, confidentiality and nondiscrimination; and

     (p) Explain the importance of emotional issues and support for individuals and long-term care workers.

     Long-term care workers who complete a DSHS-approved basic training meet the four hours of AIDS education as required by the department of health in WAC 246-980-040.

     (16) Regarding the competency on grief and loss, support yourself and the individual in the grieving process:

     (a) Define grief and loss;

     (b) Describe common losses an individual or long-term care worker may experience;

     (c) Identify common symptoms associated with grief and loss;

     (d) Describe why self-care is important during the grieving process; and

     (e) Identify beneficial ways and resources to work through feelings of grief and loss..

[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, § 388-112-0055, filed 7/11/02, effective 8/11/02.]

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-112-0059   What is the only developmental disabilities supported living provider training that is required and what must it include?   (1) The only developmental disabilities supported living provider training that is required is an integrated seventy-five hour curriculum designed specifically for instruction and support services staff in the supported living programs.

     (2) Developmental disabilities supported living provider training must include the following topics:

     (a) Individual rights and dignity;

     (b) Abuse, neglect, financial exploitation, and mandatory reporting;

     (c) Observation and reporting;

     (d) Instruction and support activities;

     (e) Communication skills;

     (f) Problem solving;

     (g) Cultural awareness and sensitivity;

     (h) Infection control;

     (i) Blood-borne pathogens and HIV/AIDS;

     (j) Skin care;

     (k) Fall prevention;

     (l) Health and functioning;

     (m) Medication assistance;

     (n) Instruction and support services staff roles and boundaries;

     (o) Self-care; and

     (p) Grief and loss.

     (3) Only the curriculum developed by DSHS may be used for the developmental disabilities supported living provider training.

     (4) The developmental disabilities supported living provider training may include up to sixteen hours of on-the-job training.

     (5) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of training.

     (6) In order to become certified as a home care aide, long-term care workers who complete this course must take an additional core competency course.

[]

     (1) A qualified instructor directly observing and documenting, in writing, a long-term care worker's completion of skills. Documentation of on-the-job training must include verification of the demonstrated skills.

     (2) The hours spent in on-the-job training may count for up to sixteen hours toward the completion of basic training. Only up to sixteen hours may be applied in any combination of peer mentoring or on-the-job training effective July 1, 2011.

[]

     (2) Peer mentoring is provided by a long-term care worker who has completed twelve hours of peer mentor training and is mentoring no more than ten long-term care workers at any given time.

     (3) Participant consent must be obtained prior to providing or receiving peer mentoring.

     (4) Effective July 1, 2011, for the person receiving mentoring, the hours spent in mentoring may count for up to sixteen hours toward the completion of basic training requirements. Only up to sixteen hours may be applied in any combination of peer mentoring or on-the-job training effective July 1, 2011.

[]

     (1) Include the competencies and learning objectives published by the department for population specific training under WAC 388-112-0078 (1) through (5).

     (2) Include competency testing to meet the licensing requirements for dementia, mental health, or developmental disabilities training for adult family homes and boarding homes; and

     (3) Use only curricula developed by DSHS for the nurse delegation core, specialized diabetes trainings, and the developmental disabilities supported living provider training.

[]

     (a) The name of the trainee;

     (b) The name of the training;

     (c) The name and/or the identification number of the instructor, home or training entity giving the training;

     (d) The number of hours of training;

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

     (((e))) (f) The completion date(((s))) of the training.

     (2) The trainee must be given an original certificate(s) or transcript to keep for proof of completion of the training. A home must keep a copy of the certificate on file.

[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, § 388-112-0070, filed 7/11/02, effective 8/11/02.]

     (1) Adult family home ((providers (including)) applicants and entity representatives ((as defined under chapter 388-76 WAC))) must complete basic training ((and demonstrate competency)) before operating an adult family home.

     (2) Adult family home resident managers must complete basic training and demonstrate competency before providing services in an adult family home.

     (3) ((Caregivers)) Long-term care workers in adult family homes must complete basic training within one hundred twenty days of ((when they begin providing hands-on personal care or within one hundred twenty days of September 1, 2002, whichever is later)) employment. Until ((competency in)) completion of the basic training ((has been demonstrated, caregivers)) long-term care workers may not provide hands-on, personal care without indirect supervision.

     Boarding homes

     (4) Boarding home administrators (or their designees), except administrators with a current nursing home administrator license, must complete basic training ((and demonstrate competency)) within one hundred twenty days of employment ((or within one hundred twenty days of September 1, 2002, whichever is later)).

     (5) ((Caregivers)) Long-term care workers must complete basic training within one hundred twenty days of ((when they begin providing hands-on personal care or within one hundred twenty days of September 1, 2002, whichever is later)) employment. Until ((competency in)) completion of the basic training ((has been demonstrated)), ((caregivers)) long-term care workers may not provide hands-on personal care without direct supervision.

     Supported living providers

     (6) Supported living applicants, administrators, and instruction and support services staff must complete the developmental disabilities supported living provider integrated basic training within one hundred twenty days of employment. Until completion of the basic training, long-term care workers may not provide hands-on personal care without indirect supervision.

[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, § 388-112-0075, filed 7/11/02, effective 8/11/02.]

     (2) A person employed as a long-term care worker on December 31, 2010, who completes within one hundred twenty days of hire, all of the training requirements in effect on the date of his or her hire;

     (3) A person previously employed as a long-term care worker prior to December 31, 2010, who completed prior to January 1, 2011, all the training requirements in effect on the date of his or her hire, and was employed as a long-term care worker at some point during the calendar year 2010;

     (4) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW;

     (5) Nursing assistants-certified under chapter 18.88A RCW;

     (6) Certified counselors under chapter 18.19 RCW;

     (7) Speech language pathologists or audiologists under chapter 18.35 RCW;

     (8) Occupational therapists under chapter 18.59 RCW;

     (9) Physical therapists under chapter 18.74 RCW;

     (10) A home health aide who is employed by a medicare-certified home health agency and has met the requirements of 42 CFR, Part 483.35;

     (11) An individual with special education training and an endorsement granted by the superintendent of public instruction as described in RCW 28A.300.010;

     (12) Parent providers as described in WAC 388-71-0885; and

     (13) Until January 1, 2014, an individual provider who provides care to only one person for twenty hours or less in any calendar month.

     A long term-care worker exempted by this section from the training requirements contained in RCW 74.39A.073 may not be prohibited from enrolling in the training.

[]

     (1) Dementia specialty training;

     (2) Mental health specialty training;

     (3) Developmental disabilities specialty training;

     (4) Younger adults with physical disabilities;

     (5) Aging and older adults;

     (6) Nurse delegation core training; or

     (7) Nurse delegation specialized diabetes training.

[]

     (a) Introduction to physical disabilities;

     (b) Common physical disabilities and ability limitations;

     (c) Supporting individuals living with chronic conditions;

     (d) Independent living and individual-directed care; and

     (e) Social connections and sexual needs of adults living with disabilities.

[]

     (1) Regarding the competency on young adults with physical disabilities, work effectively with young adults with physical disabilities based upon a basic understanding of disability:

     (a) Identify basic information regarding physical disabilities, injuries, and illnesses that are more common in young adults;

     (b) Describe the impact of changing and fluctuating abilities;

     (c) Identify stereotypes, biases, and misconceptions regarding the perception of young adults with physical disabilities;

     (d) Describe how biases, stereotypes, and misconceptions can influence care to young adults with physical disabilities;

     (e) Identify and explain the Americans with Disabilities Act and rights for adults with physical disabilities; and

     (f) Describe the value of personalizing care and support to the specific individual with a disability.

     (2) Regarding the competency on common physical disabilities and ability limitations, provide individualized care based upon a basic understanding of common physical disabilities and their impact on functioning:

     (a) Describe common physical disabilities, including paraplegia and quadriplegia, diabetes, multiple sclerosis, and pulmonary disease.

     (b) Describe the characteristics and functional limitations of individuals with these specific disabilities.

     (3) Regarding the competency on supporting individuals living with chronic conditions, provide appropriate care by recognizing chronic secondary conditions that impact functioning:

     (a) Identify how common chronic medical conditions affect physical disability;

     (b) Describe how chronic medical conditions influence and impact care for a young individual with a physical disability;

     (c) Describe how to support an individual with a physical disability and multiple chronic conditions; and

     (d) Describe how to support the individual's dignity while providing personal care.

     (4) Regarding the competency on independent living and individual-directed care, support independent living and self-determination for the individual living with a disability:

     (a) Define the independent living philosophy and describe what it might look like;

     (b) Describe barriers to independent living, including accessibility and attitudes;

     (c) Describe ways to support independent living and self-determination with the individual living with a disability;

     (d) Describe individual-directed support;

     (e) Identify ways to promote individual-directed support; and

     (f) Identify resources that promote independence and self-determination for an individual living with a disability.

     (5) Regarding the competency of social connections and sexual needs of young adults living with a physical disability, provide optimum support to an individual living with a disability in his or her expression of social and sexual needs:

     (a) Describe and explain the importance of full, appropriate, and equal participation of individuals living with a physical disability;

     (b) Identify ways to support social connections and activities;

     (c) Describe and explain the importance of honoring the individual as a sexual being with diverse sexual needs, desires, and orientation; and

     (d) Identify ways to support expression of sexual needs in a respectful, professional, and confidential manner.

     To meet these population specific competencies, a curriculum must meet these competencies and learning objectives.

[]

     (1) Introduction to aging;

     (2) Age-associated physical changes;

     (3) Cultural impacts on aging;

     (4) Ageism and supporting individual dignity;

     (5) Supporting individuals living with a chronic condition;

     (6) Dealing with death, grief, and loss; and

     (7) Supporting health and wellness.

[]

     (1) Regarding the competency on an introduction to aging, draw upon a basic understanding of the aging process and demonstrate awareness of the unique needs of older adults:

     (a) Describe basic information on the aging process, including the difference between age-related changes and a disease process;

     (b) List typical changes that occur with aging;

     (c) Identify common stereotypes, biases, myths, and misconceptions regarding aging, ageism, and older adults;

     (d) Describe how ageism, biases, myths, and misconceptions can influence care to older individuals;

     (e) Describe how aging affects the individual's needs and behaviors; and

     (f) Describe the value of adapting caregiving to the age-related concerns of the individual.

     (2) Regarding the competency on age-associated physical changes, provide individualized care by understanding physical changes that are experienced in aging:

     (a) Identify common physical changes experienced in the aging process;

     (b) Describe common sensory changes that occur in aging and their impact on an older adult's activities;

     (c) Describe the difference between age-associated physical changes versus a disease process; and

     (d) Describe how age-related physical changes can impact functioning and the ability to perform personal care.

     (3) Regarding the competency on cultural impacts of aging, provide culturally compassionate care by utilizing a basic understanding of issues related to culture and aging:

     (a) Describe how race/ethnicity, poverty, and class influence the aging process;

     (b) Describe how race/ethnicity, poverty, and class influence an older adult's help-seeking behavior; and

     (c) Describe a culturally sensitive approach to working with older adults that demonstrates shared decision-making and mutual respect.

     (4) Regarding the competency on ageism and supporting individual dignity, overcome ageism and support individual dignity by understanding stereotypes and myths regarding aging:

     (a) Describe the concept of "ageism" and its possible impact on working with older adults;

     (b) Identify his or her perceptions about aging and how these perceptions may contribute to "ageism";

     (c) Describe how "ageism" can influence individual dignity; and

     (d) Describe strategies for overcoming "ageism" and supporting individual dignity.

     (5) Regarding the competency on supporting individuals living with chronic medical conditions, provide appropriate care by recognizing how chronic conditions impact functioning:

     (a) Describe how chronic medical conditions can influence and impact care for older adults;

     (b) Describe strategies for working with an older adult with multiple chronic medical conditions;

     (c) Describe proactive ways to support an older adult living with chronic medical conditions; and

     (d) Describe how to help support the older adult's dignity while providing care.

     (6) Regarding the competency on dealing with death, grief and loss, respond appropriately to an individual experiencing loss:

     (a) Describe common examples of losses encountered in the aging process;

     (b) Describe common reactions to loss of significant roles;

     (c) Describe strategies for dealing with loss;

     (d) Describe the value of promoting social engagement for the older adult;

     (e) Identify strategies and opportunities for promoting social engagement; and

     (f) Identify actions and resources that can be used to help an older adult work through feelings of grief and loss.

     (7) Regarding the competency on supporting optimum health and wellness, support the optimum health and wellness of older adults:

     (a) Identify key factors that support individual health and wellness;

     (b) Identify strategies for promoting individual optimum health while aging;

     (c) Identify strategies and opportunities to support an older adult to engage in healthy life style choices; and

     (d) Describe his or her role in promoting optimum health and wellness for older individuals.

     To meet these population specific competencies, a curriculum must meet these competencies and learning objectives.

[]

     (1) All long-term care workers, within one hundred and fifty days of hire;

     (2) Adult family home applicants, before licensure; and

     (3) Adult family home entity representatives and resident managers, before assuming the duties of the position.

[]

     (2) An approved instructor or approved training entity issuing and signing a DSHS seventy-five hour training certificate must verify that the long-term care worker has the certificates or transcript required documenting two hours of DSHS-approved orientation, three hours of approved safety training, and seventy hours of DSHS-approved basic training, as described in this chapter. Only a DSHS or training partnership seventy-five hour training certificate can be submitted by a long-term care worker applying to the department of health for a home care aide certification.

     (3) For home care aide recertification, successful completion of twelve hours of DSHS-approved continuing education training must be documented on a DSHS certificate issued by an approved instructor or approved training entity who has provided all twelve hours of continuing education training. If all twelve hours of continuing education were not provided by the same instructor or training entity, then an approved instructor or approved training entity must verify that the certified home care aide has certificates or transcripts that add up to twelve hours of DSHS-approved continuing education. Only a DSHS training partnership twelve-hour continuing education certificate can be submitted by a certified home care aide applying to the department of health for recertification.

     (4) The long-term care worker and certified home care aide must retain the original seventy-five hour training certificate and any twelve-hour continuing education training certificates. Training entities must keep a copy of the certificates on file.

[]

     (2) Manager specialty training is required for boarding home administrators (or designees), adult family home applicants or providers ((and)), resident managers, and entity representatives who are affiliated with homes that serve individuals who have the following special needs:

     (a) Developmental disabilities specialty training, under WAC 388-112-0120((, is the required training on that specialty for adult family home providers and resident managers, and for boarding home administrators (or designees.))).

     (b) Dementia specialty training, under WAC 388-112-0125, and mental health specialty training, under WAC 388-112-0135((, are the required trainings on those specialties for adult family home providers and resident managers, and for boarding home administrators (or designees))).

     (3) ((Caregiver)) Specialty training for long-term care workers in boarding homes, adult family homes, and supported living providers are as follows:

     (a) Developmental disabilities specialty training, under WAC 388-112-0120((, is the required training on that specialty for boarding home caregivers)).

     (b) ((Caregiver)) Dementia specialty training, under WAC 388-112-0130, and ((caregiver)) mental health specialty training, under WAC 388-112-0140((, are the required trainings on those specialties for boarding home caregivers)).

     (4) ((Caregiver specialty training for adult family homes:

     The provider or resident manager who has successfully completed the manager specialty training, or a person knowledgeable about the specialty area, trains adult family home caregivers in the specialty needs of the individual residents in the adult family home, and there is no required curriculum)) Specialty training may be used to meet the requirements for the basic training population specific component if completed within one hundred and twenty days of employment.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230. 06-16-072, § 388-112-0110, 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. 02-15-065, § 388-112-0110, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0115, filed 7/11/02, effective 8/11/02.]

     (a) Overview of developmental disabilities;

     (b) Values of service delivery;

     (c) Effective communication;

     (d) Introduction to interactive planning;

     (e) Understanding behavior;

     (f) Crisis prevention and intervention; and

     (g) Overview of legal issues and individual rights.

     (2) For adult family homes, the division of developmental disabilities (DDD) will provide in-home technical assistance to the adult family home upon admission of the first ((resident)) individual eligible for services from DDD and, thereafter, as determined necessary by DSHS.

     (((3) The manager and caregiver developmental disabilities specialty training learning outcomes and competencies may be obtained from the DSHS division of developmental disabilities.))

[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, § 388-112-0120, filed 7/11/02, effective 8/11/02.]

     (1) Regarding the competency on an overview of developmental disabilities, draw upon a basic understanding of developmental disabilities and demonstrate awareness of the unique needs of individuals with developmental disabilities:

     (a) Define developmental disability and describe intellectual disability, cerebral palsy, epilepsy, and autism;

     (b) Identify common myths and misconceptions about developmental disabilities;

     (c) Describe the negative effects of using labels such as "retarded" or "handicapped" to represent people and positive alternatives; and

     (d) Differentiate between developmental disabilities and mental disorders.

     (2) Regarding the competency on values of service delivery, promote and support an individual's self-determination:

     (a) Identify the principle of normalization and its significance to the work of long-term care workers;

     (b) Explain how understanding each individual's needs leads to better services and supports, which lead to better outcomes for the individual;

     (c) Describe each of the residential services guidelines and identify how the values represented in the guidelines are important in the lives of people with developmental disabilities;

     (d) Describe the principle of self-determination; and

     (e) Identify positive outcomes for individuals with developmental disabilities when they are connected to the community they live in.

     (3) Regarding the competency on communication, provide culturally compassionate and individualized care by utilizing a basic understanding of a resident or individual's history, experience, and cultural beliefs:

     (a) List the key elements of effective communication;

     (b) Describe the impact communication has on the lives of individuals with developmental disabilities;

     (c) Explain the impact a long-term care worker's behavior can have on eliciting communication;

     (d) Explain the impact of an individual's physical environment on their ability to communicate;

     (e) Describe methods of communication, other than verbal, that long-term care workers might use when supporting individuals with developmental disabilities; and

     (f) List tips for communication with individuals with developmental disabilities.

     (4) Regarding the competency on interactive planning, use person-centered and interactive planning when working with individuals with developmental disabilities:

     (a) Identify the benefits of using a person-centered planning process rather than the traditional planning methods used to develop supports for people with developmental disabilities;

     (b) Identify key elements involved in interactive planning;

     (c) Identify ways to include people with developmental disabilities and their families in the planning process; and

     (d) Identify the required planning document for the setting and list ways to have a positive impact on the plan.

     (5) Regarding the competency on challenging behaviors, use a problem solving approach and positive support principles when dealing with challenging behaviors:

     (a) Identify the essential components of the concept of positive behavioral supports;

     (b) Define the "ABCs" and describe how to use that process to discover the function of behavior;

     (c) Explain why it is critical to understand the function of behavior before developing a support plan;

     (d) Define reinforcement and identify ways to utilize it as a tool to increase an individual's ability to be successful;

     (e) Identify the problems with using punishment to manage behavior;

     (f) Identify behavior management techniques that are not allowed under DSHS policies and applicable laws;

     (g) Identify factors that can positively and negatively influence the behavior of individuals with developmental disabilities; and

     (h) List steps to be taken when crisis or danger to people is immediate.

     (6) Regarding the competency on crisis prevention, support an individual experiencing a crisis and get assistance when needed:

     (a) Identify behaviors in people with developmental disabilities that might constitute "normal stress";

     (b) Define "crisis";

     (c) Differentiate the behaviors an individual who is in crisis exhibits from mental illness;

     (d) Identify the principles of crisis prevention and intervention;

     (e) Identify what types of situations require outside assistance and at what point it becomes necessary; and

     (f) Name several ways to provide support to an individual experiencing a crisis.

     (7) Regarding the competency on legal rights, promote and protect the legal and individual rights of individuals with developmental disabilities:

     (a) Explain how the rights of individuals with disabilities compare to those of the general population;

     (b) List the rights of individuals living in adult family homes and boarding homes and the laws that support those rights;

     (c) Describe how long-term care workers can help individuals to exercise their rights;

     (d) List ways a long-term care worker must safeguard each individual's confidentiality;

     (e) Describe the three types of guardianship an individual with developmental disabilities might be subject to and why;

     (f) List less restrictive alternatives to guardianship;

     (g) Describe the responsibilities, powers, and limitations of a guardian; and

     (h) Describe the relationship between service providers and guardians/families.

     To meet these population specific competencies, a curriculum must meet these competencies and learning objectives.

[]

     (a) Introduction to the dementias;

     (b) Differentiating dementia, depression, and delirium;

     (c) Caregiving goals, values, attitudes and behaviors;

     (d) Caregiving principles and dementia problem solving;

     (e) Effects of cognitive losses on communication;

     (f) Communicating with people who have dementia;

     (g) Sexuality and dementia;

     (h) ((Rethinking "problem")) Dealing with challenging behaviors;

     (i) Hallucinations and delusions;

     (j) Helping with activities of daily living (ADLs);

     (k) Drugs and dementia;

     (l) Working with families;

     (m) Getting help from others; and

     (n) Self-care for ((caregivers)) long-term care workers.

     (2) The manager dementia specialty training learning ((outcomes)) objectives and competencies may be obtained from the DSHS aging and ((adult)) disability services administration.

[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, § 388-112-0125, filed 7/11/02, effective 8/11/02.]

     (a) Introduction to the dementias;

     (b) Dementia, depression, and delirium;

     (c) ((Resident-based caregiving;

     (d))) Dementia caregiving principles;

     (((e))) (d) Communicating with people who have dementia;

     (((f))) (e) Sexuality and dementia;

     (((g))) (f) ((Rethinking "problem")) Dealing with challenging behaviors;

     (((h))) (g) Hallucinations and delusions;

     (((i))) (h) Helping with activities of daily living (ADLs); and

     (((j))) (i) Working with family and friends.

     (((2) The learning outcomes and competencies for caregiver dementia training may be obtained from the DSHS aging and adult services administration.))

[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, § 388-112-0130, filed 7/11/02, effective 8/11/02.]

     (1) Regarding the competency on an introduction to dementia, draw upon a basic understanding of dementia and demonstrate awareness of the unique needs of individuals with dementia:

     (a) Identify basic information on dementia, including causes and treatments;

     (b) Describe how dementia affects individual needs and behaviors;

     (c) List typical behaviors and symptoms an individual with dementia would most likely experience;

     (d) Describe the differences that might be seen based on the type of dementia an individual has.

     (2) Regarding the competency on dementia, depression, and delirium, respond appropriately to individuals who have dementia, delirium, and/or depression:

     (a) Identify and differentiate between dementia, depression, and delirium;

     (b) Describe common symptoms of dementia, depression, and delirium and list possible causes;

     (c) Compare and contrast among common symptoms of dementia, depression, and delirium; and

     (d) Identify what symptom changes require immediate professional attention and how to access professional help.

     (3) Regarding the competency on dementia caregiving principles, incorporate current best practices when providing dementia care:

     (a) Identify current best practices in dementia caregiving;

     (b) Describe current best practices in caregiving;

     (c) Demonstrate the ability to support the individual's strengths using caregiving techniques to support those strengths; and

     (d) Describe how to use cultural and life information to develop and enhance care provided to individuals with dementia.

     (4) Regarding the competency on communicating with people who have dementia, communicate in a respectful and appropriate manner with individuals with dementia:

     (a) Describe common dementia-caused cognitive losses and how those losses can affect communication;

     (b) Identify appropriate and inappropriate nonverbal communication skills and discuss how each impacts an individual's behavior;

     (c) Describe how to effectively initiate and conduct a conversation with an individual who has dementia; and

     (d) Identify communication strategies to work with individuals who have dementia.

     (5) Regarding the competency on sexuality and dementia, protect a resident or individual's rights when dealing with issues of sexuality and appropriately manage unwanted or inappropriate sexual behavior:

     (a) Identify ways in which dementia affects sexuality and sexual behaviors;

     (b) Identify an individual's rights as they relate to sexuality and sexual behavior and discuss ways to support these rights; and

     (c) Describe how to respond using nonjudgmental caregiving skills to individuals' appropriate and inappropriate sexual behaviors.

     (6) Regarding the competency on dealing with challenging behaviors, use a problem-solving approach when dealing with challenging behaviors:

     (a) Describe how to use a problem-solving method to intervene in challenging behaviors or situations;

     (b) Describe some possible common causes of challenging behaviors, including aggression, catastrophic reactions, wandering, and inappropriate sexual behavior and explore their causes;

     (c) Describe how to implement a problem-solving process when working with an individual who has dementia; and

     (d) Describe how to respond appropriately to an individual who is expressing a challenging behavior.

     (7) Regarding the competency on hallucinations and delusions, respond appropriately when an individual is experiencing hallucinations or delusions:

     (a) Define and differentiate between hallucinations and delusions;

     (b) List different types of dementia-related hallucinations; and

     (c) Describe how to appropriately and safely respond to an individual with dementia who is experiencing hallucinations and delusions.

     (8) Regarding the competency on activities of daily living, make activities of daily living pleasant and meaningful:

     (a) Identify and describe ways in which to support making activities of daily living pleasant for individuals with dementia; and

     (b) Describe strategies that support meaning and utilize an individualized approach when assisting an individual with dementia with activities of daily living.

     (9) Regarding the competency on working with family and friends, respond respectfully, appropriately, and with compassion when interacting with families and friends of individuals or residents with dementia:

     (a) Identify common concerns friends and family have when a loved one has dementia;

     (b) Describe ways to be supportive and compassionate in interactions with family and friends of the individual with dementia;

     (c) Identify how to find local resources for family support needs; and

     (d) Describe a method to gather cultural and life history information from an individual and/or representative(s).

     To meet these population specific competencies, a curriculum must meet these competencies and learning objectives for dementia specialty training.

[]

     (a) Introduction to mental illness;

     (b) Culturally compassionate care;

     (c) Respectful communications;

     (d) Understanding mental illness - major mental disorders;

     (e) Understanding mental illness - baseline, decompensation, and relapse planning; responses to hallucinations and delusions;

     (f) Understanding and interventions for behaviors perceived as problems;

     (g) Aggression;

     (h) Suicide;

     (i) Medications;

     (j) Getting help from others; and

     (k) Self-care for ((caregivers)) long-term care workers.

     (2) The manager mental health specialty training learning ((outcomes)) objectives and competencies may be obtained from the DSHS aging and ((adult)) disability services administration.

[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, § 388-112-0135, filed 7/11/02, effective 8/11/02.]

     (a) Understanding major mental disorders;

     (b) Individual background, experiences and beliefs;

     (c) ((Responding to)) Respectful communication;

     (d) Creative approaches to challenging behaviors;

     (e) Decompensation((,)) and relapse((,)) planning;

     (f) Responding to hallucinations and delusions;

     (((d) Interventions for behaviors perceived as problems;

     (e))) (g) Crisis intervention and dealing with aggression; and

     (((f))) (h) Suicide prevention.

     (((2) The learning outcomes and competencies for caregiver mental health training may be obtained from the DSHS aging and adult services administration.))

[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, § 388-112-0140, filed 7/11/02, effective 8/11/02.]

     (1) Regarding the competency on understanding major mental disorders, draw upon a basic understanding of mental disorders and demonstrate awareness of the unique needs of individuals with mental disorders:

     (a) Define and describe main symptoms of depression, bipolar schizophrenia, and anxiety disorder, and list treatment options for each;

     (b) Describe causes of mental disorders;

     (c) Describe the progression of mental disorders;

     (d) Identify common myths and misinformation about mental disorders; and

     (e) Define stigma and identify how stigma can impact caregiving.

     (2) Regarding the competency on individual background, experiences and beliefs, provide culturally compassionate and individualized care by utilizing a basic understanding of the individual's history, experience, and cultural beliefs:

     (a) Demonstrate a method for gathering cultural, lifestyle, and personal value information from an individual;

     (b) Identify why obtaining cultural information from an individual is important;

     (c) Describe the importance of being sensitive to cultural differences when providing care;

     (d) Differentiate how cultural beliefs and symptoms may be misinterpreted as mental disorders; and

     (e) Identify how the long-term care worker's culture might affect caregiving.

     (3) Regarding the competency on communication and mental disorders, communicate respectfully and appropriately with individuals with a mental disorder:

     (a) Identify what is considered respectful and disrespectful communication when interacting with an individual with a mental disorder;

     (b) Identify what is judgmental communication toward an individual with a mental disorder and ways to ensure communication is nonjudgmental;

     (c) Identify examples of verbal and nonverbal communication and describe how each impacts communication; and

     (d) Describe how to effectively initiate and conduct a respectful conversation with an individual who has a mental disorder.

     (4) Regarding the competency on creative approaches to challenging behaviors, use a problem-solving approach when dealing with challenging behaviors:

     (a) Define and differentiate between inappropriate learned behaviors and symptoms of a mental disorder;

     (b) Identify possible common causes of challenging behaviors in an individual with a mental disorder;

     (c) Differentiate how challenging behaviors may be misinterpreted as mental disorders; and

     (d) Describe intervention strategies that can be used to reduce or prevent challenging behaviors.

     (5) Regarding the competency on responding to de-compensation and relapse, respond appropriately when an individual is decompensating to help prevent a relapse:

     (a) Define the terms baseline, de-compensation, and relapse;

     (b) Identify common causes and symptoms of de-compensation and relapse;

     (c) Describe the term "relapse plan" and review an example of a relapse plan; and

     (d) Identify how a long-term care worker can support and use the relapse plan.

     (6) Regarding the competency on responding to hallucinations and delusions, respond appropriately to an individual experiencing hallucinations or delusions:

     (a) Define the terms hallucination and delusion;

     (b) Identify common triggers (including stress) of delusions and hallucinations;

     (c) Identify and describe appropriate intervention strategies for an individual experiencing a hallucination or delusion; and

     (d) Describe how to accurately document an individual's behavioral symptoms, interventions, and outcomes.

     (7) Regarding the competency on crisis intervention and dealing with aggression, intervene early when dealing with aggressive behavior to increase emotional stability and ensure safety:

     (a) Define the term aggression;

     (b) Identify the difference between aggressive behaviors and aggressive feelings;

     (c) List de-escalation "do's" and "don'ts" as they relate to working with an individual expressing aggressive behavior;

     (d) Describe appropriate de-escalation techniques when working with an individual expressing aggressive behavior; and

     (e) Differentiate between nonimmediate and immediate danger and at what point additional assistance may be needed.

     (8) Regarding the competency on suicide prevention, respond appropriately to an individual at risk of suicide:

     (a) Identify and list signs an individual is possibly suicidal;

     (b) Describe how to respond appropriately to an individual experiencing suicidal thoughts, including:

     (i) How, where, and when to refer an individual who is experiencing suicidal thoughts and/ or planning; and

     (ii) Methods to keep a suicidal individual safe and ensure the safety for others.

     (c) Describe strategies to help cope with an individual's suicide.

     To meet these population specific competencies, a curriculum must meet these competencies and learning objectives.

[]

     (1) All adult family home applicants or providers ((and)), resident managers, entity representatives, and ((for)) long-term care workers; and

     (2) All boarding home administrators (or designees) and ((caregivers, as provided under WAC 388-112-0290 through 388-112-0315. Competency testing is not required for adult family home caregivers)) long-term care workers.

[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, § 388-112-0145, filed 7/11/02, effective 8/11/02.]

     There is a challenge test for ((all)) each of the specialty trainings((, including caregiver specialty trainings, except the adult family home caregiver training)). Individuals may take the DSHS challenge test instead of required specialty training. A person who does not pass a challenge test on the first attempt must attend the class.

[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, § 388-112-0150, filed 7/11/02, effective 8/11/02.]

[]

     (1) The trainee's name;

     (2) The name of the training;

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

     (4) The number of hours of the training;

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

     (((5))) (6) The date(s) of training((.)); and

     (((6))) (7) The trainee must be given an original certificate. The home must keep a copy of the certificate on file.

[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, § 388-112-0155, filed 7/11/02, effective 8/11/02.]

     (1) Adult family home applicants, providers (((including)), entity representatives ((as defined under chapter 388-76 WAC))) and resident managers must complete manager specialty training and demonstrate competency before ((admitting and serving residents)) the home is licensed or before a new resident manager is hired in order to admit or serve individuals who have special needs related to mental illness, dementia, or a developmental disability.

     (2) If ((a resident)) an individual develops special needs while living in a home without a specialty designation, the provider, entity representative, and resident manager have one hundred twenty days to complete manager specialty training and demonstrate competency.

     Boarding homes

     (3) If a boarding home serves one or more ((residents)) individuals with special needs, the boarding home administrator (or designee) must complete manager specialty training and demonstrate competency within one hundred twenty days of employment ((or within one hundred twenty days of September 1, 2002, whichever is later)). A boarding home administrator with a current nursing home administrator license is exempt from this requirement, unless the administrator will train ((their facility caregivers)) the facility's long-term care workers in a ((caregiver)) specialty.

     (4) If ((a resident)) an individual develops special needs while living in a boarding home, the boarding home administrator (or designee) has one hundred twenty days to complete manager specialty training and demonstrate competency. A boarding home administrator with a current nursing home administrator license is exempt from this requirement, unless the administrator will train ((their facility caregivers)) the facility's long-term care workers in a ((caregiver)) specialty.

[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, § 388-112-0160, filed 7/11/02, effective 8/11/02.]

     ((If an adult family home serves one or more residents with special needs, all caregivers must receive training regarding the specialty needs of individual residents in the home. The provider or resident manager knowledgeable about the specialty area may provide this training.))

     ((Boarding homes))

     If a boarding home or adult family home serves one or more ((residents)) individuals with special needs, ((caregivers)) long-term care workers in those settings must complete ((caregiver)) specialty training and demonstrate competency.

     (1) If the ((caregiver)) specialty training is integrated with basic training, ((caregivers)) long-term care workers must complete the ((caregiver)) specialty training within one hundred twenty days of ((when they begin providing hands-on personal care to a resident having special needs or within one hundred twenty days of September 1, 2002, whichever is later)) hire.

     (2) If the ((caregiver)) specialty training is not integrated with basic training, ((caregivers)) long-term care workers must complete the relevant ((caregiver)) specialty training within ninety days of completing basic training.

     (3) Until competency in the ((caregiver)) specialty training has been demonstrated, ((caregivers)) long-term care workers may not provide hands-on personal care to ((a resident)) an individual with special needs without direct supervision in a boarding home or indirect supervision in an adult family home.

[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, § 388-112-0165, filed 7/11/02, effective 8/11/02.]

     (1) Before performing any delegated nursing task, long-term care workers in adult family ((home staff)) homes, boarding homes, and supported living programs must:

     (a) Successfully complete DSHS-designated nurse delegation core training, "Nurse Delegation for Nursing Assistants";

     (b) Be a:

     (i) Certified home care aide and a nursing assistant registered; or

     (ii) Nursing assistant certified under chapter 18.88A RCW; ((and)) or

     (iii) If exempt from the home care aide certification, become a nursing assistant registered and complete the core competencies of basic training.

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

     Boarding homes

     (2) Before performing any delegated nursing task, boarding home staff must:

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

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

     (c) If a nursing assistant registered, successfully complete basic 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, § 388-112-0195, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0200, filed 7/11/02, effective 8/11/02.]

     (2) Effective July 1, 2011, long-term care workers must complete at least twelve hours of continuing education each year after obtaining certification as described in department of health WAC 246-980-110.

     (3) If exempt from certification, all long-term care workers must complete twelve hours of continuing education as described in WAC 388-112-0245.

     (4) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of continuing education.

[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, § 388-112-0205, filed 7/11/02, effective 8/11/02.]

     (1) ((Resident)) Individual rights;

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

     (3) Mental illness;

     (4) Dementia;

     (5) Developmental disabilities;

     (6) Depression;

     (7) Medication assistance;

     (8) Communication skills;

     (9) Positive ((resident)) individual behavior support;

     (10) Developing or improving ((resident)) individual-centered activities;

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

     (12) Medical conditions; ((and))

     (13) In adult family homes, safe food handling; and

     (14) Nurse delegation core and specialized diabetes.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0210, filed 12/15/05, effective 1/15/06. 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, § 388-112-0210, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0220, filed 7/11/02, effective 8/11/02.]

     (1) ((If one or more specialty trainings are completed in the same year as basic or modified basic training, the specialty training hours may be applied toward the continuing education requirement for up to two calendar years following the year of completion of the basic and specialty trainings.

     (2))) If one or more specialty trainings are completed in a different year than the year when basic ((or modified basic)) training was taken, the specialty training hours may be applied toward the continuing education requirement for the calendar year in which the specialty training is taken ((and the following calendar year)).

[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, § 388-112-0225, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0230, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0235, filed 7/11/02, effective 8/11/02.]

     (a) The trainee's name;

     (b) The title or content of the training;

     (c) The instructor's name, name of the home or training entity giving the training, or the name of the video, on-line class, professional journal, or equivalent instruction materials completed;

     (d) The number of hours of training; and

     (e) The date(s) of training.

     (2) The trainee must be given an original certificate or other documentation of continuing education.

[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, § 388-112-0240, filed 7/11/02, effective 8/11/02.]

     (1) Until June 30, 2011, adult family home providers (((including)), entity representatives ((as defined under chapter 388-76 WAC))), resident managers, and ((caregivers)) long-term care workers 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. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

     (2) ((Continuing education must be on a topic relevant to the care setting and care needs of residents in adult family homes)) Effective July 1, 2011, all certified home care aides must complete twelve hours of continuing education each year as described in department of health WAC 246-980-110.

     (3) If exempt from certification, all long-term care workers must complete twelve hours of continuing education per calendar year. Continuing education must include 0.5 hours per year on safe food handling in adult family homes.

     Boarding homes

     (4) Until June 30, 2011, boarding home administrators (or their designees) and ((caregivers)) long-term care workers 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. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

     (5) Effective July 1, 2011, all certified home care aides must complete twelve hours of continuing education each year as described in department of health WAC 246-980-110.

     (6) If exempt from certification, all long-term care workers must complete twelve hours of continuing education per calendar year. A boarding home administrator with a current nursing home administrator license is exempt from this requirement.

     Supported living providers

     (((5))) (7) ((Continuing education must be on a topic relevant to the care setting and care needs of residents in boarding homes)) Until June 30, 2011, instruction and support services staff must complete ten hours of continuing education after the year in which they complete basic training. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

     (8) Effective July 1, 2011, all instruction and support services staff must complete twelve hours of continuing education each calendar year.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0245, filed 12/15/05, effective 1/15/06. 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, § 388-112-0245, filed 7/11/02, effective 8/11/02.]

     (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.

     (4) Successful completion of first aid training, following the OSHA guidelines, also serves as proof of the CPR training.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0255, filed 12/15/05, effective 1/15/06. 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, § 388-112-0255, filed 7/11/02, effective 8/11/02.]

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

     (2) 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)) individuals.

     (3) Adult family home ((caregivers)) long-term care workers must obtain and maintain a valid CPR and first-aid card or certificate:

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

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

     Boarding homes

     (4) Boarding home administrators who provide direct care, and ((caregivers)) long-term care workers must possess a valid CPR and first-aid card or certificate within thirty days of employment, and must maintain valid cards or certificates. 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.

     Supported living

     (5) Applicants must obtain a valid CPR and first-aid card before certification and contract issuance and maintain valid cards or certificates.

     (6) Instruction and support services staff must obtain and maintain a valid CPR and first-aid card or certificate:

     (a) Within thirty days of beginning to provide care for individuals, as long as the provision of care for individuals is directly supervised by a fully qualified instruction and support services staff who has a valid CPR and first-aid card or certificate; or

     (b) Before providing care to individuals, if the provision of care is not directly supervised by a fully qualified instruction and support services staff who has a valid CPR and first-aid card or certificate.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0260, filed 12/15/05, effective 1/15/06. 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, § 388-112-0260, filed 7/11/02, effective 8/11/02.]

     Prospective providers applying for a license after January 1, 2007: Before a license for an adult family home is granted, the prospective provider)) All applicants submitting an application for an adult family home license must successfully complete the department approved forty-eight hour residential care administrator training for adult family homes before a license for an adult family home will be issued.

[Statutory Authority: RCW 74.08.090, 18.20.090, 70.128.040, chapter 70.128 RCW and 2006 c 249. 07-01-045, § 388-112-0270, filed 12/14/06, effective 1/14/07. 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, § 388-112-0270, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0290, filed 7/11/02, effective 8/11/02.]

     (1) Skills demonstration of ability to perform and/or implement specific caregiving approaches, and/or activities as appropriate for the training;

     (2) Written evaluation to show level of comprehension and knowledge of the learning ((outcomes)) objectives for the training; and

     (3) A scoring guide for the tester with clearly stated criteria and minimum proficiency standards.

     (4) Instructors who conduct competency testing must have documented experience or training in assessing competencies.

[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, § 388-112-0295, filed 7/11/02, effective 8/11/02.]

[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, § 388-112-0300, filed 7/11/02, effective 8/11/02.]

     (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, 70.128.230, and 2005 c 505. 06-01-046, § 388-112-0315, filed 12/15/05, effective 1/15/06. 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, § 388-112-0315, filed 7/11/02, effective 8/11/02.]

     (a) Basic training, both core and population specific;

     (b) ((Modified basic;

     (c))) Manager mental health, dementia, and developmental disabilities specialty training;

     (((d))) (c) ((Caregiver)) Long-term care worker mental health, dementia, and developmental disabilities specialty training ((in boarding homes)); and

     (((e))) (d) Any training that integrates basic training with a ((manager or caregiver)) specialty training.

     (2) The residential care administrator training must use a curriculum approved by DSHS.

     (3) The developmental disabilities supported living provider training, nurse delegation core and diabetes training must use only the DSHS curriculum.

     (4) A curriculum other than the DSHS curriculum must be approved before it is used. ((An attestation that the curriculum meets all requirements under this chapter will be sufficient for initial approval. Final)) Approval will be based on curriculum review, as described under WAC 388-112-0330.

[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, § 388-112-0320, filed 7/11/02, effective 8/11/02.]

     (1) A completed DSHS curriculum checklist indicating where all the ((DSHS-published learning outcomes and)) competencies and learning objectives, described in this chapter are located in the proposed curriculum for ((the)) that course;

     (2) ((Printed student)) Any materials ((that support the curriculum, a teacher's guide or manual, and learning resource materials)) students will receive, such as a textbook or student manual, learning activities, audio-visual materials, handouts, and books;

     (3) The ((recommended sequence and delivery of the material)) table of contents or outline, including the allotted time for each section;

     (4) ((The teaching methods or approaches that will be used for different sections of the course, including for each lesson)) The personal care tasks, as described in WAC 388-112-0055 (12)(a) and (b), and infection control skills (hand washing and putting on and taking off gloves) demonstration skills;

     (5) The teacher's guide or manual that includes for each section of the curriculum:

     (a) The ((expected learning outcomes)) goals and objectives;

     (b) How that section will be taught, including teaching methods and learning activities that incorporate adult learning principles ((and address the learning readiness of the student population));

     (c) ((Practice of skills to increase competency;

     (d) Feedback to the student on knowledge and skills;

     (e) An emphasis on facilitation by the teacher; and

     (f) An integration of knowledge and skills from previous lessons to build skills.

     (5))) Methods instructors will use to determine whether each long-term care worker understands the materials covered and can demonstrate all skills;

     (d) A list of the sources or references, if any, used to develop the curriculum;

     (((6))) (e) Methods of teaching and ((student evaluation for students)) how accommodations will be made for long-term care workers with limited English proficiency and/or learning disabilities; and

     (((7))) (f) ((A plan for updating material.)) Description and proof of how input was obtained from consumer and long-term care worker representatives in the development of the curriculum.

     (6) In addition, for curricula being submitted for the core competency section of basic training as described in WAC 388-112-0055, the curriculum must include how much time students will be given to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill. Substantial changes to a previously approved curriculum must be approved before they are used.

[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, § 388-112-0325, filed 7/11/02, effective 8/11/02.]

     (4))) After review of the ((alternative)) curriculum, DSHS will send a written response to the submitter, indicating approval or disapproval of the curriculum and if disapproved, the reasons for denial((;)).

     (((5))) (2) If the ((alternative)) curriculum is not approved, a revised curriculum may be resubmitted to DSHS for another review. If the reasons why the curriculum is not approved cannot be resolved, the submitter may seek a review of the nonapproval decision from the assistant secretary of aging and disability services administration (ADSA). The assistant secretary's review decision shall be the final decision of DSHS. No other administrative review is available to the submitter.

[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, § 388-112-0330, filed 7/11/02, effective 8/11/02.]

     (a) Verifies ((and)), documents, keeps on file, and makes available to the department upon request that all instructors meet ((each of)) the minimum instructor qualifications in WAC 388-112-0370 through 388-112-0395 for the course they plan to teach;

     (b) Teaches using a complete DSHS-developed or approved ((alternative)) curriculum.

     (c) Notifies DSHS in writing of the home's or service provider's intent to conduct staff training prior to providing the home's first training, and when changing training plans, including:

     (i) Home or service provider name;

     (ii) Name of training(s) the home or service provider will conduct;

     (iii) Name of approved curriculum(s) the home will use;

     (iv) Name of lead instructor and instructor's past employment in boarding homes ((and)), adult family homes or supported living programs; and

     (v) Whether the home or service provider will train only the home's or service provider's staff, or will also train staff from other homes or supported living programs. If training staff outside the home or corporation, the instructor must become a DSHS-contracted community instructor;

     (d) Ensures that DSHS competency tests are administered as required under this chapter;

     (e) Provides a certificate or transcript of completion of training to all staff that successfully complete the entire course((, including:

     (i) The trainee's name;

     (ii) The name of the training;

     (iii) The name of the home giving the training;

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

     (v) The date(s) of training));

     (f) Keeps a copy of ((student)) long-term care worker certificates on file for six years, and gives the original certificate to the trainee;

     (g) Keeps attendance records and testing records of ((students)) long-term care workers trained and tested on file for six years; and

     (h) Reports training data to DSHS in DSHS-identified time frames

     (2) ((An adult family home wishing to conduct caregiver specialty training that is taught by the provider, resident manager, or person knowledgeable about the specialty area, as required under WAC 388-112-0110 subsection (3), must document the specialty training as provided under WAC 388-112-0155)) The department may conduct a random audit at any time to review instructor qualifications.

[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, § 388-112-0335, filed 7/11/02, effective 8/11/02.]

     (2) Effective July 1, 2011, in order to be approved for any continuing education training, submit DSHS form 16-228 and class syllabus at least forty-five days in advance of delivery of the training.

[]

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0340, filed 7/11/02, effective 8/11/02.]

     (1) DSHS determines that the training fails to meet the standards under this chapter;

     (2) The home or service provider fails to notify DSHS of changes in the curriculum content prior to teaching the curriculum;

     (3) The home or service provider provides false or misleading information to long-term care workers or the public concerning the courses offered or conducted;

     (4) The home's or service provider's instructor does not meet the applicable qualifications under WAC ((388-112-0375)) 388-112-0370 through 388-112-0395; or

     (((3))) (5) The home's or service provider's instructor has been a licensee, boarding home administrator, or adult family home resident manager, as applicable, of any home subject to temporary management or subject to a revocation or summary suspension of the home's license, a stop placement of admissions order, a condition on the license related to ((resident)) individual care, or a civil fine of five thousand dollars or more, while the instructor was the licensee, administrator, or resident manager; or

     (((4))) (6) The home has been operated under temporary management or has been subject to a revocation or suspension of the home license, a stop placement of admissions order, a condition on the license related to ((resident)) individual care, or a civil fine of five thousand dollars or more, within the previous ((twelve)) eighteen months.

     (((5))) (7) Nothing in this section shall be construed to limit DSHS' authority under chapters 388-76 ((or)), 388-78A, or 388-101 WAC to require the immediate enforcement, pending any appeal, of a condition on the home license prohibiting the home or service provider from conducting its own training programs.

[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, § 388-112-0345, filed 7/11/02, effective 8/11/02.]

     (2) Nurse delegation core and specialized diabetes training ((and residential care administrator training)) must be taught by ((an)) a current Washington state RN instructor who is approved by DSHS.

[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, § 388-112-0350, filed 7/11/02, effective 8/11/02.]

     (1) CPR; and

     (2) First aid training.

[]

     (1) Coordinating and teaching classes,

     (2) Assuring that the curriculum used is taught as designed,

     (3) Selecting qualified guest speakers where applicable,

     (4) Administering or overseeing the administration of DSHS competency and challenge tests,

     (5) Maintaining training records including ((student)) long-term care worker tests and attendance records for a minimum of six years,

     (6) Reporting training data to DSHS in DSHS-identified time frames, and

     (7) Issuing or reissuing training certificates to ((students)) long-term care workers.

[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, § 388-112-0355, filed 7/11/02, effective 8/11/02.]

     (a) DSHS must approve ((any)) and/or contract with an instructor ((under contract with DSHS)) to conduct orientation, safety, basic, ((modified basic,)) residential care administrator, specialty, ((or)) nurse delegation core and specialized diabetes training ((classes using the training curricula developed by DSHS)), and continuing education.

     (b) DSHS may select contracted instructors ((through a purchased services contract procurement pursuant to chapter 236-48 WAC or through other)) using any applicable contracting procedures. Contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through ((a request for qualifications and quotations (RFQQ) or other applicable)) the contracting procedure.

     (2) Homes or service providers conducting their own training

     ((Homes conducting their own training programs)) using the training curricula developed by DSHS or ((alternative)) another curricula approved by DSHS must ensure that their instructors meet the minimum qualifications for instructors under this chapter.

     (3) ((Other instructors))

     DSHS must approve all other instructors not described in subsection (1) and (2) of this section.

[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, § 388-112-0360, filed 7/11/02, effective 8/11/02.]

     (2) DSHS may terminate ((any)) an existing 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: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0365, filed 7/11/02, effective 8/11/02.]

     (a) May only teach a specific subject in which they have expertise, ((under the supervision of the instructor. A guest speaker must have as minimum qualifications, an appropriate)) and background and experience that demonstrates that the guest speaker has expertise on the topic he or she will teach.

     (b) May not teach the entire course;

     (c) Must not supplant the primary teaching responsibilities of the primary instructor; and

     (d) Must cover the DSHS competencies and learning objectives for the topic he or she is teaching.

     (2) The approved instructor:

     (a) Must select guest speakers that meet the minimum qualifications((, and));

     (b) Maintain documentation of ((this)) the guest speaker's background and qualifications;

     (c) Supervise and monitor the guest speaker's performance; and

     (d) Is responsible for insuring the required content is taught.

     (3) DSHS does not approve guest speakers.

[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, § 388-112-0370, filed 7/11/02, effective 8/11/02.]

     (1) Twenty-one years of age; and

     (2) Has not had a professional health care, adult family home, boarding home, or social services license or certification revoked in Washington state.

     (3) Education and work experience:

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

     (i) Be a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting; or

     (ii) Have an associate degree in a health field and six months professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD per chapter 388-101 WAC, or home care setting; or

     (iii) Have a high school diploma, or equivalent, 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)) 388-101 WAC, or home care setting((; or

     (ii) An associate degree in a health field and six months 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)).

     (((2))) (4) 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 attend a class in adult education that meets the requirements of WAC 388-112-0400.

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

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

     (((5))) (7) If required under WAC ((388-112-0075 or 388-112-0105)) 388-112-0080, instructors must successfully complete basic ((or modified basic)) training prior to beginning to train others.

     (8) In addition, an instructor for nurse delegation core and diabetes training must have a current Washington state RN license in good standing without practice restrictions.

[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, § 388-112-0380, filed 7/11/02, effective 8/11/02.]

     (a) The instructor must be experienced in mental health caregiving practices and capable of demonstrating competency in the entire course content;

     (b) Education

     (i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education, or in college classes, in subjects directly related to mental health, such as, but not limited to, psychology. (One year of education equals twenty-four semester hours, thirty-six quarter hours, or one hundred ninety-two hours of seminars, conferences, and continuing education.)

     (ii) If required under WAC 388-112-0160, successful completion of the mental health specialty training, prior to beginning to train others.

     (c) Work experience - Two years full-time equivalent direct work experience with people who have a mental illness; and

     (d) Teaching experience

     (i) Two hundred hours experience teaching mental health or closely related subjects; and

     (ii) Successful completion of an adult education class ((or train the trainer as follows:)).

     (A) ((For instructors teaching alternate curricula, a class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

     (B))) For instructors teaching ((DSHS-developed)) mental health specialty training, successful completion of the DSHS((-developed train the trainer)) instructor qualification/demonstration process.

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

     (2) Instructors for ((caregiver)) mental health specialty training:

     (a) ((Caregiver)) Mental health specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager mental health specialty training. A qualified instructor under this subsection may teach ((caregiver)) specialty to ((caregivers)) long-term care workers employed at other home(s) licensed by the same licensee.

     (b) ((Caregiver)) Mental health specialty taught by a person who does not meet the requirements in subsection (2)(a) must meet the same requirements as the instructors for manager mental health specialty in subsection (1).

[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, § 388-112-0385, filed 7/11/02, effective 8/11/02.]

     (a) The instructor must be experienced in dementia caregiving practices and capable of demonstrating competency in the entire course content;

     (b) Education:

     (i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education or college classes, in dementia or subjects directly related to dementia, such as, but not limited to, psychology. (One year of education equals twenty-four semester hours, thirty-six quarter hours, or at least one hundred ninety-two hours of seminars, conferences, or continuing education.)

     (ii) If required under WAC 388-112-0160, successful completion of the dementia specialty training, prior to beginning to train others.

     (c) Work experience - Two years full-time equivalent direct work experience with people who have dementia; and

     (d) Teaching experience:

     (i) Two hundred hours experience teaching dementia or closely related subjects; and

     (ii) Successful completion of an adult education class or train the trainer as follows:

     (A) For instructors teaching alternate curricula, a class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

     (B) For instructors teaching DSHS-developed dementia specialty training, successful completion of the DSHS((-developed train the trainer)) instructor qualification approval process.

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

     (2) Instructors for ((caregiver)) long-term care worker dementia specialty training:

     (a) ((Caregiver)) Long-term care worker dementia specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager dementia specialty training. A qualified instructor under this subsection may teach ((caregiver)) specialty to ((caregivers)) long-term care workers employed at other home(s) licensed by the same licensee.

     (b) ((Caregiver)) Long-term care worker dementia specialty taught by a person who does not meet the requirements in subsection (2)(a) must meet the same requirements as the instructors for manager dementia specialty in subsection (1).

[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, § 388-112-0390, filed 7/11/02, effective 8/11/02.]

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0395   What are the minimum qualifications for instructors for manager and ((caregiver)) long-term care worker developmental disabilities specialty?   (1) The minimum qualifications for instructors for manager developmental disabilities specialty, in addition to the general qualifications under WAC ((388-112-0375)) 388-112-0380, include:

     (a) Education and work experience:

     (i) Bachelor's degree with at least two years of full-time work experience in the field of disabilities; or

     (ii) High school diploma or equivalent, with four years full time work experience in the field of developmental disabilities, including two years full time direct work experience with people who have a developmental disability.

     (b) Successful completion of developmental disabilities specialty training under WAC 388-112-0120; and

     (c) Teaching experience:

     (i) Two hundred hours of teaching experience; and

     (ii) Successful completion of adult education or train the trainer as follows:

     (A) ((For instructors teaching alternative curricula,)) A class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

     (B) For instructors teaching DSHS-developed developmental disabilities specialty training, successful completion of the DSHS-developed train the trainer.

     (d) Instructors who will administer tests must have experience in assessment and competency testing.

     (2) Instructors for ((caregiver)) long-term care worker developmental disabilities specialty training:

     (a) ((Caregiver)) Long-term care worker developmental disabilities specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager developmental disabilities specialty training. A qualified instructor under this subsection may teach ((caregiver)) developmental disabilities specialty to ((caregivers)) long-term care workers employed at other home(s) licensed by the same licensee.

     (b) ((Caregiver)) Long-term care worker developmental disabilities specialty taught by a person who does not meet the requirements in subsection (2)(a) must meet the same requirements as the instructors for manager developmental disabilities specialty in subsection (1).

[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, § 388-112-0395, filed 7/11/02, effective 8/11/02.]

     (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: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, § 388-112-0405, filed 7/11/02, effective 8/11/02.]

     (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)) Long-term care workers attending a classroom training must not be expected to leave the class to attend to job duties, except in an emergency.

[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, § 388-112-0410, filed 7/11/02, effective 8/11/02.]

     The following sections of the Washington Administrative Code are repealed:

WAC 388-112-0025	Is competency testing required for orientation?
WAC 388-112-0030	Is there a challenge test for orientation?
WAC 388-112-0050	Is there an alternative to the basic training for some health care workers?
WAC 388-112-0060	Is competency testing required for basic training?
WAC 388-112-0065	Is there a challenge test for basic training?
WAC 388-112-0080	What is modified basic training?
WAC 388-112-0085	What knowledge and skills must be included in modified basic training?
WAC 388-112-0090	Is competency testing required for modified basic training?
WAC 388-112-0095	Is there a challenge test for modified basic training?
WAC 388-112-0100	What documentation is required for successful completion of modified basic training?
WAC 388-112-0105	Who may take modified basic training instead of the full basic training?
WAC 388-112-02610	What is HIV/AIDS training?
WAC 388-112-02615	Is competency testing required for HIV/AIDS training?
WAC 388-112-02620	Is there a challenge test for HIV/AIDS training?
WAC 388-112-02625	What documentation is required for completion of HIV/AIDS training?
WAC 388-112-02630	Who is required to complete HIV/AIDS training, and when?
WAC 388-112-0340	Do homes need department approval to provide continuing education for their staff?
WAC 388-112-0375	What are the minimum general qualifications for an instructor teaching a DSHS curriculum or DSHS-approved alternate curriculum as defined under chapter 388-112 WAC?

4198.2
AMENDATORY SECTION(Amending WSR 07-16-101, filed 7/31/07, effective 9/1/07)

WAC 388-829A-050   Who is eligible to contract with DDD to provide alternative living services?   Before DDD may issue an alternative living contract, the prospective provider must:

     (1) Be twenty-one years of age or older;

     (2) Have a high school diploma or GED;

     (3) Clear a background check conducted by DSHS, as required by RCW 43.20A.710;

     (4) Have an FBI fingerprint-based background check as required by RCW 43.20A.710, if the person has not lived in the state continuously for the previous three years;

     (5) Have a business ID number, as an independent contractor; and

     (6) Meet the minimum skills and abilities described in WAC 388-829A-110.

     (7) Alternative living providers contracted after January 1, 2012 must be screened through a fingerprint-based FBI check as described in WAC 388-06-0110 through 388-06-0150.

[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. 07-16-101, § 388-829A-050, filed 7/31/07, effective 9/1/07.]

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     (1) Be twenty-one years of age or older;

     (2) Have a high school diploma or GED;

     (3) Clear a background check conducted by DSHS as required by RCW 43.20A710;

     (4) Have an FBI fingerprint-based background check as required by RCW 43.20A.710, if the person has not lived in the state continuously for the previous three years;

     (5) Have a business ID number, as an independent contractor; and

     (6) Meet the minimum skills and abilities described in WAC 388-829C-080.

     (7) Companion home providers contracted after January 1, 2012 must be screened through a fingerprint-based FBI background check as described in WAC 388-06-0110 through 388-06-0150.

[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. 07-16-102, § 388-829C-040, filed 7/31/07, effective 9/1/07.]

     Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-829C-131   What are the training requirements companion home providers contracted before January 1, 2011?   Companion home providers must ensure that staff hired before January 1, 2011 meet the training requirements as described under chapter 388-829C WAC.

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