PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 12-05-008 [12-05-086].
Title of Rule and Other Identifying Information: The department is amending and adopting new rules within the following chapters to implement Initiative 1163, related to caregiver training requirements: Chapter 388-71 WAC, Home and community services and programs and chapter 388-112 WAC, Residential long-term care programs.
Hearing Location(s): Office Building 2, Lookout Room, 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), on September 25, 2012, at 10:00 a.m.
Date of Intended Adoption: Not earlier than September 25, 2012.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on September 25, 2012.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by September 4, 2012, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at jennisha.johnson@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of the new language in chapters 388-71 and 388-112 WAC is to implement and clarify the training requirements and the criminal history background check requirements as directed in chapter 74.39A RCW and to revise the implementation effective dates as directed by Initiative 1163 and subsequently ESHB 2314. Chapter 74.39A WAC requires training for long-term care workers which includes seventy-five hours of entry-level training 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. ESHB 2314 also allows for certified home care aides to be delegated nursing tasks and this was also added to these WACs.
Reasons Supporting Proposal: Initiative 1163, enacted by the people in November 2011, requires implementation of these rules effective beginning January 7, 2012 (unless otherwise specified). Emergency rules were filed to implement the effective dates as WSR 12-05-100 and an emergency rule extension was filed as WSR 12-13-090 on June 19, 2012.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.
Statute Being Implemented: Chapter 74.39A WAC [RCW].
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of social and health services, aging and disability services administration, governmental.
Name of Agency Personnel Responsible for Drafting and Implementation: Martin Yates, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2540; and Enforcement: DSHS.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department is adopting amendments to chapters 388-71 and 388-112 WAC as expressly required by Initiative 1029 and subsequent Initiative 1163. These rules are consistent with the training and certification requirements set forth in those initiatives, therefore pursuant to RCW 19.85.025(3) and 34.05.328 (5)(b)(v), a small business economic impact statement is not required.
A cost-benefit analysis is not required under RCW 34.05.328. No cost-benefit analysis is required as this rule is exempt per RCW 34.05.328 (5)(b)(v), rules the content of which is explicitly and specifically dictated by statute.
July 24, 2012
Katherine I. Vasquez
Rules Coordinator
4200.19(1) Qualifications of an individual provider, as defined in WAC 388-106-0010;
(2) Qualifications of a long-term care worker employed by
a home care agency ((provider)), as defined in WAC 388-106-0010 and chapter ((246-336)) 246-335 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))
long-term care worker;
(4) Training requirements for an individual provider and
home care agency ((provider)) long-term care worker.
(5) Client's options for obtaining a long-term care worker. A client, as described in WAC 388-71-0836 eligible to receive long-term care services, or his/her legal representative on the client's behalf, may choose to receive personal care services in the client's home from an individual provider or a long-term care worker from a home care agency. If the client chooses to receive services from a home care agency, the agency will assign a long-term care worker employed by the agency to provide services to the client. Individual providers and home care agency long-term care workers 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.
(3) ((Complete and submit to the social worker/case
manager/designee 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;
(a) Preliminary results may require a thumb print for identification purposes;
(b) An FBI fingerprint-based background check is required if the person has lived in the state of Washington less than three years.
(4))) Effective January 8, 2012, be screened through Washington state's name and date of birth background check. Preliminary results may require a thumb print for identification purposes.
(4) Effective January 8, 2012, be screened through the national fingerprint-based background check, as required by RCW 74.39A.056.
(5) Results of background checks are provided to the department and the employer or potential employer unless otherwise prohibited by law or regulation for the purpose of determining whether the person:
(a) Is disqualified based on a disqualifying crime, a pending charge for a disqualifying crime or negative action; or
(b) Should or should not be employed as an individual provider based on his or her character, competence, and/or suitability.
(6) Disqualifying crimes and negative actions are listed in WAC 388-71-0540 (4), (5) and (6).
(7) For those providers listed in RCW 43.43.837(1), a second national fingerprint-based background check is required if they have lived out of the state of Washington since the first national fingerprint-based background check was completed.
(8) The department may require an individual provider to have a Washington state name and date of birth background check or national fingerprint-based background check, or both, at any time.
(9) Sign a home and community-based service provider
contract/agreement to provide services to a COPES, ((MNIW,))
PACE, WMIP, or medicaid personal care client, or sign a
contract as an individual provider to provide services to a
New Freedom waiver, WMIP, or PACE client 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.]
(a) Records contained in databases maintained by the Washington state patrol, including records of:
(i) Pending charges; and
(ii) Criminal conviction.
(b) Records maintained:
(i) By the Washington state department of corrections; and
(ii) By the Washington state administrative office of the courts judicial information system.
(c) Records of negative actions, final findings, or civil adjudication proceedings of any agency or sub-agency including, but not limited to:
(i) DSHS adult protective services;
(ii) DSHS residential care services;
(iii) DSHS children's protective services;
(iv) The Washington state department of health;
(v) The nursing assistant registry; and
(iv) Any pending charge, criminal conviction, civil adjudicative proceeding and/or negative action disclosed by the applicant.
(2) The national fingerprint-based background check includes a check of records maintained in the:
(a) Federal Bureau of Investigation; and
(b) National sex offender's registry.
(3) A "civil adjudication proceeding" 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.
(4) A "negative action" includes 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.
(5) Except as prohibited by federal law, results are shared with the employer or prospective employer and with the department of health as authorized.
[]
(1) Effective January 8, 2012, be screened through Washington state's name and date of birth background check. Preliminary results may require a thumb print for identification purposes.
(2) Effective January 8, 2012, be screened through the national fingerprint-based background check, as required by RCW 74.39A.056.
(3) Results of background checks are provided to the department and the employer or potential employer for the purpose of determining whether the person:
(a) Is disqualified based on a disqualifying crime, a pending charge for a disqualifying crime, or negative action; or
(b) Should or should not be employed based on his or her character, competence, and/or suitability.
(4) Disqualifying crimes and negative actions are those listed in WAC 388-71-0540 (4), (5) and (6).
(5) For those providers listed in RCW 43.43.837(1), a second national fingerprint-based background check is required if they have lived out of the state of Washington since the first national fingerprint-based background check was completed.
(6) The department may require a long-term care worker to have a Washington state name and date of birth background check or national fingerprint-based background check, or both, at any time.
[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 plan of care that is signed
by the client or legal representative ((and social worker/case
manager)), and which may be translated or interpreted, as
necessary, for the client ((and the provider));
(2) Provide the services as outlined on the client's plan
of care, as ((defined)) described in WAC 388-106-0010;
(3) Accommodate the client's individual preferences and
((differences)) unique needs in providing care;
(4) Contact the ((client's)) client, client'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
client or representative, regarding change(s) in health, take
appropriate action, and respond to emergencies;
(6) Notify the case manager immediately when the client enters a hospital, or moves to another setting;
(7) Notify the case manager immediately ((if)) in the
event of the ((client dies)) client's death;
(8) Notify the department or AAA immediately when unable to staff/serve the client; 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 must:
(a) Give at least two weeks' notice, and
(b) ((Be)) Notify the client or legal guardian in
writing: and
(c) Notify the client's case manager.
(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.))
[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.]
(1) Ensure that the assigned home care agency long-term care worker(s) understands the client's plan of care that is signed by the client or legal representative, and which may be translated or interpreted, as necessary, for the client;
(2) Provide services as outlined in a client's plan of care, as described in WAC 388-106-0010;
(3) Accommodate the client's individual preferences and unique needs in providing care;
(4) Contact the client, client's representative and case manager when there are changes observed by the assigned home care agency long-term care worker that affect the personal care and other tasks listed on the plan of care;
(5) Ensure that the assigned home care agency long-term care worker(s) observes the client for and consults with the client or representative, regarding change(s) in health, takes appropriate action, and responds to emergencies;
(6) Notify the case manager immediately when the client enters a hospital, or moves to another setting;
(7) Notify the case manager immediately in the event of the client's death;
(8) Notify the department or AAA immediately when unable to staff/serve the client;
(9) Notify the department/AAA when the home care agency will no longer provide services. The home care agency must:
(a) Give at least two weeks' notice; and
(b) Notify the client or legal guardian in writing; and
(c) Notify the case manager.
(10) Comply with time keeping requirements, and keep accurate time sheets that are accessible to the appropriate department or designee staff; and
(11) Comply with all applicable laws and regulations.
[]
[]
[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.]
| Who | Status | Orientation Training | Safety Training | Basic Training | Continuing Education | Certification HCA-C |
| (1) An individual provider who is a licensed, certified health care professional | RN, LPN, CN-A, and allied health professionals listed in WAC 388-71-0901 | Not required | Not required | Not required | Required. Ten hours through June 30, 2012 Twelve hours from July 1, 2012 forward per WAC 388-71-0990 and 388-71-0991 | Not required |
| (2) An individual provider or home care agency long term care worker with specific employment history. | Employed as a long term care worker at some point between January 1, 2011 and January 6, 2012 and who completed the basic training requirements in effect on date of his or her hire. WAC 388-71-0840. | Not required | Not required | Not required | Required. Ten hours through June 30, 2012. Twelve hours from July 1, 2012 forward per WAC 388-71-0990 and 3888-71-0991. | Not required |
| (3) Individual provider/home care agency long term care worker. | Contracted with the department OR been hired by a licensed home care agency to provide personal care service as defined in WAC 388-71-0836 and is not exempt under subsection (1) or (2). | Required. Two hours per WAC 388-71-0860. | Required. Three hours per WAC 388-71-0860. | Required. Seventy hours per WAC 388-71-0870 and 388-71-0875. | Required. Twelve hours per WAC 388-71-0990 and 388-71-0991. | Required per WAC 388-71-0975. |
| (4) An individual provider with limited hours. | Contracted individual providing twenty hours or less of care for one person per calendar month and does not meet criteria in (1) or (2). | Required. Two hours per WAC 388-71-0860. | Required. Three hours per WAC 388-71-0860. | Required. Thirty hours per WAC 388-71-0880. | Not required prior to June 30, 2014. | Not required |
| (5) Parent, step-parent, or adoptive parent as individual provider. | Department paid individual providing care for his or her adult child ONLY and receiving services through the division of developmental disabilities (WAC 388-71-0890) and not exempt under (1) or (2). | Required. Two hours per WAC 388-71-0895. | Required. Three hours per WAC 388-71-0895. | Required. Seven hours per WAC 388-71-0890. | Not required | Not required |
| (6) Biological, step, or adoptive parent/adult child as individual provider. | Who is a department paid individual providing care ONLY to his or her child or parent, and does not meet criteria in (5) and is not exempt under (1) or (2). | Required. Two hours per WAC 388-71-0860. | Required. Three hours per WAC 388-71-0860. | Required. Thirty hours per WAC 388-71-0880. | Required for adult child per WAC 388-71-0990 and 388-71-0991. Not required for parent provider per WAC 388-71-1001. | Not required. |
[]
The department, AAA, or department designee will deny
payment for the services of an individual provider or home
care agency ((provider)) long-term care worker who:
(1) Is the client's spouse, per 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 grant,
per WAC ((388-478-0030)) 388-478-0020;
(2) Is the natural/step/adoptive parent of a minor client aged seventeen or younger receiving services under medicaid personal care;
(3) Is a foster parent providing personal care to a child residing in their licensed foster home;
(4) Has a pending disqualifying charge, 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) Has abused, neglected, abandoned, or exploited a minor or vulnerable adult, as defined in chapter 74.34 RCW;
(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;
(7) ((Does not successfully complete the training
requirements within the time limits required in WAC 388-71-05665 through 388-71-05865;
(8))) Is already meeting the client's needs on an informal basis, and the client's assessment or reassessment does not identify any unmet need; and/or
(((9))) (8) Is terminated by the client (in the case of
an individual provider) or by the home care agency (in the
case of an agency provider).
(9) Does not successfully complete applicable training requirements, within one hundred twenty days of hire or the begin date of authorization or within the timeframes described in WAC 388-71-0875, 388-71-0880, 388-71-0890, and 388-71-0991. If an individual provider or long-term care worker employed by a home care agency does not complete required training within the required timeframe and:
(a) If the worker is not required to be a certified home care aide, then the long-term care worker may not provide care until the training is completed.
(b) If the worker is required to be a certified home care aide, then the long-term care worker may not provide care until the certification has been granted.
(10) Does not successfully complete the certification or recertification requirements as described under WAC 388-71-0975;
(11) 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;
(12) When the client's needs are already being met on an informal basis, and the client's assessment or reassessment does not identify any unmet need; and/or
(13) Is terminated by the client (in the case of an individual provider) or by the home care agency (in the case of a home care agency long-term care worker).
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.]
(1) Has been convicted of:
(a) Simple assault, theft in third degree, assault in the fourth degree, or prostitution, even though it has been more than three years since the conviction;
(b) Forgery or theft in the second degree, even though it has been more than five years since the conviction;
(c) Any conviction that the department determines is reasonably related to the competency of the person to provide care to a client; or
(d) 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 long-term care worker 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 long-term care worker 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 clients or have access to their records;
(13) Has a pending charge for a disqualifying crime.
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(1) Has been convicted of:
(a) Simple assault, theft in third degree, assault in the fourth degree, or prostitution, even though it has been more than three years since the conviction;
(b) Forgery or theft in the second degree, even though it has been more than five years since the conviction;
(c) Any conviction that the department determines is reasonably related to the competency of the person to provide care to a client; 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 long-term care worker 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 long-term care worker 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 clients or have access to their records;
(13) Has a pending charge for a disqualifying crime.
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(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.]
(a) The provider's home care aide certification has been revoked; or
(b) The provider's inadequate performance or inability to deliver quality care is jeopardizing the client's health, safety, or well-being.
(c) The department has determined that the provider lack the character, competence or suitability necessary to protect the client's health, safety or well-being.
(2) 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 health, safety, or well-being is in imminent
jeopardy. Examples of circumstances indicating jeopardy to
the client ((could)) 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 or other persons involved
in the client's life that places the client at risk of harm;
(((4))) (d) A report from the client's health care
provider that the client's health is negatively affected by
inadequate care being provided by the individual provider;
(((5))) (e) A complaint from the client or client's
representative that the client 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.
(3) The department, AAA or department designee may otherwise terminate the individual provider's contract for either default or convenience in accordance with the terms of the contract.
[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)) as described in chapter 388-02 WAC, and
(((2))) (b) Receive services from another currently
contracted individual provider or home care agency
((provider)) long-term care worker, or ((other options)) to
receive services through other programs the client is eligible
for((, if a contract is summarily suspended)).
(((3))) (2) The hearing rights ((afforded)) provided
under this section and WAC 388-71-0561 are ((those)) rights of
the client((, not)). The individual provider does not have a
right to appeal.
[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) He or she has not been certified by the department of health as a home care aide within the required timeframe; or
(b) If exempted from certification, he or she has not completed required training within the required timeframe.
(2) An individual provider has the right to an administrative hearing when the department terminates the individual provider's contract, or takes other enforcement measures against the individual provider because:
(a) He or she has not completed required training within the required timeframe.
(b) His or her certification as a home care aide has been revoked by the department of health.
(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.
(4) To request an administrative hearing, an individual provider must send, deliver, or fax a written request to the office of administrative hearings (OAH). OAH must receive the written request within thirty calendar days of the date the department's notice letter is served upon the individual provider.
(5) The individual provider should keep a copy of the request.
(6) ((Chapters 34.05 and 74.39A RCW, chapter 388-02 WAC,
and the provisions of this chapter govern any administrative
hearing under this section. In the event of a conflict between
the provisions of this chapter and chapter 388-02 WAC, the
provisions of this chapter shall prevail)) The appeal process
will be governed by the Administrative Procedures Act (chapter 34.05 RCW, RCW 74.39A.085, chapter 388-02 WAC and this
chapter. If there is a conflict between chapter 388-02 WAC
and this chapter, this chapter will govern.
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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.
Reviser's note: The unnecessary strikethrough and underscoring 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 388-71-0562
When does a medicaid contracted home
care agency have the right to an administrative hearing and
how can a hearing be requested?
(1) A medicaid contracted
home care agency has the right to an administrative hearing
when the department terminates its contract or takes other
enforcement action related to its contract because the home
care agency:
(a) Knowingly employs a long-term care worker who has not completed training within the required timeframe.
(b) Knowingly employs a long-term care worker who does not meet the certification requirements or whose certification has been revoked by the department of health.
(2) In an administrative hearing challenging DSHS or department designee action to terminate the contract or challenge some other enforcement against its contract, a medicaid contracted home care agency may not challenge the action by the department of health affecting the home care aide certification of a long-term care worker employed by the home care agency. Action by the department of health affecting the long-term care worker's certification must be challenged in a department of health hearing, as provided in department of health rules.
(3) To request an administrative hearing, a home care agency must send, deliver, or fax a written request to the office of administrative hearings (OAH). OAH must receive the written request within thirty calendar days of the date the department's notice letter is served upon the home care agency.
(4) The home care agency should keep a copy of the request.
(5) The appeal process will be governed by the Administrative Procedures Act (chapter 34.05 RCW), RCW 74.39A.085, chapter 388-02 WAC and this chapter. If there is a conflict between chapter 388-02 WAC and this chapter, this chapter will govern.
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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 388-71-0836
What definitions apply to the long-term
care worker training requirements?
"Care team" includes the
client and everyone involved in his or her care. The care
team can include family, friends, doctors, nurses, long-term
care workers, social workers and case managers. The role of
the care team is to support the well-being of the client,
however, the client directs the care plan.
"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.
"Challenge test" means a challenge test taken for specialty training, without first taking the class for which the test is designed and can only be used when basic training is not required.
"Client" means an individual receiving in-home services.
"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.
"Competency testing" is evaluating a trainee to determine if he or she can demonstrate the required level of skill, knowledge, and/or behavior with respect to the identified learning objectives of a particular course. The department only requires competency testing for nurse delegation core and specialized diabetes training and the specialty trainings. Training programs may integrate competency testing within their approved curriculums.
"DDD" refers to the division of developmental disabilities.
"Department" or "DSHS" refers to the department of social and health services.
"Enhancement" is additional time provided for skills practice and additional training materials or classroom activities that help a worker to thoroughly learn the course content and skills. Enhancements can include new student materials, videos or DVDs, on-line materials, and/or additional student activities.
"Functionally disabled person" or "person who is functionally disabled" means a person who because of a recognized chronic physical or mental condition or disease, or developmental disability, including chemical dependency, is impaired to the extent of being dependent upon others for direct care, support, supervision, or monitoring to perform activities of daily living. "Activities of daily living", in this context, means self-care abilities related to personal care such as bathing, eating, using the toilet, dressing, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities as they are related to the mental capacity to perform activities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.
"Guardian" means an individual as defined in chapter 11.88 RCW.
"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 74.41.030.
"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 paid, personal care services 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, community residential service providers, and any other direct care staff providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities, and supported living providers.
The following persons are not long-term care workers:
(1) Persons who are:
(a) Providing personal care services to individuals who are not receiving state-funded services; and
(b) The person is not employed by an agency or facility that is licensed by the state.
(2) Persons employed by:
(a) Nursing homes licensed under chapter 18.51 RCW;
(b) Facilities certified under 42 CFR Part 483;
(c) Residential habilitation centers under chapter 71A.20 RCW;
(d) Hospitals or other acute care settings;
(e) Hospice agencies licensed under chapter 70.127 RCW;
(f) Adult day care centers or adult day health centers.
(3) Persons whose services are exclusively limited to assistance with "instrumental activities of daily living," as that term is defined in WAC 388-106-0010.
"Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living which is, provided because a person is a functionally disabled person as defined in this chapter.
"Training entity" means an organization, including an independent contractor, who is providing or may provide training under this section using approved curriculum. Training entities may only deliver approved curriculum.
"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.
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Reviser's note: The unnecessary underscoring 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 388-71-0839
What long-term care workers are exempt
from the seventy hour, thirty hour or twelve hour basic
training requirement?
The following long term care workers
are exempt from the basic training requirement:
(1) A person already employed as a long term care worker on January 6, 2012, who completed the basic training requirements in effect on the date of his or her hire;
(2) A person employed as a long term care worker on January 6, 2012, who completes within one hundred twenty days of hire the basic training requirements in effect on the date of his or her hire;
(3) A person previously employed as a long term care worker who completed the basic training requirements in effect on the date of his or her hire, and was employed as a long term care worker at some point between January 1, 2011 and January 6, 2012, this exemption will be verified at time of hire or service begin date;
(4) An individual provider who worked as a respite provider or who provided care to a minor between January 1, 2011 and January 6, 2012, and who completed the training requirements in effect on the date of his or her hire;
(5) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW;
(6) Nursing assistants certified under chapter 18.88A RCW;
(7) Certified counselors under chapter 18.19 RCW;
(8) Speech language pathologists or audiologists under chapter 18.35 RCW;
(9) Occupational therapists under chapter 18.59 RCW;
(10) Physical therapists under chapter 18.74 RCW;
(11) 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;
(12) An individual with special education training and has an endorsement granted by the superintendent of public instruction as described in RCW 28A.300.010;
(13) Individuals who are in a training program to become credentialed in a category listed from subsection (5) through (10) must compete this training program within one hundred twenty days of hire or service begin date to meet this exemption.
(14) Parent providers as described in WAC 388 71 0890; and
(15) Providers described in WAC 388-71-0880.
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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.ORIENTATION AND SAFETY TRAINING
NEW SECTION
WAC 388-71-0841
What is orientation?
(1) Orientation is
a training of two hours regarding the long-term care worker's
role as long-term care workers and the applicable terms of
employment.
(2) The department must approve orientation curricula and instructors.
(3) There is no challenge test for orientation.
[]
(1) The care setting and the characteristics and special needs of the population served or to be 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;
(6) Client rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care and how the long-term care worker will protect and promote these rights;
(7) Mandatory reporter law and worker responsibilities; and
(8) Communication methods and techniques that can be used while working with a client or guardian, and other care team members.
One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions.
[]
(2) The department must approve safety training curricula and instructors.
(3) There is no challenge test for safety training.
[]
(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 client 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 training entity must establish a way for the long-term care worker to ask the instructor questions.
[]
[]
BASIC TRAINING(a) Core competencies; and
(b) Population specific competencies.
(2) All seventy hour basic training curriculum must be approved by the department and provided by qualified instructors.
(3) The DSHS developed revised fundamentals of caregiving (RFOC) learner's guide may be used to teach core basic training but it must include enhancements which must be approved by the department. Enhancements include:
(a) Adding more time for workers to practice skills including:
(i) The mechanics of completing the skill correctly.
(ii) Client centered communication and problem solving associated with performing the skill.
(iii) The different levels of care required for each skill (independent, supervision, limited, extensive, total).
(iv) Working with assistive devices associated with a skill.
(v) Helpful tips or best practices in working through common client challenges associated with a skill.
(vi) Disease specific concerns or challenges associated with a skill.
In most of these examples, additional student materials would be required to ensure the skill enhancements are well planned and documented for students. Materials must be submitted for approval and approved per WAC 388-71-1026.
(b) Augmenting or adding additional materials, student activities, videos or guest speakers that:
(i) More deeply reinforce and fortify the learning outcomes required for basic training.
(ii) Ensure each student integrates and retains the knowledge and skills needed to provide quality basic personal care.
(iii) Prepares workers for the certification testing environment and process.
(c) Enhancements are NOT materials and/or activities that:
(i) Are out of the scope of practice for a LTC worker such as content clearly written for registered nurses.
(ii) Are identical to, or a direct replacement of, those already included in RFOC.
(iii) Do not reinforce Washington state laws associated with client rights and client directed care.
(iv) Long-term care workers are not paid to provide.
(v) Are written above a high school reading level.
(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.
(5) The training entity must establish a way for the long-term care worker to ask the instructor questions.
(6) There is no challenge test for basic training.
[]
(1) The date of hire for home care agency long-term care workers; or
(2) From the begin date of the authorization to provide department-paid in-home services for a client for individual providers.
[]
(1) His or her biological, step, or adoptive child or parent.
(2) One department client for twenty hours or less in any calendar month.
[]
[]
(2) If the individual provider initially starts working for one client and the authorized monthly hours are twenty or fewer, he or she will have to complete the seventy hours of basic training, become certified, and complete continuing education whenever:
(a) The authorized hours increase to more than twenty hours; or
(b) He or she begins to work for a second department client.
(3) Under these circumstances from the point of this change, the individual provider will:
(a) Have an additional one hundred twenty days to complete the seventy hours of training and additional one hundred fifty days to become certified;
(b) Be required to complete continuing education under WAC 388-71-0990; and
(c) Be required to continue to comply with the higher level of training requirements, even if the monthly authorized hours are later reduced to twenty or fewer hours.
[]
[]
(a) Medicaid personal care;
(b) Assessments completed by the division of developmental disabilities;
(c) Community resources;
(d) State and federal benefits;
(f) Networking; and
(g) Client self-determination.
(2) There is no challenge test for this training.
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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 388-71-0906
What topics must be taught in the core
competencies of basic training?
Basic training must include
all of the competencies under WAC 388-71-0911 for the
following topics:
(1) Communication skills;
(2) Long-term care worker self-care;
(3) Problem solving;
(4) Client rights and maintaining dignity;
(5) Abuse, abandonment, neglect, financial exploitation and mandatory reporting;
(6) Client 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 clients, family members, and care team members:
(a) Recognize how verbal and nonverbal cues impact communication with the client and care team;
(b) Engage and respect the client through verbal and nonverbal communication;
(c) Listen attentively and determine that the client understands what has been communicated;
(d) Recognize and acknowledge clients' communication including 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 client rights and dignity, take appropriate action to promote and protect a client's legal and human rights as protected by federal and Washington state laws including:
(a) Protect a client's confidentiality, including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a noncare team member asks for confidential information;
(b) Promote dignity, privacy, encourage, and support a client's maximum independence when providing care; and
(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use;
(d) Protect and promote the client's right to live free of abuse, neglect, abandonment, and financial exploitation.
(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 74.34.053; and
(b) Identify common signs and symptoms of abuse, abandonment, neglect, and financial exploitation.
(6) Regarding the competency of client directed care, take appropriate action when following a client's direction regarding his or her care:
(a) Describe a worker's role in client directed care including determining, understanding, and supporting a client's choices;
(b) Describe the importance and impact of client directed care on a client's independence, self-determination, and quality of life;
(c) Identify effective problem solving strategies that help balance a client's choice with personal safety; and
(d) Report concerns when a client 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 use methods to determine and ensure that these 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 client; and
(b) Take proper steps to assist when a client is falling or has fallen.
(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 client'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 actions to take if a client develops a pressure ulcer;
(e) Describe current best practices that protect and maintain a client's skin integrity including position changes when sitting or lying for extended periods and proper positioning and transfer techniques;
(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and
(g) Identify when to report skin changes and to whom.
(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, how, and why to obtain information from appropriate sources about a client's condition or disease for which they are receiving services. Describe how to use this information to provide appropriate, individualized care;
(b) Describe a client's baseline based on information provided in the care plan and explain why it is important to know a client's baseline;
(c) Identify changes in a client's physical, mental, and emotional state;
(d) Report changes from baseline and/or concerns to the appropriate care team member(s);
(e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to a client's safety and well-being;
(f) Explain the purpose of a care plan and describe how it is created, used and modified;
(g) Use a client's care plan to direct a worker's job tasks and any client 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 personal care tasks including but not limited to:
(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 client preferences, maintain privacy and dignity, support the client's level of ability, and assure their 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 client's bowel and bladder functioning baseline and when to report changes.
(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 client's health;
(b) Plan, shop, and prepare meals for a client according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the care plan and client 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 client;
(e) Recognize when a client'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 (if possible), and clean 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 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 and the label instructions;
(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 client who refuses to take medications, identifying when and to whom to report when a client 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 and blood borne pathogens including HIV/AIDS, implement best practices to prevent and control the spread of infections:
(a) Identify commonly occurring 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 are recommended for adults to reduce the spread of virus 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 clients 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 client in the grieving process:
(a) Define grief and loss;
(b) Describe common losses a client and 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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(a) Dementia;
(b) Mental health;
(c) Developmental disabilities;
(d) Young adults with physical disabilities; and
(e) Aging and older adults.
(2) Specialty training per WAC 388-112-0110 may be used to meet the population specific component of basic training. The training program will provide a department issued specialty certificate in these instances.
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Competencies and learning objectives described for developmental disability specialty training in WAC 388-112-0122, dementia specialty training in WAC 388-112-0132, mental health specialty training in WAC 388-112-0142, aging and older adults in WAC 388-112-0091 and young adults with physical disabilities in WAC 388-112-0083 may be used to develop the population specific training in these topic areas. This is not a requirement.
Competencies and learning objectives used to develop the training must be submitted with the curricula when sent to DSHS for approval as described in WAC 388-71-1026.
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ON-THE-JOB TRAINING(2) On-the-job training is provided by a qualified instructor as described in WAC 388-71-1055, who directly observes, coaches, and reinforces skills training for up to two long-term care workers at a time. The instructor providing the on-the-job training:
(a) Does not have to be the instructor who has taught the core competency training;
(b) Cannot be someone whose primary job duty is providing direct care to clients; or
(c) Cannot be the immediate supervisor of the long-term care worker receiving the on-the-job training.
(3) The person overseeing on-the-job training must:
(a) Submit DSHS required forms and become an approved instructor for the core competency of basic training; and
(b) Verify on a DSHS approved skills checklist the long-term care worker's successful completion of the demonstrated skills.
(4) 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.
(5) The training program shall offer department approved on-the-job training as part of the seventy hour training.
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NURSE DELEGATION CORE AND SPECIALIZED DIABETES TRAINING(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 under chapter 18.88B RCW; 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 core competencies of basic training, unless the twenty-eight hours of revised fundamentals of care or a department approved alternative was already completed.
(d) If nurse delegation is needed to implement a care plan earlier than home care aide certification can be obtained, become a nursing assistant registered and complete core competencies of basic training.
(2) Successfully complete "Nurse Delegation for Nursing Assistants" training.
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DOCUMENTATION REQUIREMENTS(1) The name of the trainee;
(2) The title of the training as approved by the department;
(3) For continuing education the department assigned curriculum approval code;
(4) The number of hours of the training;
(5) The name and identification number of the training entity;
(6) The instructor's name. For basic core training, the instructor's name and identification number;
(7) The instructor's signature or an authorized signature from the training entity the qualified instructor is training on behalf of; and
(8) The completion date of the training.
The long-term care worker must retain the original certificate or transcript for proof of completion of the training. A home care agency must keep a copy of the certificate or transcript on file.
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(2) An 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 DSHS-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 or transcript 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 certificate issued by an 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 training entity, then an 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.
(4) The long-term care worker, certified home care aide, and their employer must retain the original seventy-five hour training certificate or transcript and any twelve-hour continuing education training certificates as long as the worker is employed and up to three years after termination of employment. Training entities must keep a copy of these certificates on file for six years.
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HOME CARE AIDE CERTIFICATION
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CONTINUING EDUCATION
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(2) Effective July 1, 2012, certified home care aides must complete twelve hours of continuing education each calendar year after obtaining certification as described in department of health WAC 246-980-110 and 246-112-020(3).
(3) If exempt from certification as described in RCW 18.88B.041, 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) A long-term care worker or certified home care aide who did not complete the continuing education requirements by the timeframe described in (1) above or in WAC 388-71-0991 cannot be paid to provide care after that date and cannot be reinstated as a long-term care worker until they complete the continuing education requirements.
(5) 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 training entity must establish a way for the long-term care worker to ask the instructor questions.
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(2) For long-term care workers who are required to be certified, if the first renewal period is less than a full year from the date of certification, no continuing education will be due for the first renewal period.
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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, a person hired as an individual provider who provides twenty hours or less of care for one person in any calendar month.
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(1) Client rights;
(2) Personal care services;
(3) Mental illness;
(4) Dementia;
(5) Developmental disabilities;
(6) Depression;
(7) Medication assistance;
(8) Communication skills;
(9) Positive client behavior support;
(10) Developing or improving client-centered activities;
(11) Dealing with wandering;
(12) Dealing with challenging client behaviors;
(13) Medical conditions; and
(14) Nurse delegation core and specialized diabetes.
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CURRICULUM APPROVAL(2) The nurse delegation core and diabetes training must use only the DSHS curriculum.
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(1) For orientation and/or safety training:
(a) Effective January 7, 2012, submit an outline of what will be covered in each training offered (for example, a table of contents or a class syllabus) showing where the required introductory topics as listed in WAC 388-71-0846 for orientation and WAC 388-71-0855 for safety training are covered in the training. Department required orientation and safety training application forms must be submitted to the department at least forty-five days in advance of when the training is expected to be offered. Training cannot be offered before receiving department curriculum and instructor approval.
(2) For continuing education:
(a) Effective July 1, 2012, submit a summary that includes the topic, a brief description of what it will cover, and a course outline. Also include the number of training hours, for on line training courses, and submit a description of how the instructor or training will assess that the students have completed the materials and integrated the information being taught. Department required continuing education training application forms must be submitted at least forty-five days in advance of when the training is expected to be offered. The trainings cannot be offered before receiving department curriculum and instructor approval as well as the unique code assigned by the department for each curriculum.
(3) For basic training, the thirty hour basic training, and the twelve hour parent provider training:
(a) If the instructor or training entity wants to use the DSHS developed revised fundamentals of caregiving learner's guide with enhancements, submit the DSHS required form with all required information. Curricula must be submitted to DSHS for approval of one or both sections (core competencies and population specific competencies) of the seventy hours required for basic training, for the thirty hour basic training, and for the twelve hour parent provider training. When submitting one or both sections of the basic training curriculum for DSHS approval, it must at a minimum include:
(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives, described in this chapter, are located in the long-term care worker materials from the proposed curriculum for that course;
(ii) Any materials long-term care workers will receive, such as a textbook or long-term care worker manual, learning activities, audio-visual materials, handouts and books;
(iii) The table of contents or outline of the curriculum including the allotted time for each section;
(iv) Demonstration skills checklists for 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);
(v) The teacher's guide or manual that includes for each section of the curriculum:
(A) The 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, that were used to develop the curriculum. If the primary source or reference is not a published citation, the instructor must provide detail on how the content was established as evidence based:
(E) Description of how the curriculum was designed to accommodate long-term care workers with limited English proficiency and/or learning disabilities; and
(F) Description and proof of how input was obtained from consumers and long-term care worker representatives in the development of the curriculum.
(vi) 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.
(vii) Entities submitting curriculum for population specific basic training must submit their own list of competencies and learning objectives used to develop the population specific basic training curriculum.
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(2) After review of the curriculum, DSHS will send a written response to the submitter, indicating approval or disapproval of the curriculum(s).
(3) If curriculum(s) are not approved, the reason(s) for denial will be given and the submitter will be told what portion(s) of the training must be changed and resubmitted for review in order for the curriculum to be approved.
(4) The submitter can make the requested changes and resubmit the curriculum(s) for review.
(5) If after working with the department 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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INSTRUCTOR QUALIFICATIONS, APPROVAL, AND RESPONSIBILITIES(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, specialized diabetes trainings, dementia specialty, mental health specialty and DDD specialty training;
(5) Maintaining training records including long-term care worker 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 long-term care workers.
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(1) DSHS must approve and/or contract with a training entity and their instructor(s) to conduct orientation, safety, seventy hour basic training (core and population specific training), thirty hour training, twelve hour DDD parent provider training, nurse delegation core training and nurse delegation specialized diabetes training, on-the-job training, and continuing education. DSHS may contract with training entities and their instructor(s) using any applicable contracting procedures.
(2) The training partnership must ensure that its instructors meet the minimum qualifications under this chapter.
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(2) DSHS may terminate any training contract in accordance with the terms of the contract. The contractor's administrative remedies shall be limited to those specified in the contract.
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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 or higher degree in the field of health or human services and six months of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD, 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, or home care setting.
(3) Teaching experience:
(a) Must have one hundred hours of teaching adults in a classroom setting 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 tests must have experience or training in assessment and competency testing; and
(6) 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 using the department's attestation process, keep on file, and make available to the department upon request, that all instructors meet the minimum instructor qualifications in WAC 388-71-1055 and 388-71-1060 for the course they plan to teach;
(b) Teach using a complete DSHS-developed or approved curriculum;
(c) When requested by DSHS, notify DSHS in writing of their intent to conduct training prior to providing training, 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(s) for only the core basic training.
(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 training and instructor qualifications.
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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.PHYSICAL RESOURCES AND STANDARD PRACTICES FOR TRAINING
NEW SECTION
WAC 388-71-1091
What physical resources are required for
classroom training and testing?
(1) Classroom facilities used
for classroom training must be accessible to trainees and
provide adequate space for learning activities, comfort,
lighting, lack of disturbance, and tools for effective
teaching and learning, such as white boards and flip charts.
Appropriate supplies and equipment must be provided for
teaching and practice of caregiving skills in the class being
taught.
(2) Testing sites 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 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) Long-term care workers attending classroom training must not be expected to leave the class to attend job duties, except in an emergency.
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COMPETENCY TESTING FOR NURSE DELEGATION CORE AND SPECIALIZED DIABETES TRAINING(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 long-term care workers before beginning a test;
(c) The amount of assistance to long-term care workers allowed during testing;
(d) The accommodation guidelines for long-term care workers with disabilities; and
(e) Accessibility guidelines for long-term care workers 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 and is there a challenge test for safety training? |
| WAC 388-71-05835 | Who is required to complete safety training, when, and how often must it be completed? |
| WAC 388-71-05836 | Will DSHS deny payment of an individual provider who does not complete safety training? |
| WAC 388-71-05837 | 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? |
(1) ((All adult family homes licensed under chapter 70.128 RCW)) Training and certification requirements that
apply to adult family homes and assisted living facilities on
or before January 6, 2012; and
(2) ((All boarding homes licensed under chapter 18.20 RCW)) Training and certification requirements that apply to
adult family homes and assisted living facilities on or after
January 7, 2012.
[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.]
(1) Adult family home applicants, resident managers, entity representatives, long-term care workers, and volunteers; and
(2) Assisted living facility administrators, designees, long-term care workers, and volunteers.
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| Who | Status | Orientation | Safety/ Orientation training | Basic/ Population Specific training | Specialty training | Continuing education | Certification HCA-C |
| (1) Adult family home resident manager, assisted living facility administrator, or long term care worker in adult family home / assisted living facility. | An RN, LPN, NA-C or allied health care professionals listed in WAC 388-112-0076 | Required per WAC 388-112-0015(1); 388-112-0040 (a) and (b) | Not required | Not required | Required per WAC 388-112-0110 | Required per WAC 388-112-0200; 388-112-0205 | Not required |
| (2) Adult family home resident manager, or assisted living administrator, or long term care worker in adult family home or assisted living facility. | A long term care worker who was employed on January 6, 2012 or was previously employed sometime between 1/1/2011 and 1/6/2012 and has completed the basic training requirements in effect on his or her hire date. WAC 388-112-0076 | Required per WAC 388-112-0015(1); 388-112-0040 (a) and (b) | Not required | Not required | Required per WAC 388-112-0110 | Required per WAC 388-112-0200; 388-112-0205 | Not required |
| (3) Adult family home resident manager, or long term care worker in adult family home or assisted living facility. | Employed in an adult family home or assisted living facility and does not meet criteria in (1) or (2) of this table. Meets definition of long term care worker in WAC 388-112-0005. | Not required | Required. Five hours per WAC 388-112-0015(2); 388-112-0040 (2)(a) | Required. Seventy hours per WAC 388-112-0045 and 388-112-0066 | Required per WAC 388-112-0110 | Required. Twelve hours per WAC 388-112-0200; 388-112-0205 | Required per WAC 388-112-0106 |
| (4) Adult family home provider | A person who has an adult family home license and meets criteria in (1) or (2). This requirement applies to an entity representative of a licensed entity. WAC 388-76-1000. | Not required | Completed prior to licensing | Completed prior to licensing | Completed prior to licensing | Required. Twelve hours per WAC 388-112-0200; 388-112-0205 | Completed prior to licensing |
| (5) Assisted living facility administrator | A qualified assisted living facility administrator or designee who does not meet criteria in (1) or (2) of this table. | Not required | Required. Five hours per WAC 388-112-0015(2); 388-112-0040 (2)(a) | Required. Seventy hours per WAC 388-112-0045 and 388-112-0066 | Required per WAC 388-112-0110 | Required. Twelve hours per WAC 388-112-0200; 388-112-0205 | Required per WAC 388-112-0106 |
| (6) Volunteer staff in adult family home or assisted living facility | An unpaid person | Required per WAC 388-112-0015(1); 388-112-0040 (a) and (b) | Not required | Not required | Not required | Not required | Not required |
| Who | Status | Orientation and Safety training | Basic/ Population Specific training | Specialty training | Continuing education | Certification HCA-C |
| (1) Adult family home applicant | An RN, LPN, ARNP, NA-C, and other allied health professionals as listed in WAC 388-112-0076 | Not required | Not required | Required per WAC 388-112-0110 | Not required during application process | Not required |
| (2) Adult family home applicant | A long term care worker employed on January 6, 2012 or was previously employed sometime between 1/1/2011 and 1/6/2012 and has completed the basic training requirements in effect on the date of his or her hire. WAC 388-112-0076 | Not required | Not required | Required per WAC 388-112-0110 | Not required during application process | Not required |
| (3) Adult family home applicant | Seeking a license to operate an adult family home and is not exempt under (1) or (2) of this table. WAC 388-112-0002 | Required. Five hours per WAC 388-112-0040 (1)(a) | Required. Seventy hours per WAC 388-112-0045 and 388-112-0066 | Required per WAC 388-112-0110 | Not required during application process | Required per WAC 388-112-0106 |
| (4) Adult family home resident manager | Employed or designated by the provider to manage an adult family home and is not exempt under (1) or (2) of this table. WAC 388-112-0002. | Required. Five hours per WAC 388-112-0040 (1)(a) | Required. Seventy hours per WAC 388-112-0045 and 388-112-0066 | Required per WAC 388-112-0110 | Required. Twelve hours per WAC 388-112-0205 | Required per WAC 388-112-0106 |
[]
(1) ((WAC 388-78A-3170)) RCW 18.20.190, for assisted
living facility providers; or
(2) WAC ((388-76-10960)) RCW 70.128.160, for adult family
home providers.
[]
Reviser's note: The unnecessary strikethrough and underscoring 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 02-15-065, filed 7/11/02,
effective 8/11/02)
WAC 388-112-0005
What definitions apply to this chapter?
"Applicant", for the purposes of this chapter, means:
(1) An individual who is applying for an adult family home license; or
(2) An individual with an ownership interest in a partnership, corporation, or other entity that is applying for an adult family home license.
(("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 resident and everyone involved in his or her care. The care team can include family, friends, doctors, nurses, long-term care workers, social workers and case managers. The role of the care team is to support the well-being of the resident, however, the resident 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 for specialty training 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.
"Competency testing" including challenge testing, is evaluating a trainee to determine if they can demonstrate the required level of skill, knowledge, and/or behavior with respect to the identified learning objectives of a particular course.
"DDD" refers to the division of developmental disabilities.
"Designee" means a person in ((a boarding home)) assisted
living facility who supervises ((caregivers)) long-term care
workers and who is designated by ((a boarding home)) assisted
living facility administrator to take the trainings in this
chapter required of the ((boarding home)) assisted living
facility administrator. A ((boarding home)) assisted living
facility administrator may have more than one designee.
"Direct care worker" means a paid individual who provides direct, personal care services to persons with disabilities or the elderly requiring long-term care.
"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)) or specialty training (if
exempt from basic training requirement).
"DSHS" or "department" refers to the department of social and health services.
"Enhancement" means additional time provided for skills practice and additional training materials or classroom activities that help a worker to thoroughly learn the course content and skills. Enhancements can include new student materials, videos or DVDs, on-line materials, and/or additional student activities.
"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.
"Functionally disabled person" or "person who is functionally disabled" means a person who because of a recognized chronic physical or mental condition or disease, or developmental disability, including chemical dependency, is impaired to the extent of being dependent upon others for direct care, support, supervision, or monitoring to perform activities of daily living. "Activities of daily living", in this context, means self-care abilities related to personal care such as bathing, eating, using the toilet, dressing, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.
"Guardian" means an individual as defined in chapter 11.88 RCW.
"Home" refers to adult family homes and ((boarding
homes)) assisted living facilities.
"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.
"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.
"Long-term care worker" includes all persons providing paid, personal care services 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 assisted living facilities, adult family homes, respite care providers, community residential service providers, and any other direct care staff providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.
The following persons are not long-term care workers:
(1) Persons who are:
(a) Providing personal care services to individuals who are not receiving state-funded services; and
(b) The person is not employed by an agency or facility that is licensed by the state.
(2) Persons employed by:
(a) Nursing homes licensed under chapter 18.51 RCW;
(b) Facilities certified under 42 CFR Part 483;
(c) Residential habilitation centers under chapter 71A.20 RCW;
(d) Hospitals or other acute care settings;
(e) Hospice agencies licensed under chapter 70.127 RCW;
(f) Adult day care centers or adult day health centers.
(3) Persons whose services are exclusively limited to assistance with "instrumental activities of daily living," as that term is defined in WAC 388-106-0010.
"Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living which is provided to meet resident's care needs because a person is a functionally disabled person as defined in this chapter.
"Provider" means any person or entity who is licensed by the department to operate an adult family home or assisted living facility, or certified by the department to provide instruction and support services to meet the needs of persons receiving services under title 71A RCW.
"Resident" means a person residing and receiving
long-term care services at ((a boarding home)) an assisted
living facility 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 WAC 388-76-10000 and this chapter.
"Routine interaction" means contact with residents that happens regularly.
"Training entity" means an organization, including an independent contractor, who is providing or may provide training under this section using approved curriculum. Training entities may only deliver approved curriculum.
[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) The long-term care worker training requirements ((of
this chapter begin September 1, 2002, or one hundred twenty
days from the date of employment, whichever is later, and
apply to:
(1) Adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who are hired or begin to provide hands-on personal care to residents subsequent to September 1, 2002; and
(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)) that were in effect on or before January 6, 2012 apply to those individuals who:
(a) Were hired on or before January 6, 2012; and
(b) Completed basic training within the required timeframes.
[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) For individuals required to complete long-term care
worker training who do not meet the criteria under subsection
(1) above, orientation ((provides basic introductory
information appropriate to the residential care setting and
population served)) is a training of two hours regarding the
long-term care worker's role and the applicable terms of
employment.
(a) The department ((does not)) must approve ((specific))
this long-term care worker orientation ((programs, materials,
or trainers for homes)) curricula and instructors.
(b) There is no test ((is required)) for this
orientation.
[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.]
(a) Long-term care services orientation may include the use of videotapes, audiotapes, and other media if the person overseeing the orientation is available to answer questions or concerns for the person(s) receiving the orientation. Orientation must include introductory information in the following areas:
(i) The care setting;
(ii) The characteristics and special needs of the population served;
(iii) Fire and life safety, including:
(A) Emergency communication (including phone system if one exists);
(B) Evacuation planning (including fire alarms and fire extinguishers where they exist);
(C) Ways to handle resident injuries and falls or other accidents;
(D) Potential risks to residents or staff (for instance, aggressive resident behaviors and how to handle them); and
(E) The location of home policies and procedures.
(iv) Communication skills and information, including:
(A) Methods for supporting effective communication among the resident/guardian, staff, and family members;
(B) Use of verbal and nonverbal communication;
(C) Review of written communications and/or documentation required for the job, including the resident's service plan;
(D) Expectations about communication with other home staff; and
(E) Whom to contact about problems and concerns.
(v) Universal precautions and infection control, including:
(A) Proper hand washing techniques;
(B) Protection from exposure to blood and other body fluids;
(C) Appropriate disposal of contaminated/hazardous articles;
(D) Reporting exposure to contaminated articles, blood, or other body fluids; and
(E) What staff should do if they are ill.
(vi) Resident rights, including:
(A) The resident's right to confidentiality of information about the resident;
(B) The resident's right to participate in making decisions about the resident's care, and to refuse care;
(C) Staff's duty to protect and promote the rights of each resident, and assist the resident to exercise his or her rights;
(D) How and to whom staff should report any concerns they may have about a resident's decision concerning the resident's care;
(E) Staff's duty to report any suspected abuse, abandonment, neglect, or exploitation of a resident;
(F) Advocates that are available to help residents (LTC ombudsmen, organizations); and
(G) Complaint lines, hot lines, and resident grievance procedures.
(vii) In adult family homes, safe food handling information must be provided to all staff, prior to handling food for residents.
(2) For long-term care worker orientation required of those individuals identified in WAC 388-112-0015(2):
(a) Long-term care worker orientation is a two hour training that must include introductory information in the following areas:
(i) The care setting and the characteristics and special needs of the population served;
(ii) Basic job responsibilities and performance expectations;
(iii) The care plan, including what it is and how to use it;
(iv) The care team;
(v) Process, policies, and procedures for observation, documentation and reporting;
(vi) Resident rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care and how the long-term care worker will protect and promote these rights;
(vii) Mandatory reporter law and worker responsibilities; and
(viii) Communication methods and techniques that can be used while working with a resident or guardian and other care team members.
One hour of completed classroom instruction or other form of training (such as a video or on line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions.
[]
(2) The department must approve safety training curricula and instructors.
(3) There is no test for safety training.
[]
(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 the worker or the resident is 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 resident is falling or falls;
(d) Location of any advance directives if available; 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 training entity must establish a way for the long-term care worker to ask the instructor questions. In adult family homes, safe food handling information must be provided to all staff, prior to handling food for residents.
[]
(1) The ((trainee's)) name of the trainee;
(2) ((A list of the specific information taught)) The
title of the training;
(3) The number of hours of the training;
(4) The signature of the ((person overseeing)) instructor
providing orientation((, indicating completion of the required
information)) and safety training;
(((4))) (5) The trainee's date of ((employment)) hire;
(((5))) (6) The name and identification number of the
home or service provider giving the orientation and safety
training; and
(((6))) (7) The date(s) of orientation and safety
training for the required, approved training described in WAC 388-112-0015(2) and WAC 388-112-0018.
(8) The documentation required under this section must be kept in a manner consistent with WAC 388-76-10198 (for adult family homes) and WAC 388-78A-2450 (for assisted living facilities).
[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 must complete
orientation before having routine interaction with residents. Orientation must be provided by appropriate adult family home
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)) The following individuals must complete long-term care training orientation requirements:
(a) Adult family homes - All volunteer staff and all long term care workers who are exempt from certification under RCW 18.88B.041 must complete orientation before having routine interaction with residents. Orientation must be provided by staff familiar with the adult family home building and operations.
(b) Assisted living facilities - Assisted living facility administrators (or their designees) and all long term care workers who are exempt from certification under RCW 18.88B.041, and volunteer staff must complete orientation before having routine interaction with residents. Orientation must be provided by staff familiar with assisted living facility building and operations.
(2) The following individuals must complete long-term care worker orientation and safety training requirements:
(a) All long-term care workers who are not exempt from certification described in RCW 18.88B.041 hired on or after January 7, 2012 must complete two hours of orientation and three hours of safety training before providing care to residents. This orientation and safety training must be provided by qualified instructors as described in WAC 388-112-0383.
[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 approve basic training curricula.
(3) Effective July 1, 2012, no more than twelve of the seventy hours may be applied for on-the-job training;
(4) The DSHS developed revised fundamentals of caregiving (RFOC) learner's guide may be used to teach core basic training but it must include enhancements which must be approved by the department. Examples of enhancements include:
(a) More time for workers to practice skills including:
(i) The mechanics of completing the skill correctly.
(ii) Resident centered communication and problem solving associated with performing the skill.
(iii) The different levels of care required for each skill (independent, supervision, limited, extensive, total).
(iv) Working with assistive devices associated with a skill.
(v) Helpful tips or best practices in working through common resident challenges associated with a skill.
(vi) Disease specific concerns or challenges associated with a skill. In most of these examples, additional student materials would be required to ensure the skill enhancements are well planned and documented for students. Materials must be submitted for approval and approved per WAC 388-112-0325.
(b) Augmenting or adding additional materials, student activities, videos or guest speakers that:
(i) More deeply reinforce and fortify the learning outcomes required for basic training.
(ii) Ensure each student integrates and retains the knowledge and skills needed to provide quality basic personal care.
(iii) Prepares workers for the certification testing environment and process.
(c) Enhancements are NOT materials and/or activities that:
(i) Are out of the scope of practice for a long-term care worker such as content clearly written for registered nurses.
(ii) Are identical to, or a direct replacement of, those already included in RFOC.
(iii) Fail to reinforce Washington state laws associated with resident rights and resident directed care.
(iv) Long-term care workers are not paid to provide.
(v) Are written above a high school reading level.
(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) The long-term care worker must be able to ask the instructor questions during the training.
(7) There is no challenge test for 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, § 388-112-0045, filed 7/11/02, effective 8/11/02.]
(1) Communication skills;
(2) Long-term care worker self-care;
(3) Problem solving;
(4) Resident rights and maintaining dignity;
(5) Abuse, abandonment, neglect, financial exploitation and mandatory reporting;
(6) Resident 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.
[]
(a) Understanding and using effective interpersonal and problem solving skills with the resident, family members, and other care team members;
(b) Taking appropriate action to promote and protect resident rights, dignity, and independence;
(c) Taking appropriate action to promote and protect the health and safety of the resident and the caregiver;
(d) Correctly performing required personal care tasks while incorporating resident preferences, maintaining the resident's privacy and dignity, and creating opportunities that encourage resident independence;
(e) Adhering to basic job standards and expectations.
(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 residents. Learning objectives are associated with each competency.
(1) Regarding communication, communicate effectively and in a respectful and appropriate manner with residents, family members, and care team members:
(a) Recognize how verbal and non-verbal cues impact communication with the resident and care team;
(b) Engage and respect the resident through verbal and non-verbal communication;
(c) Listen attentively and determine that the resident understands what has been communicated;
(d) Recognize and acknowledge residents' communication including 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:
(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 resident rights and dignity, take appropriate action to promote and protect a resident's legal and human rights as protected by federal and Washington state laws, including:
(a) Protect a resident's confidentiality including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a noncare team member asks for confidential information;
(b) Promote dignity, privacy, encourage and support a resident's maximum independence when providing care;
(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use;
(d) Protect and promote the resident's right to live free of abuse, neglect, abandonment, and financial exploitation.
(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 in RCW 74.34.020 through 74.34.053; and
(b) Identify common symptoms of abuse, abandonment, neglect, and financial exploitation.
(6) Regarding the competency of resident directed care, take appropriate action when following a resident's direction regarding his or her care:
(a) Describe a worker's role in resident directed care including determining, understanding, and supporting a resident's choices;
(b) Describe the importance and impact of resident directed care on a resident's independence, self-determination, and quality of life;
(c) Identify effective problem solving strategies that help balance a resident's choice with personal safety; and
(d) Report concerns when a resident 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 use methods to determine and ensure that these 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:
(a) Identify fall risk factors and take action to reduce fall risks for a resident; and
(b) Take proper steps to assist a resident who is falling or has fallen.
(10) Regarding the competency of skin and body care, use of personal care practices that promote and maintain skin integrity:
(a) Explain the importance of observing a resident'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 action to take if a resident appears to be developing or develops a pressure ulcer;
(e) Describe current best practices that protect and maintain a resident's skin integrity including position changes when sitting or lying for extended periods, and proper positioning and transfer techniques;
(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and
(g) Identify when to report skin changes and to whom.
(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, how, and why to obtain information from appropriate sources about a resident's condition or disease for which they are receiving services. Describe how to use this information to provide appropriate, individualized care;
(b) Describe a resident's baseline functioning level using information provided in the service plan and explain why it is important to know a resident's baseline;
(c) Identify changes in a resident's physical, mental, and emotional state through observation;
(d) Report changes from baseline and/or concerns to the appropriate care team member(s);
(e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to a resident's safety and well-being;
(f) Explain the purpose of a service plan and describe how it is created, used, and modified;
(g) Use a resident's service plan to direct a worker's job tasks and any resident 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 personal care tasks including but not limited to:
(i) Helping a resident walk;
(ii) Transferring a resident from a bed to a wheelchair;
(iii) Turning and repositioning a resident in bed;
(iv) Providing oral 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 a resident with a weak arm to dress;
(xi) Putting knee-high elastic stockings on a resident;
(xii) Providing passive range of motion for one shoulder;
(xiii) Providing passive range of motion for one knee and ankle;
(xiv) Assisting a resident 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 resident preferences, maintain privacy and dignity, support the resident's level of ability, and assure their 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 a resident's bowel and bladder functioning baseline and when to report changes.
(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 resident's health;
(b) Plan, shop, and prepare meals for a resident according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the service plan and resident 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 resident;
(e) Recognize when a resident'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 (if possible) and clean 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 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 and the label instructions;
(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 resident who refuses to take medications, identifying when and to whom to report when a resident 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 and blood borne pathogens including HIV/AIDS, implement best practices to prevent and control the spread of infections:
(a) Identify commonly occurring 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 are recommended for adults to reduce the spread of virus 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 residents 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 resident in the grieving process:
(a) Define grief and loss;
(b) Describe common losses a resident and 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.]
(2) On-the-job training is provided by a qualified instructor as defined in WAC 388-112-0380 who directly observes, coaches, and reinforces skills training for up to two long-term care workers at a time. The instructor providing the on-the-job training:
(a) Does not have to be the instructor who has taught the core competency training;
(b) Cannot be someone whose primary job duty is providing direct care to residents; or
(c) Cannot be the immediate supervisor of the long-term care worker receiving the on-the-job training.
(3) The person overseeing on-the-job training must:
(a) Submit DSHS required forms and become an approved instructor for the core competency of basic training; and
(b) Verify on a DSHS approved skills checklist the long-term care worker's successful completion of the demonstrated skills.
(4) 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.
(5) The training program shall offer department approved on-the-job training as part of the seventy hour training.
[]
(a) Dementia;
(b) Mental health;
(c) Developmental disabilities;
(d) Young adults with physical disabilities; and
(e) Aging and older adults.
(2) Specialty training per WAC 388-112-0110 may be used to meet the population specific component of basic training if completed within one hundred and twenty days of date of hire.
[]
(a) The name of the trainee;
(b) The name of the training;
(c) The number of hours of the training;
(d) The date(s) of training;
(e) The name of the home or training entity giving the training;
(((d))) (f) The instructor's name and signature; and
(((e))) (g) The name and the identification number of the
instructor for core competencies, and the home or training
entity giving the training; and
(h) The ((date(s))) completion date of training.
(2) The trainee must be given an original certificate(s)
for proof of completion of the training and retain for their
records. ((A home)) The provider, and if applicable, the
training entity must keep a copy of the certificate ((on
file)) as described in WAC 388-76-10198 (for adult family
homes) and as described in WAC 388-78A-2450 (for assisted
living facilities).
[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.]
Adult family homes
(1) Adult family home ((providers (including entity
representatives as defined under chapter 388-76 WAC)))
applicants must complete basic training ((and demonstrate
competency)) and become certified before ((operating an)) the
adult family home is licensed.
(2) Adult family home entity representatives and resident
managers ((must complete basic training and demonstrate
competency)) before ((providing services in an)) assuming the
duties of the position in the 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)) date of hire. Until ((competency in
the)) basic training has been ((demonstrated, caregivers))
completed, long-term care workers may not provide ((hands-on))
personal care without ((indirect)) direct supervision.
((Boarding homes)) Assisted living facilities
(4) ((Boarding home)) Assisted living facility
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)) date of
hire.
(5) ((Caregivers must complete basic training)) Long-term
care workers 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)) their
date of hire. 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.
(6) For certification requirements for individuals in subsections (1) through (5) refer to WAC 388-112-0106.
[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.]
(1) An applicant for an adult family home license on or before January 6, 2012 who met the basic training requirements in effect at the time of application.
(2) A person already employed as a long-term care worker on January 6, 2012, who completed the basic training requirements in effect on the date of his or her hire;
(((2))) (3) A person employed as a long-term care worker
on January 6, 2012, who completes within one hundred twenty
days of hire, the basic training requirements in effect on the
date of his or her hire;
(((3))) (4) A person previously employed as a long-term
care worker who completed the basic training requirements in
effect on the date of his or her hire, and was employed as a
long-term care worker at some point between January 1, 2011
and January 6, 2012;
(((4))) (5) Registered nurses, licensed practical nurses,
nurse technicians, or advanced registered nurse practitioner
under chapter 18.79 RCW;
(((5))) (6) Nursing assistants-certified under chapter 18.88A RCW;
(((6))) (7) Certified counselors under chapter 18.19 RCW;
(((7))) (8) Speech language pathologists or audiologists
under chapter 18.35 RCW;
(((8))) (9) Occupational therapists under chapter 18.59 RCW;
(((9))) (10) Physical therapists under chapter 18.74 RCW;
(((10))) (11) 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; and
(((11))) (12) An individual with special education
training and an endorsement granted by the superintendent of
public instruction as described in RCW 28A.300.010.
[]
Reviser's note: The unnecessary strikethrough and underscoring 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 388-112-0078
What curriculum may be used in the
population specific component of the basic training?
Homes or
providers may use the following DSHS-developed or approved
curriculum to meet all or some of the population specific
component of basic training depending on the needs of the
population served:
(1) Dementia specialty training;
(2) Mental health specialty training; and
(3) Developmental disabilities specialty training.
[]
(1) It must include the department developed competencies and learning objectives as described in WAC 388-112-0122, 388-112-0132, or 388-112-0142. Homes or providers may enhance the specialty training component by adding additional competencies, learning objectives, content, or activities. If the department approves the enhancements and an increased number of training hours, the worker's training hours will apply to the seventy hour training requirement.
(2) Long-term care workers must pass a department competency test described in WAC 388-112-0300 to meet the applicable licensing requirements for adult family homes and assisted living facilities for all specialty training.
[]
(1) Introduction to physical disabilities;
(2) Common physical disabilities and ability limitations;
(3) Supporting residents living with chronic conditions;
(4) Independent living and resident-directed care; and
(5) Social connections and sexual needs of adults living with disabilities.
[]
(1) Regarding the competency on young adults with physical disabilities, working 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 resident with a disability.
(2) Regarding the competency on common physical disabilities and ability limitations, providing 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 residents with these specific disabilities.
(3) Regarding the competency on supporting residents living with chronic conditions, providing 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 resident with a physical disability;
(c) Describe how to support a resident with a physical disability and multiple chronic conditions; and
(d) Describe how to support the resident's dignity while providing personal care.
(4) Regarding the competency on independent living and resident-directed care, supporting independent living and self-determination for the resident 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 resident living with a disability;
(d) Describe resident-directed support;
(e) Identify ways to promote resident-directed support; and
(f) Identify resources that promote independence and self-determination for a resident living with a disability.
(5) Regarding the competency of social connections and sexual needs of young adults living with a physical disability, providing optimum support to a resident 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 resident's living with a physical disability;
(b) Identify ways to support social connections and activities;
(c) Describe and explain the importance of honoring the resident 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.
[]
(1) Introduction to aging;
(2) Age-associated physical changes;
(3) Cultural impacts on aging;
(4) Ageism and supporting resident dignity;
(5) Supporting residents 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 residents;
(e) Describe how aging affects the resident's needs and behaviors; and
(f) Describe the value of adapting caregiving to the age-related concerns of the resident.
(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 resident dignity, overcome ageism and support resident 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 resident dignity; and
(d) Describe strategies for overcoming "ageism" and supporting resident dignity.
(5) Regarding the competency on supporting residents 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 a resident 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 resident health and wellness;
(b) Identify strategies for promoting resident 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 residents.
[]
[]
(1) All long-term care workers, within one hundred and fifty days of hire;
(2) Adult family home applicants, before licensure;
(3) Adult family home entity representatives and resident managers, before assuming the duties of the position; and
(4) Assisted living facility administrators or their designees within one hundred and fifty days of hire.
[]
(2) An approved training entity issuing and signing a DSHS seventy-five hour training certificate must verify that the long-term care worker has the certificates required documenting two hours of DSHS-approved orientation, three hours of DSHS-approved safety training, and seventy hours of DSHS-approved basic training, as described in this chapter. When applying to the department of health for home care aide certification, the long-term care worker may only submit a seventy-five hour training certificate that has been issued by the department or the training partnership.
(3) For home care aide recertification, successful completion of twelve hours of DSHS-approved continuing education training must be documented on a certificate or transcript issued by an 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 training entity, then an 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.
(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 or transcripts for as long as:
(a) They are employed; and
(b) Up to three years after termination of employment.
[]
(2) Manager specialty training is required for ((boarding
home)) assisted living facility administrators (or designees),
adult family home applicants or providers ((and)), resident
managers, and entity representatives who are affiliated with
homes that serve residents who have one or more of the
following special needs: developmental disabilities,
dementia, or mental health. The managers described in this
section must take one or more of the following specialty
trainings:
(a) Developmental disabilities specialty training,
((under)) described in 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) Manager dementia specialty training, ((under))
described in WAC 388-112-0125((,)); and
(c) Manager mental health specialty training, ((under))
described in 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 boarding homes))
All long-term care workers including those who are exempt from
basic training and who work in an assisted living facility or
adult family home, serving residents with the special needs
described in subsection (2) of this section, must take
long-term care worker specialty training. The long-term care
worker specialty training applies to the type of residents
served by the home as follows:
(a) Developmental disabilities specialty training,
((under)) described in WAC 388-112-0120((, is the required
training on that specialty for boarding home caregivers)).
(b) ((Caregiver)) Long-term care worker dementia
specialty training, ((under)) described in WAC 388-112-0130((,)); and ((caregiver))
(c) Long-term care worker mental health specialty
training, ((under)) described in 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 date of hire.
(5) For long term care workers who have completed the seventy-five hour training and do not have a specialty training certificate which indicates completion and competency testing, the long term care worker must complete specialty training when employed by the adult family home or assisted living facility that serves residents with special needs.
[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)) resident
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 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, drawing upon a basic understanding of developmental disabilities and demonstrate awareness of the unique needs of residents 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 illness.
(2) Regarding the competency on values of service delivery, promote and support a resident'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 resident's needs leads to better services and supports, which lead to better outcomes for the resident;
(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 residents 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 resident's history, experience, and cultural beliefs:
(a) List the key elements of effective communication;
(b) Describe the impact communication has on the lives of residents with developmental disabilities;
(c) Explain the impact a long-term care worker's behavior can have on eliciting communication;
(d) Explain the impact of a resident'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 residents with developmental disabilities; and
(f) List tips for communication with residents with developmental disabilities.
(4) Regarding the competency on interactive planning, using person-centered and interactive planning when working with residents 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 a resident'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 residents 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 a resident 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 a resident 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 a resident experiencing a crisis.
(7) Regarding the competency on legal rights, promote and protect the legal and resident rights of residents with developmental disabilities:
(a) Explain how the rights of residents with disabilities compare to those of the general population;
(b) List the rights of residents living in adult family homes and assisted living facilities and the laws that support those rights;
(c) Describe how long-term care workers can help residents to exercise their rights;
(d) List ways a caregiver or long-term care worker must safeguard each resident's confidentiality;
(e) Describe the three types of guardianship an resident 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 long-term care workers and guardians/families.
[]
(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" 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 and competencies may be obtained from the ((DSHS
aging and adult services administration)) 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, § 388-112-0125, filed 7/11/02, effective 8/11/02.]
(((a))) (1) Introduction to the dementias;
(((b))) (2) Dementia, depression, and delirium;
(((c) Resident-based caregiving;
(d))) (3) Dementia caregiving principles;
(((e))) (4) Communicating with people who have dementia;
(((f))) (5) Sexuality and dementia;
(((g))) (6) Rethinking "problem" behaviors;
(((h))) (7) Hallucinations and delusions;
(((i))) (8) Helping with activities of daily living
(ADLs); and
(((j))) (9) 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 residents with dementia:
(a) Identify basic information on dementia, including causes and treatments;
(b) Describe how dementia affects resident needs and behaviors;
(c) List typical behaviors and symptoms a resident with dementia would most likely experience;
(d) Describe the differences that might be seen based on the type of dementia a resident has.
(2) Regarding the competency on dementia, depression, and delirium, respond appropriately to residents 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 resident'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 residents with dementia.
(4) Regarding the competency on communicating with people who have dementia, communicate in a respectful and appropriate manner with residents 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 a resident's behavior;
(c) Describe how to effectively initiate and conduct a conversation with a resident who has dementia; and
(d) Identify communication strategies to work with residents who have dementia.
(5) Regarding the competency on sexuality and dementia, protect a resident or resident'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 a resident'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 residents' 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 a resident who has dementia; and
(d) Describe how to respond appropriately to a resident who is expressing a challenging behavior.
(7) Regarding the competency on hallucinations and delusions, respond appropriately when a resident 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 a resident 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 residents with dementia; and
(b) Describe strategies that support meaning and utilize an individualized approach when assisting a resident 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 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 resident 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 a resident and/or representative(s).
[]
(((a))) (1) Introduction to mental illness;
(((b))) (2) Culturally compassionate care;
(((c))) (3) Respectful communications;
(((d))) (4) Understanding mental illness - major mental
((disorders)) illnesses;
(((e))) (5) Understanding mental illness - baseline,
decompensation, and relapse planning; responses to
hallucinations and delusions;
(((f))) (6) Understanding and interventions for behaviors
perceived as problems;
(((g))) (7) Aggression;
(((h))) (8) Suicide;
(((i))) (9) Medications;
(((j))) (10) Getting help from others; and
(((k))) (11) Self-care for ((caregivers)) long-term care
workers.
(2) The manager mental health specialty training learning
outcomes and competencies may be obtained from the ((DSHS
aging and adult services administration)) 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, § 388-112-0135, 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 02-15-065, filed 7/11/02,
effective 8/11/02)
WAC 388-112-0140
What ((knowledge and skills)) topics
must ((caregiver)) the long-term care worker mental health
specialty training include?
(1) ((Caregiver)) The long-term
care worker mental health specialty training must include all
of the ((learning outcomes and competencies published by
DSHS)) competencies described in WAC 388-112-0142 for the
following ((core knowledge and skills)) topics:
(a) Understanding major mental ((disorders)) illnesses;
(b) ((Individual)) Resident 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 illnesses, draw upon a basic understanding of mental illness and demonstrate awareness of the unique needs of residents with mental illness:
(a) Define and describe main symptoms of depression, bipolar schizophrenia, and anxiety disorder, and list treatment options for each;
(b) Describe causes of mental illness;
(c) Describe the progression of mental illness;
(d) Identify common myths and misinformation about mental illness; and
(e) Define stigma and identify how stigma can impact caregiving.
(2) Regarding the competency on resident background, experiences and beliefs, provide culturally compassionate and individualized care by utilizing a basic understanding of the resident's history, experience, and cultural beliefs:
(a) Demonstrate a method for gathering cultural, lifestyle, and personal value information from a resident;
(b) Identify why obtaining cultural information from a resident 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 illness; and
(e) Identify how the long-term care worker's culture might affect caregiving.
(3) Regarding the competency on communication and mental illness, communicate respectfully and appropriately with residents with a mental illness:
(a) Identify what is considered respectful and disrespectful communication when interacting with a resident with a mental illness;
(b) Identify what is judgmental communication toward a resident with a mental illness 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 a resident who has a mental illness.
(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 illness;
(b) Identify possible common causes of challenging behaviors in a resident with a mental illness;
(c) Differentiate how challenging behaviors may be misinterpreted as mental illness; 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 a resident 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 a resident 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 a resident experiencing a hallucination or delusion; and
(d) Describe how to accurately document a resident'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 a resident expressing aggressive behavior;
(d) Describe appropriate de-escalation techniques when working with a resident 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 a resident at risk of suicide:
(a) Identify and list signs a resident is possibly suicidal;
(b) Describe how to respond appropriately to a resident experiencing suicidal thoughts, including:
(i) How, where, and when to refer a resident who is experiencing suicidal thoughts and/ or planning; and
(ii) Methods to keep a suicidal resident safe and ensure the safety for others.
(c) Describe strategies to help cope with a resident's suicide.
[]
(1) All adult family home applicants or providers
((and)), resident managers, ((and for)) entity
representatives, and long-term care workers; and
(2) All ((boarding home)) assisted living facility
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)),
and 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.]
(1) 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.
(2) A challenge test is not permitted when specialty training is taken to meet the population specifics of basic training per WAC 388-112-0066.
[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 of the trainee;
(2) The name of the training;
(3) The number of hours of the training;
(4) The name and identification number of the home or training entity giving the training;
(((4))) (5) The instructor's name and signature; and
(((5))) (6) The date(s) of training.
(((6))) The trainee must be given an original
certificate. The home must keep a copy of the certificate on
file as described in WAC 388-76-10198 (for adult family homes)
and as described in WAC 388-78A-2450 (for assisted living
facilities).
[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 entity representative or resident manager assumes
the duties of the position in order to admit or serve
residents who have special needs related to mental illness,
dementia, or a developmental disability.
(2) If a resident 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)) Assisted living facilities
(3) If ((a boarding home)) an assisted living facility
serves one or more residents with special needs, the
((boarding home)) assisted living facility 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)) date of hire. ((A boarding home))
An assisted living facility 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 develops special needs while living in
((a boarding home)) an assisted living facility, the
((boarding home)) assisted living facility administrator (or
designee) has one hundred twenty days to complete manager
specialty training and demonstrate competency. ((A boarding
home)) An assisted living facility 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)) an assisted living facility or
adult family home serves one or more residents 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 who are exempt from basic training must complete the
relevant ((caregiver)) specialty training within ninety days
of ((completing basic training)) hire.
(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
with special needs without direct supervision in an assisted
living facility or 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.]
[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, § 388-112-0170, 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
and assisted living facilities must:
(a) Successfully complete DSHS-designated nurse delegation core training, "Nurse Delegation for Nursing Assistants";
(b) Be a:
(i) Certified home care aide under chapter 18.88B RCW
((nursing assistant registered)); or
(ii) Nursing assistant certified under chapter 18.88A RCW; ((and)) or
(iii) If exempt from the home care aide certification under WAC 246-980-070, become a nursing assistant registered and complete the core competencies of basic training, unless the twenty eight hours of revised fundamentals of care or a department approved alternative was already completed.
(iv) If nurse delegation is needed to implement a care plan earlier than home care aide certification can be obtained, become a nursing assistant registered and complete 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)) the task of insulin injections,
long-term care workers in adult family homes and assisted
living facilities must:
(a) ((Successfully complete DSHS-designated nurse
delegation core training)) Meet the requirements in
subsections (1)(a) and (b) of this section; and
(b) ((Be a nursing assistant registered or certified
under chapter 18.88A RCW; and
(c) If a nursing assistant registered, successfully complete basic training)) Successfully complete DSHS-designated specialized diabetes nurse delegation 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: 2008 c 146, RCW 18.20.090, 74.08.090, chapter 70.128 RCW. 09-03-066, § 388-112-0196, filed 1/14/09, effective 2/14/09.]
[]
(a) Blood borne pathogens.
(b) CPR training.
(c) First aid training.
(d) Food handling training.
(e) When the assisted living facility or adult family home can demonstrate a need for retraining.
(2) Nurse delegation core and nurse delegation specialized diabetes training may be used to count towards 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, § 388-112-0200, filed 7/11/02, effective 8/11/02.]
(((1) Individuals subject to a continuing education
requirement)) (a) From January 1, 2012 through June 30, 2012,
adult family home providers, entity representatives, resident
managers, and long-term care workers whose birth date is
within these dates and the required basic training was
previously completed must complete ((at least)) 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 ten hours of
continuing education were completed between January 1, 2012
through June 30, 2012 for any one listed above, regardless of
birth date, then the continuing education requirements have
been met for 2012.
(((2))) (b) Effective July 1, 2012, certified home care
aides must complete twelve hours of continuing education each
calendar year after obtaining certification as described in
department of health WAC 246-980-110.
(c) If exempt from certification as described in RCW 18.88B.041, all long-term care workers must complete twelve hours of continuing education per calendar year. Continuing education must include one-half hour per year on safe food handling in adult family homes.
(2) Assisted living facilities
(a) From January 1, 2012 through June 30, 2012, assisted living facility administrators (or their designees) and long-term care workers whose birthdate is within these dates and the required basic training was previously completed must complete ten hours of continuing education. If ten hours of continuing education were completed between January 1, 2012 through June 30, 2012, for any one listed above, regardless of birthdate then the continuing education requirements have been met for 2012.
(b) Effective July 1, 2012, certified home care aides must complete twelve hours of continuing education each calendar year after obtaining certification as described in department of health WAC 246-980-110 and 246-12-020(3).
(c) If exempt from certification as described in RCW 18.88.041, all long-term care workers must complete twelve hours of continuing education per calendar year. An assisted living facility administrator with a current nursing home administrator license is exempt from this requirement.
(3) A long-term care worker or certified home care aide who did not complete the continuing education requirements by the timeframe described in subsections (1)(a) and (2)(a) of this section or in WAC 388-112-0207 cannot be paid to provide care after that date and cannot be reinstated as a long-term care worker until they complete the continuing education requirements.
(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 training entity must establish a way for the long-term care worker to ask the instructor questions.
[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.]
(2) For long term care workers who are required to be certified as a home care aide, if the first renewal period is less than a full year from the date of certification, no continuing education will be due for the first renewal period.
[]
(1) Resident rights, such as freedom from abuse, neglect, abandonment and financial exploitation;
(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 behavior support;
(10) Developing or improving resident centered activities;
(11) Dealing with wandering or aggressive resident behaviors;
(12) Medical conditions; ((and))
(13) ((In adult family homes,)) Safe food handling, CPR
and First aid described in WAC 388-112-0255 and 388-112-0260;
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)) When a specific specialty training is completed as part of basic training the hours cannot be applied to continuing education. Different specialty training taken in subsequent years may be applied as continuing education hours.
[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, § 388-112-0235, filed 7/11/02, effective 8/11/02.]
(a) The ((trainee's)) name of the trainee;
(b) The title ((or content)) of the training as approved
by DSHS;
(c) The number of hours of the training;
(d) The DSHS assigned curriculum approval code;
(e) The DSHS approved instructor's name((,)) and
signature;
(f) The name of the DSHS approved home or training entity
giving the training((, or the name of the video, on-line
class, professional journal, or equivalent instruction
materials completed)); and
(((d) The number of hours of training; and))
(((e))) (g) The date(s) of training.
(2) The trainee must be given an original certificate or other documentation of continuing education. The adult family home or assisted living facility must keep a copy of the certificate or transcript on file as described in WAC 388-76-10198 (for adult family homes) and as described in WAC 388-78A-2450 (for assisted living facilities).
[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) 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))) (a) 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))) (b) Licensed nurses working in adult family homes
must possess a valid CPR card or certificate within thirty
days of ((employment)) date of hire 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.
(((3))) (c) Adult family home ((caregivers)) long-term
care workers must obtain and maintain a valid CPR and
first-aid card or certificate:
(((a))) (i) Within thirty days of beginning to provide
care for residents, if the provision of care for residents is
directly supervised by a fully qualified ((caregiver))
long-term care worker who has a valid first-aid and CPR card
or certificate; or
(((b))) (ii) Before providing care for residents, if the
provision of care for residents 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)) (2) Assisted living facilities
(((4) Boarding home)) (a) Assisted living facility
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)) date
of hire, and must maintain valid cards or certificates. Licensed nurses working in ((boarding homes)) assisted living
facility must possess a valid CPR card or certificate within
thirty days of ((employment)) date of hire, and must maintain
a valid 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, § 388-112-0280, 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 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.]
(1) Manager dementia specialty training;
(2) Manager mental health specialty training;
(3) Long-term care worker dementia specialty training;
(4) Long-term care worker mental health specialty training;
(5) Developmental disabilities specialty training;
(6) Forty-eight hour adult family home residential care administrator training;
(7) Nurse delegation core training; and
(8) Nurse delegation specialized diabetes 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, § 388-112-0300, 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 (core and population specific training);
(b) ((Modified basic)) Orientation described in WAC 388-112-0015(2), safety, on-the-job, and continuing education;
(c) Manager mental health, dementia, and developmental disabilities specialty training;
(d) ((Caregiver)) Long-term care worker mental health,
dementia, and developmental disabilities specialty training
((in boarding homes)); and
(e) 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 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)) in 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) All the DSHS-published learning outcomes and competencies for the course;
(2) Printed student materials that support the curriculum, a teacher's guide or manual, and learning resource materials such as learning activities, audio-visual materials, handouts, and books;
(3) The recommended sequence and delivery of the material;
(4) The teaching methods or approaches that will be used for different sections of the course, including for each lesson:
(a) The expected learning outcomes;
(b) 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) A list of the sources or references, if any, used to develop the curriculum;
(6) Methods of teaching and student evaluation for students with limited English proficiency and/or learning disabilities; and
(7) A plan for updating material. Substantial changes to a previously approved curriculum must be approved before they are used)) DSHS developed curriculum(s) do not require submission to the department for approval unless the curriculum is being modified in any manner by the training entity.
(1) For orientation and/or safety training:
Effective January 7, 2012, submit an outline of what will be covered in each training offered (for example, a table of contents or a class syllabus) showing where the required introductory topics as listed in WAC 388-112-0016 for orientation and WAC 388-112-0019 for safety training are covered in the training. Department required orientation and safety training application forms must be submitted to the department at least forty-five days in advance of when the training is expected to be offered. Training cannot be offered before receiving department curriculum and instructor approval.
(2) For continuing education:
Effective July 1, 2012, submit a summary that includes the topic, a brief description of what it will cover, and a course outline. Also include the number of training hours, and a description of how the training is relevant to the care setting, care needs of residents, or long-term care worker career development. For on line training courses, also submit a description of how the instructor or training will assess that the students have integrated the information being taught. Department required continuing education training application forms must be submitted at least forty five days in advance of when the training is expected to be offered. The trainings cannot be offered before receiving department curriculum and instructor approval.
(3) For basic training:
(a) If the instructor or training entity wants to use the DSHS developed revised fundamentals of caregiving learner's guide with enhancements, submit the DSHS required form with all required information. Otherwise, the following must be submitted to DSHS for approval of one or both sections (core competencies and population specific competencies) of the seventy hours required for basic training. When submitting one or both sections of basic training curriculum for DSHS approval, it must at a minimum include:
(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives, described in this chapter, are located in the long-term care worker materials from the proposed curriculum for that course;
(ii) Any materials long-term care workers will receive, such as a textbook or long-term care worker manual, learning activities, audio-visual materials, handouts, and books;
(iii) The table of contents or outline of the curriculum, including the allotted time for each section;
(iv) Demonstration skills checklists for the personal care tasks described in WAC 388-112-0055 (12)(a) and (b), and infection control skills (hand washing and putting on and taking off gloves);
(v) The teachers guide or manual that includes for each section of the curriculum:
(A) The 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 materials covered and can demonstrate all skills;
(D) A list of the sources or references that were used to develop the curriculum. If the primary source or reference is not a published citation, the instructor must provide detail on how the content was established as evidence based;
(E) Description of how the curriculum was designed to accommodate long-term care workers with limited English proficiency and/or learning disabilities; and
(F) Description and proof of how input was obtained from consumer and long-term care worker representatives in the development of the curriculum.
(b) 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.
(c) Entities submitting curriculum for population specific basic training must submit their own list of competencies and learning objectives used to develop the population specific basic training curriculum.
(4) For specialty training:
For specialty training that is not the DSHS developed curriculum or other department approved curriculum, submit the required specialty training application form and any additional learning objectives added to the competency and learning objectives checklist, the enhancements that have been added, and additional student materials or handouts. In order to be approved, an alternative curriculum must at a minimum include:
(a) All the DSHS-published learning outcomes and competencies for the course;
(b) Printed student materials that support the curriculum, a teacher's guide or manual, and learning resource materials such as learning activities, audio-visual materials, handouts, and books;
(c) The recommended sequence and delivery of the material;
(d) The teaching methods or approaches that will be used for different sections of the course, including for each lesson:
(i) Learning activities that incorporate adult learning principles and address the learning readiness of the student population;
(ii) Practice of skills to increase competency;
(iii) Feedback to the student on knowledge and skills;
(iv) An emphasis on facilitation by the teacher; and
(v) An integration of knowledge and skills from previous lessons to build skills.
(e) A list of the sources or references, if any, used to develop the curriculum;
(f) Methods of teaching and student evaluation for students with limited English proficiency and/or learning disabilities;
(g) A plan for updating material;
(h) Substantial changes to a previous 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.]
(a) Identification of where each DSHS-published required learning outcome and competency is located in the alternate curriculum;
(b) All materials identified in WAC 388-112-0325; and
(c) A letter from the boarding home administrator or adult family home provider attesting that the training curriculum addresses all of the training competencies identified by DSHS;
(2) DSHS may approve a curriculum based upon the attestation in (1)(c) above, until it has been reviewed by DSHS;
(3) If, upon review by DSHS, the curriculum is not approved, the alternative curriculum may not be used until all required revisions have been submitted and approved by DSHS.
(4))) In order to obtain the department's approval of the curriculum for orientation, safety, basic training (core and population specific training), and continuing education:
(1) Submit the required training application forms and any other materials required for specific curriculums to the department.
(2) After review of the ((alternative)) curriculum, DSHS
will send a written response to the submitter, indicating
approval or disapproval of the curriculum(s) ((and if
disapproved, the reasons for denial;)).
(((5))) (3) If curriculum(s) are not approved, the
reason(s) for denial will be given and the submitter will be
told what portion(s) of the training must be changed and
resubmitted for review in order for the curriculum to be
approved.
(4) The submitter can make the requested changes and resubmit the curriculum(s) for review.
(5) If after working with the department the
((alternative curriculum is not approved, a revised curriculum
may be resubmitted to DSHS for another review)) 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 using the department's
attestation process, 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)) provider's
intent to conduct staff training prior to providing the
((home's)) provider's first training, and when changing
training plans, including:
(i) ((Home)) The provider's name;
(ii) Name of training(s) the ((home)) provider will
conduct;
(iii) Name of approved curriculum(s) the ((home))
provider will use;
(iv) Name of lead instructor and instructor's past
employment in ((boarding homes and)) assisted living facility
or adult family homes; and
(v) Whether the ((home)) provider will train only the
((home's)) provider's staff, or will also train staff from
other ((homes)) providers. 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)) when requested by the department.
(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 training and 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.]
[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 fails to notify DSHS of changes in the curriculum content prior to teaching the curriculum;
(3) The home provides false or misleading information to long-term care workers or the public concerning the courses offered or conducted;
(4) The home's instructor does not meet the applicable
qualifications ((under)) described in WAC ((388-112-0375))
388-112-0370, 388-112-0380, 388-112-0383, 388-112-0385,
388-112-0390 and ((through)) 388-112-0395; or
(((3))) (5) The home's instructor has been a licensee,
((boarding home)) assisted living facility 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 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 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 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 training and residential care
administrator training must be taught by an 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) Coordinating and teaching classes((,));
(2) Assuring that the curriculum used is taught as
designed((,));
(3) Selecting qualified guest speakers where
applicable((,));
(4) Establishing a method whereby the long-term care worker can ask the instructor questions;
(5) Administering or overseeing the administration of
DSHS competency and challenge tests((,));
(((5))) (6) Maintaining training records including
((student)) long-term care worker tests, certificates and
attendance records for a minimum of six years((,));
(((6))) (7) Reporting training data to DSHS ((in
DSHS-identified time frames,)) when requested by the
department; and
(((7))) (8) 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 a
training entity and their instructor(s) ((under contract with
DSHS)) to conduct orientation, safety, basic, ((modified
basic,)) population specific, residential care administrator,
manager and long-term care worker specialty, ((or)) nurse
delegation core and specialized diabetes training ((classes
using the training curricula developed by DSHS)), on-the-job
training, and continuing education.
(b) DSHS may select ((contracted instructors through a
purchased services contract procurement pursuant to chapter 236-48 WAC or through other)) training entities 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 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, through an
attestation process, that their instructors meet the minimum
qualifications for instructors under this chapter.
(3) ((Other instructors))
DSHS must approve all other training entities and their instructor(s) 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.
(3) DSHS may terminate an existing training approval of a person or entity to conduct orientation, safety, basic, modified basic, population specific, residential care administrator, specialty, continuing education, or nurse delegation core or diabetes 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, § 388-112-0365, 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, assisted living facility, 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 or higher degree in the field of health or human services and six months professional or caregiving experience within the last five years in a community based setting or an adult family home, assisted living facility, supported living through DDD, 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)) assisted
living, supported living through DDD ((per chapter 388-820 WAC)), or home care setting((; or
(ii) An associate degree in a health field and six months 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 in an appropriate setting 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 ((in)) on 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 teaching 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) If required under WAC 388-112-0075 or 388-112-0105
, instructors must successfully complete basic or modified
basic training prior to beginning to train others.))
(7) 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.]
[]
Reviser's note: The unnecessary strikethrough 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 388-112-0385
What are the minimum qualifications for
instructors for manager and ((caregiver)) long-term care
worker mental health specialty training?
(1) ((Instructors
for manager mental health specialty training:)) The minimum
qualifications for instructors for manager mental health
specialty, in addition to the general qualifications in WAC
((388-112-0375)) 388-112-0380 (1) and (2) include:
(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 at least one hundred ninety-two hours of seminars, conferences, and continuing education.)
(ii) If required ((under)) by 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))) (iii) For instructors teaching ((DSHS-developed))
mental health specialty training, successful completion of the
DSHS((-developed train the trainer)) instructor
qualification/demonstration process:
(iv) And has been approved and contracted by the department as a community instructor.
(e) Instructors who will administer tests must have experience or training in assessment and competency testing.
(2) Instructors for ((caregiver)) long-term care worker
mental health specialty training:
(a) ((Caregiver)) Long-term care worker mental health
specialty may be taught by ((a boarding home)) an assisted
living facility 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)) (3) Long-term care worker 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)) in 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))) (iii) For instructors teaching DSHS-developed
dementia specialty training, successful completion of the
DSHS((-developed train the trainer)) instructor
qualification/demonstration process;
(iv) And has been approved and contracted by the department as a community instructor.
(((d))) (e) 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)) an assisted
living facility 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.]
(a) The instructor must be experienced in developmental disabilities caregiving practices and capable of demonstrating competency in the entire course content, including the administration of competency testing;
(b) 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))) (c) Successful completion of the eighteen hour
developmental disabilities specialty training under WAC 388-112-0120; and
(((c))) (d) Teaching experience:
(i) Two hundred hours of teaching experience; and
(ii) Successful completion of an adult education ((or
train the trainer)) class 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)) DSHS
instructor qualification/demonstration process.
(e) Has been approved and contracted by the department as a community instructor.
(((d))) (f) Instructors who will administer tests must
have experience in assessment and competency testing.
(2) Instructors for ((caregiver)) developmental
disabilities specialty training:
(a) ((Caregiver)) Developmental disabilities specialty
may be taught by ((a boarding home)) an assisted living
facility administrator (or designee), adult family home
provider, or corporate trainer, who has successfully completed
the ((manager developmental disabilities specialty training))
mental health or manager dementia specialty course, the
eighteen hour developmental disabilities specialty training,
and has successfully completed the instructor
qualification/demonstration process. 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)) 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 388-112-0020 | What content must be included in an orientation? |
| 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 388-112-01965 | Who is required to complete the specialized diabetes nurse delegation training, and when? |
| WAC 388-112-0215 | Is competency testing required for continuing education? |
| WAC 388-112-0230 | May nurse delegation core training or nurse delegation specialized diabetes training be used to meet continuing education requirements? |
| WAC 388-112-0245 | Who is required to complete continuing education training, and when? |
| 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 388-112-0375 | 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? |