H-4262.1  _______________________________________________

                    SUBSTITUTE HOUSE BILL 2707

          _______________________________________________

State of Washington      57th Legislature     2002 Regular Session

By House Committee on Health Care (originally sponsored by Representatives Edwards, Skinner, Cody and Schual‑Berke)

Read first time 02/08/2002.  Referred to Committee on .

Concerning long-term caregiver training.

    AN ACT Relating to long-term caregiver training; amending RCW 18.20.270 and 70.128.230; adding a new section to chapter 43.20A RCW; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

    Sec. 1.  RCW 18.20.270 and 2000 c 121 s 2 are each amended to read as follows:

    (1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.

    (a) "Caregiver" includes any person who provides residents with hands-on personal care on behalf of a boarding home, except volunteers who are directly supervised.

    (b) "Direct supervision" means oversight by a person who has demonstrated competency in the core areas or has been fully exempted from the training requirements pursuant to this section, is on the premises, and is quickly and easily available to the caregiver.

    (2) Training must have the following components:  Orientation, basic training, specialty training as appropriate, and continuing education.  All boarding home employees or volunteers who routinely interact with residents shall complete orientation.  Boarding home administrators, or their designees, and caregivers shall complete orientation, basic training, specialty training as appropriate, and continuing education.

    (3) Orientation consists of introductory information on residents' rights, communication skills, fire and life safety, and universal precautions.  Orientation must be provided at the facility by appropriate boarding home staff to all boarding home employees before the employees have routine interaction with residents.

    (4) Basic training consists of modules on the core knowledge and skills that caregivers need to learn and understand to effectively and safely provide care to residents.  Basic training must be outcome-based, and the effectiveness of the basic training must be measured by demonstrated competency in the core areas through the use of a competency test.  Basic training must be completed by caregivers within one hundred twenty days of the date on which they begin to provide hands-on care or within one hundred twenty days of ((March)) September 1, 2002, whichever is later.  Until competency in the core areas has been demonstrated, caregivers shall not provide hands-on personal care to residents without direct supervision.  Boarding home administrators, or their designees, must complete basic training and demonstrate competency within one hundred twenty days of employment or within one hundred twenty days of ((March)) September 1, 2002, whichever is later.

    (5) For boarding homes that serve residents with special needs such as dementia, developmental disabilities, or mental illness, specialty training is required of administrators((,)) or designees((, and caregivers)).  Specialty training for administrators or designees consists of modules on the core knowledge and skills that caregivers need to effectively and safely provide care to residents with special needs.  ((Specialty training should be integrated into basic training wherever appropriate.))  Specialty training for administrators or designees must be outcome-based, and the effectiveness of the specialty training measured by demonstrated competency in the core specialty areas through the use of a competency test.  Boarding home administrators or their designees must complete specialty training and demonstrate competency within one hundred twenty days of September 1, 2002, or one hundred twenty days from the date on which the administrator or their designee is hired, whichever is later, if the boarding home serves one or more residents with special needs.

(6) The boarding home administrator, or designee, who has demonstrated competency in specialty training must ensure specialty training of caregivers.  Specialty training should be integrated into basic training wherever appropriate.  Specialty training must be completed by caregivers within one hundred twenty days of the date on which they begin to provide hands-on care to a resident having special needs or within one hundred twenty days of ((March)) September 1, 2002, whichever is later.  However, if specialty training is not integrated with basic training, the specialty training must be completed within ninety days of completion of basic training.  Until ((competency in the core)) specialty ((areas)) training has been ((demonstrated)) completed, caregivers shall not provide hands-on personal care to residents with special needs without direct supervision.  ((Boarding home administrators, or their designees, must complete specialty training and demonstrate competency within one hundred twenty days of March 1, 2002, if the boarding home serves one or more residents with special needs.

    (6))) (7) Continuing education consists of ongoing delivery of information to caregivers on various topics relevant to the care setting and care needs of residents.  Competency testing is not required for continuing education.  Continuing education is not required during the first year following completion of the basic training.  If specialty training is completed, the specialty training applies toward any continuing education requirement for up to two years following the completion of the specialty training.

    (((7))) (8) Persons who successfully challenge the competency test for basic training are fully exempt from the basic training requirements of this section.  Persons who successfully challenge the specialty training competency test are fully exempt from the specialty training requirements of this section.

    (((8))) (9) Licensed persons who perform the tasks for which they are licensed are fully or partially exempt from the training requirements of this section, as specified by the department in rule.

    (((9))) (10) In an effort to improve access to training and education and reduce costs, especially for rural communities, the coordinated system of long-term care training and education must include the use of innovative types of learning strategies such as internet resources, videotapes, and distance learning using satellite technology coordinated through community colleges or other entities, as defined by the department.

    (((10))) (11) The community long-term care training and education steering committee established under RCW 74.39A.190 shall develop criteria for the approval of orientation, basic training, and specialty training programs.

    (((11))) (12) Boarding homes that desire to deliver facility-based training with facility designated trainers, or boarding homes that desire to pool their resources to create shared training systems, must be encouraged by the department in their efforts.  The community long-term care training and education steering committee shall develop criteria for reviewing and approving trainers and training materials that are substantially similar to or better than the materials developed by the steering committee.  The department may approve a curriculum based upon attestation by a boarding home administrator that the boarding home's training curriculum addresses basic and specialty training competencies identified by the department, and shall review a curriculum to verify that it meets these requirements.  The department may conduct the review as part of the regularly scheduled yearly inspection and investigation required under RCW 18.20.110.  The department may rescind approval of any curriculum if it determines that the curriculum does not meet these requirements.

    (((12))) (13) The department shall adopt rules by ((March)) September 1, 2002, for the implementation of this section based on the recommendations of the community long-term care training and education steering committee established in RCW 74.39A.190.

    (((13))) (14) The orientation, basic training, specialty training, and continuing education requirements of this section ((take effect March)) commence September 1, 2002, or six months from the date on which the department publishes its final basic and specialty training materials, whichever is later, and shall be applied ((prospectively)) to (a) employees hired subsequent to September 1, 2002; and (b) existing employees that on September 1, 2002, have not successfully completed the training requirements under RCW 74.39A.010, and this section.  Existing employees who have not successfully completed the training requirements under RCW 74.39A.010, 74.39A.020, and this section shall be subject to all applicable requirements of this section.  However, nothing in this section affects the current training requirements under RCW 74.39A.010.

NEW SECTION. Sec. 2.  A new section is added to chapter 43.20A RCW to read as follows:

    The department shall publish its final basic and specialty training competencies and learning outcomes as required by chapter 121, Laws of 2000 no later than June 1, 2002.

    Sec. 3.  RCW 70.128.230 and 2000 c 121 s 3 are each amended to read as follows:

    (1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.

    (a) "Caregiver" includes all adult family home resident managers and any person who provides residents with hands-on personal care on behalf of an adult family home, except volunteers who are directly supervised.

    (b) "Indirect supervision" means oversight by a person who has demonstrated competency in the core areas or has been fully exempted from the training requirements pursuant to this section and is quickly and easily available to the caregiver, but not necessarily on-site.

    (2) Training must have three components:  Orientation, basic training, and continuing education.  All adult family home providers, resident managers, and employees, or volunteers who routinely interact with residents shall complete orientation.  Caregivers shall complete orientation, basic training, and continuing education.

    (3) Orientation consists of introductory information on residents' rights, communication skills, fire and life safety, and universal precautions.  Orientation must be provided at the facility by appropriate adult family home staff to all adult family home employees before the employees have routine interaction with residents.

    (4) Basic training consists of modules on the core knowledge and skills that caregivers need to learn and understand to effectively and safely provide care to residents.  Basic training must be outcome-based, and the effectiveness of the basic training must be measured by demonstrated competency in the core areas through the use of a competency test.  Basic training must be completed by caregivers within one hundred twenty days of the date on which they begin to provide hands-on care or within one hundred twenty days of ((March)) September 1, 2002, whichever is later.  Until competency in the core areas has been demonstrated, caregivers shall not provide hands-on personal care to residents without indirect supervision.

    (5) For adult family homes that serve residents with special needs such as dementia, developmental disabilities, or mental illness, specialty training is required of providers and resident managers.  Specialty training consists of modules on the core knowledge and skills that providers and resident managers need to effectively and safely provide care to residents with special needs.  Specialty training should be integrated into basic training wherever appropriate.  Specialty training must be outcome-based, and the effectiveness of the specialty training measured by demonstrated competency in the core specialty areas through the use of a competency test.  Specialty training must be completed by providers and resident managers before admitting and serving residents who have been determined to have special needs related to mental illness, dementia, or a developmental disability.  Should a resident develop special needs while living in a home without specialty designation, the provider and resident manager have one hundred twenty days to complete specialty training.

    (6) Continuing education consists of ongoing delivery of information to caregivers on various topics relevant to the care setting and care needs of residents.  Competency testing is not required for continuing education.  Continuing education is not required during the first year following completion of the basic training.  If specialty training is completed, the specialty training applies toward any continuing education requirement for up to two years following the completion of the specialty training.

    (7) Persons who successfully challenge the competency test for basic training are fully exempt from the basic training requirements of this section.  Persons who successfully challenge the specialty training competency test are fully exempt from the specialty training requirements of this section.

    (8) Licensed persons who perform the tasks for which they are licensed are fully or partially exempt from the training requirements of this section, as specified by the department in rule.

    (9) In an effort to improve access to training and education and reduce costs, especially for rural communities, the coordinated system of long-term care training and education must include the use of innovative types of learning strategies such as internet resources, videotapes, and distance learning using satellite technology coordinated through community colleges, private associations, or other entities, as defined by the department.

    (10) Adult family homes that desire to deliver facility-based training with facility designated trainers, or adult family homes that desire to pool their resources to create shared training systems, must be encouraged by the department in their efforts.  The community long-term care training and education steering committee shall develop criteria for reviewing and approving trainers and training materials.  The department may approve a curriculum based upon attestation by an adult family home administrator that the adult family home's training curriculum addresses basic and specialty training competencies identified by the department, and shall review a curriculum to verify that it meets these requirements.  The department may conduct the review as part of the inspection authorized under RCW 70.128.070.  The department may rescind approval of any curriculum if it determines that the curriculum does not meet these requirements.

    (11) The department shall adopt rules by ((March)) September 1, 2002, for the implementation of this section based on the recommendations of the community long-term care training and education steering committee established in RCW 74.39A.190.

    (12) The orientation, basic training, specialty training, and continuing education requirements of this section ((take effect March)) commence September 1, 2002, and shall be applied ((prospectively)) to (a) employees hired subsequent to September 1, 2002; or (b) existing employees that on September 1, 2002, have not successfully completed the training requirements under RCW 70.128.120, 70.128.130, and this section.  Existing employees who have not successfully completed the training requirements under RCW 70.128.120 and this section shall be subject to all applicable requirements of this section.  However, nothing in this section affects the current training requirements under RCW 70.128.120 and 70.128.130.

NEW SECTION. Sec. 4.  This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately.

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