WSR 98-18-037
PERMANENT RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)
[Filed August 27, 1998, 1:01 p.m.]
Date of Adoption: August 26, 1998.
Purpose: To comply with legislation that provides the Department of Social and Health Services with statute authority to deny a contract, or deny or terminate payment to an in-home provider who has a disqualifying crime, and to deny a contract or payment to a person who has a finding of abuse, neglect, exploitation, or abandonment of a minor or vulnerable adult.
It divides the information into easy-to-use sections using clear rule writing techniques.
Citation of Existing Rules Affected by this Order: Amending WAC 388-15-196.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, 43.43.842, 74.39A.050, 43.20A.710.
Other Authority: 42 C.F.R. 1002.210, 42 C.F.R. 431.51.
Adopted under notice filed as WSR 98-14-062 on June 29, 1998.
Changes Other than Editing from Proposed to Adopted Version: "In-home providers" replaces "individual provider" in the text whenever the content applies to both agency providers and individual providers. The differences in requirements are delineated. Instead of referencing the individual provider handbook, language has been added to the rules. The originally proposed WAC 388-15-19630 is redundant and has been deleted.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 0, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 2, amended 1, repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, amended 0, repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 9, amended 1, repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 9, amended 1, repealed 0.
Effective Date of Rule: Thirty-one days after filing.
August 26, 1998
Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
SHS-2457.5
AMENDATORY SECTION (Amending WSR 97-16-106, filed 8/6/97, effective 9/6/97)
WAC 388-15-196 ((Home and community services--Minimum
qualifications for care)) In-home providers ((in home and
community settings)). ((To protect the health and welfare of a
long-term care service client receiving an AASA administered
service, the adult client's care provider shall:
(1) Be eighteen years of age or older;
(2) Complete and submit a criminal history background
inquiry form prescribed by the department;
(3) Possess the following minimum standards of knowledge and
experience:
(a) General knowledge of acceptable standards of
performance, including the necessity to perform dependably,
report punctually, maintain flexibility, and to demonstrate
kindliness and caring to the client;
(b) Knowledge of when and how to contact the client's
representative and the client's case manager.
(4) Have the following required skills:
(a) Adequate skills to read, either directly or through an
interpreter, understand and implement the client's service plan;
(b) Adequate communication skills to convey and understand
either directly or through an interpreter information required to
implement the client's written service plan and verbal
instructions;
(c) Adequate skills to maintain provider records of services
performed and payments received.
(5) Be able to:
(a) Understand specific directions for providing the care
which the individual client requires;
(b) Observe the client for change in health status,
including weakness, confusion, and loss of appetite;
(c) Identify problem situations and take appropriate action;
(d) Respond to emergencies without direct supervision;
(e) Perform authorized housework functions competently;
(f) Perform authorized direct personal care functions
competently;
(g) Accept the client's individual differences and
preferences when performing routine tasks; and
(h) Work independently and perform responsibly within the
boundaries of the nonmedical personal care task limits.
(6)(a) Complete the department's fundamentals of caregiving
training according to the following schedule:
(i) All in-home personal care providers hired on or after
the effective date of this section shall successfully complete
the department-designated fundamentals of caregiving training
within one hundred twenty days of employment, unless he or she
meets the requirements under (iii) or (iv) of this subsection or
in subsection (6)(c) or (6)(f);
(ii) All in-home care providers hired prior to November 1,
1996 shall successfully complete the department designated
fundamentals of caregiving training prior to October 31, 1997,
unless he or she meets the requirements under (iii) or (iv) of
this subsection or in subsection (6)(c) or (6)(f);
(iii) Natural, step, or adoptive parents hired as personal
care providers for their division of developmental disabilities
(DDD) adult children prior to the effective date of this section,
will have until September 1, 1998 to complete the caregiving
training;
(iv) Natural, step, or adoptive parents hired as personal
care providers for their own adult children on or after the
effective date of this section will have one hundred eighty days
to complete the training requirements.
(b) Complete a minimum of ten hours of continuing education
credits per calendar year, on topics relevant to caregiving
unless he or she is a parent hired as a personal care provider
for their own DDD adult child:
(i) Topics include, but are not limited to:
(A) Residents' rights;
(B) Personal care (such as transfers or skin care);
(C) Dementia;
(D) Mental illness;
(E) Developmental disabilities;
(F) Depression;
(G) Medication assistance;
(H) Communication skills;
(I) Alternatives to restraints; and
(J) Activities for clients.
(ii) Parent providers of their own DDD adult children are
exempt from continuing education requirements;
(iii) Other caregivers are required to earn a certificate of
completion to meet the requirement for continuing education
credit and each hour of completed instruction will count as one
hour of continuing education credit; and
(iv) The continuing education requirement begins the
calendar year after the year in which the caregiver completes the
fundamentals or modified fundamentals of caregiving training.
(c) The following providers are exempt from the fundamentals
of caregiving training requirement in subsection (6)(a) of this
section if the provider successfully completes the department
designated modified fundamentals of caregiving training in
accordance with the dates specified in subsection (6)(a) of this
section.
(i) A provider who has successfully completed training as a
registered or licensed practical nurse, a physical or
occupational therapist, a certified nursing assistant, a
Medicare-certified home health aide, or who has successfully
completed department-approved adult family home training, or
department-approved personal care training from an area agency on
aging or their subcontractor.
(ii) A provider who has successfully completed the DDD staff
training as required by chapter 275-26 WAC is exempt from the
fundamentals of caregiving training in subsection (6)(a) of this
section as long as the provider continues to work for a DDD-contracted agency. This exemption no longer applies if the
provider leaves the DDD-contracted agency.
(iii) Parent hired as a personal care provider for their own
DD adult child. This exemption no longer applies if the parent
provides services to anyone who is not their own adult child.
(d) The provider shall provide documentation upon request
that the provider has met the education and training
requirements.
(e) The department shall not continue to authorize
reimbursement for services rendered by a care provider who does
not meet the educational requirement in subsection (6) of this
section.
(f) All in-home personal care providers are exempt from
attending the "fundamentals of caregiving" or "modified
fundamentals of caregiving" training if they successfully pass
the department's challenge test for the class they are required
to take. The provider only has one opportunity to successfully
pass the challenge test. If the provider does not pass the
challenge test then he/she must attend the "fundamentals of
caregiving" or "modified fundamentals of caregiving" training as
required)) The intent of WAC 388-15-196 through 388-15-19680 is
to describe the:
(1) Qualifications of an individual provider (IP), defined in WAC 388-15-202 (25) and (26);
(2) Qualifications of an in-home provider employed by a home care agency, defined in WAC 388-15-202(2);
(3) Conditions under which the department will pay an in-home provider; and
(4) Conditions under which the department may deny a contract or terminate payment to an in-home provider.
[Statutory Authority: RCW 74.04.050, 74.08.090, 74.39A.005, 74.39A.007, 74.39A.050 and 74.39A.070. 97-16-106, § 388-15-196, filed 8/6/97, effective 9/6/97. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.100, 74.39.010, 74.39.030 and 1996 c 302 § 5. 96-20-093, § 388-15-196, filed 10/1/96, effective 11/1/96. Statutory Authority: RCW 74.08.090, 74.09.520 and 1995 1st sp.s. c 18. 95-20-041 (Order 3904), § 388-15-196, filed 9/28/95, effective 10/29/95.]
NEW SECTION
WAC 388-15-19600 How do I apply to be an in-home provider of an adult client? A person who wants to be an in-home provider must:
(1) Contact the client's social worker or case manager; or
(2) Be employed by a home care agency.
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NEW SECTION
WAC 388-15-19610 What requirements must an adult client's in-home provider meet? An in-home provider of an adult must:
(1) Meet the requirements of chapter 246-336 WAC, if employed by a home care agency;
(2) Meet the following requirements, if employed by the client as an individual provider:
(a) Be eighteen years of age or older;
(b) Not be the spouse of the client receiving services, unless the client is on the chore personal care program or the parent of a child age seventeen or younger;
(c) Have no conviction for a disqualifying crime, as listed in RCW 43.43.830 and RCW 43.43.842;
(d) Have no findings of fact or conclusions of law or agreed orders related to abuse, neglect, financial exploitation or abandonment of a minor or vulnerable adult, as defined in RCW 74.39A.050(8);
(e) Have not had a license or a contract for the care of children or vulnerable adults denied, suspended, or revoked, or terminated; for noncompliance with state and federal regulations;
(f) Have read and understand the client's service plan, translated or interpreted, as necessary, for the client and/or IP; and
(g) Provide the services, as outlined in the client's service plan within the scope of practice in WAC 388-15-203.
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NEW SECTION
WAC 388-15-19620 How do I get paid as an individual provider? In order to be paid by the department, an individual provider must:
(1) Be hired by a client/legal guardian;
(2) Provide the social worker or case manager with a Social Security card and picture identification;
(3) Complete and submit to the social worker or case manager the department's criminal conviction background inquiry application;
(4) Sign a home and community-based service provider contract/agreement to provide services to a COPES or Medicaid personal care client, or other department contract or agreement; and
(5) Meet the conditions in WAC 388-15-19610(2).
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NEW SECTION
WAC 388-15-19630 Under what conditions will the department deny payment to an in-home provider? The department will deny payment when an in-home provider:
(1) Does not meet the conditions of the contract;
(2) Has been terminated by the department for cause;
(3) Does not successfully complete the training requirements within the time limits in WAC 388-15-19650 through 388-15-19680;
(4) Demonstrates an unwillingness or inability to provide care following mandatory training or other training provided by the client's social worker/case manager or through the nurse expertise service; or
(5) Does not meet the conditions as stated in WAC 388-15-19610 and 388-15-19620.
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NEW SECTION
WAC 388-15-19640 Does the in-home provider have responsibilities in addition to the service plan? In addition to providing services as outlined on the client's service plan, the in-home provider must:
(1) Accommodate client's individual preferences and differences in providing care;
(2) Contact the client's representative and case manager when there are changes which affect the personal care and other tasks listed on the service plan;
(3) Observe the client for change(s) in health, and respond to emergencies;
(4) Notify the case manager immediately when the client enters a hospital, an adult family home, an adult residential care facility, an enhanced adult residential care facility, an assisted living facility, or a nursing facility; and
(5) Notify the case manager immediately if the client dies.
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NEW SECTION
WAC 388-15-19650 What are the educational requirements for an in-home provider? To meet the educational requirements, an in-home provider must:
(1) Possess a certificate of successfully completing department-designated fundamentals of caregiving training within one hundred and twenty days after beginning employment;
(2) Complete a minimum of ten hours of continuing education credits each calendar year following the year in which the fundamentals of caregiving training is taken. One hour of completed instruction equals one hour of credit on topics that pertain to services provided in an in-home setting including, but not limited to:
(a) Client's rights;
(b) Personal care (such as transfers or skin care);
(c) Dementia;
(d) Mental illness;
(e) Depression;
(f) Medication assistance;
(g) Communication skills;
(h) Alternatives to restraints;
(i) Activities for clients; and
(3) Provide the department with proof of completion of continuing education credits.
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NEW SECTION
WAC 388-15-19660 Do all in-home providers have to take the fundamentals of caregiving training? An IP can do the following instead of taking the fundamentals of caregiving:
(1) Pass the department's challenge test for the required class. This test can be taken once only. An IP contacts the AAA designated trainer to request the test; or
(2) Complete the department designated modified fundamentals of caregiving training and be a:
(a) Registered or licensed practical nurse;
(b) Physical or occupational therapist;
(c) Certified nursing assistant; or
(d) Medicare-certified home health aide; or
(3) Complete the division of developmental disabilities' (DDD) staff training required by chapter 275-26 WAC and continue to work for a DDD-contracted agency.
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NEW SECTION
WAC 388-15-19670 Are there special rules about training for parents who are the in-home providers of division of developmental disabilities (DDD) adult children? Natural, step, or adoptive parents of adult DDD children:
(1) Must possess a certificate of successfully completing a six-hour DDD-approved training or a specially designed department-approved training within one hundred eighty days after beginning employment;
(2) Are exempt from continuing education requirements; and
(3) Are exempt from the fundamentals of caregiving training if they provide care only for their own adult DDD child.
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NEW SECTION
WAC 388-15-19680 Are there special rules about training for parents who are the in-home providers of non-DDD adult children? Natural, step, or adoptive parents of adult non-DDD children must:
(1) Possess a certificate of successfully completing the fundamentals of caregiving training within one hundred eighty days after beginning employment; or
(2) Pass the department's challenge test; and
(3) Complete and provide proof of ten hours of continuing education credits as required under WAC 388-15-19650 (2) and (3).
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