WSR 02-15-066

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)

[ Filed July 11, 2002, 4:33 p.m. ]

Date of Adoption: July 10, 2002.

Purpose: Adopting new WAC 388-112-0200 through 388-112-0410. These rules implement requirements for licensed boarding home administrators and caregivers to have continuing education; moves all training requirements for these two settings into one training WAC; and implements processes for approval of alternative curricula and instructors. Proposed amendments to WAC 388-78A-060 filed as WSR 01-23-074 were withdrawn.

Citation of Existing Rules Affected by this Order: Amending WAC 388-78A-050.

Statutory Authority for Adoption: RCW 18.20.090, 70.128.040, 74.39A.050, and 34.05.020.

Other Authority: Chapter 121, Laws of 2000 and chapter 233, Laws of 2002.

Adopted under notice filed as WSR 01-23-074 on November 20, 2001, and supplemental notice filed as WSR 02-11-031 on May 7, 2002.

Changes Other than Editing from Proposed to Adopted Version: These rules were originally filed as WSR 01-23-074. As a result of public comments and statutory directives, the rules were revised, renumbered, and reproposed.


Rules as Proposed Changes (additions underlined, deletions struck through) Explanation of changes
WAC 388-112-0225 May specialty training be used to meet continuing education requirements? Manager Sspecialty training and caregiver specialty training, using an approved curriculum, except any specialty training completed through a challenge test, may be used to meet continuing education requirements. Clarify separate manager and caregiver specialty training, and that an approved curriculum must be used.
WAC 388-112-0240 What are the documentation requirements for continuing education?

(1) (c) The instructor's name, name of the home or training entity giving the training, or the name of the video, on-line class, professional journal, or equivalent instruction materials completed;

Clarification, since instructor's name alone will not identify the home or other training entity involved.
WAC 388-112-0245 Who is required to complete continuing education training, and when?

(3) Boarding home administrators (or their designees) and caregivers must complete ten hours of continuing education each calendar year (January 1 through December 31) after the year in which they successfully complete basic or modified basic training. A boarding home administrator with a current nursing home administrator license is exempt from this requirement.

Exemption for administrators with NH license based on public comment.
WAC 388-112-0260 What are the CPR and first aid training requirements?

(4) Boarding home administrators who provide direct care, and caregivers must take possess a valid CPR and first aid card or certificate within thirty days of employment, and must maintain valid cards or certificates. Boarding home licensed nurses must possess a valid CPR card or certificate within thirty days of employment, and must maintain a valid card or certificate.

Based on public comment, licensed nurses are not required to take first aid; only BH administrators who provide direct care are required to take first aid.

"Possess a valid card" rewording based on public comment that someone may already possess a valid card, and should not have to retake the training.

WAC 388-112-0285 What documentation is required for residential care administrator training?

(1) (c) The location of name of the training entity giving the training;

Clarify the meaning of "location" because some people thought it meant the city, not the training entity.
WAC 388-112-0300 What training must include the DSHS-developed competency test?

Basic, modified basic, manager specialty, caregiver specialty in boarding homes, and nurse-delegation core training must include the DSHS-developed competency test.

Renumbering; clarify separate specialty training for caregivers and managers; clarify that only the BH caregiver specialty includes a test, and not the AFH caregiver specialty training.
WAC 388-112-0305 How must competency test administration be standardized?

To standardize competency test administration, testing must include the following components:

(1) The person teaching the course must oversee administer or supervise the administration of all testing; and

"Oversee" was not clear, so it was reworded for clarity, based on comments.
WAC 388-112-0320 What trainings must be taught with a curriculum approved by DSHS?

(1) (c) Manager mental health, dementia, and developmental disabilities specialty training;

(d) Caregiver specialty training in boarding homes; and

(e) Any training that integrates basic with a manager specialty training or caregiver specialty training. ...

(4) A curriculum other than the DSHS curriculum must be approved by attestation before it is used. An attestation that the curriculum meets all requirements under this chapter will be sufficient for initial approval. Final approval will be based on curriculum review, as described under WAC 388-112-0330.

Separate references to manager and caregiver specialty.

Clarify that a review and final approval will follow.

WAC 388-112-0335 What are the requirements for a boarding home or adult family home that wishes to conduct basic, modified basic, manager specialty, or caregiver specialty staff training?

(1) A boarding home or adult family home wishing to conduct basic, modified basic, manager specialty, or caregiver specialty training for boarding home caregivers may do so if the home:

Renumbering within the section for clarity. Clarify manager and caregiver specialty training, and that this does not apply to AFH caregiver specialty training.
(1a) Verifies ...;

(2b) Teaches ...

Internal renumbering.
(3c) Notifies DSHS in writing of the home's intent to conduct staff training prior to providing the home's first training, and when changing training plans, including: Clarification based on public comment.
(ai) Home name;

(bii) Name of training(s) ...;

(ciii) Name of curriculum(s) ...;

Internal renumbering.
(iv) Name of lead instructor and instructor's past employment in boarding homes and adult family homes; and Add information needed per WAC 388-112-0345.
(dv) Whether the home ...

(4d) Ensures that ...;

Internal renumbering.
(5e) Provides a certificate ...:

(ai) The trainee's ...

(bii) The name ...;

Internal renumbering.

(ciii) The location name of the home giving of the training; Clarification.
(div) The instructor's ...

(ev) The date(s) ...;

(6f) Keeps a copy ...;

(7g) Keeps ...

(8h) Reports ....

Internal renumbering.
(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. Clarify that AFH requirements are different from BH; not changing from current WAC except to clarify documentation requirement.
(3) The home's instructor has been a licensee, boarding home administrator, or adult family home resident manager, as applicable, of any home while it was under 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 Response to public comment, that someone coming in after a home is under enforcement, to help the home improve, should not be prohibited from becoming an instructor.
WAC 388-112-0345 (4) The home has been operated under temporary management or has been subject to a revocation or 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 within the previous twelve months. Response to public comment, adding a clear time limit to this subsection.
WAC 388-112-0380 (1)(a) Upon initial approval or hire, must have:

(i) A high school diploma and one year of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD per chapter 388-820 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.

These changes were made in response to public comment to allow professional experience as well as caregiving experience to meet the work requirement.
(b) Meet up to Must have forty hours of the one hundred hours of teaching experience, hour for hour, by teaching while being mentored by an instructor who meets these qualifications; and attend a class in adult education that meets the requirements of WAC 388-112-0400. Clarification based on public comment.
WAC 388-112-0385

What are the minimum qualifications for instructors for manager and caregiver mental health specialty instructors? (1) Instructors for manager mental health specialty training: The minimum qualifications for instructors for manager mental health specialty, instructors, in addition to the general qualifications in WAC 388-112-0375, include: Clarify there are different requirements for manager and caregiver training. This section includes both.
(1a) The instructor ...; Internal renumbering.
(2b) Education -

(ai) Bachelor's degree... (One year of education equals twenty-four semester hours, forty-five thirty-six quarter hours, or one hundred ninety-two hours of seminars, conferences, and continuing education.):

Equivalent number of quarter hours changed in response to public comment.
(b) (ii) If required ....

(3c) Work experience ...

(4d) Teaching experience

(ai) Two hundred hours...

(bii) Successful completion ...:

(Ai) For instructors ...;

(iiB) For instructors ...

(5e) Instructors ....

Internal renumbering.
(2) Instructors for caregiver mental health specialty training: Clarify separate training requirements.
(a) Caregiver mental health specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager mental health specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers employed at other home(s) licensed by the same licensee. Options for in home training with reduced requirements, based on public comments about cost. This was moved into this section from sections 0110 and 0360, based on public comment.
(b) Caregiver mental health specialty taught by a person who does not meet the requirements in subsection (2)(a) must meet the same requirements as the instructors for manager mental health specialty in subsection (1). Clarification.
WAC 388-112-0390 What are the minimum qualifications for instructors for manager and caregiver dementia specialty instructors? (1) The minimum qualifications for instructors for manager dementia specialty instructors, in addition to the general qualifications under WAC 388-112-0375, include: Clarify there are different requirements for manager and caregiver training. This section includes both.

Internal renumbering throughout the section.

(1a) The instructor ... Internal renumbering throughout subsection (1).
(2b) Education -

(ai) Bachelor's degree, ... (One year of education equals twenty-four semester hours, forty-five thirty-six quarter hours, or one hundred ninety-two hours of seminars, conferences, and continuing education.)

Equivalent number of quarter hours changed in response to public comment.
(b)(ii) If required ...

(3c) Work experience ...

(4d) Teaching ...

(ai) Two hundred ..

(ii) Successful completion ...

(B) For instructors ....

(5d) Instructors ....

Internal renumbering.
(2) Instructors for caregiver dementia specialty training: Clarify different requirements for caregiver training.
(a) Caregiver dementia specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager dementia specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers employed at other home(s) licensed by the same licensee. Options for home-based training with reduced requirements, based on public comments about cost.

This was moved into this section from sections 0110 and 0360, based on public comment.

(b) Caregiver 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). Clarification.
WAC 388-112-0395 What are the minimum qualifications for instructors for manager and caregiver developmental disabilities specialty training instructors?

(1) The minimum qualifications for instructors for manager developmental disabilities specialty instructors, in addition to the general qualifications under WAC 388-112-0375, includee:

Clarify there are different requirements for manager and caregiver training. This section includes both.
(1a) Education ...:

(i) Bachelor's ...

Internal renumbering.
(bii) High school diploma ...

(2b) Successful ...

(3c) Teaching experience:

(ai) Two hundred hours ...

(bii) Successful ...

(iA) For instructors ...

(iiB) For instructors ....

(4d) Instructors ...

Internal renumbering.
(2) Instructors for caregiver developmental disabilities specialty training: Identify caregiver training requirements.
(c) Caregiver developmental disabilities specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager developmental disabilities specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers employed at other home(s) licensed by the same licensee. Options for home-based training with reduced requirements, based on public comments about cost.
(d) 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). Clarification, given option listed above.
WAC 388-112-0405 What physical resources are required for basic, modified basic, managers' specialty, caregivers' specialty, or nurse delegation core classroom training and testing?

(1) Classroom space used for basic, modified basic, managers' specialty, caregiver specialty, or nurse delegation core 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 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.

Clarify two types of specialty; editing.

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 43, Amended 0, Repealed 1.

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 0, Amended 0, 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 43, Amended 0, Repealed 1.
Effective Date of Rule: Thirty-one days after filing.

July 10, 2002

Brian H. Lindgren, Manager

Rules and Policies

3012.12SECTION VII -- CONTINUING EDUCATION
NEW SECTION
WAC 388-112-0200   What is continuing education?   Continuing education is additional caregiving-related training designed to increase and keep current a person's knowledge and skills. DSHS does not pre-approve continuing education programs or instructors.

[]


NEW SECTION
WAC 388-112-0205   How many hours of continuing education are required each year?   (1) Individuals subject to a continuing education requirement 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.

(2) 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.

[]


NEW SECTION
WAC 388-112-0210   What kinds of training topics are required for continuing education?   Continuing education must be on a topic relevant to the care setting and care needs of residents, including but not limited to:

(1) Resident rights;

(2) Personal care (such as transfers or skin care);

(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; and

(12) Medical conditions.

[]


NEW SECTION
WAC 388-112-0215   Is competency testing required for continuing education?   Competency testing is not required for continuing education.

[]


NEW SECTION
WAC 388-112-0220   May basic or modified basic training be completed a second time and used to meet the continuing education requirement?   Re-taking basic or modified basic training may not be used to meet the continuing education requirement.

[]


NEW SECTION
WAC 388-112-0225   May specialty training be used to meet continuing education requirements?   Manager specialty training and caregiver specialty training, except any specialty training completed through a challenge test, may be used to meet continuing education requirements.

(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.

[]


NEW SECTION
WAC 388-112-0230   May nurse delegation core training be used to meet continuing education requirements?   Nurse delegation training under WAC 388-112-0175 may be applied toward continuing education requirements for the calendar year in which it is completed.

[]


NEW SECTION
WAC 388-112-0235   May residential care administrator training be used to meet continuing education requirements?   Residential care administrator training under WAC 388-112-0275 may be used to meet ten hours of continuing education requirements.

[]


NEW SECTION
WAC 388-112-0240   What are the documentation requirements for continuing education?   (1) The adult family home or boarding home must maintain documentation of continuing education including:

(a) The trainee's name;

(b) The title or content of the training;

(c) The instructor's name, name of the home or training entity giving the training, or the name of the video, on-line class, professional journal, or equivalent instruction materials completed;

(d) The number of hours of training; and

(e) The date(s) of training.

(2) The trainee must be given an original certificate or other documentation of continuing education.

[]


NEW SECTION
WAC 388-112-0245   Who is required to complete continuing education training, and when?   Adult Family Homes

(1) Adult family home providers (including entity representatives as defined under chapter 388-76 WAC), resident managers, and caregivers must complete ten hours of continuing education each calendar year (January 1 through December 31) after the year in which they successfully complete basic or modified basic training.

(2) Continuing education must be on a topic relevant to the care setting and care needs of residents in adult family homes.

Boarding Homes

(3) Boarding home administrators (or their designees) and caregivers must complete ten hours of continuing education each calendar year (January 1 through December 31) after the year in which they successfully complete basic or modified basic training. A boarding home administrator with a current nursing home administrator license is exempt from this requirement.

(4) Continuing education must be on a topic relevant to the care setting and care needs of residents in boarding homes.

[]

SECTION VIII -- CPR AND FIRST AID TRAINING
NEW SECTION
WAC 388-112-0250   What is CPR training?   Cardio-pulmonary resuscitation (CPR) training is training that meets the content requirements in WAC 296-800-15010.

[]


NEW SECTION
WAC 388-112-0255   What is first aid training?   First aid training is training that meets the content requirements in WAC 296-800-15010.

[]


NEW SECTION
WAC 388-112-0260   What are the CPR and first aid training requirements?   Adult Family Homes

(1) Adult family home providers and resident managers must possess a valid CPR and first aid card or certificate prior to providing care for residents, and must maintain valid cards or certificates.

(2) Adult family home caregivers must obtain a valid CPR and first aid card or certificate:

(a) 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 who has a valid first aid and CPR card or certificate; or

(b) Before providing care for residents, if the provision of care for residents is not directly supervised by a fully qualified caregiver who has a valid first aid and CPR card or certificate.

(3) Adult family home caregivers must maintain valid CPR and first aid cards or certificates.

Boarding Homes

(4) Boarding home administrators who provide direct care, and caregivers must possess a valid CPR and first aid card or certificate within thirty days of employment, and must maintain valid cards or certificates. Boarding home licensed nurses must possess a valid CPR card or certificate within thirty days of employment, and must maintain a valid card or certificate.

[]

SECTION IX -- RESIDENTIAL CARE ADMINISTRATOR TRAINING
NEW SECTION
WAC 388-112-0265   What is residential care administrator training?   Residential care administrator training is a minimum of forty-eight hours of training on topics related to the management of adult family homes. DSHS must approve residential care administrator training curricula.

[]


NEW SECTION
WAC 388-112-0270   Who must take residential care administrator training and when?   Before operating more than one adult family home, the provider (including an entity representative as defined under chapter 388-76 WAC) must successfully complete residential care administrator training.

[]


NEW SECTION
WAC 388-112-0275   What knowledge and skills must residential care administrator training include?   Minimally, residential care administrator training must have at least forty-eight hours of class time, and include all of the following:

(1) Business planning and marketing;

(2) Fiscal planning and management;

(3) Human resource planning;

(4) Resident health services;

(5) Nutrition and food service;

(6) Working with people who are elderly, chronically mentally ill, or developmentally disabled;

(7) The licensing process;

(8) Social and recreational activities;

(9) Resident rights;

(10) Legal issues;

(11) Physical maintenance and fire safety; and

(12) Housekeeping.

[]


NEW SECTION
WAC 388-112-0280   Is competency testing required for residential care administrator training?   Competency testing is not required for residential care administrator training.

[]


NEW SECTION
WAC 388-112-0285   What documentation is required for residential care administrator training?   (1) Residential care administrator training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes:

(a) The trainee's name;

(b) The name of the training;

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

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

(e) The date(s) of training.

(2) The trainee must be given an original certificate. A copy of the certificate must be in the adult family home's files.

[]

SECTION X -- COMPETENCY TESTING
NEW SECTION
WAC 388-112-0290   What is competency testing?   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 outcomes of a particular course.

[]


NEW SECTION
WAC 388-112-0295   What components must competency testing include?   Competency testing must include the following components:

(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 for the training; and

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

[]


NEW SECTION
WAC 388-112-0300   What training must include the DSHS-developed competency test?   Basic, modified basic, manager specialty, caregiver specialty, and nurse-delegation core training must include the DSHS-developed competency test.

[]


NEW SECTION
WAC 388-112-0305   How must competency test administration be standardized?   To standardize competency test administration, testing must include the following components:

(1) The person teaching the course must administer or supervise the administration of all testing; and

(2) The tester must follow DSHS guidelines for:

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

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

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

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

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

[]


NEW SECTION
WAC 388-112-0310   What form of identification must students provide before taking a competency or challenge test?   Students must provide photo identification before taking a competency test (or challenge test, when applicable) for basic, modified basic, specialty, or nurse delegation training.

[]


NEW SECTION
WAC 388-112-0315   How many times may a competency test be taken?   (1) A competency test that is part of a course may be taken twice. If the test is failed a second time, the person must re-take the course before any additional tests are administered.

(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.

[]

SECTION XI -- CURRICULUM APPROVAL
NEW SECTION
WAC 388-112-0320   What trainings must be taught with a curriculum approved by DSHS?   (1) The following trainings must be taught using the DSHS curriculum or other curriculum approved by DSHS:

(a) Basic;

(b) Modified basic;

(c) Manager mental health, dementia, and developmental disabilities specialty training;

(d) Caregiver 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 training must use only the DSHS curriculum.

(4) A curriculum other than the DSHS curriculum must be approved before it is used. An attestation that the curriculum meets all requirements under this chapter will be sufficient for initial approval. Final approval will be based on curriculum review, as described under WAC 388-112-0330.

[]


NEW SECTION
WAC 388-112-0325   What are the minimum components that an alternative curriculum must include in order to be approved?   In order to be approved, an alternative curriculum must at a minimum include:

(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.

[]


NEW SECTION
WAC 388-112-0330   What is the curriculum approval process?   (1) An alternative curriculum must be submitted to DSHS for approval with:

(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) After review of the alternative curriculum, DSHS will send a written response to the submitter, indicating approval or disapproval of the curriculum and if disapproved, the reasons for denial;

(5) If the alternative curriculum is not approved, a revised curriculum may be re-submitted to DSHS for another review.

[]

SECTION XII -- HOME-BASED TRAINING
NEW SECTION
WAC 388-112-0335   What are the requirements for a boarding home or adult family home that wishes to conduct basic, modified basic, manager specialty, or caregiver specialty training?   (1) A boarding home or adult family home wishing to conduct basic, modified basic, manager specialty, or caregiver specialty training for boarding home caregivers may do so if the home:

(a) Verifies and documents that all instructors meet each of the minimum instructor qualifications 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 intent to conduct staff training prior to providing the home's first training, and when changing training plans, including:

(i) Home name;

(ii) Name of training(s) the home will conduct;

(iii) Name of curriculum(s) the home will use;

(iv) Name of lead instructor and instructor's past employment in boarding homes and adult family homes; and

(v) Whether the home will train only the home's staff, or will also train staff from other homes;

(d) Ensures that DSHS competency tests are administered as required under this chapter;

(e) Provides a certificate 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 certificates on file for six years, and gives the original certificate to the trainee;

(g) Keeps attendance records and testing records of students trained and tested on file for six years; and

(h) Reports training data to DSHS in DSHS-identified time frames

(2) An adult family home wishing to conduct caregiver specialty training that is taught by the provider, resident manager, or person knowledgeable about the specialty area, as required under WAC 388-112-0110 subsection (3), must document the specialty training as provided under WAC 388-112-0155.

[]


NEW SECTION
WAC 388-112-0340   Do homes need department approval to provide continuing education for their staff?   Homes may provide continuing education for their staff without prior approval of curricula or instructors by the department.

[]


NEW SECTION
WAC 388-112-0345   When can DSHS prohibit a home from conducting its own training?   DSHS may prohibit a home from providing its own basic, modified basic, specialty, or caregiver specialty training when:

(1) DSHS determines that the training fails to meet the standards under this chapter;

(2) The home's instructor does not meet the applicable qualifications under WAC 388-112-0375 through 388-112-0395; or

(3) The home's instructor has been a licensee, boarding home administrator, or adult family home resident manager, as applicable, of any home subject to temporary management or subject to a revocation or summary suspension of the home's license, a stop placement of admissions order, a condition on the license related to resident care, or a civil fine of five thousand dollars or more, while the instructor was the licensee, administrator, or resident manager; or

(4) 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 months.

(5) Nothing in this section shall be construed to limit DSHS' authority under chapters 388-76 or 388-78A 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.

[]

XIII -- INSTRUCTOR APPROVAL
NEW SECTION
WAC 388-112-0350   What trainings must be taught by an instructor who meets the applicable minimum qualifications under this chapter?   (1) The following trainings must be taught by an instructor who meets the applicable minimum qualifications for that training: Basic training; modified basic training; mental health, dementia, and developmental disability specialty training; and caregiver specialty training that is not taught by the boarding home administrator (or designee) or adult family home provider or resident manager.

(2) Nurse delegation training and residential care administrator training must be taught by an instructor who is approved by DSHS.

[]


NEW SECTION
WAC 388-112-0355   What are an instructor's or training entity's responsibilities?   The instructor or training entity is responsible for:

(1) Coordinating and teaching classes,

(2) Assuring that the curriculum used is taught as designed,

(3) Selecting qualified guest speakers where applicable,

(4) Administering or overseeing the administration of DSHS competency and challenge tests,

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

(6) Reporting training data to DSHS in DSHS-identified time frames, and

(7) Issuing or re-issuing training certificates to students.

[]


NEW SECTION
WAC 388-112-0360   Must instructors be approved by DSHS?   (1) DSHS-contracted instructors

(a) DSHS must approve any instructor under contract with DSHS to conduct basic, modified basic, specialty, or nurse delegation core training classes using the training curricula developed by DSHS.

(b) DSHS may select contracted instructors through a purchased services contract procurement pursuant to chapter 236-48 WAC or through other 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 contracting procedure.

(2) Homes conducting their own training

Homes conducting their own training programs using the training curricula developed by DSHS or alternative curricula approved by DSHS must ensure that their instructors meet the minimum qualifications for instructors under this chapter.

(3) Other instructors

DSHS must approve all other instructors not described in subsection (1) and (2) of this section.

[]


NEW SECTION
WAC 388-112-0365   Can DSHS deny or terminate a contract with an instructor or training entity?   (1) DSHS may determine not to accept a bid or other offer by a person or organization seeking a contract with DSHS to conduct basic, modified basic, specialty, or nurse delegation core training classes using the training curricula developed by DSHS. The protest procedures under chapter 236-48 WAC, as applicable, are a bidder's exclusive administrative remedy. No administrative remedies are available to dispute DSHS' decision not to accept an offer that is not governed by chapter 236-48 WAC, except as may be provided through the contracting process.

(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.

[]


NEW SECTION
WAC 388-112-0370   What is a guest speaker, and what are the minimum qualifications to be a guest speaker for basic and developmental disabilities specialty training?   Guest speakers for basic and developmental disabilities specialty training 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 background and experience that demonstrates that the guest speaker has expertise on the topic he or she will teach. The instructor must select guest speakers that meet the minimum qualifications, and maintain documentation of this background. DSHS does not approve guest speakers.

[]


NEW SECTION
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?   An instructor teaching a DSHS curriculum or DSHS-approved alternate curriculum must meet the following minimum general qualifications:

(1) Twenty-one years of age; and

(2) Has not had a professional health care or social services license or certification revoked in Washington state (however, no license or certification is required).

[]


NEW SECTION
WAC 388-112-0380   What are the minimum qualifications for an instructor for basic or modified basic training?   An instructor for basic or modified basic training must meet the following minimum qualifications in addition to the general instructor qualifications in WAC 388-112-0375:

(1) Education and work experience:

(a) Upon initial approval or hire, must have:

(i) A high school diploma and one year of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD per chapter 388-820 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) Teaching experience:

(a) Must have one hundred hours of experience teaching adults on topics directly related to the basic training; or

(b) Must have forty hours of teaching while being mentored by an instructor who meets these qualifications, and attend a class in adult education that meets the requirements of WAC 388-112-0400.

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

(4) 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.

[]


NEW SECTION
WAC 388-112-0385   What are the minimum qualifications for instructors for manager and caregiver mental health specialty?   (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 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 one hundred ninety-two hours of seminars, conferences, and continuing education.)

(ii) If required under WAC 388-112-0160, successful completion of the mental health specialty training, prior to beginning to train others.

(c) Work experience - Two years full-time equivalent direct work experience with people who have a mental illness; and

(d) Teaching experience

(i) Two hundred hours experience teaching mental health or closely related subjects; and

(ii) Successful completion of an adult education class or train the trainer as follows:

(A) For instructors teaching alternate curricula, a class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

(B) For instructors teaching DSHS-developed mental health specialty training, successful completion of the DSHS-developed train the trainer.

(e) Instructors who will administer tests must have experience or training in assessment and competency testing.

(2) Instructors for caregiver mental health specialty training:

(a) Caregiver mental health specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager mental health specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers employed at other home(s) licensed by the same licensee.

(b) Caregiver mental health specialty taught by a person who does not meet the requirements in subsection (2)(a) must meet the same requirements as the instructors for manager mental health specialty in subsection (1).

[]


NEW SECTION
WAC 388-112-0390   What are the minimum qualifications for instructors for manager and caregiver dementia specialty?   (1) The minimum qualifications for instructors for manager dementia specialty, in addition to the general qualifications under WAC 388-112-0375, include:

(a) The instructor must be experienced in dementia caregiving practices and capable of demonstrating competency in the entire course content;

(b) Education

(i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education or college classes, in dementia or subjects directly related to dementia, such as, but not limited to, psychology. (One year of education equals twenty-four semester hours, thirty-six quarter hours, or at least one hundred ninety-two hours of seminars, conferences, or continuing education.)

(ii) If required under WAC 388-112-0160, successful completion of the dementia specialty training, prior to beginning to train others.

(c) Work experience - Two years full-time equivalent direct work experience with people who have dementia; and

(d) Teaching experience

(i) Two hundred hours experience teaching dementia or closely related subjects; and

(ii) Successful completion of an adult education class or train the trainer as follows:

(A) For instructors teaching alternate curricula, a class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

(B) For instructors teaching DSHS-developed dementia specialty training, successful completion of the DSHS-developed train the trainer.

(d) Instructors who will administer tests must have experience or training in assessment and competency testing.

(2) Instructors for caregiver dementia specialty training:

(a) Caregiver dementia specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager dementia specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers employed at other home(s) licensed by the same licensee.

(b) Caregiver 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).

[]


NEW SECTION
WAC 388-112-0395   What are the minimum qualifications for instructors for manager and caregiver developmental disabilities specialty?   (1) The minimum qualifications for instructors for manager developmental disabilities specialty, in addition to the general qualifications under WAC 388-112-0375, include:

(a) Education and work experience:

(i) Bachelor's degree with at least two years of full-time work experience in the field of disabilities; or

(ii) High school diploma or equivalent, with four years full time work experience in the field of developmental disabilities, including two years full time direct work experience with people who have a developmental disability.

(b) Successful completion of developmental disabilities specialty training under WAC 388-112-0120; and

(c) Teaching experience:

(i) Two hundred hours of teaching experience; and

(ii) Successful completion of adult education or train the trainer as follows:

(A) For instructors teaching alternative curricula, a class in adult education that meets the requirements of WAC 388-112-0400, or a train the trainer class for the curriculum they are teaching;

(B) For instructors teaching DSHS-developed developmental disabilities specialty training, successful completion of the DSHS-developed train the trainer.

(d) Instructors who will administer tests must have experience in assessment and competency testing.

(2) Instructors for caregiver developmental disabilities specialty training:

(a) Caregiver developmental disabilities specialty may be taught by a boarding home administrator (or designee), adult family home provider, or corporate trainer, who has successfully completed the manager developmental disabilities specialty training. A qualified instructor under this subsection may teach caregiver specialty to caregivers 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).

[]


NEW SECTION
WAC 388-112-0400   What must be included in a class on adult education?   A class on adult education must include content, student practice, and evaluation of student skills by the instructor in:

(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 and literacy issues).

[]

SECTION XIV -- PHYSICAL RESOURCES AND STANDARD PRACTICES FOR TRAINING
NEW SECTION
WAC 388-112-0405   What physical resources are required for basic, modified basic, specialty, or nurse delegation core classroom training and testing?   (1) Classroom space used for basic, modified basic, specialty, or nurse delegation core 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 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.

[]


NEW SECTION
WAC 388-112-0410   What standard training practices must be maintained for basic, modified basic, specialty, or nurse delegation core classroom training and testing?   The following training standards must be maintained for basic, modified basic, specialty or nurse delegation core classroom training and testing:

(1) Training, including all breaks, must not exceed eight hours within one day;

(2) Training provided in short time segments must include an entire unit, skill or concept;

(3) Training must include regular breaks; and

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

[]

3008.4
AMENDATORY SECTION(Amending WSR 99-15-067, filed 7/19/99, effective 8/19/99)

WAC 388-78A-050   Staff.   (1) The licensee shall:

(a) Develop and maintain written job descriptions for the administrator and each staff position;

(b) Verify work references;

(c) Verify required credentialling is current and in good standing for licensed and certified staff;

(d) Document and retain weekly staffing schedules, as planned and worked, for the last twelve months;

(e) Provide sufficient, trained staff in each boarding home to:

(i) Furnish the services and care needed by residents;

(ii) Maintain the boarding home free of safety hazards; and

(iii) Implement fire and disaster plans;

(f) Assure one or more resident-care staff eighteen years of age or older, with current cardiopulmonary resuscitation and first-aid cards, is present to assist residents at all times:

(i) On the boarding home premises when one or more residents are present;

(ii) Off the boarding home premises during boarding home activities; and

(iii) When staff transport a resident;

(g) Assure staff provide "on-premises" supervision when any resident is working for, or employed by, the boarding home; and

(h) Provide staff orientation and appropriate training for expected duties, including:

(i) Organization of boarding home;

(ii) Physical boarding home layout;

(iii) Specific duties and responsibilities; and

(iv) Policies, procedures, and equipment necessary to perform duties.

(2) The licensee shall ensure that the administrator and staff complete any training required under chapter 388-112 WAC.

(3) The licensee shall, in addition to following WISHA requirements, protect residents from tuberculosis by requiring each staff person to have, upon employment:

(a) A tuberculin skin test by the Mantoux method, unless the staff person:

(i) Documents a previous positive Mantoux skin test, which is ten or more millimeters of induration read at forty-eight to seventy-two hours;

(ii) Documents meeting the requirements of this subsection within the six months preceding the date of employment; or

(iii) Provides a written waiver from the department or authorized local health department stating the Mantoux skin test presents a hazard to the staff person's health;

(b) A second test one to three weeks after a negative Mantoux skin test for staff thirty-five years of age or older;

(c) A chest x-ray within seven days of any positive Mantoux skin test.

(((3))) (4) The licensee shall report positive chest x-rays to the appropriate public health authority, and follow precautions ordered by a physician or public health authority.

(((4))) (5) The licensee shall retain records of tuberculin test results, reports of x-ray findings, exceptions, physician or public health official orders, and waivers in the boarding home.

(((5) The licensee shall assure that all resident-care staff including those transporting residents and supervising resident activities, except licensed staff whose professional training exceeds first-responder training, have within thirty days of employment:

(a) Current cardiopulmonary resuscitation cards from instructors certified by:

(i) American Red Cross;

(ii) American Heart Association;

(iii) United States Bureau of Mines; or

(iv) Washington state department of labor and industries; and

(b) Current first-aid cards from instructors certified as in (a) of this subsection, except nurses do not need first-aid cards.))

(6) The licensee shall restrict a staff person's contact with residents when the staff person has a known communicable disease in the infectious stage which is likely to be spread in the boarding home setting or by casual contact.

(7) The licensee shall assure any staff person suspected or accused of abuse does not have access to any resident until the licensee investigates and takes action to assure resident safety to the satisfaction of the department.

(8) The licensee shall not interfere with the investigation of a complaint, coerce a resident, or conceal evidence of alleged improprieties occurring within the boarding home.

(9) The licensee shall prohibit an employee from being directly employed by a resident or a resident's family during the hours the employee is working for the boarding home.

(10) The licensee shall maintain the following documentation on the boarding home premises, during employment, and at least two years following termination of employment:

(a) Staff orientation and training pertinent to duties, including but not limited to cardiopulmonary resuscitation, first-aid, tuberculin skin testing and HIV/AIDS training;

(b) Criminal history disclosure and background checks as required in WAC 388-78A-045; and

(c) Verification of contacting work references and professional licensing and certification boards as required by subsection (1) of this section.

[Statutory Authority: RCW 18.20.240. 99-15-067, 388-78A-050, filed 7/19/99, effective 8/19/99; 98-20-021, recodified as 388-78A-050, filed 9/25/98, effective 9/25/98. Statutory Authority: RCW 18.20.090. 94-13-180, 246-316-050, filed 6/21/94, effective 7/22/94. Statutory Authority: RCW 43.43.830 through 43.43.842. 93-16-030 (Order 381), 246-316-050, filed 7/26/93, effective 8/26/93. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as 246-316-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.20.090. 89-09-034 (Order 2786), 248-16-046, filed 4/14/89.]

Washington State Code Reviser's Office