DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Developmental Disabilities Administration)

SECTION I - PURPOSE AND DEFINITIONS

The purpose of this chapter is to describe the following:

(1) Training and certification requirements that apply to community residential service businesses (CRSB) beginning on January 1, 2016;

(2) Curricula and instructor requirements; and

(3) Curricula and instructor approval process.

(1) Long-term care workers and volunteers working for community residential service businesses (CRSB), including supported living services, DDA group homes, group training homes, and licensed staffed residential homes must follow the training requirements of this chapter.

(2) DDA group homes, also licensed as adult family homes or assisted living facilities, must also meet home care aide certification requirements described in WAC 388-112-0106 and WAC 388-112-0108. Long-term care workers in all other CRSB settings must comply with the training and curricula requirements of this chapter, but are exempt from home care aide certification through the department of health.

(3) Adult family homes and assisted living facilities not contracted as a community residential service business must follow training, curricula and certification requirements described in chapter 388-112 WAC.

"Activities of daily living (ADL)" means the same as defined in WAC 388-106-0010.

"Agency orientation" is training provided to introduce a new employee to the agency.

"ALTSA" refers to the aging and long-term support administration.

"Approved training" is training that has been submitted to and approved by DSHS as evidenced by a curriculum number.

"Attestation" means to bear witness to the authenticity of a document or documents by signing one's name to it to affirm it is genuine.

"Basic training" includes seventy hours of required training: forty hours of DDA residential training and thirty hours of topics outlined in WAC 388-829-0100(b).

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

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

""Community residential service business" (CRSB) has the same meaning as defined in RCW 74.39A.009.

"Competency" or "core competency" means 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 student 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.

"DD" refers to developmental disability.

"DDA" refers to the developmental disabilities administration.

"Direct care" services rendered by direct support professionals which includes not only those services defined by "personal care services", but also those which promote habilitation and further life-long independence, growth, and development opportunities for individuals.

"Direct support professional" means a paid individual who provides direct, personal, care services and support to one or more persons with developmental disabilities 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 has been exempted from the basic training requirements, is on the premises, and is quickly available to the direct support professional.

"DOH" refers to the department of health.

"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 such as, videos or DVDs, online materials, and/or additional student activities.

"Entity representative" means the individual designated by a community residential service business (CRSB) provider who is or will be responsible for the daily operations of a community residential service business (CRSB).

"Guardian" means a legal representative as defined in chapter 11.88 RCW.

"Habilitation" means services defined to assist participants in acquiring, retaining and improving the self-help, socialization and adaptive skills necessary to reside successfully in home and community-based settings.

"Home" means the place where a person lives.

"Home care aid–certified (HCA-C)" means a person who has holds a current certificate issued by the department of health.

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

"Individual" means a person who has a developmental disability as defined in RCW 71A.10.020(5) who also has been determined eligible to receive services by the division under chapter 71A.16 RCW. Other terms commonly used include "client" and "resident".

"Individual specific" means topics that are unique to an individual.

"Learning objectives" means 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.

"Letter of exemption" means a letter provided during the calendar year 2015 which exempts CRSB staff from the seventy-five hours of training as required by Initiative 1163 for staff hired prior to January 1, 2016.

"Long-term care worker" has the same meaning as defined in RCW 74.39A.009.

"Mental health specialist" has the same meaning as defined in WAC 388-865-0200

"Peer mentor/coach" means a person who has been trained in twelve hours of coaching skills and who works with new employees to coach them on working with individuals and their support needs. This coaching is a method of transferring knowledge about the individual to the new employee while building a positive relationship with the new employee and encouraging a positive relationship between the new employee and the individual they support.

"Personal care services" means physical or verbal assistance with activities of daily living, and instrumental activities of daily living which is provided to meet an individual's support needs.

"Population specific" refers to topics such as developmental disabilities, autism, and gerontology that are applicable to a group of people.

"Provider" means any person or entity who is contracted by the department to operate a community residential service business, or certified by the department to provide instruction and support services to meet the needs of persons receiving services under Title 71A RCW.

"Revised fundamentals of care" (RFOC) refers to the basic training curriculum provided by trainers under aging and long-term support administration (ALTSA).

"Routine interaction" means contact with an individual that happens regularly.

"Support team" means the individual and persons involved in his or her care. The support team may include family, friends, doctors, nurses, long-term care workers, social workers and vocational vendors. The role of the support team is to support the well-being of the individual; however, the individual directs the service plan when able.

"Training entity" means an organization, including an independent contractor, who is providing or may provide training under this section using approved curriculum. Training entities must only deliver DSHS approved curriculum to CRSB staff.

The following chart provides a summary of the training and certification requirements. The remainder of the rules under this chapter contains a more detailed description of the requirements.

Key:

R means required

Blank means not required

* Means see WAC text for information

Note: Other trainings that may be required and not considered to be part of the seventy-five hour certificate are not listed in tables above. Includes but is not limited to:

(1) First aid and CPR WAC 388-101-3290;

(2) Nurse delegation WAC 388-101-3375; and

(3) Blood borne pathogens.

(1) The long-term care worker training requirements described in this chapter go into effect January 1, 2016.

(2) The long-term care worker training requirements that were in effect on or before December 31, 2015 apply to those individuals who:

(a) Were hired on or before December 31, 2015; and

(b) Complete(d) training requirements in existing rules at time of hire by February 29, 2016.

Exempt individuals as of January 1, 2016 include:

(1) Staff hired January 1, 2015 through December 31, 2015, with no break in service to January 1, 2016 and hold a letter of exemption. Letters of exemption are portable from agency to agency:

(a) For staff with continuous employment; and

(b) For staff with intermittent work over a three year period who have completed their annual continuing education credits; or

(c) For staff who made up the twelve hours of continuing education prior to their date of hire and are current with all required CE credits.

(2) The HCA-C replaces the requirements for the training under the seventy-five hour certificate.

(a) Staff holding a HCA-C must complete agency orientation.

(b) Staff who obtained an HCA-C and took the revised fundamentals of care giving (RFOC) training through ALTSA prior to January 1, 2016, must also take the eighteen hour DDA specialty training.

(3) A home health aide who is employed by a medicare-certified home health agency and has met the requirements of 42 C.F.R., Part 483.35.

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

(5) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW; Nursing assistants-certified under chapter 18.88A RCW.

SECTION II - SEVENTY-FIVE HOUR CERTIFICATE

The seventy-five hour certificate is a combination of trainings and certifications that when complete add up to seventy-five hours. The certificate covers:

(1) Five hour orientation and safety (Section III);

(2) Forty hour residential (Section IV); and

(3) Thirty hour peer coaching and other provider requirements.

In addition to the seventy-five hour certificate, twelve hours of continuing education credits are required each calendar year. HCA-C staff will follow the schedule for CEs as described in WAC 246-980-110.

The following people must complete the seventy-five hours of training as described:

(1) Non exempt employees hired as a new employee to work for CRSB agencies as a LTCW.

(2) Anyone who wants to complete the home care aid certification.

There are two types of orientation training: long-term care worker (LTCW) orientation training and agency orientation training.

(1) LTCW orientation.

Orientation is two hours of DDA developed and approved training regarding the LTCW's role and the applicable terms of employment as described in WAC 388-829-0055. DDA's curriculum is the only approved LTCW training for CRSB. There is no test for this training.

(2) Agency orientation.

Agency orientation is of varied length and provides basic introductory information appropriate to the residential care setting and population served and covers agency specific information. The department does not approve this specific orientation program, materials, or trainers, and there is no test for this orientation.

This orientation must include:

(a) Current individual instruction and support plans of each client with whom the employee works;

(b) Emergency procedures for clients;

(c) The reporting requirements for abuse and neglect under chapter 74.34 RCW; and

(d) Client confidentiality.

For those individuals working in a CRSB:

(1) Long-term care worker orientation must be taught by an approved trainer and follow the DDA approved two hour orientation curriculum which includes the following topics:

(a) The care setting and the agency mission;

(b) The characteristics and special needs of the population served;

(c) Fire and life safety, including:

(i) Emergency communication (including phone system if one exists);

(ii) Evacuation planning (including fire alarms and fire extinguishers);

(iii) Ways to handle individual injuries, falls or other accidents; and

(iv) Potential risks to individuals or staff (for instance, aggressive individual behaviors and how to handle them)

(d) The location of home policies and procedures.

(e) Communication skills and information, including:

(i) Methods for supporting effective communication among the individual/guardian/family, staff, and DDA staff;

(ii) Use of verbal and nonverbal communication; and

(iii) Review of written communication and/or documentation required for the job, including the individual's ISP.

(f) Expectations about communication with other direct support staff;

(g) Whom to contact about problems and concerns.

(h) Proper body mechanics;

(i) What staff should do if they are ill;

(j) Individual rights, including:

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

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

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

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

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

(vi) Advocates that are available to help individuals (LTC ombudsmen, organizations);

(vii) Complaint lines, hot lines, and individual grievance procedures; and

(vii) Working in an individual's home compared to working in agency facility or adult family home.

(2) LTCW orientation is the first part of the five hour certificate.

(1) People hired to work in a CRSB who do not have a valid seventy-five hour certificate.

(2) LTCWs who were exempt in 2012 or 2015 with a break in service of three or more years will be treated as a new hire and will require the full seventy-five hours of training.

(3) Volunteers who will have indirect supervision during direct support duties.

The purpose of this training is to orient the staff to the agency. Some topics of agency orientation may be covered in LTCW orientation but due to individual support needs, must be trained outside of LTCW orientation.

Agency orientation must include but is not limited to:

(1) The setting and the agency mission;

(2) The characteristics and special needs of the population served;

(3) Fire and life safety, including:

(a) Emergency communication (including phone system if one exists);

(b) Evacuation planning (including fire alarms and fire extinguishers);

(c) Ways to handle individuals' injuries, falls and other accidents; and

(d) Potential risks to individuals or staff (for instance, aggressive individual behaviors and how to handle them);

(4) The location of policies and procedures;

(5) Communication skills and information, including:

(i) Methods for supporting effective communication among the individual/guardian/family, staff, and DDA staff;

(ii) Use of verbal and nonverbal communication; and

(iii) Review of written communications and/or documentation required for the job, including the individual's IISP;

(6) Expectations about communication with other home staff;

(7) Whom to contact about problems and concerns;

(8) Rules for working in someone's home as opposed to agency facility; and

(9) Respect for individual's property including their food, home, water, electricity or anything paid for out of the individual's account.

Staff who have never worked for a particular agency or who have not worked for the agency for more than one year must complete the agency orientation.

Safety training is part of the long-term care worker requirements and must be provided by approved instructors. It is three hours of training developed by DDA and includes basic safety precautions, emergency procedures, and infection control. There is no test for safety training.

The following individuals must complete safety training before providing care under indirect supervision:

(1) All non-exempt LTCWs hired after Dec 31, 2015 who do not currently hold a safety certificate as described in RCW 18.88B.041,

(2) Volunteers who will have direct support duties.

Safety training must include:

(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) Call prevention;

(f) Long-term care worker safety; and

(e) 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 individual is sick or injured, including to whom to report illness or injury.

(h) Safe food handling information must be provided to all staff, prior to handling food for individuals.

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

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

(a) Medical emergencies;

(b) Response to fire;

(c) Natural disasters or other community emergencies;

(d) Location of any advance directives if available;

(e) Missing individuals;

(f) Unmanageable individual behavior; and

(g) Individuals involved with law enforcement.

SECTION IV - BASIC TRAINING

(1) Basic training is in addition to the orientation and safety training totals seventy hours of training: Basic training is made up of two components; the forty hour residential training and thirty hours of additional topics as defined by subsubsection 1(b) of this section.

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

(ii) Practice and demonstration of skills;

(iii) DD history;

(iv) Positive behavior support plan;

(v) Residential guidelines;

(vi) Individual instruction and support plan (IISP);

(vii) Effective communication;

(A) Between staff;

(B) With family;

(C) With individuals;

(viii) Nutrition and dietary guidelines;

(ix) Healthcare/health management;

(x) Medication management;

(xi) Abuse and neglect;

(xii) Confidentiality;

(xiii) Emergency procedures;

(xiv) Staff roles, self-care, boundaries; and

(xv) Grief and loss.

(b) Additional topics – thirty hours.

(i) Peer coaching as defined in RCW 74.39A.331 for on the job training.

(ii) Population specific if appropriate.

(iii) Individual specific.

(2) The core competencies requirement for DDA must be met by completing:

(a) The DDA developed forty-hour residential training; or

(b) The DSHS approved revised fundamentals of caregiving (RFOC) (or the approved curriculum by DSHS) and the eighteen hour DD specialty training.

(3) Additional training will be required:

(i) Individual specific training; and

(ii) If changing agencies, the agency orientation;

(4) The long-term care worker must be able to ask the instructor questions during the training.

(5) There is no challenge test for 2a or b.

Basic training for LTCWs in a CRSB must include the DDA forty hour residential training. Competencies within this DSHS/DDA approved curriculum includes but is not limited to:

(1) Fall prevention;

(2) Food preparation and handling;

(3) Communication skills;

(5) Individual rights and maintaining dignity;

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

(7) Individual directed care;

(8) Cultural sensitivity;

(9) Skin and body care;

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

(11) Supporting activities of daily living;

(12) Medication assistance;

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

(14) Problem solving;

(15) Grief and loss; and

(16) Building positive relationships.

(1) LTCW training must be documented by the following:

(a) Agency orientation, LTCW orientation and safety:

(i) The training and documentation must be issued by the service provider familiar with the agency. Proof must be documented with:

(A) Original sign in sheets, dated with name of training and instructor; or

(B) Original check lists used to ensure all training was completed; or

(C) Personnel records that provide proof of completion.

(ii) If certificates are used for agency orientation, LTCW orientation and safety the certificates must have:

(A) The name of the student;

(B) The name of the training;

(C) The number of hours of the training;

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

(E) The instructor's name, printed and signature;

(F) The training completion date;

(G) The student's date of hire; and

(H) The date(s) of the training.

(b) Basic training:

(i) Documentation for basic training is the same as subsubsection (1)(a)(i) in this section.

(ii) Certificates for basic training must include all of subsubsection (1)(a)(ii) in this section and the name and identification number of the basic training instructor.

(c) Agency training for the thirty hours of training:

(i) Documentation of the thirty hours is a certificate developed by DDA showing all of the requirements were completed for this training. Documentation must include but is not limited to:

(A) Training checklists signed by a supervisor or an approved peer coach and the trainee;

(B) Other certificates from department approved population specific training; and

(C) Other certificates from department specialty training.

(d) Seventy-five hour certificate:

(i) A single seventy-five hour training certificate may be issued by a training entity, in lieu of individual certificates if that training entity was wholly responsible for providing all seventy-five of the training hours.

(ii) The last training entity responsible for providing instruction to a long-term care worker will be responsible for providing the seventy-five hour certificate.

(iii) The last training entity must see the other documents if they were provided by a training program, community instructor or other entity outside of the agency where the staff is currently employed:

(A) The seventy-five hour certificate template was developed by DDA and no other form may be used.

(B) The certificate must be an original.

(C) The issuer of the seventy-five hour certificate must maintain a copy of the seventy-five hour certificate and all supporting document for six years from the date of issue.

(D) Issuer of the certificate must be approved by the department.

(iv) The LTCW must be given the original seventy-five hour certificate(s) for proof of completion of the training and retain for their own records.

(v) To take the HCA-C exam using the DDA seventy-five hour certificate, the certificate must indicate:

(A) DDA residential curriculum for 15 chapters, or

(B) DDA residential curriculum AND a certificate for Residential Services Curriculum chapter 15 separately, or

(C) DDA residential curriculum and a CE certificate for Residential Services Curriculum chapter 15 taken within the first two years of hire and before the end of two years of employment in the field.

(2) LTCWs who are exempt from the seventy-five hours of training, hired prior to January 1, 2016, and not in a different professional exemption category, must have a letter of exemption indicating their training for the year of 2015 is current and met the requirements of working for the CRSB in lieu of a certificate.

(a) Letters of exemption must include:

(i) Name of the agency;

(ii) Name of the staff;

(iii) Date of hire;

(iv) Language regarding completion of current training requirements in 2015;

(v) Date of termination if appropriate;

(vi) Signature and printed name of agency administrator; and

(vii) Date letter was signed.

(b) Letters of exemption expire when the staff does not work in the field for three years.

(c) Letters of exemption expire when staff who work intermittently do not maintain the twelve CEs required annually.

(i) Intermittent workers may complete the CE requirements (twelve per year) prior to hire and continue to use their exemption letter.

(ii) Intermittent workers who do not complete their CE requirements over a three year span forfeit their letter of exemption.

(iii) Staff who forfeit their letter of exemption must start training as a new hire and complete all seventy-five hours of training.

A copy of the exemption letter must remain in the personnel file for six years. The original letter is the responsibility of the staff.

Basic training and LTCW orientation and safety training certificates remain valid as long as the staff maintains their twelve hours of continuing education annually. Certificates are portable from one agency to another.

For the purpose of becoming a HCA-C, the seventy-five hour certificates expire after two years. If CRSB staff choose to take the HCA-C exams for certification; their seventy-five hour certificate must meet the DOH requirements as outlined in WAC 246-980-060. Costs incurred for the testing and certification are the sole responsibility of the staff person taking them.

The following individuals must complete basic training requirements:

(1) Long-term care workers in CRSB within one hundred twenty days of date of hire. Until basic training has been completed, long-term care workers can only provide direct care with indirect supervision.

(2) Exempted employees hired after December 31, 2015, returning to work after a three year break in service must complete the seventy-five hours of training as if a new employee to the field.

(3) Exempted employees hired after December 31, 2015 with intermittent work must:

(a) Maintain or complete the CEs to meet the annual requirements prior to hiring date; or

(b) Must complete the seventy-five hours of training as if a new employee to the field.

(4) Volunteers who will provide direct support services with indirect supervision. Family members are not considered to be volunteers.

Entities wanting to instruct staff on the DDA forty hour residential curriculum and meet the requirements of WAC 388-829-0380 must take the train the trainer course offered through DDA. Instructors may be approved through ALTSA or DDA and will have only one instructor code. Certificates for the train the trainer course will be required as proof of taking this training and completing the course. Instructors are responsible to maintain their original certificates and may be asked to show them as proof of attendance at the train the trainer. Agencies hiring community instructors or other training programs must maintain a copy of the trainer's original certificate for their records.

(1) Staff hired after January 7, 2012 who work in a DDA group home licensed as an adult family home or an assisted living facility are required to obtain home care aide certification through the department of health (DOH).

(2) All other CRSB staff are required to meet the training requirements of this chapter, but are exempt from home care aide certification through DOH.

(3) Any staff working for a CRSB who completes the seventy-five hour training described in this chapter, and the HCA-C supplemental training chapter may pursue certification as a home care aide through the DOH.

(1) Successful completion of seventy-five hours of training must be documented on a DSHS seventy five hour training certificate, signed by an approved training entity verifying that a total of seventy-five hours of approved training have occurred. For DDA developed or approved training, the seventy five hour training certificate issued must indicate "HCA-C Approved."

(2) An approved training entity issuing and signing a DSHS seventy five hour training certificate must verify that the LTCW 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. The department of health will only accept a seventy-five hour training certificate that has been issued by the department or the training partnership for 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(s) or transcript(s) issued by a DSHS-approved training entity.

(4) The LTCW and certified home care aide must retain any twelve hour training certificates or transcripts for as long as they are employed.

SECTION V - POPULATION-SPECIFIC

(1) The DDA forty hour residential curriculum required for all CRSB staff hired on or after January 1, 2016 includes DD population specific information.

(2) Staff trained using the DDA forty hour residential curriculum are not required to take the eighteen hour DD specialty training course.

SECTION VI - SPECIALTY TRAINING

Specialty or "special needs" training provides instruction in care giving skills that meet the special needs of people living with mental illness, dementia, or developmental disabilities. Specialty trainings are different for each population served and are not interchangeable. Specialty training may be integrated with basic training if the complete content of each training is included. DSHS must approve specialty training curricula for long-term care workers.

Specialty training includes:

(1) Mental health training;

(2) Dementia training;

(3) Eighteen hour DD specialty training; and

(4) Other specialty training as identified as required by the population being supported.

(1) Specialty training requirements are described in WAC 388-112-0110.

(2) Staff with a current HCA-C hired by a CRSB on or after January 1, 2016 must complete the eighteen hour DD specialty training or DDA forty hour residential curriculum within ninety days of working with individuals unless;

(a) They provide proof of prior completion of this training or

(b) Have taken the DDA forty hour residential curriculum training.

SECTION VII - NURSE DELEGATION CORE TRAINING

Nurse delegation training is coursework regarding assisting a person with support needs in the area of taking medications and other delegated tasks. Nurse delegation core training is required before a nursing assistant certified or nursing assistant registered or certified home care aide can be delegated a nursing task. DSHS approves instructors for nurse delegation core training.

Nurse delegation training is not approved for use under the seventy-five hour certificate but may be used for continuing education following the first one hundred twenty days of employment. Nurse delegation is described in WAC 388-112-0170 through 388-112-0197.

SECTION VIII - CONTINUING EDUCATION

(1) Continuing education (CE) is annual training designed to increase a support staff's knowledge and skills. DSHS must approve continuing education curricula and instructors. The same continuing education course cannot be repeated for credit unless it is a new or more advanced training on the same topic. The exceptions to this are:

(a) Blood-borne pathogens;

(b) CPR training;

(c) First aid training;

(d) Food handling training (thirty minutes allowed); and

(e) When the agency can demonstrate a need for retraining.

(2) Nurse delegation core and nurse delegation specialized diabetes training may be used to count towards continuing education.

Effective January 1, 2016, CRSB staff who provide direct support must complete twelve hours of continuing education per calendar year. Training must be taken from a DSHS approved instructor with DSHS approved curriculum.

CRSB staff may complete their CE by taking any class with curriculum approved through DSHS DDA or ALTSA home and community services (HCS).

(1) Effective January 1, 2016, all long-term care workers who work for a CRSB must complete twelve hours of continuing education as described in WAC 388-829-0220 by the end of each calendar year.

(2) For CRSB staff hired on or after January 1, 2016:

(i) CEs must not be credited during the first one hundred twenty days of employment.

(ii) Staff who hold the HCA-C must follow the rules for their certification and complete CE's based on DOH rules per chapter 246-980 WAC.

Continuing education must be on a topic relevant to the care needs of individuals in their support setting, or long-term care worker career development. Trainers must be DSHS approved. Topics or courses may include but are not limited to:

(1) Individual rights, such as freedom from abuse, neglect, abandonment and financial exploitation;

(2) Personal support/care services;

(3) Mental illness;

(4) Dementia;

(5) Developmental disabilities;

(6) Depression;

(7) Medication assistance;

(8) Communication skills;

(9) Positive individual behavior support;

(10) Developing or improving individual centered activities;

(11) Dealing with wandering or aggressive individual behaviors;

(12) Medical conditions;

(13) Staff career development;

(14) Safe food handling;

(15) CPR and first aid;

(16) Nurse delegation core training; and

(17) Nurse delegation specialized diabetes.

Specialty training, except if completed through a challenge test, may be used to meet continuing education requirements.

(1) When hours from a specialty training are counted toward basic training requirements, the hours may not be counted toward continuing education.

(2) Additional hours not used to meet the basic training requirement may be applied toward the continuing education requirement.

(3) Eighteen hour DD specialty training taken separately from the forty hour curriculum may be used as CEs. Twelve hours count towards the current year and six hours may be carried over to the following year for this training only.

The training entity must maintain written documentation of department approved continuing education for six years:

(1) Training provided by a DSHS approved agency or community instructor.

(a) Original or electronic copy of sign-in sheets with the name of the instructor, training and date.

(2) Training curriculum approval form/letter from DDA or ALTSA.

(3) Trainer approval form/letter from DDA or ALTSA.

Certificates must contain the following information:

(1) Name of the student;

(2) Title of the training;

(3) Number of hours of the training;

(4) Assigned curriculum approval code;

(5) Instructor's name, printed and signature;

(6) Printed name of the training entity giving the training;

(7) Entity program code; and

(8) Date(s) of training.

Cardiopulmonary resuscitation (CPR) is an emergency procedure performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. CPR training must be provided by an approved CPR instructor. Trainees must successfully complete the CPR course and receive a certificate.

CPR is required to be taken within the first sixty days of hire.

SECTION IX - CURRICULUM APPROVAL

(1) The department must preapprove the curriculum and instructors for all LTCW orientation, safety, basic, and continuing education taught as part of the requirements of this chapter.

(2) Training entities must use only the DSHS curriculum for the following;

(i) Nurse delegation core and diabetes training;

(ii) DDA LTCW orientation and safety (five hours);

(iii) DDA residential training (forty hours); and

(iv) DDA peer coaching (varied time length).

(3) Approval for all other trainings will be based on curriculum review, as described in WAC 388-829-0305.

Application forms must be submitted at least forty five days in advance of the training date. Approvals must be dated prior to delivery of training. The following must be submitted before the curriculum will be reviewed:

(1) CE curriculum delivery models will only be lead by a DSHS approved instructor. All learners, including online learners, must have access to an approved instructor.

(a) For instructor lead curriculum, developed by the training entity submit a DDA CE approval application that includes all of the information requested on the form, and:

(i) A summary that includes:

(A) The topic; and

(B) A description of how the training is relevant to the support setting, care needs of individuals, or long-term care worker career development.

(ii) A course outline;

(iii) The number of training hours;

(iv) The learning objectives;

(v) A bibliography listing resources used to develop the curriculum;

(vi) The trainee evaluation; and

(vii) The DDA trainer approval form indicating which trainer will be offering the course with attestation language completed.

(b) For online training courses:

(i) Everything in subsubsection 1(a) in this section; and

(ii) On-line course which meet the on-line standards provided at this link: http://www.altsa.dshs.wa.gov/Professional/training/CE/OnlineCEStandards.htm

(c) For curriculum developed by a professional curriculum developer who is not the training entity:

(i) Everything listed in subsubsection 1(a) in this section; and

(ii) A bill of sale or letter granting the training entity permission to use the curriculum.

Department developed curriculum does not require submission to the department for approval unless otherwise modified.

(1) After review of the curriculum, DSHS will send a written response to the submitter, indicating approval or disapproval of the curriculum.

(2) Reasons for denial will be identified and revised curriculum may be resubmitted for review.

(3) If revised curriculum is not approved and resolution is not reached, the submitter may seek a review of the nonapproval decision from the DDA assistant secretary or designee. The assistant secretary's review decision shall be the final decision of DSHS.

XI - INSTRUCTOR APPROVAL

The training entity is responsible for:

(1) Coordinating and teaching classes;

(2) Assuring the curriculum used is taught as designed;

(3) Assuring the trainer is approved for this curriculum;

(4) Verifying the curriculum is approved and has been assigned a code;

(5) Selecting qualified guest speakers where applicable;

(6) Establishing a method whereby the long-term care worker can ask the instructor questions;

(7) Administering or overseeing the administration of DSHS competency and challenge tests when appropriate;

(8) Maintaining training records including long-term care worker attendance records for a minimum of six years;

(9) Reporting training data to DSHS when requested by the department;

(10) Issuing or reissuing training certificates to long-term care workers; and

(11) Maintaining documentation as stated in this chapter.

(1) For all DSHS contracted training entities:

(a) DSHS must approve and/or contract with a training entity and their instructor(s) to conduct LTCW orientation, safety, basic, population specific, long-term care worker specialty, nurse delegation core and specialized diabetes training, and continuing education.

(b) DSHS may select training entities using any applicable contracting procedures. Contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through the contracting procedure.

(2) Agencies conducting their own training programs using the training curricula developed by DSHS or another curricula approved by DSHS must ensure and attest that their instructors meet the minimum qualifications for instructors under this chapter.

(3) DSHS must approve all other training entities and their instructor(s) not described in subsection (1) and (2) of this section.

(a) Community instructors who contract with DSHS for continuing education may be utilized for CEs at CRSBs.

(b) Approved community instructors who wish to provide basic training in a CRSB must take the DDA residential train the trainer course and notify the agency they work with of their certification.

(1) DSHS may deny a person or organization seeking a contract with, or approval by, DSHS to conduct training.

(2) DSHS may terminate an existing training contract in accordance with the terms of the contract. The contractor's 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 training.

(1) A guest speaker is a person selected by an approved instructor to teach a specific topic. A guest speaker:

(a) Must have demonstrated background and expertise on the topic;

(b) Must 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 based on the guest speaker's knowledge and experience in the specific topic;

(b) Maintain documentation of the guest speaker's qualifications and/or experience;

(c) Supervise and monitor the guest speaker's performance in person to ensure required content is taught; and

(d) Signs and provides the CE certificate.

(3) DSHS does not approve guest speakers.

An instructor for basic and population specific training must meet the following minimum qualifications:

(1) Twenty-one years of age or older;

(2) Has not had a professional health care, CRSB, agency, or social services license or certification revoked in Washington state; and

(3) Has the following education and work experience upon initial approval or hire:

(a) Have a bachelor's degree and work experience with persons with disabilities requiring long-term support in a community setting within the last five years; or

(b) Have an associate degree or higher degree in the field of health or human services and six months professional or support experience within the last five years in a community based setting, CRSB through DDA, or home care setting; or

(c) Have a high school diploma, or equivalent, and at least one year of professional or care giving experience within the last five years in a CRSB setting through DDA, or home care setting.

(4) Has the following 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 on adult education which includes 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) Working with adults with special training needs (for example, English as a second language or learning and literacy issues); and

(5) The instructor must be experienced in care giving practices and capable of demonstrating competency with respect to teaching the course content or units being taught.

An instructor for LTCW orientation, safety, and continuing education must have specific knowledge, training, and work experience in the provision of direct, personal support or other relevant services to persons with disabilities requiring long-term support.

The minimum qualifications for instructors for long term-care worker mental health specialty are defined in WAC 388-112-0385.

The minimum qualifications for instructors for long term-care worker dementia specialty are defined in WAC 388-112-0390.

The minimum qualifications for instructors for long term-care worker developmental disabilities specialty are defined in WAC 388-112-0395.

SECTION XII - PHYSICAL RESOURCES AND STANDARD PRACTICES FOR TRAINING

Classroom facilities and sites must be accessible to students and provide adequate space for learning activities, comfort, lighting, lack of disturbance, and tools for effective teaching and learning. Appropriate supplies and equipment must be provided for teaching and practice of skills in the class being taught.

The following training standards must be maintained for classroom training and testing:

(1) Training must not exceed eight hours within one day not including breaks and meals;

(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 a classroom training must attend the entirety of the training to receive credit.