WSR 02-10-117

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)

[ Filed April 30, 2002, 4:34 p.m. ]

Date of Adoption: April 24, 2002.

Purpose: Implements revisions of chapter 388-71 WAC requirements for staff orientation in Medicaid home care and processes for approval of instructors. New WAC 388-71-05936 as proposed in WSR 01-23-072 is being withdrawn. WAC 388-71-05936 as adopted was originally proposed as WAC 388-71-05937. Also, the department will publish a supplemental proposed rule-making notice and revised text of new WAC 388-71-05949, originally proposed as WAC 388-71-05950, which was amended as a result of public comments. The department will accept written comments and conduct a public hearing on revisions to this proposed rule.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-71-0525, 388-71-0530 and 388-71-0535; and amending WAC 388-71-0500, 388-71-0520, and 388-71-0540.

Statutory Authority for Adoption: Chapter 74.39A RCW, Long-term care services options -- Expansion.

Other Authority: Chapter 121, Laws of 2000.

Adopted under notice filed as WSR 01-23-072 on November 20, 2001.

Changes Other than Editing from Proposed to Adopted Version: The following changes have been made in response to public comments.

Rules as Proposed Changes (additions underlined, deletions struck through) Explanation of changes
WAC 388-71-05910 "Client" means an individual 18 years or older, who is receiving in-home services through Medicaid personal care, COPES, or Chore programs. As applicable, the term client also means the client's legal guardian or other surrogate decision maker. Clarify that "client" in these WACs applies only to adults.
"Outcome based training" means training that bases the curriculum design, content, delivery, and assessment on the specific knowledge, skills, and behaviors needed to demonstrate competency. "Outcome based training" is a term used in the statute but not in the WAC, so it is deleted here.
"Routine interaction" means contact with residents or clients that happens more than infrequently regularly. Under Routine Interaction, "More than infrequently" was not clear writing. The change should be more understandable.
WAC 388-71-05911 Orientation provides basic introductory information appropriate to the in-home setting and population served. The department does not approve specific orientation programs, materials, or trainers for home care agencies. Department-developed orientation materials must be used for orientation of individual providers. No test is required for orientation. Clarification.
WAC 388-71-05912 (4)(a) Methods for supporting effective communication among the client/guardian, the provider, and family members.

(6) (c) The provider's duty to refrain from interfering with protect and promote the rights of each client, and assist the client's to exercise of his or her rights;

(d) How and to whom providers should report any concerns they may have about a client's decision concerning the client's care including the client's case manager;

Clarify that communication with a guardian, when there is one, is included in this topic.

(6) (c) Clarify intention of teaching active support of clients' rights, consistent with orientation requirements for AFH and BH.

(d) Clarification pointing out the importance of the case manager.

WAC 388-71-05915 WAC 388-71-05915 What documentation is required for orientation? The home care agency or individual provider must maintain documentation of completion of orientation issued by the home care agency, area agency on aging, or DSHS office that provides the orientation, that includes:

(1) A list of the specific information and skills taught;

(2) Signatures of the instructor and trainee indicating completion of the required information and skills;

(3) The trainee's date of employment;

(4) The location of the training orientation; and

(5) The date(s) of training orientation.

Clarify who issues the documentation of completion of orientation.


Clarify that orientation includes only information, and does not include skills.


A number of people found it confusing to refer to orientation as "training," so the term is changed to "orientation."

WAC 388-71-05916(2) (2) Individual providers must complete orientation provided by DSHS or the area agency on aging (AAA) no later than fourteen calendar days after beginning to work with their first DSHS client. Individual providers who live and are providing care at a great distance from the DSHS or AAA office may be oriented by distance learning, with phone contact by the person overseeing the orientation to answer questions. Orientation must be provided by DSHS or area agency on aging (AAA) staff. Some individual providers (IPs) live, and are providing care at a great distance from a DSHS or AAA office. Those IPs may be oriented by distance learning, with phone contact by DSHS or AAA staff to answer questions. This situation is unique to individual providers.
WAC 388-71-05919 What core knowledge and skills must be taught in basic training? The Bbasic training knowledge and skills must include all of the learning outcomes and competencies published by the department, for the following core knowledge and skills:....

....The basic training outcomes and competencies may be obtained from the DSHS Aging and Adult Services Administration.

Clarifies that there are more detailed learning outcomes published by the department, in addition to the core knowledge and skills listed.


Explain where to get the outcomes and competencies for basic training.

WAC 388-71-05920 ...as provided under WAC 388-71-05940 05938 through 388-71-05946 05944 Reflects renumbering.
WAC 388-71-05922 Basic training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes: Clarify who issues the certificate.
WAC 388-71-05924 Modified basic training is a subset of the basic training curriculum designed for certain health care workers defined in WAC 388-71-05929,... Only the training curriculum developed by DSHS may be used for modified basic training. Clarifications.
WAC 388-71-05925 Modified basic training must include the following all of the outcomes and competencies published by DSHS for the following core knowledge and skills:...

The modified basic outcomes and competencies may be obtained from the DSHS Aging and Adult Services Administration.

Clarifies that there are more detailed learning outcomes published by the department, in addition to the core knowledge and skills listed.

Explain where to get the outcomes and competencies for basic training.

WAC 388-71-05926 ...as provided in under WAC 388-71-05940 05938 through 388-71-05946 05944 Reflects renumbering; make wording consistent with other sections.
WAC 388-71-05928 Modified basic training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes: Clarify who issues the certificate of successful completion.
WAC 388-71-05930 (1) Must possess a certificate... within one hundred eighty days of beginning employment; and Clarify that both (1) and (2) must be met.
WAC 388-71-05931 (1) Must:

(a) Possess a certificate of successfully completing modified basic training or the modified basic challenge test, within one hundred eighty days of beginning employment, and have documentation that the parent has received individualized or other specific instruction on the care of the adult child; or

(b) Pass the DSHS challenge test; or

(c) (b) Possess a certificate of successfully completing basic training or the basic training challenge test.

(2) Is exempt from the orientation and continuing education requirements if the parent provides care only for his or her own adult child.

(1) Clarify that taking a class or the challenge test for that class meets the requirements.

(2) Clarify that this applies only if the parent provides care only for his or her own adult child.

WAC 388-71-05933 (1) Individual providers and home care agency providers 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. Clarification of when CE requirement begins, based on changes in the statute made in SHB 2707, 2002 legislative session.
WAC 388-71-05936

Section deleted and withdrawn as proposed in WSR 01-23-072. See new WAC 388-71-036 below. Change in the law made this unnecessary and inaccurate.
WAC # as Proposed


WAC 388-71-05937

WAC 388-71-05938

WAC 388-71-05939

WAC 388-71-05940

WAC 388-71-05941

WAC 388-71-05942

WAC 388-71-05943

WAC 388-71-05944

WAC 388-71-05945

WAC 388-71-05946

WAC 388-71-05947

WAC 388-71-05948

WAC 388-71-05949

WAC 388-71-05950

WAC 388-71-05951

WAC 388-71-05952

WAC 388-71-05953

WAC # as Adopted


WAC 388-71-05936

WAC 388-71-05937

WAC 388-71-05938

WAC 388-71-05939

WAC 388-71-05940

WAC 388-71-05941

WAC 388-71-05942

WAC 388-71-05943

WAC 388-71-05944

WAC 388-71-05945

WAC 388-71-05946

WAC 388-71-05947

WAC 388-71-05948

WAC 388-71-05949

WAC 388-71-05950

WAC 388-71-05951

WAC 388-71-05952

Editing and renumbering.
WAC 388-71-05938 WAC 388-71-05937 8 Home care individual providers must provide DSHS or the area agency on aging with proof documentation of completion of continuing education credits. Clarification.
WAC 388-71-05939 WAC 388-71-05938 9 Competency testing, including challenge testing,... Clarify that challenge testing is included in references to competency testing.
WAC 388-71-05941 WAC 388-71-05940 1 Individuals who perform competency testing must have documentable documented experience or training in assessing competencies. Edit.
WAC 388-71-05943 WAC 388-71-05942 3 How must competency test administration be standardized? To standardize competency test administration... Clarification.
WAC 388-71-05945 WAC 388-71-05944 5 A competency test that is part of a course may be taken twice ...administered. 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. Differentiate testing procedures for testing as part of a class, and challenge testing.
WAC 388-71-05946 WAC 388-71-05945 6 The instructor or training entity is responsible for: Where there is an educational entity such as a community college or private business that provides training, the training entity holds some of these responsibilities.
WAC 388-71-05947 WAC 388-71-05946 7

DSHS contracts with area agencies on aging (AAA) or other entities to conduct orientation, basic, modified basic, and continuing education training programs for individual providers and home care agency providers. The AAA training entity must approve any instructor under contract with the AAA entity to conduct training programs. The AAA's entity's contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through the AAA's entity's contracting procedures.

DSHS contracts with other educational entities besides AAAs.
WAC 388-71-05948 WAC 388-71-05947 8 When cCan DSHS or the AAA not approve an instructor?

(1) DSHS... programs. No administrative remedies are available to dispute DSHS' or the AAA's decision not to accept an offer, except as may be provided through the contracting process.

This change clarifies that the applicable contracting procedure determines what remedies may be available.
WAC 388-71-05950


WAC 388-71-05949 50 Not included. The department will publish a supplemental proposed rule-making notice and revised text of proposed new WAC 388-71-05950, which was amended as a result of public comments. The department will accept written comments and conduct a public hearing on revisions to this proposed rule.
WAC 388-71-05952 WAC 388-71-05951 2 What must be included in a class on principles of adult education theory and practice? A class on adult education theory and principles must include... Editing.
WAC 388-71-05953 WAC 388-71-05952 3

(1) Training, including all breaks, must not exceed eight hours within a day twenty-four hour period;

Clarify "training" to include instruction or testing time plus breaks.
WAC 388-71-0500 What is the purpose of WAC 388-71-0500 through 388-71-0580 05952? A client/legal representative may choose an individual provider or a home care agency provider. The intent of WAC 388-71-0500 through 388-71-0580 388-71-05952... Correct numbering.
WAC 388-71-0520 An individual provider or a home care agency provider for an adult client must meet the training requirements in WAC 388-71-05910 through 388-71-05952. Correct numbering.
WAC 388-71-0540 (6) Does not successfully complete the training requirements within the time limits required in WAC 388-71-05910 through 388-71-05952;... Correct numbering.

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 42, Amended 3, Repealed 3.

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 42, Amended 3, Repealed 3; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 0, Repealed 0.
Effective Date of Rule: Thirty-one days after filing.

April 24, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3006.6
AMENDATORY SECTION(Amending WSR 01-11-019, filed 5/4/01, effective 6/4/01)

WAC 388-71-0500   What is the purpose of WAC 388-71-0500 through ((388-71-0580)) 388-71-05952?   A client/legal representative may choose an individual provider or a home care agency provider. The intent of WAC 388-71-0500 through ((388-71-0580)) 388-71-05952 is to describe the:

(1) Qualifications of an individual provider, as defined in WAC 388-15-202 (25) and (26);

(2) Qualifications of a home care agency provider, as defined in WAC 388-15-202(2) and chapter 246-336 WAC;

(3) Conditions under which the department or the area agency on aging (AAA) will pay for the services of an individual provider or a home care agency provider;

(4) Training requirements for an individual provider and home care agency provider.

[Statutory Authority: R.W. 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830, 74.39.095. 01-11-019, 388-71-0500, filed 5/4/01, effective 6/4/01. Statutory Authority: R.W. 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. 00-03-043, 388-71-0500, filed 1/13/00, effective 2/13/00.]


AMENDATORY SECTION(Amending WSR 00-03-043, filed 1/13/00, effective 2/13/00)

WAC 388-71-0520   Are there ((educational)) training requirements for an individual provider or a home care agency provider of an adult client?   ((There are educational requirements for an)) An individual provider or a home care agency ((employee)) provider for an adult client must meet the training requirements in WAC 388-71-05910 through 388-71-05952. ((They must:

(1) Possess a certificate of successfully completing department-designated fundamentals of care giving training within one hundred and twenty days after beginning employment;

(2) Complete a minimum of ten hours of continuing education credits each calendar year following the year in which the fundamentals of care giving training is taken. One hour of completed instruction equals one hour of credit on topics that pertain to services provided in an in-home setting including, but not limited to:

(a) Client's rights;

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

(c) Mental illness;

(d) Dementia;

(e) Depression;

(f) Medication assistance;

(g) Communication skills;

(h) Alternatives to restraints;

(I) Activities for clients; and

(3) Provide the department/AAA with proof of completion of continuing education credits.))

[Statutory Authority: R.W. 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. 00-03-043, 388-71-0520, filed 1/13/00, effective 2/13/00.]


AMENDATORY SECTION(Amending WSR 01-11-019, filed 5/4/01, effective 6/4/01)

WAC 388-71-0540   When will the department or AAA deny payment for services of an individual provider or home care agency provider?   The department or AAA will deny payment for the services of an individual provider or home care agency provider who:

(1) Is the client's spouse, per 42 C.F.A. 441.360(g), except in the case of an individual provider for a Chore services client. Note: For Chore espousal providers, the department pays a rate not to exceed the amount of a one-person standard for a continuing general assistance grant, per WAC 388-478-0030;

(2) Is the natural/step/adoptive parent of a minor client aged seventeen or younger receiving services under this chapter;

(3) Has been convicted of a disqualifying crime, under R.W. 43.43.830 and 43.43.842 or of a crime relating to drugs as defined in R.W. 43.43.830;

(4) Has abused, neglected, abandoned, or exploited a minor or vulnerable adult, as defined in chapter 74.34 R.W.;

(5) Has had a license, certification, or a contract for the care of children or vulnerable adults denied, suspended, revoked, or terminated for noncompliance with state and/or federal regulations;

(6) Does not successfully complete the training requirements within the time limits required in WAC ((388-71-0520)) 388-71-05910 through 388-71-05952;

(7) Is already meeting the client's needs on an informal basis, and the client's assessment or reassessment does not identify any unmet need; and/or

(8) Is terminated by the client (in the case of an individual provider) or by the home care agency (in the case of an agency provider).

(9) In addition, the department or AAA may deny payment to or terminate the contract of an individual provider as provided under WAC 388-71-0546, 388-71-0551, and 388-71-0556.

[Statutory Authority: R.W. 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830, 74.39.095. 01-11-019, 388-71-0540, filed 5/4/01, effective 6/4/01. Statutory Authority: R.W. 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. 00-03-043, 388-71-0540, filed 1/13/00, effective 2/13/00.]

Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-71-0525 Are there any exemptions from the training requirements?
WAC 388-71-0530 Are there special rules about training for parents who are the individual providers of division of developmental disabilities (DID) adult children?
WAC 388-71-0535 Are there special rules about training for parents who are the individual providers of non-DID adult children?
3013.10
NEW SECTION
WAC 388-71-05910   What definitions apply to WAC 388-71-05911 through 388-71-05952?   "Client" means an individual age eighteen or older, receiving in-home services through Medicaid personal care, COPES, or Chore programs. As applicable, the term client also means the client's legal guardian or other surrogate decision maker.

"Competency" means the minimum level of information and skill trainees are required to know and be able to demonstrate.

"DSHS" refers to the department of social and health services.

"Learning outcomes" means the specific information, skills and behaviors desired of the learner as a result of a specific unit of instruction, such as what they would learn by the end of a single class or an entire course. Learning outcomes are generally identified with a specific lesson plan or curriculum.

"Routine interaction" means contact with clients that happens regularly.

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NEW SECTION
WAC 388-71-05911   What is orientation?   Orientation provides basic introductory information appropriate to the in-home setting and population served. The department does not approve specific orientation programs, materials, or trainers for home care agencies. Department-developed orientation materials must be used for orientation of individual providers. No test is required for orientation.

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NEW SECTION
WAC 388-71-05912   What content must be included in an orientation?   Orientation may include the use of videotapes, audiotapes, and other media if the person overseeing the orientation is available to answer questions or concerns for the person(s) receiving the orientation. Orientation must include introductory information in the following areas:

(1) The care setting;

(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 where they exist);

(c) Ways to handle client injuries and falls or other accidents;

(d) Potential risks to clients or providers (for instance, aggressive client behaviors and how to handle them); and

(e) The location of agency policies and procedures, when orientation takes place in a home care agency.

(4) Communication skills and information, including:

(a) Methods for supporting effective communication among the client/guardian, the provider, and family members;

(b) Use of verbal and nonverbal communication;

(c) Review of written communications and/or documentation required for the job, including the client's service plan; and

(d) Whom to contact about problems and concerns.

(5) Universal precautions and infection control, including:

(a) Proper hand washing techniques;

(b) Protection from exposure to blood and other body fluids;

(c) Appropriate disposal of contaminated/hazardous articles;

(d) Reporting exposure to contaminated articles, blood, or other body fluids; and

(e) What a provider should do if they are ill.

(6) Client rights, including:

(a) The client's right to confidentiality of information about the client;

(b) The client's right to participate in decisions about the client's care, and to refuse care;

(c) The provider's duty to protect and promote the rights of each client, and assist the client to exercise his or her rights;

(d) How and to whom providers should report any concerns they may have about a client's decision concerning the client's care, including the client's case manager;

(e) Providers' duty to report any suspected abuse, abandonment, neglect, or exploitation of a client;

(f) Advocates that are available to help clients (LTC ombudsmen, organizations); and

(g) Complaint lines, hot lines, and client grievance procedures.

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NEW SECTION
WAC 388-71-05913   Is competency testing required for orientation?   There is no competency testing required for orientation.

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NEW SECTION
WAC 388-71-05914   Is there a challenge test for orientation?   There is no challenge test for orientation.

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NEW SECTION
WAC 388-71-05915   What documentation is required for orientation?   The home care agency or individual provider must maintain documentation of completion of orientation, issued by the home care agency, area agency on aging, or DSHS office that provides the orientation, that includes:

(1) The trainee's name;

(2) A list of the specific information taught;

(3) Signature of the person overseeing the orientation indicating completion of the required information;

(4) The trainee's date of employment;

(5) The location of the orientation; and

(6) The date(s) of orientation.

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NEW SECTION
WAC 388-71-05916   Who is required to complete orientation, and when must it be completed?   (1) Home care agency providers must complete orientation before working with the agency's clients. Orientation must be provided by appropriate agency staff.

(2) Individual providers must complete orientation provided by DSHS or the area agency on aging (AAA) no later than fourteen calendar days after beginning to work with their first DSHS client. Individual providers who live and are providing care at a great distance from the DSHS or AAA office may be oriented by distance learning, with phone contact by the person overseeing the orientation to answer questions.

(3) Parents who are individual providers for their adult children are exempt from the orientation requirement.

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NEW SECTION
WAC 388-71-05917   What is basic training?   Basic training includes the core knowledge and skills that providers need to provide personal care services effectively and safely. Only the training curriculum developed by DSHS may be used for basic training.

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NEW SECTION
WAC 388-71-05918   Is there an alternative to the basic training for some health care workers?   Certain health care workers may complete the modified basic training instead of basic training if they meet the requirements in WAC 388-71-05929.

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NEW SECTION
WAC 388-71-05919   What core knowledge and skills must be taught in basic training?   The basic training knowledge and skills must include all of the learning outcomes and competencies published by the department for the following core knowledge and skills:

(1) Understanding and using effective interpersonal and problem solving skills with clients, family members, and other care team members;

(2) Taking appropriate action to promote and protect client rights, dignity, and independence;

(3) Taking appropriate action to promote and protect the health and safety of the client and the caregiver;

(4) Correctly performing required personal care tasks while incorporating client preferences, maintaining the client's privacy and dignity, and creating opportunities that encourage client independence;

(5) Adhering to basic job standards and expectations.

The basic training learning outcomes and competencies may be obtained from the DSHS Aging and Adult Services Administration.

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NEW SECTION
WAC 388-71-05920   Is competency testing required for basic training?   Competency testing is required for basic training as provided under WAC 388-71-05938 through 388-71-05944.

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NEW SECTION
WAC 388-71-05921   Is there a challenge test for basic training?   Individuals may take the DSHS challenge test instead of the required training. If a person does not pass a challenge test on the first attempt, they may not re-take the challenge test and must attend a class.

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NEW SECTION
WAC 388-71-05922   What documentation is required for successful completion of basic training?   Basic training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes:

(1) The name of the trainee;

(2) The name of the training;

(3) The location of the training;

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

(5) The date(s) of training.

The trainee must retain the original certificate. A home care agency must keep a copy of the certificate on file. An individual provider must give a copy of the certificate to DSHS or area agency on aging.

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NEW SECTION
WAC 388-71-05923   Who is required to complete basic training, and when?   Individual providers and home care agency providers must complete department-developed basic training and demonstrate competency within one hundred twenty days after beginning to work with their first DSHS client.

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NEW SECTION
WAC 388-71-05924   What is modified basic training?   Modified basic training is a subset of the basic training curriculum designed for certain health care workers defined in WAC 388-71-05929, whose previous training includes many of the competencies taught in the full basic training. Only the training curriculum developed by DSHS may be used for modified basic training.

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NEW SECTION
WAC 388-71-05925   What knowledge and skills must be included in modified basic training?   Modified basic training must include all of the learning outcomes and competencies published by DSHS for the following core knowledge and skills:

(1) Client rights, including mandatory reporting requirements;

(2) Medication assistance regulations;

(3) Nurse delegation regulations;

(4) Assessment and observations in home and community settings;

(5) Documentation in home and community settings;

(6) Service planning in home and community care settings;

(7) Resource information, including information on continuing education; and

(8) Self-directed care regulations.

The modified basic learning outcomes and competencies may be obtained from the DSHS aging and adult services administration.

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NEW SECTION
WAC 388-71-05926   Is competency testing required for modified basic training?   Competency testing is required for modified basic training as provided under WAC 388-71-05938 through 388-71-05944.

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NEW SECTION
WAC 388-71-05927   Is there a challenge test for modified basic training?   Individuals may take the department's challenge test instead of the required training. If a person does not pass a challenge test on the first attempt, they may not re-take the challenge test and must attend the class.

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NEW SECTION
WAC 388-71-05928   What documentation is required for successful completion of modified basic training?   Modified basic training must be documented by a certificate of successful completion of training, issued by the instructor or training entity, that includes:

(1) The name of the trainee;

(2) The name of the training;

(3) The location of the training;

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

(5) The date(s) of training.

The trainee must retain the original certificate. A home care agency must keep a copy of their employees' certificates on file. An individual provider must give a copy to DSHS or area agency on aging.

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NEW SECTION
WAC 388-71-05929   Who may take modified basic training instead of the full basic training?   Modified basic training may be taken, instead of the full basic training, by a person who can document they have successfully completed training as a registered or licensed practical nurse, certified nursing assistant, physical therapist, occupational therapist, or Medicare-certified home health aide. In addition, modified basic training may be taken by a natural, step, or adoptive parent who is the individual provider for his or her adult child who is not receiving services through DSHS' division of developmental disabilities.

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NEW SECTION
WAC 388-71-05930   What are the training requirements and exemptions for parents who are individual providers for their adult children receiving services through DDD?   A natural, step, or adoptive parent who is the individual provider for his or her adult child who is receiving services through DSHS' division of developmental disabilities (DDD):

(1) Must possess a certificate of successfully completing a six-hour DDD-approved training or a specially designed DSHS-approved training within one hundred eighty days of beginning employment; and

(2) Is exempt from the orientation, basic training, and continuing education requirements if the parent provides care only for his or her own adult child.

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NEW SECTION
WAC 388-71-05931   What are the training requirements and exemptions for parents who are individual providers for their adult children who do not receive services through DDD?   A natural, step, or adoptive parent who is the individual provider for his or her adult child who is not receiving services through DSHS' division of developmental disabilities:

(1) Must:

(a) Possess a certificate of successfully completing modified basic training or the modified basic challenge test within one hundred eighty days of beginning employment, and have documentation that the parent has received individualized or other specific instruction on the care of the adult child; or

(b) Possess a certificate of successfully completing basic training or the basic training challenge test.

(2) Is exempt from the orientation and continuing education requirements if the parent provides care only for his or her own adult child.

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NEW SECTION
WAC 388-71-05932   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.

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NEW SECTION
WAC 388-71-05933   How many hours of continuing education are required each year?   (1) Individual providers and home care agency providers 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.

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NEW SECTION
WAC 388-71-05934   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 clients, including but not limited to:

(1) Client 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 client behavior support;

(10) Developing or improving client centered activities;

(11) Dealing with wandering or aggressive client behaviors; and

(12) Medical conditions.

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NEW SECTION
WAC 388-71-05935   Is competency testing required for continuing education?   Competency testing is not required for continuing education.

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NEW SECTION
WAC 388-71-05936   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.

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NEW SECTION
WAC 388-71-05937   What are the documentation requirements for continuing education?   (1) The home care agency or individual provider 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 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) Home care individual providers must provide DSHS or the area agency on aging with documentation of completion of continuing education credits.

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NEW SECTION
WAC 388-71-05938   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.

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NEW SECTION
WAC 388-71-05939   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 knowledge of the learning outcomes included in the training; and

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

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NEW SECTION
WAC 388-71-05940   What experience or training must individuals have to be able to perform competency testing?   Individuals who perform competency testing must have documented experience or training in assessing competencies.

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NEW SECTION
WAC 388-71-05941   What training must include the DSHS-developed competency test?   Basic and modified basic training must include the DSHS-developed competency test.

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NEW SECTION
WAC 388-71-05942   How must competency test administration be standardized?   To standardize competency test administration, testing must include the following components:

(1) An instructor for the course who meets all minimum qualifications for the course he or she teaches must oversee all testing; and

(2) The tester must follow 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.

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NEW SECTION
WAC 388-71-05943   What form of identification must providers show a tester before taking a competency or challenge test?   Providers must show a tester photo identification before taking a competency test (or challenge test, when applicable) for basic or modified basic training.

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NEW SECTION
WAC 388-71-05944   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.

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NEW SECTION
WAC 388-71-05945   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.

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NEW SECTION
WAC 388-71-05946   Must instructors be approved by DSHS or an AAA?   (1) DSHS must approve any instructor under contract with DSHS to conduct basic or modified basic training classes using the training curricula developed by DSHS. DSHS may select contracted instructors 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) DSHS contracts with area agencies on aging (AAA) or other entities to conduct orientation, basic, modified basic, and continuing education training programs for individual providers and home care agency providers. The training entity must approve any instructor under contract with the entity to conduct training programs. The entity's contractors must meet the minimum qualifications for instructors under this chapter and any additional qualifications established through the entity's contracting procedures.

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NEW SECTION
WAC 388-71-05947   Can DSHS or the AAA deny or terminate a contact with an instructor or training entity?   (1) DSHS or an area agency on aging (AAA), as applicable, may determine not to accept an offer by a person or organization seeking a contract with DSHS or the AAA to conduct training programs. No administrative remedies are available to dispute DSHS' or the AAA's decision not to accept an offer, except as may be provided through the contracting process.

(2) DSHS or the AAA may terminate any training contract in accordance with the terms of the contract. The contractor's administrative remedies shall be limited to those specified in the contract.

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NEW SECTION
WAC 388-71-05948   What is a guest speaker, and what are the minimum qualifications to be a guest speaker for basic training?   Guest speakers for basic training programs teach a specific subject in which they have expertise, under the supervision of the instructor. The 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.

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NEW SECTION
WAC 388-71-05950   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).

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NEW SECTION
WAC 388-71-05951   What physical resources are required for basic or modified basic classroom training and testing?   (1) Classroom facilities used for basic or modified basic 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.

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NEW SECTION
WAC 388-71-05952   What standard training practices must be maintained for basic or modified basic classroom training and testing?   The following training standards must be maintained for basic or modified basic 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.

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Washington State Code Reviser's Office