WSR 11-10-028

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed April 27, 2011, 9:28 a.m. , effective April 29, 2011 ]


Effective Date of Rule: April 29, 2011.

Purpose: The purpose of the new language in chapters 388-71, 388-112, 388-829A, and 388-829C WAC is to implement and clarify the training requirements and the criminal history background check requirements as directed in chapter 74.39A RCW. These rules were originally filed as an emergency CR-103 as WSR 11-02-033, effective January 1, 2011. This emergency rule filing will extend these emergency rules beyond April 28, 2011. Chapter 74.39A RCW requires training for long-term care workers which includes seventy-five hours of entry-level training and also requires federal and state criminal history background checks for all long-term care workers. This law increases the basic training hour requirements for long-term care workers from thirty-two hours to seventy-five hours and increases their continuing education hour requirement from ten to twelve hours annually.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-71-05665, 388-71-05670, 388-71-05675, 388-71-05680, 388-71-05685, 388-71-05690, 388-71-05695, 388-71-05700, 388-71-05705, 388-71-05710, 388-71-05715, 388-71-05720, 388-71-05725, 388-71-05730, 388-71-05735, 388-71-05740, 388-71-05745, 388-71-05750, 388-71-05755, 388-71-05760, 388-71-05765, 388-71-05770, 388-71-05775, 388-71-05780, 388-71-05785, 388-71-05790, 388-71-05795, 388-71-05799, 388-71-05805, 388-71-05810, 388-71-05815, 388-71-05820, 388-71-05825, 388-71-05830, 388-71-05832, 388-71-05835, 388-71-05840, 388-71-05845, 388-71-05850, 388-71-05855, 388-71-05860, 388-71-05865, 388-71-05870, 388-71-05875, 388-71-05880, 388-71-05885, 388-71-05890, 388-71-05895, 388-71-05899, 388-71-05905, 388-71-05909, 388-71-0801, 388-71-0806, 388-71-0811, 388-71-0816, 388-71-0821, 388-71-0826, 388-112-0025, 388-112-0030, 388-112-0050, 388-112-0060, 388-112-0065, 388-112-0080, 388-112-0085, 388-112-0090, 388-112-0095, 388-112-0100, 388-112-0105, 388-112-0245, 388-112-02610, 388-112-02615, 388-112-02620, 388-112-02625, 388-112-02630, and 388-112-0375; and amending WAC 388-71-0500, 388-71-0505, 388-71-0510, 388-71-0513, 388-71-0515, 388-71-0520, 388-71-0540, 388-71-0546, 388-71-0551, 388-71-0560, 388-112-0001, 388-112-0003, 388-112-0005, 388-112-0010, 388-112-0015, 388-112-0035, 388-112-0040, 388-112-0045, 388-112-0055, 388-112-0070, 388-112-0075, 388-112-0110, 388-112-0115, 388-112-0120, 388-112-0125, 388-112-0130, 388-112-0135, 388-112-0140, 388-112-0145, 388-112-0150, 388-112-0155, 388-112-0160, 388-112-0165, 388-112-0195, 388-112-0200, 388-112-0205, 388-112-0210, 388-112-0220, 388-112-0225, 388-112-0230, 388-112-0235, 388-112-0240, 388-112-0255, 388-112-0260, 388-112-0270, 388-112-0295, 388-112-0300, 388-112-0315, 388-112-0320, 388-112-0325, 388-112-0330, 388-112-0335, 388-112-0340, 388-112-0345, 388-112-0350, 388-112-0355, 388-112-0360, 388-112-0365, 388-112-0370, 388-112-0380, 388-112-0385, 388-112-0390, 388-112-0395, 388-112-0405, 388-112-0410, 388-829A-050, and 388-829C-040.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, Washington state 2009-11 budget (ESHB 1244, 206(5)).

Under RCW 34.05.350 the agency for good cause finds that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

Reasons for this Finding: Emergency adoption of these rules is necessary in order to comply with state law which requires implementation of these training rules by January 1, 2011. These rules were to be adopted by August 1, 2010. However, given the significant number of stakeholder comments received after the CR-102 hearing, the department needed to fully vet the additional comments and thus the rules could not be adopted by August 1, 2010. They were adopted as emergency rules in order to comply with the January 1, 2011, legislatively mandated date for implementation. This emergency rule filing will extend these emergency rules beyond April 28, 2011.

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 83, Amended 67, Repealed 74.

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 83, Amended 67, Repealed 74.

Date Adopted: April 15, 2011.

Katherine I. Vasquez

Rules Coordinator

4200.5
AMENDATORY SECTION(Amending WSR 05-11-082, filed 5/17/05, effective 6/17/05)

WAC 388-71-0500   What is the purpose of WAC 388-71-0500 through (([388-71-05952] [388-71-05909])) 388-71-0562 and 388-71-0836 through 388-71-1006?   ((A client/legal representative may choose an individual provider or a home care agency provider.)) The ((intent)) purpose of WAC 388-71-0500 through (([388-71-05952] [388-71-05909])) 388-71-0562 and WAC 388-71-0836 through 388-71-1006 is to describe the:

(1) Qualifications of an individual provider, as defined in WAC 388-106-0010;

(2) Qualifications of a long-term care worker employed by a home care agency ((provider)), as defined in WAC 388-106-0010 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)) long-term care worker;

(4) Training requirements for an individual provider and home care agency ((provider)) long-term care worker.

A client, as described in WAC 388-71-0836 eligible to receive long-term care services, or his/her legal representative on the client's behalf, may choose to receive personal care services in the client's home from an individual provider or a long-term care worker from a home care agency. If the client chooses to receive services from a home care agency, the agency will assign a long-term care worker employed by the agency to provide services to the client. Individual providers and home care agency long-term care workers are "long-term care workers" as defined in RCW 74.39A.009 and are subject to background checks under RCW 74.39A.055 and 43.20.710.

[Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-71-0500, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.39A.090. 02-21-098, 388-71-0500, filed 10/21/02, effective 11/21/02. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, 388-71-0500, filed 4/30/02, effective 5/31/02. Statutory Authority: RCW 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: RCW 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 01-11-019, filed 5/4/01, effective 6/4/01)

WAC 388-71-0505   How does a client hire an individual provider?   The client, or legal representative:

(1) Has the primary responsibility for locating, screening, hiring, supervising, and terminating an individual provider;

(2) Establishes an employer/employee relationship with the individual provider; and

(3) May receive assistance from the social worker/case manager or other resources in this process.

[Statutory Authority: RCW 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, 388-71-0505, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 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, 388-71-0505, filed 1/13/00, effective 2/13/00.]


AMENDATORY SECTION(Amending WSR 04-16-029, filed 7/26/04, effective 8/26/04)

WAC 388-71-0510   How does a person become an individual provider?   In order to become an individual provider, a person must:

(1) Be eighteen years of age or older;

(2) Provide the social worker/case manager/designee with:

(a) A valid Washington state driver's license or other valid picture identification; and either

(b) A Social Security card; or

(c) Proof of authorization to work in the United States as required on the employment verification form.

(3) ((Complete and submit to the social worker/case manager/designee)) Prior to January 1, 2012, be screened through the department's ((criminal conviction)) background ((inquiry application, unless the provider is also the parent of the adult DDD client and exempted, per chapter 74.15 RCW;)) check process:

(a) Preliminary results may require a thumb print for identification purposes;

(b) ((An FBI)) A fingerprint-based background check is required if:

(i) The person has lived in the state of Washington less than three consecutive years immediately before the date of the background check; or

(ii) The department has reasonable cause to believe the person has a conviction, pending charges, and/or negative actions in another state.

(4) Effective January 1, 2012, be screened through the department's fingerprint-based background check, as required by RCW 74.39A.055. As provided in RCW 43.20A.710, results of the background check are provided to the department and employer for the purpose of determining:

(a) Whether the person is disqualified based on a disqualifying crime or negative action; or

(b) Whether the person should or should not be employed as an individual provider based on his or her character, competence, and/or suitability.

(c) Disqualifying crimes and negative actions are those listed in WAC 388-71-0540 (5) and (6).

(5) Sign a home and community-based service provider contract/agreement to provide services to a COPES, MNIW, PACE, WMIP, or medicaid personal care client, or sign a contract as an individual provider to provide services to a New Freedom waiver, WMIP, or PACE client under chapter 388-106 WAC.

[Statutory Authority: 2004 c 276 206 (6)(b) and Townsend vs. DSHS, U.S. District Court, Western District of Washington, No. C 00-0944Z. 04-16-029, 388-71-0510, filed 7/26/04, effective 8/26/04. Statutory Authority: RCW 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, 388-71-0510, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 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, 388-71-0510, filed 1/13/00, effective 2/13/00.]


NEW SECTION
WAC 388-71-0512   What is included in the department's fingerprint-based background check?   The department's fingerprint-based background check includes a check of:

(1) Records contained in databases maintained by the Washington state patrol and the Federal Bureau of Investigation, including records of:

(a) Pending charges; and

(b) criminal conviction.

(2) Records maintained:

(a) In the national sex offenders registry;

(b) By the Washington state department of corrections;

(c) By Washington courts; and

(d) In the justice information system.

(3) Records of negative actions, final findings, or civil adjudication proceedings of any agency or subagency including, but not limited to:

(a) DSHS adult protective services;

(b) DSHS residential care services;

(c) DSHS children's protective services;

(d) The Washington state department of health;

(e) The nursing assistant registry; and

(f) Any pending charge, criminal conviction, civil adjudicative proceeding and/or negative action disclosed by the applicant.

(4) Any "civil adjudication proceeding", which is a judicial or administrative adjudicative proceeding that results in a finding of, or upholds any agency finding of, domestic violence, abuse, sexual abuse, exploitation, financial exploitation, neglect, abandonment, violation of a child or vulnerable adult under any provision of law, including but not limited to chapters 13.34, 26.44, or 74.34 RCW or rules adopted under chapters 18.51 and 74.42 RCW. "Civil adjudication proceeding" also includes judicial or administrative findings that become final due to the failure of the alleged perpetrator to timely exercise a legal right to administratively challenge such findings.

(5) Negative actions which include the denial, suspension, revocation, or termination of a license, certification, or contract for the care of children, as defined in RCW 26.44.020, or vulnerable adults, as defined in RCW 74.34.020, for noncompliance with any state or federal regulation.

(6) Except as prohibited by federal law, results are shared with the employer or prospective employer and with the department of health as authorized.

[]


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

WAC 388-71-0513   Is a background check required of a long-term care worker employed by a home care agency ((provider))?   In order to be a long-term care worker employed by a home care agency ((provider)), a person who works for a home care agency that has a contract with the department must ((complete)):

(1) Prior to January 1, 2012, be screened through the department's ((criminal conviction)) background ((inquiry application, which is submitted by the agency to the department. This includes an FBI fingerprint-based background check if the home care agency provider has lived in the state of Washington less than three years)) check process:

(a) Preliminary results may require a thumb print for identification purposes; and

(b) A fingerprint-based background check is required if the long-term care worker employed by a home care agency has lived in the state of Washington for less than three consecutive years immediately before the date of the background check.

(2) Effective January 1, 2012, be screened through the department's fingerprint-based background check, as required by RCW 74.39A.055. As provided by RCW 43.20A.710, results are provided to the department and home care agency for the purpose of determining:

(a) Whether the person is disqualified from being a home care agency long-term care worker based on a disqualifying crime, civil adjudication proceeding, or negative action as defined under WAC 388-71-0512; and

(b) Whether the person should or should not be employed as a home care agency long-term care worker based on his or her character, competence, and/or suitability. Except as prohibited by federal law, results are shared with the employer or prospective employer and the department of health for purposes of making this determination.

(3) Disqualifying crimes, civil adjudicative proceedings, and negative actions are listed in WAC 388-71-0540.

(4) Effective January 1, 2012, all home care agencies, including those that do not have a contract to provide in-home care services to department clients, must initiate the required background check upon the date of the long-term care worker's hire.

(5) The required background check on long-term care workers employed by home care agencies will be performed at department expense; home care agencies are not responsible for payment for the required background check.

[Statutory Authority: RCW 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, 388-71-0513, filed 5/4/01, effective 6/4/01.]


NEW SECTION
WAC 388-71-0514   Can an individual provider or home care agency long-term care worker work pending the outcome of the fingerprint-based background check?   An individual provider or home care agency long-term care worker may work up to one hundred twenty days pending the outcome of the fingerprint-based background check provided that the person is not disqualified as a result of the department's background check.

[]


AMENDATORY SECTION(Amending WSR 10-06-112, filed 3/3/10, effective 4/3/10)

WAC 388-71-0515   What are the responsibilities of an individual provider ((or home care agency provider)) when ((employed to provide)) providing care to a client?   An individual provider ((or home care agency provider)) must:

(1) Understand the client's plan of care that is signed by the client or legal representative ((and social worker/case manager)), and which may be translated or interpreted, as necessary, for the client and the provider;

(2) Provide the services as outlined on the client's plan of care, as ((defined)) described in WAC 388-106-0010;

(3) Accommodate the client's individual preferences and ((differences)) unique needs in providing care;

(4) Contact the ((client's)) client, client's representative and case manager when there are changes ((which)) that affect the personal care and other tasks listed on the plan of care;

(5) Observe ((the client for)) and consult with the client or representative, regarding change(s) in health, take appropriate action, and respond to emergencies;

(6) Notify the case manager immediately when the client enters a hospital, or moves to another setting;

(7) Notify the case manager immediately ((if)) in the event of the ((client dies)) client's death;

(8) Notify the department or AAA immediately when unable to staff/serve the client; and

(9) Notify the department/AAA when the individual provider ((or home care agency)) will no longer provide services. ((Notification to the client/legal guardian)) The individual provider must:

(a) Give at least two weeks' notice, and

(b) ((Be)) Notify the client or legal guardian in writing.

(10) Complete and keep accurate time sheets that are accessible to the social worker/case manager; and

(11) Comply with all applicable laws and regulations.

(((12) A home care agency must not bill the department for in-home medicaid funded personal care or DDD respite services when the agency employee providing care is a family member of the client served, unless approved to do so through an exception to rule under WAC 388-440-0001. For purposes of this section, family member means related by blood, marriage, adoption, or registered domestic partnership.))

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 571, and Washington state 2009-11 budget, section 206(17). 10-06-112, 388-71-0515, filed 3/3/10, effective 4/3/10. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-71-0515, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.39A.090. 02-21-098, 388-71-0515, filed 10/21/02, effective 11/21/02. Statutory Authority: RCW 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, 388-71-0515, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 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, 388-71-0515, filed 1/13/00, effective 2/13/00.]


NEW SECTION
WAC 388-71-0516   What are the responsibilities of home care agency when providing care to a client?   In providing care to a client, a home care agency must:

(1) Ensure that the assigned home care agency long-term care worker(s) understands the client's plan of care that is signed by the client or legal representative, and which may be translated or interpreted, as necessary, for the client and the assigned home care agency long-term care worker(s);

(2) Provide services as outlined in a client's plan of care, as described in WAC 388-106-0010;

(3) Accommodate the client's individual preferences and unique needs in providing care;

(4) Contact the client, client's representative and case manager when there are changes observed by the assigned home care agency long-term care worker that affect the personal care and other tasks listed on the plan of care;

(5) Ensure that the assigned home care agency long-term care worker(s) observes the client for and consults with the client or representative, regarding change(s) in health, takes appropriate action, and responds to emergencies;

(6) Notify the case manager immediately when the client enters a hospital, or moves to another setting;

(7) Notify the case manager immediately in the event of the client's death;

(8) Notify the department or AAA immediately when unable to staff/serve the client;

(9) Notify the department/AAA when the home care agency will no longer provide services. The home care agency must:

(a) Give at least two weeks' notice; and

(b) Notify the client or legal guardian in writing.

(10) Complete and keep accurate time sheets that are accessible to the social worker/case manager; and

(11) Comply with all applicable laws and regulations.

[]


NEW SECTION
WAC 388-71-0517   What are the responsibilities of a home care agency when the home care agency long-term care worker is a family member of the client and the client is receiving in-home medicaid-funded personal care or DDD respite services?   A home care agency must not bill the department for in-home medicaid-funded personal care or DDD respite services when the agency employee providing care is a family member of the client served, unless approved to do so through an exception to rule under WAC 388-440-0001. For purposes of this section, family member means related by blood, marriage, adoption, or registered domestic partnership.

[]


AMENDATORY SECTION(Amending WSR 09-03-066, filed 1/14/09, effective 2/14/09)

WAC 388-71-0520   ((Are there)) What are the training requirements for an individual provider or a home care agency ((provider of an adult client)) long-term care worker?   An individual provider or a home care agency ((provider for an adult client)) long-term care worker must meet the training requirements ((in)) under WAC ((388-71-05665)) 388-71-0836 through ((388-71-05865 and WAC 388-71-0801 through 388-71-0826)) 388-71-1006.

[Statutory Authority: 2008 c 146, RCW 18.20.090, 74.08.090, chapter 70.128 RCW. 09-03-066, 388-71-0520, filed 1/14/09, effective 2/14/09. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-71-0520, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.39A.050, 2003 c 140, chapters 18.79, 18.88A RCW. 04-02-001, 388-71-0520, filed 12/24/03, effective 1/24/04. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, 388-71-0520, filed 4/30/02, effective 5/31/02. Statutory Authority: RCW 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 10-06-112, filed 3/3/10, effective 4/3/10)

WAC 388-71-0540   When will the department, AAA, or department designee deny payment for services of an individual provider or home care agency ((provider)) long-term care worker?   The department, AAA, or department designee will deny payment for the services of an individual provider or home care agency ((provider if)) long-term care worker:

(1) When the services are provided by ((an employee of the)) a home care agency ((who is)) employee that is a family member, as described under RCW 74.39A.326, of the client, including individuals related by blood, marriage, adoption, or registered domestic partnership to the ((client.

The department, AAA, or department designee will deny payment for the services of an individual provider or home care agency provider who:

(1))) client, except in circumstances described in RCW 74.39A.326 (1)(b);

(2) Who is the client's spouse((, per)) in accordance with 42 C.F.R. 441.360(g), except in the case of an individual provider for a chore services client. Note: For chore spousal providers, the department pays a rate not to exceed the amount of a one-person standard for a ((continuing general assistance)) disability lifeline grant, per WAC 388-478-0030;

(((2))) (3) Who is the natural/step/adoptive parent of a minor client aged seventeen or younger receiving services under medicaid personal care;

(((3))) (4) Who is a foster parent providing personal care to a child residing in ((their)) the foster parent's licensed foster home;

(((4) Has been convicted of a disqualifying crime, under RCW 43.43.830 and 43.43.842 or of a crime relating to drugs as defined in RCW 43.43.830;))

(5) With any of the pending or disqualifying convictions, history, or findings, described below:

(a) A history of noncompliance with federal or state laws or regulations in the provision of care or services to children or vulnerable adults;

(b) A conviction for a crime in federal court or in any other state, and the department determines that the crime is equivalent to a crime under subsections (5)(c) through (g) of this section;

(c) A conviction for a "crime against children or other persons" as described under RCW 43.43.830, unless the crime is simple assault, assault in the fourth degree, or prostitution and more than three years has passed since conviction;

(d) A conviction for "crimes related to financial exploitation" as described under RCW 43.43.830, unless the crime is theft in the third degree and more than three years have passed since conviction, or unless the crime was forgery or theft in the second degree and more than five years have passed since conviction;

(e) Has been convicted of the manufacture, delivery, or possession with intent to manufacture or deliver drugs under one of the following laws:

(i) Violation of the imitation controlled substances act (VISCA);

(ii) Violation of the uniform controlled substances act (VUCSA);

(iii) Violation of the uniform legend drug act (VULDA); or

(iv) Violation of the uniform precursor drug act (VUPDA).

(f) Has been convicted of sending or bringing into the state depictions of a minor engaged in sexually explicit conduct;

(g) Has been convicted of criminal mistreatment;

(h) Has been found to have abused, neglected, abandoned, or financially exploited a minor or vulnerable adult by court of law or a disciplining authority, ((as defined in)) including the department of health. Examples of legal proceedings in which such findings could be made include juvenile court proceedings under chapter 13.34 RCW, domestic relations proceedings under title 26 RCW, and vulnerable adult protection proceedings under chapter 74.34 RCW;

(i) Has a finding of abuse or neglect of a child, per RCW 26.44.020 and chapter 388-15 WAC that is:

(i) Listed on the department's background check central unit (BCCU) report; or

(ii) Disclosed by the individual, except for findings made before December, 1998. Findings made before December, 1998, require a character, competence and suitability determination.

(j) Has a finding of abuse, neglect, financial exploitation, or abandonment of a vulnerable adult that is:

(i) Listed on any registry, including the department's registry;

(ii) Listed on the department's background check central unit (BCCU) report; or

(iii) Disclosed by the individual, except for adult protective services findings made before October, 2003. Findings made before October, 2003, require a character, competence, and suitability determination.

(6) 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)) medicaid or medicare provider agreement or any other contract for the care and treatment of children or vulnerable adults terminated, cancelled, suspended, revoked, or not renewed by any public agency, including a state medicaid agency;

(7) Who does not successfully complete ((the)) applicable training requirements, within ((the time limits required in WAC 388-71-05665 through 388-71-05865;)) one hundred and twenty days of hire or the begin date of authorization or within the timeframes described in WAC 388-71-0875, 388-71-0880, 388-71-0890, and 388-71-0991. If an individual provider or long-term care worker employed by a home care agency does not complete required training within the required timeframe:

(a) If certification is not required as described in WAC 246-980-070, then the long-term care worker may not provide care until the training is completed.

(b) If home care aide certification is required, then the long-term care worker may not provide care until the certification has been granted.

(8) ((Is already meeting)) Who does not successfully complete the certification or recertification requirements as described under WAC 388-71-0975;

(9) Who has had a home care aide certification denied, suspended, or revoked and is not eligible to work until his or her certification has been reissued;

(10) When the client's needs are already being met on an informal basis, and the client's assessment or reassessment does not identify any unmet need; and/or

(((9))) (11) Who is terminated by the client (in the case of an individual provider) or by the home care agency (in the case of ((an)) a home care agency ((provider)) long-term care worker).

(12) In addition, the department, AAA, or department designee may deny payment to or terminate the contract of an individual provider as provided under WAC 388-71-0543, 388-71-0546, and 388-71-0551((, and 388-71-0556)).

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 571, and Washington state 2009-11 budget, section 206(17). 10-06-112, 388-71-0540, filed 3/3/10, effective 4/3/10. Statutory Authority: RCW 74.08.090, 74.09.520. 07-24-026, 388-71-0540, filed 11/28/07, effective 1/1/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, 388-71-0540, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-71-0540, filed 5/17/05, effective 6/17/05. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, 388-71-0540, filed 4/30/02, effective 5/31/02. Statutory Authority: RCW 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: RCW 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.]


NEW SECTION
WAC 388-71-0543   When may the department, AAA, or department designee deny payment for the services of an individual provider?   The department, AAA, or department designee may deny payment for the services of an individual provider:

(1) Who has been convicted of:

(a) Simple assault, theft in third degree, assault in the fourth degree, or prostitution and more than three years has passed since conviction;

(b) Forgery or theft in the second degree and more than five years has passed since conviction;

(c) Any conviction that the department determines is reasonably related to the competency of the person to provide care to a client; or

(d) A crime involving a firearm used in commission of a felony or in any act of violence against a person.

(2) Has engaged in the illegal use of drugs, or excessive use of alcohol or drugs without the evidence of rehabilitation;

(3) Has committed an act of domestic violence toward a family or household member;

(4) Has been found in any final decision of a federal or state agency to have abandoned, neglected, abused or financially exploited a vulnerable adult, unless such decision requires a denial of payment under this chapter;

(5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, terminated, or not renewed;

(6) Has had any health care provider license, certification or contract denied, suspended, revoked, terminated, even though the license was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

(7) Has had any residential care facility or health care facility license, certification, contract denied, suspended, revoked, terminated, even though the license, certification or contract was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

(8) Has been enjoined from operating a facility for the care and services of children or adults;

(9) Has been the subject of a sanction or corrective or remedial action taken by federal, state, county, or municipal officials or safety officials related to the care or treatment of children or vulnerable adults;

(10) Has obtained or attempted to obtain a license, certification or contract by fraudulent means or misrepresentation;

(11) Knowingly, or with reason to know, made a false statement of material fact on his or her application for a license, certification, contract or any data attached to the application, or in any matter involving the department;

(12) Willfully prevented or interfered with or failed to cooperate with any inspection, investigation, or monitoring visit made by the department, including refusal to permit authorized department representatives to interview clients or have access to their records.

[]


NEW SECTION
WAC 388-71-0544   When may the department, AAA, or department designee deny payment to a home care agency for the services of a long-term care worker that it employs?   The department, AAA, or department designee may deny payment to a home care agency for services provided to a department client by a home care agency long-term care worker that it employs:

(1) Who has been convicted of:

(a) Simple assault, theft in third degree, assault in the fourth degree, or prostitution and more than three years has passed since conviction;

(b) Forgery or theft in the second degree and more than five years has passed since conviction;

(c) Any conviction that the department determines is reasonably related to the competency of the person to provide care to a client; or

(d) A crime involving a firearm used in commission of a felony or in any act of violence against a person.

(2) Has engaged in the illegal use of drugs, or excessive use of alcohol or drugs without the evidence of rehabilitation;

(3) Has committed an act of domestic violence toward a family or household member;

(4) Has been found in any final decision of a federal or state agency to have abandoned, neglected, abused or financially exploited a vulnerable adult, unless such decision requires a denial of payment under this chapter;

(5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, terminated, or not renewed;

(6) Has had any health care provider license, certification or contract denied, suspended, revoked, terminated, even though the license was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

(7) Has had any residential care facility or health care facility license, certification, contract denied, suspended, revoked, terminated, even though the license, certification or contract was later reinstated after satisfactory completion of conditions or other requirements. This provision also applies to a long-term care worker who voluntarily relinquished a license, certification or contract in lieu of revocation or termination;

(8) Has been enjoined from operating a facility for the care and services of children or adults;

(9) Has been the subject of a sanction or corrective or remedial action taken by federal, state, county, or municipal officials or safety officials related to the care or treatment of children or vulnerable adults;

(10) Has obtained or attempted to obtain a license, certification or contract by fraudulent means or misrepresentation;

(11) Knowingly, or with reason to know, made a false statement of material fact on his or her application for a license, certification, contract or any data attached to the application, or in any matter involving the department;

(12) Willfully prevented or interfered with or failed to cooperate with any inspection, investigation, or monitoring visit made by the department, including refusal to permit authorized department representatives to interview clients or have access to their records.

[]


AMENDATORY SECTION(Amending WSR 06-05-022, filed 2/6/06, effective 3/9/06)

WAC 388-71-0546   When can the department, AAA, or ((managed care entity)) department designee reject ((the client's)) your choice of an individual provider?   The department, AAA, or ((managed care entity)) department designee may reject ((a client's)) your request to have a family member or other person serve as ((his or her)) your individual provider if the case manager has a reasonable, good faith belief that the person is or will be unable to appropriately meet ((the client's)) your needs. Examples of circumstances indicating an inability to meet ((the client's)) your needs ((could)) include, ((without limitation)) but are not limited to:

(1) Evidence of alcohol or drug abuse;

(2) A reported history of domestic violence committed by the individual provider, no-contact orders entered against the individual provider, or criminal conduct committed by the individual provider (whether or not the conduct is disqualifying under ((RCW 43.43.830 and 43.43.842)) WAC 388-71-0540);

(3) A report from ((the client's health care provider or other)) any knowledgeable person that the ((requested)) individual provider lacks the ability or willingness to provide adequate care;

(4) The individual provider has other employment or responsibilities that prevent or interfere with the provision of required services;

(5) Excessive commuting distance that would make it impractical for the individual provider to provide services as they are needed and outlined in ((the client's)) your service plan.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, 388-71-0546, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 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, 388-71-0546, filed 5/4/01, effective 6/4/01.]


AMENDATORY SECTION(Amending WSR 06-05-022, filed 2/6/06, effective 3/9/06)

WAC 388-71-0551   When can the department, AAA, or ((managed care entity)) department designee terminate or summarily suspend an individual provider's contract?   The department, AAA, or ((managed care entity)) department designee may take action to terminate an individual provider's home and community-based service provider contract/agreement to provide services to a COPES, MNIW, or medicaid personal care client, or terminate a contract to an individual provider to provide services to a New Freedom waiver, WMIP, or PACE client under chapter 388-106 WAC if the provider's:

(1) Home care aide certification has been revoked; or

(2) Inadequate performance or inability to deliver quality care is jeopardizing the client's health, safety, or well-being.

(3) The department, AAA, or ((managed care entity)) department designee may summarily suspend the contract pending a hearing based on a reasonable, good faith belief that the client's health, safety, or well-being is in imminent jeopardy. Examples of circumstances indicating jeopardy to the client ((could)) include, ((without limitation)) but are not limited to:

(((1))) (a) The individual provider has committed domestic violence or abuse, neglect, abandonment, or exploitation of a ((minor)) child, as defined in RCW 26.44.020 or a vulnerable adult, as defined in RCW 74.34.020;

(((2) Using or being)) (b) The individual provider uses or is under the influence of alcohol or illegal drugs during working hours;

(((3))) (c) The individual provider engages in other behavior directed toward the client or other persons involved in the client's life that places the client at risk of harm;

(((4))) (d) A report from the client's health care provider that the client's health is negatively affected by inadequate care being provided by the individual provider;

(((5))) (e) A complaint from the client or client's representative that the client is not receiving adequate care from the individual provider;

(((6))) (f) The ((absence of)) individual provider's failure to engage in essential interventions identified in the service plan, such as medications or medical supplies; and/or

(((7))) (g) The individual provider's failure to respond appropriately to emergencies.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, 388-71-0551, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 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, 388-71-0551, filed 5/4/01, effective 6/4/01.]


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

WAC 388-71-0560   What are the client's rights if the department denies, terminates, or summarily suspends an individual provider's contract?   (1) If the department denies, terminates, or summarily suspends the individual provider's contract, the client has the right to:

(((1) A fair)) (a) An administrative hearing to appeal the decision, ((per)) under chapter 388-02 WAC, and

(((2))) (b) Receive services from another currently contracted individual provider or home care agency ((provider)) long-term care worker, or ((other options)) to receive services through other programs the client is eligible for((, if a contract is summarily suspended)).

(((3))) (2) The hearing rights ((afforded)) provided under this section are those of the client, not the individual provider's rights.

[Statutory Authority: RCW 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, 388-71-0560, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 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, 388-71-0560, filed 1/13/00, effective 2/13/00.]


NEW SECTION
WAC 388-71-0561   When does an individual provider have the right to an administrative hearing?   (1) An individual provider has the right to an administrative hearing when the department denies payment to the individual provider because:

(a) He or she has not been certified by the department of health as a home care aide within the required timeframe; or

(b) If exempted from certification, he or she has not completed required training within the required timeframe.

(2) An individual provider has the right to an administrative hearing when the department terminates the individual provider's contract, or takes other enforcement measures against the individual provider because:

(a) He or she has not completed required training within the required timeframe.

(b) His or her certification as a home care aide has been revoked by the department of health.

(3) In an administrative hearing challenging DSHS action to deny payment to an individual provider or to terminate the contract of an individual provider, the individual provider may not challenge the action by the department of health affecting the individual provider's certification. Action by the department of health affecting the individual provider's certification must be challenged in a department of health hearing, as provided in department of health rules.

[]


NEW SECTION
WAC 388-71-0562   When does a medicaid contracted home care agency have the right to an administrative hearing?   (1) A medicaid contracted home care agency has the right to an administrative hearing when the department terminates its contract or takes other enforcement action related to its contract because the home care agency:

(a) Knowingly employs a long-term care worker who has not completed training within the required timeframe.

(b) Knowingly employs a long-term care worker who does not meet the certification requirements or whose certification has been revoked by the department of health.

(2) In an administrative hearing challenging DSHS action to terminate the contract or challenge some other enforcement against its contract, a medicaid contracted home care agency may not challenge the action by the department of health affecting the home care aide certification of a long-term care worker employed by the home care agency. Action by the department of health affecting the long-term care worker's certification must be challenged in a department of health hearing, as provided in department of health rules.

[]


NEW SECTION
WAC 388-71-0836   What definitions apply to the long-term care worker training requirements?   "Care team" includes the client and everyone involved in his or her care. The care team can include family, friends, doctors, nurses, long-term care workers, social workers and case managers. The role of the care team is to support the well-being of the client, however, the client directs the care plan.

"Certified home care aide" means a long-term care worker who has obtained and maintains a home care aide certification through the department of health.

"Challenge test" means a challenge test taken for specialty training, without first taking the class for which the test is designed and can only be used when basic training is not required.

"Client" means an individual receiving in-home services.

"Competency" defines the integrated knowledge, skills, or behavior expected of a long-term care worker after completing training in a required topic area. Learning objectives are associated with each competency.

"Competency testing" is evaluating a trainee to determine if he or she can demonstrate the required level of skill, knowledge, and/or behavior with respect to the identified learning objectives of a particular course. The department only requires competency testing for nurse delegation core and specialized diabetes training and the specialty trainings. Training programs may integrate competency testing within their approved curriculums.

"DDD" refers to the division of developmental disabilities.

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

"Direct care worker" means a paid individual who provides direct, hands-on, personal care services to persons with disabilities or the elderly requiring long-term care.

"Functionally disabled person" or "person who is functionally disabled" is synonymous with chronic functionally disabled and means a person who because of a recognized chronic physical or mental condition or disease, or developmental disability, including chemical dependency, is impaired to the extent of being dependent upon others for direct care, support, supervision, or monitoring to perform activities of daily living. "Activities of daily living", in this context, means self-care abilities related to personal care such as bathing, eating, using the toilet, dressing, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities as they are related to the mental capacity to perform activities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.

"Guardian" means an individual as defined in chapter 11.88 RCW.

"Individual provider" means a person who has contracted with the department to provide personal care or respite care services to persons with functional disabilities under medicaid personal care, community options program entry system (COPES), chore services, or respite care program, or to provide respite care or residential services and supports to person with developmental disabilities under chapter 71A.12 RCW or to provide respite care as defined in RCW 74.13.270.

"Learning objectives" are 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. Curriculum developers have the flexibility to determine how learning objectives are met and may include additional content deemed necessary to best meet the competency in a particular setting.

"Long-term care worker" includes all persons providing paid, hands-on, personal care services for the elderly or persons with disabilities, including individual providers of home care services, direct care employees of home care agencies, providers of home care services to persons with developmental disabilities under Title 71 RCW, all direct care workers in state-licensed boarding homes, adult family homes, respite care providers, community residential service providers, and any other direct care staff providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities, and supported living providers.

The following persons are not long-term care workers:

(1) Persons who are:

(a) Providing personal care services to individuals who are not receiving state-funded services; and

(b) The person is not employed by an agency or facility that is licensed by the state.

(2) Persons employed by:

(a) Nursing homes licensed under chapter 18.51 RCW;

(b) Facilities certified under 42 CFR Part 483;

(c) Residential habilitation centers under chapter 71A.20 RCW;

(d) Hospitals or other acute care settings;

(e) Hospice agencies licensed under chapter 70.127 RCW;

(f) Adult day care centers or adult day health centers.

(3) Persons whose services are exclusively limited to assistance with "instrumental activities of daily living," as that term is defined in WAC 388-106-0010.

"Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living which is, provided because a person is a functionally disabled person as defined in this chapter.

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

"Training partnership" means a joint partnership or trust that includes the office of the governor and the exclusive bargaining representative of individual providers under RCW 74.39A.270 with the capacity to provide training, peer mentoring, and workforce development, or other services to individual providers.

[]

Reviser's note: The unnecessary underscoring in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.ORIENTATION AND SAFETY TRAINING
NEW SECTION
WAC 388-71-0841   What is orientation?   (1) Orientation is a training of two hours regarding the long-term care worker's role as long-term care workers and the applicable terms of employment.

(2) The department must approve orientation curricula and instructors.

(3) There is no challenge test for orientation.

[]


NEW SECTION
WAC 388-71-0846   What content must be included in orientation?   Orientation must include introductory information in the following areas:

(1) The care setting and the characteristics and special needs of the population served or to be served;

(2) Basic job responsibilities and performance expectations;

(3) The care plan, including what it is and how to use it;

(4) The care team;

(5) Process, policies, and procedures for observation, documentation and reporting;

(6) Client rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care and how the long-term care worker will protect and promote these rights;

(7) Mandatory reporter law and worker responsibilities; and

(8) Communication methods and techniques that can be used during the first weeks working with a client or guardian, and other care team members.

One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions.

[]


NEW SECTION
WAC 388-71-0850   What is safety training?   (1) Safety training is a training of three hours that includes basic safety precautions, emergency procedures, and infection control.

(2) The department must approve safety training curricula and instructors.

(3) There is no challenge test for safety training.

[]


NEW SECTION
WAC 388-71-0855   What content must be included in safety training?   Safety training consists of introductory information in the following areas:

(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) Long-term care worker safety; and

(f) 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 sick or injured, including whom to report this to.

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

(a) Evacuation preparedness;

(b) When and where to call for help in an emergency;

(c) What to do when a client is falling or falls;

(d) Location of any advanced directives and when they are given; and

(e) Basic fire emergency procedures.

One hour of completed classroom instruction or other form of training (such as video or on-line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions.

[]


NEW SECTION
WAC 388-71-0860   Who must complete orientation and safety training and by when?   Unless exempted in WAC 388-71-0901, or the long-term care worker is a parent provider as described in WAC 388-71-0890, all long-term care workers must complete orientation and safety training prior to providing care to a client.

[]

BASIC TRAINING
NEW SECTION
WAC 388-71-0870   What is basic training?   (1) Basic training is seventy hours of training that includes:

(a) Core competencies; and

(b) Population specific competencies.

(2) All basic training curriculum must be approved by the department and include qualified instructors.

(3) The DSHS developed revised fundamentals of caregiving (RFOC) learner's guide may be used to teach core basic training but it must include enhancements which must be approved by the department. With the increase in training hours, more time must be allotted for skills practice and additional training materials and/or classroom activities that help a worker to thoroughly learn the course content and skills. This must be approved per WAC 388-71-1026.

(4) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of training.

(5) The training entity must establish a way for the long-term care worker to ask the instructor questions.

(6) There is no challenge test for basic training.

[]


NEW SECTION
WAC 388-71-0875   Who must complete basic training and by when?   Unless exempt from training in WAC 388-71-0901, all long-term care workers must complete core and population specific competencies within one hundred twenty days of:

(1) The date of hire for home care agency long-term care workers; or

(2) From the begin date of the authorization to provide department-paid in-home services for a client for individual providers.

[]


NEW SECTION
WAC 388-71-0880   Who must take the thirty hour training instead of the seventy hour basic training and when must it be completed?   The thirty hour basic training, as described in WAC 388-71-0885, must be completed within one hundred twenty days from the begin date of the authorization to provide department paid, in-home services by:

(1) An individual provider caring only for his or her biological, step, or adoptive child or parent; and

(2) Until January 1, 2014, an individual provider who:

(a) Provides care to only one person; and

(b) Provides no more than twenty hours of care in any calendar month.

[]


NEW SECTION
WAC 388-71-0885   What is the thirty hour training?   The thirty hour training is a subset of the seventy hour basic training that must include core and population specific basic training. Topics completed in the subset must be on topics relevant to the care needs of the client(s). There is no challenge test for the thirty hour training.

[]


NEW SECTION
WAC 388-71-0890   What are the training requirements for parent providers who are individual providers for their adult children through DDD?   A natural, step, or adoptive parent who is the individual provider for his or her adult child receiving services through the DSHS division of developmental disabilities must complete the twelve hour parent provider training, as described in WAC 388-71-0895, within one hundred twenty days from the begin date of the authorization to provide department paid, in-home services.

[]


NEW SECTION
WAC 388-71-0895   What is the twelve hour parent provider training?   (1) The twelve hour parent provider training must include the following topics:

(a) Medicaid personal care;

(b) Assessments completed by the division of developmental disabilities;

(c) Community resources;

(d) State and federal benefits;

(f) Networking; and

(g) Client self-determination.

(2) There is no challenge test for this training.

[]

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-71-0901   What long-term care workers are exempt from the basic training requirement?   The following long-term care workers are exempt from the basic training requirement:

(1) A person employed as a long-term care worker on December 31, 2010, who completed prior to January 1, 2011, the basic training requirements in effect on the date of his or her hire;

(2) A person employed as a long-term care worker on December 31, 2010, who completes within one hundred twenty days of hire, the basic training requirements in effect on the date of his or her hire;

(3) A person previously employed as a long-term care worker prior to December 31, 2010, who completed prior to January 1, 2011, the basic training requirements in effect on the date of his or her hire, and was employed as a long-term care worker at some point during the calendar year 2010;

(4) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW;

(5) Nursing assistants-certified under chapter 18.88A RCW;

(6) Certified counselors under chapter 18.19 RCW;

(7) Speech language pathologists or audiologists under chapter 18.35 RCW;

(8) Occupational therapists under chapter 18.59 RCW;

(9) Physical therapists under chapter 18.74 RCW;

(10) A home health aide who is employed by a medicare-certified home health agency and has met the requirements of 42 CFR, Part 483.35;

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

(12) Parent providers as described in WAC 388-71-0890;

(13) Providers described in WAC 388-71-0880; and

(14) Until January 1, 2014, an individual provider who:

(a) Provides care to only one person; and

(b) Provides no more than twenty hours of care in any calendar month.

[]


NEW SECTION
WAC 388-71-0906   What topics must be taught in the core competencies of basic training?   Basic training must include all of the competencies under WAC 388-71-0911 for the following topics:

(1) Communication skills;

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

(3) Problem solving;

(4) Client rights and maintaining dignity;

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

(6) Client directed care;

(7) Cultural sensitivity;

(8) Body mechanics;

(9) Fall prevention;

(10) Skin and body care;

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

(12) Supporting activities of daily living;

(13) Food preparation and handling;

(14) Medication assistance;

(15) Infection control, blood-borne pathogens, HIV/AIDS; and

(16) Grief and loss.

[]


NEW SECTION
WAC 388-71-0911   What are the competencies and learning objectives for the core competencies of basic training?   The core competencies describe the behavior and skills that a long-term care worker should exhibit when working with clients. Learning objectives are associated with each competency.

(1) Regarding communication, communicate effectively and in a respectful and appropriate manner with clients, family members, and care team members:

(a) Recognize how verbal and nonverbal cues impact communication with the client and care team;

(b) Engage and respect the client through verbal and nonverbal communication;

(c) Listen attentively and determine that the client understands what has been communicated;

(d) Recognize and acknowledge clients' communication including indicators of pain, confusion, or misunderstanding;

(e) Utilize communication strategies to deal with difficult situations; and

(f) Recognize common barriers to effective communication and identify how to eliminate them.

(2) Regarding long-term care worker self-care, take appropriate action to reduce stress and avoid burnout:

(a) Identify behaviors, practices and resources to reduce stress and avoid burnout;

(b) Recognize common barriers to self-care and ways to overcome them; and

(c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout; and the importance of taking action to practice self-care to avoid burnout.

(3) Regarding the competency of effective problem solving, use effective problem solving skills:

(a) Explain why it is necessary to understand and utilize a problem solving method;

(b) Implement a problem solving process/method; and

(c) Identify obstacles to effective problem solving and ways to overcome them.

(4) Regarding the competency of client rights and dignity, take appropriate action to promote and protect a client's legal and human rights as protected by federal and Washington state laws including:

(a) Protect a client's confidentiality, including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a noncare team member asks for confidential information;

(b) Promote dignity, privacy, encourage, and support a client's maximum independence when providing care; and

(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use;

(d) Protect and promote the client's right to live free of abuse, neglect, abandonment, and financial exploitation.

(5) Regarding the competency of abuse and mandatory reporting, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:

(a) Describe long-term care workers' responsibilities as a mandatory reporter as defined in RCW 74.34.020 through 74.34.053; and

(b) Identify common signs and symptoms of abuse, abandonment, neglect, and financial exploitation.

(6) Regarding the competency of client directed care, take appropriate action when following a client's direction regarding his or her care:

(a) Describe a worker's role in client directed care including determining, understanding, and supporting a client's choices;

(b) Describe the importance and impact of client directed care on a client's independence, self-determination, and quality of life;

(c) Identify effective problem solving strategies that help balance a client's choice with personal safety; and

(d) Report concerns when a client refuses care or makes choices that present a possible safety concern.

(7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:

(a) Describe how cultural background, lifestyle practices, and traditions can impact care and use methods to determine and ensure that these are respected and considered when providing care.

(8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the care plan.

(9) Regarding the competency on fall prevention, prevent or reduce the risk of falls:

(a) Identify fall risk factors and take action to reduce fall risks for a client; and

(b) Take proper steps to assist when a client is falling or has fallen.

(10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:

(a) Explain the importance of observing a client's skin, when to observe it and what to look for including common signs and symptoms of skin breakdown;

(b) Identify risk factors of skin breakdown;

(c) Observe skin at pressure point locations and report any concerns;

(d) Describe what a pressure ulcer is, what it looks like, and what actions to take if a client develops a pressure ulcer;

(e) Describe current best practices that protect and maintain a client's skin integrity including position changes when sitting or lying for extended periods and proper positioning and transfer techniques;

(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and

(g) Identify when to report skin changes and to whom.

(11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:

(a) Identify when, how, and why to obtain information from appropriate sources about a client's condition or disease for which they are receiving services. Describe how to use this information to provide appropriate, individualized care;

(b) Describe a client's baseline based on information provided in the care plan and explain why it is important to know a client's baseline;

(c) Identify changes in a client's physical, mental, and emotional state;

(d) Report changes from baseline and/or concerns to the appropriate care team member(s);

(e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to a client's safety and well-being;

(f) Explain the purpose of a care plan and describe how it is created, used and modified;

(g) Use a client's care plan to direct a worker's job tasks and any client directed care tasks;

(h) Identify what is required of a long-term care worker, as described in WAC 388-71-0946, prior to performing a nurse-delegated task;

(i) Describe the role of a care team and a long-term care worker's role in it;

(j) Describe professional boundaries and the importance of maintaining them; and

(k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them.

(12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

(a) Demonstrate, in the presence of a qualified instructor, all critical steps required for personal care tasks including but not limited to:

(i) Helping an individual walk;

(ii) Transferring an individual from bed to wheelchair;

(iii) Turning and repositioning an individual in bed;

(iv) Providing mouth care;

(v) Cleaning and storing dentures;

(vi) Shaving a face;

(vii) Providing fingernail care;

(viii) Providing foot care;

(ix) Providing a bed bath;

(x) Assisting an individual with a weak arm to dress;

(xi) Putting knee-high elastic stockings on an individual;

(xii) Providing passive range of motion for one shoulder;

(xiii) Providing passive range of motion for one knee and ankle;

(xiv) Assisting an individual to eat;

(xv) Assisting with peri-care;

(xvi) Assisting with the use of a bedpan;

(xvii) Assisting with catheter care;

(xviii) Assisting with condom catheter care; and

(xix) Providing medication assistance.

(b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate client preferences, maintain privacy and dignity, support the client's level of ability, and assure their comfort and safety;

(c) Appropriately utilize assistive device(s) specified in the care plan;

(d) Describe any safety concerns related to each task and how to address the concerns;

(e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

(f) Identify the importance of knowing a client's bowel and bladder functioning baseline and when to report changes.

(13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:

(a) Describe how nutrition and hydration can impact a client's health;

(b) Plan, shop, and prepare meals for a client according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the care plan and client preferences;

(c) Describe common signs of poor nutrition and hydration, and when to report concerns and to whom;

(d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a client;

(e) Recognize when a client's food choices vary from specifications on the care plan, describe when and to whom to report concerns;

(f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

(g) Describe appropriate food handling practices, including: avoiding cross contamination from one food to another, safe storage requirements for cooling of leftover foods, including depth, types of containers, and temperatures, the need to maintain food at proper temperatures to limit bacterial growth and what are the safe food storage and holding temperatures for both cold and hot foods, best practices for thawing and re-heating food, and using clean gloves (if possible), and clean utensils when preparing food;

(h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

(i) Describe why a long-term care worker with certain types of illnesses and/or symptoms must not prepare food.

Long-term care workers who complete DSHS approved basic training meet the training requirements for adult family homes in RCW 70.128.250.

(14) Regarding the competency of medication assistance, appropriately assist with medications:

(a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications as described in chapter 246-888 WAC;

(b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;

(c) Identify common symptoms of medication side effects and when and to whom to report concerns;

(d) Store medications according to safe practices and the label instructions;

(e) Describe, in the proper sequence, each of the five rights of medication assistance; and

(f) Identify what to do for medication-related concerns, including describing ways to work with a client who refuses to take medications, identifying when and to whom to report when a client refuses medication or there are other medication-related concerns, and identifying what is considered a medication error and when and to whom it must be reported.

(15) Regarding the competency of infection control and blood borne pathogens including HIV/AIDS, implement best practices to prevent and control the spread of infections:

(a) Identify commonly occurring infections, ways that infections are spread, and symptoms of infections;

(b) Describe the purpose, benefit and proper implementation of standard precautions in infection control;

(c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;

(d) Demonstrate proper hand washing and putting on and taking off gloves;

(e) Identify immunizations that are recommended for adults to reduce the spread of virus and bacteria;

(f) Describe laundry and housekeeping measures that help in controlling the spread of infection;

(g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;

(h) Describe what blood-borne (BB) pathogens are and how they are transmitted;

(i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;

(j) Identify measures to take to prevent BB diseases;

(k) Describe what to do if exposed to BB pathogens and how to report an exposure;

(l) Describe how HIV works in the body;

(m) Explain that testing and counseling for HIV/AIDS is available;

(n) Describe the common symptoms of HIV/AIDS;

(o) Explain the legal and ethical issues related to HIV including required reporting, confidentiality and nondiscrimination; and

(p) Explain the importance of emotional issues and support for clients and long-term care workers.

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

(16) Regarding the competency on grief and loss, support yourself and the client in the grieving process:

(a) Define grief and loss;

(b) Describe common losses a client and long-term care worker may experience;

(c) Identify common symptoms associated with grief and loss;

(d) Describe why self-care is important during the grieving process; and

(e) Identify beneficial ways and resources to work through feelings of grief and loss.

[]


NEW SECTION
WAC 388-71-0916   What topics may be taught in the population specific competencies of basic training?   Population specific training may include but is not limited to one or more of the following topics. Which topic(s) to include in population specific training is based on the needs of the population(s) served or to be served.

(1) Dementia;

(2) Mental health;

(3) Developmental disabilities;

(4) Young adults with physical disabilities; and

(5) Aging and older adults.

[]


NEW SECTION
WAC 388-71-0921   What are the population specific competencies?   There are no DSHS mandatory competencies or learning objectives for population specific training. The training entity developing the training determines the competencies and learning objectives that best meet the care needs of the population(s) served.

Competencies and learning objectives described for developmental disability specialty training in WAC 388-112-0122, dementia specialty training in WAC 388-112-0132, mental health specialty training in WAC 388-112-0142, aging and older adults in WAC 388-112-0091 and young adults with physical disabilities in WAC 388-112-0083 may be used to develop the population specific training in these topic areas. This is not a requirement.

Competencies and learning objectives used to develop the training must be submitted with the curricula when sent to DSHS for approval as described in WAC 388-71-1026.

[]


NEW SECTION
WAC 388-71-0931   What other methods of training may count towards the seventy hour basic training requirement?   On-the-job training provided after July 1, 2011 may count towards the seventy hour basic training requirement.

[]


NEW SECTION
WAC 388-71-0932   What is on-the-job training?   (1) Effective July 1, 2011, on the job training is a method of training when the long-term care worker successfully demonstrates any or all of the personal care or infection control skills included in the core basic training while working with a client versus in a practice training setting.

(2) On-the-job training is provided by a qualified instructor as described in WAC 388-71-1055, who directly observes, coaches, and reinforces skills training for up to two long-term care workers at a time. The instructor providing the on-the-job training:

(a) Does not have to be the instructor who has taught the core competency training;

(b) Cannot be someone whose primary job duty is providing direct care to clients; or

(c) Cannot be the immediate supervisor of the long-term care worker receiving the on-the-job training.

(3) The person overseeing on-the-job training must:

(a) Submit DSHS required forms and become an approved instructor for the core competency of basic training; and

(b) Verify on a DSHS approved skills checklist the long-term care worker's successful completion of the demonstrated skills.

(4) For the person receiving on-the-job training, the hours spent in on the job training may count for up to twelve hours toward the completion of basic training requirements. It is not a requirement to include on-the-job training hours in the basic training hours.

[]

NURSE DELEGATION CORE AND SPECIALIZED DIABETES TRAINING
NEW SECTION
WAC 388-71-0936   What is nurse delegation core training?   (1) Nurse delegation core training is the required course a nursing assistant, certified or registered, must successfully complete before being delegated a nursing task.

(2) Only the curriculum developed by DSHS, "Nurse Delegation for Nursing Assistants" meets the training requirement for nurse delegation core training.

(3) DSHS must approve the instructors for nurse delegation core training prior to an instructor offering a course.

[]


NEW SECTION
WAC 388-71-0941   What is specialized diabetes nurse delegation training?   (1) Specialized diabetes nurse delegation training is the required course for nursing assistants, certified or registered, who will be delegated the task of insulin injections.

(2) The specialized diabetes nurse delegation training consists of three modules which are diabetes, insulin, and injections.

(3) Only the curriculum developed by DSHS, "Nurse Delegation for Nursing Assistants: Special Focus on Diabetes" may be used for the specialized diabetes nurse delegation training.

(4) DSHS approves the instructors for the specialized diabetes nurse delegation training prior to an instructor offering a course.

[]


NEW SECTION
WAC 388-71-0946   Who is required to complete the nurse delegation core training, and when?   Before performing any delegated task, a long-term care worker must:

(1) Be a:

(a) Certified home care aide and nursing assistant registered; or

(b) Nursing assistant certified under chapter 18.88A RCW; or

(c) If exempt from the home care aide certification, become a nursing assistant registered and complete the basic training core competencies.

(2) Successfully complete "Nurse Delegation for Nursing Assistants" training.

[]


NEW SECTION
WAC 388-71-0951   Who is required to complete the specialized diabetes nurse delegation training, and when?   Specialized diabetes nurse delegation training is required before a nursing assistant, certified or registered, who meets the qualifications in WAC 388-71-0946 may be delegated the task of insulin injections.

[]


NEW SECTION
WAC 388-71-0953   Can nurse delegation core and specialized diabetes training occur in the same year as basic training?   Nurse delegation core and specialized diabetes training can occur in the same year as basic training if required to be able to perform delegated tasks. If this occurs, the maximum of twelve hours for this training can be applied towards the continuing education requirement for the following year. Nurse delegation core and specialized diabetes trainings do not apply towards basic training.

[]


NEW SECTION
WAC 388-71-0956   Is competency testing required for the nurse delegation core training and specialized diabetes training?   Passing the DSHS competency test is required for successful completion of nurse delegation core training and specialized diabetes training, as provided in WAC 388-71-1106 through 388-71-1130.

[]

ON-THE-JOB TRAINING
NEW SECTION
WAC 388-71-0970   What documentation is required for completion of each training?   Orientation, safety, basic training, including core and population specific, the thirty hour training, the twelve hour parent provider training, on-the-job training, continuing education, and nurse delegation core and specialized diabetes training, must be documented by a certificate(s) or transcript of completion of training issued by a qualified instructor or qualified training entity that includes:

(1) The name of the trainee;

(2) The name of the training;

(3) The number of hours of the training;

(4) The name and/or identification number of the training entity. The training entity's identification number for basic core training is provided by the department and is issued by the department of health's contractor for the home care aide certification test;

(5) The instructor's name. For basic core training, the instructor's name and identification number. The instructor's identification number of basic core training is provided by the department and is issued by the department of health's contractor for the home care aide certification test;

(6) The instructor's signature or an authorized signature from the training entity the qualified instructor is training on behalf of; and

(7) The completion date of the training.

The long-term care worker must retain the original certificate or transcript for proof of completion of the training. A home care agency must keep a copy of the certificate or transcript on file.

[]


NEW SECTION
WAC 388-71-0973   What documentation is required for a long-term care worker to apply for the home care aide certification or recertification?   (1) Successful completion of seventy-five hours of training must be documented on a DSHS seventy-five hour training certificate by an approved training entity who has provided or verified that a total of seventy-five hours of training has occurred.

(2) An approved training entity issuing and signing a DSHS seventy-five hour training certificate must verify that the long-term care worker has the certificates or transcript 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. Only a DSHS or training partnership seventy-five hour training certificate can be submitted by a long-term care worker applying to the department of health for a 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 DSHS certificate issued by an approved training entity who has provided all twelve hours of continuing education training. If all twelve hours of continuing education were not provided by the same training entity, then an approved training entity must verify that the certified home care aide has certificates or transcripts that add up to twelve hours of DSHS-approved continuing education. Only a DSHS or training partnership twelve-hour continuing education certificate can be submitted by a certified home care aide applying to the department of health for recertification.

(4) The long-term care worker and certified home care aide must retain the original seventy-five hour training certificate and any twelve-hour continuing education training certificates as long as they are employed and up to three years after termination of employment. Training entities must keep a copy of these certificates on file for six years.

[]

HOME CARE AIDE CERTIFICATION
NEW SECTION
WAC 388-71-0975   Who is required to obtain certification as a home care aide, and when?   All long-term care workers, who do not fall within the exemptions under the department of health WAC 246-980-070, must obtain certification within one hundred and fifty days of hire or begin date of the authorization to provide department paid in-home services effective January 1, 2011.

[]


NEW SECTION
WAC 388-71-0980   Can a home care agency employ a long-term care worker who has not completed the training and/or certification requirements?   A home care agency cannot employ an individual to work as a long-term care worker if the individual has previously worked as a long-term care worker and has not completed applicable training and/or certification requirements within the required timeframe. Such individual may be employed by a home care agency to work as a long-term care worker only after applicable training and/or certification requirements are met. The department is authorized by RCW 74.39A.085 to take enforcement action for noncompliance related to training and/or certification requirements.

[]

CONTINUING EDUCATION
NEW SECTION
WAC 388-71-0985   What is continuing education?   Continuing education is additional caregiving-related training designed to keep current a person's knowledge and skills. DSHS must approve continuing education curricula and instructors. The same continuing education course may not be repeated for credit unless it is a new or more advanced training on the same topic. Nurse delegation core and nurse delegation specialized diabetes training may be used to count towards continuing education.

[]


NEW SECTION
WAC 388-71-0990   How many hours of continuing education are required each year?   (1) Until June 30, 2011, individual providers and home care agency long-term care workers must complete ten hours of continuing education each calendar year after the year in which they complete basic training. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

(2) Effective July 1, 2011, certified home care aides must complete twelve hours of continuing education each calendar year after obtaining certification as described in department of health WAC 246-980-110 and 246-112-020(3).

(3) If exempt from certification as described in RCW 18.88B.040, all long-term care workers must complete twelve hours of continuing education per calendar year unless exempt from continuing education as described in WAC 388-71-1001.

(4) A long-term care worker or certified home care aide who did not complete the continuing education requirements by the timeframe described in WAC 388-71-0991 cannot be paid to provide care after that date and cannot be reinstated as a long-term care worker until they complete the continuing education requirements.

(5) 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. The training entity must establish a way for the long-term care worker to ask the instructor questions.

[]


NEW SECTION
WAC 388-71-0991   When must a long-term care worker or certified home care aide complete continuing education?   (1) Effective January 1, 2011 and for the year 2011, a long-term care worker must complete the continuing education requirements described in WAC 388-71-0990 by their birthday:

(a) A long-term care worker whose birthday occurs between January 1, 2011 and June 30, 2011, must complete the continuing education requirement by June 30, 2011.

(b) A long-term care worker whose birthday occurs on or after July 1, 2011, must complete the continuing education requirement by their birthday.

(2) Effective January 1, 2012, all long-term care workers and certified home care aides must complete the continuing education requirements described in WAC 388-71-0990 by their birthday.

(3) For long term care workers who are required to be certified, if the first renewal period is less than a full year from the date of certification, no continuing education will be due for the first renewal period.

[]


NEW SECTION
WAC 388-71-1001   What long-term care workers are exempt from the continuing education requirement?   Unless voluntarily certified as a home care aide, continuing education is not required for:

(1) Individual providers caring only for his or her biological, step, or adoptive son or daughter; and

(2) Before June 30, 2014, an individual provider who:

(a) Provides care to only one person; and

(b) Provides no more than twenty hours of care in any calendar month.

[]


NEW SECTION
WAC 388-71-1006   What kinds of training topics may be covered in continuing education?   Continuing education must be on a topic relevant to the care setting, care needs of clients, or long-term care worker career development. Topics may include but are not limited to:

(1) Client rights;

(2) Personal care services;

(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;

(12) Dealing with challenging client behaviors;

(13) Medical conditions; and

(14) Nurse delegation core and specialized diabetes.

[]

CURRICULUM APPROVAL
NEW SECTION
WAC 388-71-1021   What trainings must be taught with a curriculum approved by DSHS?   (1) Orientation, safety, on-the-job, basic training (core and population specific training), the thirty hour basic training, the twelve hour parent provider training, and continuing education must be taught with a curriculum approved by DSHS before use.

(2) The nurse delegation core and diabetes training must use only the DSHS curriculum.

[]


NEW SECTION
WAC 388-71-1026   What must be submitted to DSHS for curriculum approval?   DSHS developed curriculum(s) do not require submission to the department for approval unless the curriculum is being modified in any manner by the training entity.

(1) For orientation and/or safety training:

(a) Effective January 1, 2011, submit an outline of what will be covered in each training offered (for example, a table of contents or a class syllabus) showing that the required introductory topics as listed in WAC 388-71-0846 for orientation and WAC 388-71-0855 for safety training are covered in the training. Department required orientation and safety training application forms must be submitted to the department at least forty-five days in advance of when the training is expected to be offered. Training cannot be offered before receiving department curriculum and instructor approval.

(2) For continuing education:

(a) Effective July 1, 2011, submit an outline of what will be covered in the training (for example, a table of contents or the class syllabus), the number of training hours, and a description of how the training is relevant to the care setting, care needs of the client, or long-term care worker career development. Department required continuing education training application forms must be submitted at least forty-five days in advance of when the training is expected to be offered. The trainings cannot be offered before receiving department curriculum and instructor approval.

(3) For basic training, the thirty hour basic training, and the twelve hour parent provider training:

(a) If the instructor or training entity wants to use the DSHS developed revised fundamentals of caregiving learner's guide with enhancements, submit the DSHS required form with all required information. The following must be submitted to DSHS for approval of the seventy hours required for basic training, for the thirty hour basic training, and the twelve hour parent provider training. Curricula must be submitted to DSHS for approval of one or both sections (core competencies and population specific competencies) of the seventy hours required for basic training, for the thirty hour basic training, and for the twelve hour parent provider training. When submitting one or both sections of the basic training curriculum for DSHS approval, it must at a minimum include:

(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives, described in this chapter, are located in the long-term care worker materials from the proposed curriculum for that course;

(ii) Any materials long-term care workers will receive, such as a textbook or long-term care worker manual, learning activities, audio-visual materials, handouts and books;

(iii) The table of contents or outline of the curriculum including the allotted time for each section;

(iv) Demonstration skills checklists for the personal care tasks described in WAC 388-71-0911 (12)(a) and (b), and infection control skills (hand washing and putting on and taking off gloves);

(v) The teacher's guide or manual that includes for each section of the curriculum:

(A) The goals and objectives;

(B) How that section will be taught including teaching methods and learning activities that incorporate adult learning principles;

(C) Methods instructors will use to determine whether each long-term care worker understands the material covered and can demonstrate all skills;

(D) A list of sources or references, that were used to develop the curriculum. If the primary source or reference is not a published citation, the instructor must provide detail on how the content was established as evidence based:

(E) Description of how the curriculum was designed to accommodate long-term care workers with limited English proficiency and/or learning disabilities; and

(F) Description and proof of how input was obtained from consumers and long-term care worker representatives in the development of the curriculum.

(vi) In addition, for curricula being submitted for the core competency section of the basic training as described in WAC 388-71-0911, the curriculum must include how much time long-term care workers will be given to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill.

(vii) Entities submitting curriculum for population specific basic training must submit their own list of competencies and learning objectives used to develop the population specific basic training curriculum.

[]


NEW SECTION
WAC 388-71-1031   What is the curriculum approval process for orientation, safety, basic training (core and population specific training), the thirty hour basic training, the twelve hour parent provider training, and continuing education?   (1) Submit the required training application forms and any other materials required for specific curriculums to the department.

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

(3) If curriculum(s) are not approved, the reason(s) for denial will be given and the submitter will be told what portion(s) of the training must be changed and resubmitted for review in order for the curriculum to be approved.

(4) The submitter can make the requested changes and resubmit the curriculum(s) for review.

(5) If after working with the department the reasons why the curriculum is not approved cannot be resolved, the submitter may seek review of the nonapproval decision from the assistant secretary of aging and disability services administration. The assistant secretary's review decision shall be the final decision of DSHS; no other administrative review is available to the submitter.

[]

INSTRUCTOR QUALIFICATIONS, APPROVAL, AND RESPONSIBILITIES
NEW SECTION
WAC 388-71-1045   What are a training entity's responsibilities?   The training entity is responsible for:

(1) Coordinating and teaching classes;

(2) Assuring that the curriculum used is DSHS-approved and taught as designed;

(3) Selecting and monitoring qualified guest speakers, where applicable;

(4) Administering or overseeing the administration of the DSHS competency tests for nurse delegation core and specialized diabetes trainings;

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

(6) Reporting training data to DSHS in DSHS-identified timeframes; and

(7) Issuing or reissuing training certificates to long-term care workers.

[]


NEW SECTION
WAC 388-71-1050   Must training entities and their instructors be approved by DSHS?   All training entities and their instructor(s) for orientation, safety, and continuing education must meet the minimum qualifications under WAC 388-71-1060. All instructors for basic training (core and population specific training), on-the-job training, nurse delegation core training and nurse delegation specialized diabetes training must meet the minimum qualifications under WAC 388-71-1055.

(1) DSHS must approve and/or contract with a training entity and their instructor(s) to conduct orientation, safety, basic training (core and population specific training), nurse delegation core training and nurse delegation specialized diabetes training, on-the-job training, and continuing education. DSHS may contract with training entities and their instructor(s) using any applicable contracting procedures.

(2) The training partnership must ensure that its instructors meet the minimum qualifications under this chapter.

[]


NEW SECTION
WAC 388-71-1055   What are the minimum qualifications for an instructor of basic training (core and population specific training), on-the-job training, nurse delegation core training, and nurse delegation specialized diabetes training?   An instructor for basic training (core and population specific training), on-the-job training, nurse delegation core training, and nurse delegation specialized diabetes training must meet the following minimum qualifications:

(1) General qualifications:

(a) Twenty-one years of age; and

(b) Has not had a professional health care, adult family home, boarding home, or social services license or certification revoked in Washington state.

(2) Education and work experience:

(a) Upon initial approval or hire, an instructor must:

(i) Be a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting; or

(ii) Have an associate degree or higher degree in the field of health or human services and six months of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD, or home care setting; or

(iii) Have a high school diploma, or equivalent, and one year of professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD, or home care setting.

(3) Teaching experience:

(a) Must have one hundred hours of teaching adults in a classroom 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 that meets the requirements in WAC 388-71-1066.

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

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

(6) An instructor for nurse delegation core and specialized diabetes trainings must have a current Washington state RN license in good standing without practice restrictions.

[]


NEW SECTION
WAC 388-71-1060   What are the minimum qualifications for an instructor of orientation, safety, and continuing education?   An instructor of orientation, safety, and continuing education must be a registered nurse or other person with specific knowledge, training, and work experience in the provision of direct, hands-on personal care or other relevant services to the elderly or persons with disabilities requiring long-term care.

[]


NEW SECTION
WAC 388-71-1066   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 or literacy issues).

[]


NEW SECTION
WAC 388-71-1076   What is a guest speaker, and what are the minimum qualifications to be a guest speaker?   (1) A guest speaker is a person selected by an approved instructor to teach on a specific topic. A guest speaker:

(a) May only teach a specific subject in which he or she has expertise, background, and experience that establishes his or her expertise on that specific topic;

(b) May not teach the entire course;

(c) Must not supplant the primary teaching responsibilities of the 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 ensure the guest speaker meets these minimum qualifications;

(b) Maintain documentation of the guest speaker's qualifications and background;

(c) Supervise and monitor the guest speaker's performance; and

(d) Is responsible for ensuring the required content is taught.

(3) DSHS does not approve guest speakers.

[]


NEW SECTION
WAC 388-71-1081   What are the requirements for the training partnership to conduct training?   (1) The training partnership must:

(a) Verify, document using the department's attestation process, keep on file, and make available to the department upon request, that all instructors meet the minimum instructor qualifications in WAC 388-71-1055 and 388-71-1060 for the course they plan to teach;

(b) Teach using a complete DSHS-developed or approved curriculum;

(c) When requested by DSHS, notify DSHS in writing of their intent to conduct training prior to providing training, when changing training plans, including:

(i) Name and schedule of training(s) the partnership will conduct;

(ii) Name of approved curriculum(s) the partnership will use; and

(iii) Name of the instructor(s) for only the core basic training.

(d) Ensure that DSHS competency tests are administered when conducting nurse delegation core or specialized diabetes training;

(e) Keep a copy of long-term care worker certificates on file for six years and give the original certificate to the trainee;

(f) Keep attendance records and testing records of long-term care workers trained and tested on file for six years; and

(g) Report training data to DSHS when requested by the department.

(2) The department may conduct a random audit at any time to review training and instructor qualifications.

[]


NEW SECTION
WAC 388-71-1083   Must the department verify that training entities and their community instructors meet the minimum instructor qualifications?   The department through its contracting process must verify that the community instructors meet the minimum qualifications as described in WACs 388-71-1055 and 388-71-1060. The department will conduct random audits of the training provided and of the instructor qualifications.

[]

PHYSICAL RESOURCES AND STANDARD PRACTICES FOR TRAINING
NEW SECTION
WAC 388-71-1091   What physical resources are required for classroom training and testing?   (1) Classroom facilities used for 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 for nurse delegation core and specialized diabetes training must provide adequate space for testing, comfort, lighting, 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 388-71-1096   What standard training practices must be maintained for classroom training and testing?   The following training standards must be maintained for classroom training and testing:

(1) Training 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) Long-term care workers attending classroom training must not be expected to leave the class to attend job duties, except in an emergency.

[]

COMPETENCY TESTING FOR NURSE DELEGATION CORE AND SPECIALIZED DIABETES TRAINING
NEW SECTION
WAC 388-71-1106   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 to the training;

(2) Written evaluation to show knowledge of the learning objectives included in the training; and

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

[]


NEW SECTION
WAC 388-71-1111   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.

[]


NEW SECTION
WAC 388-71-1120   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 the DSHS guidelines for:

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

(b) The amount and nature of instruction given long-term care workers before beginning a test;

(c) The amount of assistance to long-term care workers allowed during testing;

(d) The accommodation guidelines for long-term care workers with disabilities; and

(e) Accessibility guidelines for long-term care workers with limited English proficiency.

[]


NEW SECTION
WAC 388-71-1125   What form of identification must long-term care workers show before taking a competency test?   Long-term care workers must show photo identification before taking a competency test.

[]


NEW SECTION
WAC 388-71-1130   How many times may a competency test be taken?   For the trainings under WAC 388-71-0936 and 388-71-0941, competency testing may be taken twice. If the test is failed a second time, the person must retake the course before taking the test for that course again.

[]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-71-05665 What definitions apply to WAC 388-71-05670 through 388-71-05909?
WAC 388-71-05670 What is orientation?
WAC 388-71-05675 What content must be included in an orientation?
WAC 388-71-05680 Is competency testing required for orientation?
WAC 388-71-05685 Is there a challenge test for orientation?
WAC 388-71-05690 What documentation is required for orientation?
WAC 388-71-05695 Who is required to complete orientation, and when must it be completed?
WAC 388-71-05700 What is basic training?
WAC 388-71-05705 Is there an alternative to the basic training for some health care workers?
WAC 388-71-05710 What core knowledge and skills must be taught in basic training?
WAC 388-71-05715 Is competency testing required for basic training?
WAC 388-71-05720 Is there a challenge test for basic training?
WAC 388-71-05725 What documentation is required for successful completion of basic training?
WAC 388-71-05730 Who is required to complete basic training, and when?
WAC 388-71-05735 What is modified basic training?
WAC 388-71-05740 What knowledge and skills must be included in modified basic training?
WAC 388-71-05745 Is competency testing required for modified basic training?
WAC 388-71-05750 Is there a challenge test for modified basic training?
WAC 388-71-05755 What documentation is required for successful completion of modified basic training?
WAC 388-71-05760 Who may take modified basic training instead of the full basic training?
WAC 388-71-05765 What are the training requirements and exemptions for parents who are individual providers for their adult children receiving services through DDD?
WAC 388-71-05770 What are the training requirements and exemptions for parents who are individual providers for their adult children who do not receive services through DDD?
WAC 388-71-05775 What is continuing education?
WAC 388-71-05780 How many hours of continuing education are required each year?
WAC 388-71-05785 What kinds of training topics are required for continuing education?
WAC 388-71-05790 Is competency testing required for continuing education?
WAC 388-71-05795 May basic or modified basic training be completed a second time and used to meet the continuing education requirement?
WAC 388-71-05799 What are the documentation requirements for continuing education?
WAC 388-71-05805 What is nurse delegation core training?
WAC 388-71-05810 What knowledge and skills must nurse delegation core training include?
WAC 388-71-05815 Is competency testing required for nurse delegation core training?
WAC 388-71-05820 Is there a challenge test for nurse delegation core training?
WAC 388-71-05825 What documentation is required for successful completion of nurse delegation core training?
WAC 388-71-05830 Who is required to complete nurse delegation core training, and when?
WAC 388-71-05832 What is safety training?
WAC 388-71-05835 What is competency testing?
WAC 388-71-05840 What components must competency testing include?
WAC 388-71-05845 What experience or training must individuals have to be able to perform competency testing?
WAC 388-71-05850 What training must include the DSHS-developed competency test?
WAC 388-71-05855 How must competency test administration be standardized?
WAC 388-71-05860 What form of identification must providers show a tester before taking a competency or challenge test?
WAC 388-71-05865 How many times may a competency test be taken?
WAC 388-71-05870 What are an instructor's or training entity's responsibilities?
WAC 388-71-05875 Must instructors be approved by DSHS?
WAC 388-71-05880 Can DSHS deny or terminate a contract with an instructor or training entity?
WAC 388-71-05885 What is a guest speaker, and what are the minimum qualifications to be a guest speaker for basic training?
WAC 388-71-05890 What are the minimum qualifications for an instructor for basic, modified basic or nurse delegation core and specialized diabetes training?
WAC 388-71-05895 What additional qualifications are required for instructors of nurse delegation core training and specialized diabetes nurse delegation training?
WAC 388-71-05899 What must be included in a class on adult education?
WAC 388-71-05905 What physical resources are required for basic, modified basic, or nurse delegation core classroom training and testing?
WAC 388-71-05909 What standard training practices must be maintained for basic, modified basic, or nurse delegation core classroom training and testing?
WAC 388-71-0801 What is specialized diabetes nurse delegation training?
WAC 388-71-0806 What knowledge and skills must specialized diabetes nurse delegation training include?
WAC 388-71-0811 Is competency testing required for the specialized diabetes nurse delegation training?
WAC 388-71-0816 Is there a challenge test for specialized diabetes nurse delegation training?
WAC 388-71-0821 What documentation is required for successful completion of specialized diabetes nurse delegation training?
WAC 388-71-0826 Who is required to complete the specialized diabetes nurse delegation training, and when?
4201.8
AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0001   What is the purpose of this chapter?   The ((residential)) purpose of this chapter is to describe the long-term care worker training requirements ((under this chapter apply to:

(1) All adult family homes licensed under chapter 70.128 RCW ; and

(2) All boarding homes licensed under chapter 18.20 RCW)).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0001, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0002   To whom do the long-term care worker training requirements apply?   (1) Unless exempt under RCW 18.88B.040, the long-term care worker training requirements under this chapter apply to:

(a) All direct care workers in boarding homes licensed under chapter 18.20 RCW and chapter 388-78A WAC;

(b) Boarding home administrators (or their designees) in accordance with chapter 388-78A WAC;

(c) All direct care workers in adult family homes licensed under chapter 70.128 RCW and chapter 388-76 WAC;

(d) Adult family home applicants, resident managers, and entity representatives in accordance with chapter 388-76 WAC;

(e) All staff providing instruction and support services in supported living settings operating under chapter 71A.12 RCW, chapter 74.15 RCW, chapter 388-101 WAC and chapter 388-148 WAC; and

(f) Supported living applicants and administrators in accordance with chapter 388-101 WAC.

(2) The adult family home provider, boarding home provider, and supported living provider must ensure that any one used by them receives orientation and training from an approved instructor, appropriate for their expected duties, even if the person, including a volunteer, is not included in the definition of long-term care worker.

[]


NEW SECTION
WAC 388-112-0003   What action(s) may the department take for provider noncompliance with the requirements of this chapter?   A provider's failure to comply with the requirements of this chapter may be subject to an enforcement action authorized under:

(1) WAC 388-78A-3170, for boarding home providers;

(2) WAC 388-76-10960, for adult family home providers; or

(3) WAC 388-101-4200, for supported living providers.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0005   What definitions apply to this chapter?   "Applicant" means an individual, partnership, corporation, or other entity seeking to operate an adult family home or a supported living program.

(("Caregiver" means anyone providing hands-on personal care to another person including but not limited to cuing, reminding, or supervision of residents, on behalf of an adult family home or boarding home, except volunteers who are directly supervised.))

"Care team" includes the resident and everyone involved in his or her care. The care team can include family, friends, doctors, nurses, long-term care workers, social workers and case managers. The role of the care team is to support the well-being of the resident, however, the resident directs the service plan.

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

"Challenge test" means a competency test taken for specialty training without first taking the class for which the test is designed and can only be used when basic training is not required.

"Client" means a person as defined in WAC 388-101-3000.

"Competency" ((means the minimum level of information and skill trainees are required to know and be able to demonstrate)) defines 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 trainee 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. The department only requires competency testing for nurse delegation core and specialized diabetes training and the specialty trainings. Training programs may integrate competency testing within their approved curriculums.

"DDD" refers to the division of developmental disabilities.

"Designee" means a person in a boarding home who supervises ((caregivers)) long-term care workers and who is designated by a boarding home administrator to take the trainings in this chapter required of the boarding home administrator. A boarding home administrator may have more than one designee.

"Direct care worker" means a paid individual who provides direct, hands-on, personal care services to persons with disabilities or the elderly 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 who has been exempted from the basic training requirements, is on the premises, and is quickly and easily available to the ((caregiver)) long-term care worker.

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

"Entity representative" means the individual designated by an adult family home provider who is or will be responsible for the daily operations of an adult family home.

"Functionally disabled person" or "person who is functionally disabled" is synonymous with chronic functionally disabled and means a person who because of a recognized chronic physical or mental condition or disease, or developmental disability, including chemical dependency, is impaired to the extent of being dependent upon others for direct care, support, supervision, or monitoring to perform activities of daily living. "Activities of daily living", in this context, means self-care abilities related to personal care such as bathing, eating, using the toilet, dressing, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.

"Guardian" means an individual as defined in chapter 11.88 RCW.

"Home" refers to adult family homes and boarding homes.

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

"Instruction and support services staff" means long-term care workers of supported living providers whose primary job function is the provision of instruction and support services to clients. Instruction and support services staff shall also include employees of the service provider whose primary job function is the supervision of instruction and support services staff. In addition, both applicants, prior to initial supported living certification, and administrators, prior to assuming duties, who may provide instruction and support services to clients shall be considered instruction and support services staff for the purposes of the applicable training requirements of this chapter.

"Learning ((outcomes)) objectives" ((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)) are 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. Curriculum designers have the flexibility to determine how learning objectives are met and may include additional content deemed necessary to best meet the competency in a particular setting.

"Long-term care worker" includes all persons providing paid, hands-on personal care services for the elderly or persons with disabilities, including individual providers of home care services, direct care employees of home care agencies, providers of home care services to persons with developmental disabilities under title 71A RCW, all direct care workers in state-licensed boarding homes, adult family homes, respite care providers, community residential service providers, and any other direct care staff providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities, and supported living providers.

The following persons are not long-term care workers:

(1) Persons who are:

(a) Providing personal care services to individuals who are not receiving state-funded services; and

(b) The person is not employed by an agency or facility that is licensed by the state.

(2) Persons employed by:

(a) Nursing homes licensed under chapter 18.51 RCW;

(b) Facilities certified under 42 CFR Part 483;

(c) Residential habilitation centers under chapter 71A.20 RCW;

(d) Hospitals or other acute care settings;

(e) Hospice agencies licensed under chapter 70.127 RCW;

(f) Adult day care centers or adult day health centers.

(3) Persons whose services are exclusively limited to assistance with "instrumental activities of daily living," as that term is defined in WAC 388-106-0010.

"Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living which is provided because a person is a functionally disabled person as defined in this chapter.

"Provider" means any person or entity who is licensed by the department to operate an adult family home or boarding home, or certified by the department to provide instruction and support services to meet the needs of persons receiving services under title 71A RCW.

"Resident" means a person residing and receiving long-term care services at a boarding home or adult family home. As applicable, the term resident also means the resident's legal guardian or other surrogate decision maker.

"Resident manager" means a person employed or designated by the provider to manage the adult family home who meets the requirements in chapter 388-76 WAC and this chapter.

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

"Supported living provider" means a person or entity that provides instruction and support services to meet the needs of persons receiving services under title 71A RCW and chapter 74.15 RCW. These providers include persons or entities certified under chapter 388-101 WAC, group training homes, alternative living providers, companion home providers, licensed staff residential programs, and group care facilities and staffed residential homes licensed to care for children under chapter 388-148 WAC.

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

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0005, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0010   When do the training requirements go into effect?   The training requirements ((of)) under this chapter ((begin September 1, 2002, or one hundred twenty days from the date of employment, whichever is later, and apply to:

(1) Adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who are hired or begin to provide hands-on personal care to residents subsequent to September 1, 2002; and

(2) Existing adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who on September 1, 2002, have not successfully completed the training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130 and this chapter. Existing adult family home providers, resident managers, and caregivers, and boarding home administrators, designees, and caregivers, who have not successfully completed the training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130 are subject to all applicable requirements of this chapter. However, until September 1, 2002, nothing in this chapter affects the current training requirements under RCW 74.39A.010, 74.39A.020, 70.128.120, or 70.128.130)) apply to persons described in WAC 388-112-0002, who are hired on or apply on or after January 1, 2011, unless exempt under RCW 18.88B.040.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0010, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0015   What is orientation?   (1) Orientation ((provides basic introductory information appropriate to the residential care setting and population served)) is a training of two hours regarding the long-term care worker's role as long-term care workers and the applicable terms of employment.

(2) The department ((does not)) must approve ((specific)) orientation ((programs, materials, or trainers for homes)) curricula and instructors.

(3) There is no challenge test ((is required)) for orientation.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0015, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0016   What content must be included in orientation?   Orientation must include introductory information in the following areas:

(1) The care setting and the characteristics and special needs of the population served;

(2) Basic job responsibilities and performance expectations;

(3) The care plan, including what it is and how to use it;

(4) The care team;

(5) Process, policies, and procedures for observation, documentation and reporting;

(6) Resident rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care and how the long-term care worker will protect and promote these rights;

(7) Mandatory reporter law and worker responsibilities; and

(8) Communication methods and techniques that can be used while working with a resident or guardian and other care team members.

One hour of completed classroom instruction or other form of training (such as a video or on line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions.

[]


NEW SECTION
WAC 388-112-0018   What is safety training?   (1) Safety training is a training of three hours that includes basic safety precautions, emergency procedures, and infection control.

(2) The department must approve safety training curricula and instructors.

(3) There is no challenge test for safety training.

[]


NEW SECTION
WAC 388-112-0019   What content must be included in safety training?   Safety training consists of introductory information in the following areas:

(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) Long term care worker safety; and

(f) 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 resident is sick or injured, including whom to report this to.

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

(a) Evacuation preparedness;

(b) When and where to call for help in an emergency;

(c) What to do when a resident is falling or falls;

(d) Location of any advanced directives and when they are given; and

(e) Basic fire emergency procedures.

One hour of completed classroom instruction or other form of training (such as video or on line course) equals one hour of training. The training entity must establish a way for the long-term care worker to ask the instructor questions. In adult family homes, safe food handling information must be provided to all staff, prior to handling food for residents.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0035   What documentation is required for orientation and safety training?   The adult family home, boarding home, or supported living provider must maintain documentation of the completion of orientation and safety training, issued by the ((home)) instructor as described in WAC 388-112-0383, that includes:

(1) The ((trainee's)) name of the trainee;

(2) A list of the specific information taught;

(3) The number of hours of the training;

(4) The signature of the ((person overseeing)) instructor providing orientation((, indicating completion of the required information)) and safety training;

(((4))) (5) The trainee's date of employment;

(((5))) (6) The name and identification number of the home or service provider giving the orientation and safety training; and

(((6))) (7) The date(s) of orientation and safety training.

(8) The home must keep a copy as described in WAC 388-76-10198 (for adult family homes) and as described in WAC 388-78A-2450 (for boarding homes).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0035, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0040   Who ((is required to)) must complete orientation and safety training, and by when ((must it be completed))?   ((Adult family home))

(((1))) All ((paid or volunteer staff in adult family homes who begin work September 1, 2002 or later)) long-term care workers must complete orientation and safety training before ((having routine interaction with residents)) providing care to residents/clients. All volunteers who routinely interact with resident/clients must complete orientation and safety training before interacting with residents/clients. Orientation and safety training must be provided by ((appropriate adult family home staff)) qualified instructors as described in WAC 388-112-0383.

((Boarding home

(2) Boarding home administrators (or their designees), caregivers, and all paid or volunteer staff who begin work September 1, 2002 or later must complete orientation before having routine interaction with residents. Orientation must be provided by appropriate staff.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0040, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0045   What is basic training?   (1) Basic training is a training of seventy hours which includes ((the)):

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

(b) Practice and demonstration of skills;

(c) Population specific competencies.

(2) DSHS must approve basic training curricula.

(3) For instruction and support services staff, orientation, safety training, and basic training are all included in the developmental disabilities supported living providers training.

(4) Effective July 1, 2011, only up to twelve hours may be applied for on-the-job training;

(5) The DSHS developed revised fundamentals of caregiving (RFOC) learner's guide may be used to teach core basic training but it must include enhancements which must be approved by the department. With the increase in training hours, more time must be allotted for skills practice and additional training materials and/or classroom activities that help a worker to thoroughly learn the course content and skills. This must be approved per WAC 388-112-0325.

(6) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of training.

(7) The training entity must establish a way for the long-term care worker to ask the instructor questions.

(8) There is no challenge test for basic training.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0045, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0053   What topics must be taught in the core competencies of basic training?   Basic training must include all of the competencies under WAC 388-112-0055 for the following topics:

(1) Communication skills;

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

(3) Problem solving;

(4) Resident rights and maintaining dignity;

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

(6) Resident directed care;

(7) Cultural sensitivity;

(8) Body mechanics;

(9) Fall prevention;

(10) Skin and body care;

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

(12) Supporting activities of daily living;

(13) Food preparation and handling;

(14) Medication assistance;

(15) Infection control, blood-borne pathogens, HIV/AIDS; and

(16) Grief and loss.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0055   What ((knowledge and skills must be taught in)) are the core competencies and learning objectives for basic training?   (((1))) 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:

(a) Understanding and using effective interpersonal and problem solving skills with the resident, family members, and other care team members;

(b) Taking appropriate action to promote and protect resident rights, dignity, and independence;

(c) Taking appropriate action to promote and protect the health and safety of the resident and the caregiver;

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

(e) Adhering to basic job standards and expectations.

(2) The basic training learning outcomes and competencies may be obtained from the DSHS aging and adult services administration)) core competencies describe the behavior and skills that a long-term care worker must exhibit when working with residents. Learning objectives are associated with each competency.

(1) Regarding communication, communicate effectively and in a respectful and appropriate manner with residents, family members, and care team members:

(a) Recognize how verbal and non-verbal cues impact communication with the resident and care team;

(b) Engage and respect the resident through verbal and non-verbal communication;

(c) Listen attentively and determine that the resident understands what has been communicated;

(d) Recognize and acknowledge residents' communication including indicators of pain, confusion, or misunderstanding;

(e) Utilize communication strategies to deal with difficult situations; and

(f) Recognize common barriers to effective communication and identify how to eliminate them.

(2) Regarding long-term care worker self-care, take appropriate action to reduce stress and avoid burnout:

(a) Identify behaviors, practices and resources to reduce stress and avoid burnout;

(b) Recognize common barriers to self-care and ways to overcome them; and

(c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout; and the importance of taking action to practice self-care to avoid burnout.

(3) Regarding the competency of effective problem solving, use effective problem solving skills:

(a) Explain why it is necessary to understand and utilize a problem solving method;

(b) Implement a problem solving process/method; and

(c) Identify obstacles to effective problem solving and ways to overcome them.

(4) Regarding the competency of resident rights and dignity, take appropriate action to promote and protect a resident's legal and human rights as protected by federal and Washington state laws, including:

(a) Protect a resident's confidentiality including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a noncare team member asks for confidential information;

(b) Promote dignity, privacy, encourage and support a resident's maximum independence when providing care; and

(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use;

(d) Protect and promote the resident's right to live free of abuse, neglect, abandonment, and financial exploitation.

(5) Regarding the competency of abuse and mandatory reporting, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:

(a) Describe long-term care workers' responsibilities as a mandatory reporter as described under RCW 74.34.020 through 74.34.053; and

(b) Identify common symptoms of abuse, abandonment, neglect, and financial exploitation.

(6) Regarding the competency of resident directed care, take appropriate action when following a resident's direction regarding his or her care:

(a) Describe a worker's role in resident directed care including determining, understanding, and supporting a resident's choices;

(b) Describe the importance and impact of resident directed care on a resident's independence, self-determination, and quality of life;

(c) Identify effective problem solving strategies that help balance a resident's choice with personal safety; and

(d) Report concerns when a resident refuses care or makes choices that present a possible safety concern.

(7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:

(a) Describe how cultural background, lifestyle practices, and traditions can impact care and use methods to determine and ensure that these are respected and considered when providing care.

(8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the service plan.

(9) Regarding the competency on fall prevention, prevent or reduce the risk of falls:

(a) Identify fall risk factors and take action to reduce fall risks for a resident; and

(b) Take proper steps to assist a resident who is falling or has fallen.

(10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:

(a) Explain the importance of observing a resident's skin, when to observe it and what to look for including common signs and symptoms of skin breakdown;

(b) Identify risk factors of skin breakdown;

(c) Observe skin at pressure point locations and report any concerns;

(d) Describe what a pressure ulcer is, what it looks like, and what to take if a resident develops a pressure ulcer;

(e) Describe current best practices that protect and maintain a resident's skin integrity including position changes when sitting or lying for extended periods and proper positioning and transfer techniques;

(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and

(g) Identify when to report skin changes and to whom.

(11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:

(a) Identify when, how, and why to obtain information from appropriate sources about a resident's condition or disease for which they are receiving services. Describe how to use this information to provide appropriate, individualized care;

(b) Describe a resident's baseline based on information provided in the service plan and explain why it is important to know a resident's baseline;

(c) Identify changes in a resident's physical, mental, and emotional state through observation;

(d) Report changes from baseline and/or concerns to the appropriate care team member(s);

(e) Identify basic job standards and requirements (e.g. coming to work on time) and describe how maintaining these standards are critical to a resident's safety and well-being;

(f) Explain the purpose of a service plan and describe how it is created, used, and modified;

(g) Use a resident's service plan to direct a worker's job tasks and any resident directed care tasks;

(h) Identify what is required of a long-term care worker, as described in WAC 388-112-0195, prior to performing a nurse-delegated task;

(i) Describe the role of a care team and a long-term care worker's role in it;

(j) Describe professional boundaries and the importance of maintaining them; and

(k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them.

(12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

(a) Demonstrate, in the presence of a qualified instructor, all critical steps required for personal care tasks including but not limited to:

(i) Helping a resident walk;

(ii) Transferring a resident from a bed to a wheelchair;

(iii) Turning and repositioning a resident in bed;

(iv) Providing mouth care;

(v) Cleaning and storing dentures;

(vi) Shaving a face;

(vii) Providing fingernail care;

(viii) Providing foot care;

(ix) Providing a bed bath;

(x) Assisting a resident with a weak arm to dress;

(xi) Putting knee-high elastic stockings on a resident;

(xii) Providing passive range of motion for one shoulder;

(xiii) Providing passive range of motion for one knee and ankle;

(xiv) Assisting a resident to eat;

(xv) Assisting with peri-care;

(xvi) Assisting with the use of a bedpan;

(xvii) Assisting with catheter care;

(xviii) Assisting with condom catheter care; and

(xix) Providing medication assistance.

(b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate resident preferences, maintain privacy and dignity, support the resident's level of ability, and assure their comfort and safety;

(c) Appropriately utilize assistive device(s) specified on the service plan;

(d) Describe any safety concerns related to each task and how to address the concerns;

(e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

(f) Identify the importance of knowing a resident's bowel and bladder functioning baseline and when to report changes.

(13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:

(a) Describe how nutrition and hydration can impact a resident's health;

(b) Plan, shop, and prepare meals for a resident according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the service plan and resident preferences;

(c) Describe common signs of poor nutrition and hydration, and when to report concerns and to whom;

(d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a resident;

(e) Recognize when a resident's food choices vary from specifications on the care plan, describe when and to whom to report concerns;

(f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

(g) Describe appropriate food handling practices, including: avoiding cross contamination from one food to another, safe storage requirements for cooling of leftover foods, including depth, types of containers, and temperatures, the need to maintain food at proper temperatures to limit bacterial growth and what are the safe food storage and holding temperatures for both cold and hot foods, best practices for thawing and re-heating food, and using clean gloves (if possible) and clean utensils when preparing food;

(h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

(i) Describe why a long-term care worker with certain types of illnesses and/or symptoms must not prepare food.

Long-term care workers who complete a DSHS-approved basic training meet the training requirements for adult family homes in RCW 70.128.250.

(14) Regarding the competency of medication assistance, appropriately assist with medications:

(a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications as described in chapter 246-888 WAC;

(b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;

(c) Identify common symptoms of medication side effects and when and to whom to report concerns;

(d) Store medications according to safe practices and the label instructions;

(e) Describe, in the proper sequence, each of the five rights of medication assistance; and

(f) Identify what to do for medication-related concerns, including describing ways to work with a resident who refuses to take medications, identifying when and to whom to report when a resident refuses medication or there are other medication-related concerns, and identifying what is considered a medication error and when and to whom it must be reported.

(15) Regarding the competency of infection control and blood borne pathogens including HIV/AIDS, implement best practices to prevent and control the spread of infections:

(a) Identify commonly occurring infections, ways that infections are spread, and symptoms of infections;

(b) Describe the purpose, benefit and proper implementation of standard precautions in infection control;

(c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;

(d) Demonstrate proper hand washing and putting on and taking off gloves;

(e) Identify immunizations that are recommended for adults to reduce the spread of virus and bacteria;

(f) Describe laundry and housekeeping measures that help in controlling the spread of infection;

(g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;

(h) Describe what BB pathogens are and how they are transmitted;

(i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;

(j) Identify measures to take to prevent BB diseases;

(k) Describe what to do if exposed to BB pathogens and how to report an exposure;

(l) Describe how HIV works in the body;

(m) Explain that testing and counseling for HIV/AIDS is available;

(n) Describe the common symptoms of HIV/AIDS;

(o) Explain the legal and ethical issues related to HIV including required reporting, confidentiality and nondiscrimination; and

(p) Explain the importance of emotional issues and support for residents and long-term care workers.

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

(16) Regarding the competency on grief and loss, support yourself and the resident in the grieving process:

(a) Define grief and loss;

(b) Describe common losses a resident and long-term care worker may experience;

(c) Identify common symptoms associated with grief and loss;

(d) Describe why self-care is important during the grieving process; and

(e) Identify beneficial ways and resources to work through feelings of grief and loss.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0055, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0059   What training is required for instruction and support staff in supported living programs?   (1) The training that is required for instruction and support staff in supported living programs is an integrated seventy-five hour curriculum designed specifically for instruction and support services staff in the supported living programs.

(2) Developmental disabilities supported living provider training must include the following topics:

(a) Orientation and safety;

(b) Client rights and dignity;

(c) Activities of daily living;

(d) Abuse, neglect, financial exploitation, and mandatory reporting;

(e) Observation and reporting;

(f) Instruction and support activities;

(g) Communication skills;

(h) Problem solving;

(i) Cultural awareness and sensitivity;

(j) Infection control;

(k) Blood-borne pathogens and HIV/AIDS;

(l) Skin care;

(m) Fall prevention;

(n) Health and functioning;

(o) Medication assistance;

(p) Food preparation and handling;

(q) Instruction and support services staff roles and boundaries;

(r) Long-term care worker self-care; and

(s) Grief and loss.

(3) Regarding the topic of supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

(a) Demonstrate, in the presence of a qualified instructor, all critical steps required for personal care tasks including but not limited to:

(i) Helping a client walk;

(ii) Transferring a client from a bed to a wheelchair;

(iii) Turning and repositioning a client in bed;

(iv) Providing mouth care;

(v) Cleaning and storing dentures;

(vi) Shaving a face;

(vii) Providing fingernail care;

(viii) Providing foot care;

(ix) Providing a bed bath;

(x) Assisting a client with a weak arm to dress;

(xi) Putting knee-high elastic stockings on a client;

(xii) Providing passive range of motion for one shoulder;

(xiii) Providing passive range of motion for one knee and ankle;

(xiv) Assisting a client to eat;

(xv) Assisting with peri-care;

(xvi) Assisting with the use of a bedpan;

(xvii) Assisting with catheter care;

(xviii) Assisting with condom catheter care; and

(xix) Providing medication assistance.

An approved skills checklist will be used to determine that each long-term care worker can proficiently complete each skill.

(b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectively while explaining what the long-term care worker is doing, incorporate client preferences, maintain privacy and dignity, support the client's level of ability, and assure their comfort and safety;

(c) Appropriately utilize assistive device(s) specified on the service plan;

(d) Describe any safety concerns related to each task and how to address the concerns;

(e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

(f) Identify the importance of knowing a client's bowel and bladder functioning baseline and when to report changes.

(4) Regarding the topic of food preparation and handling, assist a client to plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by assisting a client to prepare and handle food in a safe manner.

(a) Describe how nutrition and hydration can impact a client's health;

(b) Plan, shop, and assist to prepare meals according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions per the service plan and client preferences;

(c) Describe common signs of poor nutrition and hydration, and when to report concerns and to whom;

(d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a client;

(e) Recognize when a client's food choices vary from specifications on the service plan, describe when and to whom to report concerns;

(f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

(g) Describe appropriate food handling practices, including: avoiding cross contamination from one food to another, safe storage requirements for cooling of leftover foods, including depth, types of containers, and temperatures, the need to maintain food at proper temperatures to limit bacterial growth and what are the safe food storage and holding temperatures for both cold and hot foods, best practices for thawing and re heating food, and using clean gloves (if possible) and clean utensils when preparing food;

(h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

(i) Describe why a long term care worker with certain types of illnesses and/or symptoms must not prepare food.

(5) Only the curriculum developed by DSHS may be used for the developmental disabilities supported living provider training.

(6) The developmental disabilities supported living provider training may include up to twelve hours of on-the-job training.

(7) One hour of completed classroom instruction or other form of training (such as a video or on-line course) equals one hour of training.

(8) In order to become certified as a home care aide, instruction and support staff who complete this course may choose to become a certified home care aide without taking an additional core competency course.

(9) There is no challenge test for this training.

[]


NEW SECTION
WAC 388-112-0062   What is on-the-job training?   (1) Effective July 1, 2011, on-the-job training is a method of training when the long-term care worker successfully demonstrates any or all of the personal care or infection control skills included in the core basic training while working with a client versus in a practice training setting.

(2) On-the-job training is provided by a qualified instructor as defined in WAC 388-112-0380 who directly observes, coaches, and reinforces skills training for up to two long-term care workers at a time. The instructor providing the on-the-job training:

(a) Does not have to be the instructor who has taught the core competency training;

(b) Cannot be someone whose primary job duty is providing direct care to clients; or

(c) Cannot be the immediate supervisor of the long-term care worker receiving the on-the-job training.

(3) The person overseeing on-the-job training must:

(a) Submit DSHS required forms and become an approved instructor for the core competency of basic training; and

(b) Verify on a DSHS approved skills checklist the long-term care worker's successful completion of the demonstrated skills.

(4) For the person receiving on-the-job training, the hours spent in on-the-job training may count for up to twelve hours toward the completion of basic training requirements. It is not a requirement to include on-the-job training hours in the basic training hours.

[]


NEW SECTION
WAC 388-112-0066   What is the population specific component of basic training?   Population specific basic training is training on topics that are unique to the care needs of the population that the home or provider is serving. Topics can include but are not limited to:

(1) Dementia;

(2) Mental health;

(3) Developmental disabilities;

(4) Young adults with physical disabilities; and

(5) Aging and older adults.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0070   What documentation is required ((for successful)) to show completion of seventy hours of basic training that includes both core competencies and population specific competencies?   (1) Basic training must be documented by a certificate(s) or transcript of ((successful)) completion of training, issued by the instructor or training entity, that includes:

(a) The name of the trainee;

(b) The name of the training;

(c) The number of hours of the training;

(d) The name and the identification number of the instructor for core competencies, and the home or training entity giving the training. The instructor's, home's, or training entity's identification number for basic core training is provided by the department and is issued by the department of health's contractor for the home care aide certification test;

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

(((e))) (f) The completion date(((s))) of the training.

(2) The trainee must be given an original certificate(s) or transcript for proof of completion of the training. A home must keep a copy of the certificate on file as described in WAC 388-76-10198 (for adult family homes) and as described in WAC 388-78A-2450 (for boarding homes).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0070, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0075   Who is required to complete basic training, and when, unless exempt as described in WAC 388-112-0076?   Adult family homes

(1) Adult family home ((providers (including entity representatives as defined under chapter 388-76 WAC))) applicants must complete basic training ((and demonstrate competency)) before ((operating an)) licensure of the adult family home.

(2) Adult family home entity representatives and resident managers must complete basic training and demonstrate competency before ((providing services in an)) assuming the duties of the position in the adult family home.

(3) ((Caregivers)) Long-term care workers in adult family homes must complete basic training within one hundred twenty days of ((when they begin providing hands-on personal care or within one hundred twenty days of September 1, 2002, whichever is later)) employment. Until ((competency in)) completion of the basic training ((has been demonstrated, caregivers)) long-term care workers may not provide hands-on, personal care without indirect supervision.

Boarding homes

(4) Boarding home administrators (or their designees), except administrators with a current nursing home administrator license, must complete basic training ((and demonstrate competency)) within one hundred twenty days of employment ((or within one hundred twenty days of September 1, 2002, whichever is later)).

(5) ((Caregivers)) Long-term care workers must complete basic training within one hundred twenty days of ((when they begin providing hands-on personal care or within one hundred twenty days of September 1, 2002, whichever is later)) employment. Until ((competency in)) completion of the basic training ((has been demonstrated)), ((caregivers)) long-term care workers may not provide hands-on personal care without direct supervision.

Supported living providers

(6) Supported living applicants, administrators, and instruction and support services staff must complete the developmental disabilities supported living provider integrated basic training within one hundred twenty days of employment. Until completion of the basic training, long-term care workers may not provide hands-on personal care without indirect supervision.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0075, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0076   What long-term care workers are exempt from the basic training requirement?   The following long-term care workers are exempt from the basic training requirement:

(1) A person employed as a long-term care worker on December 31, 2010, who completed prior to January 1, 2011, the basic training requirements in effect on the date of his or her hire;

(2) A person employed as a long-term care worker on December 31, 2010, who completes within one hundred twenty days of hire, the basic training requirements in effect on the date of his or her hire;

(3) A person previously employed as a long-term care worker prior to December 31, 2010, who completed prior to January 1, 2011, the basic training requirements in effect on the date of his or her hire, and was employed as a long-term care worker at some point during the calendar year 2010;

(4) Registered nurses, licensed practical nurses, nurse technicians, or advanced registered nurse practitioner under chapter 18.79 RCW;

(5) Nursing assistants-certified under chapter 18.88A RCW;

(6) Certified counselors under chapter 18.19 RCW;

(7) Speech language pathologists or audiologists under chapter 18.35 RCW;

(8) Occupational therapists under chapter 18.59 RCW;

(9) Physical therapists under chapter 18.74 RCW;

(10) A home health aide who is employed by a medicare-certified home health agency and has met the requirements of 42 CFR, Part 483.35; and

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

[]


NEW SECTION
WAC 388-112-0078   What DSHS-developed curriculum may be used in the population specific component of the basic training?   Homes or providers may use the following DSHS-developed curriculum to meet all or some of the population specific component of basic training depending on the needs of the population served:

(1) Dementia specialty training;

(2) Mental health specialty training; and

(3) Developmental disabilities specialty training.

[]


NEW SECTION
WAC 388-112-0079   What are the requirements for using basic training to meet the specialty training requirements as described in WAC 388-112-0385, 388-112-0390 and 388-112-0395   When basic training is used to meet the specialty training requirements:

(1) It must include the department developed competencies and learning objectives as described in WAC 388-112-0385, 388-112-0390, or 388-112-0395. Homes or providers may enhance the specialty training component by adding additional competencies, learning objectives, content, or activities. If the department approves the enhancements and an increased number of training hours, the worker's training hours will apply to the seventy hour training requirement.

(2) Long-term care workers must take and pass a department competency test to meet the licensing requirements for adult family homes and boarding homes for all specialty training.

[]

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-112-0081   What topics may the training on young adults with physical disabilities include?   The training on young adults with physical disabilities may include all of the competencies and learning objectives under WAC 388-112-0083 for the following topics:

(1) Introduction to physical disabilities;

(2) Common physical disabilities and ability limitations;

(3) Supporting residents living with chronic conditions;

(4) Independent living and resident-directed care; and

(5) Social connections and sexual needs of adults living with disabilities.

[]


NEW SECTION
WAC 388-112-0083   What are the competencies and learning objectives for the training on young adults with physical disabilities?   The competencies define the integrated knowledge, skills, or behavior expected of a long-term care worker after completing the training on young adults with physical disabilities. Learning objectives are associated with each competency.

(1) Regarding the competency on young adults with physical disabilities, work effectively with young adults with physical disabilities based upon a basic understanding of disability:

(a) Identify basic information regarding physical disabilities, injuries, and illnesses that are more common in young adults;

(b) Describe the impact of changing and fluctuating abilities;

(c) Identify stereotypes, biases, and misconceptions regarding the perception of young adults with physical disabilities;

(d) Describe how biases, stereotypes, and misconceptions can influence care to young adults with physical disabilities;

(e) Identify and explain the Americans with Disabilities Act and rights for adults with physical disabilities; and

(f) Describe the value of personalizing care and support to the specific resident with a disability.

(2) Regarding the competency on common physical disabilities and ability limitations, provide individualized care based upon a basic understanding of common physical disabilities and their impact on functioning:

(a) Describe common physical disabilities, including paraplegia and quadriplegia, diabetes, multiple sclerosis, and pulmonary disease.

(b) Describe the characteristics and functional limitations of residents with these specific disabilities.

(3) Regarding the competency on supporting residents living with chronic conditions, provide appropriate care by recognizing chronic secondary conditions that impact functioning:

(a) Identify how common chronic medical conditions affect physical disability;

(b) Describe how chronic medical conditions influence and impact care for a young resident with a physical disability;

(c) Describe how to support a resident with a physical disability and multiple chronic conditions; and

(d) Describe how to support the resident's dignity while providing personal care.

(4) Regarding the competency on independent living and resident-directed care, support independent living and self-determination for the resident living with a disability:

(a) Define the independent living philosophy and describe what it might look like;

(b) Describe barriers to independent living, including accessibility and attitudes;

(c) Describe ways to support independent living and self-determination with the resident living with a disability;

(d) Describe resident-directed support;

(e) Identify ways to promote resident-directed support; and

(f) Identify resources that promote independence and self-determination for a resident living with a disability.

(5) Regarding the competency of social connections and sexual needs of young adults living with a physical disability, provide optimum support to a resident living with a disability in his or her expression of social and sexual needs:

(a) Describe and explain the importance of full, appropriate, and equal participation of resident's living with a physical disability;

(b) Identify ways to support social connections and activities;

(c) Describe and explain the importance of honoring the resident as a sexual being with diverse sexual needs, desires, and orientation; and

(d) Identify ways to support expression of sexual needs in a respectful, professional, and confidential manner.

[]


NEW SECTION
WAC 388-112-0088   What topics may the training on aging and older adults include?   Training on aging and older adults may include all of the competencies and learning objectives under WAC 388-112-0091 for the following core knowledge and skills:

(1) Introduction to aging;

(2) Age-associated physical changes;

(3) Cultural impacts on aging;

(4) Ageism and supporting resident dignity;

(5) Supporting residents living with a chronic condition;

(6) Dealing with death, grief, and loss; and

(7) Supporting health and wellness.

[]


NEW SECTION
WAC 388-112-0091   What are the competencies and learning objectives for training on aging and older adults?   The competencies define the integrated knowledge, skills, or behavior expected of a long-term care worker after completing the training on aging and older adults. Learning objectives are associated with each competency.

(1) Regarding the competency on an introduction to aging, draw upon a basic understanding of the aging process and demonstrate awareness of the unique needs of older adults:

(a) Describe basic information on the aging process, including the difference between age-related changes and a disease process;

(b) List typical changes that occur with aging;

(c) Identify common stereotypes, biases, myths, and misconceptions regarding aging, ageism, and older adults;

(d) Describe how ageism, biases, myths, and misconceptions can influence care to older residents;

(e) Describe how aging affects the resident's needs and behaviors; and

(f) Describe the value of adapting caregiving to the age-related concerns of the resident.

(2) Regarding the competency on age-associated physical changes, provide individualized care by understanding physical changes that are experienced in aging:

(a) Identify common physical changes experienced in the aging process;

(b) Describe common sensory changes that occur in aging and their impact on an older adult's activities;

(c) Describe the difference between age-associated physical changes versus a disease process; and

(d) Describe how age-related physical changes can impact functioning and the ability to perform personal care.

(3) Regarding the competency on cultural impacts of aging, provide culturally compassionate care by utilizing a basic understanding of issues related to culture and aging:

(a) Describe how race/ethnicity, poverty, and class influence the aging process;

(b) Describe how race/ethnicity, poverty, and class influence an older adult's help-seeking behavior; and

(c) Describe a culturally sensitive approach to working with older adults that demonstrates shared decision-making and mutual respect.

(4) Regarding the competency on ageism and supporting resident dignity, overcome ageism and support resident dignity by understanding stereotypes and myths regarding aging:

(a) Describe the concept of "ageism" and its possible impact on working with older adults;

(b) Identify his or her perceptions about aging and how these perceptions may contribute to "ageism";

(c) Describe how "ageism" can influence resident dignity; and

(d) Describe strategies for overcoming "ageism" and supporting resident dignity.

(5) Regarding the competency on supporting residents living with chronic medical conditions, provide appropriate care by recognizing how chronic conditions impact functioning:

(a) Describe how chronic medical conditions can influence and impact care for older adults;

(b) Describe strategies for working with an older adult with multiple chronic medical conditions;

(c) Describe proactive ways to support an older adult living with chronic medical conditions; and

(d) Describe how to help support the older adult's dignity while providing care.

(6) Regarding the competency on dealing with death, grief and loss, respond appropriately to a resident experiencing loss:

(a) Describe common examples of losses encountered in the aging process;

(b) Describe common reactions to loss of significant roles;

(c) Describe strategies for dealing with loss;

(d) Describe the value of promoting social engagement for the older adult;

(e) Identify strategies and opportunities for promoting social engagement; and

(f) Identify actions and resources that can be used to help an older adult work through feelings of grief and loss.

(7) Regarding the competency on supporting optimum health and wellness, support the optimum health and wellness of older adults:

(a) Identify key factors that support resident health and wellness;

(b) Identify strategies for promoting resident optimum health while aging;

(c) Identify strategies and opportunities to support an older adult to engage in healthy life style choices; and

(d) Describe his or her role in promoting optimum health and wellness for older residents.

[]


NEW SECTION
WAC 388-112-0092   What learning objectives may be included in the curriculum for young adults with physical disabilities and/or for aging and older adults?   Homes or providers may develop a curriculum for young adults with physical disabilities and/or for aging and older adults using the learning objectives in WACs 388-112-0083 and WAC 388-112-0091 or any other relevant learning objectives for these populations and submit it for approval by the department.

[]


NEW SECTION
WAC 388-112-0106   Who is required to obtain certification as a home care aide, and when?   Unless exempt under WAC 246-980-070, the following must be certified by the department of health as a home care aide within the required timeframes:

(1) All long-term care workers, within one hundred and fifty days of hire;

(2) Adult family home applicants, before licensure;

(3) Adult family home entity representatives and resident managers, before assuming the duties of the position; and

(4) Boarding home administrators or their designee within one hundred and fifty days of hire.

[]


NEW SECTION
WAC 388-112-0107   Can an adult family home, boarding home, or supported living provider employ an individual to work as a long-term care worker if the individual has not completed the training and/or certification requirements?   An adult family home, boarding home, or supported living provider cannot employ an individual to work as a long-term care worker if the individual has previously worked as a long-term care worker and has not completed applicable training and/or certification requirements within the specific time limits. Such individual may be employed by an adult family home, boarding home or supported living provider to work as a long-term care worker only after applicable training and/or certification requirements are met. The department is authorized by RCW 70.128.160 to take enforcement action against an adult family home provider for noncompliance related to training and/or certification requirements. The department is authorized by RCW 18.20.190 to take enforcement action against a boarding home provider for noncompliance related to training and/or certification requirements. The department is authorized by WAC 388-101-4200 to take enforcement action against a supported living provider for noncompliance related to training and/or certification requirements.

[]


NEW SECTION
WAC 388-112-0108   What documentation is required for a long-term care worker to apply for the home care aide certification or recertification?   (1) Successful completion of seventy-five hours of training must be documented on a DSHS seventy-five hour training certificate by an approved training entity who has provided or verified that a total of seventy-five hours of training have occurred.

(2) An approved training entity issuing and signing a DSHS seventy-five hour training certificate must verify that the long-term care worker has the certificates or transcript 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. Only a DSHS or training partnership seventy-five hour training certificate can be submitted by a long-term care worker applying to the department of health for a 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 DSHS certificate issued by an approved training entity who has provided all twelve hours of continuing education training. If all twelve hours of continuing education were not provided by the same training entity, then an approved training entity must verify that the certified home care aide has certificates or transcripts that add up to twelve hours of DSHS-approved continuing education. Only a DSHS or a training partnership twelve-hour continuing education certificate can be submitted by a certified home care aide applying to the department of health for recertification.

(4) The long-term care worker and certified home care aide must retain the original seventy-five hour training certificate and any twelve-hour continuing education training certificates as long as they are employed and up to three years after termination of employment. Training entities must keep a copy of the certificates on file for six years.

[]


AMENDATORY SECTION(Amending WSR 06-16-072, filed 7/28/06, effective 8/28/06)

WAC 388-112-0110   What is specialty training and who is required to take specialty training?   (1) Specialty or "special needs" training((, including caregiver specialty training,)) provides instruction in caregiving 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 managers and ((caregivers, except for adult family home caregiver specialty training)) long-term care workers.

(2) Manager specialty training is required for boarding home administrators (or designees), adult family home applicants or providers ((and)), resident managers, and entity representatives who are affiliated with homes that serve residents who have one or more of the following special needs: developmental disabilities, dementia, or mental health. The managers described in subsection (2) of this section must take one or more of the following specialty trainings:

(a) Developmental disabilities specialty training, under WAC 388-112-0120((, is the required training on that specialty for adult family home providers and resident managers, and for boarding home administrators (or designees.)));

(b) Manager dementia specialty training, under WAC 388-112-0125((,)); and

(c) Manager mental health specialty training, under WAC 388-112-0135((, are the required trainings on those specialties for adult family home providers and resident managers, and for boarding home administrators (or designees))).

(3) ((Caregiver specialty training for boarding homes)) All long-term care workers including those who are exempt from basic training and who work in a boarding home, adult family home, or a supported living program, serving residents/clients with the special needs described in subsection (2) of this section, must take long-term care worker specialty training. Long-term care worker specialty training is as follows:

(a) Developmental disabilities specialty training, under WAC 388-112-0120((, is the required training on that specialty for boarding home caregivers)).

(b) ((Caregiver)) Long-term care worker dementia specialty training, under WAC 388-112-0130((,)); and ((caregiver))

(c) Long-term care worker mental health specialty training, under WAC 388-112-0140((, are the required trainings on those specialties for boarding home caregivers)).

(4) ((Caregiver specialty training for adult family homes:

The provider or resident manager who has successfully completed the manager specialty training, or a person knowledgeable about the specialty area, trains adult family home caregivers in the specialty needs of the individual residents in the adult family home, and there is no required curriculum)) Specialty training may be used to meet the requirements for the basic training population specific component if completed within one hundred and twenty days of employment.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230. 06-16-072, 388-112-0110, filed 7/28/06, effective 8/28/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0110, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0115   What specialty training((, including caregiver specialty training,)) is required if a resident has more than one special need?   If ((an individual)) a resident has needs in more than one of the special needs areas, the home must determine which of the specialty trainings will most appropriately address the overall needs of the person and ensure that the specialty training that addresses the overall needs is completed as required. If additional training beyond the specialty training is needed to meet all of the resident's needs, the home must ensure that additional training is completed.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0115, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0120   What ((knowledge and skills)) topics must ((manager and caregiver)) developmental disabilities specialty trainings include?   (1) ((Manager and caregiver developmental disabilities specialty trainings)) Developmental disabilities specialty training must include all of the ((learning outcomes and competencies published by DSHS)) competencies and learning objectives described under WAC 388-112-0122 for the following ((core knowledge and skills)) topics:

(a) Overview of developmental disabilities;

(b) Values of service delivery;

(c) Effective communication;

(d) Introduction to interactive planning;

(e) Understanding behavior;

(f) Crisis prevention and intervention; and

(g) Overview of legal issues and ((individual)) resident rights.

(2) For adult family homes, the division of developmental disabilities (DDD) will provide in-home technical assistance to the adult family home upon admission of the first resident eligible for services from DDD and, thereafter, as determined necessary by DSHS.

(((3) The manager and caregiver developmental disabilities specialty training learning outcomes and competencies may be obtained from the DSHS division of developmental disabilities.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0120, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0122   What are the competencies and learning objectives for the departmental disability specialty training?   The developmental disabilities specialty competencies describe the behavior and skills a long-term care worker should exhibit when working with residents. Learning objectives are associated with each competency.

(1) Regarding the competency on an overview of developmental disabilities, draw upon a basic understanding of developmental disabilities and demonstrate awareness of the unique needs of residents with developmental disabilities:

(a) Define developmental disability and describe intellectual disability, cerebral palsy, epilepsy, and autism;

(b) Identify common myths and misconceptions about developmental disabilities;

(c) Describe the negative effects of using labels such as "retarded" or "handicapped" to represent people and positive alternatives; and

(d) Differentiate between developmental disabilities and mental illness.

(2) Regarding the competency on values of service delivery, promote and support a resident's self-determination:

(a) Identify the principle of normalization and its significance to the work of long-term care workers;

(b) Explain how understanding each resident's needs leads to better services and supports, which lead to better outcomes for the resident;

(c) Describe each of the residential services guidelines and identify how the values represented in the guidelines are important in the lives of people with developmental disabilities;

(d) Describe the principle of self-determination; and

(e) Identify positive outcomes for residents with developmental disabilities when they are connected to the community they live in.

(3) Regarding the competency on communication, provide culturally compassionate and individualized care by utilizing a basic understanding of a resident or resident's history, experience, and cultural beliefs:

(a) List the key elements of effective communication;

(b) Describe the impact communication has on the lives of residents with developmental disabilities;

(c) Explain the impact a long-term care worker's behavior can have on eliciting communication;

(d) Explain the impact of a resident's physical environment on their ability to communicate;

(e) Describe methods of communication, other than verbal, that long-term care workers might use when supporting residents with developmental disabilities; and

(f) List tips for communication with residents with developmental disabilities.

(4) Regarding the competency on interactive planning, use person-centered and interactive planning when working with residents with developmental disabilities:

(a) Identify the benefits of using a person-centered planning process rather than the traditional planning methods used to develop supports for people with developmental disabilities;

(b) Identify key elements involved in interactive planning;

(c) Identify ways to include people with developmental disabilities and their families in the planning process; and

(d) Identify the required planning document for the setting and list ways to have a positive impact on the plan.

(5) Regarding the competency on challenging behaviors, use a problem solving approach and positive support principles when dealing with challenging behaviors:

(a) Identify the essential components of the concept of positive behavioral supports;

(b) Define the "ABCs" and describe how to use that process to discover the function of behavior;

(c) Explain why it is critical to understand the function of behavior before developing a support plan;

(d) Define reinforcement and identify ways to utilize it as a tool to increase a resident's ability to be successful;

(e) Identify the problems with using punishment to manage behavior;

(f) Identify behavior management techniques that are not allowed under DSHS policies and applicable laws;

(g) Identify factors that can positively and negatively influence the behavior of residents with developmental disabilities; and

(h) List steps to be taken when crisis or danger to people is immediate.

(6) Regarding the competency on crisis prevention, support a resident experiencing a crisis and get assistance when needed:

(a) Identify behaviors in people with developmental disabilities that might constitute "normal stress";

(b) Define "crisis";

(c) Differentiate the behaviors a resident who is in crisis exhibits from mental illness;

(d) Identify the principles of crisis prevention and intervention;

(e) Identify what types of situations require outside assistance and at what point it becomes necessary; and

(f) Name several ways to provide support to a resident experiencing a crisis.

(7) Regarding the competency on legal rights, promote and protect the legal and resident rights of residents with developmental disabilities:

(a) Explain how the rights of residents with disabilities compare to those of the general population;

(b) List the rights of residents living in adult family homes and boarding homes and the laws that support those rights;

(c) Describe how long-term care workers can help residents to exercise their rights;

(d) List ways a long-term care worker must safeguard each resident's confidentiality;

(e) Describe the three types of guardianship an resident with developmental disabilities might be subject to and why;

(f) List less restrictive alternatives to guardianship;

(g) Describe the responsibilities, powers, and limitations of a guardian; and

(h) Describe the relationship between long-term care workers and guardians/families.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0125   What knowledge and skills must manager dementia specialty training include?   (1) Manager dementia specialty training must include all the learning ((outcomes)) objectives and competencies published by DSHS for the following core knowledge and skills:

(a) Introduction to the dementias;

(b) Differentiating dementia, depression, and delirium;

(c) Caregiving goals, values, attitudes and behaviors;

(d) Caregiving principles and dementia problem solving;

(e) Effects of cognitive losses on communication;

(f) Communicating with people who have dementia;

(g) Sexuality and dementia;

(h) Rethinking "problem" behaviors;

(i) Hallucinations and delusions;

(j) Helping with activities of daily living (ADLs);

(k) Drugs and dementia;

(l) Working with families;

(m) Getting help from others; and

(n) Self-care for ((caregivers)) long-term care workers.

(((2) The manager dementia specialty training learning outcomes and competencies may be obtained from the DSHS aging and adult services administration.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0125, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0130   What ((knowledge and skills)) topics must ((caregiver)) long-term care worker dementia specialty training include?   (((1) Caregiver)) Long-term care worker dementia specialty training must include all the ((learning outcomes and competencies published by DSHS)) competencies and learning objectives under WAC 388-112-0132 for the following ((core knowledge and skills)) topics:

(((a))) (1) Introduction to the dementias;

(((b))) (2) Dementia, depression, and delirium;

(((c) Resident-based caregiving;

(d))) (3) Dementia caregiving principles;

(((e))) (4) Communicating with people who have dementia;

(((f))) (5) Sexuality and dementia;

(((g))) (6) Rethinking "problem" behaviors;

(((h))) (7) Hallucinations and delusions;

(((i))) (8) Helping with activities of daily living (ADLs); and

(((j))) (9) Working with family and friends.

(((2) The learning outcomes and competencies for caregiver dementia training may be obtained from the DSHS aging and adult services administration.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0130, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0132   What are the competencies and learning objectives for the long-term care worker dementia specialty training?   The dementia specialty competencies describe the behavior and skills a long-term care worker should exhibit when working with residents. Learning objectives are associated with each competency.

(1) Regarding the competency on an introduction to dementia, draw upon a basic understanding of dementia and demonstrate awareness of the unique needs of residents with dementia:

(a) Identify basic information on dementia, including causes and treatments;

(b) Describe how dementia affects resident needs and behaviors;

(c) List typical behaviors and symptoms a resident with dementia would most likely experience;

(d) Describe the differences that might be seen based on the type of dementia a resident has.

(2) Regarding the competency on dementia, depression, and delirium, respond appropriately to residents who have dementia, delirium, and/or depression:

(a) Identify and differentiate between dementia, depression, and delirium;

(b) Describe common symptoms of dementia, depression, and delirium and list possible causes;

(c) Compare and contrast among common symptoms of dementia, depression, and delirium; and

(d) Identify what symptom changes require immediate professional attention and how to access professional help.

(3) Regarding the competency on dementia caregiving principles, incorporate current best practices when providing dementia care:

(a) Identify current best practices in dementia caregiving;

(b) Describe current best practices in caregiving;

(c) Demonstrate the ability to support the resident's strengths using caregiving techniques to support those strengths; and

(d) Describe how to use cultural and life information to develop and enhance care provided to residents with dementia.

(4) Regarding the competency on communicating with people who have dementia, communicate in a respectful and appropriate manner with residents with dementia:

(a) Describe common dementia-caused cognitive losses and how those losses can affect communication;

(b) Identify appropriate and inappropriate nonverbal communication skills and discuss how each impacts a resident's behavior;

(c) Describe how to effectively initiate and conduct a conversation with a resident who has dementia; and

(d) Identify communication strategies to work with residents who have dementia.

(5) Regarding the competency on sexuality and dementia, protect a resident or resident's rights when dealing with issues of sexuality and appropriately manage unwanted or inappropriate sexual behavior:

(a) Identify ways in which dementia affects sexuality and sexual behaviors;

(b) Identify a resident's rights as they relate to sexuality and sexual behavior and discuss ways to support these rights; and

(c) Describe how to respond using nonjudgmental caregiving skills to residents' appropriate and inappropriate sexual behaviors.

(6) Regarding the competency on dealing with challenging behaviors, use a problem-solving approach when dealing with challenging behaviors:

(a) Describe how to use a problem-solving method to intervene in challenging behaviors or situations;

(b) Describe some possible common causes of challenging behaviors, including aggression, catastrophic reactions, wandering, and inappropriate sexual behavior and explore their causes;

(c) Describe how to implement a problem-solving process when working with a resident who has dementia; and

(d) Describe how to respond appropriately to a resident who is expressing a challenging behavior.

(7) Regarding the competency on hallucinations and delusions, respond appropriately when a resident is experiencing hallucinations or delusions:

(a) Define and differentiate between hallucinations and delusions;

(b) List different types of dementia-related hallucinations; and

(c) Describe how to appropriately and safely respond to a resident with dementia who is experiencing hallucinations and delusions.

(8) Regarding the competency on activities of daily living, make activities of daily living pleasant and meaningful:

(a) Identify and describe ways in which to support making activities of daily living pleasant for residents with dementia; and

(b) Describe strategies that support meaning and utilize an individualized approach when assisting a resident with dementia with activities of daily living.

(9) Regarding the competency on working with family and friends, respond respectfully, appropriately, and with compassion when interacting with families and friends of residents with dementia:

(a) Identify common concerns friends and family have when a loved one has dementia;

(b) Describe ways to be supportive and compassionate in interactions with family and friends of the resident with dementia;

(c) Identify how to find local resources for family support needs; and

(d) Describe a method to gather cultural and life history information from a resident and/or representative(s).

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0135   What knowledge and skills must manager mental health specialty training include?   (1) Manager mental health specialty training must include all the learning ((outcomes)) objectives and competencies published by DSHS for the following core knowledge and skills:

(a) Introduction to mental illness;

(b) Culturally compassionate care;

(c) Respectful communications;

(d) Understanding mental illness - major mental ((disorders)) illnesses;

(e) Understanding mental illness - baseline, decompensation, and relapse planning; responses to hallucinations and delusions;

(f) Understanding and interventions for behaviors perceived as problems;

(g) Aggression;

(h) Suicide;

(i) Medications;

(j) Getting help from others; and

(k) Self-care for ((caregivers)) long-term care workers.

(((2) The manager mental health specialty training learning outcomes and competencies may be obtained from the DSHS aging and adult services administration.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0135, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0140   What ((knowledge and skills)) topics must ((caregiver)) the long-term care worker mental health specialty training include?   (1) ((Caregiver)) The long-term care worker mental health specialty training must include all the ((learning outcomes and competencies published by DSHS)) competencies under WAC 388-112-0142 for the following ((core knowledge and skills)) topics:

(a) Understanding major mental ((disorders)) illnesses;

(b) ((Individual)) Resident background, experiences and beliefs;

(c) ((Responding to)) Respectful communication;

(d) Creative approaches to challenging behaviors;

(e) Decompensation((,)) and relapse((,)) planning;

(f) Responding to hallucinations and delusions;

(((d) Interventions for behaviors perceived as problems;

(e))) (g) Crisis intervention and dealing with aggression; and

(((f))) (h) Suicide prevention.

(((2) The learning outcomes and competencies for caregiver mental health training may be obtained from the DSHS aging and adult services administration.))

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0140, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0142   What are the competencies and learning objectives for the long-term care worker mental health specialty training?   The mental health specialty competencies describe the behavior and skills a long-term care worker should exhibit when working with residents. Learning objectives are associated with each competency.

(1) Regarding the competency on understanding major mental illnesses, draw upon a basic understanding of mental illness and demonstrate awareness of the unique needs of residents with mental illness:

(a) Define and describe main symptoms of depression, bipolar schizophrenia, and anxiety disorder, and list treatment options for each;

(b) Describe causes of mental illness;

(c) Describe the progression of mental illness;

(d) Identify common myths and misinformation about mental illness; and

(e) Define stigma and identify how stigma can impact caregiving.

(2) Regarding the competency on resident background, experiences and beliefs, provide culturally compassionate and individualized care by utilizing a basic understanding of the resident's history, experience, and cultural beliefs:

(a) Demonstrate a method for gathering cultural, lifestyle, and personal value information from a resident;

(b) Identify why obtaining cultural information from a resident is important;

(c) Describe the importance of being sensitive to cultural differences when providing care;

(d) Differentiate how cultural beliefs and symptoms may be misinterpreted as mental illness; and

(e) Identify how the long-term care worker's culture might affect caregiving.

(3) Regarding the competency on communication and mental illness, communicate respectfully and appropriately with residents with a mental illness:

(a) Identify what is considered respectful and disrespectful communication when interacting with a resident with a mental illness;

(b) Identify what is judgmental communication toward a resident with a mental illness and ways to ensure communication is nonjudgmental;

(c) Identify examples of verbal and nonverbal communication and describe how each impacts communication; and

(d) Describe how to effectively initiate and conduct a respectful conversation with a resident who has a mental illness.

(4) Regarding the competency on creative approaches to challenging behaviors, use a problem-solving approach when dealing with challenging behaviors:

(a) Define and differentiate between inappropriate learned behaviors and symptoms of a mental illness;

(b) Identify possible common causes of challenging behaviors in a resident with a mental illness;

(c) Differentiate how challenging behaviors may be misinterpreted as mental illness; and

(d) Describe intervention strategies that can be used to reduce or prevent challenging behaviors.

(5) Regarding the competency on responding to de-compensation and relapse, respond appropriately when a resident is decompensating to help prevent a relapse:

(a) Define the terms baseline, de-compensation, and relapse;

(b) Identify common causes and symptoms of de-compensation and relapse;

(c) Describe the term "relapse plan" and review an example of a relapse plan; and

(d) Identify how a long-term care worker can support and use the relapse plan.

(6) Regarding the competency on responding to hallucinations and delusions, respond appropriately to a resident experiencing hallucinations or delusions:

(a) Define the terms hallucination and delusion;

(b) Identify common triggers (including stress) of delusions and hallucinations;

(c) Identify and describe appropriate intervention strategies for a resident experiencing a hallucination or delusion; and

(d) Describe how to accurately document a resident's behavioral symptoms, interventions, and outcomes.

(7) Regarding the competency on crisis intervention and dealing with aggression, intervene early when dealing with aggressive behavior to increase emotional stability and ensure safety:

(a) Define the term aggression;

(b) Identify the difference between aggressive behaviors and aggressive feelings;

(c) List de-escalation "do's" and "don'ts" as they relate to working with a resident expressing aggressive behavior;

(d) Describe appropriate de-escalation techniques when working with a resident expressing aggressive behavior; and

(e) Differentiate between nonimmediate and immediate danger and at what point additional assistance may be needed.

(8) Regarding the competency on suicide prevention, respond appropriately to a resident at risk of suicide:

(a) Identify and list signs a resident is possibly suicidal;

(b) Describe how to respond appropriately to a resident experiencing suicidal thoughts, including:

(i) How, where, and when to refer a resident who is experiencing suicidal thoughts and/ or planning; and

(ii) Methods to keep a suicidal resident safe and ensure the safety for others.

(c) Describe strategies to help cope with a resident's suicide.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0145   ((Is)) Who is required to complete competency testing ((required)) for specialty training((, including caregiver specialty training))?   Passing the DSHS competency test, as provided under WAC 388-112-0295 through 388-112-0315 is required for successful completion of specialty training for:

(1) All adult family home applicants or providers ((and)), resident managers, entity representatives, and ((for)) long-term care workers; and

(2) All boarding home administrators (or designees) and ((caregivers, as provided under WAC 388-112-0290 through 388-112-0315. Competency testing is not required for adult family home caregivers)) long-term care workers.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0145, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0150   Is there a challenge test for specialty training((, including caregiver specialty training))?   There is a challenge test for ((all)) each of the specialty trainings((, including caregiver specialty trainings, except the adult family home caregiver training)). Individuals may take the DSHS challenge test instead of required specialty training. A person who does not pass a challenge test on the first attempt must attend the class.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0150, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0152   Is competency testing required for population specific trainings on young adults with physical disabilities, aging and older adults, and the supported living provider training?   No, there is no competency testing required for the population specific trainings on young adults with physical disabilities, aging and older adults, and the supported living provider training.

[]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0155   What documentation is required for successful completion of specialty training((, including caregiver specialty training))?   Specialty training((, including caregiver specialty training,)) as applicable, must be documented by a certificate or transcript of successful completion of training, issued by the instructor or training entity((,)) that includes:

(1) The ((trainee's)) name of the trainee;

(2) The name of the training;

(3) The number of hours of the training;

(4) The name and identification number of the home or training entity giving the training;

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

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

(((6))) The trainee must be given an original certificate. The home must keep a copy of the certificate on file as described in WAC 388-76-10198 (for adult family homes) and as described in WAC 388-78A-2450 (for boarding homes).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0155, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0160   Who is required to complete manager specialty training, and when?   Adult family homes

(1) Adult family home applicants, providers (((including)), entity representatives ((as defined under chapter 388-76 WAC))) and resident managers must complete manager specialty training and demonstrate competency before ((admitting and serving residents)) the home is licensed or before a new resident manager is hired in order to admit or serve residents who have special needs related to mental illness, dementia, or a developmental disability.

(2) If a resident develops special needs while living in a home without a specialty designation, the provider, entity representative, and resident manager have one hundred twenty days to complete manager specialty training and demonstrate competency.

Boarding homes

(3) If a boarding home serves one or more residents with special needs, the boarding home administrator (or designee) must complete manager specialty training and demonstrate competency within one hundred twenty days of employment ((or within one hundred twenty days of September 1, 2002, whichever is later)). A boarding home administrator with a current nursing home administrator license is exempt from this requirement, unless the administrator will train ((their facility caregivers)) the facility's long-term care workers in a ((caregiver)) specialty.

(4) If a resident develops special needs while living in a boarding home, the boarding home administrator (or designee) has one hundred twenty days to complete manager specialty training and demonstrate competency. A boarding home administrator with a current nursing home administrator license is exempt from this requirement, unless the administrator will train ((their facility caregivers)) the facility's long-term care workers in a ((caregiver)) specialty.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0160, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0165   Who is required to complete ((caregiver)) long-term care worker specialty training, and when?   ((Adult family homes))

((If an adult family home serves one or more residents with special needs, all caregivers must receive training regarding the specialty needs of individual residents in the home. The provider or resident manager knowledgeable about the specialty area may provide this training.))

((Boarding homes))

If a boarding home or adult family home serves one or more residents with special needs, ((caregivers)) long-term care workers in those settings must complete ((caregiver)) specialty training and demonstrate competency.

(1) If the ((caregiver)) specialty training is integrated with basic training, ((caregivers)) long-term care workers must complete the ((caregiver)) specialty training within one hundred twenty days of ((when they begin providing hands-on personal care to a resident having special needs or within one hundred twenty days of September 1, 2002, whichever is later)) hire.

(2) ((If the caregiver specialty training is not integrated with basic training, caregivers)) Long-term care workers who are exempt from basic training must complete the relevant ((caregiver)) specialty training within ninety days of ((completing basic training)) hire.

(3) Until competency in the ((caregiver)) specialty training has been demonstrated, ((caregivers)) long-term care workers may not provide hands-on personal care to a resident with special needs without direct supervision in a boarding home or indirect supervision in an adult family home.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0165, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-065, filed 7/11/02, effective 8/11/02)

WAC 388-112-0195   Who is required to complete nurse delegation core training and nurse delegation specialized diabetes training, and when?   ((Adult family homes))

(1) Before performing any delegated nursing task, long-term care workers in adult family ((home staff)) homes, boarding homes, and supported living programs must:

(a) Successfully complete DSHS-designated nurse delegation core training, "Nurse Delegation for Nursing Assistants";

(b) Be a:

(i) Certified home care aide and a nursing assistant registered; or

(ii) Nursing assistant certified under chapter 18.88A RCW; ((and)) or

(iii) If exempt from the home care aide certification, become a nursing assistant registered and complete the core competencies of basic training.

(((c) If a nursing assistant registered, successfully complete basic training.

Boarding homes))

(2) Before performing ((any delegated nursing task, boarding home staff)) the task of insulin injections, long-term care workers in adult family homes, boarding homes, and supported living programs must:

(a) ((Successfully complete DSHS-designated nurse delegation core training)) Meet the requirements in subsections (1)(a) and (b) of this section; and

(b) ((Be a nursing assistant registered or certified under chapter 18.88A RCW; and

(c) If a nursing assistant registered, successfully complete basic training)) Successfully complete DSHS-designated specialized diabetes nurse delegation training.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-065, 388-112-0195, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0197   Can nurse delegation core and specialized diabetes training occur in the same year as basic training?   Nurse delegation core and specialized diabetes training can occur in the same year as basic training if required to be able to perform delegated tasks. If this occurs, the maximum of twelve hours for this training can be applied towards the continuing education requirement for the following year. Nurse delegation core and specialized diabetes trainings do not apply towards the population specific training.

[]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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 preapprove)) must approve continuing education ((programs or instructors)) curricula and instructors. The same continuing education course may not be repeated for credit unless it is a new or more advanced training on the same topic. Nurse delegation core and nurse delegation specialized diabetes training may be used to count towards continuing education.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0200, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0205   Who is required to complete continuing education training, and how many hours of continuing education are required each year?   Adult family homes

(1) ((Individuals subject to a continuing education requirement)) Until June 30, 2011, adult family home providers, entity representatives, resident managers, and long-term care workers 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. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

(2) Effective July 1, 2011, certified home care aides must complete twelve hours of continuing education each calendar year after obtaining certification as described in department of health WAC 246-980-110.

(3) If exempt from certification as described in RCW 18.88B.040, all long-term care workers must complete twelve hours of continuing education per calendar year. Continuing education must include one-half hour per year on safe food handling in adult family homes.

Boarding homes

(4) Until June 30, 2011, boarding home administrators (or their designees) and long-term care workers must complete ten hours of continuing education each calendar year after the year in which they complete basic training. If the ten hours of continuing education were completed between January 1, 2011 and June 30, 2011, then the continuing education requirements have been met for 2011.

(5) Effective July 1, 2011, certified home care aides must complete twelve hours of continuing education each calendar year after obtaining certification as described in department of health WAC 246-980-110 and 246-12-020(3).

(6) If exempt from certification as described in RCW 18.88.040, all long-term care workers must complete twelve hours of continuing education per calendar year. A boarding home administrator with a current nursing home administrator license is exempt from this requirement.

Supported living providers

(7) Effective July 1, 2011, all instruction and support services staff must complete twelve hours of continuing education each calendar year.

(8) A long-term care worker or certified home care aide who did not complete the continuing education requirements by the timeframe described in WAC 388-112-0207 cannot be paid to provide care after that date and cannot be reinstated as a long-term care worker until they complete the continuing education requirements.

(9) 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. The training entity must establish a way for the long-term care worker to ask the instructor questions.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0205, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0207   When must a long-term care worker or certified home care aide complete continuing education?   (1) Effective January 1, 2011 and for the year 2011, a long-term care worker must complete the continuing education requirements described in WAC 388-112-0205 by their birthday:

(a) A long-term care worker whose birthday occurs between January 1, 2011 and June 30, 2011, must complete the continuing education requirement by June 30, 2011.

(b) A long-term care worker whose birthday occurs on or after July 1, 2011, must complete the continuing education requirement by their birthday.

(2) Effective January 1, 2012, all long-term care workers and certified home care aides must complete the continuing education requirements described in WAC 388-112-0205 by their birthday.

(3) For long term care workers who are required to be certified, if the first renewal period is less than a full year from the date of certification, no continuing education will be due for the first renewal period.

[]


AMENDATORY SECTION(Amending WSR 06-01-046, filed 12/15/05, effective 1/15/06)

WAC 388-112-0210   What kinds of training topics ((are required for)) may be covered in continuing education?   Continuing education must be on a topic relevant to the care setting ((and)), care needs of residents, ((including)) or long-term care career development. Topics may include but are not limited to:

(1) Resident rights;

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

(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;

(12) Medical conditions; ((and))

(13) In adult family homes, safe food handling; and

(14) Nurse delegation core and specialized diabetes.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, 388-112-0210, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0210, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0220   May basic ((or modified basic)) training be completed a second time and used to meet the continuing education requirement?   Retaking basic ((or modified basic)) training may not be used to meet the continuing education requirement.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0220, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0225   May specialty training be used to meet continuing education requirements?   Manager specialty training and ((caregiver)) long-term care worker 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)) a different specialty training((s are)) is 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)) this other specialty training is taken ((and the following calendar year)).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0225, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0230   May nurse delegation core training or nurse delegation specialized diabetes training be used to meet continuing education requirements?   Nurse delegation training under WAC 388-112-0175 and 388-112-01961 may be applied toward continuing education requirements for the calendar year in which it is completed.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0230, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) the continuing education requirements described in WAC 388-112-0205.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0235, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0240   What are the documentation requirements for continuing education?   (1) The adult family home ((or)), boarding home, or supported living provider must maintain ((documentation)) DSHS certificates or transcripts of continuing education including:

(a) The ((trainee's)) name of the trainee;

(b) The title or content of the training;

(c) The number of hours of the training;

(d) 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; and

(((d) The number of hours of training; and))

(e) The date(s) of training.

(2) The trainee must be given an original DSHS certificate or other documentation of continuing education. The adult family home or boarding home must keep a copy of the certificate on file as described in WAC 388-76-10198 (for adult family homes) and as described in WAC 388-78A-2450 (for boarding homes). The supported living provider must keep a copy of the certificate on file and make it available for department inspections or reviews.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0240, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 06-01-046, filed 12/15/05, effective 1/15/06)

WAC 388-112-0255   What is first-aid training?   First-aid training is training that meets the guidelines established by the Occupational Safety and Health Administration (OSHA) and ((listed)) described at www.osha.gov. Under OSHA guidelines, training must include hands-on skills development through the use of mannequins or trainee partners. Topics include:

(1) General program elements, including:

(a) Responding to a health emergency;

(b) Surveying the scene;

(c) Basic cardiopulmonary resuscitation (CPR);

(d) Basic first aid intervention;

(e) Standard precautions;

(f) First aid supplies; and

(g) Trainee assessments.

(2) Type of injury training, including:

(a) Shock;

(b) Bleeding;

(c) Poisoning;

(d) Burns;

(e) Temperature extremes;

(f) Musculoskeletal injuries;

(g) Bites and stings;

(h) Confined spaces; and

(i) Medical emergencies; including heart attack, stroke, asthma attack, diabetes, seizures, and pregnancy.

(3) Site of injury training, including:

(a) Head and neck;

(b) Eye;

(c) Nose;

(d) Mouth and teeth;

(e) Chest;

(f) Abdomen; and

(g) Hand, finger and foot.

(4) Successful completion of first aid training, following the OSHA guidelines, also serves as proof of the CPR training.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, 388-112-0255, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0255, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 06-01-046, filed 12/15/05, effective 1/15/06)

WAC 388-112-0260   What are the CPR and first-aid training requirements?   Adult family homes

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

(2) Licensed nurses working in adult family homes must possess a valid CPR card or certificate within thirty days of employment and must maintain a valid card or certificate. If the licensed nurse is an adult family home provider or resident manager, the valid CPR card or certificate must be obtained prior to providing care for residents.

(3) Adult family home ((caregivers)) long-term care workers must obtain and maintain 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)) long-term care worker 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)) long-term care worker who has a valid first-aid and CPR card or certificate.

Boarding homes

(4) Boarding home administrators who provide direct care, and ((caregivers)) long-term care workers must possess a valid CPR and first-aid card or certificate within thirty days of employment, and must maintain valid cards or certificates. Licensed nurses working in boarding homes must possess a valid CPR card or certificate within thirty days of employment, and must maintain a valid card or certificate.

Supported living

(5) Applicants must obtain a valid CPR and first-aid card before certification and contract issuance and maintain valid cards or certificates.

(6) Instruction and support services staff must obtain and maintain a valid CPR and first-aid card or certificate:

(a) Within thirty days of beginning to provide care for clients, as long as the provision of care for clients is directly supervised by a fully qualified instruction and support services staff who has a valid CPR and first-aid card or certificate; or

(b) Before providing care to clients, if the provision of care is not directly supervised by a fully qualified instruction and support services staff who has a valid CPR and first-aid card or certificate.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, 388-112-0260, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0260, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 07-01-045, filed 12/14/06, effective 1/14/07)

WAC 388-112-0270   Who must take the forty-eight hour adult family home residential care administrator training and when?   ((Providers licensed prior to December 31, 2006: Before operating more than one adult family home, the provider (including an entity representative as defined under chapter 388-76 WAC) must successfully complete the department approved forty-eight hour residential care administrator training.

Prospective providers applying for a license after January 1, 2007: Before a license for an adult family home is granted, the prospective provider)) All applicants submitting an application for an adult family home license must successfully complete the department approved forty-eight hour residential care administrator training for adult family homes before a license for an adult family home will be issued.

[Statutory Authority: RCW 74.08.090, 18.20.090, 70.128.040, chapter 70.128 RCW and 2006 c 249. 07-01-045, 388-112-0270, filed 12/14/06, effective 1/14/07. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0270, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) objectives for the training; and

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

(4) Instructors who conduct competency testing must have experience or training in assessing competencies.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0295, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) The following trainings must include the DSHS-developed competency test:

(1) Manager dementia specialty training;

(2) Manager mental health specialty training;

(3) Long-term care worker dementia specialty training;

(4) Long-term care worker mental health specialty training;

(5) Developmental disabilities specialty training;

(6) Nurse delegation core training; and

(7) Nurse delegation specialized diabetes training.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0300, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 06-01-046, filed 12/15/05, effective 1/15/06)

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 retake the course before any additional tests are administered. ((Licensed adult family providers and employees who fail the food handling section of the basic training competency test a second time, must obtain a valid food worker permit.))

(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.

[Statutory Authority: RCW 18.20.090, 70.128.040, 70.128.230, and 2005 c 505. 06-01-046, 388-112-0315, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0315, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) with a curriculum ((or other curriculum)) approved by DSHS before use:

(a) Basic training (core and population specific training);

(b) ((Modified basic)) Orientation, safety, on-the-job, and continuing education;

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

(d) ((Caregiver)) Long-term care worker mental health, dementia, and developmental disabilities 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 developmental disabilities supported living provider training, nurse delegation core and diabetes 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.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0320, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0325   What ((are the minimum components that an alternative curriculum must include in order to be approved)) must be submitted to DSHS for curriculum approval?   ((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)) DSHS developed curriculum(s) do not require submission to the department for approval unless the curriculum is being modified in any manner by the training entity.

(1) For orientation and/or safety training:

Effective January 1, 2011, submit an outline of what will be covered in each training offered (for example, a table of contents or a class syllabus) showing that the required introductory topics as listed in WAC 388-112-0016 for orientation and WAC 388-112-0855 for safety training are covered in the training. Department required orientation and safety training application forms must be submitted to the department at least forty-five days in advance of when the training is expected to be offered. Training cannot be offered before receiving department curriculum and instructor approval.

(2) For continuing education:

Effective July 1, 2011, submit an outline of what will be covered in the training (for example, a table of contents or the class syllabus), the number of training hours, and a description of how the training is relevant to the care setting, care needs of residents, or long-term care worker career development. Department required continuing education training application forms must be submitted at least forty five days in advance of when the training is expected to be offered. The trainings cannot be offered before receiving department curriculum and instructor approval.

(3) For basic training:

(a) If the instructor or training entity wants to use the DSHS developed revised fundamentals of caregiving learner's guide with enhancements, submit the DSHS required form with all required information. Otherwise, the following must be submitted to DSHS for approval of one or both sections (core competencies and population specific competencies) of the seventy hours required for basic training. When submitting one or both sections of basic training curriculum for DSHS approval, it must at a minimum include:

(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives, described in this chapter, are located in the long-term care worker materials from the proposed curriculum for that course;

(ii) Any materials long-term care workers will receive, such as a textbook or long-term care worker manual, learning activities, audio-visual materials, handouts, and books;

(iii) The table of contents or outline of the curriculum, including the allotted time for each section;

(iv) Demonstration skills checklists for the personal care tasks described in WAC 388-112-0055(12)(a) and (b), and infection control skills (hand washing and putting on and taking off gloves);

(v) The teachers guide or manual that includes for each section of the curriculum:

(A) The goals and objectives;

(B) How that section will be taught, including teaching methods and learning activities that incorporate adult learning principles;

(C) Methods instructors will use to determine whether each long-term care worker understands the materials covered and can demonstrate all skills;

(D) A list of the sources or references that were used to develop the curriculum. If the primary source or reference is not a published citation, the instructor must provide detail on how the content was established as evidence based;

(E) Description of how the curriculum was designed to accommodate long-term care workers with limited English proficiency and/or learning disabilities; and

(F) Description and proof of how input was obtained from consumer and long-term care worker representatives in the development of the curriculum.

(b) In addition, for curricula being submitted for the core competency section of basic training as described in WAC 388-112-0055, the curriculum must include how much time students will be given to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill.

(c) Entities submitting curriculum for population specific basic training must submit their own list of competencies and learning objectives used to develop the population specific basic training curriculum.

(4) For specialty training:

For specialty training that is not the DSHS developed curriculum or other department approved curriculum, submit the required specialty training application form and any additional learning objectives added to the competency and learning objectives checklist, the enhancements that have been added, and additional student materials or handouts.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0325, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0330   What is the curriculum approval process for orientation, safety, basic training (core and population specific training), and continuing education?   (((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))) In order to obtain the department's approval of the curriculum for orientation, safety, basic training (core and population specific training), and continuing education:

(1) Submit the required training application forms and any other materials required for specific curriculums to the department.

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

(((5))) (3) If curriculum(s) are not approved, the reason(s) for denial will be given and the submitter will be told what portion(s) of the training must be changed and resubmitted for review in order for the curriculum to be approved.

(4) The submitter can make the requested changes and resubmit the curriculum(s) for review.

(5) If after working with the department the ((alternative curriculum is not approved, a revised curriculum may be resubmitted to DSHS for another review)) reasons why the curriculum is not approved cannot be resolved, the submitter may seek a review of the nonapproval decision from the assistant secretary of aging and disability services administration (ADSA). The assistant secretary's review decision shall be the final decision of DSHS. No other administrative review is available to the submitter.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0330, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0335   What are the requirements for a boarding home or adult family home that wishes to conduct orientation, safety, basic, ((modified basic, manager specialty, or caregiver)) on-the-job training, continuing education, or long-term care worker specialty training?   (1) A boarding home provider or adult family home provider wishing to conduct orientation, safety, basic, ((modified basic, manager specialty)) on-the-job training, continuing education, or ((caregiver)) long-term care worker specialty training ((for boarding home caregivers)) may do so if the ((home)) provider:

(a) Verifies ((and)), documents using the department's attestation process, keeps on file, and makes available to the department upon request that all instructors meet ((each of)) the minimum instructor qualifications in WAC 388-112-0370 through 388-112-0395 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)) provider's intent to conduct staff training prior to providing the ((home's)) provider's first training, and when changing training plans, including:

(i) ((Home)) The provider's name;

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

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

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

(v) Whether the ((home)) provider will train only the ((home's)) provider's staff, or will also train staff from other ((homes)) providers. If training staff outside the home or corporation, the instructor must become a DSHS-contracted community instructor;

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

(e) Provides a certificate or transcript 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)) long-term care worker certificates on file for six years, and gives the original certificate to the trainee;

(g) Keeps attendance records and testing records of ((students)) long-term care workers trained and tested on file for six years; and

(h) Reports training data to DSHS ((in DSHS-identified time frames)) when requested by the department.

(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)) The department may conduct a random audit at any time to review training and instructor qualifications.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0335, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0340   ((Do homes need)) Is department approval required to provide continuing education ((for their staff))?   Homes, supported living providers, or entities may provide continuing education for their staff with((out)) prior approval of the training curricula ((or)) and instructors by the department.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0340, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0345   When can DSHS prohibit a home or supported living provider from conducting its own training?   DSHS may prohibit a home or supported living provider from providing its own basic, ((modified basic,)) population specific, specialty, or ((caregiver specialty)) supported living provider training when:

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

(2) The home or supported living provider fails to notify DSHS of changes in the curriculum content prior to teaching the curriculum;

(3) The home or supported living provider provides false or misleading information to long-term care workers or the public concerning the courses offered or conducted;

(4) The home's or supported living provider's instructor does not meet the applicable qualifications under WAC ((388-112-0375)) 388-112-0370 through 388-112-0395; or

(((3))) (5) The home's or supported living provider'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))) (6) 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)) eighteen months.

(((5))) (7) Nothing in this section shall be construed to limit DSHS' authority under chapters 388-76 ((or)), 388-78A, or 388-101 WAC to require the immediate enforcement, pending any appeal, of a condition on the home license prohibiting the home or supported living provider from conducting its own training programs.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0345, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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 as described in WAC 388-112-0380, 388-112-0383 and 388-112-0385 through 388-112-0395 for that training: Orientation, safety training, basic training((;)), modified basic training((;)), young adults with physical disabilities, aging and older adults, manager and long-term care worker 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)), on-the-job training, and continuing education.

(2) Nurse delegation core and specialized diabetes training ((and residential care administrator training)) must be taught by ((an instructor)) a current Washington state RN who is approved by DSHS. The RN's license must be in good standing without practice restrictions.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0350, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0352   What trainings may be taught by an instructor that does not meet the minimum qualifications under this chapter?   The following trainings may be taught by an instructor that does not meet the minimum qualifications under this chapter:

(1) CPR; and

(2) First aid training.

[]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0355   What are ((an instructor's or)) a 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)) long-term care worker 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 reissuing training certificates to ((students)) long-term care workers.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0355, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0360   Must training entities and their instructors be approved by DSHS?   (1) DSHS-contracted ((instructors)) training entities:

(a) DSHS must approve ((any)) and/or contract with a training entity and their instructor(s) ((under contract with DSHS)) to conduct orientation, safety, basic, modified basic, population specific, residential care administrator, manager and long-term care worker specialty, ((or)) nurse delegation core and specialized diabetes training ((classes using the training curricula developed by DSHS)), on-the-job training, and continuing education.

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

(2) Homes or supported living providers conducting their own training

((Homes conducting their own training)) programs using the training curricula developed by DSHS or ((alternative)) another curricula approved by DSHS must ensure, through an attestation process, that their instructors meet the minimum qualifications for instructors under this chapter.

(3) ((Other instructors))

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

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0360, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) deny a person or organization seeking a contract with DSHS to conduct orientation, safety, basic, modified basic, population specific, residential care administrator, specialty, or nurse delegation core or specialized diabetes 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)) contract, except as may be provided through the contracting process.

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

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0365, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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?   (1) A guest speaker((s for basic and developmental disabilities specialty training)) is a person selected by an approved instructor to teach a specific topic. A guest speaker:

(a) May only 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)) and background and experience that demonstrates that the guest speaker has expertise on the topic he or she will teach.

(b) May 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 that meet the minimum qualifications((, and));

(b) Maintain documentation of ((this)) the guest speaker's background and qualifications;

(c) Supervise and monitor the guest speaker's performance; and

(d) Is responsible for insuring the required content is taught.

(3) DSHS does not approve guest speakers.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0370, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0380   What are the minimum qualifications for ((an instructor for basic or modified basic)) an instructor for basic, population specific, on-the-job training, residential care administrator, and nurse delegation core and specialized diabetes training?   An instructor for basic ((or modified basic)), population specific, on-the-job training, residential care administrator, nurse delegation core and nurse delegation specialized diabetes training must meet the following minimum qualifications ((in addition to the general instructor qualifications in WAC 388-112-0375)):

(1) Twenty-one years of age; and

(2) Has not had a professional health care, adult family home, boarding home, or social services license or certification revoked in Washington state.

(3) Education and work experience:

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

(i) Be a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting; or

(ii) Have an associate degree or higher degree in the field of health or human services and six months professional or caregiving experience within the last five years in an adult family home, boarding home, supported living through DDD, or home care setting; or

(iii) Have a high school diploma, or equivalent, 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))) (4) Teaching experience:

(a) Must have one hundred hours of experience teaching adults in a classroom 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 ((in)) on adult education that meets the requirements of WAC 388-112-0400.

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

(((4))) (6) 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.))

(7) In addition, an instructor for nurse delegation core and diabetes training must have a current Washington state RN license in good standing without practice restrictions.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0380, filed 7/11/02, effective 8/11/02.]


NEW SECTION
WAC 388-112-0383   What are the minimum qualifications for an instructor for orientation, safety, and continuing education?   An instructor for orientation, safety, and continuing education must be a registered nurse or other person with specific knowledge, training, and work experience in the provision of direct, hands-on personal care or other relevant services to the elderly or persons with disabilities requiring long-term care.

[]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0385   What are the minimum qualifications for instructors for manager and ((caregiver)) long-term care worker mental health specialty training?   (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)) 388-112-0380(1) and (2) 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 at least 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)) instructor qualification/demonstration process.

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

(2) Instructors for ((caregiver)) long-term care worker mental health specialty training:

(a) ((Caregiver)) Long-term care worker 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)) long-term care workers employed at other home(s) licensed by the same licensee.

(b) ((Caregiver)) Long-term care worker 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).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0385, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0390   What are the minimum qualifications for instructors for manager and ((caregiver)) long-term care worker dementia specialty?   (1) The minimum qualifications for instructors for manager dementia specialty, in addition to the general qualifications under WAC ((388-112-0375,)) 388-112-0380(1) and (2) 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)) instructor qualification/demonstration process.

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

(2) Instructors for ((caregiver)) long-term care worker dementia specialty training:

(a) ((Caregiver)) Long-term care worker 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)) long-term care workers employed at other home(s) licensed by the same licensee.

(b) ((Caregiver)) Long-term care worker 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).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0390, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

WAC 388-112-0395   What are the minimum qualifications for instructors for ((manager and caregiver)) long-term care worker 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)) 388-112-0380(1) and (2), include:

(a) The instructor must be experienced in developmental disabilities caregiving practices and capable of demonstrating competency in the entire course content, including the administration of competency testing;

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

(((c))) (d) Teaching experience:

(i) Two hundred hours of teaching experience; and

(ii) Successful completion of an 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)) mental health or manager dementia specialty course, the eighteen hour developmental disabilities specialty training, and has successfully completed the instructor qualification/demonstration process. A qualified instructor under this subsection may teach ((caregiver)) developmental disabilities specialty to ((caregivers)) long-term care workers 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).

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0395, filed 7/11/02, effective 8/11/02.]

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) facilities 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.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0405, filed 7/11/02, effective 8/11/02.]


AMENDATORY SECTION(Amending WSR 02-15-066, filed 7/11/02, effective 8/11/02)

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)) Long-term care workers attending a classroom training must not be expected to leave the class to attend to job duties, except in an emergency.

[Statutory Authority: RCW 18.20.090, 70.128.040, 74.39A.050, 34.05.020, 2000 c 121, and 2002 c 233. 02-15-066, 388-112-0410, filed 7/11/02, effective 8/11/02.]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-112-0025 Is competency testing required for orientation?
WAC 388-112-0030 Is there a challenge test for orientation?
WAC 388-112-0050 Is there an alternative to the basic training for some health care workers?
WAC 388-112-0060 Is competency testing required for basic training?
WAC 388-112-0065 Is there a challenge test for basic training?
WAC 388-112-0080 What is modified basic training?
WAC 388-112-0085 What knowledge and skills must be included in modified basic training?
WAC 388-112-0090 Is competency testing required for modified basic training?
WAC 388-112-0095 Is there a challenge test for modified basic training?
WAC 388-112-0100 What documentation is required for successful completion of modified basic training?
WAC 388-112-0105 Who may take modified basic training instead of the full basic training?
WAC 388-112-0245 Who is required to complete continuing education training, and when?
WAC 388-112-02610 What is HIV/AIDS training?
WAC 388-112-02615 Is competency testing required for HIV/AIDS training?
WAC 388-112-02620 Is there a challenge test for HIV/AIDS training?
WAC 388-112-02625 What documentation is required for completion of HIV/AIDS training?
WAC 388-112-02630 Who is required to complete HIV/AIDS training, and when?
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?
4198.2
AMENDATORY SECTION(Amending WSR 07-16-101, filed 7/31/07, effective 9/1/07)

WAC 388-829A-050   Who is eligible to contract with DDD to provide alternative living services?   Before DDD may issue an alternative living contract, the prospective provider must:

(1) Be twenty-one years of age or older;

(2) Have a high school diploma or GED;

(3) Clear a background check conducted by DSHS, as required by RCW 43.20A.710;

(4) Have an FBI fingerprint-based background check as required by RCW 43.20A.710, if the person has not lived in the state continuously for the previous three years;

(5) Have a business ID number, as an independent contractor; and

(6) Meet the minimum skills and abilities described in WAC 388-829A-110.

(7) Alternative living providers contracted after January 1, 2012 must be screened through a fingerprint-based FBI check as described in WAC 388-06-0110 through 388-06-0150.

[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. 07-16-101, 388-829A-050, filed 7/31/07, effective 9/1/07.]


NEW SECTION
WAC 388-829A-161   What are the training requirements for alternative living providers contracted before January 1, 2011?   Alternative living providers contracted before January 1, 2011 must meet the training requirements as described under WAC 388-829A-140 through 388-829A-160.

[]


NEW SECTION
WAC 388-829A-162   What are the training requirements for alternative living providers contracted on or after January 1, 2011?   Alternative living providers contracted on or after January 1, 2011 must meet the training requirements as described under chapter 388-112 WAC.

[]

4199.3
AMENDATORY SECTION(Amending WSR 07-16-102, filed 7/31/07, effective 9/1/07)

WAC 388-829C-040   Who is eligible to contract with DDD to provide companion home residential services?   To be eligible to contract with DDD to provide companion home residential services, a person must:

(1) Be twenty-one years of age or older;

(2) Have a high school diploma or GED;

(3) Clear a background check conducted by DSHS as required by RCW 43.20A.710;

(4) Have an FBI fingerprint-based background check as required by RCW 43.20A.710, if the person has not lived in the state continuously for the previous three years;

(5) Have a business ID number, as an independent contractor; and

(6) Meet the minimum skills and abilities described in WAC 388-829C-080.

(7) Companion home providers contracted after January 1, 2012 must be screened through a fingerprint-based FBI background check as described in WAC 388-06-0110 through 388-06-0150.

[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. 07-16-102, 388-829C-040, filed 7/31/07, effective 9/1/07.]


NEW SECTION
WAC 388-829C-131   What are the training requirements for companion home providers contracted before January 1, 2011?   Companion home providers must ensure that staff hired before January 1, 2011 meet the training requirements as described under chapter 388-829C WAC.

[]


NEW SECTION
WAC 388-829C-132   What are the training requirements for companion home providers contracted on or after January 1, 2011?   Companion home providers must ensure that staff hired on or after January 1, 2011 meet training requirements as described under chapter 388-112 WAC.

[]

Washington State Code Reviser's Office