WSR 26-02-034
PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Home and Community Living Administration)
[Filed December 30, 2025, 4:52 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 25-14-066.
Title of Rule and Other Identifying Information: The proposed rules are related to SHB 1142 (chapter 18, Laws of 2025). These rules bring alignment to training requirements and certification exemptions for long-term care (LTC) workers providing in-home care for family members. This is care provided by an individual provider through the consumer direct care network, through a home care agency and paid for by WA Cares, or through WA Cares third option, which will be defined in rule. These sections are WAC 388-71-0503 What definitions apply to this chapter?, 388-71-0520 What are the training requirements for a home care agency long-term care worker?, 388-71-0523 What are the training and certification requirements for long-term care workers providing in-home care?, 388-71-05415 When will the department deny payment to the home care agency?, 388-71-0836 What definitions apply to the long-term care worker training requirements?, 388-71-0839 Which long-term care workers are exempt from the 70-hour, 30-hour, 16-hour, nine-hour, or seven-hour basic training requirements?, 388-71-0860 Who must complete orientation and safety, by when, and when does orientation and safety training attestation process need to be completed?, 388-71-0880 Who must complete the 30-hour basic training and by when must it be completed?, 388-71-0888 When do the 70-hour basic training and certification requirements apply to an individual whose required basic training was previously less than 70 hours?, 388-71-0890 What are the training requirements for parent providers who are long-term care workers for their adult children through DDA?, 388-71-0893 Who must complete the nine-hour basic training and by when must it be completed?, 388-71-0897 Who must complete the 21-hour basic training and by when must it be completed?, 388-71-0899 What is the 21-hour training?, 388-71-0971 Prior to hiring a long-term care worker, what training and certification requirements must be reviewed by the home care agency, consumer directed employer, or department?, 388-71-0977 Once an individual is required to obtain certification as a home care aide, may that individual revert to exempt status?, 388-71-0980 When may a home care agency, consumer directed employer or the department employ a long-term care worker who has not completed the 70-hour basic training or certification requirements?, 388-71-0985 What is continuing education and what topics may be covered in continuing education?, 388-71-0991 Who is required to complete continuing education training and when must a long-term care worker or certified home care aide complete continuing education?, 388-71-1001 Which long-term care workers are exempt from the continuing education requirement?, 388-115-0510 What are the qualifications of an individual provider?, 388-115-0523 What are the training and certification requirements for individual providers?, and 388-115-0540 When will the consumer directed employer (CDE) reject your selected individual provider?
Hearing Location(s): On February 24, 2026, at 10:00 a.m., virtually via Teams or call in. See the department of social and health services (DSHS) website at https://www.dshs.wa.gov/sesa/rpau/proposed-rules-and-public-hearings for the most current information.
Date of Intended Adoption: Not before February 25, 2026.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, email DSHSRPAURulesCoordinator@dshs.wa.gov, beginning noon on January 7, 2026, by 5:00 p.m. on February 24, 2026.
Assistance for Persons with Disabilities: Contact Shelley Tencza, rules consultant, phone 360-664-6036, TTY 711 relay service, email shelley.tencza@dshs.wa.gov, by 5:00 p.m. on February 10, 2026.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of the proposal is to amend WAC 388-71-0503, 388-71-0520, 388-71-0523, 388-71-05415, 388-71-0836, 388-71-0839, 388-71-0860, 388-71-0880, 388-71-0888, 388-71-0890, 388-71-0893, 388-71-0897, 388-71-0899, 388-71-0971, 388-71-0977, 388-71-0980, 388-71-0985, 388-71-0991, 388-71-1001, 388-115-0510, 388-115-0523, and 388-[115-]0540 to align WAC with the requirements of SHB 1142. Specifically, legislation driven changes include replacing the phrase "individual provider" with LTC worker. This aligns basic training and home care aide certification rules across in-home care provider employers, including home care agencies, the consumer directed employer, and the long-term services and supports trust (WA Cares) potential "third option" for "qualified family members." Further changes are being made to add new sections to chapter 388-71 WAC to explain what LTC providers are required to complete the spouse/domestic partner basic training, as well as defining what that training includes. Also being modified is the WAC language regarding when a LTC provider may be rehired, that family providers working for home care agencies are required annual continuing education, and how long the LTC worker may be allowed to achieve the department of health home care aide certification. Further changes are made for housekeeping purposes and to correct other language and typographical errors in these sections.
Reasons Supporting Proposal: The reason for supporting this proposal is passed legislation (chapter 18, Laws of 2025) standardizing basic training and certification requirements for LTC workers who provide in-home care for their family members, including spouses or domestic partners.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: DSHS, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Brad McFadden, P.O. Box 45600, Lacey, WA 98504-5600, 360-725-2563.
A school district fiscal impact statement is not required under RCW
28A.305.135.
A cost-benefit analysis is required under RCW
34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Brad McFadden, P.O. Box 45600, Lacey, WA 98504-5600, phone 360-725-2563, TTY 711 relay service, email
bradley.mcfadden@dshs.wa.gov.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Is exempt under RCW
19.85.061 because this rule making is being adopted solely to conform and/or comply with federal statute or regulations. Citation of the specific federal statute or regulation and description of the consequences to the state if the rule is not adopted: Changes in RCW
18.88B.041 and chapter 322, Laws of 2024, RCW
74.39A.076 and section 2, chapter 322, Laws of 2024, and new section 3 under RCW
74.39A.076.
Is exempt under RCW
19.85.025(3) as the rules only correct typographical errors, make address or name changes, or clarify language of a rule without changing its effect.
Explanation of exemptions: The proposed rule clarifies and standardizes training and certification requirements for LTC workers who provide in-home care for their family members, including spouses and domestic partners under RCW
34.05.310 (4)(d).
Scope of exemption for rule proposal:
Is fully exempt.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. [No information supplied by agency].
December 29, 2025
Katherine I. Vasquez
Rules Coordinator
SHS-5117.3
((HOME CARE AGENCY))IN-HOME LONG-TERM CARE PROVIDER QUALIFICATIONS
AMENDATORY SECTION(Amending WSR 25-07-060, filed 3/13/25, effective 4/13/25)
WAC 388-71-0503What definitions apply to this chapter?
"Agency provider" means a long-term care worker (LTC) who works for a home care agency.
"Area agencies on aging (AAA)" means a contracted entity that aging and long-term support administration (ALTSA) grants funds to in order to carry out the functions of the Older Americans Act, general-fund state programs, and to provide case management services and supports to individuals 18 and older who receive medicaid-funded long-term care (LTC) in their own homes.
"Applicant" means a person who is in the process of becoming an in-home ((long-term care))LTC worker.
"Background check" means a name and date of birth check, or a fingerprint-based background check, or both.
"Background check result" is defined in WAC 388-113-0010.
"Background check central unit (BCCU)" means the DSHS entity responsible for conducting background checks for the department.
"Character, competence, and suitability determination (CC&S)" is defined in WAC 388-113-0050.
"Client" means an individual receiving ((medicaid-funded)) in-home long-term care services from ((the department))DSHS that are funded by medicaid or the long-term services and supports trust program (WA cares).
"Conflict of interest" means under 42 CFR 431 (c)(1)(vi), case management must be separate from service delivery functions. A contracted entity that aging and long-term support administration (ALTSA) grants funds to in order to carry out the functions of the Older Americans Act, general-fund state programs, and to provide case management services and supports to individuals 18 and older who receive medicaid-funded LTC in their own homes must comply with conflict-free case management.
"Department" means the department of social and health services (DSHS) or its designees.
"Family member" includes, but is not limited to a ((parent, child, sibling, aunt, uncle, niece, nephew, cousin, grandparent, grandchild, grandniece, grandnephew, or such relatives when related by marriage.)):
(1) Spouse or domestic partner;
(2) Parent, child, sibling, aunt, uncle, niece, nephew, cousin, grandparent, grandchild, grandniece, grandnephew, or such relatives when related by marriage or domestic partnership.
"Federally recognized Indian tribe" means self-governing American Indian/Alaskan Native (AI/AN) governments recognized under applicable federal and common law. Because of their sovereignty, federally recognized tribes have the inherent power to make and enforce laws on their lands, and to create governmental entities. A federally recognized tribe is an AI/AN tribal entity that is recognized as having a government-to-government relationship with the United States, with the responsibilities, powers, limitations, and obligations attached to that designation, and is eligible for funding and services from the Bureau of Indian Affairs. In addition, for the purpose of this rule, federally recognized Indian tribes are contracted entities that the aging and long-term support administration (ALTSA) may grant funds to carry out functions and to provide case management services and supports to individuals 18 and older who receive medicaid-funded long-term care in their own homes and general fund state programs.
"Fingerprint-based background check" means a search of in-state criminal history records through the Washington state patrol and national criminal history records through the Federal Bureau of Investigation.
"Home care agency (HCA)" means an entity that is licensed by the department of health to provide home care services through a contract arrangement with the department to clients in places of permanent or temporary residence.
"Home care agency long-term care (LTC) worker" means ((a long-term care))a LTC worker who works for a home care agency.
"Long-term care (LTC) worker" means any of the following:
(1) A((a)) direct care worker employed by a home care agency((.));
(2) An individual provider employed by a consumer directed employer; or
(3) Long-term services and supports trust (WA cares) "qualified family members".
"Name and date of birth check" is a search conducted by the background check central unit (BCCU) of Washington state criminal history and negative action records using the applicant's name and date of birth.
"Negative actions" are listed in WAC 388-113-0030.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0523What are the training and certification requirements for ((individual providers and home care agency)) long-term care (LTC) workers providing in-home care?
A LTC worker, hired on or after January 7, 2012, must meet the training requirements described in WAC 388-71-0836 through 388-71-1001. These training requirements also apply to LTC workers who were hired before January 7, 2012, if they did not complete the training requirements in effect at the time within 120 days of the date of hire. Prior to reinstating these individuals to work as a LTC worker, these training requirements and certification, if required, must be met, or the LTC worker must have been rehired as allowed under WAC 388-71-0837. The following chart provides a summary of the training and certification requirements for ((individual providers and home care agency long-term care))LTC workers as defined in WAC 388-71-0503. This includes criteria for ((those)) providers working limited hours for only one person, caring only for ((one's))the worker's child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild including when related by marriage or domestic partnership, providing approved services only for a spouse or registered domestic partner, or providing respite services((, or providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs)):
Who | Status | Orientation training | Safety training | Basic training | Continuing education | Required credential |
(1) (( An individual provider or home care agency long-term care)) A LTC worker who is a licensed, certified health care professional in good standing through the Washington state department of health, or (( an individual provider or home care agency)) a(( long-term care)) LTC worker with special education training who meets the criteria in RCW 18.88B.041 (1)(a)(i)(A). | ARNP, RN, LPN, HCA, NA-C, or other professionals listed in WAC 388-71-0839. | Not required. | Not required. | Not required. | Not required of ARNPs, RNs, or LPNs in chapter 388-71 WAC. Required 12 hours under WAC 388-71-0991 of NA-Cs, HCAs, and other professionals listed in WAC 388-71-0839, such as an individual with special education training with an endorsement granted by the superintendent of public instruction under RCW 28A.300.010. For NA-C and those with special education training 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Required under chapter 246-980 WAC. |
(2) ((An individual provider or home care agency long-term care))A LTC worker with specific employment history. | A ((long-term care))LTC worker who was employed at some point between January 1, 2011, and January 6, 2012, and ((has))who completed the basic training requirements in effect on the date of hire. WAC 388-71-0839. | Not required. | Not required. | Not required. | 12 hours is required every year while working in ((long-term care))LTC under WAC 388-71-0991. | Not required. |
(3) ((An individual provider or home care agency long-term care))A LTC worker employed by the consumer directed employer or home care agency. | Hired by a licensed home care agency or the consumer directed employer to provide personal care service as defined in WAC 388-71-0836 and is not exempt under subsection (1) or (2) of this section . | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 70 hours under WAC 388-71-0870 and 388-71-0875. | Required. 12 hours under WAC 388-71-0991. | Required under chapter 246-980 WAC. |
(4) ((An))A LTC worker who is an individual provider who works limited personal care hours for only one person. | An individual provider (employed by the consumer directed employer) providing 20 hours or less of nonrespite care for one person per calendar month and does not meet the criteria in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required. | Not required. |
(5) ((An)) A LTC worker who is an individual provider,((who)) provides only respite services, and works 300 hours or less in any calendar year. | (a) An individual providing respite care who works no more than 300 hours in the calendar year, is not exempt in subsection (1) or (2) of this section, and does not meet criteria in subsection (6) of this section. (b) Individual providing only in-home respite services for individuals with developmental disabilities , as defined in WAC 388-845-1600, that receive services under Title 71A RCW and for individuals that receive services under chapter 74.39A, that is working 300 hours or less in any calendar year, and that is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. Nine hours under WAC ((388-71-0890))388-71-0893. | Not required. | Not required. |
(6) (( An individual provider caring only for the provider's adult child who receives services through the developmental disabilities administration)) A parent (including when related by marriage or domestic partnership) who is the LTC worker providing in-home care only for the provider's developmentally disabled adult child receiving services under Title 71A RCW. | An individual providing care only for the provider's developmentally disabled adult child (( who receives services through the developmental disabilitiesadministration)) receiving services under Title 71A RCW and not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0895. | Required. Three hours under WAC 388-71-0895. | Required. Seven hours under WAC 388-71-0890. | Not required for LTC workers working as individual providers. 12 hours is required every year following completion of basic training while working in LTC as an agency provider. Parents working as individual providers and caring only for their for children will remain exempt from continuing education after Jan 1, 2027. | Not required. |
(7) ((An individual provider))A LTC worker caring only for the provider's parent, child (not covered in subsection (6) of this section), sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership. | ((An individual providing care))A LTC worker caring only for the ((individual provider's))worker's child (not covered in subsection (6) of this section, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership, who is not exempt in subsection (1) or (2) of this section, and does not meet the criteria in subsection (6) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required for LTC workers working as an individual provider until January 1, 2027, then 12 hours is required every year while working in ((long-term care))LTC under WAC 388-71-0991. 12 hours is required every year following completion of basic training while working in long-term care as an agency provider
Parents working as individual providers and caring only for the worker's children will remain exempt from continuing education after Jan 1, 2027. | Not required. |
(((8) An individual provider caring only for the provider's adult child. | An individual providing care only for the provider's adult child and not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0895. | Required. Three hours under WAC 388-71-0895. | Required 30 hours under WAC 388-71-0880. | Not required. | Not required.)) |
(((9)))(8) A ((long-term care))LTC worker providing approved services only for a spouse or registered domestic partner ((and funded through the United States department of veterans' affairs home and community-based programs)). | A ((long-term care))LTC worker providing approved services only for a spouse or registered domestic partner ((and funded through the United States department of veterans' affairs home and community-based programs)) who is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880 until July 1, 2026. The requirement is 16 hours beginning July 1, 2026. | 12 hours is required every year following completion of basic training while working in ((long-term care))LTC under 388-71-0991. | Not required. |
AMENDATORY SECTION(Amending WSR 21-18-081, filed 8/30/21, effective 10/1/21)
WAC 388-71-05415When will ((the department))DSHS deny payment to the home care agency?
((The department))DSHS will deny payment to the home care agency for services provided to a department client by an agency provider that it employs who:
(1) Does not meet the qualifications in WAC 388-71-0510; or
AMENDATORY SECTION(Amending WSR 25-16-084, filed 8/5/25, effective 10/1/25)
WAC 388-71-0836What definitions apply to the long-term care (LTC) worker training requirements?
The following definitions apply to the ((long-term care))LTC worker training requirements:
(1) "Activities of daily living" means self-care abilities related to personal care such as bathing, eating, using the toilet, medication assistance, 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.
(2) "Care team" means the client and everyone involved in the individual's care. The care team may include family, friends, doctors, nurses, ((long-term care))LTC workers, social workers, and case managers. The role of the care team is to support the client's well-being. However, the client directs the care plan.
(3) "Challenge test" means a competency test taken for specialty training without first taking the class for which the test is designed and may only be used when basic training is not required.
(4) "Client" means an individual receiving in-home services.
(5) "Competency" means the integrated knowledge, skills, or behavior expected of a ((long-term care))LTC worker after completing training in a required topic area. Learning objectives are associated with each competency.
(6) "Competency testing" means evaluating a student to determine if the student can demonstrate the required level of skill, knowledge, and 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 and expanded specialty trainings. Training programs may integrate competency testing within each programs' approved curricula.
(7) "Compliance year" means the 12-month period allowed to complete the required 12 annual hours of continuing education, whether a caregiver's compliance year be the calendar year or birthdate to birthdate, as required by their provider type.
(8) "Core basic training" means the portion of the 70-hour home care aide basic training that covers the core competencies and skills that ((long-term care))LTC workers need in order to provide personal care services efficiently and safely. The core basic training hours also includes hours devoted to student practice and demonstration of skills.
(9) "Date of hire" for determining time frames related to training and certification, means the first day the ((long-term care))LTC worker is employed by any employer.
(10) "DDA" refers to the developmental disabilities administration.
(11) "Direct care worker" means a paid individual who provides direct, personal care services to persons with disabilities or the elderly requiring ((long-term care))LTC (see also the definition of ((long-term care))LTC worker, which includes client care workers).
(12) "Department" or "DSHS" means the department of social and health services.
(13) "Enhancement" means additional time provided for skills practice and additional training materials or classroom activities that help a ((long-term care))LTC worker to thoroughly learn the course content and skills. Enhancements can include new student materials, videos or DVDs, online materials, and additional student activities.
(14) "Expanded specialty training" means optional curricula that provide caregivers with advanced knowledge and skills related to specialty training or providing person-centered care to clients or residents living with conditions other than developmental disabilities, dementia, and mental health. The optional expanded specialty training may include such topics as traumatic brain injury, diabetes care, and bariatric care. The optional expanded specialty training curricula must be DSHS developed and based on competencies and learning objectives established by ((the department))DSHS.
(15)
"Guardian" means an individual as defined in chapter
11.130 RCW.
(16) "Home care aide" or "certified home care aide" means a ((long-term care))LTC worker who has obtained and maintains a home care aide certification through the department of health.
(17) "Hybrid" means a combination of online training and in-person, remote, or virtual classroom instruction.
(18) "Individual provider" or "IP" means a ((person))LTC worker employed by the consumer directed employer to provide personal care or respite care services to persons with functional disabilities under a medicaid state plan program, such as the medicaid personal care or community first choice programs, under a federal medicaid waiver program, ((or)) through the veteran directed home care (VDHC) program, or through the long-term services and supports trust (WA cares) program.
(19) "Learning objectives" means measurable, written statements that clearly describe what a ((long-term care))LTC 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.
(20) "Long-term care (LTC) worker" means:
(a) All persons who provide paid, personal care services for the elderly or persons with disabilities, including but not limited to, individual providers of home care services, direct care workers employed by home care agencies, providers of home care services to persons with developmental disabilities under Title
71A RCW, all direct care workers in state-licensed assisted living facilities, adult family homes, respite care providers, community residential service providers, and any other direct care staff who provide home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.
(b) ((Long-term care))LTC workers do not include:
(i) Persons employed by the following facilities or agencies: Nursing homes subject to chapter
18.51 RCW, hospitals or other acute care settings, residential habilitation centers under chapter
71A.20 RCW, facilities certified under 42 C.F.R., Part 483, hospice agencies subject to chapter
70.127 RCW, adult day care centers; or
(ii) Persons who are not paid by the state, by a private agency, or facility licensed by the state to provide personal care services.
(21) "Online training" means a course taken through an automated, asynchronous learning management system or other technology that conforms to the online training standards posted on the DSHS website at https://bit.ly/dshs-online-standards.
(22) "Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living that are provided to the client.
(23) "Professional development" for ((long-term care))LTC workers means training related to enhancing and improving the skills and knowledge required in their current caregiving role. Information related to home care aide advancement into administrative duties may be included as part of an overall conference experience related to the current caregiving role.
(24) "Remote skills training" means training conducted in a virtual classroom environment, or online when a student either demonstrates a skill live or provides a video recorded file of themselves performing a skill that is forwarded for feedback to an approved instructor or a proctor trained by an approved instructor, or both. A training program must be approved by DSHS to provide remote skills training.
(25) "70-hour home care aide training" means the 70 hours of required training that a new ((long-term care))LTC worker must complete within 120 days of hire. It has three components: Core competencies, practice of skills, and population specific topics, which may include specialty and nurse delegation training.
(26)
"Specialty training" means curricula that meets the requirements of RCW
18.20.270 and
70.128.230 to provide basic core knowledge and skills that caregivers need to learn and understand to effectively and safely provide care to residents living with mental illness, dementia, or developmental disabilities. The specialty training curricula may be DSHS developed or DSHS approved and must be based on the competencies and learning objectives in WAC 388-112A-0430, 388-112A-0440, or 388-112A-0450.
(27) "Training entity" means an organization, including an independent contractor, who provides or may provide training under this chapter using approved curriculum. Training entities may only deliver approved curriculum.
(28)
"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.
(29) "Virtual classroom" means a synchronous, instructor-led, remote learning environment conducted in real time that conforms to the virtual classroom standards posted on the DSHS website at https://bit.ly/dshs-online-standards. A training program must be approved by DSHS to provide virtual classroom instruction.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0839Which long-term care workers (LTC) are exempt from the 70-hour, 30-hour, 16-hour, nine-hour, or seven-hour basic training requirements?
The following ((long-term care))LTC workers are exempt from the 70-hour, 30-hour, 16-hour, nine-hour, or seven-hour basic training requirement:
(1) An individual employed as a ((long-term care))LTC worker on January 6, 2012, who complied with the basic training requirements in effect on the date of hire;
(2) An individual previously employed as a ((long-term care))LTC worker who completed the basic training requirements in effect on the date of hire, and was employed as a ((long-term care))LTC worker at some point between January 1, 2011, and January 6, 2012;
(3) Registered nurses, licensed practical nurses, and advanced registered nurse practitioners licensed under chapter
18.79 or
18.80 RCW;
(4) Nursing assistants certified under chapter
18.88A RCW and persons in an approved training program for certified nursing assistants under chapter
18.88A RCW provided that they complete the training program within 120 days of the date of hire and the department of health has issued a nursing assistant certified credential within 200 days of the date of hire;
(5) A home health aide who was employed by a medicare certified home health agency within the year before being hired as a ((long-term care))LTC worker and has met the requirements of 42 C.F.R., Sec. 484.36;
(6) An individual with special education training who has an endorsement granted by the Washington state superintendent of public instruction as described in RCW
28A.300.010; and
(7) A home care aide (HCA) certified under chapter
18.88B RCW.
AMENDATORY SECTION(Amending WSR 23-01-022, filed 12/9/22, effective 1/9/23)
WAC 388-71-0860Who must complete orientation and safety, by when, and when does an orientation and safety training attestation process need to be completed?
(((1))) Unless exempted in WAC 388-71-0839 (((1) through (7))), all long-term care workers must complete orientation and safety training prior to providing care to a client.
(((2) All individual providers must contact the training partnership and follow the required procedures to confirm that they have completed the orientation and safety training, once it is completed.))
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0880Who must complete the 30-hour basic training and by when must it be completed?
Unless exempt from the basic training requirements under WAC 388-71-0839 (((1) through (7))), the following individuals must complete the 30-hour basic training under WAC 388-71-0885 within 120 days of the date of hire as described in WAC 388-71-0837:
(1) ((An individual provider))A long-term care worker who only cares for ((that provider's))the worker's child, parent (not covered in WAC 388-71-0890), sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership;
(2) ((A))Through June 30, 2026, a long-term care worker providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs; or
(3) A long-term care worker, working as an individual provider, who provides no more than 20 hours of nonrespite care per month, for one person who is not the individual provider's:
(a) Spouse or domestic partner.
(b) Child((child)), parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, ((including))or such relatives when related by marriage or domestic partnership.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0888When do the 70-hour basic training and certification requirements apply to an individual whose required basic training was previously less than 70 hours?
(1) The following ((individual providers))long-term care (LTC) workers must complete 70 hours of basic training and become a certified home care aide under WAC 388-71-0523:
(a) An individual provider (IP) who previously provided no more than 20 hours of nonrespite care in any calendar month for one ((person who is not the provider's))unrelated client and who:
(i) ((Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or
(ii) Spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs;
(A) Who continue to work for one unrelated client whose authorized monthly hours fluctuate above 20 hours per month; or
(B) Who begin to work for a second client))Continues to work for one unrelated client whose authorized monthly hours fluctuate above 20 hours per month; or
(ii) Begins to work for a second client.
(b) ((An IP))A LTC worker (working only as an individual provider) who provides respite services and worked more than 300 respite hours in any calendar year;
(c) ((An IP))A LTC worker (working only as an individual provider) who begins working for an unrelated client who previously only provided personal care to the provider's:
(i) Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or
(ii) Spouse or registered domestic partner ((and funded through the United States department of veterans' affairs home and community-based programs)).
(2) When ((an IP))a LTC worker (providing in-home care) described in subsection (1) of this section is required to complete the 70-hour basic training and become a certified home care aide, the ((IP))LTC worker will:
(a) Have 120 days from the date of the change to complete the 70-hour basic training and ((200))365 days from the date of the change to become certified as a home care aide; and
(b) Be required to complete continuing education under WAC ((388-71-0990))388-71-0991.
(3) For the purpose of this section, the date of the change means the date on which the ((IP))LTC worker:
(a) Began working for a client that is not the individual's:
(i) Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or
(ii) Spouse or registered domestic partner ((receiving approved services funded through the United States department of veterans' affairs home and community-based programs)).
(b) Exceeded 20 hours of work in one month; or
(c) Exceeded 300 respite hours in one calendar year.
(4) If ((an IP))a LTC worker is required to or chooses to become a certified home care aide and completes the 70-hour basic training requirements under this section, the individual will be required to continue to comply with ((these requirements))the requirement to maintain the credential and complete continuing education requirements even if:
(a) The monthly authorized hours are later reduced to 20 or fewer hours;
(b) The individual no longer works for more than one unrelated client; or
(c) The individual works 300 or fewer respite hours in a calendar year.
(5) The training and certification requirements for an individual that met the criteria in subsection (4) of this section ((does))do not apply if the individual returns to work only for the individual's:
(a) Parent, adult child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or
(b) Spouse or registered domestic partner ((receiving approved services funded through the United States department of veterans' affairs home and community-based programs)).
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0890
What are the training requirements for parent providers who are ((individual providers))long-term care (LTC) workers for their ((adult children through DDA))developmentally disabled adult child receiving services under Title 71A RCW?Unless exempt from the basic training requirements as defined in WAC 388-71-0839 ((
(1) through (7))), a parent, including when related by marriage or domestic partnership, who is the ((
individual provider for their adult child receiving services through the DSHS developmental disabilities administration))
LTC worker providing in-home care only for the provider's developmentally disabled adult child receiving services under Title 71A RCW must complete the 12-hour parent provider training, as described in WAC 388-71-0895, within 120 days from the begin date of the authorization to provide department paid, in-home services.
AMENDATORY SECTION(Amending WSR 24-05-003, filed 2/8/24, effective 3/10/24)
WAC 388-71-0893Who must complete the nine-hour basic training and by when must it be completed?
(1) Unless exempt from the basic training requirements under WAC 388-71-0839 (((1) through (7))), a long-term care (LTC) worker working as an individual provider must complete orientation and safety training and nine hours of training within 120 days of the date of hire as described in WAC 388-71-0837 if the provider meets the following criteria:
(a) Provides respite services for individuals with developmental disabilities receiving services under Title
71A RCW; and
(b) Works 300 hours or less (of respite) in ((any))a calendar year.
(2) The individual ((provider)) must complete the orientation and safety training before providing care.
(3) The training partnership identified in RCW
74.39A.360 must offer at least 12 of the 14 total hours online and five of these online hours must be individually selected from elective courses.
(4) An individual must complete the nine hours basic training required under this section within 120 days of the ((long-term care))LTC worker's date of hire.
NEW SECTION
WAC 388-71-0897Who must complete the 21-hour basic training and by when must it be completed?
Effective July 1, 2026, a spouse or registered domestic partner who is a long-term care worker only for a spouse or domestic partner must complete 21 hours of basic training.
NEW SECTION
WAC 388-71-0899What is the 21-hour basic training?
The 21-hours of basic training must include:
(1) Five hours of orientation and safety training to be completed prior to providing care;
(2) Ten hours of basic training taken from WAC 388-71-0906; and
(3) At least six hours of additional focused training based on the care-receiving spouse's or partner's needs and selected by the caregiver, to be chosen from DSHS approved courses.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0971Prior to hiring a long-term care (LTC) worker, what training and certification requirements must be reviewed by the home care agency or ((department))consumer directed employer?
Before hiring a ((
long-term care))
LTC worker, the home care agency ((
or the department acting on behalf of the client)), as defined under RCW
74.39A.009; or the consumer directed employer (CDE) under chapter
74.39A RCW; must review and verify the highest level of training or certification achieved by the individual.
(1) When the individual is a home care aide certified under chapter
18.88B RCW, the home care agency((
, CDE, or department))
or CDE must:
(a) Verify that the individual's home care aide certification is current and in good standing; and
(b) Confirm and document that the individual either holds current home care aide certification, or if not required to obtain certification, is in compliance with continuing education as required under WAC 388-71-0991 only for the compliance year in which they are hired.
(2) When the individual is exempt from the 70-hour home care aide training and certification requirements under WAC 388-71-0839, the home care agency((, CDE, or department))or CDE must review and verify the following:
(a) Documents demonstrating the individual's exemption status from training and certification which may include:
(i) Washington state provider active credential number, showing that the individual's license or certification is current and in good standing;
(ii) A letter from a former or current employer documenting work history during the exemption period described in WAC 388-71-0839;
(iii) Employment history records from the Washington state employment security department documenting work history information during the exemption period;
(iv) Federal tax statements documenting work history information during the exemption period; or
(v) Documentation showing completion of the basic training as required under WAC 388-71-0839;
(b) For the year in which they are hired, documentation of completion of 12 hours of continuing education, or information on when the continuing education must be completed, that complies with WAC 388-71-0991.
(3) Individuals who have worked as ((long-term care))LTC workers in the past, but who did not complete the basic training or certification required at the time, may be eligible to have the date of hire reset in accordance with this section and WAC 388-71-0980.
(a) Individuals who are eligible to reset their date of hire as provided in WAC 388-71-0980 must submit a new application and fee to the department of health and adhere to the training or certification requirement under this chapter.
(b) Individuals who are not eligible to reset the date of hire as provided in WAC 388-71-0980 must not be paid to provide personal care assistance until they complete required training and become certified as a ((long-term care))LTC worker.
(4) The home care agency((
, or the department acting on behalf of the client,)) as defined under RCW
74.39A.009; or the CDE under chapter
74.39A RCW must comply with continuing education documentation requirements under WAC 388-71-0970.
(a) Individuals are held accountable for continuing education completion by their new employer on the date of hire and shall provide at new hire, documentation of their continuing education compliance for the calendar year hired; or
(b) Individuals who work for multiple employers or move between employers ((shall))must on the date of hire, provide documentation of continuing education compliance for the calendar year in which they are hired, if hired after their birthdate.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0977Once an individual is required to obtain certification as a home care aide, may that individual revert to exempt status?
(1) If an individual is required to or chooses to become a certified home care aide and completes the 70-hour training requirements under this section, the individual will be required to continue to comply with these requirements to maintain the credential and complete continuing education requirements even if:
(a) The monthly authorized hours are later reduced to 20 or fewer hours;
(b) The individual no longer works for a second unrelated client; or
(c) The individual works 300 respite hours or less in a calendar year.
(2) The training and certification requirements for an individual that met the criteria in subsection (1) of this section ((does))do not apply when the individual returns to work only for the individual's:
(a) Spouse or registered domestic partner; or
(b) Parent, adult child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership((; or
(b) Spouse or registered domestic partner receiving approved services funded through the United States department of veterans' affairs home and community-based programs)).
AMENDATORY SECTION(Amending WSR 24-05-003, filed 2/8/24, effective 3/10/24)
WAC 388-71-0980When may a home care agency or ((client))consumer directed employer employ a long-term care (LTC) worker who has not completed the 70-hour basic training or certification requirements?
(1) If an individual has previously worked as a ((
long-term care))
LTC worker, but did not complete the training or certification requirements under RCW
18.88B.041,
74.39A.074, and
74.39A.076, and this chapter, a home care agency or ((
client))
consumer directed employer must not employ the individual to work as a ((
long-term care))
LTC worker until the individual has completed the required training certification unless the date of hire has been reset as described under subsection (2) of this section.
(2) The date of hire may be reset according to WAC 388-71-0837.
(3) Unless exempt from the 70-hour basic training as described in WAC 388-71-0875, individuals who meet the criteria in subsection (2) of this section are allowed a new 120 days to complete the 70-hour home care aide basic training and a new ((200))365 days to become certified as a home care aide, if required by WAC 246-980-020.
(4) Individuals who meet the criteria in subsection (2) of this section must submit a new application and fee to the department of health.
AMENDATORY SECTION(Amending WSR 25-16-084, filed 8/5/25, effective 10/1/25)
WAC 388-71-0985What is continuing education and what topics may be covered in continuing education?
(1) Continuing education is annual training designed to promote professional development and increase a person's knowledge, expertise, and skills. DSHS must approve continuing education curricula and instructors.
(2) Continuing education courses may be repeated for credit, however:
(a) The same course may not be repeated within an individual's current continuing education compliance year as defined in WAC 388-71-0836 and 388-112-0010; and
(b) If a course becomes available in an individual's preferred language, the translated course will be considered a new course.
(3) Continuing education must be on a topic relevant to any of the following options:
(a) The care setting;
(b) Care needs of clients;
(c) Caregiver self-care;
(d) Long-term care worker professional development as defined in WAC 388-71-0836 and ((388-112-0010))388-112A-0010.
(4) Nurse delegation core and nurse delegation specialized diabetes training hours when not applied to basic training hours may count toward continuing education.
(5) Specialty training, except if completed through a challenge test or counted toward basic training requirements, may be used to meet continuing education requirements.
(6) Successful completion of a department of health approved home care aide certified alternative bridge program may be applied for up to 12 hours of continuing education in the year it was completed.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-0991Who is required to complete continuing education training and when must a long-term care (LTC) worker or certified home care aide complete continuing education?
(1) All ((long-term care))LTC workers who are certified home care aides must comply with the continuing education requirements under chapter 246-980 WAC.
(2) ((
Long-term care))
LTC workers, who are exempt from home care aide certification as described in RCW
18.88B.041, unless exempt from continuing education as described under WAC 388-71-1001 must complete and provide documentation of 12 hours of continuing education within 45 calendar days of being hired or by the ((
long-term care))
LTC worker's birthday in the calendar year hired, whichever is later; and
(a) Must complete 12 hours of continuing education by the ((long-term care))LTC worker's birthday each calendar year worked thereafter; or
(b) If the 45 calendar day time period allows the ((long-term care))LTC worker to complete continuing education in January or February of the following year, the credit hours earned will be applied to the calendar year in which the ((long-term care))LTC worker was hired.
(3) If the renewal period following initial certification as a home care aide (HCA) or nursing assistant (NA-C), is less than a full year from the date of certification, no continuing education will be due for the first renewal period.
(4) Unless exempt under WAC 388-71-1001, ((long-term care))LTC workers who are caring for a:
(a) Spouse or domestic partner; or
((parent))(b) Parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership((, or providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs,))must complete continuing education ((must be completed)) on or before their birthday in the year after basic training was completed.
(5) A certified home care aide or ((
long-term care))
LTC worker exempt from home care aide certification as described in RCW
18.88B.041 who did not complete the continuing education requirements by the time frame described in this section must not be paid to provide care after that date
, unless the person is returning to employment, and their date of hire is reset according to WAC 388-71-0837.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-71-1001Which long-term care (LTC) workers are exempt from the continuing education requirement?
(1) Until January 1, 2025, continuing education is not required for individual providers caring for only the provider's:
(a) Biological, step, or adoptive child, or
(b) Sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.
(2) Beginning January 1, 2025, and until January 1, 2027, continuing education is not required for ((individual providers))LTC workers (working as individual providers) caring only for the provider's parent, child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.
(3) Continuing education is not required for LTC workers working as individual providers that:
(a) Provide no more than 20 hours of nonrespite care in any calendar month to only one person who is not the provider's parent, child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership((,)); or
(b) Provide respite services and work 300 hours or less of respite in any calendar year.
(4) Continuing education is not required for registered nurses, licensed practical nurses, and advanced registered nurse practitioners licensed under chapter
18.79 or
18.80 RCW, even if voluntarily certified as a home care aide under chapter
18.88B RCW.
(5) Beginning January 1, 2025, LTC workers working as individual providers covered under this section may voluntarily take continuing education and be paid for up to 12 hours of continuing education annually.
(6) Parents working as individual providers and caring only for their children will remain exempt from continuing education after January 1, 2027.
AMENDATORY SECTION(Amending WSR 21-18-081, filed 8/30/21, effective 10/1/21)
WAC 388-115-0510What are the qualifications of an individual provider?
In order to be qualified as an individual provider, an applicant must:
(1) Be ((eighteen))18 years of age or older;
(2) Not have a disqualifying crime or negative action under chapter 388-113 WAC based on a completed background check;
(3) Not be disqualified based on a character, competence, and suitability determination;
(4) Complete training and certification requirements as required by ((WAC 388-71-0520 and)) WAC 388-71-0523;
(5) If required, have a home care aide certification or other qualifying credential by the ((DOH))department of health that is both active and in good standing;
(6) Be an employee of the consumer directed employer to provide personal care services;
(7) Pass the federal exclusion list screening; and
(8) Not have credible allegations of fraud which are pending investigation, unless they fit within the exceptions listed in 42 C.F.R. 455.23.
AMENDATORY SECTION(Amending WSR 25-07-033, filed 3/11/25, effective 4/11/25)
WAC 388-115-0523What are the training and certification requirements for individual providers?
((The following chart provides a summary of the training and certification requirements for individual providers. This))Refer to WAC 388-71-0523 which includes criteria for those providers working limited hours for one person, caring only for one's child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild including when related by marriage or domestic partnership, providing respite services, or providing approved services ((only)) for a spouse or registered domestic partner ((and funded through the United States department of veterans' affairs home and community-based programs:)).
((Who | Status | Orientation training | Safety training | Basic training | Continuing education | Required credential |
(1) An individual provider who is a licensed, certified health care professional in good standing through the Washington state department of health, or an individual provider with special education training who meets the criteria in RCW 18.88B.041 (1)(a)(i)(A). | ARNP, RN, LPN, HCA, NA-C, or other professionals listed in WAC 388-71-0839. | Not required. | Not required. | Not required. | Not required of ARNPs, RNs, or LPNs in chapter 388-71 WAC. Required 12 hours under WAC 388-71-0991 of NA-Cs, HCAs, and other professionals listed in WAC 388-71-0839, such as an individual with special education training with an endorsement granted by the superintendent of public instruction under RCW 28A.300.010. For NA-C and those with special education training, 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Required under chapter 246-980 WAC. |
(2) An individual provider with specific employment history. | A long-term care worker employed at some point between January 1, 2011, and January 6, 2012, and has completed the basic training requirements in effect on the worker's date of hire. WAC 388-71-0839. | Not required. | Not required. | Not required. | 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Not required. |
(3) An individual provider. | Hired by the consumer directed employer to provide personal care service as defined in WAC 388-71-0836 and is not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 70 hours under WAC 388-71-0870 and 388-71-0875. | Required. 12 hours under WAC 388-71-0991. | Required under chapter 246-980 WAC. |
(4) An individual provider who works limited hours for one person. | An individual provider employed by the consumer directed employer providing 20 hours or less of nonrespite care for one person per calendar month and does not meet the criteria in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required. | Not required. |
(5) An individual who provides respite services and works 300 hours or less in any calendar year. | (a) An individual providing respite care and works no more than 300 hours in the calendar year, is not exempt in subsection (1) or (2) of this section, and does not meet criteria in subsection (7) of this section. (b) An individual providing respite services for individuals with developmental disabilities that receive services under Title 71A RCW and for individuals that receive services under chapter 74.39A, that is working 300 hours or less in any calendar year, and that is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. Nine hours under WAC 388-71-0890. | Not required. | Not required. |
(6) An individual provider caring only for the provider's adult child who receives services through the developmental disabilities administration. | An individual providing care only for the provider's adult child who receives services through the developmental disabilities administration and not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0895. | Required. Three hours under WAC 388-71-0895. | Required. Seven hours under WAC 388-71-0890. | Not required. | Not required. |
(7) An individual provider caring only for the individual provider's parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership. | An individual providing care only for the individual provider's parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership, who is not exempt in subsection (1) or (2) of this section, and does not meet criteria in subsection (6) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required until January 1, 2027, then 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Not required. |
(8) An individual provider caring only for the provider's adult child. | An individual providing care only for the provider's adult child and not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0895. | Required. Three hours under WAC 388-71-0895. | Required 30 hours under WAC 388-71-0880. | Not required. | Not required. |
(9) A long-term care worker providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs. | A long-term care worker providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs who is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Not required.)) |
AMENDATORY SECTION(Amending WSR 24-05-003, filed 2/8/24, effective 3/10/24)
WAC 388-115-0540When will the consumer directed employer (CDE) reject your selected individual provider?
(1) The CDE will reject an individual provider who:
(a) Is the client's spouse, except in the case of an individual provider for a chore services client or when the client is receiving services under the veteran directed home care ((program))or long-term care services and supports trust (WA cares) programs;
(b) Is the natural, step, or adoptive parent of a minor client aged 17 or younger;
(c) Is the foster parent providing personal care or skills acquisition training to a child residing in the individual's licensed foster home; or
(d) Does not meet the qualifications under WAC 388-115-0510.
(2) The CDE will also reject an individual provider when the CDE believes that the individual will be unable to appropriately meet the care needs of the consumer, including health and safety.
REPEALER
The following section of the Washington Administrative Code is repealed:
WAC 388-71-0520 | What are the training requirements for a home care agency long-term care worker? |