Staff Training Requirements and Competency Test

 

DEPARTMENT OF ELDER AFFAIRS

Federal Aging Programs

RULE NO.:RULE TITLE:

58A-5.0191Administrator, Manager, and Staff Training Requirements

 

NOTICE OF CHANGE

 

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 38, No. 76, November 21, 2012 issue of the Florida Administrative Register. The changes are in response to input received at a public hearing held on the proposed rules on May 1, 2013 in Tallahassee, Florida. No additional hearings were requested pursuant to Section 120.54(3)(c)1., F.S. The Department considered the testimony of the parties at the hearings, as well as suggestions made by the Joint Administrative Procedures Committee, and determined that the following changes are appropriate.

 

Section 58A-5.0191, F.A.C., is amended to read:

 

58A-5.0191 Administrator, Manager, and Staff Training Requirements.

Administrators, managers, and staff must satisfy the minimum training, testing, continuing education, and documentation requirements as specified in this rule.

(1) ALL FACILITY STAFF. All facility staff, regardless of responsibilities or duties, must satisfy the following requirements within 30 days of beginning employment:

(a) Completion of a one-time education training course on HIV and AIDS, which includes the topics prescribed in Section 381.0035, F.S. Staff subject to the requirements of Section 456.033, F.S., or who have documentation of prior completion of this training course, are exempt from this requirement.

(b) Completion of in-service training regarding the facility’s resident elopement response policies and procedures.

(c) Completion of in-service training relating to the facility’s policies and procedures regarding Do Not Resuscitate Orders (DNROs).

(2) ADMINISTRATORS AND MANAGERS. Administrators and managers must satisfy the training requirements as stated below.

(a) Core Training. Completion of a qualified assisted living facility core training course consisting of a minimum of 40 hours of training. Completion of a qualified core training course is required before registering for the core competency test. A listing of approved training providers and qualified courses may be obtained from http://elderaffairs.state.fl.us/doea/alf.php or http://www.alf.usf.edu.

(b) Core Competency Test. Successful passage of the core competency test within 24 months of completing a qualified core training course. The overall passing score for the competency test is 75%. Registration information for the core competency test may be obtained from the ALF Core Competency Testing Office at http://www.alf.usf.edu, or by calling [phone].

1. Administrators and managers who fail to pass the core competency test after three attempts must retake a qualified core training course before retaking the core competency test.

2. The fees for the core competency test shall not exceed $200. The payment for the competency test fee shall be remitted to the entity administering the test. A new fee is due each time the test is taken.

3. Before July 1, 2014, any individual registering to take the core competency test must have completed a qualified 26 hour core training course, obtained from an approved training provider listed at http://elderaffairs.state.fl.us/doea/alf.php or http://www.alf.usf.edu. On or after July 1, 2014, any individual registering to take the core competency test must have completed a qualified 40 hour core training course, as provided above.

(c) Initial Specialty License Training. Administrators and managers of facilities holding the following specialty licenses must satisfy the specific training identified below:

1. Extended Congregate Care. Completion of 4 hours of initial training in extended congregate care prior to the facility’s receiving its initial extended congregate care license, or within 30 days of beginning employment in a facility with an existing extended congregate care license. The training must address extended congregate care concepts and requirements, including statutory and rule requirements, and delivery of personal care and supportive services in an extended congregate care facility.

2. Limited Mental Health. Completion of a minimum of 6 hours of training in working with individuals with mental health diagnoses, and successful passage of a limited mental health competency test, within 6 months of the facility’s receiving an initial limited mental health license, or within 30 days of beginning employment in a facility with an existing limited mental health license.

a. Beginning December 1, 2013, the training course will be offered online by the Department of Children and Families or, if conducted in a group setting, must be provided by a trainer approved by the Department of Children and Families, or its designee.

b. Passage of the limited mental health competency test is required beginning December 1, 2013, and the minimum passing score for each module of the test is 75%. Administrators and managers who begin employment at a facility with a limited mental health license before December 1, 2013 and who have completed a minimum of 6 hours of training in working with individuals with mental health diagnoses are not required to pass the limited mental health competency test.

(d) Continuing Education. Completion of 12 18 hours of continuing education every 2 years in topics related to the core training curriculum as specified in DOEA Form ALFCT-001, Assisted Living Facility Minimum Core Training Curriculum, June 2009, incorporated in Rule 58T-1.205, F.A.C., or other topics relating to the operation and maintenance of an assisted living facility and the care of residents residing in assisted living facilities. Continuing education must be obtained from courses or workshops offered by providers as specified below.

1. Continuing Education Providers. Continuing education hours may be obtained either online or in person as offered, and must be obtained from the following providers:

a. Core trainers registered with the department;

b. Providers offering courses through an accredited college, university, or private post-secondary institution;

c. Providers and courses registered within the continuing education tracking databases maintained by the department, the agency, or the Department of Health;

d. Courses and workshops offered by or in conjunction with a state agency which are approved by the department;

e. Courses and workshops approved by the department and offered by associations representing assisted living facilities;

f. For training related to food services, continuing education may be obtained from a certified food manager, certified dietary manager, registered or licensed dietitian, dietetic registered technician, or health department sanitarian; or

g. For training related to nutrition, continuing education may be obtained from a certified food manager, certified dietary manager, registered or licensed dietitian, or dietetic registered technician.

2. Extended Congregate Care. Administrators and managers of facilities maintaining an extended congregate care license must complete a minimum of 4 of the required 12 18 hours of continuing education in topics relating to the medical, physical, psychological, or social needs of frail elderly and disabled persons. The initial extended congregate care training received under subparagraph (2)(c)1. of this rule may count once for 4 of the required 12 18 hours of continuing education.

3. Limited Mental Health.

a. Administrators and managers of facilities maintaining a limited mental health license must complete a minimum of 3 of the required 12 18 hours of continuing education in the following topics:

(i) Mental health diagnoses; and

(ii) Mental health treatment such as mental health needs, services, behaviors and appropriate interventions; resident progress in achieving treatment goals; how to recognize changes in the resident’s status or condition that may affect other services received or may require intervention; and crisis services and Baker Act procedures.

b. The initial limited mental health training received under subparagraph (2)(c)2. of this rule may count once for 6 of the required 12 18 hours of continuing education.

4. Food Services. If the administrator or manager is responsible for total food services and the day-to-day supervision of food services staff, the administrator or manager must annually obtain a minimum of 2 hours of continuing education in topics related to nutrition or food services in an assisted living facility.

(3) STAFF INTERACTING WITH RESIDENTS. Direct care staff, other than administrators and managers who have satisfied the training requirements of subsection (2) of this rule, must satisfy the training requirements as stated below. Additionally, staff in regular contact with residents must satisfy the limited mental health training specified in subparagraph (3)(c)2. below.

(a) Pre-Service Training. Facility administrators or managers must provide or arrange through approved providers as set forth in subparagraph (2)(d)1. of this rule, a minimum of 1 hour of training for direct care staff relating to infection control, universal precautions, and facility sanitation procedures.

1. Pre-service training must be completed before direct care staff may provide personal care to residents.

2. Documentation of compliance with the staff training requirements of 29 CFR 1910.1030, relating to blood borne pathogens, July 2012, which is hereby incorporated by reference and available at: http://www.gpo.gov/fdsys/pkg/CFR-2010-title29-vol6/pdf/CFR-2010-title29-vol6-sec1910-1030.pdf, may be used to meet this requirement.

3. Nurses, certified nursing assistants, and home health aides trained in accordance with Rule 59A-8.0095, F.A.C., are exempt from the pre-service training requirements.

(b) In-Service Training. Facility administrators or managers must provide or arrange through approved providers as set forth in subparagraph (2)(d)1. of this rule, the following in-service training within 30 days of direct care staff beginning employment:

1. 1 hour of training covering the reporting of adverse incidents, and facility emergency procedures, including chain-of-command and staff roles relating to emergency evacuation;

2. 1 hour of training covering resident rights in an assisted living facility, and recognizing and reporting resident abuse, neglect, and exploitation; and

3. 3 hours of training covering resident behavior and needs, and providing assistance with the activities of daily living. Nurses, certified nursing assistants, and home health aides trained in accordance with Rule 59A-8.0095, F.A.C., are exempt from this 3 hour in-service training requirement.

(c) Specialty License Training.

1. Extended Congregate Care. All direct care staff providing care to residents receiving an extended congregate care services program must complete at least 2 hours of in-service training, provided by the facility administrator or manager, within 30 days of beginning employment in the facility. The training must address extended congregate care concepts and requirements, including statutory and rule requirements, and delivery of personal care and supportive services in an extended congregate care facility.

2. Limited Mental Health. Direct care staff and staff in regular contact with mental health residents must complete a minimum of 6 hours of training in working with individuals with mental health diagnoses, and must successfully pass a limited mental health competency test, within 6 months of the facility’s receiving an initial limited mental health license, or within 30 days of beginning employment in a facility with an existing limited mental health license.

a. Beginning December 1, 2013, the training course will be offered online by the Department of Children and Families or, if conducted in a group setting, must be provided by a trainer approved by the Department of Children and Families, or its designee.

b. Passage of the limited mental health competency test is required beginning December 1, 2013, and the minimum passing score for each module of the test is 75%. Direct care staff and staff in regular contact with mental health residents who begin employment at a facility with a limited mental health license before December 1, 2013 and who have completed a minimum of 6 hours of training in working with individuals with mental health diagnoses are not required to pass the limited mental health competency test.

(d) Continuing Education. Direct care staff and staff in regular contact with mental health residents in a licensed mental health facility must complete a minimum of 3 hours of continuing education every 2 years from continuing education providers specified in subparagraph (2)(d)1. of this rule in the following topics:

1. Mental health diagnoses; and

2. Mental health treatment such as mental health needs, services, behaviors and appropriate interventions; resident progress in achieving treatment goals; how to recognize changes in the resident’s status or condition that may affect other services received or may require intervention; and crisis services and Baker Act procedures.

(4) ADDITIONAL TRAINING REQUIREMENTS FOR ADMINISTRATORS, MANAGERS AND STAFF. Additional training requirements for administrators, managers, and staff are specified below.

(a) Alzheimer’s Disease or Related Disorders (“ADRD”) Training. Facilities providing special care for persons with ADRD, or which maintain secured areas as described in Chapter 4, Section 434.4.6 of the Florida Building Code, as adopted in Rule 61G20-1.001, F.A.C., must ensure that facility staff receives the following training.

1. Individuals other than direct care staff or staff in regular contact with residents with ADRD must receive general written information provided by the facility on interacting with such residents within 3 months of beginning employment.

2. Direct care staff and staff in regular contact with residents with ADRD must obtain 4 hours of initial training within 3 months of beginning employment. The following individuals will be considered as having met this initial training requirement:

a. Administrators and managers who have successfully completed the training requirements of subsection (2) of this rule;

b. Facility staff who meet the requirements of an ADRD training provider pursuant to Rule 58A-5.0194, F.A.C.; and

c. Staff who have received both the initial one hour and continuing three hours of ADRD training pursuant to Sections 400.1755, 400.6045(1), and 429.917, F.S.

3. The initial training, entitled “Alzheimer’s Disease or Related Disorders Level I Training,” must address the following subject areas:

a. Understanding Alzheimer’s disease or related disorders;

b. Characteristics of Alzheimer’s disease or related disorders;

c. Communicating with residents with Alzheimer’s disease or related disorders;

d. Family issues;

e. Resident environment; and

f. Ethics.

4. Direct care staff must obtain an additional 4 hours of training within 9 months of beginning employment. Facility staff who meet the requirements of an ADRD training provider pursuant to Rule 58A-5.0194, F.A.C., will be considered as having met this requirement.

5. The additional training, entitled “Alzheimer’s Disease or Related Disorders Level II Training,” must address the following subject areas:

a. Behavior management;

b. Assistance with activities of daily living;

c. Activities for residents;

d. Stress management for the caregiver; and

e. Medical information.

6. Continuing education. Direct care staff, including administrators and managers, must obtain 4 hours of continuing education annually in topics related to Alzheimer’s Disease or Related Disorders Level I and II Training.

(b) Assistance With Self-Administered Medication Training. Unlicensed persons, as defined in Section 429.256(1)(b), F.S., who provide assistance with self-administered medications as described in Rule 58A-5.0185, F.A.C., must complete 6 hours of training provided by a registered nurse, licensed pharmacist, or department staff prior to assuming this responsibility. Training shall include demonstrations of proper techniques and provide opportunities for hands-on learning through practice exercises. Unlicensed persons who have received a training certificate demonstrating successful completion of a 4 hour course before May 1, 2013 are not required to retake the initial 6 hour training.

1. Courses provided in fulfillment of this requirement must address the following subject areas:

a. State law and rule requirements with respect to recognizing the differences between providing assistance with the self-administration of medications and the supervision, administration, and management of medications in assisted living facilities;

b. Procedures and techniques for assisting the resident with self-administration of medication including how to read a prescription label;

c. Providing the right medications to the right resident;

d. Common medications;

e. The importance of taking medications as prescribed;

f. Recognition of side effects, adverse reactions, and procedures to follow when residents appear to be experiencing side effects and adverse reactions;

g. Documentation and record keeping; and

h. Medication storage and disposal.

2. A training certificate will be issued to a trainee after successfully demonstrating the ability to provide assistance with self-administration, including the ability to:

a. Read and understand a prescription label;

b. Assist with oral dosage forms, topical dosage forms, and topical ophthalmic, otic, and nasal dosage forms, including solutions, suspensions, sprays, and inhalers;

c. Measure liquid medications, break scored tablets, and crush tablets in accordance with prescription directions;

d. Recognize the need to obtain clarification of an “as needed” prescription order;

e. Recognize a medication order which requires judgment or discretion, and to advise the resident, resident’s health care provider, or facility employer of inability to assist in the administration of such orders;

f. Complete a medication observation record;

g. Retrieve and store medication; and

h. Recognize the general signs of adverse reactions to medications and report such reactions.

3. Continuing education. Unlicensed persons who provide assistance with self-administered medications, and who have successfully completed the initial 6 hour training, must obtain annually a minimum of 2 hours of continuing education in topics relating to providing assistance with self-administered medications and safe medication practices in an assisted living facility. The 2 hours of continuing education may only be provided by a registered nurse, licensed pharmacist, or department staff.

(c) Food Services.

1. Staff who prepare or serve food, who have not taken the assisted living facility core training must receive a minimum of 1 hour in-service training within 30 days of employment in safe food handling practices.

2. Continuing education. An individual, other than an administrator or manager, who has been designated as specified in Rule 58A-5.020, F.A.C., as responsible for total food services and the day-to-day supervision of food services staff must obtain annually a minimum of 2 hours of continuing education in topics related to nutrition or food services in an assisted living facility. This continuing education may be obtained from the providers specified in subparagraph (2)(d)1. of this rule.

(5) TRAINING DOCUMENTATION AND MONITORING.

(a) Certificates or copies of certificates of any training required by this rule must be documented in the facility’s personnel files for a period of 3 years. The documentation must include the following:

1. The title of the training program;

2. The subject matter of the training program;

3. The training program agenda;

4. The number of hours of the training program;

5. The trainee’s name, dates of participation, and location of the training program; and

6. The training provider’s name, dated signature, credentials, and professional license number, if applicable.

(b) Upon successful completion of training, the training provider must issue a certificate to the trainee as specified in this rule.

(c) Administrators, managers, and staff do not have to repeat the initial or one-time training specified in this rule upon a change of employment if a copy of the training certificate is provided to the new employer for retention in the facility’s personnel files. Administrators, managers, and staff must also ensure that copies of the continuing education training certificates are provided to the facility for retention in the facility’s personnel files.

(d) Upon request, the facility must provide training documentation to the department or agency for review.

(e) The department and agency reserve the right to attend and monitor any training which is intended to meet regulatory requirements under this rule.

Rulemaking Authority 429.178, 429.41, 429.52 FS. Law Implemented 429.07, 429.075, 429.178, 429.256, 429.41, 429.52 FS. History–New 9-30-92, Formerly 10A-5.0191, Amended 10-30-95, 6-2-96, 4-20-98, 11-2-98, 10-17-99, 7-5-05, 7-30-06, 10-9-06, 7-1-08, 4-15-10,_________.