Current through Register Vol. 24-18, September 15, 2024
The applicant or licensee must develop and operationalize
personnel, contractor, and volunteer policies and procedures that
describe:
(1) Employment criteria
regarding discrimination consistent with chapter 49.60 RCW;
(2) Job descriptions that contain
responsibilities and are consistent with health care professional credentialing
and scope of practice as defined in relevant practice acts and rules;
(3) References for personnel, contractors and
volunteers;
(4) Contracting process
when using a contractor. The contract should include, at minimum, a description
of the duties the contractor will perform, and a statement indicating that the
contractor, not the employer, is responsible for withholding any necessary
taxes. As with personnel and volunteers, contractors are subject to all
applicable requirements in this chapter;
(5) Credentials of health care professionals
that are current and in good standing;
(6) Criminal history background checks and
disclosure statements for personnel, contractors, volunteers, students, and any
other individual associated with the licensee having direct contact with
children under sixteen years of age, people with developmental disabilities or
vulnerable persons, according to
RCW
43.43.830 through
43.43.842 and the following:
(a) Criminal history background checks must
be processed through the Washington state patrol;
(b) Disclosure statements must be approved by
the department; and
(c) All
criminal history background checks and disclosure statements required under
this chapter must be renewed within two years from the date of the previous
check;
(7) Character,
competence, and suitability determination conducted for personnel, contractors,
volunteers, and students whose background check results reveal nondisqualifying
convictions, pending charges, or negative actions. Factors to consider when
making a determination include, but are not limited to:
(a) Whether there is a reasonable, good faith
belief that they would be unable to meet the care needs of the
patient;
(b) Level of vulnerability
of the patient under their care;
(c) Behaviors since the convictions, charges,
negative actions or other adverse behaviors;
(d) Pattern of offenses or other behaviors
that may put the patient at risk;
(e) Number of years since the conviction,
negative action, or other issue;
(f) Whether they self-disclosed the
conviction(s), pending charge(s) and/or negative action(s);
(g) Other health and safety concerns;
and
(h) Although a licensee may
determine, based on their assessment process, that an employee is suitable to
work with vulnerable patients, the department has the final authority to deny,
revoke, modify, or suspend any professional credential it issues based on
application and criminal background check information.
(8) Mandatory reporting:
(a) Mandatory reporters shall report failure
to comply with the requirements of chapters 246-335 WAC and 70.127 RCW to the
department. The report must be submitted on department forms. Reports must be
submitted within fourteen calendar days after the reporting person has
knowledge of noncompliance that must be reported;
(b) Mandatory reporters shall report
suspected abandonment, abuse, financial exploitation, or neglect of a person in
violation of
RCW
74.34.020 or
26.44.030 to the department of
social and health services and the proper law enforcement agency. Reports must
be submitted immediately when the reporting person has reasonable cause to
believe that abandonment, abuse, financial exploitation, or neglect of a
vulnerable adult has occurred.
(9) In-person orientation to current agency
policies and procedures and verification of skills or training prior to
independently providing patient care. Examples of skills verification include
written testing, skills observation, and evidence of previous training and
experience such as a certified nursing assistant training as detailed in WAC
246-841-400;
(10) The process for personnel and
contractors holding a nursing assistant registration to become credentialed as
a nursing assistant certified. The policies and procedures must include, at
minimum:
(a) Personnel and contractors
holding a nursing assistant registration must become credentialed as a nursing
assistant certified within twelve months of the date of hire. The date of hire
is specific to each registered nursing assistant, not to the employer, and does
not change if the registered nursing assistant changes employers;
(b) Personnel and contractors who hold a
nursing assistant registration and do not become credentialed as a nursing
assistant certified within twelve months of the date of hire cannot continue to
provide patient care; and
(c)
Personnel and contractors hired by an in-home services licensee prior to March
1, 2018, who held a nursing assistant registration and have maintained their
registration and employment with the licensee are not required to become
credentialed as a nursing assistant certified.
(11) Training on the use of telehealth or
telemedicine for patient consultation and the transmission of health
data;
(12) Ongoing training
pertinent to patient care needs;
(13) Safe food storage, preparation and
handling practices consistent with the United States Food and Drug
Administration's recommendations for "food safety at home" for personnel,
contractors, and volunteers involved in food preparation services on behalf of
patients. Personnel, contractors, and volunteers may not provide patients with
homemade food items or baked goods that they themselves prepared;
(14) Current cardiopulmonary resuscitation
(CPR) training consistent with agency policies and procedures for direct care
personnel and contractors. Internet-based classroom training is permissible but
demonstration of skills must be hands on and observed by a certified
trainer;
(15) Infection control
practices, communicable disease testing, and vaccinations. Policies and
procedures must include, at minimum:
(a)
Standard precautions such as hand hygiene, respiratory hygiene and cough
etiquette, and personal protective equipment;
(b) Availability of personal protective
equipment and other equipment necessary to implement client plans of
care;
(c) Tuberculosis (TB)
infection control program. Key elements include, but are not limited to:
(i) Conducting a TB risk assessment for all
new employees upon hire. Agencies must use a tuberculosis risk assessment form
provided by the department. Based on risk assessment results, determine the
agency's responsibility to conduct TB testing of new employees. If TB testing
is required, follow the department's tuberculosis risk assessment form testing
recommendations;
(ii) Conducting an
annual assessment of new TB risk factors for all employees. Agencies must use a
tuberculosis risk assessment form provided by the department. Based on risk
assessment results, determine agency's responsibility to conduct TB testing of
employees. Retesting should only be done for persons who previously tested
negative and have new risk factors since the last assessment; and
(iii) Ensuring workers receive TB related
training and education at the time of hire or during new employee orientation.
Training and education must be consistent with the department's tuberculosis
program's online posted educational materials.
(d) Actions to take when personnel,
volunteers, contractors, or clients exhibit or report symptoms of a
communicable disease in an infectious stage in accordance with chapters 246-100
and 246-101 WAC;
(e) Exposure to
bloodborne pathogens such as Hepatitis B and HIV, and other potentially
infectious materials in compliance with the department of labor and industries
chapter 296-823 WAC. Key elements include, but are not limited to:
(i) Conducting an initial risk assessment of
the environment in which personnel, volunteers, and contractors perform their
assigned duties to determine occupational exposure. The results of the risk
assessment will inform policy and procedure development and level of employee
training and education. Annually, agencies must determine if significant
changes have occurred that would require a new risk assessment to be
performed;
(ii) If the risk
assessment concludes that workers have a reasonably anticipated risk of
occupational exposure to blood and other potentially infectious materials,
agencies must offer workers the Hepatitis B vaccine series at the agency's
expense. Workers have the right to decline the Hepatitis B vaccine series;
and
(f) Agencies must
document an annual review of applicable state and federal health authority
recommendations related to infection control practices, communicable disease
testing, and vaccinations and update trainings and policies and procedures as
necessary.
(16) Annual
performance evaluations of all personnel and volunteers providing direct
patient care, including on-site observation of care and skills specific to the
care needs of patients; and
(17)
Annual evaluations of services provided by contractors providing direct patient
care.
