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340:100-3-38.5. Training requirements for staff providing supports in family's or service recipient's home through an In-Home Supports Waiver

Revised 9-15-17

(a) Applicability.Oklahoma Administrative Code (OAC) 340:100-3-38.5 sets forth training requirements for staff providing direct supports funded through an In-Home Supports Waiver (IHSW) in the family's or service recipient's home.Staff providing employment supports must complete training per OAC 340:100-3-38.2.

(b) New employee training.No later than 30-calendar days following the hire date, staff providing direct supports or supervising at any level the delivery of direct supports must complete the online or first available Developmental Disabilities Services (DDS)-approved foundation training course and effective teaching course.The supervisory staff training requirement does not apply to the service recipient or representative who is self-directing services per OAC 317:40-9-1.The person directing services per OAC  317:40-9-1 must complete the approved self-directed services training course.The first available class is the first unfilled class held within 60 miles of staff's work location following staff's hire date.

(c) First aid and cardio-pulmonary resuscitation (CPR).Direct support staff must be certified in an approved course of first aid and CPR before providing services alone or with other untrained staff.

(1) First aid and CPR certification of staff must occur within 90-calendar days following the staff's hire date.

(2) The service recipient's Personal Support Team (Team) may determine, based on the service recipient's needs, that staff must receive first aid and CPR certification in less than 90-calendar days.

(d) Medication administration training.Staff must be certified in an approved medication administration course per OAC 340:100-3-38.10 before administering medication to a service recipient or assisting with a service recipient's medication support plan.

(e) Individual-specific in-service training.Individual-specific in-service training is identified for direct support staff in the service recipient's Individual Plan (Plan).

(1) Training requirements are based on the service recipient's identified needs through team discussion and review of available assessment information.

(2) The service recipient's Team specifies required completion time frames of individual-specific in-service training.When time frames are not identified in the Plan, required individual-specific in-service training must be completed before working with the service recipient.

(3) As the service recipient's needs require changes in supports or programs, the Team documents in the Plan or in addenda to the Plan, any new or additional in-service training required, with completion time frames.

(4) The Team identifies the person responsible for providing individual-specific training and verifies staff has knowledge and skills necessary to provide the identified services.Videos may be used when approved by the Team.

(f) Job-specific training.Staff must complete:

(1) within 90-calendar days after assignment date, Health course; and

(2) within six months after assignment date:

(A) Communication course; and

(B) Skill Building course.

(g) Specialized training.Additional specialized training courses may be required for direct support staff working with service recipients who have significant health, physical or behavior support issues.

(1) Staff supporting a service recipient with a protective intervention protocol (PIP) that includes non-restrictive intervention techniques must be trained on these techniques before use.

(2) Completion of an approved behavior support course is required for staff supporting a service recipient with a PIP that:

(A) addresses challenging behavior that places the service recipient's physical safety, environment, relationships, or community participation at serious risk; and

(B) contains one or more of these procedures:

(i) physical guidance to overcome resistance;

(ii) physical guidance to move to safety; or

(iii) physical hold to restrict movement.

(3) The approved behavior support course must be completed before working alone or with other untrained staff, but no later than 60-calendar days after starting work with the service recipient.

(4) Staff must complete the approved physical management course before using any technique of physical management identified in a PIP.

(A) All staff must complete foundation training with the approved effective teaching course and behavior support course.

(B) Staff working with the service recipient implements the positive components of the Plan, as well as non-intrusive procedures to assist the service recipient during a crisis.

(C) The PIP must be reviewed and approved by the Statewide Human Rights and Behavior Review Committee.

(D) Training in physical management procedures occurs only within the requirements per this subsection.

(E) Only staff and staff supervisors providing support to the service recipient are trained on use of a physical management procedure.

(F) Staff formally trained to use physical management procedures does not use those techniques with other service recipients, except in emergencies per OAC 340:100-5-57.

(G) Training curricula regarding behavior support are approved by the DDS human resource development director and behavioral supports director.

(5) Training regarding physical management procedures must be obtained from trainers approved by the DDS human resource development director.

(6) Staff must complete annual retraining on the physical management or physical restraint procedures in the approved PIP.

(h) Ongoing training.Direct support staff employed by approved provider agencies that provide services funded through an IHSW complete 12 hours of annual training.

(1) Annual training may come from:

(A) required re-certification classes in first aid, CPR, and medication administration training;

(B) courses per OAC 340:100-3-38(b)(1);

(C) courses, conferences, or workshops approved by the DDS human resource development director;

(D) individual-specific training; or

(E) agency-specific in-services.

(2) Direct support staff may challenge or test out of required annual recertification when an approved option is available.Training completion hours are granted equal to the number of hours for the standard recertification class.

(i) Certification of competency.When the service recipient, if applicable, legal guardian, or parent(s) of a minor service recipient determines the person chosen to provide services demonstrated competency in providing care to the service recipient, the service recipient, legal guardian, or parent(s) may exempt the person from training requirements, per this Section, by signing Form 06IS037E, In-Home Supports Waiver - Certificate of Competency.

(1) The exemption from training is intended to allow a friend, neighbor, family member, or other person who has been trained and deemed competent by the service recipient, or if applicable, legal guardian or parent(s) of a minor service recipient to provide services.

(A) No person may coerce or in any way influence a service recipient, legal guardian, or family member to sign Form 06IS037E.

(B) Violation of this prohibition may result in sanctions per OAC 340:100-3-27.

(2) When a service recipient, if applicable, legal guardian, or parent(s) of a minor service recipient chooses to exempt staff from training, neither the Oklahoma Department of Human Services (DHS) nor the employing contract agency is liable in the event of harm attributable to lack of training, to the service recipient while in the care of contract agency staff.

(3) When an adult service recipient without a legal guardian chooses to exempt staff from training, training requirements are not waived without written concurrence, on Form 06IS038E, In-Home Supports Waiver - Family Member's Statement, from a parent(s) or family member closest to the service recipient.

(4) The provider agency employing the staff may require training not included in the exemption.

(5) All staff, regardless of signed Form 06IS037E, must successfully complete:

(A) certification in first aid and CPR before working alone or with untrained staff, but no later than 90-calendar days after starting work with the service recipient;

(B) an approved medication administration course per OAC 340:100-3-38.10; and

(C) individual-specific in-service training per (e) of this Section.

(6) Form 06IS037E:

(A) is valid for no longer than one year from the signature date; and

(B) may be withdrawn at any time by the service recipient, if applicable, legal guardian, or parent(s) of a minor service recipient by writing to the DDS case manager and provider agency.

(7) DHS may withdraw the exemption from training at any time.

(j) Exceptions.Exceptions to training requirements per this Section may be made by the DDS director or designee.

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