DHS 83 Update

ATTENTION CBRFs

Important Links!

  1. WALA's DHS 83 Frequently Asked Questions
  2. 83.20 Four approved curriculum memo is now out
  3. Read the new DHS 83 Code
  4. View the BAL Webcasts
  5. BAL's DHS 83 Frequently Asked Questions

As always, WALA is taking the lead to keep you updated on DHS 83 new training requirements.

83.20 Department Approved Training

As you know, you can still keep teaching the 83.20 four department-approved trainings until the new system is in place by April 1. These four curriculums are standard precautions, fire safety, medication management and first aid. Remember that anyone who has successfully completed the current four courses by March 31, 2010 will not need to take additional 83.20 training or enter the system described below.

On November 10, BAL announced that they have contracted with the University of Oshkosh, Center for Career Development and Employability Training (known as CCDET) to develop the four curriculums. As you will see in the entire document on our website, CCDET will develop the curriculums (except First Aid), trainers guide, activities and trainer's notes, as well as student guides, tests and information.

They expect this to be ready by Feb 1, 2010.

Instructors for these four curriculums will need to apply to CCDET to be approved for each of these four curriculums they wish to teach. Approval will be for two years with additional criteria to maintain their approval status. All approved instructors and the names of all they teach who successfully complete the course(s) will be published on a public website for easy access that will be managed by CCDET.

Please visit the link below to view DQA Memo 09-045/Notice of Department Designee for CBRF Department-approved training.

http://dhs.wisconsin.gov/rl_dsl/Publications/09-045.htm  

The fees for these new curriculums are not cheap, when you add these costs on top of the courses themselves, release time, travel etc. If you feel these fees are excessive, send a note to WALA at info@ewala.org with your reasons why. We are compiling responses to BAL. Fortunately, BAL was able to absorb the curriculum development costs so those are not reflected in these fees.
View Info Sheet and Pricing Structure here.

View Power Point Presentation from AL Forum from CCDET here.

BAL's FAQs
BAL has issued answers to many Frequently Asked Questions (FAQ). Since these answers have been reviewed by DHS legal counsel, they are "gospel". Please review them carefully as there is a lot of clarification on many issues of concern. We are specifically gratified that BAL is allowing caregivers to receive gifts of "nominal value." View BAL's FAQs here.

Medication Management Initiative
This is a treasure trove of meds related information from BAL including documentation, PRN meds, medication errors, psychotropic, self administration and much, much more. Go to the Medication Management Initiative here.

CBRF Pharmacy FAQs
Consultant Pharmacist Doug Engelbert has also published pharmacy related FAQs for CBRFs. While not all related to the rewrite, they give you a good look into many reoccurring issues. View the CBRF Pharmacy FAQs here.

DQA Pharmacy Q & A for Assisted Living
Another resource in Q & A formats for all AL regulatory categories. View DQA Pharmacy Q & A for Assisted Living here.

83.15 Department-approved assisted living administrator's training course.
As you know, one of the ways that a person can become an approved CBRF administrator is to successfully complete a Department-approved assisted living administrator's training course. On October 27, BAL announced the draft curriculum and it is not anticipated that there will be any changes in this course content. An assisted living administrator's training course must consist of a minimum of 60 classroom hours of training in the following six core competency areas. All required hours of training must be conducted in the physical presence of the approved trainer. The training curriculum must include the topics specified in each of the six core areas. For details, the entire memo here. WALA has already started preparing the curriculum for this course. Naturally, a course this complex will require a lot of professional development so it may take awhile. Stayed tuned!

1. Leadership/Management Skills (minimum of 12 hours of training)

2. Resident Care & Services (minimum of 18 hours of training)

A. Physical Needs
B. Psychosocial Needs
C. Food Service & Nutrition
D. Infection Control
E. Community & Support Services for Residents
F. Nurse Delegation
G. Medications & Medication Administration
H. Admissions/Residency/Discharge
I. Assessment
J. Development of an Individualized Service Plan
K. Program Services
L. Communication with External Health & Social Service Providers

3. Resident Rights, Advocacy and Legal Issues (minimum of 8 hours of training)

o Resident Rights
o Advocacy
o Surrogate Decision Making
o Abuse/Neglect/Misappropriation

4. Physical Environment/Life Safety (minimum of 8 hours of training)

o Creating a Home-Like Environment
o Safe, Clean Environment
o Fire Safety

 

Memo by BAL regarding DHS 83 Implementation, Training and Guideline of Changes.

Read the Memo and the Attachment 1, entitled "Guideline of DHS 83 Rule Changes", "provides an outline of the areas of change for Wis. Admin. Code Ch. DHS 83. The guideline does not include all of the changes effective in the new rule. Furthermore, the guideline does not include entire area of change or state the exact rule language, NOTE: It is the responsibility of each provider to review and become familiar with the specific language and requirements that are identified in the newly revides Chapter DHS 83." Read the new DHS 83 Code here.

ALL about DHS 83 Re-Write

On August 29, 2008, the Department sent the latest version of the DHS 83 rewrite to the Legislature. After due consideration, the two Legislative committees chose not to hold hearings.  When the final rule left the legislature on September 17, it went back to DHS for any final changes. On November 25 the final rule was filed. The new rule is expected to go into effect April 1, 2009. You can imagine how tickled we would be with that date to begin implementation!

At that time, the rule is in effect and the implementation as laid out in the Final Proposed Rulemaking Order will begin – which in most cases is immediately. There is a provision to allow 12 months to implement the new training requirements and a few other items that have different timelines.

Follow the following link to view the Final Rulemaking Order Filed.

While BAL is not expected to start issuing citations for those not meeting the new rule the day it is in effect, and will use the next year as a phase in, it is imperative that you start to review your operations and physical plant to meet the new expectations. You can begin now to see what will be expected of you by reviewing the documents listed below and starting to plan now.
 
We have been informed that BAL plans to do one live training for CBRF providers, in each of the five regions as well as a web cast.  We expect the BAL trainings to be at no cost to the providers and we were told that it is anticipated that BAL will do these trainings before the rule goes into effect – which would mean in March.  They intend to hold both provider training and staff training.

The WALA DHS 83 Rewrite Committee has already met to begin development of our very comprehensive trainings. Current plans are to provide regional overview trainings across the state and then more specific courses in more complex issues such as the new training requirements, new assessments/ISP, etc.  The Committee is seeking comments from you, WALA members, on issues you notice, comments you have and items that WALA should highlight in these trainings.  It is too early to announce when these trainings will occur.

To review the documents that were sent to Legislature you can read the following documents found in the below links:

All who testified or sent written comments in December have their comments listed on page 13 - 21 of the Report to the Legislature. There is complete list of the 114 persons who attended the public hearing or submitted comments on the proposed rule, the position taken by the commenter and whether or not the individual provided written or oral comments.  From page 22 - 66 of the Report to the Legislature are the Rule Provision, Public Comment and the Department Response. Read Carefully - this will answer many of your questions.

WALA'S Proposal on Alternate Administrator Qualifications was approved (page 33 of Report to The Legislature) "The Department has amended DHS 83.15 (1) as requested by the commentators to permit individuals . . . who have completed a Department approved course and at least 2 years experience working in a health care related field to be employed as a CBRF administrator." Actual language (Final Proposed Rulemaking Order page 34): 83.15 (d) "At least 2 years experience working in a health care related field having direct contact with one or more of the client groups identified under s. DHS 83.02(16) and have successfully completed a department-approved assisted living administrator's training course."

Updates - Check the WALA website at www.ewala.org on a regular basis as we will post all information as soon as we receive it.

The old WALA DHS 83 FAQ can be found here.