WALA's DHS 83 FAQ's
Q & A Transcribed by WALA from BAL staff at 5/12/09 AL Forum
From WALAs DHS 83 Training Sessions
Medication Q & A
A CBRF resident takes the city bus to attend work once a week. His employer requires the resident's medications to be delivered to the facility and that facility staff hand medications to work staff. The facility does not feel it is safe to transfer the resident's punch card with him as he travels on the city bus. Codes do not allow staff to take medications out of unit dose packaging for routine events. How can the facility meet all requirements while also maintaining the resident's independent bus travel and allowing medication transfer between staff ?
A sample of multiple, potential options include:
a. The prescription may be changed so that the medication does not need to be taken at work.
b. The employer maintains a month's supply of medication so that handoffs can be made monthly rather than weekly.
c. After consideration, an employer may allow a resident to hand-off medications to work staff. If medication tampering is a concern, the use of some type of sealed, tamper-evident packaging may be possible.
The resident, work staff, facility staff, and the pharmacist need to discuss and understand all relevant regulations and/or requirements and find a viable solution that maintains the resident's desired level of independence.
83.03 Variance and Waiver
Q. When do our current variances and waivers expire? Posted 3/20/09
A. WALA NOTE: The following was not addressed by BAL until WALA pointed out the timing issue.
Variances and Waivers expire April 1, 2009. However WALA was informed 3/10/09 by BAL that unless there is a compelling reason to renew them quickly, wait for BAL to take the lead at the time of your next survey. Be sure and have the list of your variances and waivers ready for your survey.
83.12 (4) (c) Investigation - Other Reporting
Q. Do I have to report injuries if the resident is sent only to the emergency room, and not the hospital? Posted 3/21/09
A. Yes. "Any incident or accident resulting in serious injury requiring hospital admission or emergency room treatment of a resident." WALA NOTE: This is only for serious injury per your company's policy.
83.13 General records, retention and posting
Q. When "house rules" are to be posted, is that rules for employees or rules for residents? Posted 7/23/09
A. House rules 83.13 General records, retention and posting. (3) Posting ... "(b) House rules, resident rights, and grievance as required under DHS 83.32 (2) (b)"...which adds "in a prominent public place available to residents, employees and guests." We take that to mean the house rules for the residents.
83.16 Employees
Q. Must all my resident care staff (RCS) be at least 18 years old? Posted 5/11/09
A. Read the RCS definition carefully to see if your food service, etc. staff are, or are not RCS. Some providers have kitchen staff etc. who work exclusively in the kitchen and are not considered RCS, and thus do not need to be 18. The definition of RCS can be found in 83.02 (47) of the code.
83.17 Hiring and Employment
Q. In reference to 83.17 and the screening for communicable disease with caregivers. Is there a form that our community can use for this? Posted 7/23/09
A. Currently, there is no prescribed form from the state for documentation of freedom from communicable disease. You are required to provide documentation that your employees have been screened for "clinically apparent" communicable disease. It is up to the practitioner to determine the process and testing (if any) they will use to make that determination. As for the documentation, it could be something as simple as a statement you provide that the physician signs stating that the employee has been evaluated for clinically apparent communicable disease including tuberculosis, and his/her findings are negative. Whatever source you use for documentation of this is up to you to develop as long as you have followed the requirement and have it documented respectively.
83.21 (3) All Employee Training- Challenging Behaviors/ Suicide Prevention
Q. For Challenging Behaviors in All Employee Training, do I have to train "suicide prevention" and what resources are available for me to train this new topic? Posted 4/27/09
A. BAL confirmed with WALA on 4/22/09 that the intent of this training is suicide awareness not suicide prevention. BAL does not expect care staff in a CBRF to be mental health professionals, only to be aware of signs that can lead to severe depression and even suicide. A few resources for you to train your staff include:
http://www.mhawisconsin.org/Content/suicide_prevention.asp
http://dhs.wisconsin.gov/health/InjuryPrevention/pdffiles/WISuicidePrevStrategy.pdf
WALA thanks Christel Giesen - Information and Assistance Team Leader - Aging and Disability Resource Center of Brown County for these links.
83.25 Continuing Ed
Q. When they are talking about the 15 hours of continuing education and how it needs to be completed in the calendar year, do they mean starting on the employees anniversary date or on Jan 1st? Posted 11/2/09
A. 83.25 states: The administrator and resident care staff recieve at least 15 hours per calendar year of continuing education beginning with the first full calendar year of employement.
That means that once an employee has been hired, that the 15 hour requirement starts with the "first calendar" year and they then need 15 hours.
In other words, you hire an employee Dec 1, 2009. That trainee has to do all the current training etc. - some now, some within 90 days. And "beginning with the first full calendar year of employment", the employee then has to start the 15 hours. That would be January 1, 2010. So the employee would need 15 hours in 2010.
We do feel you can use part of the other training you have to do as the 15 hours of continuing ed, just keep track of the time and topics and make sure it is in their file as 83.25 continuing ed.
From BAL: Yes, the 15 hours is based on the first full and every calendar year after the date of hire, and is not based on the employee's hire date. This example is correct.
83.36 Staffing requirements
Q. When posting Employees on time schedules, do first and last name HAVE to be included on the roster? Posted 7/23/09
A. 83.36 Staffing requirements (2) Staffing Schedule ..."The schedule shall include each employee's full name, job assignment and time worked." We take that to mean first and last name.
83.59 (2) (e) Toilet doors
Q. With all the confusion on installing 2 way hinges on toilet doors, what should I do? Posted 4/17/09
A. WALA met with BAL on 4/16/09 and were informed that unless you are doing new construction hold off on doing any remodeling to meet the code for toilet doors until there is further clarification. See memo by BAL on 7/15/09 for clarification.