Wisconsin Legislature: DHS 129.16(7)

(1) A person may not provide hands-on assistance with feeding or hydrating residents unless the person has successfully completed all of the following:

(a) A training program approved by the state for feeding assistants, including additional instruction on the selected resident population and the Wisconsin Caregiver Program requirements.

(b) After completing the training course, a state-approved standardized written quiz with a score of 75 percent or greater. Individuals may request the quiz to be administered orally. Instructors shall consider the needs of persons who have limited English proficiency or literacy difficulties.

(c) A state-approved standardized skill demonstration, determining hand washing and resident feeding competency with a score of 75 percent or greater.

(2) The instructor shall observe the trainee’s performance and initial and date each skill to verify the satisfactory or unsatisfactory performance.

(3) Students who do not successfully pass the initial competency evaluation will be allowed the opportunity to review the training materials and retake the test. Programs can establish the number of times a candidate may retake the test. However, the program shall document the failure, opportunity for review and subsequent retake testing date.

(5) The instructor shall issue a state-approved certificate to each participant who successfully completes the feeding assistant program, documenting the name of the participant, the training program and the date of successful completion.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.14 Standards for instructors of feeding assistant training programs.

(1) The feeding assistant training programs shall determine the appropriate qualifications for their instructors based on the needs of the selected clients and the nursing home.

(2) Training programs shall provide the name and qualifications of the proposed instructor to the department.

(3) The primary instructor may supplement the course by including other individuals for lecture or demonstration whose qualifications or experience add benefit to the training program.

(4) A paid feeding assistant is not permitted to lead the training of another paid feeding assistant student.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.15 Feeding assistant training program approval process.

(1) A nursing home wishing to operate a feeding assistant training program shall apply for approval from the department on a form provided by the department with the nursing home’s proposed selected resident population, curriculum, and proposed feeding assistant instructor information.

(2) The department shall review the application and supporting materials to determine whether to approve or deny the feeding assistant training program. The department will issue a written notice regarding the decision of whether to approve or deny the application within 45 calendar days of receiving a complete application.

(3) Upon approval, the department shall issue, to the feeding assistant program, the standardized training curriculum the program selects, a Wisconsin Caregiver Program video cassette, standardized competency evaluation materials, feeding assistant training program, certificate template, and a feeding assistant roster.

Note: Link to the WI Caregiver program video and guide at https://www.dhs.wisconsin.gov/publications/p6/p63161.pdf and https://vimeo.com/546007413.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.16 Feeding assistant employment requirements.

(1) A nursing home may not employ or use any person as a feeding assistant unless the person is at least 16 years of age and has:

(a) Successfully passed a caregiver background check, that includes no employment or licensure-prohibitive offenses in s. 146.40 (4r), Stats., or s. 48.685, Stats.

(b) Successfully completed a feeding assistant training and competency evaluation program and been determined competent to provide feeding and hydration services to residents.

(2) Nursing homes shall ensure feeding assistants only serve residents who have no complicated feeding problems with eating and hydration.

(3) Residents with complicated feeding problems, as defined in s. DHS 129.03 (10) shall be fed and hydrated by either a licensed health care professional or a nurse aide.

(4) The facility shall base their resident selection for feeding assistants based on the charge nurse’s assessment and each resident’s latest assessment and plan of care.

(5) Feeding assistants who are 16 or 17 years of age shall work under the direct supervision of an RN or LPN.

(6) Feeding assistants 18 years and older shall work under the general supervision of an RN, or an LPN. The feeding assistant is not permitted to perform other nursing or nursing-related duties including, but not limited to, measuring or recording intake or output, transferring, or toileting, etc.

(7) A nursing home may not employ or use any individual who has successfully completed a feeding assistant training and competency evaluation program as a feeding assistant unless that nursing home has a department-approved feeding assistant training program.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.17 Feeding assistant training program requirements. Approved feeding assistant training programs shall submit all of the following information to the department:

(1) The program designee shall submit for approval a substantial change in the program to the department in writing. A program may not implement the proposed change in the program without the department’s written approval. In this subdivision, “substantial change” means a change in the program designee, primary instructor under s. DHS 129.14 (2) and the curriculum under s. DHS 129.12.

(2) The program designee shall submit an annual report to the department on a form provided by the department, and shall indicate the number of feeding assistants who were trained and tested during the year, including the number of individuals who dropped out or who failed the program.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.18 Feeding assistant training program record retention requirements.

(1) Feeding assistant training programs shall maintain all of the following records for at least 3 years:

(a) All student skill checklists, written examinations, certificates and other relevant training records.

(b) Documentation of the training conducted and identification of the instructor who conducted the training.

(c) Records of all individuals who have successfully completed the feeding assistant training and competency testing program.

(2) Training programs shall maintain the security of the test materials and certificate templates, to ensure disclosure or forgery does not occur.

(3) Nursing homes employing feeding assistants shall maintain all of the following personnel and other records for at least 3 years after feeding assistant has competed training:

(a) A feeding assistant roster, recording all individuals employed by the facility as feeding assistants who successfully completed the feeding assistant training and competency evaluation, including a written or oral exam and a skill demonstration.

(b) A copy of each feeding assistant’s training certificate, kept in the person’s personnel file.

(d) The feeding assistant’s annual in-service session(s), relating to feeding assistant duties.

(e) Annual evaluation documentation, determining a feeding assistant’s continued competence in feeding residents.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.19 Feeding assistant training program prohibitions.

(1) The department will review substandard quality of care citations made under 42 CFR 483 that result in a prohibition of a nurse aide training or competency evaluation program for a nursing home, in order to determine the appropriate action for a feeding assistant training program. Program decisions will be made on a case-by-case basis.

(2) Any nursing home citation that directly relates to a feeding assistant training program may result in termination by the department of the feeding assistant training program.

(3) Feeding assistant training programs may request a waiver of the feeding assistant training prohibition by submitting a request in writing to the department. The department shall issue a written decision, either approving or denying the request, within 45 calendar days of receiving a complete waiver request.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.20 Feeding assistant training program appeals.

(1) For any of the following department actions, a feeding assistant training program may request a hearing by filing an appeal with the department of administration’s division of hearings and appeals.

(a) A denial of an application to operate a feeding assistant training program.

(b) A denial of an approval of a feeding assistant instructor.

(d) An imposed plan of correction.

(e) A denial of a request for a waiver or the revocation of a waiver.

(2) A request for a hearing shall be in writing and shall be filed with the department of administration’s division of hearings and appeals no later than 30 days after the date of the denial, suspension or revocation. An appeal is considered filed when received by the division of hearings and appeals.

Note: The address of the Department of Administration’s Division of Hearings and Appeals is P.O. Box 7875, Madison, Wisconsin 53707. Appeals may be delivered in person to that office at 5005 University Avenue, Room 201, Madison, Wisconsin.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

Subchapter IV — Medication Aides

DHS 129.21 Medication aide training program application and approval process.

(1) Approval process.

(a) All medication aide training programs based in nursing homes shall be approved by the department.

(b) Nursing homes and other entities wishing to operate a nursing home medication aide program shall submit a proposal for developing a medication aide course. The proposal shall include documentation of client needs, staff resources to provide the training and a description of the physical location of the training site. The proposal will be approved or denied by the department, and the department shall issue a decision within 30 calendar days of a completed proposal submittal.

(c) After a medication aide program proposal is approved, medication aide course curriculum, course outline, instructor qualifications and other materials shall be submitted to and approved by the department before the training program can be implemented. The department will issue a decision on a completed course submittal within 90 calendar days.

(d) The department will limit the number of approved programs to a maximum of 10, subject to determined needs as submitted in program development proposals. If the department determines there is a geographical or consumer-based need, the department may approve additional programs.

(2) Post approval review and monitoring.

(a) The department shall conduct a post-approval review of a program every 2 years after the date on which the department formally approved the program. The department may conduct an on-site review of the program at any time to verify the program remains in compliance with the requirements of this chapter.

(b) The program designee shall submit a report at least every 2 years to the department on a form provided by the department and shall provide any additional information requested by the department during its review of the program. The program designee shall allow reasonable means for the department to examine records and gather requested information.

(c) The program designee shall report a substantial change in the program to the department in writing within 10 days of the change. A program may not operate without the department’s approval of any replacement or substantial change. Notwithstanding s. DHS 129.03 (51), in this subdivision, “substantial change” means any change in the instructor under s. DHS 129.22, or curriculum under s. DHS 129.24 (1).

(d) All approved courses are subject to inspection. If at any time the department determines that a program has failed to comply with a requirement of this chapter, the department may, after providing written notice, impose a plan of correction on the program, suspend or revoke approval of the program.

(e) The department may revoke approval of an instructor if the department determines the instructor failed to comply with any requirement of this subchapter.

Note: Current course proposal and course curriculum content requirements can be obtained from the Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.22 Standards for instructors of medication aide training programs. A medication aide program instructor shall be one of the following:

(1) A registered nurse, licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques and one or more years of experience in one of the following positions within the last 5 years immediately before the person will be a program instructor:

(a) An instructor in a school of nursing.

(b) A director of nursing in a nursing home or a hospital.

(d) A supervisory nurse in a nursing home.

(2) An approved primary instructor for nurse aide training under s. DHS 129.06.

(3) A pharmacist who is licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques, and who has at least one year of experience as a consultant to a nursing home.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.23 Nursing home medication aide student qualifications.

(1) Student requirements. The student shall be at least 18 years of age, have a high school diploma or a high school equivalency diploma, and shall be listed on the registry as eligible to work in federally-certified health care settings.