(c) Employee records shall be retained for 3 years following a caregiver’s separation from employment at the ADCC.
Subchapter III – Personnel
DHS 105.14.13 Operator. (1) QUALIFICATIONS. (a) An operator shall be at least 21 years of age.
(b) An operator shall meet the caregiver background requirements under s. 50.065, Wis. Stat., and ch. DHS 12. (2) RESPONSIBILITIES. (a) The operator shall ensure the ADCC and its operation comply with all laws governing the ADCC.
(b) The ADCC shall comply with the requirements set by the Federal 1991 Americans with Disabilities Act, and by the Federal Occupation, Safety and Health Administration.
(c) The operator shall develop a procedure to implement standard precautions.
(d) The operator shall develop and implement written policies and procedures to investigate allegations of employee misconduct and injuries of unknown source as defined in s. DHS 105.14 (11). (e) The operator shall report any change in participant group in writing to the department at least 30 days in advance and may not implement the change until the operator receives written approval from the department.
(f) The operator shall not change the ADCC’s capacity until the operator receives written approval from the department.
(g) The operator shall provide to each participant, or the participant’s legal representative, and third party payer, a 30 day written notice of any change in the ADCC’s capacity or client group.
(h) The operator shall post the ADCC certification, any statement of deficiency, notice of revocation and any other notice of enforcement action in a public area that is visually and physically accessible. A statement of deficiency shall remain posted for 90 days following receipt. Notices of revocation and other notices of enforcement action shall remain posted until a final determination is made.
(i) The operator may not permit the existence or continuation of any condition which is or may create a substantial risk to the health, safety, well-being or welfare of any participant.
(j) The operator shall ensure that the presence of other occupants does not adversely affect the health, safety, well-being or welfare of participants.
DHS 105.14.14 Program director. (1) QUALIFICATIONS. The program director of an ADCC shall be at least 21 years of age and have the capacity to respond to the needs of the participants and manage the day to day operations of the ADCC. The Director shall have any one of the following qualifications:
(a) An associate degree or higher from an accredited college in a health care related field.
(b) At least 2 years’ experience working in health care or related field, which served a population similar to the population at the adult day care center.
(c) Persons who are the qualified program director of record with the department of an ADCC on the date this rule becomes effective, shall be exempt from the qualification requirements specified under sub. (1). (2) RESPONSIBILITIES. (a) The program director shall supervise the daily operation of the ADCC, including but not limited to, participant care and services, personnel, finances, and physical plant. The program director shall provide the supervision necessary to ensure that the participants receive proper care and treatment, that their health and safety are protected and promoted and that their rights are respected.
(b) The program director shall be responsible for the training and competency of all caregivers.
(c) A qualified caregiver who is at least 18 years old shall be designated as in charge whenever the program director is absent from the ADCC.
DHS 105.14.15 Caregiver. (1) Each caregiver shall have the skills, education, experience and ability to fulfill the caregiver’s job requirements.
(2) A caregiver shall be at least 16 years old.
DHS 105.14.16 Hiring and employment. (1) CAREGIVER BACKGROUND CHECK. Before hire, employment or contract and every 4 years after, the operator shall conduct and document a caregiver background check following the procedures in s.50.065, Wis. Stat., and ch. DHS 12. An operator shall not employ, contract with or permit a person to work or reside at the ADCC if the person has been convicted of the crimes or offenses, or has a governmental finding of misconduct, found in s. 50.065, Wis. Stat., and ch. DHS 12, Appendix A, unless the person has been approved under the department’s rehabilitation process as defined in ch. DHS 12. (2) EMPLOYEE HEALTH COMMUNICABLE DISEASE CONTROL. (a) The ADCC shall obtain documentation from a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse indicating all employees have been screened for clinically apparent communicable disease including tuberculosis. Screening for tuberculosis shall be conducted in accordance with current standards of practice. The screening and documentation shall be completed within 90 days before the start of employment or before assumption of duties in which the caregiver will have direct contact with participants. The ADCC shall keep screening documentation confidential, except the department shall have access to the screening documentation for verification purposes.
(b) Employees shall be re-screened for clinically apparent communicable disease as described in par. (a) based on the likelihood of exposure to communicable disease, including tuberculosis. (c) A person who has a communicable disease shall not be permitted to work or be present in the ADCC if the disease would present a risk to the health or safety of participants.
DHS 105.14.17 Employee records. (1) A separate record for each employee shall be maintained, kept current, and at a minimum, include:
(a) Beginning date of employment.
(b) Educational qualifications for program director.
(c) A completed caregiver background check following procedures under s. 50.065, Wis. Stat., and ch. DHS 12. (d) Documentation of orientation and training.
(2) Employee records shall be available upon request at the ADCC for review by the department.
Subchapter IV – Orientation and Training
DHS 105.14.18 Orientation. (1) Before performing any job duties, all employees shall receive appropriate orientation to their job responsibilities and to the center and its policies, including, but not limited to, emergency and evacuation procedures, participant rights and prevention and reporting of participant abuse, neglect and misappropriation of participant property.
DHS 105.14.19 Training. (1) Within 90 days of employment the ADCC shall provide, obtain or otherwise ensure all caregivers receive training in the following areas:
(a) Training specific to each participant group served to include the physical, social and mental health needs of the participant group. Specific training topics shall include, as applicable: activities, safety risks, managing and responding to challenging behaviors, environmental considerations, disease processes, communication skills, and nutritional needs.
(2) The ADCC shall provide, obtain, or otherwise ensure caregivers receive specific task training prior to assuming these job duties, to include:
(a) Personal Care. All caregivers responsible for providing assistance with activities of daily living shall successfully complete training appropriate to the care and services provided. Specific training topics may include, but not limited to, toileting and incontinence care, mobility and transferring, eating, bathing, and dressing.
(b) Standard precautions. All caregivers who may be exposed to blood, body fluids or other moist body substances, including mucous membranes, non-intact skin, secretions, and excretions except sweat, whether or not they contain visible blood shall successfully complete training in standard precautions.
(c) Medication administration. Any caregiver, who manages, administers or assists participants with prescribed or over-the-counter medications shall complete training in medication administration and management.
DHS 105.14.20. Caregiver supervision. Until a caregiver has completed all required training, the caregiver shall be directly supervised by the program director or by a qualified caregiver.
DHS 105.14.21 Continuing education. The program director and all caregivers shall receive at least 10 hours per calendar year of continuing education beginning with the first full calendar year of employment. Continuing education shall be relevant to the job responsibilities and shall include, at a minimum:
(1) Standard precautions.
(2) Participant rights.
(3) Prevention and reporting of abuse, neglect and misappropriation.
(4) Emergency and evacuation procedures.
DHS 105.14.22 Documentation. (1) The ADCC shall maintain documentation of all the applicable training under subch. IV to include the name of the employee, the name of the instructor, the dates of training, a description of the course content, and the length of the training.
(2) Orientation, training, and hours of continuing education shall be documented in the employee’s file.
Subchapter V - Admission, Retention and Discharge
DHS 105.14.23 Limitations on enrollment and retention. (1) Certification Capacity. (a) No ADCC may serve more participants than the maximum participant capacity on its certification at any time during hours of operation.
(2) Enrollment and retention limitations. No person under the age of 18 years may be enrolled as an ADCC participant, unless approved for enrollment by the department.
(a) Requests for approval to enroll a person under the age of 18 years shall be made in writing and shall include:
1. A statement from the referring physician stating the services required by the minor;
2. A statement from the program director certifying that the required services can be provided;
3. A statement from the persons or agencies assuming financial responsibility; and
4. Evidence of guardianship and legal representative, if any.
DHS 105.14.24 Enrollment procedures. (1) ASSESSMENT. The ADCC shall assess each participant before enrollment as required under s. DHS 105.14.27. (2) Enrollment Information. The ADCC shall obtain and document the following information about the participant upon acceptance into the program:
(a) Participant’s full name, address, telephone number, date of birth and living arrangement;
(b) Name, address and telephone number of designated contact person, and legal representative, if any;
(c) Name, address and telephone number of the participant’s primary physician;
(d) Name and address of the referring or coordinating agency and case manager, if applicable; and
(e) Advance Directives, if executed by the participant, such as a power of attorney for health care, or a do-not-resuscitate order.
(3) Services and Charges. An enrollment agreement shall be signed by the participant, or legal representative, if applicable, that includes a written description of the services to be provided, the cost of those services, and a statement of the participant’s rights have been received.
(4) HEALTH SCREENING. (a) Participant health screening. 1. Within 90 days before or 7 days after enrollment, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each person enrolled in the ADCC for clinically apparent communicable disease, including tuberculosis, and document the results of the screening.
2. Screening for tuberculosis and all immunizations shall be conducted in accordance with current standards of practice.
3. The ADCC shall maintain the screening documentation in each participant’s record.
DHS 105.14.25 Discharge. (1) APPLICABILITY. This section applies to all ADCC participant discharges.
(2) The ADCC shall develop criteria for voluntary and involuntary discharge of a participant from the program.
(3) The ADCC may not involuntarily discharge a participant except for any of the following reasons:
