Chapter DHS 129

DHS 129.05(2)(b)1. 1. The department shall conduct a preliminary approval onsite review before issuing a preliminary approval, to verify that the classroom and equipment are adequate for the training program.

DHS 129.05(2)(b)2. 2. Following the 3 month preliminary approval period, the department shall conduct an onsite review to verify compliance with the requirements of this chapter. The department shall either issue a formal approval or revoke the preliminary approval.

DHS 129.05(2)(b)3. 3. If preliminary approval for a training program is denied or revoked, the program may not resubmit a request for approval to train nurse aides for 6 months from the date the preliminary approval for the training program was denied or revoked.

DHS 129.05(2)(c) (c) Post-approval review and monitoring.

DHS 129.05(2)(c)1. 1. The department shall conduct a post-approval review of a program every 2 years after the date on which the department formally approves the program. The department may conduct an announced or an unannounced on-site review of the program at any time to verify that the program remains in compliance with this chapter.

DHS 129.05(2)(c)2. 2. The program designee shall submit an annual report to the department on a form provided by the department and shall provide any additional information requested by the department during the department’s review of the program. The program designee shall provide reasonable means for the department to examine records and gather requested information.

DHS 129.05(2)(c)3. 3. The program designee shall submit for approval any 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 under s. DHS 129.05 (1) (c), primary instructor under s. DHS 129.06 (1), training course for primary instructors under s. DHS 129.06 (3), curriculum under s. DHS 129.07 (1), or program site under s. DHS 129.07 (2) (a) or (c).

DHS 129.05(2)(c)4. 4. An approved training program may be granted inactive status if no training was conducted in the previous 24 consecutive months. The training program will be required to submit a new application in its entirety if the period of inactivity is 36 consecutive months or longer.

DHS 129.05(2)(c)5. 5. 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, or suspend or revoke approval of the program.

DHS 129.05(2)(d) (d) Enforcement.

DHS 129.05(2)(d)1. 1. The department may deny or withdraw approval of a new or existing program for any of the following reasons:

DHS 129.05(2)(d)1.a. a. The program cannot provide satisfactory evidence that the program meets the standards for program approval.

DHS 129.05(2)(d)1.b. b. The program did not conduct any training classes within the previous 24 consecutive months.

DHS 129.05(2)(d)1.c. c. The program fails to allow the department to conduct an on-site visit of the training program.

DHS 129.05(2)(d)2. 2. The department may withdraw program approval immediately or prescribe the time within which the deficiencies identified during an onsite review shall be corrected. All notices of deficiency shall be given in writing to the program contact, identified in s. DHS 129.05 (1) (c). The program contact may submit a plan of correction to the department. If the program fails to correct the deficiency within the specified time, the approval may be withdrawn.

DHS 129.05(2)(d)3. 3. When program approval is withdrawn, the program shall do all of the following:

DHS 129.05(2)(d)3.a. a. Submit a plan to the department within 10 business days after the withdrawal of the program’s approval for the completion of the program of the enrolled students with another program in good standing with the department.

DHS 129.05(2)(d)3.b. b. Allow students who have started that program to complete the course with another program that is in good standing with the department.

DHS 129.05(2)(d)3.c. c. Provide for custody of the training records for a 3 year time period as required in s. DHS 129.07 (2) (f).

DHS 129.05(2)(d)4. 4. Denial or withdrawal of facility-based training is subject to the requirements of applicable federal law.

DHS 129.05(2)(d)5. 5. If the approval is withdrawn, the program may request a hearing under in s. DHS 129.10.

DHS 129.05(2)(d)6. 6. If approval of the program is denied or withdrawn under subd. 1., the program may not reapply for program approval for 6 months from the date of the denial or withdrawal of the program approval.

DHS 129.05 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correction in (2) (d) 6. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 20-068: am. (2) (a) 1. e. Register December 2021 No. 792, eff. 1-1-22.

DHS 129.06 DHS 129.06 Standards for instructors of nurse aide training programs.

DHS 129.06(1) (1) Primary instructor.

DHS 129.06(1)(a) (a) The primary instructor for a training program shall be a registered nurse licensed to practice in Wisconsin, who has at least 2 years of experience working as a registered nurse, of which at least one year of experience shall be actual work experience in providing care in a nursing home that meets the requirements of sections 1919(a), (b), (c) and (d) of the Social Security Act.

DHS 129.06(1)(b) (b) Notwithstanding par. (a), the primary instructor for a training program conducted by a hospital shall have at least one of the 2 years experience working as a registered nurse in a hospital.

DHS 129.06(1)(c) (c) Notwithstanding par. (a), for a primary instructor in a training program in a home health agency-based program, shall have at least one of the 2 years experience working as a registered nurse in the provision of home health care.

DHS 129.06(1)(d) (d) A primary instructor shall provide to the program a resume documenting the instructor’s education and clinical experience in meeting clients’ psychosocial, behavioral, cognitive and physical needs, and the program shall maintain the instructor’s resume on file and shall include a copy of the instructor’s resume with the program’s application for program approval.

DHS 129.06(1)(e) (e) The primary instructor shall attend a training course for instructors approved by the department under sub. (3). The department may waive this requirement for an instructor who has taken a substantially equivalent course or who has substantially equivalent training or clinical experience.

DHS 129.06(1)(f) (f) A primary instructor is considered active as long as the instructor remains affiliated with an approved course. If the primary instructor leaves the program and does not become affiliated with another program the instructor’s approval as a primary instructor is inactivated as of the date the instructor leaves the approved program.

DHS 129.06(1)(g) (g) The department may revoke approval of a primary instructor if the department determines the primary instructor failed to comply with any requirement of this chapter.

DHS 129.06(2) (2) Program trainer.

DHS 129.06(2)(a) (a) Only persons licensed in health care and public health fields may serve as program trainers to meet specialized training needs. This may include licensed registered nurses, licensed practical nurses, pharmacists, dietitians, social workers, registered sanitarians, fire safety experts, health care administrators, gerontologists, psychologists, physical and occupational therapists, activity therapists, speech and language pathologists, audiologists, and high school instructors who are approved by the administration in their respective districts to teach health occupation courses.

DHS 129.06(2)(b) (b) A program trainer shall have at least one year of work experience in the area the program trainer will provide training.

DHS 129.06(2)(c) (c) A program trainer shall work under the general supervision of the primary instructor.

DHS 129.06(3) (3) Training course for primary instructors. Application for approval of a training course for primary instructors shall be made on a form provided by the department. The department shall review an application for approval of a training course for primary instructors and shall approve or deny the application within 90 days after receiving the application. The application shall include documentation of all of the following:

DHS 129.06(3)(a) (a) The instructor shall be a registered nurse licensed to practice in Wisconsin and have at least 2 years of experience as an instructor of nursing practice or nurse aides.

DHS 129.06(3)(b) (b) The course shall be a minimum of 16 hours in length.

DHS 129.06(3)(c) (c) The training course shall include the following areas:

DHS 129.06(3)(c)1. 1. The principles of adult learning and training techniques.

DHS 129.06(3)(c)2. 2. Formulating training objectives, including behavior objectives which state measurable performance criteria to provide a basis for competency evaluation.

DHS 129.06(3)(c)3. 3. Designing the curriculum to provide a logical organization of the material to be covered.

DHS 129.06(3)(c)4. 4. Developing lesson plans.

DHS 129.06(3)(c)5. 5. Choosing appropriate teaching strategies and methodologies.

DHS 129.06(3)(c)6. 6. Developing learning materials.

DHS 129.06(3)(c)7. 7. Applying methods for evaluating trainee learning.

DHS 129.06(3)(c)8. 8. Effectively supervising trainees’ clinical practice.

DHS 129.06(3)(c)9. 9. Defining criteria for successful achievement of training program objectives, including development of oral and written examinations and development of methods for demonstrating skills based on behaviorally stated course objectives; and

DHS 129.06(3)(c)10. 10. Developing a recordkeeping system.

DHS 129.06 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.07 DHS 129.07 Standards for nurse aide training programs.

DHS 129.07(1) (1) Curriculum for a nurse aide training program. The training program shall include theory and practice in all of the following care areas:

DHS 129.07(1)(a) (a) Interpersonal communication and social interaction. The program shall include the theory of and practice in communicating and interacting on a one-to-one basis with a client; serving as part of a team implementing client care objectives; demonstrating sensitivity to a client’s emotional; social and psychological needs through directed interactions; and skills that enable expressions of age-appropriate behavior by allowing a client to make personal choices and by reinforcing behavior that supports a client’s sense of dignity. After completion of this portion of the training program, a nurse aide shall do all of the following:

DHS 129.07(1)(a)1. 1. Identify the components of a caregiver-client relationship and be able to recognize and demonstrate understanding of all of the following:

DHS 129.07(1)(a)1.a. a. The uniqueness of each client, in terms of that person’s age, disability, family status, financial status, gender, marital status, race, and sexual orientation, and cultural, generational, social, ethnic, religious or other background, values or characteristics.

DHS 129.07(1)(a)1.b. b. The needs of a client with Alzheimer’s disease, dementia, mental illness, intellectual disability, or other cognitive disabilities or impairments.

DHS 129.07(1)(a)1.c. c. Ways both nurse aides and clients can cope with stress.

DHS 129.07(1)(a)1.d. d. What constitutes caregiver misconduct.

DHS 129.07(1)(a)1.e. e. The messages conveyed by body language, speech and facial expressions.

DHS 129.07(1)(a)2. 2. Demonstrate an ability to establish effective relationships with clients and be able to do all of the following:

DHS 129.07(1)(a)2.a. a. Communicate with clients in a respectful manner that affords clients dignity.

DHS 129.07(1)(a)2.b. b. Explain procedures and activities to clients before carrying out those procedures or beginning those activities.

DHS 129.07(1)(a)2.c. c. Demonstrate concern for clients who have long-term or disabling illnesses or who are dying.

DHS 129.07(1)(a)2.d. d. Identify developmental tasks associated with the aging process.

DHS 129.07(1)(a)3. 3. Demonstrate an ability to use appropriate verbal and nonverbal communication skills with clients and be able to do all of the following:

DHS 129.07(1)(a)3.a. a. Recognize effective listening techniques.

DHS 129.07(1)(a)3.b. b. Distinguish assertive from aggressive responses.

DHS 129.07(1)(a)3.c. c. Identify the difference between non-acceptable and acceptable touching during job performance.

DHS 129.07(1)(a)3.d. d. Identify therapeutic interventions and specialized techniques for responding to client’s wandering and confusion.

DHS 129.07(1)(a)4. 4. Recognize common barriers to communication, including language, vision changes, hearing loss, speech problems, memory loss, disorientation and pain.

DHS 129.07(1)(a)5. 5. Demonstrate an ability to promote the independence of clients within the limitations of their physical, mental and intellectual impairments by fostering self-help skills through appropriate responses to clients’ attempts to provide self care, including recognizing clients’ level of ability in self care activities.

DHS 129.07(1)(a)6. 6. Identify the role of the family and other persons of importance to the client in the client’s care and as resources for client emotional support.

DHS 129.07(1)(b) (b) Basic nursing skills. The program shall include the theory of and practice in basic nursing skills, including bed making, taking vital signs, measuring height and weight, caring for the client’s environment, measuring fluid and nutrient intake and output, assisting in the provision of proper nutritional care, walking or transferring the client using body mechanics and appropriately selected equipment with regard to principles of client care ergonomics, and maintaining infection control and safety standards. A nurse aide shall do all of the following:

DHS 129.07(1)(b)1. 1. Use acceptable personal hygiene.

DHS 129.07(1)(b)2. 2. Recognize the components of working relationships.

DHS 129.07(1)(b)3. 3. Identify how and when to seek guidance, using the supervisory channels of communication within the facility or agency.

DHS 129.07(1)(b)4. 4. Use proper body mechanics.

DHS 129.07(1)(b)5. 5. Demonstrate an understanding of the meaning of common medical terms and abbreviations.

DHS 129.07(1)(b)6. 6. Observe and report changes in client behavior and physical status, including signs and symptoms of common diseases and conditions.

DHS 129.07(1)(b)7. 7. Recognize when a client may be choking and respond appropriately.

DHS 129.07(1)(b)8. 8. Recognize the normal physical and psychological changes associated with aging.

DHS 129.07(1)(b)9. 9. Identify the basic principles of nutrition and hydration.

DHS 129.07(1)(b)10. 10. Recognize and report deviations from a client’s normal food and fluid intake and output.

DHS 129.07(1)(b)11. 11. Recognize the basic requirements of commonly prescribed therapeutic diets.

DHS 129.07(1)(b)12. 12. Use common measures to promote a client’s skin integrity, considering the client’s ethnicity, race and age.

DHS 129.07(1)(b)13. 13. Demonstrate appropriate techniques in walking, transferring, positioning and transporting clients.

DHS 129.07(1)(b)14. 14. Recognize and respond appropriately to unsafe environmental conditions, including damp floors, frayed electrical cords and loose hand rails.

DHS 129.07(1)(b)15. 15. Recognize and respond appropriately to emergency situations including following emergency evacuation procedures.