Health, Family Health and Preparedness, Licensing

Rule R432-725

Personal Care Agency Rule

Notice of Proposed Rule

(New Rule)

DAR File No.: 35027
Filed: 07/11/2011 01:20:39 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

Historically the Personal Care Agency rule was located within the Home Health rule, with very few providers. Over the years more Personal Care agencies have opened and become licensed. The Health Facility Committee recommended this new rule to replace the section within the Home Health rule to clarify and define the Personal Care agencies.

Summary of the rule or change:

The Health Facility Committee recommended this new rule to replace the section within the Home Health rule to clarify and define the Personal Care agencies.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

No state budgets will be affected because the provisions of the new rule are very similar to the provisions of the old section in the Home Health rule.

local governments:

No local government budgets will be affected because the provisions of the new rule are very similar to the provisions of the old section in the Home Health rule.

small businesses:

No small business budgets will be affected because the provisions of the new rule are very similar to the provisions of the old section in the Home Health rule.

persons other than small businesses, businesses, or local governmental entities:

No other persons budgets will be affected because the provisions of the new rule are very similar to the provisions of the old section in the Home Health rule.

Compliance costs for affected persons:

No affected persons budgets will be affected because the provisions of the new rule are very similar to the provisions of the old section in the Home Health rule.

Comments by the department head on the fiscal impact the rule may have on businesses:

As part of ongoing review of administrative rules in the Department to reduce unnecessary negative business impacts, this rule change separates personal care agencies from the home health rule. Positive impact on business.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at [email protected]
• Carmen Richins at the above address, by phone at 801-538-9087, by FAX at 801-538-6024, or by Internet E-mail at [email protected]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/31/2011

This rule may become effective on:

09/07/2011

Authorized by:

David Patton, Executive Director

R432. Health, Family Health and Preparedness, Licensing.

R432-725. Personal Care Agency Rule.

R432-725-1. Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

 

R432-725-2. Purpose.

The purpose of this rule is to promote the public health and welfare through the establishment and enforcement of licensure standards. This rule sets standards for the operation of personal care agencies.

 

R432-725-3. Compliance.

(1) A personal care agency consists of two or more individuals providing personal care services on a visiting basis.

(2) A Personal Care Agency shall not exceed personal care services as defined in R432-725-4(2)(b).

 

R432-725-4. Definitions.

(1) See common definitions rule R432-1-3.

(2) Special definitions:

(a) "Licensed health care professional" means a registered nurse, physician assistant, advanced practice registered nurse, or physician licensed by the Utah Department of Commerce who has education and experience to assess and evaluate the health care needs of the resident.

(b) "Personal Care Services" means:

(i) self-administration of medications by:

(A) Reminding the client to take medications, and

(B) Opening containers for the client;

(ii) transferring;

(iii) personal grooming and dressing;

(iv) eating and meal preparation;

(v) oral hygiene and denture care;

(vi) toileting and toilet hygiene;

(vii) bathing;

(viii) taking and recording temperatures and weights;

(ix) administering emergency first aid;

(x) providing transportation.

(c) "Service Agreement" means a written agreement for services between the client and the personal care provider which outlines how the services are to be provided.

 

R432-725-5. Administrator.

(1) The licensee shall appoint by name and in writing a qualified administrator who is responsible for the agency's overall functions.

(2) The administrator shall be at least 21 years of age and have at least one year of managerial or supervisory experience.

(3) The administrator shall designate in writing a qualified person who is at least 21 years of age and who shall act in his absence. The designee shall have sufficient power, authority, and freedom to act in the best interests of the client safety and well being.

(4) The administrator or designee shall be available during the agency's hours of operation.

 

R432-725-6. Personnel.

(1) The agency shall maintain documentation for each employee required to be licensed or certified.

(2) Copies shall be maintained for Department review that staff have a current license, certificate, or registration. New employees shall have 45 days to present the original document.

(3) The agency shall ensure each employee maintains a minimum of six hours of in-service per calendar year, prorated for the first year of employment.

(4) An annual in-service shall be documented that staff have been trained in the reporting requirements for suspected abuse, neglect and exploitation.

 

R432-725-7. Health Surveillance.

(1) The agency shall establish and implement a policy and procedure for health screening of all agency health care workers (persons with direct client contact) to identify any situation which would prevent the employee from performing assigned duties in a satisfactory manner.

(2) Employee health screening and immunization components of personnel health programs shall be developed in accordance with R386-704, Communicable Disease Rules.

(3) Employee skin testing by the Mantoux method or other FDA approved in-vitro serologic test and follow up for tuberculosis shall be done in accordance with R388-804, Special Measures for the Control of Tuberculosis.

(a) The licensee shall ensure that all employees are skin-tested for tuberculosis within two weeks of:

(i) initial hiring;

(ii) suspected exposure to a person with active tuberculosis; and

(iii) development of symptoms of tuberculosis.

(b) Skin testing shall be exempted for all employees with known positive reaction to skin tests.

(4) All infections and communicable diseases reportable by law shall be reported by the facility to the local health department in accordance with R386-702-2.

 

R432-725-8. Orientation.

(1) There shall be documentation that all employees are oriented to the agency and the job for which they are hired.

(2) Orientation shall include but is not limited to:

(a) Job descriptions/duties;

(b) Ethics, confidentiality, and clients' rights;

(c) Reporting requirements for suspected abuse, neglect or exploitation.

 

R432-725-9. Admission and Retention.

(1) The agency may accept and retain clients for service if the client's needs do not exceed the level of personal care services as determined and documented by a licensed health care professional.

(2) If the client's needs exceed the personal care services, the agency shall make a referral to a licensed health care professional or an appropriate alternative service.

 

R432-725-10. Service Agreement.

(1) The agency shall obtain a signed and dated service agreement from the client and/or his responsible party.  The service agreement shall include the following:

(a) A description of services to be performed by the Personal Care Aide;

(b) Charges for the services;

(c) A statement that a 30-day notice shall be given prior to a change in base charges.

 

R432-725-11. Termination of Services Policies.

(1) The agency may discharge a client under any of the following circumstances:

(a) Payment for services cannot be met;

(b) The safety of the client or provider cannot be assured;

(c) The needs of the client exceed the level of care provided by the agency;

(d) The client requests termination of services; or

(e) The agency discontinues services.

 

R432-725-12. Clients' Rights.

(1) Written clients' rights shall be established and made available to the client, guardian, next of kin, sponsoring agency, representative payee, and the public.

(2) Agency policy may determine how clients' rights information is distributed.

(3) The agency shall insure that each client receiving services has the following rights:

(a) To be fully informed of these rights and all rules governing client conduct, as evidenced by documentation in the clinical record;

(b) To be fully informed of services and related charges for which the client or a private insurer may be responsible, and to be informed of all changes in charges;

(c) To be free of mental abuse, physical abuse and/or exploitation;

(d) To be afforded the opportunity to participate in the planning of personal care services, including referral to health care institutions or other agencies, and to refuse to participate in experimental research;

(e) To be assured confidential treatment of personal records, and to approve or refuse their release to any individual outside the agency, except in the case of transfer to another agency or health facility, or as required by law or third-party payment contract;

(f) To be treated with consideration, respect, and full recognition of dignity and individuality, including privacy in treatment and in care for personal needs;

(g) To be assured that personnel who provide care demonstrate competency through education and experience to carry out the services for which they are responsible;

(h) To receive proper identification from the individual providing personal care services;

(i) To receive information concerning the procedures to follow to voice complaints about services being performed.

 

R432-725-13. Client Records.

(1) The Personal Care Agency shall maintain accurate and complete records. Records shall be filed, stored safely, and be easily accessible to staff and the Department.

(2) Client records shall be retained by the agency for three years following the last date of service;

(3) The client record shall contain the following:

(a) Client's name, date of birth and address;

(b) Client service agreement;

(c) Name, address, and telephone number of the individual to be notified in case of accident, emergency or death;

(d) Documentation of date and reason for the termination of services.

 

R432-725-14. Personal Care Aides.

(1) Personal care aides shall be at least 18 years of age and must:

(a) Have knowledge of agency policy and procedures;

(b) Be trained in first aid;

(c) Be able to demonstrate competency in all areas of training for personal care.

(2) Personal Care Aides shall be supervised by an individual with the following qualifications:

(a) A licensed nurse; or

(b) A Certified Nursing Aide with at least two years experience in personal or home care.

(3) The supervisor shall complete an on-site evaluation of the personal care aide and document the quality of the personal care services provided in the client's place of residence every six months.

(4) Personal Care Aides shall document observations and services in the individual client record.

 

R432-725-15. Penalties.

Any person who violates any provision of this rule may be subject to the penalties enumerated in 26-21-11 and R432-3-6 and be punished for violation of a class A misdemeanor as provided in 26-21-16.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: 2011

Authorizing, and Implemented or Interpreted Law: 26-21