THE HFS 83 REWRITE

1. THE HFS 83 REWRITE WALA Conference March 24, 2005 Laurie Arkens

2. AGENDA History Objectives Process Changes Time Line Question and Answer

3. HISTORY HFS 83 effective 1997 1997 Directive from Secretary Series of meetings with core group/subcommittees 2002 process delayed 2004 process resumed

4. OBJECTIVES Less prescriptive More concise Better organized Update to related requirements Incorporate 20 bed over requirements

5. PROCESS HFS 83 Re-write Workgroup Working draft from original workgroup(s) Review of other states/national organizations Advisory Committee Revision Request Form

6. CHANGES INCORPORATED Chapter 50 Caregiver law Appropriate BQA memos Family Care requirements Current Comm language

7. AREAS OF CHANGE - TRAINING 83.14 Training requirements Department Approval Standard Precautions Fire Safety First Aid/Choking Medications Facility Training Job Related Training Complete within 90 days Exemptions

8. TRAINING PLAN-overview Department Approved Training Provided by approved trainers Data Base of approved trainers Fee for initial approval and renewals Training Advisory Groups Letters of interest Groups determined by 83 workgroup

9. TRAINING PLAN-overview Training Advisory Groups BQA representatives Provider representatives Trainer representatives determine curriculum skills/knowledge assessment trainer qualifications application form for approval

10. Training Provided by Facility Provide, obtain or otherwise ensure� Resident rights Challenging behaviors Resident group specific Must provide specific topics within each training area

11. Job Related Training Provide, obtain or otherwise ensure... Complete prior to, or within 90 days Needs assessment and ISP Dietary Medications Must provide specific topics within each training area

12. AREAS OF CHANGE -MEDICATION Made its own section Major reorganization General Requirements Medication Administration administration by staff self administration by resident self administration instruction Medication Storage

13. GENERAL REQUIREMENTS Medications from a licensed pharmacist or physician Packaging policy Supplements to be documented Regimen review by MD, RPh, or RN Policy for disposing of medications

14. GENERAL REUIREMENTS cont... Psychotropic Medications quarterly assessment by MD., RPh, or RN PRN use requires: protocol for use documentation of rationale, effectiveness and side effects

15. MEDICATION ADMINISTATION REQUIREMENTS Supervision requirements clarified Administration via other routes

16. MEDICATION STORAGE Transfer from bulk containers Transfer from unit dose packaging Exemption for AODA and Corrections facilities

17. OTHER AREAS OF CHANGE 83.04 Definitions 83.07 Program Statement Change of Ownership 83.12 Administrator 83.14 Orientation

18. AREAS OF CHANGE cont. 83.15 Staffing Patterns 83.16 Admission Agreement 83.19 Reporting Requirements 83.20 Discharge Requirements 83.21 Resident Rights 83.32 Assessment and ISP 83.35 Food Service

19. PHYSICAL ENVIRONMENT CHANGES -Overview Eliminated conflicts with Commerce & ADA Updated terminology Incorporated Bureau memos Rearranged for easier reading and flow Eliminated prescriptive language

20. PHYSICAL ENVIROMENT Language reflects more outcome and quality of life requirements. Less prescriptive

21. SAFETY 83.42 Evacuation Chart: easier readability Evacuation: documentation requirements evaluation annually for all residents Emergency phone numbers posted Small facilities to arrange for fire inspection Installation of smoke and heat systems 5 year delay for small class Cs Reliable water supply

22. OTHER CHANGES... 83.45 Accessibility chart deleted 83.52 Construction chart updated ARA now Area of Refuge Exits/Passageways updated to Comm. Delayed Egress Windows 16� clear opening coverings

23. NEW CONSTRUCTION, REMODELLING, ADDITIONS, ... Subchapter VIII Additional requirements for new construction, additions, change in licensure class or newly licensed existing structures General requirements include compliance with any applicable rules and standards (Comm., NFPA, Plumbing, Electrical)

24. Timeline Final draft- summer 2005 Rule Order Process begins: Department Review Legislative Review Public Hearings EFFECTIVE DATE - Late 2006?

25. QUESTIONS