Subchapter E. REQUIREMENTS FOR DIRECT-CARE AND SUPPORT STAFF
Sec.
5320.41. Physical examinations.
5320.42. Staffing levels.
5320.43. Program director and direct-care staff qualifications.
5320.44. Staff supervision.
5320.45. Staff orientation and training.
5320.46. Interdisciplinary treatment team.§ 5320.41. Physical examinations.
The provider shall require and document preemployment and biennial physical examinations for direct-care and support staff to include screening for:
(1) Tuberculosis
§ 5320.42. Staffing levels.
The provider of LTSR services shall:
(1) Retain staff having an appropriate combination of education, work experience and training to meet the special needs of the population being served so that the service and program standards of this chapter are maintained.
(2) Retain full-time staffing levels sufficient to provide active treatment, psychosocial rehabilitation and 24-hour supervision on weekdays, weekends and holidays.
(3) Have a minimum of two direct-care staff persons awake and on duty within the LTSR whenever 10 to 16 residents inclusive are on the premises. A third direct-care staff person shall be either onsite or available to respond onsite within 30 minutes.
(4) Have a minimum of two direct-care staff, awake and on duty within the LTSR whenever fewer than 10 residents are on the premises.
(5) Have sufficient psychiatric time available to meet the psychiatric needs of the resident. At least 1/2 hour of psychiatric time per resident per week is required.
(6) Employ the program director on a full-time basis.
(7) Employ a mental health professional as provided in § 5320.43(b) (relating to program director and direct-care staff qualifications) onsite for at least 8 out of every 24 hours. This requirement may be met by the presence of the program director.
(8) Employ substitute staff with equivalent qualifications when staff are absent so that minimum direct-care staffing requirements are always met.
(9) Have direct-care staff certified in CPR and first aid on duty 24 hours a day.
Cross References This section cited in 55 Pa. Code § 5320.22 (relating to governing body).
§ 5320.43. Program director and direct-care staff qualifications.
(a) The program director shall:
(1) Have a Master’s degree in a generally recognized clinical discipline and 2 years of mental health clinical experience.
(2) Be registered, licensed or certified to practice his profession, if that profession is governed by a registration, licensing or certification board in this Commonwealth.
(b) A mental health professional shall:
(1) Have a Master’s degree or higher in a generally recognized clinical discipline and 1 year of mental health clinical experience.
(2) Be registered, licensed or certified to practice in his profession, if that profession is governed by a licensing board in this Commonwealth.
(c) A mental health worker shall be a person who has completed 12 semester hours of college training in a mental health related field or has at least a high school diploma or equivalency and 6 months of formal training in mental health or a related field.
Cross References This section cited in 55 Pa. Code § 5320.42 (relating to staffing levels).
§ 5320.44. Staff supervision.
The program director shall oversee supervision of the staff, including:
(1) Maintenance and review of resident care records.
(2) Annual evaluations of job performance.
(3) Orientation and training programs.
§ 5320.45. Staff orientation and training.
The program director shall oversee orientation and training of the staff, including:
(1) In-service and out-service training relevant to the needs of the population being served by the facility.
(2) A written policy for orientation and training of direct care and support staff according to the following criteria:
(i) Full-time staff, defined as working 30 hours per week or more, shall receive a minimum amount of orientation as follows:
(A) Direct care staff—20 hours.
(B) Support staff—4 hours.
(ii) Regularly scheduled part-time staff, defined as working less than 30 hours per week, shall receive a minimum amount of orientation as follows:
(A) Part-time direct care staff—10 hours.
(B) Part-time support staff—2 hours.
(3) Written documentation that an orientation program includes the following topics:
(i) Program philosophy, mission statement, goals and objectives.
(ii) Review and update of all policies and procedures.
(iii) Infection control including universal precautions, risk reduction and HIV education.
(iv) Confidentiality.
(v) Safety, fire safety and evacuation procedures.
(vi) Resident rights as specified at § § 5100.51—5100.56 (relating to patient rights).
(vii) Conflict resolution (direct-care staff only).
(viii) Crisis prevention, management and reporting.
(ix) Abuse prevention and reporting.
(x) An overview of the main effects and side effects of medication (direct-care staff only).
(xi) Interdisciplinary treatment process and treatment planning (direct-care staff only).
(xii) Quality improvement and service utilization (direct-care staff only).
(xiii) Documentation and reporting mechanisms (direct-care staff only).
(4) Written documentation that ongoing training includes review and update of all policies and procedures including those listed under topics for orientation.
(5) Orientation shall be completed before the direct-care staff has independent, unsupervised, interaction with residents.
Cross References This section cited in 55 Pa. Code § 5320.25 (relating to provider records).
§ 5320.46. Interdisciplinary treatment team.
(a) The interdisciplinary treatment team shall be comprised of at least three mental health professionals who are appointed by the program director and who are involved in the resident’s treatment. At least one member of the treatment team shall be a physician. The other members shall represent different clinical disciplines.
(b) The director of the interdisciplinary treatment team shall be appointed by the program director and be a physician or a licensed psychologist with a clinical background. The program director may serve as one of the three members of the treatment team. The director of the interdisciplinary treatment team shall be responsible for:
(1) Assuring that the resident, and the resident’s family if the resident consents, is involved in the treatment planning process. The director shall document efforts to maintain this involvement and the results of these efforts.
(2) Implementing and reviewing the treatment plan and coordinating treatment service delivery with service providers.
(3) Utilizing external specialty consultants when needed.
(4) Assuring that direct-care staff and consulting professionals participate in the development, implementation and review of the treatment plan and that they have credentials in the use of the modalities proposed in the plan.
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