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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 550LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER CGENERAL PROVISIONS
DIVISION 3NURSING AND STAFFING REQUIREMENTS
RULE §550.415Staffing Policies for Staff Orientation, Development, and Training

(a) A center must adopt and enforce a written staffing policies and procedures that govern all staff providing services on behalf of the center, including employees, volunteers, and contractors.

(b) A center's written staffing policies must include:

  (1) requirements for orientation to the policies, procedures, and objectives of the center;

  (2) requirements and procedures for processing criminal history checks;

  (3) requirements that staff are current on immunizations;

  (4) requirements that an applicant for employment provide written documentation to rule out communicable diseases, including but not limited to tuberculosis;

  (5) requirements for direct care staff to demonstrate the necessary skills and competency to meet the direct care needs of a minor to which he or she is assigned and as described in their job description;

  (6) requirements for staff to participate in appropriate employee development programs quarterly;

  (7) requirements for participation by all staff in job-specific training;

  (8) staff training policies that ensure:

    (A) staff are properly oriented to tasks performed;

    (B) demonstration of competency for tasks when competency cannot be determined through education, license, certification, or experience;

    (C) quarterly continuing systemic training for all staff who provide services, including training on infection prevention and control;

    (D) staff are informed of changes in techniques, philosophies, organization, minor's rights, ethics and confidentiality, medical record requirements, information relating to minor's development, goals, and products relating to a minor's care;

    (E) staff are properly oriented and trained in the proper use of person-centered direction and guidance as outlined in center policy and in accordance with §15.206 of this subchapter (relating to Person-Centered Direction and Guidance);

    (F) staff are properly oriented and trained in the proper use and application of protective devices; and

    (G) staff are properly oriented and trained in the proper use and application of restraints in accordance with the following requirements:

      (i) all center staff whose job responsibilities include the use of restraint during a behavioral emergency must be trained before assuming direct care responsibilities for a minor;

      (ii) all center staff must receive training and demonstrate competency in the following areas:

        (I) using any restraint techniques or procedures that are expected or anticipated to be employed;

        (II) identifying the underlying causes or functions of threatening behaviors;

        (III) understanding how the behavior of staff members affects the behavior of minors;

        (IV) using de-escalation, mediation, self-protection, and other techniques, such as quiet time, to prevent or reduce the use of restraint;

        (V) applying principles of trauma informed care; and

        (VI) recognizing and responding to signs of distress in a minor who is being restrained; and

      (iii) all center staff must complete training and demonstrate competence in the use of restraint in a behavioral emergency at least every 12 months following initial training; and

    (H) job-specific training is documented with the following information:

      (i) the name and qualifications of the trainer;

      (ii) the training topics and length; and

      (iii) a list of staff who completed the training and demonstrated competence;

  (9) a requirement to have a written job description that is a statement of the functions and responsibilities, and job qualifications, including the specific education and training requirements for each position at the center;

  (10) procedures for searching the nurse aide registry and the employee misconduct registry for staff in accordance with §15.418 of this division (relating to Criminal History Checks, Nurse Aid Registry (NAR) and Employee Misconduct Registry (EMR) Requirements);

  (11) a requirement to have annual evaluation of employee and volunteer performance;

  (12) a description of employee and volunteer disciplinary action and procedures;

  (13) a policy regarding the use of volunteers that is in compliance with §15.414 of this division (relating to Volunteers); and

  (14) a requirement that all staff providing services on behalf of a center sign a statement that the staff have read, understand, and will comply with all applicable center policies.

(c) A center must adopt and enforce written policies and procedures for parent orientation and training programs in accordance with §15.509 of this subchapter (relating to Parent Training). The policy must:

  (1) require orientation be provided to each parent of each minor admitted to the center; and

  (2) ensure that orientation includes:

    (A) the philosophy of the center;

    (B) the basic services as defined in this chapter;

    (C) on-going parent training needs as determined by the individual needs of the minor;

    (D) a minor's parent agreement and disclosure form;

    (E) the center attendance policy for minors; and

    (F) information about a minor's rights while receiving services at the center.


Source Note: The provisions of this §550.415 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875

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