Washington State Home Care Referral Registry



-153619365800438913094330 An Introduction to Becoming an Individual Provider In Washington State 00 An Introduction to Becoming an Individual Provider In Washington State leftbottomHow to Use this GuideThis guide will provide you with some background about the work and work environment of an Individual Provider. It is designed to give you enough information about what it’s like to be a caregiver so that you will be able to determine if this type of work and work environment are a good match for your personality and interest. Introduction An Individual Provider (IP) works with and supports one or more persons with disabilities or chronic illnesses in the home of the consumer/employer. It is important that the IP understands their roles and responsibilities and respect the consumer’s (employer) right to make their own decisions about their life. IP employment supports the overall mission of Washington State’s long term in-home care system:Helping individuals and their families develop and maintain self-sufficiency;Remain valued and contributing members of their community; andMaximizes quality of life by managing services that are high quality, cost effective, and responsive to individual needs and preferences.Eligibility for IP18 years or olderPass a WA state criminal conviction background checkValid State picture IDSuccessfully complete all of the Individual Provider training requirementsSign a contract with DSHS and agree to conditions listed in itMeet with Case Manager (CM) before beginning work with a clientWho are the Consumer/Employer an IP Supports?Your consumer/employer may be:A person with a functional disabilityA person with a developmental disabilityA person who is olderA childRemember that above all, your consumer/employer is a PERSON.The people you, as an IP, support come from interesting backgrounds just like you. They have many unique preferences and qualities you can get to know as you learn about them. What the consumers/employers you support have in common is that they have functional or developmental disabilities.What is a Functional Disability?A functional disability may include one or all of the following:Limitations in or inability to perform a variety of physical activitiesSerious sensory impairmentLong term care needsUse of assistive devicesWhat is a Developmental Disability? According to Washington State Law:Physical, cognitive or emotional impairmentBeginning before the person reaches 18 years of ageIs present throughout the person’s lifeLimits the person’s ability to learn, communicate or perform one or more activities of daily livingIP Work EnvironmentAn IP works with and supports one or more persons with disabilities or chronic illnesses in the places they live. IPs perform their jobs in the home of the consumer/employer. This work setting is very different from a more traditional employment setting with supportive coworkers. The IP work setting is a very independent one and the IP should take this in consideration when considering this type of employment.Get to know your consumer/employer Discover how to meet the care needs of your consumer/employer by utilizing good communication munication Tools:Active Listening We all need to take the time to figure out the words we hear. We may even need to ask the person who said them if we heard correctly before we respond. That means that we have to pay very close attention to each word the person is saying. This is called active listening because it involves focus and energy. Steps for active listening:Hear the words.Figure out the meaning of the consumer’s words by asking questions and clarifying your understanding of their words.Once you understand the meaning of their words, ask consumers how you can best personalize their care. Routines and RitualsWhat are their preferences - how do they want their personal care needs met? Ask about their routines and rituals - what is their morning ritual? How exactly do they drink their coffee? When bathing, do they use a washcloth or do they prefer a scrubby? Asking about the consumer’s routines and rituals is one example of getting to very individualized information of how to help your employer get the supports needed to have personalized care.When asking consumers about their routines consider:How do they take their medicine—do they drink a whole glass of water and take one pill at a time? Do they prefer to take medicine with milk? Do they eat before or after taking medication?Bathing - what products does the consumer use? What is their preferred water temperature? Do they use one towel or two following a bath or shower? What time of day do they prefer to bathe? Do they prefer a bath or a shower?Meal preparation - What are the consumer’s favorite foods? Where do they best like to eat their meals? Do they like to play music at mealtime?Do they have a bedtime ritual? What things do they do to prepare for bed? Do they like to watch TV or read prior to bed? Do they like to wash up before changing for bed? Good Day/Bad DayAsk consumer’s about their routines on a good day and what these routines look like on a bad day. How can you best support the consumer on a good day and what are the differences on how to best provide support for the consumer on what they defined as a bad day. For some consumers a good day or a bad day may be equated to how they are physically feeling. For other consumers a good day or bad day may be equated to how they are emotionally feeling. Knowing these differences will help guide you in finding out how to help them.Working Well/Not Working WellCheck in with your consumer/employer and see what worked well and what did not work well from their perspective and how they can best be supported in the future to best have their personal care needs met. Share from your (IP) perspective what worked well while trying to meet the care needs while honoring the consumer/employer preferences.Ethics Good communication skills are guided by our ethics. The National Alliance of Direct Support Professionals (NADSP) code provides a relevant ethical guide that Individual Providers may find helpful. Below is a condensed version:Person-Centered SupportsMy first allegiance is to the person I support; all other activities and functions I perform flow from this allegianceRecognize that each person must direct his or her own life and support and that the unique social network, circumstances, personality, preferences, needs and gifts of each person supported must be the primary guide for the selection, structure, and use of supports for that individual.Promoting Physical and Emotional Well-BeingI am responsible for supporting the emotional, physical, and personal well-being of the individuals receiving support. I will encourage growth and recognize the autonomy of the individuals receiving support while being attentive and energetic in reducing their risk of harmKnow and respect the values of the people I support and facilitate their expression of choices related to those values.Integrity and ResponsibilityI will support the mission and vitality of my profession to assist people in leading self-directed lives and to foster a spirit of partnership with the people I support, other professionals, and the community.Be conscious of my own values and how they influence my professional decisions.ConfidentialityI will safeguard and respect the confidentiality and privacy of the people I support.Seek information directly from those I support regarding their wishes in how, when and with whom privileged information should be shared.Justice, Fairness and EquityI will promote and practice justice, fairness, and equity for the people I support and the community as a whole. I will affirm the human rights, civil rights and responsibilities of the people I support.Help the people I support use the opportunities and the resources of the community available to everyone.RespectI will respect the human dignity and uniqueness of the people I support. I will recognize each person I support as valuable and help others understand their value.Seek to understand the individuals I support today in the context of their personal history, their social and family networks, and their hopes and dreams for the future.RelationshipsI will assist the people I support to develop and maintain relationships.Advocate for the people I support when they do not have access to opportunities and education to facilitate building and maintaining relationships.Self-DeterminationI will assist the people I support to direct the course of their own lives.Work in partnership with others to support individuals leading self-directed lives.AdvocacyI will advocate with the people I support for justice, inclusion, and full community participation.Support individuals to speak for themselves in all matters where my assistance is needed.An IP should not:Accept gifts from the consumerGive out any information about the client without their written permissionProvide services in your own home unless otherwise authorizedBegin working for the client before you have spoken with their case manager and have been authorized to provide servicesAbuse or restrain the clientTake personal belongings from the clientWhen to communicate with the Case Manager Every consumer/employer receiving Medicaid waiver services through DSHS is assigned a case manager. The case manager is the IPs contact when there are questions or concerns about the consumer/employer or the personal care tasks assigned in the care plan. Contact the case manager assigned to your consumer/employer:Before beginning work with a consumer/employer Specialized training needs are needed to best support your consumer/employer Change in consumer/employer conditionIllnessHospitalizationEmergencyIf you, the IP, are unable to attend workConsumer change of addressConsumer deceasedConcerns about consumer/employer safety or personal safetyObserving your client’s changes in their physical and mental condition is another part of the caregiving role. Observation involves noticing change in a client’s health, attitude, appearance, or behavior. Observations begin with getting to know your client so you can tell when something changes. It is helpful to start by looking at their care plan to see if your client is still performing the tasks the same way they were when assessed by the case manager. Any change in their performance needs to be reported to the case manager. Talking with the case manager about consumer changes will help them to determine if a new assessment is needed.Safety PrecautionsAs an Individual Provider you will be providing many personal care tasks that may potentially expose you to blood or other body fluids. There are some diseases, such as HIV/AIDS and Hepatitis B and C, which are transmitted through blood and body fluids. To protect you from contact with these diseases the Center for Disease Control (CDC) have made recommendations called Standard Precautions. These recommendations are:Washing your hands with liquid soap, warm water and preferably drying your hands with paper towels frequently throughout the day.Wearing vinyl or latex gloves when having contact with blood and/or body fluids. Your client should have medical coverage which can be used to get gloves from the pharmacy. Talk with their case manager about that process. Wear gloves to clean up articles soiled with body fluids, such as urine, feces, vomit, vaginal fluids, or semen.Non-disposable rubber gloves may be used for general household cleaning.Waste which is soiled with blood or body fluids should be double bagged before placing it in the outdoor waste bin.Client’s receiving insulin injections or performing blood glucose monitoring should place their needles in a hard plastic container. They can be provided by the pharmacy or they may use a hard plastic juice container. Contact the client’s waste collection agency for disposal options for the container.To remove blood or body fluids from surfaces, wash with soap and hot water and disinfect with a household cleaning product or with a solution of 1 tablespoon of bleach to 1 quart of water.If you have cuts, breaks or sores on exposed skin, cover them with a bandage and use gloves.Mandated ReportingAs an IP you are considered a mandatory reporter. That means you must report abuse of a vulnerable adult or child. You are mandated to report if you suspect abuse is happening, if you witness abuse or if your client states they are being abused. You do not need to know for sure if abuse is happening, verifying the abuse is the responsibility of the DSHS reporting agency. If you witness the abuse, you may need to call 911 first to keep the client safe and then report it to the DSHS reporting agency. Not reporting abuse of a child or vulnerable adult is legally considered a gross misdemeanor.95250290194How to Report Abuse or Neglect of a Vulnerable Adult or ChildTo report abuse or neglect of a vulnerable adult or a child in Washington State, call the DSHS toll-free EndHarm hotline anytime day or night. ENDHARM is TTY accessible. When you call, you will speak with a real person, who will connect you to the direct, local number to make your report: 1-866-363-4276. You may also file a report online by following this link: 00How to Report Abuse or Neglect of a Vulnerable Adult or ChildTo report abuse or neglect of a vulnerable adult or a child in Washington State, call the DSHS toll-free EndHarm hotline anytime day or night. ENDHARM is TTY accessible. When you call, you will speak with a real person, who will connect you to the direct, local number to make your report: 1-866-363-4276. You may also file a report online by following this link: HCRR MissionThe mission of the Home Care Referral Registry (HCRR) is to improve the quality of, and access to, providers of in-home care services and to empower consumers that are eligible for Medicaid in-home care services by:Providing access to screened Individual Providers; Producing information on how consumer can best manage their in-home care services; andEngaging in activities and partnerships to resolve workforce issues and promote training opportunities for Individual Providers and consumers of in-home care.Personal Care Tasks DefinitionsTypical DutiesThese definitions describe what services/supports a worker is allowed to provide under the Medicaid Personal Care programs. Actual tasks and duties are determined by the CARE assessment completed by the case manager. Provide protective supervision to a consumer/employer who cannot be left alone because of impaired judgmentPlease note - Supervision with personal care tasks means being available to: Help the employer with personal care tasks that cannot be scheduled (toileting, ambulation, transfer, positioning, some medication assistance); and/orProvide protective supervision to an employer who cannot be left alone because of impaired judgment“Ambulation” means assisting the consumer/employer to move around. Ambulation includes supervising when walking alone or with the help of a mechanical device such as a walker if guided, assisting with challenging parts of walking such as climbing stairs, supervising if able to propel a wheelchair if guided, pushing the wheelchair and providing constant physical assistance totally if consumer/employer is unable to walk alone or with a mechanical device.“Bathing” means assisting the consumer/employer to wash self. Bathing includes supervising the consumer who is able to bath self when guided, assist with challenging tasks such as getting in or out of the tub or washing back or hair and completely bathing consumer/employer if totally unable to wash self.“Body Care” means assisting the consumer/employer with exercises, skin care including the application of non-prescribed ointments or lotions, changing dry bandages or dressings when professional judgment is not required and pedicure to trim toenails and apply lotion to feet. Body care excludes: (I) Foot care for consumer/employers who are diabetic or have poor circulation; or (ii) changing bandages or dressings when sterile procedures are required.“Dressing” means assistance with dressing and undressing. Dressing includes supervision and guiding the consumer/employer when dressing and undressing, assisting with challenging tasks such as tying shoes and buttoning, and completely dressing or undressing when unable to participate in dressing or undressing.“Eating” means assistance with eating. Eating includes supervising the consumer/employer when able to feed self if guided, assisting with challenging tasks such as cutting food or buttering bread, and feeding the consumer/employer when unable to feed self.“Housework” means performing or helping the consumer/employer perform those periodic tasks required to maintain a safe and healthy environment. Activities performed include such things as cleaning the kitchen and bathroom, sweeping, vacuuming, mopping, cleaning the oven, defrosting the freezer, and shoveling snow. Washing inside windows and walls is allowed but is limited to twice a year. Assistance with housework is limited to those areas of the home, actually used by the consumer/employer. This task is not a maid service and does not include yard care.“Laundry” means washing; drying, ironing, and mending clothes and linens used by the consumer/employer or helping them to perform these tasks.“Meal preparation” means assistance with preparing meals. Meal preparation includes planning meals including special diets, assisting consumer/employer to participate in meal preparation, preparing meals when unable to participate and cleaning up after meals. This task may not be authorized to just planning meals or clean up after meals, they must need assistance with actual meal preparation.“Personal Hygiene” means assistance with care of hair, teeth, dentures, shaving, filing of nails, and other basic personal hygiene and grooming needs. Personal hygiene includes supervising the consumer/employer when performing the tasks, assisting to care for their own appearance, and performing grooming tasks when they are unable to care for own appearance.“Positioning” means assisting the consumer/employer to assume a desired position. Positioning includes assistance in turning and positioning to prevent secondary disabilities, such as contractures and balance deficits or exercises to maintain the highest level of functioning attained and/or to prevent the decline in physical functional level. (Range of motion ordered as part of a physical therapy treatment is not included.)“Self-medication” means assisting the consumer/employer to self-administer medications prescribed by attending physician. Self-medication includes reminding when it is time to take prescribed medication, handing the medication container to the consumer/employer and opening a container. There are specific rules that define the scope of what is allowed to assist persons to self-administer their medications. “Toileting” means assistance with bladder or bowel functions. Toileting includes supervising the consumer/employer when able to care for own toileting needs if guided, helping to and from the bathroom, assisting with bedpan routines, incontinence briefs/pads and lifting consumer/employer on and off the toilet. Toileting may include performing routine peri-colostomy catheter tasks, when the consumer/employer is able to supervise the activities.“Transfer” means assistance with getting in and out of bed or wheelchair or on and off the toilet or in and out of the bathtub. Transfer includes supervising the consumer/employer when able to transfer if guided, providing steadying, and helping when the consumer/employer assists in own transfer. Lifting when they are unable to assist in their transfer requires specialized training.“Travel to medical services” means accompanying or transporting the consumer/employer to a physician’s office or clinic in the local area to obtain medical diagnosis or treatment.“Essential shopping” means assistance with shopping to meet the consumer/employer health care or nutritional needs. Limited to brief, occasional trips in the local area to shop for food, medical necessities, and household items required specifically for the health and maintenance, and well-being of the consumer/employer. Essential shopping includes assisting when the consumer/employer can participate in shopping and doing the shopping when they are unable to participate.“Wood Supply” means splitting, stacking, or carrying wood for the employer when the employer uses wood as the sole source of fuel for heating and/or cooking. This task is limited to splitting, stacking or carrying wood the consumer/employer has at their own home. The department shall not allow payment for a provider to use a chain saw or to fell trees.RESOURCESHome Care Referral Registry of Washington State DSHS - Aging and Long Term Support Administration - Developmental Disabilities Administration Developmental Disability Council, Washington State Arc of Washington State Alliance for Caregiving National Alliance of Direct Support Professionals SEIU 775 Benefits Group - Training Partnership ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download