Header:
CODE OF RHODE ISLAND RULES
AGENCY 18. DEPARTMENT OF BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS
SUB-AGENCY 020. RETARDATION DIVISION
CHAPTER 005. LICENSING AGENCIES PROVIDING SERVICES TO ADULTS WITH DEVELOPMENTAL DISABILITIES
Date:
08/31/2009
Document:
18 020 005. LICENSING AGENCIES PROVIDING SERVICES TO ADULTS WITH DEVELOPMENTAL DISABILITIES
…
Section 18.0 Safety: Emergency Management Plan.
18.1 Providers shall post the following emergency telephone numbers in close proximity to all phones used by staff.
18.1.1 The telephone numbers of the local fire, police department, and ambulance service (if not served by a 911 emergency services); and
18.1.2 The telephone number of the program's executive director, primary care physician and additional persons to be contacted in the event of an emergency.
18.2 If a participant regularly accesses the community independently, the provider must provide the participant with information about appropriate steps to take in an emergency, such as emergency contact telephone numbers, contacting police or fire personnel, or other strategies to obtain assistance.
18.3 The DDO shall develop, maintain, update, and implement a written Emergency Management Plan for the protection of all participants in the event of an emergency or natural disaster.
18.3.1 The Emergency Management Plan shall:
18.3.1.1 Be practiced at least annually. The Emergency Management Plan practice may consist of a walk-through of the duties or a discussion exercise dealing with a hypothetical event, commonly known as a tabletop exercise.
18.3.1.2 Consider the needs of the participants being served and address all natural and human-caused events identified as a significant risk for the facility where a licensed service is provided, such as a pandemic or an earthquake.
18.3.1.3 Include provisions and sufficient supplies, such as sanitation supplies, to shelter in place, when unable to relocate, for a minimum of three (3) days under the following conditions:
a) Extended utility outage;
b) No running water;
c) Inability to replace food or supplies; and
d) Staff unable to report as scheduled.
18.3.1.4 Include provisions for evacuation and relocation that identifies:
a) The duties of staff during evacuation, transporting, and housing of participants including instructions to staff to notify the Department of the plan to evacuate or the actual evacuation as soon as the emergency or disaster reasonably allows;
b) The method and source of transportation;
c) Planned relocation sites that are reasonably anticipated to meet the needs of the participants;
d) A method that provides persons unknown to a participant the ability to identify each participant by the participant's name and to identify the name of the participant's supporting provider; and
e) A method for tracking and reporting to the Department, the physical location of each participant until a different entity resumes responsibility for the participant.
18.3.1.5 Address the needs of the participants, including provisions to provide:
a) Immediate and continued access to medical treatment with the evacuation of the participant's summary sheet identified above and the participant's emergency information also identified above and other information necessary to obtain care, treatment, food, and fluids for participants.
b) Continued access to life-sustaining pharmaceuticals, medical supplies and equipment during and after an evacuation and relocation;
c) Behavior support needs anticipated during an emergency; and
d) Adequate staffing to meet the life-sustaining and safety needs of the participants.
18.4 Providers shall instruct and provide training to all staff, at least annually, about their duties and responsibilities for implementing the Emergency Management Plan.
18.5 The provider shall review the Emergency Management Plan annually and re-evaluate and revise it when there is a significant change in the threats identified or in the needs of the participants.
18.6 Applicable parts of the Emergency Management Plan shall coordinate with each applicable day program or supported employment provider to address the possibility of an emergency or disaster during work hours.
Section 19.0 Safety: Fire Safety and Fire Drill Requirements.
19.1 The program shall assess within twenty-four (24) hours of entry to the community residence the participant's ability to evacuate the community residence in response to an alarm or simulated emergency. At a minimum, each participant's ability to evacuate shall be reassessed and documented on an annual basis and when there is a substantial change in the participant's functional capacity (physical and/or mental).
19.2 The program shall document the level of assistance needed by each participant to safely evacuate the community residence within twenty-four (24) hours of entry to the community residence and on an annual basis and when there is a substantial change in the participant's functional capacity (physical and/or mental). Such documentation shall be maintained both in the community residence and the participant's records. Staffing shall reflect the level of assistance required for evacuation and provide for the health and safety of all of the participants as included in the core residential and day program services requirements contained herein.
19.3 A written Emergency Evacuation Plan shall be in effect and available at each location where licensed services are delivered, including but not limited to, community residences. This plan shall include policies and procedures for the evacuation of all occupants from the building in the event of fire, and for their relocation to a safe area outside the building. This plan shall be reviewed annually and updated as the needs of the building occupants change. Staffing shall reflect the level of assistance required for evacuation and provide for the health and safety of all of the participants as included in the core residential and day program services requirements contained herein.
19.4 All direct service staff shall have specific fire training, consisting of not less than four (4) documented hours per year, and shall include training in the program's emergency evacuation procedures. Staff working in multiple service locations shall review the Emergency Evacuation Plan for each program in which they work.
19.5 All participants residing in a community residence and/or participating in a day program shall be trained in and practice the proper actions to be taken in the event of fire. This training shall include actions to take in the event the primary escape route is blocked.
19.6 Fire exit drills shall be conducted not less than six (6) times per year on a bimonthly basis for community residences with not less than two (2) drills conducted during the night when participants are sleeping. Drills shall occur at different times of the day, evening and night shifts with exit routes being varied based on the location of a simulated fire. The complete drill shall involve the actual evacuation of the building to a meeting place outside the home where the participants know to congregate as specified in the written Emergency Evacuation Plan.
19.7 Fire exit drills shall be conducted not less than quarterly for non-residential programs. The complete drill shall involve the actual evacuation of the building to a meeting place outside the building where the participants know to congregate as specified in the written Emergency Evacuation Plan.
19.8 Written documentation shall be made at the time of the fire drill and shall be kept by the DDO for at least five (5) years following the drill. Fire drill documentation shall include:
a) The date and time of the drill and the type of drill (obstructed or unobstructed);
b) The location of the simulated fire and exit route;
c) The names of all participants and staff present on the premises at the time of the drill;
d) The type of evacuation assistance provided by staff to participants as specified in each Participant's safety plan;
e) The amount of time required by each participant to evacuate;
f) The amount of time taken to evacuate the building;
g) The signature of the staff conducting the drill; and
h) The record of problems and steps taken to correct them.
…
Support Staff Training
49.44 Agencies shall have written policies and procedures for ongoing health care training as outlined in the Agency Health Care Manual for all support staff. Specific health care related training shall be conducted or supervised by a licensed nurse or a qualified instructor as specified in the agency's policies. Nursing staff shall delegate tasks only to support staff that have received training commensurate with the agency's protocols and have demonstrated competencies in each area of training. Support staff shall be deemed competent upon documentation of satisfactory completion of training. Satisfactory completion and documentation of training shall include knowledge and demonstration of the delegated task. A competency training checklist shall be completed by a professional nurse prior to the delegation of any health care task, including medication administration. The intent of the competency check is to ensure for the delegating nurse that the staff person has satisfactorily completed all required elements of the training program and has satisfactorily demonstrated skills and competencies in the designated areas.
49.45 Support staff shall receive annual training and a competency evaluation in the following health care/health and life education areas:
49.46 Core Curriculum: The support staff will demonstrate a working knowledge of comprehensive health care principles and procedures and shall demonstrate the ability to assist individuals to more fully understand their health care needs. The Core Curriculum is intended to provide a standardized guideline of minimum expectations for staff training and shall be followed by agency specific policies, procedures and protocols.
49.47 Standard Precautions: The support staff shall demonstrate the ability to apply measures to prevent communicable diseases, to recognize and report the presence or onset of communicable disease, and to carry out the recommended procedures.
a. Communicable Diseases
b. Infection Control
c. Exposure Control Plan (OSHA)
49.48 Wellness & Prevention of Illness: The support staff shall demonstrate an understanding of a comprehensive, holistic approach to health care and positive, healthy behaviors which will enhance the individuals' overall physical and mental health.
a. Nutrition/Food Handling
b. Personal Hygiene
c. Sexual & Reproductive Health
d. Healthy Lifestyle
…
**Note: Only the section analyzed by the PHASYS team is included here as the entire regulation exceeded ~100 pages.
|