1. (a)

   1. (1) The psychiatric residential treatment facility must document in the staff personnel records that the required training and demonstration of competency were successfully completed.
   2. (2) Documentation must include the date the training was completed, number of hours, the name of the source, the name of persons certifying the completion of training, and the topic or title of the training.
2. (b) All training programs and materials used by the psychiatric residential treatment facility must be available for review by the Office of Long-Term Care, the Office of Substance Abuse and Mental Health, and the Division of Medical Services, and by the federal Centers for Medicare & Medicaid Services.
3. (c) Individuals who are qualified by education, training, and experience must provide staff training.
4. (d) All trainings must be a mixture of in-person and online interactive modules that require competency testing.

5. (e) Training shall be conducted immediately upon hire and annually thereafter and must be completed in order for staff to be included in staffing ratio requirements and shall include, without limitation:

   1. (1) Confidentiality including the restricted use of social media and the Health Insurance Portability and Accountability Act of 1996;
   2. (2) Resident grievance process;
   3. (3) Fire and disaster plans;
   4. (4) Suicide awareness and protocol;
   5. (5) Crisis de-escalation and the management of aggressive behavior including acceptable and prohibited responses;
   6. (6) Seclusions and restraints;
   7. (7) Trauma-informed care;
   8. (8) Knowledge of appropriate relationships with clients;
   9. (9) Recordkeeping. Observing beneficiary, reporting or recording observations;
   10. (10) Knowledge of behavioral health illnesses;
   11. (11) Group interaction;
   12. (12) Childhood development;
   13. (13) Agency policies and procedures;
   14. (14) Child Maltreatment Mandated Reporter rule, 9 CAR § 40-102; and
   15. (15) First Aid and CPR;
6. (f) If offering a sexualized rehabilitation program, all staff shall have at least ten (10) hours of sexualized rehabilitation specific training.

7. (g)

   1. (1) No staff shall be allowed to participate in any type of physical or chemical restraint until properly trained to do so.
   2. (2) Staff training must include training exercises in which staff members successfully demonstrate in practice the techniques they have learned for managing emergency safety situations that could lead to an emergency safety intervention.
   3. (3) The facility shall ensure that staff are trained and demonstrate competency and this shall be documented in the staff personnel records, including date the training was completed and name of the person or persons certifying completion of training.

8. (h) The psychiatric residential treatment facility must require and record staff to have ongoing research-based education, training, and demonstrated knowledge of:

   1. (1) Techniques to identify staff and resident behaviors, events, and environmental factors that may trigger emergency safety situations;
   2. (2) The use of nonphysical intervention skills, such as de-escalation, mediation conflict resolution, active listening, and verbal and observational methods to prevent emergency safety situations; and
   3. (3) The safe use of restraint and the safe use of seclusion, including the ability to recognize and respond to signs of physical distress in residents who are restrained or in seclusion.

Codification Notes: The Health Insurance Portability and Accountability Act of 1996 is Pub. L. No. 104-191, 110 Stat. 1936 (codified as amended in scattered sections of 18 U.S.C., 26 U.S.C., 29 U.S.C., and 42 U.S.C.).