1. (a) Within the first month of providing HCBS waiver services, a provider agency shall train each provider, staff, and contractor in:

   1. (1) An overview of the rights of persons who receive services, as described in He-M 202 and He-M 310; and
   2. (2) Developing an understanding of the stigmas, negative labels, and common life experiences of people with disabilities including how individuals utilize behavior as communication.
2. (b) All provider agency providers, staff, and contractors who have direct contact with individuals and families shall meet the applicable requirements in He-M 504.11.
3. (c) All provider agency providers, staff, and contractors who have direct contact with individuals or are hired after March 31,2025 shall participate in a person-centered thinking program and demonstrate competencies within the first 3 months of providing HCBS waiver services and every 5 years thereafter.
4. (d) Person-centered programs for (c) above shall consist of nationally recognized models and best practices as identified by the National Center on Advancing Person-Centered Practices and Systems (NCAPPS) or the National Alliance for Direct Support Professionals (NADSP).

5. (e) Prior to working directly with an individual, providers, staff, and contractors shall be trained in the following information regarding the individual:

   1. (1) Personal profile;
   2. (2) Goals;

   3. (3) Specific health-related requirements, including:

      1. a. All current medical conditions, medical history, and routine and emergency protocols;
      2. b. Any special nutrition, hydration, elimination, personal hygiene, oral health, or ambulation needs; and
      3. c. Any special, cognitive, mental health, or behavioral needs;
   4. (4) Information the family, and guardian if applicable, believe would be helpful to the service provision process;
   5. (5) Emergency contact information;
   6. (6) Safety plan;
   7. (7) Behavior or risk management plan;
   8. (8) HRST information pertinent to supporting the individual;
   9. (9) SIS information pertinent to supporting the individual;
   10. (10) Any other information needed to ensure the individual’s health and safety needs are understood; and
   11. (11) Any information in the service agreement not specified in (1)-(10) above.
6. (f) Staff with no prior experience providing services directly to individuals shall be assigned to work with an experienced staff member, for not less than 16 hours during their orientation.
7. (g) Prior to staff working directly with an individual and annually thereafter, supervisors shall ask each staff to demonstrate, through examples, their understanding of the information presented pursuant to (e) above.
8. (h) At least monthly, supervisors or their designees shall conduct unannounced visits to staff at community locations while they are providing services for individuals. The purpose of the visits shall be to assure that services are provided in accordance with each individual's service agreement.
9. (i) Providers, staff, and contractors shall be re-trained annually in an overview of the rights of individuals, as described in He-M 202 and He-M 310. Provider agencies shall re-train providers, staff, and contractors and the re-training shall include examples of rights violations.

10. (j) A provider agency shall train providers, staff, and contractors in the following areas within the first 6 months of providing HCBS waiver services:

    1. (1) An overview of developmental disabilities and acquired brain disorders, which shall include:

       1. a. An overview of the different types of developmental disabilities and acquired brain disorders and their causes;
       2. b. An overview of the local and state service delivery system; and
       3. c. An overview of professional services and technologies including therapies, assistive technologies, and environmental modifications necessary to achieve individuals' goals at home, in the community, in the workplace and in recreation or leisure activities;

    2. (2) An overview of conditions promoting or detracting from the quality of life that individuals enjoy, which shall provide providers, staff, and contractors the competencies necessary to:

       1. a. Support individuals to obtain and maintain valued social roles;
       2. b. Support individuals to build relationships with their families, neighbors, co-workers, and other community members;

       3. c. Create and enhance opportunities for individuals to:

          1. 1. Increase their presence in the life of their local communities; and
          2. 2. Increase the ways in which they contribute to their communities;
       4. d. Support individuals to have as much control as possible over their own lives;
       5. e. Build individuals’ skills, strengths, and interests that are functional and meaningful in natural community environments;
       6. f. Create supports that enable individuals to explore and participate in a wide variety of community activities and experiences in settings that are available to the general public; and
       7. g. Support individuals to gain as much independence as possible;
    3. (3) Methods to assist individuals with challenging behaviors utilizing positive behavioral supports as described in He-M 1001.07 (d);
    4. (4) Understanding, and assisting individuals to manage behavior that derives from neurological compromises or limitations;

    5. (5) Techniques to:

       1. a. Facilitate social relationships;
       2. b. Enhance skills that improve everyday living and promote independence; and
       3. c. Teach, coach, and mentor individuals to learn skills that maximize independence;

    6. (6) Basic health and safety practices related to:

       1. a. Personal wellness;
       2. b. Success in living, working, and recreating in the community; and
       3. c. An understanding of the importance of common signs and symptoms of illness;
    7. (7) Training relative to supporting individuals in employment pursuant to He-M 518, as appropriate;

    8. (8) Skills necessary to support individuals and their families to:

       1. a. Make their own decisions;
       2. b. Advocate for themselves; and
       3. c. Create their own social networks;
    9. (9) Any trainings specified in an individual’s service agreement; and
    10. (10) Training in orienting individuals to fire safety and emergency evacuation procedures.

Source. #2033, eff 6-7-82; ss by #2679, eff 4-18-84; ss by #5047, eff 1-18-91, EXPIRED: 1-18-97 New. #6645, eff 12-2-97, EXPIRED: 12-2-05 New. #8604, eff 4-11-06; ss by #10528, eff 3-1-14; ss by #14039, eff 8-1-24