Section 144-117-5 - Staff Qualifications5.1Personnel Policies. The program shall have policies that address all personnel practices including job descriptions, orientation, training and evaluation.5.2Staff Qualifications. The program must employ, on a full time, part time or consulting basis, those persons necessary to carry out the provisions of these regulations. Preference shall be given to staff that have a minimum of one (1) year of training or experience in social or health care services. An Adult Day Services Program that is co-located in a licensed Nursing or Assisted Living Facility shall schedule staff with distinct hours that are assigned to the Adult Day Services Program.5.2.1 Any person working in the program who is not a consumer must demonstrate the following: 5.2.1.1 Conduct which demonstrates an understanding of, and compliance with, consumers' rights;5.2.1.2 The ability and willingness to comply with all applicable laws and regulations;5.2.1.3 The ability to provide safe and compassionate services; and5.2.1.4 A history of honest and lawful conduct.5.3Staff Requirements. Adult Day Services Programs shall maintain a minimum staff to consumer ratio of one to six (1:6) at all times when consumers are present. Adult Day Services Programs with three to six (3-6) consumers must maintain a second staff person to be on call and available for emergencies at all times that consumers are present. The Department reserves the right to require additional personnel or to modify the requirements of this section based on the needs of the consumers served. Required Minimum Staff to Consumer Ratio:
| Number of Staff | Number of Consumers |
| 1 | 3-6 |
| 2 | 7-12 |
| 3 | 13-18 |
| 4 | 19-24 |
| 5 | 25-30 |
| 6 | 31-36 |
| 7 | 37-42 |
| 8 | 43-48 |
| 9 | 49-54 |
| 10 | 55-60 |
For each 6 consumers above 60, there will be an additional staff person employed.
5.4Volunteers. Volunteers may be included in the staff ratio only when they conform to the same standards and requirements as paid staff, meet the job qualification standards of the organization and have designated responsibilities5.5Required Inservice Training Programs.5.5.1 There shall be an orientation program for all new employees and volunteers that includes a review of applicable program policies, consumer rights, emergency procedures and fire safety, job description and related responsibilities, confidentiality, communication skills, needs of the population served, elder abuse reporting, Standard Precautions and licensing regulations. The orientation program for those volunteers who are not involved with providing direct care may be limited to those items that are consistent with the responsibilities of the volunteer. Under all circumstances, the facility will be responsible for the actions of the volunteer.5.5.2 The program must also provide at least six (6) hoursa year for part time and volunteer staff (twenty (20) hours or less per week) and a minimum of twelve (12) hours per year education and training to all full time employees and volunteers who meet the job qualification standards and have designated responsibilities twenty-one (21) hours a week or more.5.5.3 The annual training programs shall be planned and include topics relating to consumer rights, emergency preparedness, workplace safety, body mechanics, choking prevention and intervention techniques, basic nutrition and food safety, first aid, behavioral interventions and specific training for services related to consumers with cognitive impairments and those conditions which may be applicable to the consumer population served.5.6Personnel Records5.6.1Employee Records. A record shall be completed for each staff member, kept on file at the program site or at the agency central office, and shall be available to Department personnel for inspection. Each record shall contain documentation of references and background checks, dates of employment, date of birth, home address and telephone number, education or background, social security number, past experience or type of employment, where previously employed, job description of position employed for in this program and the current occupational license number, when applicable, record of participation in in-service, orientation or other training programs, results of annual personnel evaluations, disciplinary actions, illness and injury records, and date of and reason for terminating employment. Records shall be kept at least two (2) years after termination of employment. Records may be computerized.5.7Monthly Time Schedule. Each program shall maintain a dated staff monthly time schedule in a convenient place for staff use. This shall contain each employee's name, job title and hours of work and days of each week. This monthly time schedule shall be kept on file at the program site or at the agency central office for at least two (2) years and shall be available to Department personnel for inspection.5.8Confidentiality Agreement. All paid employees and volunteers shall sign a confidentiality agreement and hold all information about consumers and families in confidence.5.9Employees with Contagious or Infectious Diseases. No licensed program shall employ or otherwise permit any person to serve therein in any capacity if such person has a communicable or infectious disease or condition which would make him/her dangerous to the health and welfare of consumers therein. 5.10Employment Restrictions. The program may not employ individuals who have been convicted by a court of law of abusing, neglecting, mistreating, exploiting individuals or misappropriating funds in a health care or related setting.5.11Age Requirement. No person under the age of eighteen (18) shall fulfill the staffing requirements for this program, unless one is enrolled in a health related course of study and one is at least sixteen (16) years of age and otherwise meets all the employment requirements outlined herein. There must be documented proof of enrollment in a health related course of study in the employee file.5.12 Unlicensed assistive personnel. Unlicensed assistive personnel administering medications and/or treatments must successfully complete training approved by the Department. The facility shall maintain records documenting the completion of training by unlicensed assistive personnel. Whenever the standards or guidelines of the medication administration course are substantiallyrevised, unlicensed assistive personnel must be re-certified within one (1) year of the revision, by a method approved by the Department. An additional exception will be made on a case-by-case basis for persons who only administer dietary supplements and/or minor medicated treatments, shampoos, lotions and creams that could be obtained over the counter without a physician's order. A person qualified to administer medications must be on site at the facility whenever a consumer has medications prescribed "as needed" (PRN) if this medication is not self-administered.
All unlicensed assistive personnel administering medications and/or treatments must complete a Department-approved eight (8) hour refresher course biennially for re-certification within two (2) years of the original certification.
5.12.1 No injectable medications may be administered by an unlicensed person, with the exception of bee sting kits and insulin.5.12.2 Before using a bee sting kit, unlicensed persons must be trained by a registered professional nurse in regard to the safe and proper use of the kit. Documentation of the training shall be included in the employee record.5.12.3 If a consumer has diabetes, unlicensed persons must be trained by a registered professional nurse in regard to the management of persons with diabetes. The registered professional nurse will document the in-service training in the employee record; such training shall include:5.12.3.1 Dietary requirements5.12.3.2 Anti-diabetic oral medications - inclusive of adverse reactions and interventions, and hypo and hyperglycemic reactions;5.12.3.3 Insulin mixing including insulin actions;5.12.3.4 Insulin storage;5.12.3.5 Injection techniques and site rotation;5.12.3.6 Treatment and prevention of insulin reaction including signs and symptoms;5.12.3.8 Lab testing, urine testing and blood glucose monitoring; and5.12.3.9 Standard precautions.10-144 C.M.R. ch. 117, § 5