Ill. Admin. Code tit. 89 § 240.1555

Current through Register Vol. 48, No. 36, September 6, 2024

Section 240.1555 - General Adult Day Service Staffing Requirements

a) A separate and identifiable staff must be designated for sole use by the adult day service program.

b) Each adult day service provider shall have at the adult day service site adequate personnel in number and skill to comply with subsection (c) and Section 240.1520(f) and to provide for:

1) program and fiscal administration;

2) nursing and personal care services;

3) nutritional services;

4) planned therapeutic/recreational activities;

5) obtaining prompt services of emergency personnel and hospitalization, if needed;

6) immediately notifying the participant's authorized representative or family member of any illness, accident or injury to the participant;

7) provision/arrangement of transportation services to and from the adult day service site;

8) record keeping;

9) development, implementation and semi-annual review of individualized person-centered plans of care;

10) program evaluation and marketing;

11) supervision and evaluation of staff;

12) monitoring and meeting staff training needs; and

13) maintenance of a clean and safe physical environment.

c) The minimum ratio of full-time staff (qualified adult day service staff, trained volunteers or substitutes) or full-time equivalent (FTE) staff present at the adult day service site to participants, when participants are in attendance, shall be:

Staff	Participants
2	1 to 12
3	13 to 20
4	21 to 28
5	29 to 35
6	36 to 45

1) Add one additional staff person for each seven additional participants.

2) Fifty percent or more of a staff member's time shall be spent in on-site direct service or supervision on behalf of one or more participants in order to be considered in the ratio.

3) Staff included in the staff-participant ratio shall include only those who work on site, are actively involved with the participants, and are immediately available in the activity area, except for during client drop-off and pick-up times in normal business hours, to meet the participants' needs.

d) Each adult day direct service contact employee shall have:

1) Pre-service Training

Pre-service training totaling a minimum of 26 hours training within the first week of employment (exclusive of orientation). Two of those hours shall be mandatory dementia training which include shall include subjects related to Alzheimer's Dementia and Related Disorders; Safety risks; and Communication and behavior. A worker may be exempted from pre-service training, but not dementia training, by the provider if the worker has had previous documented training equivalent to 24 hours, with another CCP agency, or in a related field, within the past two years prior to this employment or is an active CNA or CMA or holds a valid RN or LPN license, and/or a BA, BS, BSW or higher degree. At least 18 hours of the remaining training selected from the following topics:

A) Purpose and goals of adult day service;

B) Facility, environmental and safety considerations;

C) Assistance with activities of daily living;

D) Basic principles of personal care;

E) Dealing with adverse behaviors: wandering, aggression, mental illness and depression;

F) Promoting participant dignity, independence, self-determination, privacy, choice and rights;

G) Understanding aging and functionally-impaired persons;

H) Recognizing participant abuse, neglect and/or exploitation; abuse and neglect prevention and reporting requirements;

I) Confidentiality of participant information;

J) Communication/interaction skills;

K) Universal precautions, blood-borne pathogens and infection control;

L) Fire and life safety, including emergency procedures to be implemented under the agency's all hazards disaster operations plan;

M) Family dynamics;

N) Body mechanics and normal range of motion, transfer techniques and positioning;

O) Cultural diversity;

P) Recognizing changes in bodily functions that should be reported to the supervisor;

Q) Nutrition and safe food handling;

R) CPR and first aid;

S) Participant activities;

T) Respiratory services;

U) Use of seclusion and restraint.

2) In-service Training

A minimum of 14 hours of in-service training for continuing education per year shall be mandatory for all adult day service employees. Pre-service training received under subsection (d)(1) shall fulfill the continuing education requirement for new employees for the first year. Two of those hours shall be mandatory dementia training which include shall include subjects related to Alzheimer's Dementia and Related Disorders; Safety Risks; and Communication and Behavior. At least the remaining nine hours of training selected from among the following topics:

A) Responding to emergency situations, including, but not limited to, site-related emergencies (e.g., late pick-up of participants), participant-related emergencies (e.g., participants leaving the site unattended), choking prevention and intervention techniques;

B) Appropriate and safe techniques in performing and assisting with personal care;

C) Developing and improving participant centered activities;

D) Modification of the environment to support engagement/well-being;

E) Promoting participant dignity, independence, self-determination, privacy, choice and rights;

F) Special characteristics of the elderly population; physical, emotional and developmental needs of the participant;

G) Recognizing participant abuse, neglect and/or exploitation; abuse and neglect prevention and reporting requirements;

H) Confidentiality of participant information;

I) Communication skills;

J) Universal precautions, blood-borne pathogens and infection control;

K) Fire and life safety, including emergency procedures to be implemented under the agency's all hazards disaster operations plan;

L) Dealing with adverse behaviors, e.g., mental illness, depression, aggression and wandering;

M) Family dynamics;

N) Body mechanics and normal range of motion, transfer techniques and positioning;

O) Chronic illness, death and dying;

P) Medicaid fraud and abuse;

Q) Cultural diversity;

R) Recognizing changes in bodily functions that should be reported to the supervisor;

S) CPR and first aid;

T) Understanding advance directives;

U) Nutrition and safe food handling;

V) Respiratory services;

W) Use of seclusion and restraint.

3) Progress toward certification in a related field (e.g., CNA) may be used for up to three hours of in-service training per calendar year.

4) All provider employees not in receipt of Department training certificates must complete two hours of dementia training within 30 days of the start of their employment and every calendar year thereafter. This training must include the following subjects: Alzheimer's Dementia and Related Disorders; Safety Risks; and Communication and Behavior.

e) At least two program adult day service staff shall be certified in CPR and trained in first aid, and at least one trained staff shall be on-site when participants are present.

Ill. Admin. Code tit. 89, § 240.1555

Amended at 33 Ill. Reg. 4830, effective March 23, 2009

Amended at 42 Ill. Reg. 20653, effective 1/1/2019

Amended at 48 Ill. Reg. 11053, effective 7/16/2024