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What DSS's Statewide Waiver means for Assisted Living Resident and Families
This article is designed to provide context and detail for what the PIN 20-08-ASC has waived for all Adult and Senior Care facilities in California during this State of Emergency. CARR has read through the PIN created by the Department of Social Service and has provided context for what these waivers mean for residents and their families. All information is current as of March 19th, 2020. For any questions, please contact our offices at (619) 540-1648.
Waiver of Planned Activity Rights:
During this time of social distancing, planned activities are probably the first thing that comes to mind to getting cut. Many facilities have canceled activities that involve outside parties coming into the facility, like school groups or live music. Some have even limited the number of residents in their dining area at the same time.
But seniors can't just be left in their rooms all day. While keeping social distancing in mind, facilities must come up with some kind of activity to keep seniors entertained. Since this will differ between facilities, make sure to contact the administrator of your loved one’s facility to know how they are still providing activities for residents.
Waiver of Visitation Rights:
All unnecessary visits to the facility are restricted. This means that unless it is necessary, (for example: end-of-life) in person visits are not allowed. This waiver can also apply to other residents in the facility if it is used as a containment or mitigation method. The waiver of visitation rights does not mean that you cannot contact your loved one in a facility. It is the limitation of in-person visits to limit exposure to residents.
Facilities are required to provide alternatives for in-person visits by setting up webcams, FaceTime, Skype, and other forms of video communication. Increased phone calls can also be another method.
While there is no replacement for in-person visits, during this pandemic we all need to be careful. Please keep in mind that staff are also at risk and cannot work from home like you might be able to.
Waiver of Building and Grounds/Capacity Rights:
Facilities are authorized to waive regulations related to bedroom sharing and capacity as necessary to isolate or quarantine someone who is exhibiting symptoms of COVID-19 or a respiratory illness. This means that more than 2 residents may be sharing a room to allow for a symptomatic resident to be isolated in a room by themselves.
While it might be cramped, facilities are still obligated to conduct room assignments in a way that does not put their health and safety at risk. Resident must still be able to maneuver within the bedroom and access any exits safely.
Waiver of Staffing Ratio & Personnel Requirements:
The waiver of staffing ratio applies mostly to Adult Residential Care facilities (ARF) as they have staffing ratios during the day as well as at night. For ARFs, they have a ratio of 1 staff to every 3 residents during the day. Residential care facilities for the elderly have no such daytime staffing ratios. During the nighttime, ratios for ARFs and RCFEs are similar, roughly 3 caregivers for 100 residents. There are also requirements for staff to have fulltime responsibilities are activity planners or meal preparation. The waiver of these requirements may allow for more staff to be able to assist residents with their care needs.
Waiver of Criminal Background Clearance Requirements:
This one may be one of the most significant waivers – the waiver of staff background clearance. This waiver allows for previously background cleared staff to begin working earlier than previously allowed. Staff may start working as soon as they request their background clearance and association to be transferred to the facility they plan on working at. New staff must submit proof of background clearance from a state or local government and get fingerprinted to go through the usual background clearance process within 5 days of employment.
This waiver will speed up the number of caregivers facilities can employ to care for residents. This waiver does not void the requirement to have background clearance or to be assigned to a facility, it just allows them to work while the Dept. of Social Services finishes paperwork.
Waiver of Personnel Requirements:
A few different regulations have been waived for staffing requirements: training, Tuberculosis testing, and age requirements. For testing, staff are permitted to start caring for residents as soon as they complete first aid training and are trained on universal, droplet, and other precautions mandated by the CDC. They will then be trained on tasks they will need to do and will need to meet initial training requirements within 30 days of employment. As a precaution, new staff under this waiver will not be left alone while residents are still present at the facility and will not be designated for substitute management.
Staff may begin working upon submission of proof of Tuberculosis clearance within the last year. The final change to staffing requirements is the lowering of the age of caregivers to allow 17 year olds to provide care. Staff who are minors must provide proof of a work permit and are not allowed to be left unsupervised with residents present and will not be a substitute administrator or facility manager.
Again, these requirements being waived will increase the available caregivers for residents but does not jeopardize resident care. Under-trained, underage staff are not allowed to be left alone if any residents are in the facility. They will be under constant supervision and will still be required to meet all training requirements
Waiver of Administrator Certification Requirements:
Administrator certification training is moving online. Vendors who are currently approved by Dept. of Social Services may live-stream previously approved training courses. Vendors must still meet all regulations regarding administrator training courses, simply changing an in-person training to an online live-stream.
All people looking to become facility administrators for the first time will not be able to complete the Administrator Certification Testing due to its inability to be held online. They must instead apply for a Conditional Administrator Certificate which, if granted, will be valid for 90 days. When the State of Emergency is lifted, all administrators with conditional certificates must take and pass the in-person Administrator Examination.
Finally, for current Administrators who need to complete their in-person Continuing Education hours, the requirement for in-person training has been waived. Training can be taken with live-steam courses by Department-approved vendors, be completed before the Administrator Certificate expiration date (to avoid fees), and cannot complete more than 10 hours a day. There is no waiver of fees, timelines, or lowered number of training hours at this time.
The waiver of in-person training does not make the training of Administrators any less. Administrators with a Conditional Administrator Certificate have completed the same number of hours of training as those who were able to complete their test before the State of Emergency order.
Please keep in mind that the situation is constantly changing. CARR will be monitoring the DSS website for updates and will be providing updates here on our website and our social media pages. Check back daily for changes.