309-040-0335 Training Requirements for Providers, Resident Managers, and Substitute Caregivers (1) All providers, resident managers, and substitute caregivers must satisfactorily meet all educational requirements established by the Division. Providers and staff may not provide care to any resident prior to acquiring education or supervised training designed to impart the basic knowledge and skills necessary to maintain the health, safety, and welfare of the resident. Required course work and necessary skills may include, but are not limited to, physical caregiving; screening for care and service needs; appropriate behavior towards residents with physical, cognitive, and emotional disabilities; emergency procedures; medication management; personal care products; food preparation; home environment and safety procedures; residents' rights; issues related to architectural accessibility; and mandatory abuse reporting. (2) The provider, resident manager, and substitute caregivers must be able to understand and communicate in oral and written English in accordance with ORS 443.730. (3) Training for all licensees, resident managers, and substitute caregivers must comply with ORS 443.738. All providers must satisfactorily pass any testing requirements established by the Division before being licensed or becoming a resident manager or substitute caregiver. The test must be completed by the licensee, resident managers, and substitute caregivers without the help of any other person, and must be proctored by the CMHP. The licensee, resident manager, and substitute caregiver must have the ability to, but not be limited to, understand and respond appropriately to emergency situations, changes in medical conditions, physicians' orders and professional instructions, nutritional needs, and residents’ preferences and conflicts. (4) The Division may make exceptions to the training requirements for individuals who are appropriately licensed medical care professionals in Oregon or who possess sufficient education, training, or experience to warrant an exception. The Division may not make any exceptions to the testing requirements. (5) In accordance with ORS 443.738, the Division may permit a person who has not completed the training or passed the required test to act as a resident manager until the training and testing are completed or for 60 days, whichever is shorter, if the Division determines that an unexpected and urgent staffing need exists. The licensee must notify the Division of the situation and demonstrate that the licensee is unable to find a qualified resident manager, that the individual meets the requirements for a substitute caregiver for the AFH, and that the licensee must provide adequate supervision. (6) Prior to providing care to any resident, the provider or resident manager must orient all caregivers to the home and to the residents. Orientation includes, but is not limited to: (a) Location of all fire extinguishers; (b) Demonstration of evacuation procedures; (c) Instruction of the Emergency Preparedness Plan; (d) Location of and documentation within resident records; (e) Location of phone numbers for telephone numbers of the local fire department, police department, the poison control center, the provider, and the residents’ LMP; (f) Location of medications, proper medication administration and proper documentation in medication administration records; (g) Introduction to each resident; (h) Review of care and services required for each resident; and (i) Registered Nurse delegation necessary to provide care and services to residents. (7) The provider or resident manager must maintain current documentation of the training, testing, and qualifications of substitute caregivers including but not limited to: (a) Documentation of an approved background check in compliance with OAR 943-007-0001 through 0501; (b) A new background check must be completed: (A) Every two years; (B) Prior to any subject individual’s change in employment position; and (C) If the Division has reason to believe a new background check is needed. (c) Documentation that a substitute caregiver has successfully completed the training required by the Division; (d) Documentation that the provider has trained the caregiver to meet the routine and emergency needs of the residents ; (e) Documentation that the provider has oriented the caregiver to the residents in the AFH, their care needs and skills training, personal care plan, and the physical characteristics of the AFH. (8) A minimum of twelve hours of training directly related to the care and services for residents with mental illness is required annually. All providers, resident managers, and substitute caregivers of an AFH must complete required training and document the training in the provider, resident manager, and substitute caregiver’s training records. The training is in addition to any orientation that is attended by applicants prior to licensing and must include, but is not limited to: (a) Understanding mental and emotional conditions ; (b) Understanding the mental health assessment and implementing the residential care plan (c) Medication management; (d) Cardiopulmonary Resuscitation (CPR) which includes in-person competency check by a qualified instructor, and First Aid; (e) Opioid overdose kits and administration of an FDA-approved short-acting, non-injectable, opioid antagonist medication. (f) Have a clear understanding of their job responsibilities, have knowledge of the residents’ residential care plans, and the ability to provide the care specified for each resident; ; (g) Resident rights; (h) Safety, emergency, and emergency preparedness planning; (i) Behavior management including positive engagement, redirection, and de-escalation techniques; (j) Complaints, grievances, incident and abuse reporting; (k) Nutrition and food services; and (l) Other information relevant to the job description and scheduled shifts. (m) All caregivers, including licensees, resident managers, and substitute caregivers are required to complete the Authority-approved HCBS training, as provided below: (A) Effective June 30, 2025, all caregivers must have completed the required training. (B) All new caregivers, hired on or after July 1, 2025, must complete the required training prior to beginning job responsibilities. (9) Providers, resident managers, and substitute caregivers must complete the Authority approved LGBTQIA2S+ residents and residents living with human immunodeficiency virus training as mandated by ORS 441.111 to 441.122. The Authority approved training shall address the elements described in 309-040-0335(11)(c) of this rule. The following dates apply to the initial LGBTQIA2S+ residents and residents living with human immunodeficiency virus trainings: (a) Effective June 30, 2025, all staff must have completed the required training. (b) All new staff, hired on or after July 1, 2025, must complete the required training prior to beginning job responsibilities. (10) Providers, resident managers, and caregivers are required to complete biennial training addressing LGBTQIA2S+ residents and residents living with human immunodeficiency virus protections, as described in this section. Providers are responsible for the cost of providing this training to all staff. (a) The provider or administrator must select the LGBTQIA2S+ residents and residents living with human immunodeficiency virus training to be used by the AFH by either: (A) Choosing to use the standard Department-approved biennial LGBTQIA2S+ residents and residents living with human immunodeficiency virus training; or (B) Applying to the Department to request approval of a biennial LGBTQIA2S+ residents and residents living with human immunodeficiency virus training to be developed and provided by the licensee or administrator. (b) ORS 441.116 requires all LGBTQIA2S+ residents and residents living with human immunodeficiency virus trainings address: (A) Caring for LGBTQIA2S+ residents and residents living with human immunodeficiency virus; and (B) Preventing discrimination based on a resident’s sexual orientation, gender identity, gender expression or human immunodeficiency virus status. (C) The defined terms commonly associated with LGBTQIA2S+ individuals and human immunodeficiency virus status. (D) Best practices for communicating with or about LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including the use of an individual’s chosen name and pronouns. (E) A description of the health and social challenges historically experienced by LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including discrimination when seeking or receiving care at care facilities and the demonstrated physical and mental health effects within the LGBTQIA2S+ residents and residents living with human immunodeficiency virus community associated with such discrimination. (F) Strategies to create a safe and affirming environment for LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including suggested changes to care facility policies and procedures, forms, signage, communication between residents and their families, activities, in-house services and staff training. (G) The individual or entity providing the training must demonstrate a commitment to advancing quality care for LGBTQIA2S+ residents and residents living with human immunodeficiency virus in this state. (c) The proposal for training submitted by a provider, administrator, entity, or individual shall include: (A) The regulatory criteria described in section 309-040-0335(11)(c). (B) The following elements must be included in the proposal: (i) A statement of the qualifications and training experience of the individual or entity providing the training. (ii) The proposed methodology for providing the training either online or in person. (iii) An outline of the training. (iv) Copies of the materials to be used in the training. (C) The Department will review the materials and determine whether to approve or deny the training. No later than 90 days after the request is received, the Department will inform the licensee or administrator in writing of the Department’s decision. (11) The Division may require a provider, resident manager, or substitute caregiver to obtain additional training, whether or not the twelve-hour annual training requirement has already been met. (12) Providers, resident managers, or substitute caregivers who perform delegated or assigned nursing care services as part of the residential care plan must receive training and appropriate monitoring from a registered nurse on performance and delivery of those services. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 14-2024, amend filed 06/24/2024, effective 07/01/2024 BHS 2-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 07/07/2024 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0030, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85