309-045-0450 Temporary rule language in effect until 04/06/2026. Direct Support Worker Training Requirements (1) Direct support workers must complete an Agency with Choice-specific orientation before providing services to individuals. The orientation must be a minimum of four hours, obtained online or in person, and include, but not be limited to, the following subject areas: (a) Direct support workers' job description and requirements highlighting the importance of supporting individual self-direction; (b) Abuse and mandatory reporting; (c) Confidentiality; (d) Individuals' rights; (e) Medication safety; (f) Preventing Medicaid fraud; (g) Providing person-centered services; (h) Universal precautions and infection control; (i) An overview of the Agency with Choice's policies and procedures as required in in thee rules; (j) A description of the supports provided by the Agency with Choice to the Direct Support Worker; (k) Use of the Agency with Choice’s Electronic Visit Verification system; and (l) The documentation requirements outlined in OAR 410-120-1360 , OAR 410-172-0620 and OAR 410-173-0045 . (2) Direct support workers must complete a minimum eight house of competency-based training intended to improve the direct support worker’s ability to better serve individuals from a qualified training entity or qualified trainer. Competency-based training must be completed within 120 days of the direct support worker beginning work with individuals. Training must include, but is not limited to: (a) Recognizing and responding to medical emergencies; (b) Understanding and recognizing mental and emotional conditions; (c) Appropriate and safe techniques in ADL and IADL tasks, especially related to Critical Incident prevention; (d) Methods and techniques to prevent skin breakdown, tightening of skin, muscles, or tendons limiting movements, and falls; (e) Proper body movement, posture, alignment, and positioning to prevent injury of the Individual and the Direct Support Worker; and (f) Behavioral interventions; (g) Culturally responsive training; (h) Mandatory abuse reporting; (i) Ethics training, including confidentiality of individual information; (j) An overview of the Agency with Choice's policies and procedures; (k) Documentation of individuals' needs and services provided in compliance with OAR 410-120-1360 , OAR 410-172-0620 , and OAR 410-173-0045 ; and (l) Information about what constitutes medication reminding and its specific limitations. (3) Direct support workers must complete a competency-based evaluation, conducted by a qualified training entity or qualified trainer, that must include a combination of both direct observation and written testing. (4) Direct support workers who do not complete the required training with 120 days of hire, or who fail to competency-based evaluation, must immediately cease providing services to any individuals to whom they were assigned. (5) Direct support workers assigned to provide medication services must obtain a minimum of four hours of basic non-injectable medication training before providing the services. Medication training must include, but is not limited to, the following areas: (a) Medication terminology and abbreviations; (b) Reading medication orders and directions; (c) Reading medication labels and packages, including pill packs provided by a pharmacy; (d) Administering non-injectable medications: (i) Pill forms, including identification of pills that cannot be crushed; (ii) Non-injectable liquid forms, including those administered by syringe or dropper and eye and ear drops; (iii) Suppository forms; and (iv) Topical forms. (e) Identifying and reporting adverse medication reactions, interactions, contraindications and side effects; (f) Infection control related to medication administration; and (g) Techniques and methods to ensure safe and accurate medication administration. (6) Prior to providing medication services, direct support workers must demonstrate appropriate and safe techniques in the provision of medication tasks described in this rule and that must be evaluated by a qualified trainer through a successful return demonstration that includes: (a) The reason why each medication is taken; (b) The amount or dose of each medication that needs to be taken; (c) the route the medication needs to be taken; and (d) The time of day each medication needs to be taken. (7) Direct support workers providing medication services must receive a minimum of one hour of continuing education from a qualified trainer or qualified training entity related to direct support worker duties annually. (8) The training required in this rule must be clearly documented and maintained in each direct support worker’s personnel record and must include the following information, if applicable: (a) Title and content of the training for each topic. (b) The date(s), times(s) and training topics covered. (c) The name(s) and signature(s) of the Agency with Choice-specific orientation instructor, qualified training entity or qualified trainer who conducted the training. (d) Medication services training must clearly document: (A) Evidence of successful return demonstrations; and (B) A statement from the qualified trainer that the direct support worker has been evaluated to be competent to provide the medication services described in this rule. (9) Direct support workers who have previously served as a homecare worker, personal support worker, personal care attendant, direct support worker at another Agency with Choice or staff at an in-home care agency are not subject to additional competency-based training requirements if the previous training is not expired and is documented in the hiring Agency with Choice personnel records. Direct support worker orientation is still required. (10) Direct support workers with proof of a current Oregon health-care related license or certificate such as a nursing license or certified nursing assistant, is exempt from competency-based training. A direct support worker must provide annual proof of this license or certificate to remain exempt. Direct support worker orientation is still required. Statutory/Other Authority: ORS 413.042, Oregon Law 2024, Chapter 37 & HB 4129 (2024) Statutes/Other Implemented: Oregon Law 2024, Chapter 37 History: BHS 23-2025, temporary adopt filed 10/09/2025, effective 10/09/2025 through 04/06/2026