1. Health and Wellness for all Arizonans P ERSONAL C ARE S ERVICES IN A B EHAVIORAL H EALTH R ESIDENTIAL F ACILIT Y May 20, 2015

2. Health and Wellness for all Arizonans Personal Care Services Defined in Arizona Revised Statutes (ARS) ARS 36-401.36 - "Personal care services" means assistance with activities of daily living that can be performed by persons without professional skills or professional training and includes the coordination or provision of intermittent nursing services and the administration of medications and treatments by a nurse who is licensed pursuant to title 32, chapter 15 or as otherwise provided by law. 2

3. Health and Wellness for all Arizonans Personal Care Services Also includes Supervisory Care ARS 36-401.43 -"Supervisory care services" means general supervision, including daily awareness of resident functioning and continuing needs, the ability to intervene in a crisis and assistance in the self- administration of prescribed medications. 3

4. Health and Wellness for all Arizonans Personal Care Services Residents requiring personal care services – Behavioral health residents requiring assistance with activities of daily living. – Residents can still direct self care and recognized danger 4

5. Health and Wellness for all Arizonans Requesting Personal Care Services Complete “Health Care Institution Services Provided” form provided on ADHS Website. Write a letter requesting the personal care services to be added and send to ADHS Bureau of Residential Facilities Licensing. Personal Care Services Must be Authorized 5

6. Health and Wellness for all Arizonans Integrating Behavioral Health Services and Physical Health Services 6

7. Health and Wellness for all Arizonans Personal Care Services R9-10-715 Physical Health Services An administrator of a behavioral health residential facility that provides personal care services shall ensure that: 1. Personnel members who provide personal care services have documentation of completion of a caregiver training program that complies with A.A.C. R4-33-702(A)(5); 2. Residents receive personal care services according to the requirements in R9-10-814(A), (C), (D), and (E); and 3. A resident who has a stage 3 or stage 4 pressure sore is not admitted to the behavioral health residential facility. 7

8. Health and Wellness for all Arizonans R9-10-814 Personal Care Services A. A manager of an assisted living facility authorized to provide personal care services shall not accept or retain a resident who: 1. Is unable to direct self-care; 2. Except as specified in subsection (B), is confined to a bed or chair because of an inability toambulate even with assistance; or 3. Except as specified in subsection (C), has a stage 3 or stage 4 pressure sore, as determined by a registered nurse or medical practitioner 8

9. Health and Wellness for all Arizonans R9-10-814 Personal Care Services C. A manager of an assisted living facility authorized to provide personal care services may accept or retain a resident who has a stage 3 or stage 4 pressure sore, as determined by a registered nurse or medical practitioner, if the requirements in subsection (B)(2) are met. 9

10. Health and Wellness for all Arizonans R9-10-814 Personal Care Services D. A manager of an assisted living facility authorized to provide personal care services may accept or retain a resident who: 1. Is receiving nursing services from a home health agency or a hospice service agency; or 2. Requires intermittent nursing services if: a. The resident’s condition for which nursing services are required is a result of a short-term illness or injury, and b. The requirements of subsection (B)(2) are met. 10

11. Health and Wellness for all Arizonans R9-10-814 Personal Care Services E. A manager shall ensure that a bell, intercom, or other mechanical means to alert employees to a resident's needs or emergencies is available and accessible in a bedroom or residential unit being used by a resident receiving personal care services. 11

12. Health and Wellness for all Arizonans Personal Care Services Facility must have policies and procedures that meet R9-10-715 Physical Health Services. Must have a personnel member that is a certified caregiver that complies with A.A.C.R4-33-702. (NCIA Board) – Completed and passed a certified caregiver training program 12

13. Health and Wellness for all Arizonans NCIA Board NCIA Board = Arizona Board of Nursing Care Institution Administrator and Assisted Living Facility Managers. Approves caregiver training programs http://www.aznciaboard.us/ http://www.aznciaboard.us/CGT%20Applicants.pdf A CNA is not a certified caregiver 13

14. Health and Wellness for all Arizonans Questions??? 14

15. Health and Wellness for all Arizonans Kathryn McCanna Kathryn.mccanna@azdhs.gov 602-364-2481 Diane Eckles Diane.eckles@azdhs.gov 602-364-2632 Diane.eckles@azdhs.gov Residential Facilities Licensing Residential.licensing@azdhs.gov 602-364-2639 15