Previous

History: Eff. 5/24/2007, Register 182

Authority: AS 47.32.010

AS 47.32.030

7 AAC 12.334. Physical therapy services

A full-service hospice agency may provide physical therapy services. If the agency provides physical therapy services, the agency shall ensure that

(1) the physical therapist and any physical therapist assistant meet the requirements of 7 AAC 12.690; and

(2) in fulfilling supervisory duties required under 7 AAC 12.690, the physical therapist makes supervisory visits to the client's residence at least every two weeks to

(A) evaluate the effectiveness of the services furnished by any physical therapy assistant; and

(B) document the client's condition in the clinical record.

History: Eff. 5/24/2007, Register 182

Authority: AS 47.32.010

AS 47.32.030

7 AAC 12.335. Social work services

(a) A full-service hospice agency shall provide social work services required by 7 AAC 12.316(a) (3)

(1) under the direction of a physician or advanced nurse practitioner; and

(2) by a social worker who

(A) has a master's degree from a social work curriculum accredited by the Council on Social Work Education; and

(B) is licensed as a clinical social worker or a master social worker under AS 08.95.

(b) The social worker must be available to the extent necessary to meet the needs of clients and their families for care that is reasonable and necessary for palliative care and management of terminal illness and related conditions.

(c) In addition to performing the duties set out in 7 AAC 12.700(a) (1) - (6), the social worker shall provide ongoing psychosocial assessment of the family's capacity to cope with the client's terminal condition.

History: Eff. 5/24/2007, Register 182

Authority: AS 47.32.010

AS 47.32.030

7 AAC 12.336. Volunteer services

(a) A hospice agency shall ensure that each volunteer provides care and services in accordance with the client's plan of care, and under the supervision of a designated hospice employee.

(b) The agency shall develop and maintain policies and procedures that address the following with respect to volunteers in the program:

(1) recruitment, retention, and dismissal;

(2) screening;

(3) orientation;

(4) scope of function;

(5) supervision;

(6) ongoing training and support;

(7) team conferencing;

(8) records of volunteer activities;

(9) bereavement services.

(c) A volunteer is subject to the applicable requirements of 7 AAC 12.338.

(d) The hospice agency shall document active and ongoing efforts to recruit and retain volunteers.

History: Eff. 5/24/2007, Register 182

Authority: AS 47.32.010

AS 47.32.030

7 AAC 12.337. Counseling services

(a) A full-service hospice agency shall develop an organized program to provide spiritual, emotional, bereavement, and other counseling services under the supervision of a qualified professional. Counseling services may include the provision of written material, social reorientation, and group support.

(b) While the client is receiving hospice care, a full-service hospice agency shall make available spiritual, emotional, and other counseling services to the client and to the client's family as reasonable and necessary for palliative care and management of terminal illness and related conditions.

(c) A full-service hospice agency shall make available bereavement counseling to assist the client's family and caregivers in coping with grief experienced after the client's death.

(d) Any spiritual counseling, if desired by the client or the client's family, must be provided by a pastoral or spiritual counselor recognized by the governing body to be capable of providing spiritual, religious, and emotional support to the client and, as necessary, the client's family. The hospice agency may not request or require the client or the client's family to accept any value or belief system. The pastoral or spiritual counselor shall

(1) regularly reassess the spiritual needs of the client and the client's family related to the changing status of the client's terminal condition;

(2) support and assist the client, the client's family, or both;

(3) develop and maintain contact, subject to the client's approval, with the client's identified religious representative; and

(4) be a member of the interdisciplinary team.

(e) A full-service hospice agency shall make available dietary counseling to the client, the client's family, or caregivers, as necessary, including counseling that will assist the family or caregiver in preparing food for the client. The agency shall ensure that dietary counseling is related to the client's needs rather than the personal needs of the family or caregiver. Dietary counseling shall be provided to clients who experience difficulty in meeting nutritional needs, including clients with dysphasia or other swallowing problems, problems with enteral feedings, or nutritional issues resulting from nausea, vomiting, or the dying process. Dietary counseling must be provided by a registered nurse or other person with relevant education or training. In this subsection, "enteral feeding" means the delivery of liquid feedings through a tube for individuals who have a functioning gastrointestinal tract, but are unable to orally ingest adequate nutrients to meet their metabolic and nutritional needs.

History: Eff. 5/24/2007, Register 182

Authority: AS 47.32.010

AS 47.32.030

7 AAC 12.338. Hiring, orientation, and training

(a) A full-service or volunteer hospice agency shall require each volunteer and each direct service provider

(1) to submit a written application;

(2) to undergo a screening interview and an interview after training;

(3) to receive the orientation and training required

(A) under (b), (c), and (k) of this section, if a volunteer; and

(B) under (b) - (k) of this section, if a direct service provider;

(4) to submit a confidentiality statement, signed by the volunteer or direct service provider, in which the volunteer or direct service provider agrees to follow the program's policy regarding confidentiality; and

(5) if the volunteer or direct service provider will transport individuals, to provide proof of

(A) the motor vehicle liability insurance required under AS 28.22.019 ; and

(B) a valid driver's license issued by this state.

(b) Before allowing a volunteer or direct service provider to provide a hospice service, a full-service or volunteer hospice agency shall ensure that the individual receives an orientation of at least four hours that is specific to hospice services. The agency shall document this orientation within the first week of employment.

(c) A full-service or volunteer hospice agency shall develop policies and procedures that define the agenda of the orientation. The orientation must include at least the following subjects:

(1) hospice philosophy;

(2) personal death awareness;

(3) communication skills;

(4) personnel issues;

(5) identification of hospice resource people;

(6) stress management;

(7) ethics and confidentiality;

(8) stages of dying;

(9) funeral arrangements.

(d) A full-service hospice agency shall develop policies and procedures to ensure that each indirect service volunteer receives an orientation applicable to the duties the volunteer will perform.

(e) A full-service hospice agency shall provide an educational program that offers a comprehensive overview of hospice philosophy and hospice care. The agency shall provide a minimum of 18 hours of education within a one-year period for each direct service provider delivering hospice care. The four hours of orientation training required under (b) of this section may be counted as part of the 18 hours required under this subsection. The educational program must include at least the following subjects:

(1) hospice philosophy;

(2) family dynamics;

(3) pain and symptom management;

(4) grief, loss, and transition;

(5) psychological perspectives on death and dying;

(6) spirituality;

(7) communication skills;

(8) volunteer roles;

(9) multidisciplinary management.

(f) Documentation of completion of the education program described in (e) of this section is transferable from one hospice agency to another.

(g) A full-service hospice agency shall provide a program of continuing training directed at the maintenance of appropriate skill levels for hospice employees who provide services to clients and their families.

(h) In addition to meeting the other requirements of this section, a full-service hospice agency shall conduct in each service area an orientation program for each new employee and annual in-service training for all employees, including volunteers and contractors, that covers the following topics:

(1) agency policies and procedures;

(2) job duties and responsibilities specific to each employee's job;

(3) recognition of and responses to potential fire, emergency, and home safety hazards;

(4) principles and techniques of infection control; the agency shall verify that its employees, contractors, and volunteers who provide client care, receive training on

(A) universal precautions; in this subparagraph, "universal precautions" means the infectious control precautions that are recommended by the United States Department of Health and Human Services, Centers for Disease Control and Prevention, to be used to prevent the transmission of blood-borne germs such as human immunodeficiency virus and hepatitis B virus;

(B) the prevention, transmission, and treatment of tuberculosis;

(5) ethics and confidentiality;

(6) applicable state and federal law and the agency's policies and procedures;

(7) functions of other employed health personnel, including functions of hospice volunteers;

(8) coordination of services within the agency and with community services.

(i) A full-service hospice agency shall require cardiopulmonary resuscitation (CPR) training every two years for each employee who works directly with clients.

(j) To meet the training requirements of this section, a full-service hospice agency shall provide a nurse aide with at least 12 hours of in-service training each calendar year combined with six hours of additional training during the first year of employment. The 12 hours of in-service training must be based on the training needs identified through supervisory visits and the needs of the client being served by the agency. The agency shall provide training for all care duties not included in the basic competency skills identified in 7 AAC 12.333(c) .

(k) A full-service or volunteer hospice agency shall provide or arrange for a volunteer training and continuing education program that provides, at a minimum,

(1) orientation and training for new volunteers to acquaint them with the philosophy, organization, services, practices and goals of the hospice program;

(2) the psychosocial and psychological aspects of terminal disease;

(3) family dynamics and psychosocial issues surrounding terminal disease, death, and bereavement;

(4) communication skills; and

(5) initial and continued training needs specific to the duties, responsibilities and competency of each volunteer.

Next