ACT NMMM ACT No. 571 NURSING FACILITY and ADULT RESIDENTIAL CARE FACILITY DEMENTIA TRAINING CURRICULUM APPROVAL APPLICATION PACKET

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ACT NMMM ACT No. 571 NURSING FACILITY and ADULT RESIDENTIAL CARE FACILITY DEMENTIA TRAINING CURRICULUM APPROVAL APPLICATION PACKET GENERAL INFORMATION Acts 2008, No. 571 was enacted in the Regular Session of the Louisiana Legislature in 2008. The legislation is to define requirements for dementia training in Adult Residential Care and Nursing Facilities. The legislation requires that all employees in these facilities be trained according to the provisions of Acts 2008, No. 571 (R.S. 40:2200.1-.5). Department of Health and Hospitals, Office of Aging and Adult Services (OAAS) designated Baton Rouge Community College (BRCC) as the Oversight Organization for the review and approval of dementia training curricula used in long-term care settings. Any provider, organization, entity or individual may submit a curriculum for approval. The information and instructions that follow will assist you in completing your applications for curriculum approval. Should you have any questions concerning the application and approval process please contact: BRCC Social Sciences Department 201 Community College Dr. (225) 216-8095 (225) 216-8155 fax sonnierb@mybrcc.edu 1

CURRICULUM APPROVAL APPLICATION PROCESS Within 10 working days of receiving an application, BRCC will notify applicants as to whether their application is administratively complete and ready for technical review or whether additional information or materials need to be submitted in order for the curriculum to be reviewed. Once receipt of a complete application has been confirmed, BRCC has 30 calendar days to complete the technical review of the curriculum. BRCC will notify applicants in writing of: approval status expiration date of curriculum approval approval number for the curriculum. Status assigned will be approved, approved with comments and recommendations, or denied with comments. Approved curricula and contact information for the provider will be posted on BRCC s web site. BRCC will provide a link to the DHH site where requirements for compliance with Acts 2008, No. 571 can be found. CURRICULUM TYPES AND COMPONENTS There are two types of Dementia Training curricula that are subject to review and approval/renewal: 1. Curricula intended for use with Nursing Facility staff (Nursing Facility Curriculum), or 2. Curricula intended for use with Adult Residential Care staff (ARC Curriculum). Within those two types, curricula may target all employees, including those that work on a dementia special care unit and those that do not, or it may target sub-categories of employees (for instance, just direct care staff who work on a dementia special care unit in an ARC). The fees for an initial curriculum review depends on the scope of the submitted curriculum (i.e., numbers of hours) and the category and type of employee to be trained using the curriculum. The fees for a renewal also depend on the above as well as whether or not a significant change has been made to a previously approved curriculum. CURRICULUM Documentation of Curriculum must include: objectives clearly stated in measurable terms for each of the curriculum requirements for the specific employee category topics to be included and outline of information to be presented on each topic topics must include those required by Acts 2008, No. 571: (1) an overview of Alzheimer s disease and related dementias; (2) communicating with persons with dementia; (3) behavior management for person with dementia; (4) promoting independence in activities of daily living for persons with dementia; and (5) understanding and dealing with family issues for persons with dementia; amount of time dedicated to each topic covered teaching methods to be used references on which the curriculum is based It is your responsibility to ensure that no copyright laws have been violated if material from another source is used as part of your curriculum. Documents required for review and approval must include the following: One (1) copy of each curriculum (handouts, power point slides, instructor notes, etc.) identified by employee category for training Name of training coordinator and his/her qualifications Current resume of coordinator 2

Method of instruction (classroom, web-based or brochure) Method of evaluation of instruction (see below) RENEWALS Please note that for renewals, any significant change to a previously-approved curriculum must be indicated. A significant change is defined as any change of 50% or more to the training content; a change to the content regarding three or more required topics; or a change in the delivery method of the training (e.g., from classroom-based to web-based). PROGRAM EVALUATION Curriculum providers must include some methods of evaluation to determine the effectiveness of the Dementia Training curriculum. Evaluations should be done at the conclusion of each curricula training session. The purpose of such evaluation is to ensure that learning needs of employees have been fulfilled and to assist in planning better programs in the future. Evaluation of the curricula training session must include: achievement of objectives evaluation of satisfaction with the presenter's content evaluation of the facilities and arrangements for the training session DETERMINATION OF CREDIT HOURS The number of training hours (60 minutes equals one contact hour) will be reviewed based on the employee category requirements as specified in Acts 2008, No. 571. Curricula must be approved by BRCC prior to Dementia Training for credit to be awarded to individual employees. Approved contact hour credit will apply only to designated instruction time with the presenter and discussions led by the presenter or staff. It shall not include informal discussions over lunch or other non-instructional activities outside designated instruction time. DOCUMENTATION OF ATTENDANCE Each Nursing Facility and Adult Residential Care Facility must monitor participant attendance at Dementia Training through the use of sign-in records. Electronic records can be used for computer based instruction. ISSUANCE OF CERTIFICATES Certificates must be issued to all participants who have successfully completed the program. The certificate must include the employee name and job title, curriculum title, date and location (city) of the program and signature of the trainer. The certificate must include the following statement: This Dementia Training Curriculum has been approved for (number) Dementia Training contact hours by Baton Rouge Community College as authorized by the State of Louisiana Department of Health and Hospitals. Certificates for partial attendance may not be issued. PERMANENT RECORDS As part of the permanent record of each approved curricula, and in order to document compliance with Acts 2008, No. 571, Nursing Facility and Adult Residential Care providers should keep the following information: Curriculum approval number Intended audience Course learning objectives Program content Program length Teaching methodology/format Curricula developer and presenter qualifications Evaluation of presenter Sign-sheets Handouts provided to participants Copy of approved curriculum and references 3

Acts 2008, No. 571 NURSING FACILITY and ADULT RESIDENTIAL CARE FACILITY DEMENTIA TRAINING REQUIREMENTS CURRICULUM APPROVAL APPLICATION FORM SPECIAL INSTRUCTIONS: Please carefully read this application and fill in all of the blanks. Return the completed application along with proof of your eligibility to: By Regular or Express Mail: BRCC Social Sciences Dept. 201 Community College Drive APPLICANT CONTACT INFORMATION: For Agency Use Only: ID# Date Type Initial Renewal Received Acknowledged / Need More Information Other Approved / Comments Name: Credentials: Organization: Mailing Address: (Street or P.O. Box) (City) (State) (Zip code) Telephone: ( ) Fax: ( ) Email: Check the proper code for each curriculum for which you are seeking approval/renewal: NF/SCU-8 NF-4A ARC/SCU-8 ARC-2 NF/SCU-4 NF-4B ARC/SCU-4 ARC-W NF/SCU-W NF-W ARC/SCU-W 4

Is this application for a renewal of previously approved curricula? YES NO If renewing, has there been a significant change to the curriculum (as defined on page 3)? Yes (please detail changes on a separate page) No APPLICATION AFFIDAVIT I HERBY AFFIRM THAT ALL INFORMATION INCLUDED IN THIS APPLICATION PACKET IS TRUE AND CORRECT. Print or Type Name of Applicant Signature of Applicant Date 5

APPLICATION FEES: The fee for the curriculum review depends on the scope of the submitted curriculum (i.e., the number of hours) and the category and type of employees to be trained using the curriculum. Renewal fees also depend on the category and type of employees being trained and whether or not a significant change in content has been made to a previously approved curriculum. Significant change is defined as any change of 50% or more to the training content; a change to the content regarding three or more required topics; or a change in the delivery method of the training (e.g., from classroom-based to web-based). INITIAL APPLICATION: Facility Type (A) Employee provides direct care (B) Employee provides regular communication, NO direct care Employee has incidental contact with residents Nursing Facility with Special Care Unit 8 hours $200 4 hours $100 Written $35 Nursing Facility with NO Special Care Unit 4 hours $100 4 hours $100 Written $35 Adult Residential Care with Special Care Unit 8 hours $200 4 hours $100 Written $35 Adult Residential Care with NO Special Care Unit 2 hours $75 Written $35 Written $35 Facility Type SIMPLE RENEWAL (NO Significant Change): (A) Employee provides direct care (B) Employee provides regular communication, NO direct care Employee has incidental contact with residents Nursing Facility with Special Care Unit 8 hours $100 4 hours $50 Written $20 Nursing Facility with NO Special Care Unit 4 hours $50 4 hours $50 Written $20 Adult Residential Care with Special Care Unit 8 hours $100 4 hours $50 Written $20 Adult Residential Care with NO Special Care Unit 2 hours $35 Written $20 Written $20 RENEWAL/REVISION WITH SIGNIFICANT CHANGE TO PREVIOUSLY APPROVED CURRICULUM Facility Type (A) Employee provides direct care (B) Employee provides regular communication, NO direct care Employee has incidental contact with residents Nursing Facility with Special Care Unit 8 hours $150 4 hours $75 Written $25 Nursing Facility with NO Special Care Unit 4 hours $75 4 hours $75 Written $25 Adult Residential Care with Special Care Unit 8 hours $150 4 hours $75 Written $25 Adult Residential Care with NO Special Care Unit 2 hours $50 Written $25 Written $25 An approved training curriculum remains effective seven (7) years from the date approval is obtained from the Oversight Organization. Make checks payable to: BRCC Foundation, Social Sciences Dept. All fees are nonrefundable. Mail payment and application materials to: BRCC Social Sciences Department 201 Community College Drive 6

APPLICANT CHECKLIST Application Contact Information Form Curriculum Category for Approval or Renewal Indication That a Significant Change Has/Has Not Been Made (if renewing) Name of Curriculum Coordinator Qualifications Current Resume Curriculum Title Page(s) for Each Employee Category Objectives Content Topic Detailed Content Outline Time Frame for Each Topic Teaching Methods Curriculum Evaluation Form Sign-in Sheet Sample Certificate One (1) Copy of Each Curriculum Enclosed (copies will not be returned) OVERSIGHT ORGANIZATION S CONTACT INFORMATION: BRCC Social Sciences Department 201 Community College Drive If you have any questions regarding this application, please call (225) 216-8096 or email sonnierb@mybrcc.edu. 7