Regulatory Review of Adult Day Services: Final Report - Section 2. Wyoming

08/26/2005

Overview

Adult day care facilities in Wyoming are licensed by the state Department of Health. Adult day care is provided under the long-term care waiver program. Medicaid providers do not have to meet requirements other than licensure.

Licensure and Certification Requirements

Licensure and Certification Requirements
Licensure Only  ☒ 
Certification Only  ☐ 
Both Required  ☐ 
Other  ☐ 

Definitions

Adult day care facility means any facility not otherwise certified by the Department of Health engaged in the business of providing activities of daily living support and supervision services programming based on a social model to four or more persons 18 years of age or older with physical or mental disabilities.

Adult day care is a community-based group program designed to meet the needs of adults with physical and mental disabilities through an individual activity care plan. It is a structured, comprehensive program that provides a variety of health, social, and related support services in a protective setting during any part of a day, but less than 24 hours.

Parameters for Who Can Be Served

The parameters for who can be served are contained within the state's definition of the target population: adults (1) who require assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL), (2) with physical problems that require health monitoring and supervision on a regular basis, (3) with emotional problems that interfere with ADL, (4) with significant memory loss and cognitive impairment, and (5) who require assistance in overcoming the isolation associated with functional limitations or disabilities.

A facility may refuse to serve adults with communicable disease, adults who are actively alcoholic or addicted to drugs, adults with a history of violence to self or others and/or whose behavior is not manageable within the group setting, and adults whose need for care requires more time and skill than the individual program is able and qualified to provide. Providers may discharge participants whose needs can no longer be met by the program of care.

Inspection and Monitoring

Inspection and Monitoring
Yes  ☒ 
No  ☐ 

The Survey Division of the Wyoming Department of Health, Division on Aging, performs initial and annual renewal on-site licensure evaluation surveys to determine compliance with State of Wyoming rules and regulations for adult day care facilities.

Required and Optional Services

  Adult Day Care
Required Optional
Activities of Daily Living (ADL) Assistance  ☒   ☐ 
Health Education and Counseling  ☐   ☐ 
Health Monitoring/Health-Related Services  ☐   ☐ 
Medication Administration  ☐   ☒ 
Nursing Services  ☐   ☐ 
Physical Therapy, Occupational Therapy, or Speech Therapy  ☐   ☐ 
Skilled Nursing Services  ☐   ☐ 
Social Services  ☐   ☐ 
Transportation  ☐   ☒ 

Provisions Regarding Medications

Participants may keep and take their own medicine provided that their physicians have deemed them capable of doing so and have authorized self-administration in writing. The facility must ensure that participants do not have access to other participants' medicine.

If a physician has deemed a participant incapable of self-administering medicine, each staff person who administers the medicine shall be authorized to do so by the Wyoming Nurse Practice Act. To administer medicine means to read the label, to open the container of medicine, to remove the prescribed dosage, and to give it to the person for whom it is prescribed. Persons authorized to administer medicine under the Act include licensed physicians, registered nurses, licensed practical nurses, and physicians' assistants.

Provisions for Groups with Special Needs

Provisions for Groups with Special Needs
Dementia  ☐ 
Mental Retardation/Developmental Disabilities  ☐ 
Other  ☐ 

Staffing Requirements

Type of staff. The director, or an adult appointed or designated by the director, shall be responsible for the day-to-day operation and management of the facility.

The program director shall be responsible for the program of the facility. If the program director is present in the facility fewer than 4 hours per day, there shall be an officially designated assistant program director.

All volunteer personnel shall be under the individual supervision of a director, program director, assistant program director, or designated staff person.

Staffing ratios. There shall be a minimum of one staff person on duty providing direct care and supervision for every six participants in care. The number of any additional staff persons required shall depend upon the program and services the facility provides and the functional level of the participants.

At least one staff person on the premises at all times during the hours of operation shall have certification by an appropriate provider in first aid (multimedia, personal safety, or standard first aid modular) issued within the past 3 years, and at least one employee or staff member on the premises at all times during the hours of operation shall have current certification in cardiovascular pulmonary resuscitation (CPR) issued through the American Red Cross or the American Heart Association. The CPR certificate must be renewed every 2 years.

Staff members must be 18 years of age or older to be counted in the staff-to-participant ratio. Paid or volunteer assistants may be between the ages of 14 and 18 but cannot be included in the staff-to-participant ratio.

Training Requirements

Before assuming job responsibility or within 1 week of hire, all staff persons shall receive job orientation training. The orientation shall include training specific to the staff's assigned responsibilities, as well as training on more general topics including purposes of the adult day care facility, state procedures for addressing abuse and neglect, confidentiality of personal information, employee responsibilities, capabilities and special needs of the elderly and disabled, the facility activity schedule, and record keeping responsibilities.

All staff shall be trained in the appropriate procedures for handling emergencies before job responsibilities are assumed, including at least fire, illness, or injury, and lost or missing person emergencies.

All staff primarily responsible for the direct care of the participants shall attend at least 8 hours of staff development activities annually, which shall consist of in-service training programs, workshops, or conferences related to adult day care or gerontology, provided that both subject areas are addressed during the year.

Relevant Medicaid Contracting Requirements for Adult Day Services Providers

None in addition to licensure.

Location of Licensing, Certification, or Other Requirements

  1. http://soswy.state.wy.us/rules/3633.pdf
  2. http://soswy.state.wy.us/rules/3345.pdf

Citations

  1. Rules and Regulations for Program Administration For Adult Day Care Facilities, Department of Health, Aging Division, Chapter 7, Wyoming Rules and Regulations. [7/20/99]
  2. Rules and Regulations for Licensure of Adult Day Care Facilities, Department of Health, Health Quality Program, Chapter 2, Wyoming Rules and Regulations. [4/20/2000]

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