State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Alzheimer Training

05/15/2003

SB1202 required that nursing homes provide Department of Elder Affairs (DOEA) approved Alzheimer's disease training to specified employees. The Alzheimer's Association was at the table at the LTC task force and advocated strongly for this initiative. The goal is to provide a very basic understanding, information and working knowledge of how to work with Alzheimer Disease and related dementia populations. As a condition of licensure, facilities must provide to each of their employees, upon beginning employment, basic written information about interacting with persons with Alzheimer's disease or a related disorder. All employees who are expected to have direct contact with residents with Alzheimer's Disease must have one hour of training within three months of employment. All individuals who provide direct care must have an additional three hours of training within nine months of employment. If facilities are not in compliance with this, they will be cited by surveyors.

The rule published in February 2002 identifies the qualifications of the trainer They must have a Bachelor's Degree in health care, geriatrics or human services, or hold a license as an RN and possess one of the following three 1) teaching experience of caregivers or 2) have at least one year practical experience working with Alzheimer patients/related dementias or 3) have completed specialized training from a university or accredited program. A Masters Degree could substitute for the training experience. The Director of Nursing or the training coordinator usually functions as the trainer.

All nursing home Alzheimer's disease training providers and curricula must be submitted to DOEA's contractor, the University of South Florida, Florida Policy Exchange Center on Aging (FPECA). Curricula are developed by the facilities--some are based on the old state curriculum with some updates. USF/FPECA reviewed over 1,000 applications from trainers in the first 30 days of the program for approval. Many of the proposed training programs contained incorrect or out-of-date information (example: inappropriate meds) and had to be returned to facilities for correction and resubmission. The curricula must also be resubmitted every three years. Currently 130 different curricula have been approved. The website lists approved providers and curricula.

DOEA receives $100K from general funds per year to administer the program. Nursing homes were very concerned about the fiscal impact of this mandate since nursing facilities have to bear all the costs associated with training. A state official indicated funding for the initiative could be in trouble because the industry feels that the government should not be in the business of approving training and curricula. The legislature is also going to want to know whether the training is effective. Right now, the only evidence is the review of the curricula itself which showed that many of the proposed training programs contained incorrect or out-of-date information.

More information on the state's Alzheimer Training program can be found in Appendix D, which contains the Florida Steering Committee's Consensus Document of Core Competencies for Dementia Training of Licensed Practical Nurses (LPNs) in Long-Term Care.

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