Who’s that Caregiver?

Caregiver training is regulated by the Arizona Board of Nursing Care Institution Administrators and Assisted Living Facility Managers Board (NCIA Board). Caregivers are currently required to have a total of 62 hours of classroom instruction by a program certified by the NCIA Board and pass a test with a score of at least 80% in order to obtain a caregiver certificate in Arizona. Caregivers are authorized to pass medications, whereas CNA’s and unauthorized home health aides are not allowed to touch medication in Arizona. NCIA Board-approved training schools also impose requirements to pass an Arizona Food Handler’s Safety Card and usually assist their students with applying for state-issued Fingerprint Clearance Cards and/or First Aid and CPR certification. A list of state-certified programs can be found at: AZ NCIA Approved Caregiver Schools.

•Caregiver training certificates DO NOT expire

•For caregiver certificates issued prior to August 3, 2013, call the NCIA Board to assist with certificate verification at (602) 364-2374

•Verification of a person who took caregiver training after August 3, 2013 can be checked at the following website: https://az.tmuniverse.com/

•Any training taken after August 3, 2013, from a provider not on the NCIA-approved list is NOT valid                                       

Unlike Manager requirements, Arizona does not currently mandate continuing education for Caregivers. Among other things, a manager is required to document that staff has proof of freedom from infectious TB (which must be updated annually); a valid fingerprint clearance card; and documentation of current First Aid and CPR training. (See A.A.C. R9-10-806).

However, if the licensed assisted living facility has a requirement in their written policies and procedures for caregiver education, the Arizona Department of Health Services (AZ DHS) will expect documentation proving that the training had been provided in accordance with the policies and procedures. Thus, we often recommend that the policies and procedures either: (a) not mandate any specific continuing education, or (b) leave additional training within the Manager’s discretion, or (c) simply include a statement that training will be offered in accordance with any applicable statutory or regulatory requirements.

One exception to the above statement regarding continuing education is a recent Arizona legislative requirement concerning fall prevention and recovery. Ariz. Rev. Stat. § 36-420.01:

Each health care institution shall develop and administer a training program for all staff regarding fall prevention and fall recovery. The training program shall include initial training and continued competency training in fall prevention and fall recovery. A health care institution may use information and training materials from the department's Arizona falls prevention coalition in developing the training program. 

In Arizona, a Manager shall ensure that a personnel record for each employee or volunteer includes:

a. The individual's name, date of birth, and contact telephone number

b. The individual's starting date of employment or volunteer service and, if applicable, the ending date; and

c. Documentation of:

i. The individual's qualifications, including skills and knowledge applicable to the individual's job duties;

ii. The individual's education and experience applicable to the individual's job duties;

iii. The individual's completed orientation and in-service education required by policies and procedures;

iv. The individual's license or certification, if the individual is required to be licensed or certified in this Article or in policies and procedures;

v. If the individual is a behavioral health technician, clinical oversight required in R9-10-115;

vi. Evidence of freedom from infectious tuberculosis, if required for the individual according to subsection (A)(8);

vii. Cardiopulmonary resuscitation training, if required for the individual in this Article or policies and procedures;

viii. First aid training, if required for the individual in this Article or policies and procedures; and

ix. Documentation of compliance with the requirements in A.R.S. § 36-411(A) and (C).

Ariz. Admin. Code § 9-10-806

The last item above pertains to Fingerprint Clearance card requirements. Arizona providers are also cautioned to check the rules regarding TB clearance requirements, since expedited rule-making was recently initiated that will result in some published changes to these rules and the annual certifications around proof of freedom from infectious TB. 

One item missing in the above list is photo identification. While a valid photo ID may be required under other hiring regulations (i.e. E-verify), and it is good practice to confirm the applicant’s qualifications, certifications, etc. against a government-issued identification to ensure that the employee is not misappropriating someone else’s identify, that is NOT a requirement under existing Arizona DHS licensing regulations. Therefore, the surveyor cannot require a caregiver nor manager to produce a proof of identification. Asking for employee photo IDs may constitute unlawful profiling on the part of the Agency.

Look for more weekly blog posts on topics of interest to Arizona Assisted Living and Behavioral Health operators.  The information herein is intended to be educational and an introduction to the subject matter presented. It is NOT specific legal advice to be relied upon for specific individual circumstances. Contact your own legal professional or reach out to our firm if you would like specific advice on this topic.  We welcome topic suggestions!  Write to info@pinkowskilaw.com if you are curious to learn more about a certain topic impacting assisted living or other group housing concerns.