PA-HCS 9: Personnel Qualifications and Supervision
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Care providers are qualified to deliver services provided and work with the
supervision of a trained professional.
Agencies that screen and hire home care workers insure applicants meet state requirements, and are qualified in their ability to:
- meet minimum age and applicable background check requirements;
- read, understand, and carry out written and verbal care plan directions;
- perform personal care and housekeeping tasks and activities in the care plan;
- exercise good judgment and tact in responding to an individual’s suggestions and preferences;
- monitor and accurately record changes in an individual’s condition; and
- contribute observations and recommendations at care plan conferences.
Interpretation: State law may specify minimum education requirements and mandatory criminal background checks and fingerprinting for applicants filling state funded positions, and may specify grounds for disqualification for employment related to prior experience working with vulnerable populations.
Direct care workers are:
- experienced in providing services to the population served;
- able to work as a member of a care team;
- comfortable and competent working in a client-centered service delivery environment;
- mature, reliable, flexible, and supportive; and
- able to adapt to a range of in-home care circumstances.
Direct care workers have access to a supervisor or other professional at all times while on duty, and have the support of a supervisor who visits the individual’s home routinely.
Interpretation: This standard addresses supervisory support that is separate and distinct from standard PA-HCS 5.01.
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Research Note: The perceived differences between a paraprofessional’s and professional’s role is described in a qualitative analysis of conditions that promote poor home health aide job performance. While research has not established the extent of role confusion for service recipients, or factored in objective positive influences on delivery of home care, such as amount and kind of training or coaching, future useful research could examine knowledge held by aides who have the closest, most frequent contact with care recipients, compared to a care manager and other decision makers with infrequent care recipient contact. Lack of opportunity to make decisions, limited recognition and respect, and little training and supervision, factors found to be associated with a high worker turnover rate, also are noted in a study of worker stress and satisfaction using two models of care. |
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Personnel who conduct client screening, level of care assessments and periodic re-assessments, care management and coordination, and supervision of direct care providers are qualified by:
- a master’s degree in social work, nursing, counseling, consumer education, human development, or a related human services field; or
- a bachelor's degree and an equivalent number of years experience and demonstrated competence providing direct care making care decisions for in home service delivery.
Interpretation: Individuals can demonstrate competence through a combination of appropriate supervision by an individual with an
advanced degree, specialized training, experience, and skills.
Supervisors have:
- experience working with the service population and formal training in supervision; and/or
- on-the-job supervisory training for the first three months of service as a supervisor.
The agency coordinating and delivering services provides all individuals with:
- a care provider who is trained and qualified to deliver appropriate services;
- a supervising social service or health professional, as appropriate; and
- other service personnel, as needed.
Personnel maintain a manageable workload and assignments are made with due consideration for:
- the qualifications and competencies of direct service personnel and supervisors;
- case complexity;
- case status and progress toward achievement of desired outcomes;
- length and strength of worker-client relationship;
- whether services are provided by multiple individuals and providers or teams;
- ability of direct service personnel to meet the individual’s or family’s needs; and
- relevant cultural and religious factors.
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Research Note: A large state-wide study of factors associated with home care elder abuse and neglect found type and stability of client-home care worker relationship, and turnover, associated with higher risk for neglect, yelling and material abuse. Family ties and informal support, worker-client relationship and language compatibility, and provider turnover to be as significant for positive outcomes as service delivery model. |
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Prior to providing in-home services, personnel receive a health
evaluation, to determine their ability to perform the essential functions of the job, with or without reasonable accommodation.
Interpretation: While a physical examination is preferred, personnel may receive a general health screening performed by a
qualified medical practitioner, provided that the screening addresses communicable diseases.
NA The agency provides homemaker services only.
