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Touch of Class
Initial Employment Copies of Consents
Infection Control
The infection control program will focus on the prevention of the spread of infectious and communicable disease. The program will
ensure compliance with the Communicable Disease and Prevention and Control Act, Health and Safety
Code, Chapter 81, OSHA, 29 CFR Part 1910.1030 relating to blood borne pathogens and Appendix A to 1910.1030, and the Health
and Safety Code, Chapter 85, Subchapter I.
Touch of Class will keep an infection control log in order to document infections that are acquired while a client is receiving services
from Touch of Class. The documentation will include the date that the infections were disclosed to the agency employee, the client’s
name, and treatment as disclosed by the client.
Use Standard Precautions for all client care. This is basic infection control for blood borne diseases – to protect you and your clients.
Standard Precautions is to assume that all body fluids except sweat are potentially contagious.
Universal Precautions and Blood borne Pathogens
PURPOSE:
To ensure the health and safety of patients and clinical staff in the provision of patient care.
Although the body’s natural defense system defends well against disease, pathogens (disease causing agents also known as germs or
microorganisms) can still enter the body and sometimes cause infection. These pathogens can be transmitted in four ways:
1)
2)
3)
4)
By inhaling air exhaled by an infected person
By direct contact with an infected person
By indirect contact with a soiled object;
By inhaling air exhaled by an infected person
Infectious diseases that employees should be aware of include hepatitis, herpes, and meningitis, tuberculosis, and HIV infection,
including AIDS.
Disease transmission
Four ways diseases are passed around:
A- Airborne transmission
Airborne germs can travel long distances through the air and are breathed in by people. Example of diseases caused by airborne
germs: TB, chickenpox.
B- Blood borne transmission
The blood of an infected person somehow comes in contact the bloodstream of another person, allowing germs from the infected
person into the other person’s bloodstream. Blood borne pathogens can be present in other body fluids, such as urine, feces,
saliva, and vomit. Examples of blood borne germs that cause diseases are: AIDS, hepatitis.
C- Contact Transmission:
Touching certain objects can cause the spread of disease. Sometimes you touch an infected person, having direct contact with the
germ. Indirect contact is touching an object that has been handled by an infected person. Examples of diseases caused by contact
germs: pink-eye, scabies, wound infections, MRSA.
D- Droplet Transmission:
Some germs can only travel short distances through the air, usually not more than three feet. Sneezing, coughing and talking can
spread these germs. Examples of diseases caused by droplet germs: flu, pneumonia.
Four conditions of infection must be present for a disease to be transmitted:
1.
2.
3.
4.
a pathogen must be present
there must be enough of the pathogen to cause disease
a person must be susceptible to the pathogen
the pathogen must pass through a correct entry site.
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OSHA regulations on blood bourne pathogens have placed specific responsibilities on employers for protection of employees
including, but not limited to:
1.
2.
3.
Using work practices, such as following precautions (frequent hand washing, proper grooming, immunizations/vaccinations,
providing training, etc.), to minimize the possibility of infection;
Offering the opportunity for employees to get medical care such as the hepatitis B vaccination at no cost to the employee;
Establishing clear procedures to follow for reporting an exposure.
Following OSHA guidelines, especially the precautions, greatly decreases the employee’s risk of contracting or transmitting an
infectious disease. If any Touch of Class employee suspects they have been exposed to such a disease, they must document it
immediately by utilizing the incident report and notify their supervisor and any other involved personnel.
The infection control program includes:
1.
Organizational policies and procedures addressing infection control as it relates to service and care provided.
2.
Instructions to staff, participants, and caregivers in the precautions related to infection control.
3.
Exposure Control Program and post-exposure follow-up.
4.
An ongoing system for tracking and documenting participant infections.
5.
Policies and procedures in compliance with current applicable state, federal, and OSHA regulations.
The Infection and Exposure Control Program is reviewed at least bi-annually by the Touch of Class’s Governing Body, and
QAPI Committee/Quality Assurance Committees.
MANAGEMENT OF EMPLOYEE COMMUNICABLE INFECTIONS/EXPOSURE
TASK CLASSIFICATION
Universal Precautions are mandated by the CDC, OSHA, and the U.S. Departments of Labor and Health and Human Services. This
approach supports categorizing the nature of all potential patient/health care worker contacts and protecting workers based on the
probability of direct contact with blood or body fluids. Thus some people at different times during their work may move among
categories of tasks with varying risk of exposure. They therefore must adjust work practice controls and Personal Protective
Equipment in accordance with the task being performed.
Category I:
Those tasks which are likely to result in contact with blood/body fluids.
Types of body fluids/blood:
 Oral/Pharyngeal Secretions (Mouth, Trachea, Nares)
 Blood (from any site)
 Fecal Drainage (Normal defecation, ostomy drainage, diapers, incontinency, impaction removal)
 Lesions or Wound Drainage (Traumatic, operative, necrotic, erosions)
 Other Body Fluids (Moist tissue, cerebrospinal fluid, peritoneal dialysis fluid, vaginal discharge, pleural fluid, abdominal
fluid, vomitus, nasogastric tube drainage, tissues/organs, synovial joint fluid, tears)
Work Practice Controls/Personal Protective Equipment:
1.
Hand washing
2.
Gloves
3.
Mask and goggles if aerosolization is likely
4.
Gowns if soiling is likely
5.
No recapping, bending or breaking of needles
6.
Disposable resuscitation device
Sample of Procedures:
Includes, but is not limited to, the following:
1.
Suctioning
2.
Resuscitation
3.
Specimen collection (including venipuncture, heel/finger sticks, etc.)
4.
Oral examinations
5.
Tracheostomy care
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6.
7.
8.
9.
Handling linen or articles soiled with secretions or excretions
Transfusions
Intravenous line insertions
Wound examination; managing blood or drainage from wounds; cleansing or irrigating wounds; changing wound dressings
(regardless of infective status)
10.
Trauma wound care
11.
Catheterizations (straight or foley)
12.
Irrigation of catheters or ilealconduits.
13.
Perineal care
14.
Toileting assistance
15.
Administering enemas
16.
Incontinence care
17.
Ostomy care
18.
Diarrhea (all types)
19.
Rectal examination, removal of impactions, rectal tube insertion
20.
Bathing non-intact skin
21.
Peritoneal dialysis
22.
Vaginal exams
Category I Employees include:
1.
RN/LVN
2.
HHA
3.
PT., O.T., S.T., MSW, other therapist (In infrequent instances)
4.
Attendants
Category II:
Tasks that involve no exposure to blood, body fluids or tissues, but occupation may require performing unplanned Category I tasks.
Work Practice Controls/Personal Protective Equipment:
1.
Hand washing
2.
Personal Protective Equipment is used only if contact with blood or body fluids is likely (refer to Category I tasks).
3.
Otherwise, no barriers are needed.
Sample of Procedures:

Patient/family interviews, admissions, counseling, etc.

Patient transfers

All tasks not falling into Category I such as
a) Bathing
b) Dressing
c) Feeding
d) Ambulation
e) Routine assessments
f) Playing, interacting with patients

Physical examinations excluding focused exams listed in Category I

Routine housekeeping in patient care areas

Responding to emergencies involving combative persons

Handling patient equipment
Category II Employees
1.
RN/LVN
2.
HHA
3.
PT., O.T., S.T., MSW, other therapist (In infrequent instances)
4.
Attendants
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Tasks that involve no exposure to blood or body fluids or tissues, and occupation does not require performing Category I tasks
(although situations can be imagined or hypothesized under which anyone, anywhere, might encounter exposure to body fluids).
Work Practice Controls/Personal Protective Equipment:
No barriers are needed
Samples of Procedures:
Tasks routinely performed by/ routine maintenance
1.
Information management personnel
2.
Office personnel (i.e., managers, secretaries, file clerks, receptionist, finance personnel, etc.)
3.
QAPI/UR/Risk Management personnel
Category III Employees
Office Personnel
PERSONAL PROTECTIVE EQUIPMENT
Personal protective equipment used by home care personnel is designed to protect employees from direct contact with blood or other
potentially infectious or hazardous materials and will be issued when necessary.
Employees will be provided with personal protective equipment that is:
1.
Appropriate for the task performed.
2.
Effective in preventing the penetration of blood and other potentially infectious
material.
3.
Free of charge to the employees.
4.
Accessible and conveniently located.
5.
Available in the proper size.
Gloves, gowns and masks (excluding high-efficiency particulate air respirator masks) are disposable and for one-time use
only and will be replaced if used.
Disposable resuscitation devices will be provided to clinical employees. Employees will receive orientation and at least
annual education regarding proper selection, indications, mandated use and proper procedures for disposal or reprocessing
of protective equipment. Home care professionals should provide participants and caregivers with education regarding the
use of protective equipment and attire as indicated.
Gloves
Gloves will be made available in an accessible location. They should be suitable for the task being performed.
Gloves should be worn when:
a. There is reasonable likelihood of contact with blood or other body fluids potentially infectious or hazardous material.
b. During all vascular access procedures.
c. When there is contact with mucous membranes and non-intact skin.
Alternatives will be provided for employees who are allergic to the gloves normally provided.
Workplace procedures shall prohibit washing and decontamination for reuse of disposable gloves.
Masks
1.
Masks will be provided and worn when there is any possibility of airborne contaminant entering the respiratory tract of the
employee.
2.
When a patient is suspected or known to have active tuberculosis, a high-efficiency particulate air respirator mask will be
used.
3.
Masks will also be worn when the physician orders protective (reverse) isolation for the participant.
Face and Eye Protection
1.
Face and eye protection shall be provided when there is a potential for splashing, spraying, or splattering of blood or
potentially infectious or hazardous material.
2.
Employees should wear eye and mouth protection such as goggles and masks or glasses with solid eye shields and masks.
3.
When eyeglasses are used as protective eyewear, they should have an eye shield cover.
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Gowns
1. Gowns are needed when contamination of employee's clothing is likely to occur such as when providing wound care.
Gowns are for one participant use only and are to be removed by the employee prior to leaving the work area.
2. If soiling of clothes occurs, the employee should not proceed to the next participant's home, but should contact his/her
immediate supervisor to arrange for a change of clothing. Employees' clothes contaminated with blood, body substances, or other
hazardous materials, should be bagged and taken to commercial cleaners for laundering.
3. Disposable caps and shoe covers are also provided, for one-time use only, when there is reasonable expectation that shoes or
hair may be contaminated with blood, body substances, or other hazardous materials. Contaminated protective clothing should be
double bagged and placed in a receptacle for pickup.
UNIVERSAL PRECAUTIONS (Including work practice and engineering controls)
All health care workers involved with the delivery of care to participants in the home setting will utilize appropriate Infection Control
Guidelines and Procedures consistent with those used in a hospital setting. Since medical history and examination cannot reliably
identify all patients infected with HIV or other blood borne pathogens, universal precautions shall be consistently used for all patients.
Gloves
Employees are to wear gloves when touching blood and body fluids, mucous membranes,
non-intact skin of all patients, for handling items or surfaces soiled with blood or other body
fluids and for performing venipuncture and other vascular access procedures.
Hand washing
Hands and other skin surfaces must be washed immediately and thoroughly with antibacterial
soap if contaminated with blood/body fluids.
Hands must be washed immediately after gloves are removed.
Masks and Protective Eyewear
Employees are to wear masks and protective eyewear during procedures, which are likely to
generate blood/body fluid droplets or splashes to prevent exposure of mucous membranes of
the mouth, nose and eyes.
Gowns
Employees are to wear gowns during procedures that are likely to generate splashes of blood or body fluids.
Needles/Sharps
1.
All personnel are to take precautions to prevent injuries caused by needles and other sharp objects during procedures
and disposal.
2.
Needles are not to be recapped, bent or cut or manipulated by hand.
3.
Nurses will be provided with puncture resistant, non-penetrable, non-glass containers, which should be kept in their
possession.
4.
Disposable needles and syringes will be used.
5.
Needles used in the home setting will be disposed of in a puncture resistant, non-penetrable, non-glass container.
When a puncture proof container in the participant’s home is no longer needed or is two-thirds full, the lid should be
tightly fitted and taped closed to prevent loss of contents. The container should be double bagged before being
placed in trash receptacle for removal by waste disposal company. Nurses' individual sharps containers should also
be disposed of when two-thirds full. These containers are to be transported to the Touch of Class office in the
"dirty" section of the nurse's bag and placed in designated receptacle to be removed by the appropriate waste
management company.
6.
Broken glassware, which may be contaminated with blood/body fluid, will not be picked up directly by hands.
Glass fragments will be cleaned up using mechanical means, such as a brush and dustpan, tongs or forceps. Glass
fragments are to be disposed of in a puncture-resistant, non-penetrable, non-glass container.
Lesions/Dermatitis
1.
Personnel who have draining lesions or weeping dermatitis should refrain from all direct care and from handling
participant’s equipment until the condition resolves.
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2.
Personnel with open cuts that cannot be covered by gloves or other forms of barrier protection should refrain from
patient care.
Pregnant Personnel
1.
Pregnant personnel are not known to be at greater risk of contracting blood borne diseases than non-pregnant
workers; however, if an infection develops during pregnancy, the infant may be at risk.
2.
If possible, the pregnant employee should not work with participants with known blood borne diseases.
3.
The pregnant employee should be especially familiar with and adhere to precautions to minimize blood/body fluid
risks.
Direct or Indirect Contact with Source of Infection
1.
If direct or indirect contact with wound drainage, secretions or excretions is likely, appropriate precautions should
be taken --- requires hand washing and gloves. Gowns should also be used if contamination of clothing with
infectious source is likely.
2.
Contaminated articles must be disinfected or discarded.
Housekeeping
Blood/Body Fluid Spills:
1.
Blood/body fluid spill cleanup:
a. Wear gloves.
b. Wipe spills carefully with paper towels.
c. Clean area with approved germicidal spray or spray with a freshly made 1:10 dilution of chloride bleach and water and
allow to stand for 2 to 3 minutes.
d. Wipe area thoroughly with clean paper towels.
e. Discard towels and gloves in a plastic bag, close and place in another bag for disposal.
f. Wash hands thoroughly and carefully.
2.
Any splattering of potentially contaminated material shall be cleaned and decontaminated using gloves and a 1:10 chloride
bleach solution, made fresh daily, or approved germicidal spray/cloth.
3.
Patient care items such as bedpans, emesis basins, and oxygen tubing should be cleaned using gloves and a 1:10 chloride
bleach solution, made fresh daily, or approved germicidal spray/cloth.
4.
All obviously soiled contaminated work surfaces and equipment should be decontaminated after each visit using gloves
and a 1:10 chloride bleach solution, made fresh daily, or approved germicidal spray/cloth.
Laundry
1.
2.
3.
4.
Miscellaneous
1.
Laundry is not to be transported for decontamination by employees of Touch of Class.
When laundry is done in the participant's home as part of personal care, gloves (and gown as needed) are to be worn
when there is any possibility that the linen is contaminated with any body fluids.
Laundry should be handled with minimum agitation and shaking and should be held away from the body.
Laundry should never be placed on the floor.
Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in participant
care areas where there is reasonable likelihood of occupational exposure to blood or body substances.
2.
Food and drinks are not to be kept in areas where blood or other potentially infectious materials are present.
3.
All clinical procedures should be performed in such a manner to minimize splashing, spraying, splattering or
generating droplets of blood or body substances.
Specimen Collection
1.
All participant specimens should be treated as potentially infectious material.
2.
Gloves should be worn when collecting blood or other specimens. Other barrier protection articles should be utilized as
appropriate if there is risk of a spill or splash.
3.
Specimen container should be placed in a special plastic specimen bag to be obtained from the lab. The bag should be
sealed. If outside of this bag is contaminated, the specimen should be placed in a second bag.
4.
Specimen in bag will then be placed in a secondary insulated transport container with a biohazardous label. This container
is leak proof.
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5.
6.
Gloves and other protective equipment should be removed and disposed of as outlined within the Infection Control Plan.
Hand washing procedure should be followed.
Specimen Refrigerator
1.
Will be properly labeled as "biohazardous".
2.
Food and drinks will not be stored in specimen refrigerator.
Other Protective Practices
In the event of eye or body contact with a participant's blood or body substances: (1) irrigate the eye with water (2) wash
the exposed body part with soap and water and (3) contact the home health Touch of Class clinical supervisor for followup instructions. Procedure for management of employee infectious exposure and post exposure evaluation and follow-up
should be followed.
Hand washing
Hand washing is the single most important activity an employee can undertake to help prevent the spread of infection. Hand
washing with anti-microbial soap and warm running water will be performed at the following times:
1.
before and after participant contact.
2.
upon removal of gloves following participant care or procedures. (NOTE: The wearing of gloves does not eliminate
the need for hand washing)
3.
before and after contact with wounds or invasive procedures.
4.
after contact with soilage or contamination with any excretions or secretions.
5.
before and after administering medications into eyes, mucous membranes, tissues, etc.
6.
before and after eating and smoking.
7.
after use of toilet or wiping nose.
8.
before preparation and serving of meals.
NOTE: Hand washing with soap and water should be done as soon as possible if waterless solution is used.
Procedure:
Equipment: Soap, warm running water, paper towels or waterless cleansing agent
1.
Wet hands and wrists with warm water and apply soap. Hold hands below elbow level to avoid contaminating clean areas.
Wash vigorously with soap under a stream of water. This removes transient flora.
2.
Avoid splashing water on yourself or the floor. Pathogenic bacteria spread more easily on wet surfaces and slippery floors
are dangerous. Avoid touching the sinks or faucets, which are contaminated.
3.
Work up lather by rubbing your hands together vigorously. If you cannot remove your jewelry, move it up and down the
finger to clean beneath it. Surface organisms are removed by the action of the soap, water, and friction and washed away in
the lather. The vigorous rubbing removes contaminants.
4.
The areas under the fingernails, around the cuticles, and the thumbs, knuckles and sides of hands need special attention.
5.
Always rinse hands and wrists well. Running water flushes suds, lather, soil and pathogenic bacteria away. Hands should
be kept at a lowered level to prevent residue from running back up the forearms.
6.
Pat hands and wrists dry using a paper towel. Do not rub to avoid abrasions and chapping.
7.
Turn off the faucets by wrapping them with a dry paper towel. Avoid recontamination of hands.
8.
If unable to use the participant's sink facilities, use a waterless antiseptic cleaning agent: Spread small amount to
thoroughly cover hands and rub vigorously until dry.
Hand washing with soap and water should be done as soon as possible.
Education
1.
Touch of Class employees who provide direct participant care will be provided with a Universal Precautions inservice during orientation and annually thereafter.
2.
Participant’s caregivers will be provided with instructions regarding personal hygiene, universal precautions and
infection control procedures involving care of the participant (i.e. hand washing, disinfections, etc.) by the nursing
staff.
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MANAGEMENT OF HAZARDOUS MATERIALS
An effective and efficient hazardous materials management plan is essential to eliminate the hazards associated with various
biological, infectious, or chemical materials during times of generation, handling, transport, storage, disposal and final
disposition.
Touch of Class Hazardous Materials Management Plan was developed and implemented to control and/or eliminate hazards that pose
a significant immediate or potential risk to human health or may alter the environment with subsequent increase in morbidity and
mortality.
Responsibility:
For a plan such as this to be effective, it must be enforced at all times. The development, review, evaluation and revision of the plan is
a responsibility of the QAPI Committee. The ultimate and final authority for proper implementation of the program rests with
Administration. However, every employee who generates, handles, or disposes of hazardous waste must be trained in hazardous
waste management and must become familiar and comply with these procedures. The plan is reviewed annually by the Governing
Body.
Segregation of Hazardous Materials
1.
Hazardous Materials must be separated from non-hazardous materials at the site of origin and remain separated
during storage.
Handling of Hazardous Materials
1.
Individuals handling hazardous materials must use personal protective measures to prevent injury or exposure to
infectious, chemical, or physical hazards.
2.
Handling tools, carriers, carts, etc., will be used depending on the type of hazardous materials involved.
3.
Contaminated articles must be disinfected or discarded.
Packaging of Hazardous Materials
1.
Packaging of hazardous materials (bags, puncture proof containers, etc.) must remain intact until final disposition.
2.
Bags, boxes and containers will be closed/sealed before their full weight or capacity has been reached.
3.
Puncture proof needle containers will be sealed when 2/3 full and replaced.
Transport of Hazardous Materials
1.
Any hazardous materials such as chemotherapeutic drugs, lab specimens and sharps will be transported by Touch of
Class in specially marked containers designed to prevent human and environmental exposure.
2.
Nurses’ sharps containers will be transported to the Touch of Class office in the "dirty" section of the nurses' bag for
disposal in designated container.
3.
Lab specimens will be transported in labeled, leak proof containers.
Treatment Techniques and Disposal Methods
1.
Hazardous chemical waste will be disposed of in accordance with instructions contained in the applicable Material
Safety Data Sheets.
2.
Bagged waste will be placed in designated container for removal by waste disposal company.
3.
Sharps containers and pharmaceutical waste (i.e. chemotherapy, discarded biologicals, etc.) at Touch of Class office
will be removed by contracted waste management company. Waste tracking reports from waste disposal company
will be maintained by the Safety Coordinator/Officer for five years.
Disposable Items Procedure
1.
Dispose of contaminated medical waste such as paper towels, urinary catheters, dressings, gloves, gowns, masks,
drainage bags, IV tubing, suction catheters, feminine napkins, enema supplies, oxygen tubing, and disposable
diapers in plastic bags. Gloves should be removed and placed in the bag before closing it securely.
2.
Secured bag should be placed in trash receptacle in another bag (i.e., double-bagged) for disposal by waste disposal
company.
3.
Hands should be washed.
Disposal of Organic Material:
1.
Dispose of contents of bedpans, urinals, commodes, emesis basin, suction bottles, facial tissues, cleaning solutions,
disinfectants and solutions used in wound irrigation in the toilet using appropriate protective barriers.
2.
The container should be held below waist level and solution should be cautiously poured into the toilet to avoid
splashing and aerosols.
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3.
4.
Any spills should be cleaned up immediately using gloves and a 1:10 solution of chloride bleach and water, made
fresh daily, or an approved germicidal disinfectant cloth or spray.
Hands should be washed after removal of PPE
Overview of Standard Precautions:
Standard Precautions:
1. Wash Hands

After touching blood, body fluids, or objects
contaminated by blood or body fluid. Do This Even If
You Were Wearing Gloves.

After removing gloves.

Between each participant’s care.
2.
Wear Gloves

Whenever you touch blood, body fluids, or
contaminated objects.

Before touching a participant’s broken skin or mucous
membranes (mouth, nose), put on clean gloves.

Change gloves between tasks and between each
participant’s care.
3.
Wear a gown, mask, and goggles

If you know you might get splashed with blood or body
fluids. Use a waterproof gown if you might get heavily
splashed.

Remove dirty protective clothing as soon as you can
and wash your hands afterward.
4. Keep everything clean

Clean up spills as soon as possible.
PRECAUTIONS TO PROTECT PARTICIPANTS WITH COMPROMISED IMMUNITY
Protection for participants with compromised immunity requires--hand washing, masks, and gloves. Gowns should also be used as
indicated for direct participant contact.
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OTHER AIRBORNE DISEASES
For other airborne diseases which may include, but is not limited to hemophilus influenza, chicken pox, rubeola, rubella, meningitis,
meningococcal pneumonia, mumps, pertussis:
1.
Observe respiratory precautions
2.
Use mask (if susceptible to disease or if susceptibility is unknown).
3.
Use good hand washing.
4.
Disinfect contaminated articles according to Touch of Class infection control guidelines. (droplet transmission).
EMPLOYEE HEALTH REQUIREMENTS
Hepatitis B infection is caused by the Hepatitis B virus, which causes death in 1% to 2% of people. Most people with Hepatitis B
recover completely, but approximately 5% to 10% become chronic carriers of the virus. Most of these people have no symptoms, but
can continue to transmit the disease to others. The healthcare provider is at an increased risk for acquiring this infection.
Hepatitis B vaccine (recombinant) is available and requires three injections for adequate response, although some persons may not
develop immunity even after three doses. The duration of immunity is unknown at this time. The vaccine has been tested
extensively for safety and efficiency in large-scale clinical trials with human subjects.
Engirex-B is a non-infectious recombinant DNA Hepatitis B vaccine. It contains purified surface antigen of the virus obtained by
culturing a genetically engineered yeast cell, which carries the surface antigen gene of the Hepatitis B virus. The product contains no
more than a 5% yeast protein.The vaccine side effects are very low. Tenderness and redness of the injection site and low-grade fever
may occur. Rash, nausea, joint pain and mild fatigue have also been reported. I should not take this vaccine if pregnant or nursing
because effects at this time are unknown. I further understand that I should not take this vaccine if active infection is present, an
allergy to this compound is known, or if hypersensitive to yeast.
Hepatitis B vaccine (recombinant) is available and requires three injections for adequate response, although some persons may not
develop immunity even after three doses. The duration of immunity is unknown at this time. The vaccine has been tested extensively
for safety and efficiency in large-scale clinical trials with human subjects.
EMPLOYEE BLOODBORNE PATHOGENS EXPOSURE EVALUATION AND POST-EXPOSURE FOLLOW-UP
EXPOSURE
An exposure incident is a specific eye, mouth, other mucous membrane, non-intact skin or parenteral contact with blood or other
potentially infectious materials that results from the performance of an employee's duties. Following a report of an exposure incident,
a confidential medical evaluation and follow-up shall be immediately available to the exposed individual/employee. If an exposure
incident occurs, the employee should:
1.
2.
3.
4.
Immediately clean the exposed area well with soap and water. If soap cannot be used on the area, such as the mouth or
eyes, rinse well with clear water, running water, if possible.
Report the following immediately to his/her supervisor: Needle stick or other cut or puncture, splashing of blood or
body fluids into your mouth, nose or eyes, direct contact or one of prolonged contact with potentially infectious fluids where
precautions were not used.
The Supervising Nurse is to complete an Employee Post Exposure Evaluation Form as soon as possible, which states
route of exposure and the circumstances under which the exposure incident occurred. Identification and documentation of the
individual source should be included unless it is prohibited by state or local laws.
The exposure occurrence will be reported to the Supervising Nurse and Quality Control Specialist.
COLLECTION AND TESTING OF BLOOD
1.
Source Individual: The source individual's blood shall be tested as soon as feasible and after consent is obtained to
determine HBV or HIV infectivity. If consent is not obtained, the employer shall establish that legally required consent
cannot be obtained. When the source consent is not required by law, the source individual's blood, if available, shall be
tested and results documented. When the individual is known to be infected with HBV or HIV, testing source status need not
be repeated. Results of testing shall be made available to the exposed employee, and the employee shall be informed of
applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.
2.
Exposed Employee: The exposed employee's blood shall be collected as soon as feasible and tested after consent is
obtained (HIV and HBV Testing Forms). If the employee consents to baseline blood collection, but does not give consent at
that time for HIV serologic testing, arrangements can be made with the testing facility to preserve the sample for a minimum
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of 90 days. If, within 90 days of the exposure, the employee elects to have the baseline sample tested, such testing shall be
done as soon as feasible. Follow-up labs at 3, 6 and 12 months following exposure will be collected and tested if the
employee consents.
MEDICAL EVALUATION
Information provided to the treating health care professional:
 Copy of the regulation cited in CFR Section 1910.1030 Department of Labor Occupational Safety and Health
Administration-Occupational Exposure to Bloodborne Pathogens; final rule.
 A description of the exposed employee's duties as they relate to the exposure incident.
 Documentation of the route(s) of exposure and circumstances under which exposure occurred.
 Results of the source individual's blood testing, if available, and
 All medical records relevant to the appropriate treatment of the employee including vaccination status, which are the
employer's responsibility to maintain.
Treating health care professional's written opinion:

The employer shall obtain and provide the employee with a copy of the evaluating health care professional's written
opinion within 15 days of the completion of the evaluation.

The health care professional's written opinion of Hepatitis B vaccination shall be limited to whether Hepatitis B
vaccination is indicated for an employee, and if the employee has received such vaccination.

The health care professional's written opinion for post-exposure and follow-up shall be limited to the following
information:

That the employee has been informed of the results of the evaluation; and

That the employee has been told about any medical conditions resulting
from exposure to blood or other potentially infectious materials which require
further evaluation or treatment.
ALL OTHER FINDINGS AND DIAGNOSES SHALL REMAIN CONFIDENTIAL AND SHALL NOT BE INCLUDED IN THE
WRITTEN REPORT, respecting confidentiality.
POST-EXPOSURE PROPHYLAXIS: Post-exposure prophylaxis, follow-up testing, counseling and evaluation of reported illnesses,
shall be implemented according to the treating health care professional's written statement of opinion following medical evaluation.
RECORD KEEPING: All employee post exposure records will be kept by the Administrator in a confidential locked file for the
employee's duration of employment plus 30 years.
Exposure occurrence data will be reported to the QAPI Committee in a confidential manner (employee and patient names will not be
used) on a quarterly basis.
REPORTING AND EVALUATING PARTICIPANT INFECTIONS
The State Department of Health requires that specified diseases be reported to the Texas Department of Health and Human Services.
Those persons who are required to report are physicians, osteopath, coroner, medical examiner, dentist, homeopath, infection control
practitioner, medical records director, nurse, midwife, nurse practitioner, pharmacist, physician assistant, podiatrist, social worker,
veterinarian, and other health care professionals, parent, guardian, householder, school principal, operators of day care centers or
residential facilities, etc.
The report should include: the name, age, sex, address and attending physician of the case, the name of the disease, date of onset and
any other pertinent information. In addition to the mandatory reporting list, the City of Houston Health and Human Services should
also be notified if there is an outbreak of a disease or a single case of a rare or exotic disease.
The telephone number for reporting communicable diseases is: 713-794-9254
LIST OF REPORTABLE DISEASES
Acquired Immune Deficiency Syndrome
Amebiasis
Aseptic Meningitis
Blastomycosis
Brucellosis
Campylobacteriosis
Cholera
Chlamydia Infection
Encephalitis(Specify primary or post infections)
Foodborne Illnes
Gonorrhea
Granuloma Inguinale
Hepatitis (Specify type)
Herpes (Genitalia/Neonatal)
Legionellosis
Leprosy
Lyme Disease
Lymphogranuloma Venereum
Measles (Rubeola)
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Botulism
Chancroid
Diphtheria
Genital Warts
Human Immunodeficiency Virus
Leptospirosis
Malaria
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Meningitis, Hemophilus
Mumps
Pertussis (Whopping cough)
Psittacosis
Rubella (Congenital Syndrome)
Syphilis
Tuberculosis
Typhus Fever, murine (fleaborne endemic)
Meningococcal Infection
Mycobacteriosis, atypical
Plague
Rabies (Animal & Man)
Salmonellosis
Tetanus
Tularemia
Vibrio Infections (excluding Cholera)
(Including meningitis)
Ophthalmia, neonatorum
Poliomyelitis
Rocky Mountain spotted fever
Shigellosis
Trichinosis
Typhoid Fever
Yellow Fever
Emergency Preparedness Policy and Procedure
Policy: The Emergency Preparedness and Response Plan (EPRP) will be initiated for any services untoward or emergency situation
that interferes with normal operations and disrupts service delivery.
Purpose: To maintain operations and/or mitigate service disruption during untoward or emergency situations that impacts the internal
and external agency environment.
Procedure:
1. The Administrator, Supervising R.N., Alternate Administrators, Quality Assurance Coordinator, and Alternate Supervising RNs
will develop, and revise and needed the TOC EPRP.
2. The Administrator will act as the Disaster Coordinator. An Alternate Administrator will serve as Disaster Coordinator if the
Administrator is unavailable to do so.
3. The management group (Administrator, Supervising R.N., Alternate Administrators, Quality Assurance Coordinator, and Alternate
Supervising RNs), Program Directors from each office, and the Financial Dept. will report directly to the Disaster Coordinator
whenever the EPRP is activated.
4. Any offices not involved in the untoward event initiating the EPRP, will remain on standby in order to assist other offices if
needed.
5. The following natural and man-made disasters could impact TOC business and services:
Natural
Fire, Ice/Winter storms, Tornado/high wind advisories, Hurricanes, Flooding, Heat Advisories, and Disease Outbreaks
Structural/Man-made disasters
Hazardous materials incidents, Dam Failure, Power Failure, Civil Unrest, Nuclear power plant incidents, Terrorists incidents,
including weapons of mass destruction and bioterrorism
6. The Disaster Coordinator or designee(s) will monitor disaster-related news and information, including after hours, weekend, and
holidays, to receive warnings of imminent and occurring disaster- when known. Several methods, including but not limited to the
following, may be used to monitor such known or impending disasters: Television, Radio, Internet, Emergency Broadcast channels,
and/or internal agency communications.
7. The following actions will occur as part of the response and recovery phase of the EPRP:
a) The Administrator or designee may initiate each phase.
b) The Administrator or designee(s), as part of the TOC’s communication protocol (see communication tree) will communicate
with: owners and management group, office staff, county and city emergency officials, as needed, during and after an event,
State and Federal emergency management officials if warranted by the nature of the event, and other entities, such as,
DADS, Emergency medical Service, and other health care providers.
c) The primary mode of communication will be by phone or cell phone. If the primary mode of communication fails, other
methods including but not limited to the following may be used: CB radios, satellite phones, internet technologies, and HAM
radio.
8. TOC will discuss and provide the following information to each client upon admission to TOC:
a) The actions and responsibilities of agency staff during, and immediately following and emergency;
b) The participant’s responsibilities in the agency’s EPRP. The participant’s responsibilities will be included as part of the
“rights and responsibilities” given to each agency participant upon admission.
c) A list of community disaster resources that can assist a client during a disaster-related emergency, such as those provided by
DADS and local, state, and federal emergency management agencies, including the special needs registry maintained by the
state; and
d) Materials that describe survival tips and plans for evacuation and sheltering in place.
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9. TOC will release client information as allowed by State and Federal law in accordance with TOC’s current policy on release of
records (see TOC policy).
10. TOC will triage participants using a three class system (Class I, II, and III). This system will categorize clients based on services
provided by TOC, the need for continuity of services provided by TOC, and the availability of someone to assume responsibility for a
participant’s EPRP if needed by the participant. Each level is defined below:
a) Class I – Potential to be life-threatening without care. Requires ongoing treatment to preserve life. Unable to
evacuate/transport self. Unable to withstand any interruption in power supply. No readily available caregiver or caregiver
unable to provide needed care. Requires transport to an acute care facility or specialized shelter situation.
b) Class II – Not immediately life threatening, but participant may suffer adverse effect without services. Visits may be
postponed for 24 -48 hours with minimal adverse effect. Able to withstand up to 48 hour power interruption. Unable to
transfer/transport self or no transportation available from any friends/family/neighbors.
c) Class III – Low potential for adverse effect if visits are delayed 48-72 hours. Able to care for self, or willing and able
caregiver readily available (such as parent or guardian). Transportation available from family, friends, neighbors, or
volunteers.
11. TOC will identify participants who may need evacuation assistance and maintain triage records in the event of an emergency in
order to coordinate and communicate with the appropriate individuals and relevant state, federal and local officials if applicable.
TOC is not responsible for physically evacuating participants.
12. TOC will ensure that all staff and contractors are trained and oriented re: their responsibility in the agency’s EPRP upon hire and
when plan is revised. All staff are to ensure that immediate supervisor has correct contact information at all times.
13. The Administrator, the management group, and others if designated by the administrator will review the plan at least annually,
and after each actual emergency response to evaluate its effectiveness and to update the plan as needed.
14. As part of the annual internal review, the agency will test the response phase of the EPRP in a planned drill if not tested during an
actual emergency response. A planned drill is limited to implementation of TOC’s Communication Tree.
15. Touch of Class will make a good faith effort to comply with the requirements of this policy during a disaster. If the agency is
unable to comply with any of the requirements of this policy, the agency will document in the agency’s record s attempts made to
follow the procedures outlined in this EPRP.
16. Certain emergency situations are beyond the agency’s control, such as when roads are impassable or when a participant relocates
to a place3 unknown to TOC; may make it impossible to provide services. In the event that it is not possible to reach the agency’s
level 1 participants due to impassable roads, TOC will contact the appropriate county or city emergency management to respond as
appropriate. If the participant’s location is unknown, TOC will document it’s attempts to locate the participant and inform the
physician or practitioner, if necessary to the participant’s ongoing care.
17. If written records are damaged during a disaster, the agency will not reproduce or recreate paper client records. If electronic data
is available, records may be reproduced including the following: Date the record was reproduced, the TOC staff member who
reproduced the record, and how the original record was damaged.
18. Touch of Class will provide the following information to the DADS Home and Community Support Services Agencies licensing
unit, and the Texas State Board of Nursing Licensure Unit, no later than five working days after any of the following temporary
changes resulting from the effects of an emergency or disaster. The notice and information will be submitted by fax or email. If fax
and email are unavailable, notifications will be provided by telephone, and followed –up in writing as soon as possible. If
communication with DADS or the Texas State Board of Nursing Licensure Unit is not possible, TOC will fax, email, or telephone the
designated survey office to provide notification.
a) Temporary relocation of the agency;
 The license number for the place of business and the date of temporary relocation.
 The physical address and phone number of the temporary location. (If the emergency is localized to one or more
offices, temporary locations will be dispersed amount the unaffected offices.
 The date the agency or office(s) return to a place of business after temporary location.
b) Temporary expansion of the service area to provide services during a disaster:
 The license number and revised boundaries of the original service area;
 The date of temporary expansion; and
 The date an agency’s temporary expansion of its service area ends.
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Authorization for Criminal Background Check and Misconduct Registry
I acknowledge that I previously agreed to undergo a criminal background check and search the employee misconduct registry upon
signing this form for employment with Touch of Class. I hereby authorize the investigation of my criminal history and release of all
related information to Touch of Class. I am aware that information found may be cause for non-hire and/or termination from
employment. I also release Touch of Class, any person affiliated with them, and reporting agencies or persons affiliated with them
from any and all liability arising from this investigation.
As of September 1, 2009, Misconduct Registry will be done on all employees yearly. If your name is found on the Misconduct
Registry, termination will result immediately.
Authorization for Employability Status Check
I understand and agree to allow Touch of Class do the required Employability Status check prior to employment and then on an annual
basis.
Touch of Class will search the DAD’s Nurse Aide Registry, Medication Aid Registry and Employee Misconduct Registry. Results
will be kept in the employee personnel file.
A person is unemployable in a DADS regulated facility or agency if he or she:




is listed on Employee Misconduct Registry, or
is revoked on the Nurse Aide Reistry,
is revoked on the Medication Aide Registry or
has a criminal conviction listed as an automatic bar to employment in
Health and Safety Code Chapter 250
Finding an employee’s name will result in immediate termination.
Screening of Exclusion of Individuals and
Entities Reported to the Office of Inspector General for Waste, Abuse and Fraud
I acknowledge that I agree allow a check of my name with the Office of Inspector General for the purpose of checking the Excluded
Individuals and Entities database. The Federal online databases are used to search for excluded individuals and entities prior to hiring
or contracting, and on a monthly basis. I release all related information to Touch of Class. I am aware that information found may be
cause for non-hire and/or termination from employment. I also release Touch of Class, any person affiliated with them, and reporting
agencies or persons affiliated with them from any and all liability arising from this investigation.
This is done prior to hiring and monthly thereafter.
Notice of Home Care Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
WHAT IS HIPAA?
In 1996, the United States Government passed a law called the Health Insurance Portability and Accountability Act. It is referred to as
“HIPAA”. Title I of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects health insurance coverage for
workers and their families when they change or lose their jobs.
HOW DOES HIPAA SIMPLIFY HEALTH CARE?
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An important part of this rule is a system to simplify health care information so all providers, health plans, and related organizations can use
the same forms and computer programs to communicate with on another.
HOW DOES HIPAA REGULATE THE USE AND DISCLOSURE OF MY HEALTH INFORMATION?
With uniform standards for communication in place, it becomes more important than ever to make sure your health care providers and health
care plans are making every effort to protect your health information.
HIPAA rules define information about your past present or future physical or mental condition, treatment, or payment for treatment as
PROTECTED HEALTHCARE INFORMATION. We refer to this as “PHI”.
Under the rule, a healthcare provider, such as Touch of Class may use your PHI only for limited purposes without your consent. We can use
your healthcare information for purposes of providing you treatment, obtaining payment for your care, and conducting health care operations.
The Agency has established policies to guard against unnecessary disclosure of your health information.
HOW WILL TOUCH OF CLASS USE MY HEALTH INFORMATION?
To Provide Treatment: The Agency may use your health information to coordinate care within the Agency and with others involved in
your case, such as your attending physician and other health care professionals who have agreed to assist the Agency in coordinating care.
For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.
The Agency also may disclose your health care information to individuals outside of the Agency who are involved in your care, including
family members, pharmacist, suppliers of medical equipment or other health care professionals.
To Obtain Payment: The Agency may include your health information in invoices to collect payment from third parties for the care you
receive from the Agency. For example, the Agency may be required by your health insurer to provide information regarding your health care
status so that the insurer will reimburse you or the Agency. The Agency also may need to obtain prior approval from your insurer and may
need to explain to the insurer your need for home care and the services that will be provided to you.
To Conduct Health Care Operations: The Agency may use and disclose health information for its own operations in order to help and
Agency function better, and as necessary to provide quality care to all of the Agency’s patients. Health care operations include such
activities as:
Quality assessment and improvement activities.
Activities designed to improve health or reduce health care costs.
Protocol development, case management and care coordination.
Contacting health care providers and patients with information about treatment alternatives and other related functions that do
not include treatment.
Professional review and performance evaluation.
Training programs including those in which students, trainees or practitioners in health care learn under supervision.
Training of non-health care professionals.
Accreditation, certification, licensing or credentialing activities.
Review and auditing, including compliance reviews, medical review, legal services and compliance programs.
Business planning and developing including cost management and planning related analyses and formulary development.
Business management and general administrative activities of the Agency.
For example the Agency may use your health information to evaluate the employees who are taking care of you. We may combine your
health information with other Agency patients in evaluating how to more effectively serve all Agency patients. We may need to disclose
your health information to Agency staff and contracted personnel for training purpose, use your health information to contact you as a
reminder regarding a visit to you, or contact you a part of general community information mailing (unless you tell us you do not want to be
contacted).
For Appointment Reminders: The Agency may use and disclose your health information to contact you as a reminder that you have an
appointment for a home visit.
For Treatment Alternatives: The Agency may use and disclose your health information to tell you about or recommend possible treatment
options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH TOUCH
OF CLASS INFORMATION CAN USE YOU PHI UNDER HIPAA REGULATIONS:
When Legally Required: The Agency will disclose your health information when it is required to do so by any Federal, State or local law.
When There Are Risks to Public Health: The Agency may disclose your health information for public activities and purpose in order to:
Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of
public health surveillance, investigations and interventions.
Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct
post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a
disease.
Notify an employer about an individual who is a member of the workforce as legally required.
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To Report Abuse, Neglect or Domestic Violence: The Agency is allowed to notify government authorities if the Agency believes a patient
is the victim of abuse, neglect or domestic violence. The Agency will make this disclosure only when specifically required or authorized by
law or when the patient agrees to the disclosure.
To Conduct Health Oversight Activities: The Agency may disclose your health information to a health oversight agency for activities
including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. The Agency, however, may not
disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of
health care or public benefits.
In Connection With Judicial and Administrative Proceedings: The Agency may disclose your health information in the course of any
judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in
response to a subpoena, discovery request or other lawful process, but only when the Agency makes reasonable efforts to either notify you
about the request or to obtain an order protecting your health information. [Some States require a court order for the release of any
confidential medical information and may be more protective than the Federal requirements.]
For Law Enforcement Purpose: As permitted or required by State law, the Agency may disclose your health information to a law
enforcement official for certain law enforcement purpose as follows:
As required by law for reporting of certain types of wounds or other physical
injuries pursuant to the court, warrant, subpoena or summons or similar process.
For the purpose of identifying or locating a suspect, fugitive, material
witness or missing person,
Under certain limited circumstances, when you are the victim of a crime.
To a law enforcement official if the Agency has a suspicion that your death was the result of criminal conduct including criminal
conduct at the Agency.
In an emergency in order to report a crime.
To Coroners and Medical Examiners: The Agency may disclose your health information to coroners and medical examiners for purpose
of determining your case of death or for other duties, as authorized by law.
To Funeral Directors: The Agency may disclose your health information to funeral directors consistent with applicable law and if
necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, the Agency may disclose
your health information prior to and in reasonable anticipation of your death.
For Organ, Eye or Tissue Donation: The Agency may use or disclose your health information to organ procurement organizations or other
entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and
transplantation, in appropriate circumstances.
For Research Purposes: The Agency may, under very select circumstances, use your health information for research. Before the Agency
discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. You will be
notified if there is research involving your health information.
In the Event of a Serious Threat to Health or Safety: The Agency may, consistent with applicable law and ethical standards of conduct,
disclose your health information if the Agency, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and
imminent threat to your health or safety or to the health and safety of the public.
For Specified Government Functions: In certain circumstances, the Federal regulations authorize the Agency to use or disclose your
health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities,
protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.
For Worker’s Compensation: The Agency may release your health information for worker’s compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than is stated above, the Agency will not disclose your health information other than with your written authorization. If you or your
representative authorizes the Agency to use or disclose your health information, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that the Agency maintains:
Right to request restrictions. You may request restrictions on certain
uses and disclosures of your health information. You have the right to request a limit on the Agency’s disclosure of your
health information to someone who is involved in your care or the payment of your care. However, the Agency is not required to agree to
your request. If you wish to make a request for restrictions, please contact the Administrator.
Right to receive confidential communications: You have the right to request that the Agency communicate with you in a
certain way. For example, you may ask that the Agency only conduct communications pertaining to your health information with you
privately with no other family members present. If you wish to receive confidential communications, please contact your Touch of Class at
the time of Admission or contact the Agency administrator. The Agency will not request that you provide any reasons for your request and
will attempt to honor your reasonable requests for confidential communications.
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Right to inspect and copy your health information: You have the right to inspect and copy your health information,
including billing records. A request to inspect and copy records containing your health information may be made to the Administrator. If
you request a copy of your health information, the Agency may charge a reasonable fee for copying and assembling costs associated with
your request.
Right to Amend Health Care Information: You or your representative, have the right to request that the Agency amend
your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is
maintained by the Agency. A request for an amendment of records must be made in writing to the HIPAA Privacy Official at the Touch of
Class at 7171 Highway 6 North, Suite 130 Houston, TX 77095. The Agency may deny the request if it is not in writing or does not include
a reason for the amendment. The request also may be denied if your health information records were not created by the Agency, if the
records you are requesting are not part of the Agency’s records, if the health information you wish to amend is not part of the health
information you or your representative are permitted to inspect and copy, or if, in the opinion of the Agency, the records containing your
health information are accurate and complete.
Right to an Accounting: You or your representative have the right to request an accounting of disclosures of your health
information made by the Agency for certain reason, including reasons related to public purposes authorized by law and certain research. The
request for an accounting must be made in writing to The HIPAA Privacy Official. The request should specify the time period for the
accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. The
Agency would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be
subject to a reasonable cost-based fee.
Right to a Paper Copy of this Notice: You or your representative, have a right to a separate paper copy of this Notice at
any time even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact your
Touch of Class.
DUTIES OF THE AGENCY
The Agency is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice
of its duties and privacy practices. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The
Agency reserves the right to change the terms of it Notice and to make the new Notice provisions effective for all health information that it
maintains. If the Agency changes its Notice, the Agency will provide a copy of the revised Notice to you or your appointed representative.
You or your representative, have the right to express complaints to the Agency and to the Secretary of DHHS if you or your representative
believe that your privacy rights have been violated. Any complaints to the Agency should be made in writing to Touch of Class, at
7171Highway 6 North, Suite 130, Houston, TX 77095.
The Agency encourages you to express any concerns you may have regarding the privacy of your information. Touch of Class Home
Health does not permit retaliation of any kind for filing a complaint.
CONTACT PERSON
The Agency has designated the HIPAA Privacy Official as its contact person for all issues regarding patient privacy and your rights under
the Federal privacy standards. You may contact the administrator at 7171 Highway 6 North, Suite 130, Houston, TX 77041 or (281) 8581165.
EFFECTIVE DATE
This Notice is effective April 7, 2005.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT YOUR LOCAL Touch of Class OFFICE.
Agreement to Abide by Confidentiality Policies
I understand that due to the nature of my position, I will have access to information of a confidential nature regarding the participant (s) with
whom I work. I agree that any information regarding the individual (s) with whom I work will be kept strictly confidential. This includes the
name of the individual (s) unless the participant has directed me otherwise. I will participate in NO discussions regarding the individual or their
service delivery unless it is with the participant and / or legal designated representative or supervisory staff at Touch of Class. The Agency is
required by law to abide by the HIPAA Privacy Rule to maintain the privacy of the participant (s) health information. I agree to abide by the
HIPAA Privacy Rule and have received information regarding HIPAA.
Participant Rights and Responsibilities
1.
2.
Access to Care: Individuals shall be afforded impartial access to available treatment, services and accommodations within the
agency’s capacity that align with the programs stated mission, applicable law and regulation regardless of race, creed, sex, origin,
religion or disability.
Respect and Dignity: Every individual, regardless of age, has the right to considerate, respectful care and should be treated with
dignity at all times and under all circumstances.
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3.
Privacy and Confidentiality: The participant and/or legal guardian have/has the right, within the law, to personal and
informational privacy, as manifested by the right to:
a. Receive appropriate care in the least restrictive setting available.
b. Refuse to talk with or see anyone not officially connected with the agency, including visitors and persons officially
connected with the agency but not directly involved in their care.
c. Wear appropriate personal clothing and religious or other symbolic items.
d. Receives habilitation services in surroundings designed to ensure reasonable audiovisual privacy. This includes the right
not to remain disrobed any longer than is required for accomplishing the medical procedure for which the participant was
asked to disrobe.
e. Expect that any discussion or consultation involving the participant’s case, regardless of their age, will be conducted
discretely; and that individuals not directly involved in the participant’s care will not be privy to their personal
information.
f. Review their records and have the information explained, except when restricted by law.
g. Have the participants records read by individuals directly involved in their care or in the monitoring of its quality, and by
other individuals only with the participant’s (or his/her legal guardian’s) written authorization. In addition, when the
records are released to case management and to DADS personnel, confidentiality should be emphasized.
h. Except all communications and records pertaining to care of the individual, including the participant’s IPC, to be treated
as confidential.
i. Request a transfer to another direct services agency.
4. Personal Safety: The participant, regardless of age, has the right to expect reasonable safety in so far as the agency’s practice and
environment are concerned. The participant has the right to reasonable protection from harm as well as appropriate privacy, as
needed, for personal reasons.
5. Identity: The participant and/or legal guardian have/has the right to know the identity and professional status of individuals
providing service and to know which physician or other practitioner is primarily responsible for his care. This includes the right
know of the existence of any professional relationship agency to any other health care or educational institution involved in his
care. Participation by participants in habilitation training programs should be voluntary.
6. Informational: The participant and/or legal guardian have/has the right to obtain from the practitioner responsible for
coordination of her care, complete and current information concerning their diagnosis (to the degree known), treatment and any
known prognosis. This information should be communicated in terms the participant and/or legal guardian can reasonably be
expected to understand. When it is not medically advisable to give such information to the participant, the information should be
made available to a legally authorized individual.
7. Communication: The participant and/or legal guardian have/has the right to access people outside the agency by means of
visitors, verbal and written communication. The participant and/or legal guardian who does not speak or understand the
predominant language of the community should have access to an interpreter for communication. This is particularly true where
language barriers are a problem.
8. Consent: The participant and/or legal guardian have/has the right to the information necessary to enable him, in collaboration
with the healthcare practitioner, to make treatment decisions involving his healthcare that reflect his wishes. To the degree
possible, consent should be based on a clear, concise explanation of the condition and of all proposed technical side effects,
problem related to recuperation and probability of success. The participant should not be subjected to any procedure without the
voluntary consent of the individual or legal guardian. Where a medically significant need for care treatment exists, the participant
or their legal guardian shall be so informed. The participant and/or their legal guardian have/has the right to know who is
responsible for authorizing and performing the procedures and treatment. The participant and/or legal guardian shall be informed
if the agency proposes to engage in or perform habilitation projects affecting his care or treatment, and the participant has the
right not to participate in any such activity. If the participant chooses not to take part, he/she shall receive the most effective care
the agency otherwise provides.
9. Consultation: The participant or their legal guardian have/has the right to accept medical care or to refuse services to the extent
permitted by law and be informed of the medical consequences of such refusal. When refusal of service by the participant or
legal guardian prevents the provision of appropriate care in accordance with ethical and professional standards, the relationship
with the participant may be referred to the case manager for further action. The participant has the right for an individualized
habilitation plan and to participate in the development of the plan.
10. Transfer and Continuity of Care: A participant has the right to expect that the agency will provide requested services to the best
of its ability. If a transfer has been requested, the participant will be directed to case management for transfer procedure.
11. Delineation for Participant: The rights of the participant may be delineated on behalf of the participant, to the extent permitted by
law, to the participant’s guardian, next of kin or legally authorized responsible person.
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12. Rules and Regulations: The participant and/or their legal guardian should be informed of the rules and regulations applicable to
his conduct as a participant. The participant is entitled to information about the mechanism for the initiation, review and
resolution of participant complaints.
Participant Responsibilities
1.
2.
3.
A participant and/or their legal guardian have/has the responsibility to provide, to the best of their knowledge, accurate
and complete information about present complaints, alternative payees, medication and other matters relating to their
health. The participant has the responsibility to report unexpected changes in his/her condition to the responsible
practitioner. A participant and/or their legal guardian is/are responsible for making it known whether he/she clearly
comprehends and has contemplated habilitation training and what is expected of him/her.
A participant and/or their legal guardian is/are responsible for respecting the individual in dealing with employees of the
agency. Sexual harassment, racial discrimination, sexual discrimination, and endangerment to the health and safety of
agency employees is prohibited.
A participant and/or their legal guardian will assume responsibility to assure there is someone to assist you in a disaster,
and also to have an individual disaster plan in place.
Reporting Abuse, Neglect, and Exploitation
1.
2.
3.
4.
All agency employees are to report incidences of abuse, neglect, and exploitation immediately of the incident to the
Department of Family and Protective Services.
Employees are instructed to contact their immediate supervisor. The supervisor will assist the employee in following
Touch of Class’s policy on reporting abuse, neglect, and exploitation.
The participant and/or their legal guardian should receive the Department of Aging and Disability Services hotline
number. The agency will provide this information to you.
Touch of Class’s first responsibility is to the safety of our clients.
To report incidences of abuse, neglect and exploitation:
Department of Family and Protective Services:
1-800-252-5400.
Abuse, Neglect, and Exploitation
All prospective employees will receive the Department of Aging and Disability Services hotline number when oriented to the CLASS
program.
All employees will report cases of participant abuse, neglect and exploitation immediately of awareness to the Department of Family
and Protective Services: 1-800-252-5400.
I have been given the phone number for the Department of Family and Protective Services. I am aware that I must report cases of
participant abuse, neglect and exploitation immediately of awareness to the local Adult or Child Protective Services unit.
I am also responsible for notifying my immediate supervisor so that they may assist me in following Touch of Class Policy on
Reportable Conduct.
Drug Use Policy for Employees
It is the policy of Touch of Class to prohibit the use, possession or sale of alcoholic beverages, narcotics and / or illegal drugs of any
kind while attending to Touch of Class business. Immediate termination may result if this policy is violated.
Random drug testing is enforced at the discretion of the Program Director and Administrator, this policy is applicable to all
employees.
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The quantity of alcohol, narcotics, or illegal drugs consumed, possessed or sold is not relevant to the enforcement of this policy.
I have received and understand the agency policy for drug testing on any employees who have direct contact with clients, who are
employed by Touch of Class.
I acknowledge that I previously agreed to submit to drug testing when I signed my employment application with Touch of Class.
I further acknowledge that my employment is a conditional offer of employment contingent upon the results of the following
procedures:



Verification of required experience
Verification of references
Response from Drug Screening
I specifically understand and agree to undergo future (Drug and Alcohol) screening of my blood, urine, breath, saliva, or otherwise, if:
[1] There is reason to believe I am or have been impaired; [2] I was involved in a job-related accident or incident; or [3] I violated a
safety rule. I understand that I may be subject to further substance screening and/or face disciplinary consequences, up to and
including loss of employment.
I hereby authorize any physician, laboratory, hospital or medical professional retained by Touch of Class to both conduct such
screening and provide the results to Touch of Class. I consent and release Touch of Class, or any person affiliated with them, any
such institution or person from liability.
Worker’s Compensation
Touch of Class is a non-subscriber to workers’ compensation insurance.
COVERAGE: Touch of Class DOES NOT have worker’s compensation insurance coverage to protect you from damages resulting
from a work-related injury or illness. However, you may have rights under the common law of Texas. Your employer is required to
provide you with coverage information when you are hired or whenever the employer becomes, or ceases to be, covered by workers’
compensation insurance.
SAFETY HOTLINE:
The Commission has established a 24-hour toll-free telephone number for reporting usage conditions in the workplace that may
violate occupational health and safety laws. Law from suspending, termination or discriminating against any employee because he or
she in good faith reports an alleged occupational health or safety violation prohibits employers. Contact the Division of Workers’
Health & Safety at 1-800-452-9595.
Receipt of Policy and Procedure Manual
I have been made aware of the Touch of Class Policy and Procedure Manual. I understand that I am responsible for reading and
understanding the policies described within it. I understand this manual replaces any and all prior policy and procedure manuals of
Touch of Class.
I understand that a copy of the policy and procedures manual is available for me to view at any Touch of Class office during normal
business hours. I also understand that upon my request I can receive a personal copy of the manual.
I agree to abide by the policies and procedures contained in this manual. I understand that the policies and benefits contained in this
manual may be added to, deleted or changed by Touch of Class at any time. I understand that neither this manual nor any other
communication by management is intended to, in any way, create a contract of employment. I also understand that Touch of Class
abides by employment-at-will, which permits Touch of Class or the employee to terminate the employment relationship at any time,
for any reason. Touch of Class will not modify their policy of employment-at-will in any case.
If I have questions regarding the content or interpretation of this handbook, I will bring them to the attention of my supervisor.
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102.001. Soliciting Patients; Offense
It is the policy of Touch of Class to ensure compliance of the agency’s employees and contractors with the Occupation Code,
Chapter 102 (concerning the Solicitation of Patients).
(a) A person commits an offense if the person knowingly offers to pay or agrees to accept, directly or indirectly, overtly or covertly
any remuneration in cash or in kind to or from another for securing or soliciting a patient or patronage for or from a person licensed,
certified, or registered by a state health care regulatory agency.
(b) Except as provided by Subsection (c), an offense under this section is a Class A misdemeanor.
(c) An offense under this section is a felony of the third degree if it is shown on the trial of the offense that the person:
(1) has previously been convicted of an offense under this section; or
(2) was employed by a federal, state, or local government at the time of the offense.
Rights of the Elderly
Clients Over 60 Years
1.
2.
A person providing services to the elderly may not deny an elderly individual a right guaranteed by this document.
An elderly individual has all the rights, benefits, responsibilities, and privileges granted by the constitution and laws of this state
and the United States, except where lawfully restricted. The elderly individual has the right to be free of interference, coercion,
discrimination, and reprisal in exercising these civil rights.
3. An elderly individual has the right to be treated with dignity and respect for the personal integrity of the individual, without
regard to race, religion, national origin, sex, age, disability, marital status or source of payment. This means that the elderly
individual:
 Has the right to make the individual’s own choices regarding the individual’s personal affairs, care, benefits, and services:
 Has the right to be free from abuse, neglect, and exploitation; and
 If protective measures are required, has the right to designate a guardian or representative to ensure the right to quality
stewardship of the individual’s affairs.
4. An elderly individual has the right to be free from physical and mental abuse, including corporal punishment or physical or
chemical restraints that are administered for the purpose of discipline or convenience and are not required to treat the individual’s
medical symptoms. A person providing services may use physical or chemical restraints only if the use is authorized in writing by
a physician or the use is necessary in an emergency to protect the elderly individual or others from injury. A physician’s written
authorization for the use of restraints must specify the circumstances under which the restraints may be used and the duration for
which the restraints may be used. Except in an emergency, restraints may only be administered by qualified medical personnel.
5. A mentally retarded elderly individual with a court-appointed guardian of the person may participate in a behavior modification
program involving the use of restraints or adverse stimuli only with the informed consent of the guardian.
6. An elderly individual may not be prohibited from communicating in the individual’s native language with other individuals or
employees for the purpose of acquiring or providing any type of treatment, care, or services.
7. An elderly individual may complain about the individual’s care or treatment. The complaint may be made anonymously or
communicated by a person designated by the elderly individual. The person providing service shall promptly respond to resolve
the complaint. The person providing services may not discriminate or take other punitive action against an elderly individual who
makes a complaint.
8. An elderly individual is entitled to privacy while attending to personal needs and a private place for receiving visitors or
associating with other individuals unless providing privacy would infringe on the rights of other individuals. This right applies to
medical treatment, written communications, telephone conversations, meeting with family, and access to resident councils. An
elderly person may send and receive unopened mail, and the person providing services shall ensure that the individual’s mail is
sent and delivered promptly. If an elderly individual is married and the spouse is receiving similar services, the couple may share
a room.
9. An elderly individual may participate in activities of social, religious, or community groups unless the participation interferes
with the rights of other persons.
10. An elderly individual may manage the individual’s personal financial affairs. The elderly individual may authorize in writing
another person to manage the individual’s money. The elderly individual may choose the manner in which the individual’s money
is managed, including a money management program, a representative payee program, a financial power of attorney, a trust, or a
similar method, and the individual may choose the least restrictive of these methods. A person designated to manage an elderly
individual’s money shall do so in accordance with each applicable program policy, law, or rule. On request of the elderly
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11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
individual or the individual’s representative, the person designated to manage the elderly individual’s money shall make available
the related financial records and provide an accounting of the money. An elderly individual’s designation of another person to
manage the individual’s money does not affect the individual’s ability to exercise another right described by this document. If an
elderly individual is unable to designate another person to manage the individual’s affairs and a guardian is designated by a court,
the guardian shall manage the individual’s money in accordance with the Probate Code and other applicable regulations.
An elderly individual is entitled to access of the individual’s personal and clinical records. These records are confidential and may
not be released without the elderly individual’s consent, except when:
 to another person providing services at the time the elderly individual is transferred; or
 if the release is required by another law.
A person providing services shall fully inform an elderly individual, in a language that the individual can understand, of the
individual’s total medical condition and shall notify the individual whenever there is a significant change in the person’s medical
condition.
An elderly individual may choose and retain a personal physician and is entitled to be fully informed in advance about treatment
or care that may affect the individual’s well-being.
An elderly individual may participate in an individual plan of care that describes the individual’s medical, nursing, and
psychological needs and how the needs will be met.
An elderly individual may refuse medical treatment after the elderly individual:
 is advised by the person providing services of the possible consequences of refusing treatment;
 acknowledges that the individual clearly understands the consequences of refusing treatment.
An elderly individual may refuse services to the person providing services.
Not later than the 30th day after the date the elderly individual is admitted for service, a person providing services shall inform the
individual:
 whether the individual is entitled to benefits under Medicare or Medicaid; and
 which items and services are covered by these benefits, including items or services for which the elderly individual may not
be charged.
A person providing services may not transfer or discharge an elderly individual unless:
 the transfer is for the elderly individual’s welfare, and the individual’s needs cannot be met by the person providing services;
 the elderly individual’s health is improved sufficiently so that services are no longer needed;
 the elderly individual’s health and safety or the health and safety of another individual would be endangered if the transfer or
discharge was not made;
 the person providing services ceases to operate or to participate in the program that reimburses the person providing services
for the elderly individual’s treatment or care; or
 the elderly individual fails, after reasonable and appropriates notices, to pay for services.
A person providing services shall provide each elderly individual with a written list of the individual’s rights and responsibilities
before providing services or as soon after providing services as possible.
The rights described in this document are cumulative of other rights or remedies to which an elderly individual may be entitled
under law.
Grievance
Touch of Class is committed to open lines of communication and creating a positive work environment for all employees of our
agency. All employees of Touch of Class are entitled to fair and equitable treatment. When people work together, there are
times that issues of disagreement will arise. In the event that an employee feels they have grounds for a grievance, Touch of
Class has a GRIEVANCE PROCEDURE to ensure that the problem is handled quickly and fairly for all parties involved.
Regardless of the nature of the issue, it is important that employees utilize the procedure, reach resolution and move forward.
GRIEVANCE PROCEDURE
The employee is expected to:

Talk to their immediate supervisor about the issue. If the problem is with the immediate supervisor, the employee must follow
chain-of-command and take their grievance to the next supervisor in line. (See Organizational Chart)
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
If the problem is not resolved with an informal conversation, the employee must submit a written statement to the Program
Director within three (3) days of the initial conversation.

The Program Director may request a statement from other parties involved in the grievance.

The Program Director will hold a meeting to resolve the situation within three (3) days of receipt of the written statements.

Once a ruling has been made by the Program Director, the ruling stands as the final and binding rule.

Rules of Confidentiality apply to all parties involved.
Disposal Tips
Flushable waste includes feces, urine, suctioned fluids, bulk blood and any other patient/client excaudate and secretions. Items
heavily contaminated with blood or body substances are double bagged in a leak proof plastic bag and tied securely and discarded
with the rest of the household garbage. Patient care supplies such as diapers, incontinence pads, dressing supplies, foley catheters,
I.V. tubing, gloves, etc. are double bagged in a leak proof plastic bag tied securely and placed with household garbage.
Any medical waste contaminated with bodily fluids such as catheters and dressing should be double bagged and discarded in the
household.


Needles and syringes should be disposed of in a rigid, puncture proof container (coffee can, detergent bottle, etc. when full;
the lid should be taped closed, double bagged, and disposed of in the household trash. The container should be filled with
water and household bleach (1:10 dilution).
Other trash that you have from your treatment, such as wrappings and papers, may go into your household trash.
Transportation Policy
Touch of Class employees are not permitted to transport participants in the employee’s vehicle, or any other private vehicle.
Personal Attendants who are employees of Touch of Class may accompany the participant in a private vehicle, but they may not drive
the participant under any circumstances.
Participants are encouraged to access non-waiver resources as a means of transportation (i.e., public transportation, Medicaid Transit,
family, friends, neighbors, etc.) If it becomes necessary for a participant to seek transportation from a source other than a non-waiver
source, Touch of Class will work in conjunction with the case management agency to coordinate a transportation plan.
If an employee of Touch of Class violates this policy, disciplinary action will be taken.
Touch of Class assumes no liability for cost associated with any accidents or injuries related to transportation.
Back Support Acknowledgement
Receipt of Back Support
I acknowledge that if I agreed to receive one back support from the Touch of Class office. This equipment is the sole property of
Touch of Class and I agree to return it in good condition in the event that I leave the company. If I fail to return the back support, I
understand that the full cost ($50.00) of the back support will be deducted from my final paycheck. I may also agree to waive the
back support and acknowledge that Touch of Class has offered a Back Support and I may voluntarily waive receipt of support.
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Employee Education about False Claims Recovery
I.
Purpose: To communicate and comply with the contents of the Federal False Claims Act (Title 31, United States Code) and
the Federal Deficit Reduction Act of 2005, Section 6032, which requires (1) an employee education policy regarding
false claims recovery for entities receiving annual payments of at least 5 million dollars under a state Medicaid plan; and
(2) procedures for detecting and preventing fraud, waste and abuse.
II. Policy: Touch of Class employees and all contracted service providers shall be informed about the:
A. Activities that constitute false claims against state and federal funds(for example Medicaid eligibility and Medicaid
reimbursement)
B. Relief to which whistleblowers(employees who report fraud and consequently suffer discrimination for such action)
are entitled; and
C. Procedures for detecting and preventing fraud, waste and abuse.
III. Definitions
A. False Claims: False Claims occur when any person knowingly:
1. Presents or causes to be presented a false or fraudulent claim for payment
2. Makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid
3. Conspires to make a false claim or get one paid
4. Makes, uses, or causes to be made or used, a false record or statement to conceal, avoid or decrease an
obligation to repay overpayments
B. Knowingly: A person acts knowingly when that individual:
1. Has actual knowledge of the claim information
2. Acts in deliberate ignorance of the truth or falsity of the claim information
3. Acts in reckless disregard of the truth or falsity of the claim information
C. Qui Tam Relator or Plaintiff: A private person who may bring an action on behalf of a government entity to redress
false claims. Such persons may share in a percentage of the proceeds from a false claim action or settlement and are
afforded whistleblower protections.
D. Whistleblower Protections: The relief to which an employee is entitled who has been discharged, demoted,
suspended, threatened, harassed, or in any way discriminated against by his or her employer because of involvement
in a false claims disclosure. Such relief necessary to make the employee whole may include:
1. Reinstatement with the same seniority status that the employee would have had but for the discrimination
2. Two times the amount of back pay plus interest
3. Compensation for any special damage sustained because of the discrimination (including litigation costs and
reasonable attorney’s fees)
IV. Procedures
A. Employee education about false claims recovery shall be implemented by sending out notification to all Touch of
Class employees and contracted employees. All new employees will obtain this information in their new hire
packets. Updating our policy manual as of 6.15.09 with the inclusion of the Employee Education about false claims
recovery policy.
B. Procedures used by TOC for detecting and preventing fraud, waste and abuse include:
Review of all times slips, billing sheet 3625 with supporting documentation for all services provided. Review of all
Invoices. Touch of Class uses a series of checks and balance to ensure that services are being delivered and billed
accurately. Frequent chart audits to ensure complete documentation and review accurate billing. Biannual Quality
Assurance Meeting to further evaluate our processes and the accuracy of our billing procedures.
C. If Touch of Class employees or contracted service providers suspect, or become aware of fraud, waste, or abuse,
they shall report this to their supervisor. The supervisor is responsible for contacting the Administrator, who will
investigate the matter. If the matter involves Medicaid eligibility or reimbursement, the supervisor will contact the
appropriate agency
D. Websites to relevant acts and related requirements:
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1.
2.
Federal False Claims Act:
http://www.cms.hhs.gov/smdl/downloads/SMD032207Att2.pdf
PL 109-171, Section 6032- Encouraging the Enactment of State False Claim Acts; and Section 6033 –
Employee Education About False Claims Recovery:
http://thomas.loc.gov/cgibin/cpquery/?&dbname=cp109&sod=cp1091EYgl&refer=&rn=hr362.109&item=&sel=TOC_227784&
Nondisclosure of Confidential Information
It is important to the privacy and well-being of our clients and the success of Touch of
Class that our business affairs and the personal affairs of our clients remain strictly
confidential.
You may not directly or indirectly disclose or communicate to any person, firm, or agency any Touch of Class business information
obtained during the course of
employment.
Confidential Information is defined as: any information found in a participant's record, personal and work-related information in an
employee's personnel record as well as an employee's salary. All information relating to a participant's care, treatment or condition is
considered confidential information. Touch of Class is required by law to abide by the HIPAA Privacy Rules to maintain the privacy
of the participant’s health information. The Notice Privacy Practices describes how we may use and disclose the protected health
information to carry out treatment, payment, and healthcare operations and for other purposes that are permitted or required by law. It
also describes the participant’s rights to access and control of the protected health information.
Employees of Touch of Class shall never discuss a participant's condition or other information considered to be confidential with other
personnel, friends, or families. Confidential matters are not to be the subject of conversation on breaks or in areas where they may be
overheard.
Any employee who violates the confidentiality of a participant or employee related information is subject to serious
disciplinary action, up to and including termination.
Only administrative staff and participants or legal guardians are permitted access to participant’s records. No records shall leave the
office unless written approval from the Program Director and the participant or legal guardian is received, if this policy is
violated then immediate termination will result.
All participants’ records shall remain in an accessible file for the period of five years after the discharge of the participant.
All Touch of Class Administrative issues are confidential and should not be discussed with any person or official other than Touch of
Class Administrative office staff. Disclosure of any confidential office information could result in termination.
TIMESHEET AGREEMENT

Attendants are not allowed to use the participant’s home for personal use such as phones, computers, etc.

To request time off, you must fill a Vacation/Time off Request form located in the office. Touch of Class must be given a two
week notice in order to find a replacement for your shift. DO NOT use a call record to request time off.

If you claim hours on your timesheets that you did not work, this is considered Medicaid Fraud and you can be fined up to
$10,000.00 and/or jailed.

Please fill out timesheets completely in BLACK ink only with dates, signatures and hours worked. If your timesheet is incorrect
and/or not complete, it will be mailed back to you and your payroll will not be processed.
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
Timesheets are due by NOON ON TUESDAYS as stated on the Touch of Class calendar (No Exceptions). It is your
responsibility to make sure that they are here on time. TOC personnel will not follow-up with reminders.
Timesheets received after the Tuesday deadline will not be processed until the next payroll period. We will not accept any faxed
timesheets (only hand delivered or mailed).
Habilitation Attendant I – Job Description
I. Summary of Position
Working with Participants to help them become as independent as possible.
II. Qualifications
A.
B.
C.
D.
Be at least 18 years of age
Be neither legal nor foster parents of the minor child receiving the service
Not be spouse of the Participant receiving the service
Current CPR certified through American Red Cross or American Heart Assoc.
III. Description of Duties and Responsibilities
A. Working with Participant’s schedule
B. Documentation of habilitation work done
C. Attending required in-services
The following are based on the Participant’s IPP goals:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
Knowledge of the CLASS program and the TOC Policies and procedures
Perform personal care tasks as necessary
Health related tasks as necessary
Food and nutritional assistance as necessary
Money management as necessary
Household tasks as necessary
Community integration assistance as necessary
Assistance with personal decision making
Assistance with facilitation of self advocacy
Assistance with leisure time and recreational activities
Follow-up with any therapy goals as directed
Any other tasks as dictated by the IPP goals
Performance Requirements
A. Compliance with guidelines of CLASS Manual and TOC Policies and Procedures
B. Current CPR certification
Responsible to: Staffing Manager
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STATEMENT OF EMPLOYABILITY
By execution of this document, I ______________________________, hereby acknowledge that I have been informed by Touch of Class (agency name) that
a criminal history check will be performed on my name. I have informed this agency of all names (i.e., maiden name, aliases) that I have used in the past.
I hereby profess that I have not been convicted of any of the following crimes which are a permanent automatic bar to employment by this agency:


























An offense under Section 19, Penal Code (criminal homicide);
An offense under Section 20, Penal Code (kidnapping and false imprisonment);
An offense under Section 21.02, Penal Code (continuous sexual abuse of a young child or children);
An offense under Section 21.08, Penal Code (indecent exposure);
An offense under Section 21.11, Penal Code (indecency with a child);
An offense under Section 21.12, Penal Code (improper relationship between educator and student);
An offense under Section 21.15, Penal Code (improper photography or visual recording);
An offense under Section 22.011, Penal Code (sexual assault);
An offense under Section 22.02, Penal Code (aggravated assault);
An offense under Section 22.021, Penal Code (aggravated sexual assault);
An offense under Section 22.04, Penal Code (injury to a child, elderly individual or disabled individual);
An offense under Section 22.041, Penal Code (abandoning or endangering a child);
An offense under Section 22.05, Penal Code (deadly conduct);
An offense under Section 22.07, Penal Code (terroristic threat);
An offense under Section 22.08, Penal Code (aiding suicide);
An offense under Section 25.031, Penal Code (agreement to abduct from custody);
An offense under Section 25.08, Penal Code (sale or purchase of a child);
An offense under Section 28.02, Penal Code (arson);
An offense under Section 29.02, Penal Code (robbery);
An offense under Section 29.03, Penal Code (aggravated robbery);
An offense under Section 33.021, Penal Code (online solicitation of a minor);
An offense under Section 34.02, Penal Code (money laundering);
An offense under Section 35A.02, Penal Code (Medicaid fraud); and
An offense under Section 42.09, Penal Code (cruelty to livestock animals) or
An offense under Section 42.092, Penal Code (cruelty of non-livestock animals); (eff. Sept. 1, 2011)
An offense under Section 36.06. Penal Code (obstruction or retaliation): (eff. Sept. 1, 2011) and

A conviction under the laws of another state, federal law, or the Uniform Code of Military Justice for an offense containing elements that
are substantially similar to the elements of an offense listed under this subsection.
I also hereby profess that I have not been convicted of any of the following crimes within the past 5 years (applicable only to those hired on or after September
1, 2007 unless otherwise noted):
 An offense under Section 22.01, Penal Code (assault punishable as a Class A Misdemeanor or felony) [applicable to those hired on or after
September 1, 2003];
 An offense under Section 30.02, Penal Code (burglary) [applicable to those hired on or after September 1, 2003];
 An offense under Chapter 31, Penal Code (theft punishable as a felony)[applicable to those hired on or after September 1, 2001]
 An offense under Section 32.45, Penal Code (misapplication of fiduciary property or property of a financial institution punishable as a Class A
Misdemeanor or felony) [applicable to those hired on or after September 1, 2003];
 An offense under Section 32.46, Penal Code (securing execution of a document by deception punishable as a Class A misdemeanor or felony)
[applicable to those hired on or after September 1, 2003];.
 An offense under Section 37.12, Penal Code (false identification as peace officer); or
 An offense under Section 42.01(a)(7), (8), or (9), Penal Code (disorderly conduct).
I understand that if I have been placed on deferred adjudication community supervision for an offense listed above, successfully completed the period of
deferred adjudication community supervision, and received a dismissal and discharge according to Section 5(c), Article 42.12, Code of Criminal Procedure, I
am not considered convicted of that offense.
I acknowledge that if I am found to have been convicted of any other offense(s), that these offenses may also bar my employment.
I understand that all information obtained by this agency regarding any criminal history will remain confidential.
I certify that the information on this form contains no willful misrepresentation and that the information given is true and complete to the best of my knowledge.
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Signature of Applicant
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Printed Name
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Date
27
Revised 11.2011