SECTION .0200 - MINIMUM LICENSURE STANDARDS

10A NCAC 70K .0201 PERSONNEL

(a) Staff Qualifications and Functions.

(1) Executive Director. There shall be an executive director employed for the general management and supervision of the maternity home. The executive director shall meet the requirements of a Social Services Program Administrator I as defined by the North Carolina Office of State Human Resources, which is incorporated by reference, including subsequent amendments and editions. A copy of these requirements can be found at no cost at http://www.oshr.nc.gov/state-employee-resources/classification-compensation/job-classification. The college or university degree shall be from a college or university listed at the time of the degree in the Higher Education Directory, which is incorporated by reference, including subsequent amendments and editions. This information can be obtained through Higher Education Publications, Inc. at its website, www.hepinc.com at a cost of one hundred twenty-five dollars ($125.00).

The executive director shall:

(A) direct the maternity home's program of care and services in accordance with policies established by the governing board and within license standards;

(B) recruit, employ, supervise, and discharge staff;

(D) prepare the annual budget, supervise expenditures, and operate within the maternity home's budget;

(E) establish and maintain relationships with other human service agencies and represent the agency in the community; and

(F) delegate authority to a staff member meeting the qualifications described in this Subparagraph or Subparagraph (a)(3) of this Rule during his or her absence.

(2) Professional Services Staff. The maternity home shall have available professional services personnel to assure appropriate services are provided for each resident identified by her case plan or out-of-home family services agreement.

(3) Social Work Supervisor or Case Manager Supervisors. Social Work Supervisors shall be employed by the maternity home to supervise, evaluate, and monitor the work and progress of the social work staff. The Social Work Supervisor or Case Manager Supervisor shall meet the requirements of a Social Work Supervisor II as defined by the North Carolina Office of State Human Resources. The college or university degree shall be from a college or university listed at the time of the degree in the Higher Education Directory. Social work supervisors shall receive 24 hours of continuing education annually.

(4) Social Worker or Case Manager. Social Workers or Case Managers shall be employed by the maternity home to provide intake services and social work services to the residents and their families in accordance with the case plan or out-of-home family services agreement. The Social Worker or Case Manager shall meet the requirements of a Social Worker II as defined by the North Carolina Office of State Human Resources. The college or university degree shall be from a college or university listed at the time of the degree in the Higher Education Directory. Social Workers or Case Managers shall receive 24 hours of continuing education annually.

(5) Direct Care Staff. All direct care staff shall have a high school diploma or GED. Direct care staff shall receive 24 hours of continuing education annually.

(6) Direct Care Supervisory Staff. All direct care supervisory staff shall have a high school diploma or GED. Direct care supervisory staff shall receive 24 hours of continuing education annually.

(7) Staff members of the maternity home may maintain dual employment or serve as volunteers with adoption agencies or crisis pregnancy centers as long as the maternity home does not provide services to the clients of the adoption agency or crisis pregnancy center. Staff members of the maternity home may serve on the board of directors of adoption agencies or crisis pregnancy centers as long as the adoption agency or crisis pregnancy center does not provide services to the clients of the maternity home.

(b) Staffing Requirements. There shall be at least one Social Worker or Case Manager assigned for every 15 residents. Supervision of Social Workers or Case Managers shall be assigned as follows:

Supervisors Required	Social Workers or Case Managers Employed
0	0-4 (the executive director serves as social work supervisor)
1	5
2	6-10
3	11-15
There shall be one additional supervisor for every one to five additional social workers.

(c) Direct Care Staff Requirements. Direct care staff shall be employed for direct care of maternity home residents, which shall include mothers and infants as well as any children or dependents of staff members who live or are cared for in the home. There shall be at least one direct care staff member assigned for every eight residents during waking hours and one direct care staff member for every twelve residents during sleeping hours. Additional direct care staff or other personnel shall be available to assist with emergency situations or special needs of the residents.

(d) Direct Care Supervisory Staff Requirements. There shall be at least one direct care supervisor for every 15 direct care staff members.

(e) Volunteers and Interns Requirements. If the maternity home uses volunteers or interns to work directly with residents, the requirements of 10A NCAC 70F .0207 apply.

(f) Additional Personnel Requirements. In addition to those requirements specified in 10A NCAC 70F .0207, the following rules are applicable to maternity home programs:

(1) Health Examinations. All direct care staff, any food service staff, and anyone serving in those capacities shall have a medical examination completed by a physician, physician's assistant, or nurse practitioner, hereafter referred to as "licensed medical provider," within at least 12 months before beginning employment and biennially thereafter. The agency shall maintain documentation that all direct care staff and food service staff or anyone serving in those capacities have had a TB skin test or chest x-ray prior to employment unless contraindicated by a licensed medical provider. A medical history form shall be completed by all direct care staff and food service staff. The licensed medical provider shall conduct examinations that include tests necessary to determine that the staff member is able to carry out assigned duties and does not have any communicable disease or condition that poses risk of transmission in the facility. A report of each examination shall be made a part of the employee's personnel file. A medical examination report shall be completed on any adopted children or relative children of direct care staff residing in the maternity home within 12 months prior to the license date. The birth children of direct care staff who reside in the maternity home shall be tested for TB only if one or more of the parents tests positive for TB. There shall be documentation that adopted children or other relative children residing in the maternity home have had a TB skin test or chest x-ray prior to initial licensure unless contraindicated by a licensed medical provider. A medical examination and TB test, if required, shall be completed on any children or relative children of direct care staff who begin residing in the maternity home. Examinations shall include tests necessary to determine that the children or relative children of staff members who reside in the maternity home do not have any communicable diseases or conditions that pose risk of transmission in the facility. A medical history form shall be completed on any children or relative children of direct care staff who reside in the living unit. The medical history form shall be signed and dated by the staff member and contain the name, contact information, date of birth, health history, and statement of health. A copy of the medical history form ("Medical History Form" DSS-5017) can be obtained from the Division or found on the Division's website at https://www.ncdhhs.gov/division/dss. Medical examination reports and medical history forms of children of the residents residing in the maternity home shall be maintained in the personnel file of their parent or relative.

(2) Staff Development. The maternity home staff shall have a written staff development plan that provides staff training in the following areas:

(A) medical, physical, and psychological aspects of pregnancy;

(B) prenatal and postnatal care;

(D) developmental needs of infants and toddlers;

(E) parenting preparation classes;

(F) stages of growth in infants;

(G) day-to-day care of infants;

(H) disciplinary techniques;

(I) education planning;

(J) job seeking skills;

(K) locating housing;

(L) money management;

(M) food management;

(N) child care programs;

(O) health education;

(P) stress management;

(Q) life skills;

(R) decision making;

(S) substance abuse;

(T) pregnancy prevention;

(U) counseling skills;

(V) emergency medical care;

(W) nutrition and food preparation;

(X) reasonable and prudent parent standard; and

(Y) trauma informed care.

(3) A residential maternity home shall ensure that a staff member trained in cardiopulmonary resuscitation (CPR) and first-aid, such as those provided by the American Red Cross, the American Heart Association, or equivalent organizations, is always available to the clients in care. Residential maternity home staff shall, within the first 30 days of employment, successfully complete certification in first-aid, CPR, and universal precautions provided by either the American Heart Association, the American Red Cross, or equivalent organizations approved by the Division of Social Services. Division staff shall determine that an organization is substantially equivalent if the organization is already approved by the Department or meets the same standard of care as the American Heart Association or the American Red Cross. First-aid, CPR, and universal precautions training shall be renewed as required by the American Heart Association, the American Red Cross, or equivalent organizations. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor who has been approved by the American Heart Association, the American Red Cross, or other organizations approved by the Division of Social Services to provide first-aid, CPR, and universal precautions training. Training in CPR shall be appropriate for the ages of children in care. Documentation of successful completion of first-aid, CPR, and universal precautions shall be maintained by the maternity home. The Division shall not accept web-based trainings for certification in first-aid, CPR, or universal precautions.

History Note: Authority G.S. 7B-505.1; 131D-10.5(7); 131D-10.10; 143B-153;

Eff. February 1, 1986;

Amended Eff. June 1, 1990;

RRC Objection Eff. April 15, 1993 Due to Lack of Statutory Authority;

Amended Eff. August 1, 2011; August 1, 2010; November 1, 2009; October 1, 2008; July 2, 1993;

Readopted Eff. August 1, 2017.