Senior Services Plus

SENIOR SERVICES PLUS HEALTH CARE, INC.

PCW Handbook “helping people thrive”

Applicable To All Personal Care Workers Effective Date: 10.31.2013

This Manual Supersedes All Previous Manuals Distributed by Senior Services Plus Health Care, Inc. TABLE OF CONTENTS I. INTRODUCTION A. Welcome to Senior Services Plus Health Care, Inc...... 1 B. Organization Chart...... 1 II. PURPOSE OF THIS GUIDE...... 1 III. MISSION STATEMENT...... 2 IV. CONFIDENTIALITY OF INFORMATION A. Senior Services Plus Confidentiality...... 2 B. Client Confidentiality...... 2 V. EMPLOYMENT POLICIES A. Disability and Equal Employment...... 2 B. Hiring and Recruitment...... 3 C. Attendance Responsibilities...... 4 VI. BENEFITS AND POLICIES REQUIRED BY LAW A. Unemployment Fund...... 4 B. Social Security/Medicare...... 4 C. Worker’s Compensation...... 4 D. Wage Garnishment………………………………………………………………..5 VII. VOLUNTARY BENEFITS A. Holidays...... 5 VIII. COMPENSATION A. Pay Procedures...... 5 B. Exempt...... 5 C. Time Sheets...... 5 D. Time Sheet Instructions………………………………………………………… 5 E. Performance Appraisal...... 6 F. Rehire...... 6 G. Inclement Weather...... 6 IX. CORRECTIVE ACTION; DISMISSAL...... 6 X. SEPARATION FROM EMPLOYMENT A. Notice...... 7 B. Layoffs...... 7 XI. EMPLOYEE CONDUCT AND RESPONSIBILITIES A. Conduct…………………………………. …………………...... 7 B. Gift Policy...... 8 C. Personal Appearance/Dress Code...... 8 D. Personnel Records...... 8 E. Children and Visitors...... 8 F. Employee Grievances...... 8 G. Smoking in the Workplace...... 9 H. Drinking and Drugs……………………………………………………………. ….9 I. Theft………………………………………………………………………………….9

XII. CLIENT RIGHTS………………………………………………………………………..10 XIII. WORKERS RIGHTS……………………………………………………………………11 XIV. SENIOR SERVICES PLUS DISASTER PREPAREDNESS PROCEDURE A. Fire...... 12 B. Flood (Flash)...... 12 C. Tornado (Severe Weather)...... 12 D. Toxic Spill...... 12 E. Stay-in-place Order...... 12 XV. SENIOR SERVICES PLUS UNIVERSAL PRECAUTION...... 13 EXPOSURE REPORTING FORM...... 13 XVI. SENIOR SERVICES PLUS JOB DESCRIPTIONS Personal Care Worker Job Description………………………………………………14 Clinical Director (RN) Job Description………………………………………………..16 XVII. CONCLUSION………………………………………………………………………….17 XVIII. ADDRESS AND TELEPHONE NUMBERS…………………………………………17 XIX. ADDITIONAL INFORMATION Attachment re: HIPAA………………………………………………………………… 18 Client falls information………………………………………………………………….19 Illustration on “How to get up from a fall”…………………………………………….20 Travel Time Reimbursement…………………………………………………………..21 XX. SIGNATURE PAGE……………………………………………………………………..22

I. Introduction A. Welcome to Senior Services Plus Health Care, Inc.

Welcome to Senior Services Plus Health Care, Inc. (Senior Services Plus). The Senior Services Plus is a nonprofit, charitable, tax-exempt personal care agency, which was founded in 2006 to provide personal care services in the home that are safe, cost effective, efficient and personable. B. Organization Chart Board of Directors

Administrator

Clinical Director (RN) Office Manager

Personal Care Workers (PCWs) Walk in applicants, workers referred by clients

CLIENTS Stop Gap Workers Stop Gap clients, Social Worker referrals, private pay clients

II. Purpose of This Guide This Employee Handbook has been developed to be a guide and to clarify personnel policies applicable to the employees of the Senior Services Plus.

This Handbook is intended to provide information concerning important Senior Services Plus policies, procedures, privileges and responsibilities that are yours as an employee. Please read it thoroughly. Although this is not a book of rules, many of the Senior Services Plus regulations and principles are included. The policies in this Employee Handbook are not promises and this Handbook does not create contractual rights. Although we will strive to announce changes, this may not always be feasible; therefore some changes may be made without notice. Policies, procedures and/or practices may be altered from time to time to meet the needs of the Senior Services Plus or individual employees, and to comply with legal requirements.

III. Mission Statement

The mission of Senior Services Plus is as follows:

“Senior Services Plus Health Care, Inc. is a non-profit home personal care agency that provides services in the home that are safe, cost effective, efficient and personable. These supportive/supplementary services help the disabled maintain their in-home residential independence and enhance their quality of life in a dignified manner.”

Because of our charitable mission and our public support, we believe that Senior Services Plus employees have a special responsibility to adhere to the highest standards of professionalism, commitment, and diligence. We encourage congeniality and sharing of ideas of information among our staff, consultants, and collaborators.

We will enthusiastically serve clients and constituents and we will contribute positively to our community and environment. In all instances, the highest level of honesty and integrity shall be maintained with clients, other providers and employees, while treating each other with respect and dignity. IV. Confidentially of Information A. Senior Services Plus Confidentiality

The Senior Services Plus and its employees have an ethical and legal obligation to respect the privacy of our clients and to protect and maintain the confidentiality of all information that we learn about our clients, their family members and friends in the course of providing services to them. Information of a confidential nature is not to be discussed with anyone outside of Senior Services Plus. Employees have a responsibility to avoid unnecessary disclosure of non confidential internal information about the Senior Services Plus and its clients. This responsibility is not intended to impede normal business communications and relationships, but is intended to alert employees to their obligation to use discretion to safeguard internal Senior Services Plus affairs. If an employee has any question in any situation, they should consult with the Administrator. B. Client Confidentiality Client records are legally protected confidential records and must be treated as such. This means that client records maintained by Senior Services Plus must be kept in a secure location at all times except when they are being reviewed or supplemented by an authorized employee. Client records should never leave the office, except as permitted by the Senior Services Plus’s Administrator. Client records and client-related business (including the names of clients) should not be discussed with or disclosed to anyone except: co-workers who are specifically authorized under applicable Senior Services Plus’s Confidentiality Policies to have access to such information; your supervisor; the Administrator; any person authorized by the client to obtain information about the client from the employee (any such authorization must be in writing in a form approved by the Administrator and must be retained in the client file); or any person with whom the Administrator has authorized the employee to share the information. As tempting as it may be at times, it is illegal, unethical, and violation of our Confidentiality Policy for the employee to discuss client matters with the employee's friends, spouse, relatives, or anyone else, except those persons listed above, unless the employee is ordered to do so by a court or otherwise required to do so by law. If someone is insisting on obtaining information from the employee about a client, and the client has not authorized the disclosure, refer the matter to the Administrator. See HIPAA guidelines (p.18) attached at the back of this handbook.

V. Employment Policies A. Disability and Equal Employment

1. Americans with Disabilities Act (ADA) The Senior Services Plus is firmly committed to the Americans with Disabilities Act (ADA) and other federal and state legislation designed to ensure equal employment opportunities to persons with disabilities. The Senior Services Plus prohibits discrimination on the basis of disability in regard to all employment practices or terms, conditions and privileges of employment. Consistent with this policy and applicable law, the Senior Services Plus will make reasonable accommodation to the known physical or mental limitations of qualified applicants or employees, unless to do so would cause an undue hardship on the operation of its business.

2. Equal Employment Opportunity Commission (EEOC) The Senior Services Plus is an Equal Opportunity Employer. Title VII of the Civil Rights Act of 1964 (amended in 1991) prohibits employment discrimination based on race, color, religion, national origin, sex, age, marital status, sexual orientation, family responsibilities, disability, matriculation and political affiliation. The Senior Services Plus is committed to the rights of its employees.

If the employee believes that he/she has been subject to discriminatory harassment by a co-worker, supervisor, volunteer, client or vendor, or by anyone else during the course of your employment, please report your concerns immediately to the Equal Opportunity Coordinator, whose name and contact information will be posted in the lobby, under Attachment 3 “Equal Opportunity Policy’. Retaliation against an employee by any person under Senior Services Plus’s control for opposing such harassment, for filing a bona fide complaint of discriminatory harassment or for providing information in good faith regarding another employee's complaint will not be tolerated.

3. Limited English Coordinator (LEP) Senior Services Plus is committed to: providing equal opportunity in all programs and services to ensure full compliance with all civil rights laws, including Title VI of the 1964 Civil Rights Act, which requires non-discrimination on the basis of national origin. Equal opportunity includes physical and program access for persons with disabilities and program access for persons with Limited English Proficiency (LEP). Program and physical access for persons with disabilities is covered in the Americans with Disabilities Act of 1990 and the Rehabilitation Act of 1973 as amended, Section 504. I

It is the policy of this agency to provide language access services to populations of persons with Limited English Proficiency (LEP) who are eligible to be served by our programs. Such services will be focused on providing meaningful access to our programs, services and/or benefits. Senior Services Plus has assigned a ‘Limited English Proficiency Coordinator, whose name and contact information is also posted in the lobby under Attachment 4 “Limited English Proficiency Policy’.

4. Affirmative Action Equal Opportunity in Employment Policy It is the policy of Senior Services Plus to implement Affirmative Action (AA) measures designed to eliminate present effects of past discrimination and to ensure equal opportunity for women, racial or ethnic minorities, and persons with disabilities. Senior Services Plus recognizes the need to identify job groups and classifications with under-representation, and to set goals and timetables for increasing the employment of under-represented group, and to develop an AA plan for implementing those reasonable goals through outreach, recruitment, training and other activities and commitments. B. Hiring and Recruitment

1. Immigration Policy The Senior Services Plus is in compliance with the Immigration Reform and Control Act of 1986 which

requires that every newly hired employee complete an I-9 Form and verify his identity and eligibility to work in the United States. As a condition of employment, each new employee must properly complete, sign and date the first section of the Immigration and Naturalization service Form I-9. Substantiating documentation must be presented to the supervisor or the Administrator before an employee begins working at the Senior Services Plus. The supervisor or Administrator will verify documentation, sign and date the I-9 form.

2. Employment at Will The policies contained in this Handbook neither creates any contract of employment, nor do they constitute the terms of an implied agreement with the Senior Services Plus. All employees are considered "at will." Likewise, nothing in this Handbook shall be construed to erode the employment-at- will doctrine. "At will" means employment may be terminated with or without reason by either the employee or the Senior Services Plus. The employee has the right to end the employment relationship when she/he feels it to be in their overall best interest to do so, provided two weeks notice is given to their supervisor. However, employees engaged in gross misconduct or dishonesty may be dismissed without notice and will not be entitled to any pay after the last day worked.

C. Attendance Responsibilities

1. Attendance When the employee is hired, she/he will be advised of the hours he/she is expected to work. All hours and days of work are subject to change and modification. Senior Services Plus’s stated office hours are 8:00 am to 5:00 pm Monday through Friday. If you are out of work or late for any reason and have not received advance permission for the absence, please call your Supervisor's office at least one day before your regularly scheduled start time to report your absence or lateness. Because of the nature of work performed by Senior Service employees, it is critical that attendance be regular and punctual. Employees must provide as much lead time as possible when absence or delay is an issue. Absence without notice for three days may be considered a voluntary quit. Some personnel may have different working hours to ensure that there are people available to handle various matters, which arise before or after normal working hours. Telephone #’s are during office hours: 608/373-3390 or 608/757-5940 press 7.

After office hours: 608/774-5940 scheduling problems.

2. Attendance Records for Hourly Employees All employees are expected to report to their job each scheduled working day except for illness or special reasons. Employee’s presence on the job is most important to ensure the smooth operation of the Senior Services Plus. Employees are expected to notify their supervisor directly of their absence or late arrival immediately upon the opening of the business day. Phone calls to a fellow employee or to a client are not acceptable. You must contact your supervisor, after hour’s telephone # 774-5940.

3. Lateness and Absenteeism Chronic lateness or absenteeism is not acceptable. Employees who are continually late, or have more absences than normal, will meet with their supervisor. If the problem persists, penalties may include dismissal.

VI. Benefits and Policy Required by Law

A. Unemployment Fund

The Senior Services Plus pays 100 percent of the State and Federal unemployment insurance premiums for each employee. This benefit is designed to pay unemployment compensation to employees who lose their job for reasons other than: (1) misconduct or (2) voluntarily quitting. B. Social Security/Medicare

For each employee, Senior Services Plus deducts the employee’s share of Social Security and Medicare and Senior Services Plus pays matching funds to the Social Security Administration under the Federal Insurance Contributions Act (FICA) C. Worker's Compensation

All employees are covered under the applicable Worker's Compensation Act Insurance, which is paid in total by the Senior Services Plus. To be eligible for workers' compensation benefits, an employee has to incur an accidental injury in the course of and arising out of employment. It is designed to:

(1) Pay medical expenses for an on-the-job injury or illness and (2) Pay a portion of the employee's lost wages. If you are injured on the job, no matter how slight, you must seek medical attention and immediately report the accident or injury to your supervisor. Further, a report must be prepared in writing and signed by the Administrator within 24 hours after the accident or injury. Reporting on-the-job Accidents: Immediately report any accident or injury suffered on the job to your Supervisor, who will ensure that necessary medical attention is sought and forms are completed. A drug screening through Mercy Occupational Health will be required. SENIOR SERVICES PLUS: 608/373-3390 OR 608/757-5940 press 7 (DURING OFFICE HOURS) AFTER HOURS: 608/774-0022 RN D. Wage Garnishment

The garnishment of an employee's wages by a creditor is a serious matter. Therefore employees should make satisfactory arrangements with creditors so that your wages will not be attached. The Senior Services Plus must honor wage garnishments, as they represent a court order to withhold a portion of your pay.

VII. Voluntary Benefits

Holidays The following legal holidays are observed by the Senior Services Plus: (If you are scheduled to work on a holiday and your client cannot go without services, you will be paid at a higher rate per hour (requires pre-authorization). This extra pay does not apply to live-ins and family members, as we can assume you will be spending the holiday and/or weekends together.

 New Year's Day - January 1  Easter  Memorial Day - Last Monday In May  Independence Day - July 4  Labor Day - First Monday In September  Thanksgiving Day - Fourth Thursday In November  Christmas Day - December 25

VIII. Compensation A. Pay Procedures Paychecks will be distributed on semi-monthly basis. See the annual pay dates handout; located in Senior Services office by door.

Any discrepancies or questions about your pay should be raised immediately and answered to your satisfaction on the day you are paid. Please bring any such error to the immediate attention of the Administrator for correction. You can pick up your checks on payday after 4 pm. If you wish another person to pick up your check, please provide that in writing.

Deductions are made only for taxes required by law (see section VI of this manual) or court ordered wage assignment. B. Exempt Home care workers are considered ‘exempt’. ‘Exempt' -- meaning, among other things, you are exempt from overtime pay requirements of the Fair Labor Standards Act. C. Time Sheets All employees are responsible for completing and submitting time sheets; if you are unaware of the procedures for doing so please see the Office Manger. See the following section entitled ‘Timesheet Instructions’. D. Time Sheet Instructions

Timesheet, P.1: with the checklist, should correspond with the PCW Care Plan duty list (assignment sheet). This form will be in the client’s folder usually located on the refrigerator. On left side “comments”: What you need to write in this narrative is an explanation as to why a care on the Plan of Care (on the line of that task) was not able to be performed, refusals of care by the client. Call the RN Supervisor with any changes in your client’s health (mental or physical), increased pain, and document this, use the back of your timesheet if you need more space. Also if there is a hospital admission or discharge - write day, time, reason.

Fill in your dates of service – needs to correspond to your schedule with the client, include arrival and departure times.

Finally sign the top of this timesheet, write your title (PCW or CNA) and date. After you have completed your timesheet, have your client sign and date at the bottom of the front page. FURTHER EXPLANATION:  Be familiar with your ‘Worker Plan of Care’ (POC) this is your assignment sheet; please consult with this plan every visit because it may have been updated.  If bathing is required every M-W-F on the POC then your timesheet should have this assignment completed and filled in accordingly to reflect that you are following the plan and providing the care(s) authorized by the State.  Write down the date which corresponds to the weekday on your timesheet and include your arrival and departure times (should correspond to client schedule). Write down the total hours in ¼ hour (15 minute) increments.  If you are not a live-in caregiver include your travel time on the front of the timesheet. Circle if you left from C (client’s) of H (your home) or O (other).  If assistance with toileting is required you may put an (x) each time you assist with this duty per day.  Provide any additional information on the back of your timesheet.  On the notation side of timesheet: report how you find your client, how you leave your client, note any refusals of care on the task line and the client’s reason, reason for any deviation from POC, reason for any increase or

decrease in hours from the POC, hospital admissions any remarkable comments. Use the back if you need more space.  Authenticate your timesheet: sign your timesheet legibly (on top), write your title and date it.

E. Performance Appraisal

Your pay increase (subject to favorable economic business conditions) is based upon your skills, experience, education and value to the Senior Services Plus. Your supervisor's appraisal of your job performance provides a systematic way for you to measure your development and to know how well you are meeting the requirements of the job.

Each employee will be considered on an individual basis.

The agency’s financial ability to fund an increase.

Your compensation as well as that of other employees is private and personal matters between the employee and the Senior Services Plus’s management. To discuss these matters with anyone else is against the Senior Services Plus’s policy. F. Rehire

An employee rehired after a break in service shall in every respect be treated as a new employee. G. Inclement Weather

In the event of inclement weather such as heavy snow, tornado, etc., employee early departure or absence from work will be without pay. In the event the office closes due to severe weather we will reimburse the workers, assigned to clients who cannot be left alone at a higher rate of pay. See also Section titled “Disaster Preparedness”. IX. Corrective Action: Dismissal

When performance issues are identified with respect to an employee, when instances of unacceptable conduct occur, or when for any reason the employment relationship has become problematic from the point of view of the Senior Services Plus, any of a variety of steps might be taken, up to and including termination of the employee. In some cases, the employee might be given an oral or written warning. In other cases, immediate probation, suspension (with or without pay), demotion, termination or other corrective action might take place. The Senior Services Plus reserves the right to determine what it believes is an appropriate response to inappropriate conduct, and will implement it.

Examples of unsatisfactory job performance include, but are not limited to: Repeated tardiness, excessive absenteeism, repeated unexcused absences Failure to perform work in a manner satisfactory to supervision Discourtesy or lack of cooperation Failure to follow Senior Services Plus’s policies, procedures or a supervisor's instructions Disclosure of confidential information, see HIPAA P.18. Misconduct, which is subject to disciplinary action, including immediate termination, includes the following: Theft or misuse of Senior Services Plus or client property Falsification of records including employment application or resume

Sale, possession or use of illegal drugs while at work; engaging in illegal activities while at work Intoxication while at work Conviction of a crime which indicates unfitness for the job Physically fighting with another employee Possessing/displaying a firearm while at work

X. Separation from Employment

As stated in Chapter Five, section B-2 of this manual, all employees of the Senior Services Plus are employed "at will," meaning that they or the employer may terminate the employment relationship at any time, with or without cause. The following policies apply to those who are separating from the Senior Services Plus’s employment. A. Notice

Employees are asked to give at least two weeks notice of resignation. B. Layoffs

Layoffs will probably occur when your client is transferred into a nursing home, moves or dies. We will try to reassign you but this is not always immediately possible, in which case, you will be considered laid off.

In the event of termination of employment (voluntary or involuntary), no references good or bad will be given by the Senior Services Plus. The Senior Services Plus will verify the position, compensation and dates of employment only. While an employee may request a reference from any supervisor, no supervisor is authorized to give references from the Senior Services Plus. Any reference, which may be given by a supervisor, represents solely the personal view of that supervisor and the Senior Services Plus disclaims any responsibility for the reference.

XI. Employee Conduct and Responsibilities A. Conduct

The job performance and personal conduct of each employee reflects directly upon the image and reputation of the Senior Services Plus. It is expected that each employee will conform to the established Senior Services Plus policies and that dealings with clients and fellow employees will at all times reflect honesty and the highest ethical standards. Employees will observe the following guidelines to maintain the ethical standards of the Senior Services Plus:

 Promote client satisfaction for the Senior Services Plus.

 Employees must not accept from, or give to: clients gifts; or accept bequests, commissions or fees of any nature from clients; or borrow, from clients.

 Integrity is a must for continued employment. Theft, embezzlement, misappropriation of funds, false entries in any report or statement with intent to defraud, and falsification of expense accounts is cause for immediate dismissal and possible referral of the matter to the appropriate enforcement personnel.

 It is the responsibility of each employee to report to management any knowledge that a crime has been or will be committed. Not reporting is cause for immediate dismissal.

 Strict compliance with laws and regulations is necessary. Noncompliance could result in adversity both for the employee and the Senior Services Plus.

 A client's confidential information must not be divulged to third parties except with proper authority from the client.

 If my assignment requires me to transport my client in my vehicle I will present to Senior Services Plus Health Care, Inc. a copy of my current driver’s license and current auto insurance prior to this transport.

 Fill out your timesheets (front and back) at the end of each visit, following the Plan of Care, which is usually located in the client’s file on their refrigerator.

 Turn your timesheets in at least one day before the scheduled pay date (see annual pay dates schedule). B. Gift Policy and Procedure

Policy Senior Services Plus Health Care, Inc. staff will transact business with clients free from offers or solicitation of gifts and favors in exchange for influence or assistance. It is Senior Services Plus Health Care’s intent that this policy be construed broadly to avoid even the appearance of improper activity.

Procedure Senior Services Plus Health Care staff is prohibited from soliciting tips, personal gratuities, or gifts from clients. Senior Services Plus Health Care staff is also prohibited from accepting money from clients. If a client or another individual wishes to present Senior Services Plus Health Care with a monetary gift, he or she should be referred to the Senior Services Plus Health Care Administrator.

1. Senior Services Plus Health Care staff will not accept gifts, favors, services, entertainment, or other things of value to the extent that decision-making or actions affecting Senior Services Plus Health Care might be influenced. Therefore, Senior Services Plus Health Care staff may only accept gifts of a nominal value from clients.

2. If a client has any doubt or concern about whether a specific gift should be accepted, the client should contact the Administrator of Senior Services Plus Health Care, Inc. C. Personal Appearance/Dress Code

Each employee maintaining a professional image is vital to the success of the Senior Services Plus in our transactions with clients and the public. Employees must attire themselves in a neat, clean, and professional manner. D. Personnel Records

Accurate personnel records are required for the benefit of both the employee and the Organization. It is the employee's responsibility to keep the Senior Services Plus informed of your current address, telephone number, change in name, number of dependents and individuals to notify in case of an emergency. The Senior Services Plus will rely on the employee's address for communications by mail, the telephone number in case of an emergency, and marital status changes for income tax withholdings. E. Children and Visitors

If a child is brought to the Senior Services Plus, the employee must hold the Senior Services Plus harmless in the event of a child's injury or accident while on the premises. Likewise, friends and family members visiting you at your assignment during working hours are not allowed. F. Employee Grievances

Each employee who has a grievance on any matter has the right to meet with his/her supervisor to discuss the grievance.

If the grievance is not resolved with the supervisor, the employee's grievance and the supervisor's response shall be written and should be submitted to the Administrator. The Administrator, in consultation with the Senior Services Plus Personnel Committee Board Chair shall make the final decision in the grievance procedure. The entire process will not exceed two weeks from the time the employee notifies his/her supervisor of the grievance.

If the grievance is not resolved with the Administrator, or if the grievance is with the Administrator, the employee may appeal to the appropriate committee of the Senior Services Plus Board of Directors. G. Smoking in the Workplace

Because of our belief that smoking is hazardous to people's health, the Senior Services Plus office has established a smoke free policy for all inside and enclosed areas. Smoking will not be permitted in the offices of the Senior Services Plus or in the homes of our clients. As a condition of employment, we expect each individual to abide by this policy. Violation of this policy may result in termination of employment. Smoking is permitted outside and smokers are required to dispose of their smoking devices appropriately.

The use of chewable tobacco products are also prohibited as they can create safety hazards. Smoking and/or chewable tobacco products in the presence of a client or fellow employee may be offensive. The rights of others must be considered at all times. H. Drinking and Drugs

Congress has recognized the problem of drug abuse by enacting the Drug-Free Workplace Act of 1988. In compliance with the Act, illegal drugs or alcoholic beverages are not permitted on the Senior Services Plus’s premises. For your own safety, you are prohibited from working under the influence of alcohol or drugs. Impaired conduct endangers yourself, your co-workers, and our clients, and it damages the reputation of the Senior Services Plus. Employees using prescription drugs as prescribed by a physician must immediately report the usage to your manager. Management may require an employee to submit to a drug or alcohol test, where there is probable suspicion of drug or alcohol use, or in the event of an accident while on Senior Services Plus’s premises.

As a condition of employment, all applicants who are offered a position with the Senior Services Plus may be required to submit to a physical examination which will include a screen for the use of drugs or alcohol by a State or Federal Government certified laboratory. Additionally, in the event Management has probable cause to believe that an employee is under the influence of alcohol or a controlled substance, it may demand the employee submit to a test to determine the presence of any of the aforesaid substances. Those individuals whose screen produces a positive result for the use of alcohol, illegal drug or a controlled dangerous substance may be ineligible for employment or continued employment.

In the case of a positive result for the use of alcohol or any controlled dangerous substance, Management shall provide each person who submitted to the test: (1) a copy of the laboratory test indicating the test results; (2) a copy of this policy; (3) if applicable, written notice of Management's intent to take disciplinary action, terminate employment, or change the conditions of continued

employment; (4) provide a written notice concerning the person's right to request an independent test at the person's own cost. The Senior Services Plus will assist employees seeking treatment. Employees who seek referrals to local rehabilitation and counseling programs should contact the Administrator.

Employees who report to work under the influence of alcohol or drugs will not be permitted to work. Consuming, selling, transferring, distributing alcohol or illegal drugs on or off the job or any violation of the above Senior Services Plus policy can result in immediate dismissal. I. Theft

Unauthorized possession or use of any Senior Services Plus property or our client’s property constitutes grounds for immediate dismissal and the filing of criminal charges. We will call the police to investigate.

XII. Client Rights

To maintain compliance with the State of Wisconsin - Department of Health Services – Personal Care Providers – DHS 105.17(1w)(b)3. “A statement of client’s rights which shall include all of the following:” a. To be fully informed of these rights and all of the provider’s rules governing client responsibilities. b. To be fully informed of services available from the provider. c. To be informed of all changes in services and charges as they occur. d. To participate in the planning of services, including referral to a health care institution or other provider and to refuse to participate in experimental research. dm. To have access to information about the client’s health condition to the extent required by law. e. To refuse service and to be informed of the consequences of that refusal. f. To confidential treatment of personal and medical records and to approve or refuse their release to any individual outside the provider, except in the case of transfer to another provider or to a health facility, or as otherwise permitted by law. g. To be treated with consideration, respect and full recognition of dignity and individuality, including privacy in treatment and in care for personal needs. h. To be taught the service required so that the client can, to the extent possible, help himself or herself. i. To have a person designated by the client taught the service required, so that, to the extent possible, the person designated can understand and help the client. j. To have one’s property treated with respect. k. To complain about the care that was provided or not provided, and to seek resolution of the complaint without fear of recrimination.

L. To have the client’s legal representative exercise the client’s rights when the legal representative is legally authorized to do so.

XIII. Worker Rights AS A PERSON ON THIS JOB I HAVE THE RIGHT TO:

- Be myself. - Refuse unreasonable requests without feeling selfish. - Have the supplies and equipment I need to provide services; and to call the agency if I do not have what I need - Be competent and be proud of my accomplishments. - Be treated as a capable adult. - Change my mind. - Say, “I don’t know.” - Say, “I don’t agree” - Say, “I don’t understand.” - Ask for clarification so I can to a good job. - To make amends. - The opportunity for improvement. - The right to know when I am not meeting your needs or standards - Have my opinions given respect. - Have my needs be as important as the needs of others. - Express my professional needs to my Supervisor. - Judge my own behavior, thoughts, and emotions and be responsible for their initiation and the consequences upon myself. - Judge if I am responsible for finding solutions to other people’s problems. - Grow, learn and change and to value my age and experience. - Follow a Plan of Care and a work schedule. - Inquire if the client has anything extra to do before the shift ends.

Complete my timesheet before the end of the shift - Call the office and request assistance if I am continually staying over my shift. - Contact my Supervisor if my work situation has become unmanageable. - Right to request a re-assignment.

XIV. Senior Services Plus Disaster Preparedness Procedure The Supervising RN shall oversee the implementation of the following procedures:

A. Fire 1. You must identify all exits and be aware at all times of available exit routes at each site. In multiple dwelling residences identify exits, evacuation routes and building procedures. 2. In case of fire leave through the nearest exit with your client IMMEDIATELY. Move a safe distance from the building until assistance comes. 3. At the first opportunity contact 911 to report the fire. 4. If you are in an apartment, exit through the nearest exit and follow the building’s fire evacuation procedures as posted and practiced. 5. Insure that your client has all assistive equipment to facilitate the evacuation. 6. Contact the office to report the Fire and client status. The office shall notify the family and give you further instruction. B. Flood (Flash) If a flood is likely to occur at your worksite you should: 1. Call 911 to report the danger and ask for instructions. 2. Listen to the radio or television for information 3. Be aware that flash flooding can occur any time. 4. The cities of Janesville, Beloit and Rock County will evacuate you and your client from the home if there is a risk to public health or safety. Affected residents shall be contacted by Area Emergency Services and given directions for evacuation. 5. If the home starts flooding, move yourself and your client to higher ground. Insure that all assistive devices and medications accompany your client. 6. Be advised that 6 inches of water will reach the bottom of most passenger vehicles causing loss of control and possible stalling. A foot of water will float most vehicles. 7. Do not walk through moving water. 8. Upon arrival at a secure site, contact client’s family to inform them of your client’s situation. POLICE, FIRE, MEDICAL, DISASTER 911, BELOIT FLOOD HOTLINE 361-6418, JANESVILLE FLOOD HOTLINE 373-6000

SENIOR SERVICES PLUS: 608/373-3390 OR 608/757-5940 PRESS 7 (DURING OFFICE HOURS) 608/774-0022 (RN AFTER HOURS) C. Tornado (Severe Weather) 1. During severe weather listen to the radio or television for information. 2. If you are under a tornado warning, take yourself and your client to shelter immediately.

3. Go to a pre-designated shelter area such as a safe room, basement storm cellar on the lowest building level. If there is no basement, go to center of an interior room on the lowest level (closet, interior hallway) away from corners, windows, doors and outside walls. Put as many walls as possible between you and the outside. Get under a sturdy table and use your arms to protect the head and neck of you and your client. Do not open windows. 4. Be aware of and follow all posted Severe Weather procedures if the site is in a multiple dwelling building. 5. Emergency Response Teams will be on site to assist you and your client with any damage or physical injury after the all clear is determined. D. Toxic Spill Evacuation When an evacuation is ordered, LEAVE IMMEDIATELY. Call 911 or tune to the radio or television for information on evacuation routes, temporary shelters and procedures. Follow the routes with your client, recommended by the authorities-short cuts may not be safe. Leave at once. Take all client assistive equipment and medications. Contact all significant persons after you are both in a place of safety. E. Stay-in-Place Order Bring pets inside. Close and lock all exterior doors and windows. Close vents, fireplace dampers, and as many interior doors as possible. Turn off air-conditioners and ventilation systems. In large buildings, set ventilation systems to 100% recirculation so that no outside air is drawn into the building. If this is not possible, ventilation systems should be shut off.

Go into a pre-selected room; it should be above ground and have the fewest openings to the outside. Seal gaps by doors, windows, AC units and exhaust fans with wet towels, plastic sheeting and duct tape. Call 911 or listen to the radio or TV for further information and instructions. XV. Senior Services Plus Universal Precaution If you find any traces of blood from your client, you need to exercise precaution to prevent the spread of blood borne pathogens as follows:

First and foremost wash your hands thoroughly with soap and water before and after providing care. Put on disposable gloves when providing personal cares, laundering bed linens, nightclothes, underclothing and towels. Wash these items with soap, water and bleach. This agency has a supply of gloves (small, medium, large and x-large). DO NOT HANDLE your client’s needles, sharps or lancets. Your client will handle their own needle & sharps use and disposal. You may only hand your client their red sharps container for disposal. When cleaning up blood use gloves and bleach or antimicrobial wipes, dispose of wipes and gloves in trash receptacle. If you have no wipes use paper towels and a bleach formula of 1 part bleach to 10 parts water. If the spill is mixed with any sharp objects, such as glass or needles do not pick these up; instead use cardboard or thick paper. Next, disinfect by putting the bleach wipes on the area for 20 minutes, clean up, and dispose of wipes and gloves. Call your supervisor if in doubt of proper disposal.

If you suspect you have been exposed to an infectious disease, contact your supervisor @ 373-3390, ask for and fill out the exposure reporting form, and see your personal physician immediately.

RECOMMENDED PROTECTIVE EQUIPMENT AGAINST HIV AND HBV TRANSMISSION:

TASK OR DISPOSABLE GOWN MASK PROTECTIVE ACTIVITY GLOVES EYEWEAR

Bleeding control Yes Yes Yes Yes with spurting blood Bleeding control Yes No No No with minimal bleeding Oral/nasal Yes No No, unless No, unless suctioning splashing is splashing is likely manually clearing likely airway Handling and Yes No, unless soiling is No No cleaning likely contaminated equipment and clothing Exposure Reporting Form Date ___/___/_____ Name:______While at (Client’s) ______home, I performed the following task(s):______And the following exposure occurred:______Check all that apply: (if unable to perform call your supervisor immediately) ___containment of blood or other potentially infectious material: (describe)______disinfect affected area ___dispose of biohazard material properly (call supervisor) ___wash the affected area ___sought medical attention with______on ___/___/______post exposure vaccination with ______on ___/___/______contacted Supervisor ___test of material to see if infected on ___/___/______infected? Yes no ___follow-up with worker on ___/___/______Signed by worker:______title:______date: ______

Supervisor:______title:______date:______

XVI. Job Descriptions Personal Care Worker Job Description Policy 1. "personal care services are medically oriented activities related to assisting a recipient with activities of daily living necessary to maintain the recipient in his or her place of residence in the community. These services shall be provided upon

written orders of a physician by a provider certified under s. DHS 105.17 and by a personal care worker employed by the provider or under contract to the provider who is supervised by a registered nurse according to a written plan of care. The personal care worker shall be assigned by the supervising registered nurse to specific recipients to do specific tasks for those recipients for whom the personal care worker has been trained. The personal care worker’s training for these specific tasks shall be assured by the supervising registered nurse. The personal care worker is limited to performing only those tasks and services as assigned for each recipient and for which he or she has been specifically trained”. Department of Health Services DHS107.112 Personal care services.

Reports To: Senior Services Plus Health Care, Inc. Registered Nurse

Job Requirements 1. Be a person who has not been convicted of a crime which directly relates to the occupation of providing personal care or other health care services. 2. Complete a Personal Care Worker training course which consists of a minimum of 40 classroom hours, at least 25 of which are devoted to personal and restorative care, or 6 months of equivalent experience. Training shall emphasize techniques for and aspects of caring for the population served by the provider. 5. Follow the ‘Plan of Care’ (plan of treatment) located in client’s home (usually on the refrigerator) and complete your timesheet in correlation with this ‘Plan of Care’. 6. Turn in timesheets according to due dates on annual pay schedules. 7. Review the “Ethics, Confidentiality and Client Rights Policy and Procedure” and sign the ‘Signature Page’ of the PCW Employee Handbook. 8. Have good verbal and written communication skills.

Job Duties 1. Follow a written Plan of Care regarding a client as directed by a Senior Services Plus Health Care, Inc. registered nurse. 2. The Plan of Care, instructions, and demonstrations (as appropriate) will be reviewed by a Senior Services Plus Health Care, Inc. registered nurse with the Personal Care Worker. 3. The Personal Care Worker will care for clients in the home. 4. The Personal Care Worker will observe and report any changes in a client’s health and/or illness condition to the Senior Services Plus Health Care, Inc. registered nurse. 5. The Personal Care Worker will recognize a life threatening emergency and call the emergency medical service (911) prior to informing a Senior Services Plus Health Care, Inc. registered nurse.

6. The Personal Care Worker will report in writing to the registered nurse on each assignment. 7. The Personal Care Worker will discuss any questions, concerns and clients’ progress with the registered nurse. 8. Perform the following skills which may include: a. assistance with bathing; b. assistance with getting in and out of bed; c. teeth, mouth, denture and hair care; d. assistance with mobility and ambulation including use of walker, cane or crutches; e. changing the recipient’s bed and laundering the bed linens and the recipient’s personal clothing; f. skin care excluding wound care; g. care of eyeglasses and hearing aids; h. assistance with dressing and undressing, i. toileting, including use and care of bedpan, urinal, commode or toilet; j. light cleaning in essential areas of the home used during personal care service activities; k. meal preparation, food purchasing and meal serving; l. simple transfers including bed to chair or wheelchair and reverse; and, m. accompanying the recipient to obtain medical diagnosis and treatment. 9. Satisfactory supervisory review by a registered nurse at least every 60 days.

Clinical Director (RN) Job Description: Reporting Responsibility The Clinical Director reports to the Administrator of Senior Services Plus Health Care, Inc.

Policy To maintain compliance with Department of Health Services – Personal Care Providers DHS 105.17 (1n) PERSONNEL MANAGEMENT (d) 1 states “supervise the provision of personal care services. …services for all clients shall be supervised by a registered nurse… Job Requirements 1. Current licensure as a registered nurse under s.441.06, Stats. 2. Training and experience in the provision of personal care services or in a related program. 3. Excellent communication skills across diverse populations. 4. At least one year of supervisory or administrative experience in personal care services or in a related program. 5. Screened for tuberculosis infection and found free from TB before client contact. Job Duties 1. Evaluate the need for service and make referrals to other services as appropriate. 2. Secure written orders from the client’s physician. These orders are to be renewed once every 3 months unless the physician specifies that orders covering a period of time up to one year are appropriate, or when the client’s need change, whoever occurs first. Physician orders for personal care service are not required for clients who are not Medicaid recipients unless the personal care service is a delegated medical act as defined in s. N 6.02 (4). This provision does not mitigate the RN supervisor’s responsibility to follow the standards contained in ch. N 6. 3. The Develop a plan of care for the client, giving full consideration to the client’s preferences for service arrangements and choice of personal care workers, interpret the plan to the personal care worker, include a copy of the plan in the client’s health record, and review the plan at least every 60 days and update it as necessary. 3m. Promptly notify a client’s physician or other appropriate medical personnel and legal representative, if any, of any significant changes observed or reported in the client’s condition. 4. Develop appropriate time and service reporting mechanisms for personal care workers and instruct the workers on their use.

5. Give the personal care worker written instructions about the services to be performed and arrange for an appropriate person to demonstrate to the personal care worker how to perform the services. 6. Evaluate the competency of the personal care worker to perform the service

XVII. Conclusion

The greatest asset Senior Services Plus will ever have is a satisfied client. We believe that the client is an integral partner in the decision making process. If we are to receive "high grades" on the customer's "report card," each of us must appreciate the fact that satisfying the client is our number one priority. It sits at the very core of Senior Services Plus’s ability to thrive and prosper.

A significant factor in delivering client satisfaction evolves around the quality of the service we offer. In our organization, service is our "product." It is a product that each of us must deliver day-in and day-out. It is part of everyone's job to deliver a quality service product, whether it is face-to-face or behind the scenes.

The quality of the service we offer cannot be separated from the quality of the provider. This means that each of us individually holds the key to the Senior Services Plus reaching the pinnacle of client satisfaction. If we try our very best to provide better service today than we did yesterday, we will have made great strides in ensuring a future for Senior Services Plus and for ourselves.

The Senior Services Plus spends time and dollars each year to attract new grants and clients. Each of us must play our part to keep them coming back. We must be driven by a desire to make quality service our top goal. We must never lose sight of the fact that the impression we leave on our clients is an advertisement, good or bad. Every time we provide a service to the client we either improve the client's perception of the Senior Services Plus or diminish it.

As we proceed each day to provide quality service for our clients, it will serve each of us well to keep in mind these words: Client satisfaction is an all-of-the-time thing, not a some-of-the-time thing. It is something we do with a client, not something we do for a client. It is based on meeting the needs and wants of clients as they see them, not as we see them. It is treating each individual client as if that individual were our only client.

This Handbook has been prepared with the intent of anticipating many questions which the employee may have wanted answers. If, after reading this Handbook, you have unanswered questions, you are encouraged to discuss them with your supervisor. The supervisor will answer the question or get the answer for you.

The Senior Services Plus has the right, to make and enforce new rules and to enforce, change, abolish or modify existing rules, Senior Services Plus policies and procedures applicable to employees as it may deem necessary or advisable.

Thank you for taking time to read and study this Handbook. Should you have any questions or suggestions, please let us hear from you. XVIII. ADDRESS and TELEPHONE #s LOCATION: Senior Services Plus Health Care, Inc. 120 N. Crosby Avenue Suite #6 Janesville, WI 54548

MAILING ADDRESS: Senior Services Plus Health Care, Inc. P.O. Box 1676 Janesville, WI 53547-1676 FAX: 608/757-5948

PHONE #S: during office hours: 608/373-3390 or 608/757-5940 press 7

After office hours: (please use your discretion and call if you cannot wait until office opens)

(8a-5p) 608/774-0022 RN 608/774-5940 scheduling problems 911 Call for emergency

Page 21 SENIOR SERVICES PLUS HEALTH, CARE, INC. 120 North Crosby Avenue, P. O. Box 1676, Janesville, WI 53547-1676 608/373-3390

NOTICE TO:______

Re: PCW Competency Testing and Client Falls

Date:______

I have given true statements regarding my personal care skills and agree that I am competent and comfortable in providing those skills that I checked in the self-evaluation form. I understand that I will contact my Supervisor for any tasks on the Plan of Care that I do not feel qualified to provide and receive instruction and training. Office Hours: M-F 8a-noon and 1p-5p 608/373-3390 After hours: 608/774-0022

I also understand that I will not pick up a client that has fallen; but I will try to talk a client through the process of getting up themselves. (see ‘How to get up from a Fall’ next page).

It is my responsibility not to compromise my health, therefore, I will protect myself in these situations (refer website section titled ‘For Your Back’).

How to Assist a Falling Client: o Widen your stance o Bring client’s body close to you o Bend knees and support client o Lower client to floor o Drop to floor yourself, if necessary o DO NOT TRY TO STOP THE FALL o Call for help (for non-emergency: wait for family 10 minutes before calling 911) o When you call 911 inform them it is a ‘lift assist’ for a fall. o DO NOT GET CLIENT UP (refer to ‘How to get up from a Fall’) o Follow agency policies and procedures

See Signature Page

Page 23 NOTICE TO: EMPLOYEES

Re: TRAVEL TIME REIMBURSEMENT

You that you must check one of the following:

I drive and have provided documentation of current auto insurance. and current driver’s license I take the bus I walk Someone with auto insurance drives me Other: Explain

Furthermore, if there are any changes: in my transportation means (as listed above), auto insurance and/or driving status it is my responsibility to contact the office and/or provide documentation.

XIX. Signature Page 10.31-2013

I certify that I have received a copy of the Senior Services Plus’s Employee Handbook and Employee Orientation packet and agree to comply with the standards it establishes. It is understood that this Manual contains the operating procedures for the Senior Services Plus and it is not intended to be nor constitutes an agreement for employment. I understand that the operating procedures contained in this Handbook can be changed at the sole discretion of the Senior Services Plus without prior notification.

Please sign below to indicate you have been given the following information:

 organization chart, mission statement, agency objectives (employee handbook)

 Senior Services Plus Health Care, Inc. policies and procedures (employee handbook)

 specific job duties (job descriptions in employee handbook)

 functions of health personnel (see job descriptions in employee handbook)

 information about handling emergencies, disaster preparedness and medical services and other community services (Rock County) – in employee handbook

 information and reporting forms for infectious disease control and exposure control reporting form -- handbook

 Senior Directory (orientation packet)

 ethics, confidentiality of client information and patient’s rights (employee handbook and orientation packet)

 compliance with HIPAA (health Insurance Portability and Accountability Act of 1996) see following P. 18

 I will not STOP THE CLIENT’S FALL, see ‘PCW Competency Testing and Client Falls’ and ‘how to get from a fall’ (p. 19 and 20). If you require further explanation, talk to your RN Supervisor.

 Travel Time Reimbursement form P. 21

I give Senior Services Plus Health Care, Inc. permission to access and share any and all of my employment history and records from and/to Senior Services of Rock Co., Inc.

My signature indicates I have been given the information (listed above): read it, understand it and will practice this in conjunction with client assignments and any agency business:

Employee: ______Title:______Date:______

Supervisor:______Title:______Date:______

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