California Welfare And Institutions Code Section 4686

(a) Notwithstanding any other provision of law, an in-home respite worker may perform gastrostomy care and feeding of clients of regional centers, after successful completion of training as provided in this section. (b) In order to be eligible to receive training for purposes of this section, an in-home respite worker shall submit to the trainer proof of successful completion of a first aid course and successful completion of a cardiopulmonary resuscitation course within the preceding year. (c) The training in gastrostomy care and feeding required under this section shall be provided by physicians or registered nurses through a gastroenterology or surgical center in an acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, which meets California Children Services` Program standards for centers for children with congenital gastrointestinal disorders, or comparable standards for adults, or by a physician or registered nurse who has been certified to provide training by the center. (d) The gastroenterology or surgical center providing the training shall develop a training protocol which shall be submitted for approval to the State Department of Developmental Services. The department shall approve those protocols which specifically address all of the following: (1) Care of the gastrostomy site. (2) Performance of gastrostomy tube feeding. (3) Identification of, and appropriate response to, problems and complications associated with gastrostomy care and feeding. (4) Continuing education requirements. (e) Training by the gastroenterology or surgical center, or the certified physician or registered nurse, shall be done in accordance with the approved training protocol. Training of in-home respite workers shall be specific to the individual needs of the developmentally disabled regional center client receiving the gastrostomy feeding and shall be in accordance with orders from the client`s treating physician or surgeon. (f) The primary care physician shall give assurances to the regional center that the patient`s condition is stable prior to the regional center`s purchasing in-home gastrostomy care for the client through an appropriately trained respite worker. (g) Prior to the purchase of in-home gastrostomy care through a trained respite worker, the regional center shall do all of the following: (1) Ensure that a nursing assessment of the client, performed by a registered nurse, is conducted to determine whether an in-home respite worker, licensed vocational nurse, or registered nurse may perform the services. (2) Ensure that a nursing assessment of the home has been conducted to determine whether gastrostomy care and feeding can appropriately be provided in that setting. (h) The agency providing in-home respite services shall do all of the following: (1) Ensure adequate training of the in-home respite worker. (2) Ensure that telephone backup and emergency consultation by a registered nurse or physician is available. (3) Develop a plan for care of the gastrostomy site and for gastrostomy tube feeding to be carried out by the respite worker. (4) Ensure that the in-home respite worker and the gastrostomy services provided by the respite worker are adequately supervised by a registered nurse. (i) For purposes of this section, in-home respite worker means an individual employed by an agency which is vendored by a regional center to provide in-home respite services. These agencies include, but are not limited to, in-home respite services agencies, home health agencies, or other agencies providing these services.