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Adult Brain Injury Program Provider Manual

Direct Care Worker Competency List

General Skill Area 1	General Overview
Primary Skill A	Identify major legislative trends affecting service delivery for persons with disabilities.
Defining Elements	Describe the major federal legislation that has affected people with disabilities. [IDEA (Individuals with Disabilities Education Act), TBI Act, the Rehabilitation Act, ADA] Describe the significance of the U.S. Supreme Court Olmstead Decision. Recount history of Missouri legislation regarding TBI and service delivery.
Primary Skill B	Identify the key characteristics of TBI.
Defining Elements	Define traumatic brain injury according to Missouri state statute. Identify the major characteristics of TBI. State the causes of TBI. Distinguish between TBI and other acquired brain injury. Distinguish between the characteristics of the two types of TBI. Identify typical physical effects of TBI. Identify typical cognitive effects of TBI. Identify typical psychological/behavioral effects of TBI. Distinguish between the characteristics of TBI and MRDD.
Primary Skill C	Identify the key components of service delivery
Defining Elements	Describe the array of care for persons with TBI. Differentiate between habilitation and rehabilitation. Describe the roles of family and natural supports in community reintegration.

General Skill Area 2	Working with the Consumer in His/Her Environment
Primary Skill A	Establish a positive, professional relationship with the consumer.
Defining Elements	Use language that emphasizes the individual first and the disability second. Establish effective communication strategies. Determine culturally sensitive issues. Devise a plan to learn about the consumer. Establish the appropriate professional relationship/boundaries with the consumer (i.e., not too formal and not too personal). Convey to the consumer the level of confidentiality that the relationship provides. Convey to the consumer the importance of his/her participation in decision-making.
Primary Skill B	Identify the consumer's internal and external supports.
Defining Elements	Identify the personal resources that will affect community integration. Determine the relationships between the consumer and his or her family members. Determine the relationships between the consumer and friends, co-workers, significant others. Identify resources within the community currently used or available to the consumer. Identify the consumer’s (or the consumer’s family’s) goals.
Primary Skill C	Determine the unique physical, emotional, and cognitive abilities of the consumer.
Defining Elements	Identify any medical health concerns and prescribed treatments. Identify the consumer’s capacity for mobility in home and community and related assistive devices. Identify the consumer’s memory, judgment, organizational skills, emotionally sensitive areas, and tolerance for stress. Identify cognitive and communication compensatory strategies.

General Skill Area 3	Professional Role and Job Skills of the Direct Care Worker
Primary Skill A	Participate as a member of a person-centered planning team.
Defining Elements	Carry out the goals and activities identified by the person-centered planning team. Plan activities that support identified goals within the consumer’s (or his/her family’s) parameters (budget for community activities, preferred choices for shopping, etc.). Communicate information either in person or in writing to assist the team in decision-making (i.e., progress in achieving activities of daily living, behavior). Identify and communicate consumer’s priorities to the person-centered planning team.
Primary Skill B	Promote self-sufficiency of the consumer in everyday life.
Defining Elements	Assist the consumer in focusing on an independent lifestyle. Break tasks into small, manageable steps. Identify teachable moments to promote independence. Develop strategies to promote independence in problem-solving everyday situations.
Primary Skill C	Recognize opportunities for the use of compensatory strategies.
Defining Elements	Make objective observations of the consumer’s behavior. Anticipate and avoid counterproductive behaviors. Identify various types of cueing (verbal, written, assistive devices, etc.). Apply compensatory strategies to everyday activities.
Primary Skill D	Employ effective communication skills.
Defining Elements	Use clear and concise language. Ask consumer to paraphrase to facilitate understanding. Use verbal and behavioral de-escalations. Use negotiation skills. Employ active listening skills.
Primary Skill E	Establish and maintain appropriate boundaries of the relationship between the direct care worker and the consumer.
Defining Elements	Maintain confidentiality of the consumer. Demonstrate personal respect for the consumer.

General Skill Area 4	Learning About Community Resources
Primary Skill A	Identify general community resources and their purposes.
Defining Elements	Categorize resources as social, recreational, and crisis intervention resources. Build a resource file of appropriate community resources. Determine the availability of 911.
Primary Skill B	List community service agencies/personnel that the direct care worker may encounter (state and local agencies, ABI Service Coordinators, support groups, etc.).
Primary Skill C	Determine local leisure and social opportunities available for the consumer.

General Skill Area 5	Safety and Welfare of the Consumer
Primary Skill A	Recognize situations that require the care worker to take urgent action.
Defining Elements	Know the signs of seizures and employ proper actions. Observe the consumer's hygiene, changes in grooming habits, and general appearance. Detect potentially dangerous situations (e.g., difficulty swallowing or forgetting to eat) that occur frequently. Watch for unexplained changes in behavior, personality, or health conditions. Recognize unsafe environmental conditions (weapon storage, stairs, bathing equipment, etc.). Recognize signs of abuse or neglect. Recognize signs of consumer vulnerability (i.e., being taken advantage of). Identify dysfunctional activities (possible substance abuse, poor selection of friends, etc.). Recognize suicidal tendencies.
Primary Skill B	Demonstrate proficiency in First Aid, CPR, or other emergency care.
Defining Elements	Complete American Red Cross training or other comparable program (including choking prevention).

General Skill Area 6	Policies of the Direct Care Worker’s Organizational System
Primary Skill A	State the mission and the philosophy of the employing agency.
Defining Elements	Describe the person-centered approach to service delivery.
Primary Skill B	Describe the agency’s organizational structure and policies.
Defining Elements	State the lines of authority for reporting. State the policy for reporting absenteeism. Identify appropriate time to seek help/advice from supervisor. State employer’s documentation/records-management policy. State employer’s policy on performing duties outside job description. Identify agency policy regarding transportation of consumers. Identify agency procedures regarding the rights of individuals served by the agency.
Primary Skill C	Recognize and comply with the agency’s policy on confidentiality.
Defining Elements	State employer’s policy on properly storing confidential documents and other sensitive information. Identify the agency’s policy on release of information and confidentiality. Ensure that information is locked up when not in use. Avoid discussion or identification of consumers to unauthorized individuals.
Primary Skill D	Practice effective liability and risk management.
Defining Elements	Demonstrate body mechanics and safe lifting techniques. Explain risk management procedures. State employer’s policy on transportation/liability. State employer’s policy regarding transportation of consumers.