HOC Update
August 2000 Fall Issue
HEALTH OCCUPATIONS CREDENTIALING
900 SW Jackson, Room 1051-S Topeka, Kansas 66612-1290
(785) 296-0056
KDHE Home - Division of Health - Bureau of Health Facilities - HOC Home
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HOC UpdateAugust 2000 Fall Issue HEALTH OCCUPATIONS CREDENTIALING |
By Betty Domer and Dolores Staab
HOC is required (federal mandate) to visit sponsorship courses before they renew. Staff made site visits in April and coordinated training sessions in these areas. There was a lot that staff learned and hopefully the sponsors and those attending training sessions benefited, too.
Special appreciation goes to staff at Wichita Area Vo-Tech, Hutchinson Community College, and Barton County Community College for providing training rooms. Presentations covered completing forms, processing CMA update courses and fee payments, samples of new wallet certificates, how to seek a "waiver" from the federal ban on NATCEP and the sponsorship program. Even though some interested could not attend, "thanks" go to those who did attend. It is always a pleasure to meet face-to-face those with whom you talk regularly by phone or e-mail.
Additional thanks goes to the instructors of the four courses visited. They were very receptive and accommodating. Some said they were nervous but it seemed well under control! One of the best things about the course visits is that each class was on a different part of the curriculum, so there were observations of a variety of subjects and teaching methods. Instructors had an opportunity to discuss problems or concerns they had with the course, curriculum, or process in general. It is always helpful to hear your concerns and ideas. How else can we improve?
Some items learned from the site visits might be helpful to other instructors when planning/teaching courses. Two of the classes were small and the other two were large. In one of the larger classes there seemed to be personal issues among students. The instructor provided some history on the situation and said there had been changes to improve relationships. Some students in another large class had problems with attendance and attentiveness. The smaller classes seemed more closely-knit and worked well together.
Class size clearly has some influence on successfully teaching the course, something for instructors/coordinators to consider when scheduling courses.
Other items which might serve as helpful tips include:
Need for improvements include:
As always, HOC wants to hear your concerns, questions, or suggestions. There will be more opportunities of "taking our show on the road" in the near future! Contact staff with your comments or if you would like to have a training session in your area, please contact Dolores Staab (as noted above) or Betty Domer at (785) 296-1250 or bdomer@kdheks.gov.
Curriculum guidelines for the nurse aide course for OTAs and PTAs are available from Martha Ryan, (785) 296-0058.
If the state test is not passed on the first attempt by a person successfully completing the bridge course, the person must successfully complete an approved 90-hour nurse aide course to retake the state test.
The CMA curriculum development committee met July 14, 2000 to begin the process of drafting the curriculum. The committee will also review the regulations and practices for certified medication aides and suggest changes. If you have comments about the regulations and/or practices, please submit them to Martha Ryan, 900 S.W. Jackson, Suite 1051S, Topeka, Kansas 66612 or mryan@kdheks.gov. The committee consists of:
In order to accommodate the identified need for additional testing opportunities HOC has initiated a new policy to allow supplemental test sites for the nurse aide and home health aide tests. Special requests for additional test administration must be submitted to HOC for approval. All policies and guidelines established by HOC for testing must be followed. Payments to the proctor, including travel expenses, will be made by a third party in accordance with the HOC fee schedule. HOC will continue to approve and schedule all individuals for the tests. Potential sites will be approved in accordance with current federal regulations. In order to allow sufficient time for proctor training, approval for proctors and test sites must be obtained at least two months prior to the test date. For further information please contact Betty Domer, 785-296-1250.
HOC has convened an advisory group for the purpose of discussing various program issues relating to services HOC regulates or provides. There have been several meetings over the past months considering such topics as: CNA curriculum revisions, CMA curriculum revisions, automated testing for certification, new wallet certificates, criminal background checks, employment verifications, bridge course for physical therapist assistants and occupational therapy assistants.
This is a good forum for instructors and DONs who are working in the trenches to bring problems or concerns to HOC. We need your input to help us improve our services.
Please contact Martha Ryan at (785) 296-0058 if you have suggestions about these meetings (place, time, topic) would like to receive information on dates and times of the meetings, or if you would like to receive materials related to the meetings.
A change has been made to the regulation interpretation concerning Reports of Court Actions Against Certified Aides so that when documentation exists of a conviction of an offense listed in K.S.A. 39-970 and K.S.A. 65-5117, a notation will be made on the individual’s record in the Kansas Nurse Aide Registry. Prior to this change in the regulation interpretation, only substantiated instances of abuse, neglect, or exploitation by certified aides against residents or clients were noted on the registry.
In a bold move, a Roanoke, Virginia nursing home has added a 15-year veteran CNA to its team of three Assistant Directors of Nursing. The administrator notes this action as a " . . . natural continuation of empowerment . . . " of the facility’s team members. The 350+ bed facility provides full services with intermediate, skilled, subacute and Alzheimer’s care. There are 120 CNAs on eight units. This position places a CNA on the level of an LPN or RN, in terms of role in the facility. The position is filled by a woman with continuing hands-on care as well a being a motivator for improving work habits of the CNAs. (Source: Journal of Nurse Assistants, July 2000)
A recent report on a research study of adverse drug events in US nursing homes identified that about 24 events occur per year in facilities of 100 beds. Further, the study cites that more than 50 percent of the errors were preventable. A high percentage (47%) were related to the drug order as it was prescribed by the physician: the wrong dosage, drug-drug interaction, or wrong choice.
Notably, 49 percent were due to other healthcare providers failure to properly monitor residents, by monitoring lab results, for example. The report goes on to say that many mistakes could be prevented by computer programs which detect problems at the time the drug is ordered, or, when a lab value comes back abnormal relative to a particular drug.
Although there are some conditions surrounding the study, such as voluntary participation, review of only reported errors, this information points to the importance of training certified medication aides and keeping their certification up to date. The upcoming review of Kansas CMA regulations will help to define the educational requirements more clearly to promote continued education and competency of CMAs. (Data source: American Journal of Medicine, August 1, 2000 via Reuters Health).
Make sure the forms are filled out completely.
Missing information may delay processing.
Make sure the payment amount is the correct
amount for processing.
Remember that registered or licensed employees are exempt from CBC requirement. Certified individuals are not exempt from the requirement.
The employment verification section at the bottom of the CBC form is to be filled out only for CNAs, CMAs and HHAs. If you would like a new form you may contact our office at (785) 296-0056 or obtain one from our website at www.kdheks.gov/hoc .
In a review of data from the state-originated "exception" to the federal ban on NATCEP and the current federal "waiver" process, it is notable that under the original requirements, about 88 percent of all applications were approved, compared to 76 percent with the current system. This represents a reduction in rate of approval for waiver courses which may be attributable to several factors: increased requirements, greater volume of paperwork, and the method of reviewing applications. In an ongoing effort at streamlining processes, staff have changed the review process to enhance assistance to the applicant at the front end, spending more time and effort at getting the paperwork submitted correctly, versus simply returning the application as disapproved. Whereas this is more resource intensive, it is anticipated that this will actually reduce the time for the applicant between application and approval. Most disapprovals are for technical reasons which are eventually corrected and the application is approved. Providing technical support up front will help speed up approval so that there are more opportunities to train nurse aides.
Unfortunately another statistic emerged: an increase in courses canceled. Under the 1996-98 state process, only 1 percent were canceled. Currently 6 percent of approved waiver courses result in cancellation. This may be a function of the overall difficulties in recruitment faced by the long-term care industry in drawing candidates into the field of care for the frail and elderly. These data were annualized for comparative purposes. The period of time for the exception policy was 1996-98 (16 months) and the current waiver policy covers mid-98 through August 2000 (13 months).
When you receive the roster and "Notice to Test Letter" from HOC, please check to see if any of the students have been crossed out, or if beside their name it says, ss#, name doc, or no fee. This means there is information missing and they have not been scheduled. They should not receive a "Notice to Test Letter." HOC will send that individual a letter requesting the information. Once HOC has received the missing information then they will be scheduled to test. We have had individuals show up at the test site with a letter to test who have not been scheduled. This causes problems at the test site and frustrations for everyone concerned.
| Assistance With The Following | Call |
| Forms or not sure who to call... | 785-296-0056 |
| Initial license, license renewal, reinstatement or verification (adult care home administrator, dietitian, speech-language pathologist, audiologist)... | Brenda Nesbitt 785-296-0061 |
| Health Occupations Credentialing Act... | Marla Rhoden 785-296-6647 |
| Aide training courses, sponsorship programs, course approvals, continuing education approval for licensees... | Dolores Staab 785-296-6796 |
| Test scheduling for aides or challenging an aide test with higher education and forms... | Betty Domer 785-296-1250 |
| Medication aides or forms... | Jennifer Amorim 785-296-0060 |
| Instructor approval/aide course, interstate or reciprocity for aides... | Fran Breedlove 785-296-0059 after 3 p.m. |
| Test for ACHA, education policies... | Martha Ryan 785-296-0058 |
| Criminal background check program... | Steve Irwin 785-296-8628 Anna Householder Sarita Everett Carey Sisson |
| Open records request... | Tania Peeters 785-296-1284 |
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KANSAS NURSE AIDE REGISTRY |
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Nursing home residents are older, more frail, and have a shortened period of time as a resident. Nurse aides and medication aides are bearing the responsibility of providing what seems to be a more 'terminal' care for a more dependent population. Not that this is new information, as most of those who work in long-term care see the evidence that this study documents. (source: "Characteristics of Elderly Nursing Home Current Residents..." from Vital and Health Statistics of the Centers for Disease Control and Prevention: Advance Data, Number 312, April 25, 2000)