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Training and Competency Evaluation (1992) and (2006) and Guide to Operation of a Home Health Aide Training Program (February 1, 2012). The training and evaluation requirements and approval process set forth in this guide are consistent with Part 484 of Title 42 of the Code of Federal Regulations (42 CFR) and Section 700.2 of Title 10 of the New York Code, Rules and Regulations (10 NYCRR). In order to provide home health aide services in New York State, a person must successfully complete training and competency evaluation program or competency evaluation program only conducted by an approved HHATP and be issued a certificate of completion. Any questions regarding home health aide training and program approval requirements should be directed to the appropriate NYSDOH regional office Home Care Program Manager. (Attachment 1) TRAINING REQUIREMENTS A HHATP must include classroom and supervised practical training. The aide trainee must receive a minimum of 75 hours of training including a minimum of 59 hours classroom and 16 hours of supervised practical training. Required testing and competency evaluation are notincluded in the 75 hours. Supervised practical training means training in a skills laboratory, patient's home or other health care setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of an approved Nurse Instructor (please refer to requirements for Nurse Instructor). All 16 hours of SPT can occur in the skills laboratory under the direct supervision of an approved Nurse Instructor. Prior training or experience providing care to patients as a PCA cannot be used to satisfy the SPT requirement for the home health aide training program. Federal regulations found in 42 CFR Part 484.36 specify that a mannequin cannot be used for SPT purposes. A volunteer or “pseudo-patient” must be used during the SPT in a laboratory setting. The maximum number of trainees to the approved Nurse Instructor ratio is 20:1 in the classroom setting and 10:1 for supervised practical training in the skills laboratory and patient care setting. The number of trainees must be consistent with the available space in the classroom and appropriate to the supervised practical training location. (See space requirements on page 11) 4 STANDARDIZED CURRICULAR CONTENT Each HHATP must identify and clearly state its goals and objectives and must include measurable performance criteria specific to both the curricular subject material and clinical content required by the Department. We recommend that the curriculum be taught at a sixth grade reading level. In order to assure that all HHATPs are teaching comparable content, HHATPs are required to base their training, including lesson plans, on the content of the Home Care Curriculum (HCC) and Health Related Tasks Curriculum (HRTC) available on the DOH website and Health Commerce System (HCS). The training program's teaching staff may exercise discretion in determining the amount of time required to adequately teach each of the subject areas, however, the minimum training time required must be met for each subject area and the training hours must total a minimum of 75 hours. Other resources may be used at the discretion of the approved Nurse Instructor supervising the approved HHATP. EVALUATION OF THE TRAINEE The HHATP is also responsible for ensuring that each home health aide trainee is competent in each skill and procedure taught in the training program. Competency evaluation may be integrated throughout the training program or may be conducted subsequent to classroom and supervised practical training. Competency must be evaluated by an approved Nurse Instructor. The following methods must be utilized in the evaluation of competency: • written and/or oral examinations that demonstrate the trainee’s knowledge of the information presented in the classroom training; and • observation and demonstration by the trainee of his/her competency in performing the required skills in the laboratory or patient care setting. All training programs are required to use a published text consistent with the content of the Department’s HCC and HRTC curriculum. To evaluate each home health aide trainee's competence in performing the minimally required number of home health skills, each HHATP must utilize the procedure checklists found in the appendices of HCC and HRTC curriculum and written tests obtained from publishers who publish textbooks for the purpose of training home health aides. Test questions must be obtained from a bank of test questions. Questions must comprehensively test the student in all areas of the curriculum and questions must be rotated. If a student is retaking a test after an unsuccessful attempt, this test must be a different version from the previous test taken. A minimum score of 80% is required to ensure mastery of subject material. 5 Documentation of Competency: For each home health aide who has completed classroom and supervised practical training, all competencies must be documented on a Trainee Evaluation Form(s) (Appendix 5, 5a). The trainee evaluation form must include documentation of the competencies which were demonstrated proficiently, name, license number and initials of the approved Nurse Instructor who has evaluated the trainee’s performance of each task and the date completed. Classroom and supervised practical training and competency evaluation must be completed within 60 calendar days of each trainee’s entry into the training program. COMPETENCY EVALUATION PROGRAM In lieu of the standardized training and competency evaluation, the HHATP must make available to eligible individuals a competency evaluation program. The competency evaluation program must be derived from a comprehensive written test and procedure demonstration checklists derived from the program’s full training program. The written and procedure demonstration portions of the competency evaluation program must contain sufficient content to assure that the aide is competent in the information and required skills set forth in the HCC and HRTC curricula. Individuals eligible to complete the competency evaluation program only, in lieu of the standardized training, include: • A nursing assistant with one year of full-time experience in a general hospital within the past five years; • An individual with documented home health aide or nurse aide training and competency evaluation from an out-of-state training program; • A home health aide with documented home health aide training and competency evaluation who has not been employed as a home health aide for 24 consecutivemonths; • A nursing student who has documented evidence of successful completion of course work requiring mastery of home health aide tasks within the past 24 months. Documentation would include a transcript with passing grade(s) and course description(s) or skills checklist signed by the nursing school instructor; and • Veterans who were trained in the United States Military as medical technicians or medics. If a prospective home health aide demonstrates competency in some, but not all of the content and skills evaluated, the HHATP must provide additional training, as appropriate, and reevaluate the aide's competency only in those areas requiring remediation. 6 The trainee will be issued a Certificate of Completion upon successful completion of the competency evaluation program. This certificate will identify the training methodology as competency evaluation. NOTE: A registered professional nurse or a licensed practical nurse currently licensed and registered in the State of New York may be employed as a home health aide and will be considered exempt from training and competency evaluation requirements. The possession of a current valid registration as a nurse from the New York State Department of Education (NYSED), Office of the Professions precludes the need for a home health aide certificate.