Raise skill level of aides with certificate course

Your agency can make $$$$ with outreach training

A Maryland clinical supervisor thought it made good sense: She could improve her own home care agency’s pool of potential aides, provide a service and outreach to the community, and make her agency a tidy profit.

Holy Cross HomeCare of Silver Spring, MD, began using the National Certification Program of the nonprofit Foundation for Hospice and Homecare of Washington, DC, to develop skills of potential home health aide employees.

The program also gave Holy Cross another opportunity to provide community service. "Anything we can do to promote people getting jobs and helping the community in general, we’ll try to do," says Bobbi Whatman, RN, clinical supervisor of Holy Cross, which is a department of Holy Cross Hospital of Silver Spring, MD, and conducts 75,000 visits a year in the metropolitan District of Columbia area.

Whatman bought the course materials and recruited a home care registered nurse to teach the course. Then she advertised the program in a local newspaper. Students were charged $450 each, and the agency made a profit of $1,500 to $2,000.

So far, Holy Cross has offered the certification program twice since April, and the agency has hired eight graduates of the course.

The profit wasn’t as important as how the program gave the agency a better-qualified pool of job applicants, Whatman says.

"What I loved about this is that we needed additional staff," Whatman says. "You’re working with these students for a month or two months, and you have time to evaluate them: Were they on time to class? Were they prepared? Did they interact with others appropriately?

"It’s an excellent way to evaluate how people will perform and work with clients."

Another benefit is the program provides a special certificate to all aides who pass the course. The certification program gives agencies documentation that their aides are being trained professionally and meet all federal standards.

This may be especially useful when agencies need good public relations such as when the media attacks the home care industry as having inadequate training and educational standards. This criticism has cropped up recently in national newspaper articles and television news investigations.

Last November, USA Today published a series of articles that highlighted aides who abused clients and stole from them. The articles blamed the abuses on home care agencies and federal regulators, who, the articles declared, provide too little screening and training of home care aides.

But this isn’t a problem at Holy Cross. Whatman said the agency’s training program was so successful that plans to expand it include special pediatric and restorative training for aides.

The clinical supervisor offers these tips on how other agencies can set up a similar course:

1. Take advantage of the training material offered by the Foundation for Hospice and Homecare.

Whatman ordered the foundation’s A Model Curriculum and Teaching Guide for the Instruction of the Home Care Aide. The program is designed to be taught in 75 hours with 60 hours of classroom instruction and 15 hours of field practice.

The course also uses a skills demonstration checklist and a written exam that is scored by the foundation.

The organization’s purpose is to establish a national basic standard for the preparation of home care aides. Its program includes instruction in all of the areas in which aides must demonstrate competence to meet federal standards. The program was developed in 1978 with support from the U.S. Public Health Service, and it was revised in 1987.

The program’s standards were adopted as part of the Omnibus Budget Reconciliation Act (OBRA-87). These requirements are part of the Health Care Financing Administration Code of Federal Regulations, 484.36 Condition of Participation: Home health aide services.

2. Set up a time, schedule, and targeted student population; then, advertise.

Whatman says her agency offered the course to the community at large because many unemployed people needed extra training and job skills. The class needed a minimum of six people and was limited to 20.

But she has plans to start a similar program in January for a retirement community. She’ll tailor this one to nursing assistants.

Holy Cross charged a fee for students to take the course because the agency had to pay an instructor. "If you’re doing the training as an agency and these are your employees, you cannot charge for it," she emphasizes.

"But if you’re doing it as an outreach into the community — a job training program — you can charge for it."

Holy Cross has offered the training over two months, with classes held two or three evenings a week.

The agency mailed brochures about the program to residents and included it in a hospital newsletter. Newspaper advertising also was used.

3. Find hospitals and nursing homes that will provide hands-on training; also, look for ways to save money on materials.

The foundation’s teaching materials cost about $450 for a class of 10. This includes the skills checklists ($25 for package of 10), and the written exam, which costs $32 per student, and the home health aide handbook, which is $9.95.

The examinations are scored by the Foundation, and the certificates are forwarded to the instructor for disbursement.

But there are other needed items, and this is where an agency can save money, Whatman advises. "I get sales representatives to donate a minimal amount of supplies to me. We make a big supply kit out of sales reps’ donations of supplies, such as urinary drainage bags, catheters, and dressings.

"This keeps the overhead for supplies down."

Also, Whatman uses videos on file in the home care department and the hospital’s resources, such as laundry and medical supply. "Our durable medical equipment company will come in and set up a bed for free, as a courtesy," she says.

She had to buy basins, an overhead projector, and a few supplies, including thermometers, alcohol swabs, and shampoo.

The clinical skills section could be taught in a laboratory, Whatman says, but she chose to take aides to a nursing home, where the instructor could observe the students working with nursing home patients.

"We also spend a day in an adult day care, and then we spend a day in a children’s day care center," she adds.

[Editor’s note: The Foundation for Hospice and Homecare offers instruction on home care aides; books about home care management; manuals about treating patients with cancer, Alzheimer’s disease, high-risk infants, high-tech patients, and developmental disabilities. The foundation also sells audiotapes, videotapes, and research reports. For more information, or to order a catalog, you may write to the foundation at 513 C Street NE, Washington, DC 20002-5809. Telephone: (202) 547-6586. Fax: (202) 546-8968.]