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North Carolina Personal and Home Care Aide State Training Grant (PHCAST)


North Carolina Personal and Home Care Aide State Training Grant (PHCAST) Curriculum Overview and Orientation to Phases I & II Grantee: NC Department of Health and ... – PowerPoint PPT presentation

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Title: North Carolina Personal and Home Care Aide State Training Grant (PHCAST)

North Carolina Personal and Home Care Aide
State Training Grant (PHCAST)
  • Curriculum Overview and
  • Orientation to Phases I II
  • Grantee NC Department of Health and Human
  • PHCAST is funded by the US Department of Health
    and Human Services,
  • Health Resources and Services Administration

Welcome and Purpose
  • Barbara Boyce

PHCAST Management Team
Kathy Turner, RN, PHCAST Project Director,
Division of Health Service Regulation Jan Moxley,
PHCAST Grant Administrator, Division of Aging and
Adult Services Donna White, RN, Elder
Rights/In-Home Aide, Division of Aging and Adult
Services Susan Harmuth, Senior Program Manager,
NC Foundation for Advanced Health
Programs Phyllis Daw, PHCAST Program Coordinator,
NC Foundation for Advanced Health Programs Kathie
Smith, RN, Associate Vice President of State
Relations, Home Community-Based Care,
Association for Home and Hospice Care of
NC Cherie Rosemond, Research Scientist, UNC
Center for Health Promotion Disease
Prevention Tara Green-Royster, Program Manger,
UNC Center for Health Promotion Disease
Prevention Jennifer Craft Morgan, Assistant
Professor, Gerontology Institute, Georgia State
University Margaret Roberton, Director,
Continuing Ed-Training Standards, NC Community
College System Barbara Boyce, Assoc. VP,
Continuing Ed Workforce Initiatives, NC
Community College System
Community College Pilot Sites
Community College Phase I Phase II Phase III Phase IV
Central Carolina
Central Piedmont
Coastal Carolina
Forsyth Technical
Wake Technical
Includes both pilot years
Excludes Halifax CC Cape Fear CC/Elder House
Overview of PHCAST
  • Susan Harmuth

Reasons PHCAST Was Funded Nationally
  • Increasing demand for direct care workers
  • Personal Care Aides and Home Care Aides are the
    fastest growing occupations
  • Plus, Nurse Aides are in the top 11 jobs in terms
    of largest job growth
  • Trained, competent workers are essential to
    quality care
  • Create a Gold Standard for minimum training

Key Concepts of NC PHCAST
  • Builds on prior Direct Care Worker Initiatives
  • Creates 4-phased framework for training and
    competency to better prepare new and incumbent
  • Training Venues
  • Community Colleges
  • High Schools

Overview of NCs 4-Phase Approach
  • Phase I Introduction to Direct Care Work
  • Phase II Direct Care Basics
    (pre-Nurse Aide level)
  • Phase III Nurse Aide I
  • Phase IV Advanced NA training/competency
  • Home Care Nurse Aide
  • Geriatric Nurse Aide
  • Medication Aide
  • Option for in-service use across settings

(No Transcript)
Key Impacts
  • Better matching/redirecting of prospective
    workers to job
  • Competency based certificate or credential at
    each phase
  • More consistent Pre-NA training
  • NA I training more realistic
  • Enhanced career paths, employability and responds
    to employer need (4-phase approach specialties)

Key Impacts - Continued
  • New and incumbent workers can enter at various
  • Expands state recognized career path options
    supports workers responds to employer need
  • Broad based support for model
  • Integration with other training QI initiatives
  • Builds on prior direct care initiatives in NC

Key Impacts - Continued
  • More efficient use of NA I training programs
  • Employer recruitment of workers more focused
  • Reduces some barriers to training
  • High School students job ready (NA I and Phase

  • Framework makes sense for NC
  • Phase I, II, linked to HRD programs
  • State recognized job categories
  • Responds to employer need (employer
  • Integration with other quality improvement
  • Potential to add new modules in future

Human Resource Development and PHCAST
  • Margaret Roberton

Human Resource Development Governance
  • SBCC Code HRD Program Continuation
  • Each college shall operate a Human
    Resources Development (HRD) program to provide
    assessment services, employability training, and
    career development counseling to unemployed and
    underemployed individuals. FTE shall be generated
    from HRD programs. Each college shall provide HRD
    instruction and support necessary for unemployed
    and dislocated workers to be served within the
    college service areas.
  • Vision and Mission Statement
  • HRD is a dynamic and vital workforce development
    program with proven economic, social, and
    educational success. The purpose of the HRD
    program is to educate and train unemployed and
    underemployed individuals for success in the

HRD Program Goals
  • Provide program outreach and student recruitment
    activities to targeted populations
  • Assist students in accessing meaningful training
    and/or employment opportunities
  • Enhance and develop the students employability
  • Develop and promote the students ability to move
    towards economic self-sufficiency

Human Resources Development
1D SBCCC 300.3 Program Classifications
  • Core Services
  • Skill assessment services
  • Employability skills training
  • Career development counseling
  • Target Groups
  • Unemployed adults
  • Underemployed adults
  • Core Components
  • Assessment of an individuals assets and
  • Development of
  • a positive self-concept
  • employability skills
  • communication skills
  • problem-solving skills
  • Awareness of the impact of Information Technology
    in the workplace

HRD Fee Waiver Guidelines
  • Eligibility Requirements
  • HRD courses are not free Fees are waived
  • Waiver is based on the individuals income
  • Unemployed
  • Underemployed
  • Notification of pending lay-off

HRD Eligibility
  • For HRD purposes, underemployed is defined as
  • working and is eligible for the Federal Earned
    Income Tax Credit (FEIT) or
  • working and earning wages at or below two hundred
    percent (200) of the federal poverty guidelines.

PHCAST Needs Aligned to HRD Core
  • Assessment
  • Ability to appropriately identify individuals
    prepared to enter healthcare fields
  • Introduce occupational requirements to maximize
    success of students progressing into Nurse Aide I
  • Introduce workplace realities of personal/home
    care environments vs. residential/institutional
  • Outline pathway alternatives for health care
  • Personal Home Care Aide
  • Recognized standardized curriculum

PHCAST Needs Aligned to HRD Core
  • Employability Skills
  • Concepts contextualized for healthcare field
  • Communication, listening skills, teamwork, and
    time/stress management
  • Career Development
  • Ability to problem solve independently
  • Decision-making and management skills

Specific HRD PHCAST Courses
  • Phase I Introduction to Direct Care Work
  • (Focus on job readiness skills, literacy,
    numeracy, keyboarding, and realistic job
  • Career Exploration
  • Self-Assessment
  • General soft skill requirements
  • CPR (lay person)

Specific HRD PHCAST Courses
  • Phase II Direct Care Basics
  • (Focus on non-nurse aide personal care tasks
    and soft skill development 3) expanded nurse
    aide (NA-1) skills)
  • Introduction to base skills
  • Introduction to functional concepts within role
  • Enhanced soft skills training
  • Career counseling

Importance of PHCAST to Employers and
Personal Care Clients
  • Donna White

Importance of PHCAST to Employers Personal Care
  • Growing need for Continuum of Care
  • Rising cost of care shortage of trained workers
  • Greater efficiency in healthcare delivery
    (lowering cost while improving delivery)
  • Promote quality care for increasing numbers of
    older adults and persons with disabilities

Employer Quote
  • My PHCAST trained employees expressed joy in
    going to the classes. They were excited about
    what they were learning and they created a
    tremendous bond with each other. We had a special
    ceremony for them at our last meeting and they
    were given pins. Based on what I have heard from
    them, it was worth going through the class. They
    enjoyed it. I believe PHCAST will help with
    caregiver retention.
    Vice President/ Home Care Agency

Statistics and Projections
  • In the next 20 years the number of persons 65 and
    older will almost double from 1.3 million to 2.3
  • North Carolina is 10th nationally in size of
    total population, we are 9th in those 60 and
  • By 2025, 86 of the NCs 100 counties are
    projected to have more people over age 60 than
    age 17 and under

Statistics and Projections
  • In 2025, one in four North Carolinians will be 60
    and older
  • Over the next two decades, the 75-84 age group
    will be the fastest growing of those ages 65 and
  • The number age 85 and older will grow fastest
    beginning in 2030,when the oldest of our 2.4
    million baby boomers near their 85 birthday

Statistics and Projections
  • NC currently has more than 17,000 older adults
    with Alzheimers or other types of dementia most
    of whom are being cared for at home or by family
    and friends. By 2030, the total number is
    projected to rise to nearly 300,000
  • For those age 75 and older, 13 live below the
    federal poverty level and 30 live at or between
    100-199 of the FPL

  • Status of North Carolinians 65 and older
  • Living alone 29
  • Veterans 22
  • Have a disability 38
  • Median household income 27
  • Income below poverty level 10 (10,778)
  • Income is between 100-199
  • of the federal poverty level

Employer Quote
  • I saw a client today whose caregiver went through
    the program. After speaking with the client and
    his guardian, I understood that they are really
    impressed with the caregiver and the improvement
    they have seen. She is being very thorough, she
    is noticing different things in the home, and she
    is alerting the office. I think PHCAST is going
    to help aides improve the relationships and the
    care they are providing. The client was thrilled
    with the care.
    RN Clinical Supervisor/Home
    Care Agency

NC Home Care Licensure
  • 10A NCAC 13J allows for two levels of home care
    aide, limited and extensive
  • There are multiple funding sources that fund
    these two levels of care need

Limited Assistance
  • Limited Assistance Care to a client who requires
    hands-on care involving guided maneuvering of
    limbs with eating, toileting, bathing, dressing,
    personal hygiene, self- monitoring of medications
    or other tasks assigned that require weight
    bearing assistance half the time or less during
    the activity

Extensive Assistance
  • Extensive Assistance Client is totally dependent
    or requires weight-bearing support more than half
    the time while performing part of an activity,
    such as guiding or maneuvering of limbs, and
    meets one of the following criteria
  • Requires extensive assistance in more than two
    activities of daily living (ADLs) or
  • Needs an in-home aide to perform at least one
    task at the nurse aide II level or
  • Requires extensive assistance in more than one
    ADL and has a medical or cognitive impairment
    that requires total care more than 50 of the

  • PHCAST Phase II prepares limited assistance aides
    for the workforce

Employer Quote
  • As a supervisor, I have noticed that PHCAST
    graduates are giving me more pertinent
  • Nurse
    Supervisor/ Home Care Agency

Recruitment and Marketing of PHCAST
  • Margaret Roberton

Recruitment / Marketing Getting Their
  • Program Outreach
  • External Agencies
  • Internal Resources
  • Community

Recruitment / Marketing Getting Their
  • Program Outreach
  • External Agencies
  • JobLink Career Centers
  • Division of Workforce Solutions (ESC)
  • Social Services
  • US Committee for Refugees and Immigrants
  • Shelters
  • National Guard/Family Employee Assistant Center
  • Community-based Organizations

Recruitment / Marketing Getting Their
  • Program Outreach
  • Internal Resources
  • HRD classes
  • Introduction to Healthcare Occupations
  • HRD Strategies for Success
  • CE Healthcare classes
  • Back-to-Work intake sessions
  • Basic Skills Plus

Recruitment / Marketing Getting Their
  • Program Outreach
  • Community
  • Flyers and brochures
  • College catalogues
  • College website
  • Social Media
  • Email
  • Past HRD students (Phase I and Phase II)
  • Current and Past NA I students (Phase IV)
  • Local home care facilities

Recruitment / Marketing Challenges
  • Communication of value
  • Home care agencies
  • Benefit of contextualized training
  • Benefit of advanced standardized training (Phase
  • Participants
  • Benefit of credential for hiring
  • Benefit of commitment to entire pathway
  • Program schedule/mix

Curriculum Availability
  • PHCAST Phases I and II
  • Kathie Smith

PHCAST Phases I and II
  • Phase I Includes job readiness skills,
    literacy, numeracy, keyboarding, realistic job
  • Phase II Includes personal care tasks and soft
    skill development for non-nurse aide level
  • An aide not listed on the NC Nurse Aide Registry
    as a Nurse Aide I (CNA) but may provide personal
    care to clients with limited assistance needs in
    Home Care and in other settings where a Nurse
    Aide I is not required

PHCAST Phases I and II
  • NC PHCAST addresses the following objectives
  • Help prospective workers have an understanding of
    educational and training requirements for each
    long term care sector pathway
  • Provide a uniform pre-nurse aide training program
    through community colleges that covers essential
    soft-skills, basic home management and personal
    care skills (non-nurse aide level providing
    limited assistance to clients)

Phase I and II Curriculum
  • Curriculum must be followed as written but
    instructors may develop creative ways to
    disseminate the information, adding as needed,
    activities that are learner-centered focused
  • Student attendance requirements are up to the
    individual college this includes how classroom
    information is mastered, with flexibility for
    making up absences as allowed by the college

Phase I and II Curriculum
  • At its core, adult learner-centered training
    assumes learning is active, not passive.
  • Trainers using a learner-centered approach rely
    heavily on role plays, case scenarios, small
    group work, and other forms of interactive
  • The curriculum includes instructor guides and
    interactive lesson plans

Phase II- Skills
  • The skills portion of Phase II curriculum (module
    10) must be taught by a Registered Nurse (RN)
  • The RN also observes the correct demonstration of
    the skills by the student

Phase I and II- Slide Presentation
  • Where the curriculum calls for a pre-written flip
    chart, a PowerPoint presentation can be developed
    and used in its place

Phase I and II Role plays
  • Not every student will be comfortable with
    performing role plays
  • Let students know that role play is a learning
    tool and it may be helpful to practice before
    they are actually faced with the scenario
  • The de-brief and discussion that occurs after the
    role play is just as valuable to the learning as
    the role play itself - be sure to leave enough
    time to de-brief

Phase I and II Duplication
  • There is some duplication of subject matter in
    both phases to ensure that regardless of which
    Phase the student enters, pertinent information
    about Direct Care Work is covered
  • Activities and information vary between the two
    phases to avoid exact duplication for students
    who attend Phase I and Phase II training
  • Instructor should adjust accordingly if the same
    students attend Phase II that attended Phase I

Phase I and II Guest Speakers
  • Guest speakers for both phases
  • Invite local guest speakers as appropriate for
    the material being taught.
  • Examples
  • Workers in the industry of personal care
  • Law enforcement to talk about gangs and drugs
  • Fire department to demonstrate fire safety
  • Alzheimers disease and dementia specialists

Phase I and II Resources
  • Instructor should review and update, as needed,
    handouts, slides, and other information contained
    in the PHCAST modules related to statistics and
    standards of practice to ensure information is
    current and accurate

Phase I and II Facilitator Guide
  • A Phase I and II facilitator (instructor)
    tutorial is included with the PHCAST curriculum

Competency Skills Check List
  • Donna White

Use of Competency Skills Check List
  • North Carolina Home Care Licensure 10 A NCAC 13J
    .1110 Supervision and Competency of In-Home
  • Each licensed home care agency shall document
    that its in-home aides are competent to perform
    client care tasks or activities to which they are
  • Such individuals shall perform delegated
    activities under the supervision of person
    authorized by state law to provide such

Licensure Rule Continued
  • In-home aides who are not subject to occupational
    licensing laws, shall only be assigned client
    care activities for which they have demonstrated
    competency, the documentation of which is
    maintained by the agency
  • Meeting competency includes a correct
    demonstration of tasks to an appropriate
    professional. Each agency shall document that its
    in-home aides demonstrate competence for all
    assigned client care tasks or activities

PHASE II Direct Care Basics Skills Check Lists
  • Module 9 Home Management Skills and Module 10
    Personal Care Skills includes competency skills
    check list
  • Each skill check list includes the required
    number of steps in order to meet competency in
    that skill

PHASE II Direct Care Basics Skills Check Lists
  • The steps for each skill are numbered
  • Each step has to be dated based on learners date
    of demonstrated competency
  • Dated signature is required by the competency
    evaluator and the In-Home Aide

Module 9 Check List
  • Home Management Skills Competency Check List
  • Housekeeping for clients
  • Nutrition and meal preparation
  • Food storage and safe food handling
  • Budgeting and spending

Module 10 Check List
  • Personal Care Skills Competency Check List
    includes assisting
  • client with a tub bath/shower
  • client to wash hair
  • with hair and scalp care
  • client with mouth care
  • with normal skin care
  • a man to shave

Module 10 Check List-Continued
  • Assisting
  • client to care for hands fingernails
  • with care of toenails for clients without
    Diabetes/Peripheral Vascular Disease
  • the client to dress
  • with elastic stockings
  • the client to move up in the bed

Module 10 Check List-Continued
  • Assisting
  • client from bed to chair using limited assistance
  • client to walk
  • client with toileting
  • with applying and removing eyeglasses, contact
    lenses, hearing aids and artificial body parts.
    (Optional demonstration)

Module 9 Check List Example
Module 10 Check List Example
Pilot Experiences-Panel Discussion
  • Crystal McIver Joy McPhail
    Central Carolina Community College
  • Alan Duncan
    Sandhills Community College
  • Lynn Kavcsak
    Wake Technical Community College

  • Margaret Roberton