Director / Coordinator / Nurse Instructor Applications

GENERAL INSTRUCTIONS

Please be advised that this application will require uploading files. Please be prepared with all supporting documentation at the time of submission. Please review the application for accuracy prior to submission. When entering your work experience, begin with your most recent employment. Ensure that you provide relevant experience to demonstrate that the minimum qualifications are met.

This application is intended to add or modify the personnel of an approved Personal Care Aide Training Program, particularly the roles of the Director/Coordinator and/or Nurse Instructor. Please be advised that the training program must also submit the Significant Change Form.

Upon approval, the Department will notify the training program and record the approved personnel in the Home Care Registry.

Personnel Requirements:

Director/Coordinator of Training:
A maximum of two (2) individuals can be designated for this position.

This individual must be a registered professional nurse or social worker currently licensed in New York and must have a minimum of a bachelor’s degree in an area related to the delivery of human services or education. Human services may include health and social services.

Registered nurses may be exempt from the requirement of a bachelor’s degree if they have two years of nursing experience, at least one year of which must be in the provision of home health services.

The Director/Coordinator of training is responsible for coordinating and overseeing all aspects of training conducted by the program including basic training and the Alternative Competency Demonstration Program. The Director/Coordinator’s name will be printed on the aide’s certificate of completion.

Nurse Instructors:
There is no limit on the number of nurse instructors permitted, but each nurse must fulfill the required qualifications.

Minimum qualifications include two (2) years’ experience as a Registered Professional Nurse, one (1) year of which is in the provision of Home Care Services in an Article 36 or Article 40 approved hospice or its equivalent for out of state experience.

If you are applying as a bi-lingual instructor, please attach documentation that you are bi-lingual and fluent in the language in which instruction is given to adequately teach and evaluate the student in the foreign language. Documentation of fluency must include two (2) written references, one of which may be from the sponsoring organization, and one of which may be proof of graduation (such as diploma) where the targeted foreign language is spoken.

Please be advised of the following when completing the application:

● Your RN license must be valid and in good standing in the state of New York.

● You are attesting that the minimum qualifications listed on the application have been met.

● Your name and RN license information will appear on the Home Care Registry (HCR) database and will be associated with the PCATP that you are approved to provide instruction for.

● You are held responsible to ensure compliance with the Personal Care Aide Training Program Requirements posted on the Health Commerce System (HCS).

● All Nurse Instructors must be approved by the Department prior to inclusion in the Home Care Registry instructor database. The Nurse Instructor application must be submitted electronically to the Department of Health for review and approval at least 30 days prior to teaching any classes.

Please direct any questions to the Bureau of Professional Credentialing and Training Programs via email to:pcatp@health.ny.gov

*When attaching documents, please label each attachment with the name/title of the item being attached.*
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If more than 10 files need to be uploaded, attach the documents in a zip file.

*** Please follow the designated naming conventions when uploading files to avoid potential delays or rejection.***