Classes begin August 7, 2014

Transcription

1 BECOME A LICENSED MEDICAL ASSISTANT Classes begin August 7, 2014 Tuesdays & Thursdays 5:30 pm -9:30 pm Saturdays 8:00 am - 4:30 pm Lakeshore Drive, Clearlake Lake County Office of Education Career & College Readiness Department Questions: Please contact or tserpa@lakecoe.org

2 MEDICAL ASSISTANT CLINICAL and ADMINISTRATIVE LAKE COUNTY OFFICE OF EDUCATION Career & College Readiness Department MEDICAL ASSISTANT COURSE INFORMATION This course prepares and qualifies the student for certification in the full scope of practice as a Medical Assistant. In the United States, MA job prospects are excellent since medical assisting is predicted to be one of the nation s fastest growing occupations through The course includes 180 hours of administrative experience (front office) and 500 hours of clinical preparation (back office). MA s perform routine clinical and administrative duties under the direct supervision of a physician or other health care professional. To prepare for certification status, experience is needed, thus, an externship is arranged with doctors offices or clinics. Duties include answering telephones, greeting patients, updating and filing patients medical records, filling out insurance forms, handling correspondence, scheduling appointment, arranging hospital admissions and lab service, performing billing and book keeping. An MA also collects and/or prepares lab specimens, sterilizes medical instruments, prepares and administers medications as directed, authorizes drug refills, telephones prescriptions to a pharmacy, draws blood, prepares patients for X-rays, takes electotrocardiograms, removes sutures and changes dressings. Completing these requirements affords the student the opportunity to sit for the National Certified Medical Assistant exam. This is an independent, third-party organization that has certified over 350,000 medical professionals since Deliver Applications to: (do not mail) Lake County Office of Education Lakeshore Drive, Clearlake, CA Monday-Friday 8:00 am 5:00 pm Questions: Contact or tserpa@lakecoe.org

3 Dates of Note: July 3, 2014 Application Deadline July 12, 2014 Entrance Exam and Interview July 14, Notification of Status July 14-18, 2014 Payment in Full Due July 14-23, 2014 Fingerprinting* /Drug Screening* (*after payment received in full & as directed by LCOE) Class Dates: August 7, 2014 May 7, 2015 May 9, 2015 Externship Completed May 12, 2015 Final Grade Distributed Graduation - May 15, 2015 License Exam May 16, 2015 Class Location: Lectures Clearlake Training & Career Center Externship Varies Class Days: Tuesdays and Thursdays 5:30 PM - 9:30 PM Saturdays 8:00 AM - 4:30 PM Fees: $3, Total amount due by July 18, 2014 Fees cover: facilities fees, textbooks, fingerprinting, drug screening, blood pressure cuff, stethoscope, medical dictionary, ID badge, lanyard and medical supplies used in class. If issued items are lost, stolen or damage, the student will be responsible for replacement at their expense. STUDENT EXPENSES: 1. Physical Exam 2. Tuberculosis Test 3. Vaccinations 4. Scrubs (dark/navy blue) 5. Black or White Closed Toe Shoes 6. Watch with Second Hand 7. Black Fine Tipped Pens and Highlighters 8. Paper 9. Binder

4 REQUIREMENTS: Orientation must be attended on August 5, 2014 from 5:30 PM to 8:00 PM. Students must be at least 18 years of age, speak English fluently, be able to see and hear, possesses the physical dexterity to allow them to perform CPR in an emergency, prepare medications involving needles and syringes which includes drawing up medication through a syringe from an ampoule or bottle. Fingerprinting through the Lake County Office of Education must have been completed prior to acceptance into the program. This process affords the clearance necessary for an adult student to be in the environments required during the course as well as assures the future externship medical care provider that a background check has been done. Students are required to be drug tested at St. Helena Clearlake Hospital prior to admission to the class. Failure of any part of the drug test will result in automatic dismissal from the program. Because this is a national certification program we are unable to make allowances for those holding authorizations for medicinal marijuana use. Students will be tested for Benzodiazepine, Cocaine, Amphetamines, Cannabinoids, Opiates, and barbiturates. Students taking prescription medications that would cause a positive result on a drug test, must have their doctor list those medications on the health exam from provided. Students who do not pass the drug test or fingerprinting are not entitled to a refund. Students are also required to have a physician complete the two medical papers attached. Both the Student Health questionnaire and the Health Exam forms must be completed and signed. The application process consists of a basic skills evaluation covering spelling, reading comprehension, basic math, English grammar and critical thinking. The skills testing is available by appointment only at the Lake County Office of Education in Clearlake. Upon receiving a passing grade, an appointment can be scheduled for an interview with course instructor and the program specialist. The Medical Assistant Course is a fast paced program with many areas to cover, learn about and explore. It is expected that the students will have read the assigned chapters prior to class and complete any homework by the date due. Community members in the health care field are also involved in sharing their expertise by consenting to lecture and mentor. Out of respect for their generous donation of time and talent, it is anticipated that the students will be well prepared to receive the information offered.

5 ATTENDANCE: A total of three absences is acceptable during this 9 month course. All guest lectures MUST be attended. Only a signed doctor s note is acceptable for an absence if a student misses a guest speaker s presentation. Any student arriving late without prior approval from the instructor may be dropped from the program at the discretion of the instructor. Any absences require a call or written notice to the instructor prior to the class. DRESS CODE: Students must attend class wearing their dark/navy blue scrubs with black or white shoes. Black, grey or white long sleeve tee shirts may be worn under the scrub top. LCOE issued ID badge must be worn at all times. Long hair must be pulled back. Any facial hair or make-up must be done in a conservative fashion. No nail polish is allowed and nails must be clean and short. Only simple rings and post type earrings are permitted. Any facial piercings must be filled with a very small stud or clear plug. All tattoos must be covered. ACADEMIC GRADE: An average of 75% on course work is required before placement into the externship program. Grades are given for class participation, response papers, lab demonstrations, quarter finals and finals. The grading is weighted. EVALUATION: A written evaluation in anticipation of externship placement is performed in December. This will include: average grade, attendance, skill competencies, professionalism and an improvement plan if necessary.

6 MEDICAL ASSISTANT PROGRAM LAKE COUNTY OFFICE OF EDUCATION Physical: Lakeshore Drive, Clearlake (do NOT mail application) phone 707/ fax 707/ PERSONAL INFORMATION RECORD AND APPLICATION FORM Date of application: Cell Number: Name Last First Middle Any other names used in the past (maiden, etc.) Drivers License/ID# exp Phone Number If no phone, give message number Social Security Number - - DOB / / Gender: female male Present physical address Street City State Zip Code Mailing address Street or P.O. Box City State Zip Code address Check all that apply: Economically Disadvantaged: yes no Handicapped: yes no Limited English: yes no Single Parent: yes no Ethnicity: Hispanic/Spanish Surname Caucasian Asian African American Filipino Alaska Native American Indian Pacific Islander Person to notify in case of emergency Name Relationship Phone Number Physician s name Physician s phone number High school graduate Yes No GED Passed Yes No Have you applied for this program before? yes no Date / / Previous medical training or experience: C.N.A.: Yes No Current.: Yes No License #: Phlebotomist: Yes No Current.: Yes No License #: M.A.: Yes No Current.: Yes No Licensing Agency: Other (please give detailed information): Where: Firm/Institution Address Description Date Are you currently employed? Yes No Where? Is your employer interested in employing you as an M.A.? Yes No Are you currently attending high school? No Yes, Name of school 1

7 Previous employment: Organization Address Position Dates Have you ever been convicted of a felony? Yes No If yes, give details of incident(s) including evidence of rehabilitation. Check the appropriate box if you are a participant in any of the following programs: WIA/JTPA Rehab CalWORKS/TANF/AFDC Goodwill ACS DOR SSI Veterans Disability other I hereby certify that the above information is true to the best of my knowledge. I understand that any falsification will result in cancellation of this application. Signature Date HOLD HARMLESS AGREEMENT The UNDERSIGNED agrees to indemnify and hold harmless the Lake County Superintendent of Schools and all CTE Programs, its officers, employees, attorneys, and agents from all liability, claims, lawsuits, damages, losses, expenses, costs and attorney fees brought for, or on account of injuries to or death of any person, or damage to or destruction of any property, arising out of the activities of the undersigned Executed and Agreed to: By: (Please print name) Date: Signature: MUST PROVIDE ORIGINAL DOCUMENTS AT TIME OF APPLICATION: (Name MUST match on all docs) Social Security Card Valid California ID/Drivers License 2

8 LAKE COUNTY OFFICE OF EDUCATION CAREER & COLLEGE READINESS DEPARTMENT STUDENT AGREEMENT As a student of the Lake County Office of Education, I understand that I may be asked to perform tasks that might pose a risk of exposure to Bloodborne Pathogens causing such diseases as AIDS and Hepatitis, which can lead to serious illness or death. Accidental exposure to human blood or other potentially infectious materials (OPIM) must be reported immediately. I understand that I will be directed to obtain a risk evaluation, conducted by a clinician familiar with post-exposure evaluation and treatment, which is recommended by Centers for Disease Control and Prevention (CDC) and if deemed necessary, initiation of post-exposure prophylaxis (PEP). The CDC specifically recommends that PEP be initiated within two hours of HIV exposure to prevent disease transmission. I understand that I am personally responsible for the cost of the post-exposure medical management and treatment and that the Lake County Office of Education is in no way responsible for these expenses. I also understand that once I have enrolled in the class and paid my tuition, I will NOT receive a refund in any amount if I choose to drop the class or am terminated from the class. This includes any non-completion of the course regardless of reason including but not limited to medical necessity or catastrophic events. Students who are terminated or choose to withdraw from the class will NOT be given, offered or entitled to a spot in any future classes without paying the full tuition AGAIN. Parent/Guardian of Minor Student Signature of Medical Student Date Date Please Print Name Lakeshore Dr, Clearlake, CA (707) (707) fax

9 ACADEMIC HONESTY AGREEMENT Adult ROP The Lake County Office of Education defines cheating and collusion as the act of obtaining or attempting to obtain credit for academic work by using dishonest means. Cheating and collusion include but are not limited to Copying, in part or whole, from another s examination, paper (including homework assignments), 1. mathematical calculation(s), research, creative project or the like; Submitting as one s own work an examination, paper, mathematical calculation(s), research or creative 2. project, or the like which has been purchased, borrowed, or stolen; 3. Intentional falsification or invention of data or a source in an academic exercise; 4. Using notes, or materials not specifically authorized by the instructor during an examination; Any collaboration between a student and another person at times or in ways which are not permitted 5. by the instructor. 1 The following descriptions [from the University of Texas and the University of Exeter] further refine acts of cheating/ collusion: using unauthorized books, notes, electronic aids or other materials in an examination either aiding or obtaining aid, from another person, where such aid is not explicitly permitted in the assignment allowing someone else to write your papers allowing someone else to modify your essays in any substantive way The Lake County Office of Education defines plagiarism as the act of obtaining or attempting to obtain credit for academic work by representing the work of another as one s own (including text found on the Internet) without the necessary and appropriate acknowledgment. Specifically, plagiarism is the act of incorporating the ideas, words of sentences, paragraphs, or parts thereof without appropriate acknowledgment and representing the product as one s own work; the act of representing another s intellectual or creative work such as musical composition, computer program, photograph, painting, drawing, sculpture, research, the like as one s own. The following descriptions [from the University of Texas and the University of Exeter] further refine acts of plagiarism: failing to acknowledge the sources of any information in your paper which is not either common knowledge or personal knowledge failing to acknowledge direct quotation either by using quotation marks when quoting short passages or indention when quoting longer passages too closely paraphrasing the original words of your source borrowing the ideas, examples or structure of your source without acknowledging it taking, buying or receiving a paper written by someone else and present it as your own using one paper for two different courses, or re-using a paper previously submitted for credit, without the prior approval of both instructors direct copying of text from a book, article, fellow student s essay, handout, web page or other source without proper acknowledgement claiming individual ideas derived from a book, article, etc. as one s own and incorporating them into one s work without acknowledging the source of these ideas I have read and understood the above descriptions and illustrations of cheating, collusion and/or plagiarism and I agree to not engage in any of these acts as a student enrolled in Lake County Office of Education Classes. I understand that if, in the teachers opinion, I have violated this Agreement I will receive a warning form the teacher on the first offense, and will be dropped from the class on the second offense. No refund of tuition will be given for termination from the class for violation of this agreement. STUDENT NAME (Please Print) STUDENT SIGNATURE DATE

10 Disqualifying Penal Code Sections If you have been convicted of any of the penal codes listed, MA, CNA/HHA & Phlebotomy applicants will be automatically denied certification or ICF/DD, DDH, or DDN applicants will be denied employment. All applicants should review this list carefully to avoid wasting their time, effort and money by training, testing and submission of fingerprints since they cannot receive the required criminal background clearance if they have been convicted of any of these violations. Section 187 Murder 192(a) Manslaughter, Voluntary 203 Mayhem 205 Aggravated Mayhem 206 Torture 207 Kidnapping 209 Kidnapping for ransom, reward, or extortion or robbery 210 Extortion by posing as a kidnapper False imprisonment 211 Robbery (includes degrees in (a) and (b)) 220 Assault with intent to commit mayhem, rape, sodomy, oral copulation 222 Administering stupefying drugs to assist in commission of a felony Sexual battery (includes degrees (a) (d)) 245 Assault with a deadly weapon, all inclusive 261 Rape (includes degrees (a)-(c)) 262 Rape of spouse (includes degrees (a) (e)) Rape or penetration of genital or anal openings by foreign object 265 Abduction for marriage or defilement 266 Inveiglement or enticement of female under a Taking person without will or by misrepresentation for prostitution 266b Taking person by force 266c Sexual act by fear 266d Receiving money to place person in cohabitation 266e Placing a person for prostitution against will 266f Selling a person 266g Prostitution of wife by force 266h Pimping 266i Pandering 266j Placing child under 16 for lewd act 266k Felony enhancement for pimping/pandering 267 Abduction of person under 18 for purposes of prostitution 273a Willful harm or injury to a child; (includes degrees (a)-(c)) 273d Corporal punishment/injury to a child (includes (a)-(c)) Willful infliction of corporal injury (includes (a)-(h)) 285 Incest 286(c) Sodomy with person under 14 years against will 286(d) Voluntarily acting in concert with or aiding and abetting in act of sodomy against will 286(f) Sodomy with unconscious victim 286(g) Sodomy with victim with mental disorder or developmental or physical disability 288 Lewd or lascivious acts with child under age of a(c) Oral copulation with person under 14 years against will

11 288a(d) Voluntarily acting in concert with or aiding and abetting 288a(f) Oral copulation with unconscious victim 288a(g) Oral copulation with victim with mental disorder or developmental or physical disability Continuous sexual abuse of a child (includes degree (a)) 289 Penetration of genital or anal openings by foreign object (includes degrees (a)-(j)) Rape and sodomy (includes degrees (a) and (b)) 368 Elder or dependent adult abuse; theft or embezzlement of property (includes (b)-(f)) 451 Arson (includes degrees (a)-(e)) 459 Burglary (includes degrees in 460 (a) and (b)) 470 Forgery (includes (a)-(e)) 475 Possession or receipt of forged bills, notes, trading stamps, lottery tickets or shares (includes degrees (a)-(c)) 484 Theft 484b Intent to commit theft by fraud 484d-j Theft of access card, forgery of access card, unlawful use of access card 487 Grand theft (includes degrees (a)-(d)) 488 Petty theft 496 Receiving stolen property (includes (a)-(c)) 503 Embezzlement 518 Extortion 666 Repeated convictions for petty theft, grand theft, burglary, carjacking, robbery and receipt of stolen property I hereby certify that I have not been convicted of any of the penal codes listed. Signature Date As directed by the California Department of Public Health, failure to disclose criminal convictions may lead to involuntary disenrollment from the class.

12 STATE OF CALIFORNIA BCIA 8016A (orig. 04/2001; rev. 01/2011) DEPARTMENT OF JUSTICE Applicant Submission ORI: A0892 Code assigned by DOJ REQUEST FOR LIVE SCAN SERVICE (Public Schools or Joint Powers Agencies) Type of Applicant: Classified School Employee Credentialed School Employee The following selections are for Public Schools only: X License, Certification, Permit Peace Officer Law Enforcement Officer Volunteer Type of License/Certification/Permit OR Working Title: Medical Assistant (MA) (Maximum 30 characters - if assigned by DOJ, use exact title assigned) Contributing Agency Information: Lake County Office of Education Agency Authorized to Receive Criminal Record Information Mail Code (five-digit code assigned by DOJ) 1152 S Main St Linda DeBolt Street Address or P.O. Box Contact Name (mandatory for all school submissions) Lakeport CA (707) City State ZIP Code Contact Telephone Number Applicant Information: Last Name First Name Middle Initial Suffix Other Name (AKA or Alias) Last First Suffix Date of Birth Sex Male Female Height Weight Eye Color Hair Color Driver's License Number Billing Number Place of Birth (State or Country) Home Address Social Security Number Misc. Number (Agency Billing Number) (Other Identification Number) Street Address or P.O. Box City State ZIP Code Your Number: Level of Service: X DOJ X FBI (OCA Number (Agency Identifying Number) If re-submission, list original ATI number: (Must provide proof of rejection) Original ATI Number Live Scan Transaction Completed By: Name of Operator Date Transmitting Agency LSID ATI Number Amount Collected/Billed ORIGINAL - Live Scan Operator SECOND COPY - Applicant THIRD COPY (if needed) - Requesting Agency

13 STUDENT HEALTH QUESTIONNAIRE Last Name First Name Initial CIRCLE ONE Married Single Widowed Divorced Mailing Address Telephone Birth date Sex Family Physician Phone Number HAVE YOU HAD OR DO YOU HAE ANY OF THE FOLLOWING? Circle yes or no Disease of: Brain yes no Colds yes no Hernia yes no Eyes yes no Fainting spells yes no Stomach ulcers yes no Ears yes no Chest pains yes no Pneumonia yes no Throat yes no Shortness of breath yes no Pleurisy yes no Heart yes no Chronic cough yes no Kidney stones yes no Lungs yes no Coughing up blood yes no Hemorrhoids yes no Stomach yes no Palpitations yes no Seizures yes no Intestines yes no Allergies yes no Convulsions yes no Liver yes no Poor appetite yes no Tuberculosis yes no Spleen yes no Chronic indigestion yes no Bronchitis yes no Gallbladder yes no Recurring nausea yes no Nephritis yes no Kidneys yes no Recurring vomiting yes no Malaria yes no Bladder yes no Vomiting up blood yes no Rheumatic fever yes no Bone yes no Chronic constipation yes no Paralysis yes no Joints yes no Black or bloody Cancer yes no Spine yes no bowel movements yes no Tumors yes no Skin yes no Frequent or painful Asthma yes no Lymph nodes yes no urination yes no Hay fever yes no Genitals yes no Blood in urine yes no Diabetes yes no Operations yes no Arthritis yes no Other serious illness yes no Rheumatism yes no Dizziness yes no Nervous breakdown yes no Injuries yes no Headache yes no Mental or nervous Deafness yes no Ear infections yes no disorders yes no Other (please explain) Sore Throat yes no Painful flat feet yes no Backaches yes no Swollen ankles yes no Sinus infections yes no High blood pressure yes no Dizziness yes no Jaundice yes no Do you see well? Do you hear well? Height Weight Do you have any defect, deformity, or disease which may interfere with your work? Have you ever been rejected or discharged from military service because of illness or injury? Have you ever received any pension, insurance payments or compensation because of an injury or illness? State details of illnesses, injuries, operations or defects I CERTIFY THAT ALL MEDICAL INFORMATION SUBMITTED IS TRUE AND GIVE MY PHYSICIAN(S) PERMISSION TO ANSWER ANY QUESTIONS BY LCOE. Signature Date APPROVED BY PHYSICIAN: Signature Date Print Phone #

14 STUDENT HEALTH EXAMINATION NAME OF INSTITUTION: TO BE FILLED OUT BY STUDENT S PHYSICIAN I have examined: (Last Name) (First) (Middle) And have found no condition that appears to prevent him/her from performing the duties required of a Medical Assistant student. Further, I have found no indication of any condition which might represent a possible hazard to the health of patients or other employees in the institution, or to themselves. Patient will be drug tested for Benzodiazepine, Cocaine, Amphetamines, Cannabinoids, Opiates & Barbiturates. Please list any prescriptions that the patient is currently taking that may appear on the drug test screening. Date Signature, MD Print Name Phone #

15 NAME: MMR: Booster: Hep B: 3 part series: Diphtheria/tetanus w/pertussis: Varicella: Date (First TB test must be within the last 2 months, Second TB test must be issued one week following.) Signature, MD Print Name Phone #

16 You are required to have 2 TB TESTS.This means you must get the injection, have it read and then go back and have a second test administered and read. FIRST.TB TEST RESULTS: Date Signature, MD POS / NEG Print Name: Phone Number SECOND.TB TEST RESULTS: Date Signature, MD POS / NEG Print Name: Phone Number

17 CLASS TIMES MASTER CALENDAR LAKE COUNTY OFFICE OF EDUCATION MEDICAL ASSISTANT PROGRAM August 2014 September 2014 SU M T W TH F SA SU M T W TH F SA TUESDAY 5:30 PM - 9:30 PM THURSDAY 5:30 PM - 9:30 PM SATURDAY 8:00 AM - 4:30 PM October 2014 November 2014 December 2014 SU M T W TH F SA SU M T W TH F SA SU M T W TH F SA January 2015 February 2015 March 2015 SU M T W TH F SA SU M T W TH F SA SU M T W TH F SA April 2015 May 2015 MEDICAL ASSISTANT CLASS SCHEDULE SU M T W TH F SA SU M T W TH F SA ORIENTATION CLASS DAYS NO CLASS/HOLIDAY EXAMS CLASS & RESPONSE PAPER EXTERNSHIP COMPLETED 31 PAPERWORK COMPLETED GRADUATION LICENSING EXAM **Students will also complete 180 hours of externship with local physicians. These dates, times and locations will be scheduled to occur between January - May and are not included in the classroom schedule listed in this calendar.

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