Application for Health Information Technology (HIT) Certification Training Program September February 2016

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1 Application for Health Information Technology (HIT) Certification Training Program September February 2016

2 Dear Applicant: Thank you for your interest in Jefferson Community College s non-credit Health Information Technology (HIT) certification training program to be offered at JCC through a grant and in partnership with Fort Drum Regional Health Planning Organization (FDRHPO). We commend you for taking this important first step toward a new future in the high demand HIT field. This training program is intended for those who want to further their knowledge in the HIT field in a hospital or clinical setting. The course includes three elements: Classroom or Online Training (Your Choice): approximately 100 hours of classroom training is offered for those who choose to attend training on campus. Additional work will be required independently. Classes on campus will be at the JCC Continuing Ed. building on Friday mornings from 8:30am - 12:30pm beginning September 4th, There is also the option of taking the entire course completely online without attending classes on campus. National Certification Exam: you will sit for at least one health IT certification exam. Two exam vouchers are given to you free of charge. Vendor Training: hands-on EHR training is included from a certified Vendor Trainer. This can be taken either during on-campus hours or remotely from home. Apprenticeship: a 20 hour apprenticeship will follow your training at a healthcare related facility. The enclosed application explains how you can enter into the HIT certification training program. Before being accepted in the program you will need to: 1) Complete an application form 2) Send us an unofficial transcript from high school or college. If this is not possible then provide us with a reference letter from a current or previous employer attesting to your character and aptitude in either healthcare or technology. The deadline for applications is August 14, Payment for the program will be due before the first day of classes. You will be notified of your acceptance soon after we receive your application. Please send all documents to: Todd Parody Continuing Education Division Jefferson Community College 1220 Coffeen Street Watertown, NY Thank you for your interest in Jefferson Community College s non-credit HIT certification training program. Terrence Harris Dean for Continuing Education (315)

3 Health Information Technology Health Information Technology (HIT) makes it possible for health care providers to better manage patient care through secure use and sharing of health information. HIT includes the use of electronic health records (EHRs) instead of paper medical records to maintain people's health information. With the help of HIT, health care providers will have: Accurate and complete information about a patient's health. That way they can give the best possible care, whether during a routine visit or a medical emergency.* The ability to better coordinate the care they give. This is especially important if a patient has a serious medical condition.* A way to securely share information with patients and their family caregivers over the Internet, for patients who opt for this convenience. This means patients and their families can more fully take part in decisions about their health care.* Information to help doctors diagnose health problems sooner, reduce medical errors, and provide safer care at lower costs.* * From the Office of the National Coordinator s Web site This program includes approximately 100 hours classroom training plus an additional number of hours of independent online learning. At the end of your training, you will take certification exams in two of the six HIT roles, in order to become nationally certified. There is no additional cost for either of these tests. You will have the opportunity to take up to two certification exams for no additional cost to you. Your 20-hour apprenticeship will take place either at or toward the end of your training.

4 Course Code: CED Date: Friday September 4th - Late February (exact date TBD) Time: 8:30 a.m. 12:30 p.m. for those choosing to attend campus classes Rooms: Jefferson Community College, Extended Learning Center, E-130 Tuition for non-veterans: $1,250 (tuition) - $750 (scholarship) = $500. If you pass a certification exam we will reimburse you $250 making the total tuition cost only $250. Tuition for veterans: $1,250 (tuition) - $1000 (scholarship) = $250. If you pass a certification exam we will reimburse you $250 making the total tuition cost only $0. The completed application, and any subsequent correspondence, should be mailed to the Continuing Education Division at Jefferson Community College; 1220 Coffeen Street, Watertown, NY Attention: Todd Parody Arrange for a copy of your transcript or reference letter to be mailed to the Continuing Education Division. In order for the application to be considered and for you to be considered for a scholarship, your completed application, transcript or letter of reference must be received by August 14th. There are only 15-seats available in this program. Acceptance letters will be mailed to the 15 people selected for the program. Other qualified applicants who cannot be accommodated immediately will be given alternate status and will be notified via letter if a student position becomes available.

5 Fall 2015 Health Information Technology (HIT) Certification Training Program APPLICATION Please type or print clearly and mail to: Continuing Education Division, Jefferson Community College, 1220 Coffeen Street, Watertown, NY Attention: Todd Parody Name: Last First Middle Other/Previous Name (which may appear on records): Address: Number & Street Apt. Number City State Zip code Phone: cell or day number: Work: Social Security Number: Date of Birth: How did you hear about the HIT Program? Extra Curricular Activities (please list all school, community or religious activities in which you have participated. Include all offices which you have held and honors you have received.)

6 Give the name and address of the person to whom you have submitted the recommendation form. The reference must not be a family member. The reference should be a responsible adult who can attest to your ability to successfully complete this training. Name Title/Position Address Phone ( ) Relationship to Applicant (If you have submitted to more than one person for a letter of recommendation, use the below) Name Title/Position Address Phone ( ) Relationship to Applicant Educational Background School City Dates Attended Degree High School College Special Certification(s) Employment Present Employer Phone ( ) Address Dates of Employment Nature of Work (Additional) Name of Employer Phone ( ) Address Dates of Employment Nature of Work

7 Statement of Interest Please explain why you wish to work in the health care industry in the Health Information Technology field: Applicant s Name Date

8 Jefferson Community College Health Information Technology Certification Training Program Certificate of Information I certify, to the best of my knowledge, that the information supplied on this application is complete and accurate. Applicants signature Date Jefferson Community College admits students without regard for race, color, creed, sex, age, religion, national/ethnic origin, sexual orientation, disability, pregnancy or military status.

9 2014 Application Checklist transcript or reference letter mailed to Continuing Education Division..

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