Allied Health Programs Updated 10/21/2015 ADMISSION REQUIREMENTS STUDENT NAME CONTACT # SELECT ONE: MAP105 MIP105 PHB105 For assistance, email your questions to: swsc.advisor@estrellamountain.edu or contact the SWSC front desk at (623) 535-2700 Admission Process Attend Information Session (Thursdays at 3 p.m.) or email: swsc.advisor@estrellamountain.edu to schedule an appointment if you cannot make the session. You can download the Admission Packet at http://www.estrellamountain.edu/southwest-skillcenter/admissions-packet Obtain Student ID number. You can do this from anywhere! 1) Visit main website at My.maricopa.edu. If you have never attended a college in the Maricopa County Community College District (MCCCD), select New Student? Start Here or if you have attended within MCCCD, select Student Center in Student Tools column to retrieve your student ID and MEID; or 2) Visit EMCC Enrollment Services in person. Take Placement Test(s) at the Testing Center in Komatke Hall B Required Scores: 74 or higher in Reading and 23 or higher in Mathematics* NOTE: Items that will exempt you from placement testing: Successful completion of RDG 091 with a C or higher; Successful completion of MAT081 or higher with a C or higher; A college degree. Waiver from Program Manager. For the Medical Interpreter Program-Spanish: Spanish written and oral exam required. Written & Oral Passed: *Math score is not required for MIP Program (Provide slip showing pass) Complete Disclosure Acknowledgement Form. (Attached) Acknowledgement documents that can be viewed online at http://www.estrellamountain.edu/southwest-skill-center/disclosure-documents Complete Student Declaration of Citizenship or Status (Attached) Documents that can be used to complete this requirement are valid original Driver s License or- Certificate of Birth. Obtain Level One Finger Print Clearance Card Forms can be obtained from DPS by calling 602-223-2279. Complete Health and Safety Documentation (Attached) Submit documentation of vaccines or lab results with this form. The form MUST be signed by licensed healthcare examiner. Bring Healthcare Provider CPR Card to intake session (See page 2 for list of providers) Complete Certified Profile background clearance PASSED results (Instructions attached) *No need to print results* Attend Packet Intake Session (Wednesdays at 2 p.m.) or schedule an appointment for intake with an advisor - email: swsc.advisor@estrellamountain.edu. Attend an intake session ONLY when your Completed Student ID Maricopa ID (MEID) Don t Forget Password! 1
Allied Health Programs Updated 10/21/2015 packet is complete, you have all required documents, and you are ready to pay or have funding secured. Payment: If you applied for and received financial aid, please have your Estimate Award letter at the time you submit your complete admission packet. The Estimate Letter can be found in your student email account. The advisor will provide you with a Registration Form. You must take the Registration Form to Cashier services. After payment is made or funding is secured from third party vendor, please bring the signed Payment Form with the completed packet back to the advisor. The admission requirements and costs of SouthWest Skill Center programs are subject to change. Students must consult with the advisor to ensure appropriate requirements are met. Two Step TB Hepatitis B Secure Funding MMR/Varicella Fingerprint Background Check How Long Should It Take To Complete The Admissions Process? Weeks 2 Weeks 4 Weeks 6 Weeks 8 Weeks 8 This is the last thing you do once everything else is complete! Takes up to 2 weeks Completed Packet Weeks 10 0 1 2 3 4 5 6 7 8 9 10 CPR CARD REQUIREMENT AND ACCEPTABLE PROVIDERS Having a current CPR card is required. It must be valid for one year from the start of the program. The training cannot be online and it must include hands-on training AED, Adult, Child and Infant CPR. Provided is a list of acceptable CPR provider cards. ISSUER SouthWest Skill Center American Heart Association American Safety & Health Institute (ASHI) LEVEL OF TRAINING CPR Pro (CPR for Healthcare Professionals) Healthcare Provider CPR Pro (CPR for Healthcare Professionals) FINANCING YOUR EDUCATION Students are responsible for the total program cost, which includes tuition and fees, out of pocket expenses, and any additional expenses associated with this Program. Each student is expected to secure sufficient financial aid or Agency funding, and/or an established payment plan during their enrollment. 2
Allied Health Programs Updated 10/21/2015 PROGRAM TUITION AND FEES MEDICAL ASSISTANT (MAP105) MEDICAL INTERPRETER- SPANISH PHLEBOTOMY (PHB105) (MIP105) Registration Fee* $15.00 $15.00 $15.00 Tuition Clock Hour (830 X $5.00) (170 X $5.00) (410 X $5.00) $4,150.00 $850.00 $2,050 Course Fees $970 $101 $495.00 Commencement Fee $15.00 $15.00 $15.00 TOTAL Tuition and Fees + $5,150.00 $981.00 $2,575.00 *Registration Fee is applied per fiscal year: July 1 June 30. If a student s program crosses over June 30 th, a second Registration Fee will be assessed. Add $15.00 + All tuition and fees are subject to change pending MCCCD Governing Board Approva Additional Expense. Student will be responsible for obtaining a urine drug screen within a specified time. This screening is done on a random basis. Do not obtain a drug screen on your own as it cannot be used. Screen results from tests taken prior to the start of the class will not be accepted. Information concerning the urine drug test will be given at orientation. The charge for testing is approximately $37.00. A positive screen for any reason will require a review by the Medical Review Officer. Any student not cleared by the Medical Review Officer will be immediately withdrawn. Listed below are some options for how to finance your education. AGENCY FUNDING. Obtain required paperwork from agency (Maricopa or Phoenix Workforce Connection, Arizona Youth Resources, etc.). These agencies have specific criteria that must be met so please work carefully with your agency. A firm obligation/intent to pay with student name and amount must be received from the agency prior to enrollment. FINANCIAL AID. Only programs that are 600+ clock hours qualify for financial aid funding. Medical Assisting and Medical Billing and Coding are the only current programs that qualify. o Financial Aid processing takes approximately 4-6 weeks. o Apply on line at www.fafsa.gov. Use SWSC/EMCC school code 031563. o A minimum of 3 weeks prior to the start of the Program, submit your Estimate Award letter and COMPLETE packet. The Estimate Award letter can be found in your student email account. If the letter is not submitted 3 weeks prior to the start of your program, you are liable for all tuition and fees, until your financial aid has been completed. PAY IN FULL (BUY-IN). Use, cash, check, or credit card to pay in full at time of packet acceptance and admission into program. 3
Allied Health Programs Updated 10/21/2015 PAYMENT PLAN (BUY-IN). The student will be responsible for signing up for the Equal Payment Plan and make their first payment prior to the start of their program. The student will be required to make their payment by the 1 st of each month for the amount of their payment plan. YOUR FINANCIAL ACCOUNT For your convenience you can view account activity & make credit card payments at www.my.maricopa.edu. Credit card payments are also accepted via phone at (623) 935-8888 VERIFICATION OF COMPLETE PACKET Bring your COMPLETE Admission Packet to the Packet Intake Session on Wednesdays at 2 p.m. Bring original documents. The advisor will make photocopies as required. The advisor will verify that all admission requirements have been met by completing a Packet Intake Checklist. Partial Packets will not be accepted All Packets must be hand delivered, No exceptions Submission of packet does not guarantee admission. Admission is based on eligibility, completed documents and space in the program MARICOPA STUDENT REFUND PROGRAM (MSRP) Once your packet is complete and you have secured your funding, your packet will be submitted for processing of registration. Your next step would be to set up your Maricopa Student Refund Program (MSRP) account. In the event that you would be due a refund, having the account in place may prevent delays for you. Money Network is processing all student refunds for the Maricopa Student Refund Program (MSRP). To ensure you receive your student refunds, you will need to enroll with Money Network using this link: https://www.enroll.moneynetworkedu.com/blackboard/enrollmentapp.gft?orgid=11296 To set up your account, you will need the following information: Your Student ID # Your Date of Birth Your Official Maricopa Student Email Address For more information: www.my.maricopa.edu/msrp NONDISCRIMINATION POLICY The Maricopa County Community College District does not discriminate on the basis of race, religion, color, national origin, sex, handicap/disability, sexual orientation, age or Vietnam era/disabled Veteran status in employment or in the application, admission, participation, access and treatment of persons in instructional or employment programs and activities. 4
Allied Health Programs Updated 10/21/2015 DISABILITY RESOURCE CENTER, CLASSROOM ACCOMMODATIONS Students with disabilities who believe that they may need accommodations in a class or program must contact the Disability Resource Center (DRC) in Building Komatke-B at (623) 935-8863 or (623) 935-8935, or (623) 935-8928. The manager of Disability Resource Center is responsible for determining a student s eligibility for services and will notify the faculty in writing of the accommodations requested. During the first class session, faculty members shall announce that students may meet with them during office hours if they need special accommodations for a disability. If you have any questions or concerns, please contact the DRC. For more information about accommodating students, visit our website at www.emc.maricopa.edu/disability/. NOTICE The SouthWest Skill Center reserves the right to change, without notice, any materials, information, curriculum requirements, and regulations stated in this publication. 5
Acknowledgement Signature ACKNOWLEDGEMENT SIGNATURE PAGE It is important that you read the information that is available on our webpage regarding the areas identified below. Follow this pathway: EMCC Home > SouthWest Skill Center > Admissions Packet > Important Admission Documents I acknowledge that I have read the documentation provided on the SWSC Web page related to: Underage of 18 & Certification Testing Criminal Background Identity Authentication Influenza Prior Education Fee for externship at Banner/SQ/LSA Student ID Number College LEGAL NAME: Last Name First Name Middle Name Signature Date 6
Student Declaration of Citizenship Status STUDENT DECLARATION OF CITIZENSHIP OR STATUS State law now requires that a person who is not a citizen or legal resident of the United States or who is without lawful immigration status is not entitled to classification as an in-state student pursuant to A.R.S. Section 15-1802 or entitled to classification as a county resident pursuant to A.R.S. Section 15-1802.01. Although you have previously enrolled at this or another Maricopa County Community College, it is important that you provide this information, even if you have been asked to provide similar information in the past. Failure to provide the information requested below may result in your being now classified as an out-of-state student for tuition and fee purposes. The responsibility of providing the proper residency classification is placed upon the student. Any student who falsifies his/her residency may be subject to dismissal from the college and /or criminal action. Only those with a lawful presence in the US may qualify for Maricopa County Community College District scholarships or federal financial aid. Any information you provide about your legal status when you apply for financial aid or scholarships may be subject to mandatory reporting to federal immigration authorities under Arizona Law, A.R.S. 1-501, 1-502. Student ID Number College LEGAL NAME: Last Name First Name Middle Name Date of Birth (mm/dd/yyyy) United States Citizen Legal Immigrant/Permanent Resident Alien Registration Number Date of Issue Date of Expiration Lawful Refugee or Asylee Alien Registration Number Date of Issue Date of Expiration Legal Nonimmigrant Alien Registration Number OR I-94 Number Date of Expiration of I-94 Specify Visa or Status Do Not Qualify for Any of the Above Country of Citizenship _ Arizona Department of Motor Vehicle License Number or Identification Number Date of Issue Date of Expiration I do not possess an Arizona Department of Motor Vehicle License or Identification Card. By signing this declaration, I swear under penalty of perjury that the document(s) that I have submitted to demonstrate lawful presence in the United States are true and the information provided on this form is true and complete. Signature Date For additional information, visit: www.maricopa.edu/residency. All of the information on this form is confidential and in compliance with the Family Education Rights and Privacy Act of 1974. The Act s provisions are explained in the General Catalog. 7
Certified Profile Background Check EXPLANATION OF HEALTH AND SAFETY REQUIREMENTS Immunizations Students must be in compliance with immunization policies of the Allied Health Program in which they are enrolled. The Program Director will provide students with health requirements applicable to that program and the deadline by which students must submit proof of meeting such requirements. Students will meet these requirements by providing completed and signed Health and Safety Documentation Checklist with all accompanying required documentation and the Health Care Provider Signature Form. Women of childbearing age should only be vaccinated after review of the circumstances by a health care practitioner. Students will be responsible for the costs of completion for all immunization requirements. The following is a description of immunizations that may be required and the type of documentation that a student would have to provide to verify the requirements have been met. (See Exhibit A Health and Safety Documentation) If there is a communicable disease outbreak, additional vaccinations may be required as specified by the local public health agency. Proof of all immunizations and tuberculin skin tests should be copied and attached to the Health Declaration form. a) MMR (measles, mumps and rubella): students born in 1957 or later must provide proof of one of the following: written proof of two MMR immunizations OR proof of a positive titer for each of these diseases. According to CDC recommendations students born before 1957 are generally felt to be immune but one dose of MMR vaccine should be given to anyone born before 1957 who does not have proof of positive titers to each of the three diseases. For programs that place students at Phoenix Children's Hospital students are required to show laboratory results documenting a positive titer for Measles/rubeola and rubella. Please contact program director to verify if this is a necessary requirement for the program you are entering. If a student has a NEGATIVE OR EQUIVOCAL titer result they must obtain their first MMR vaccination and attach documentation to their health and safety checklist. The second MMR must be completed after 28 days and proof submitted to the health care program. The student must then have titers drawn 30 days later and submit results to the healthcare program. Recommendations of the Centers for Disease Control and Prevention s Advisory Committee on Immunization Practices (ACIP), Adult Immunization Schedule 2014 Varicella (chickenpox): documented proof of a positive IgG titer OR if the titer is NEGATIVE obtain the first varicella vaccination and attach documentation to the Health and Safety Documentation form. The second varicella vaccination must be obtained 4 to 8 weeks later and proof submitted to the Program Director. For programs that place students at Phoenix Children's Hospital students are required to show laboratory results documenting a positive titer for varicella. Please contact program director to verify if this is a necessary requirement for the program you are entering. 8
Certified Profile Background Check If a student has a NEGATIVE OR EQUIVOCAL titer result they must obtain their first varicella vaccination and attach documentation to their health and safety checklist. The second varicella vaccination must be completed 4 to 8 weeks later and proof submitted to the health care program. The student must then have titers drawn 30 days later and submit results to the healthcare program. Tetanus/Diphtheria (Td) or tetanus, diphtheria and cellular pertussis (Tdap): Tdap=Tetanus/Diphtheria/Pertussis TD=Tetanus/Diphtheria Students must provide proof of a one-time dose of Tdap, followed by Td booster every 10 years. Attach proof of necessary vaccinations to the Health and Safety form. Recommendations of the Centers for Disease Control and Prevention s Advisory Committee on Immunization Practices (ACIP), Adult Immunization Schedule 2014. Hepatitis B: The Centers for Disease Control and Prevention have recommended that hepatitis B vaccine be considered for a number of groups including healthcare personnel at high risk for blood or needle stick exposure. It is highly recommended that students working in direct patient contact receive the hepatitis B vaccine. Students will be provided with information on protective and standard precautions as part of their Program curriculum, but students are advised to consult with their personal physician about the advisability of receiving the hepatitis B vaccine. To meet the requirements for Hepatitis B, students must either submit proof of completion of three Hepatitis B (see Exhibit A) injections OR a copy of proof of a positive HbsAB antibody titer OR a signed declination (see Exhibit B). If a student has not received injections in the past, he/she should receive an initial dose of hepatitis B with second and third vaccinations administered in 1 month and 6 month intervals. Recommendations of the Centers for Disease Control and Prevention s Advisory Committee on Immunization Practices (ACIP), Adult Immunization Schedule 2014. Influenza: An annual influenza vaccine is highly recommended by the Allied Health Programs. If a student declines this immunization for any reason, and a clinical agency requires such a vaccination there is the possibility that the student may not be permitted to participate in the clinical experience at that agency. Health care providers who are clinically or subclinically infected with influenza virus can transmit the virus to other persons including patients whose immune systems are compromised. As such many clinical facilities are requiring that all staff, students, and volunteers show proof of an annual influenza vaccination (see Exhibit B) or a signed declination (see Exhibit B). Recommendations of the Centers for Disease Control and Prevention s Advisory Committee on Immunization Practices (ACIP), Adult Immunization Schedule 2014 9
Certified Profile Background Check Tuberculosis Testing For Allied Health students completing clinical experiences in a clinical agency, a Two Step Test* is required by the Allied Health Programs. *Two-step testing is used to reduce the likelihood that a boosted reaction will be misinterpreted as a recent infection. 1. If the reaction to the first test is classified as negative, a second test is to be done 1-3 weeks later. 2. A positive reaction to the second test probably represents a boosted reaction (past infection or prior BCG vaccination). On the basis of this second test result, the person should be classified as previously infected and cared for by a health care provider. This would not be considered a skin test conversion. If the second test result is negative, the person should be classified as uninfected. In these persons a positive reaction to any subsequent test is likely to represent new infection with M tuberculosis (skin test conversion). Two step testing should be used for the initial skin testing of adults who will be retested periodically, such as health care workers. 3. Students with a history of positive reactions to TB skin tests must provide a report of a negative chest x- ray. Further TB screenings may be required by a health care provider. *Core Curriculum on tuberculosis What the Clinician should know, Department of Health and Human Services, Centers for Disease Control for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta Georgia, 4th Edition, 2000. QuantiFERON-G may be an appropriate test for TB in certain populations of persons who are at low risk or increased risk for latent tuberculosis infection. Students should check with the Program Director for more information. CDC. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005; 54(No. RR-15):1--47. Health Care Provider Signature: Download, print and complete the Physcial Assessment Form signed by a physician (M.D. or D. O.), Nurse Practitioner, or Physicians' Assistant within the past 6 months. 10
Certified Profile Background Check Your certified Profile Service Desk is available to assist you via phone, chat and email. Monday-Friday 8am-8pm & Sunday 10am-6:30pm EST 888-914-7279 or cpservicedesk@certifiedprofile.com 11