FLORENCE DARLINGTON TECHNICAL COLLEGE ASSOCIATE DEGREE - HEALTH INFORMATION MANAGEMENT Application and Selection Program Package

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FLORENCE DARLINGTON TECHNICAL COLLEGE ASSOCIATE DEGREE - HEALTH INFORMATION MANAGEMENT MEMO to Students Dear Health Information Management Student: Thank you so much for choosing Florence Darlington Technical College for your education in the healthcare professions. We look forward to helping you succeed in the program you have selected. This letter is to make you aware of two (2) very important issues that could impact your education in allied health sciences here at FDTC. The concern for the welfare and safety of patients, students, employees, visitors, and resources within the college allied health science scope of education is critical and of utmost priority while working in the healthcare industry. In response to this concern, new policies have been instituted by our affiliating healthcare agencies where you would be participating in the clinical and/or practicum portion of your educational process. Since FDTC students are required to comply with the policies of all affiliated clinical agencies, the issues addressed in this letter are very important and required for your success. The first issue is related to the requirements for criminal background checks on all Health Science students. Beginning fall, 2009, any student entering the clinical/practicum portion of any health science related program must have a crime free criminal background check. Convictions of, pleas of guilty, pleas of nolo contendere (no contest), or any pending criminal charges during the past seven (7) years will prevent the student from meeting the requirements of clinical/practicum eligibility. There will be no time limit for crimes involving violence against a person including but not limited to: murder, manslaughter, use of deadly force, assault and battery (other than simple), sex crimes, abuse of children/elderly, abduction, or robbery and they will prohibit a student from a clinical/practicum course of study. If you know you do not have a crime free background check you may want to seek legal counsel regarding the possibility of having the record expunged or pardoned. The second issue is related to mandatory drug screens. All Allied Health Science students will be required to undergo drug screening before beginning the clinical/practicum portion of their program. The purposes of the drug screen policy are to comply with regulations of area health care agencies, to provide optimal care to patients, and to support the zero tolerance policy related to illicit use of substances as stated in the Alcohol and Drug Policy of Allied Health Science programs located in the syllabi. Random drug screens may be performed throughout the time students are enrolled in clinical courses. It is unacceptable for students to have detectable level of illegal drugs in their system, to be under the influence of alcohol, or to have detectable levels of legal drugs which are not disclosed and/or for which no prescription can be produced. A crime free criminal background check and a negative drug screen are vital to your success in the allied health science programs. Again, thank you for choosing FDTC and I wish you all the best in your educational experience. Sincerely, Lisa Hastings, MHA, RHIA, CPC Program Director HIM & MCB Revised 02/21/2014 Page 1

College Admission Admission application to the College Submission of transcripts from High School and any colleges previously attended. Complete college admission placement testing for enrollment in the appropriate General education courses (English, Math) Pre- Requisites Attend Career Talk Session and have met with HIM Advisor within 1 year. Completion of Phase 1 courses in the Health Information Management program (refer to the Semester Curriculum for the program) with a "C" or better or be currently enrolled in your final semester Phase 1 courses of which must be completed with a "C" or better before the Fall term. Application for Program Complete and turn in the Health Information Management Application Packet due by the last business day of March by 4 pm. Meet with HIM Advisor for review of program policies and requirements. Students are ranked according to the GPA in the Phase 1 and courses. Admission to Program Notification will be sent to the student of acceptance into the HIM Program Phase 2 for Fall term by June 1. Completion of required clinical forms found on the school program weblinks by August 1st (Medical form, Background Screen, Drug Screening, CPR Certification) Upon acceptance Student will be responsible for completing the following prior to Fall semester term: Health Occupations Basic Entrance Test (HOBET), Health Physical, Criminal Backgorund Check, Drug Sreen, CPR Certificaiton, and other required immunizations. Revised 02/24/2014 Page 2

APPLICATION AND SELECTION CRITERIA MINIMUM APPLICATION CRITERIA for the Health Information Management (HIM). Applicants must have a high school diploma or GED, admission to Florence Darlington Technical College and have completed the college admission placement testing for enrollment. Attended a Career Talk Session within 1 year of the application date for the program. Applicants with college credit earned in high school must be completed with a C or better to get Transfer Credit (TR). College Registrar grants TR credit. Applicants with previously completed college credit or degree must have official transcript sent to Registrar s office and have a GPA of 2.0 or better. Have completed the HIM Associate Degree Phase I courses (refer to the Semester Curriculum for Health Information Management) with a C or better, or be currently enrolled/have final phase 1 courses registration for coming term at the time of the application MINIMUM SELECTION CRITERIA for the Health Information Management Program (HIM) Students are advised that should there be a greater number of applicants than positions available: Florence, Darlington and Marion County residents and/or students completing the majority of the required Program credit hours (prerequisites and co-requisites) at FDTC are given preference in the selection process when all other requirements have been met. The Program GPA earned will be used in selecting applicants for admission. This includes any program prerequisites and/or co-requisites The number of program courses completed at FDTC In the event of a tie, the curriculum, related courses will be ranked in the following order: HIM 103, BIO 112/210, MAT 120 PROOF OF RESIDENCE Residents of South Carolina, as defined by state law, are independent or dependent persons who have domiciled in South Carolina for a period of no less than 12 months. Further proof of residency is required for the Allied Health Program Students, who do not reside in the Florence, Darlington or Marion Counties and have not taken the majority of the programs course work at FDTC. A driver s license will be accepted for proof of residency if it is at least 12 months old. STATUS NOTIFICATION The applicant will be notified electronically, by the HIM program, to their official Florence Darlington Technical College student email address. The applicants will be informed of their status regarding acceptance or rejection into the Fall HIM class. Information regarding the status of the applicant s application will not be available from the Allied Health Programs nor from the Registrar s Office during the review of the applicants files. The applicant is asked to please make inquiries regarding the application only if the applicant becomes aware that an error or omission has occurred. The Administrative Assistant will be the contact for Allied Health Departments ( 843-661-8140). We wish each applicant the best in the application and selection process. Revised 02/24/2014 Page 3

Please note that it is the applicant s responsibility to ensure that all documents are provided to the school by the last business day of March at 4:00 p.m. Applications may only be submitted the first business day of March, through the last business day of March. Print the Application and Selection Criteria and Application Checklist to the HIM Program and complete, when all of the instructions have been read. Be sure to keep a copy for your records. The Application and Application Checklist must be mailed to FDTC, Attention: HEALTH INFORMATION MANAGEMENT, P.O. Box 100548, Florence, SC 29501-0548 or delivered to Lisa Hastings HIM Program Director, Rm 359 the Health Science Campus (HSC) at 320 West Cheves Street, Florence, SC. If you would like proof of receipt you may send certified mail or by Federal Express (FedEx ). Applications are accepted beginning the first business day of March until the last business day of March, beginning at 9:00 a.m. and no later than 4:00 pm. ** NOTE** 1. The textbooks for this program are extensive. With most courses there will be textbook, workbook, additional software, and or code books for each course. I want to inform you of this so you are aware of the costs associated with the program. 2. For practicum/internship based course (HIM 163 & 164) you will be required to purchase an established attire to include dress pants, colored shirts, and a uniform vest that requires monograming. Please be aware of these additional costs. 3. The practicum/internship courses require FDTC clinical processes that include a CBC, Drug Screen, Immunizations, CPR, health physical, and for some sites additional orientations. This process can range from $200-$500 depending on the extent of the required facets. The following items, 3-10, are required upon acceptance into the HIM Degree Program: 4. Medical Examination Forms are provided by the College and should be current (within one year) and complete 5. Two-Step PPD/Chest X-Ray 6. Hepatitis B Immunization or Signed Informed Refusal 7. MMR Immunization 8. Chicken Pox Vaccination 9. CPR Certification by American Heart Association or American Red Cross 10. Background Check 11. Drug Screening Application Checklist Page 1 of Required Submission for Application Revised 02/24/2014 Page 4

Name: Preferred Email/Phone: Student ID#: The following are minimum requirements or necessary steps for consideration for admission to the Health Information Management Program. Complete each step/requirement and certify by initialing on this form that the step/requirement has been met. Submit this form with your completed application to Attention: HEALTH INFORMATION MANAGEMENT, P.O. Box 100548, Florence, SC 29501-0548 or delivered to Lisa Hastings HIM Program Director, Rm 359 the Health Science Campus (HSC) at 320 West Cheves Street, Florence, SC, by the last business day of March. If you would like proof of receipt you may send certified mail or by Federal Express(FedEx ). Each item must be initialed by the applicant indicating the requirement has been met: Admission as a credit degree- seeking student to Florence-Darlington Technical College. High School diploma or GED is on file with the Registrar. College transcripts of all transfer credits are on file with the Registrar. Attendance at Career Talk within one year of program application Overall cumulative credit grade point average of 2.0 or higher has been earned. A minimum GPA of 2.0 must be maintained in the Health Information Management Program, as a C or better is required in all Health Information Management courses and in all General Education courses. Completion of Phase I of the Health Information Management Program curriculum or be currently enrolled in your last semester of required courses at the time of application. Courses must be completed with a grade of C or better for final acceptance and enrollment. I have completed all of the above requirements. Student s Signature: Date: Revised 02/24/2014 Page 5

Page 2 of Required Submission for Application APPLICATION PLEASE PRINT CLEARLY AND PROVIDE THE INFORMATION REQUESTED IN ALL SECTIONS. INCOMPLETE APPLICATIONS CANNOT BE CONSIDERED IN THE SELECTION PROCESS. The completed application must be returned in person by the applicant to the Allied Health Administrative Assistant, Room 362 at the Health Science Campus between 8:00-am and 12:45 pm and 2:15 pm and 4:00 pm by the last business day of March. Name: (LAST) (FIRST) (MIDDLE) Any Former Names: Student ID #: If mailing address is PO Box, you must also provide a home (street) address. Mailing Address: Home Address: City: County: State: Zip: County of residence: Home Telephone #: Work/Cell #: FDTC E-mail Address: NOTE: Florence Darlington Technical College is an equal opportunity institution and as such it does not discriminate on the basis of race, color, religion, national or ethnic origin, creed, marital status, veteran status, disability, sex, or age in its admissions policies, programs, activities or employment practices. Admissions will be based on the information included on the application, and on the transcripts available. Information received after admission decisions are made will not be considered for the current application period. Revised 02/24/2014 Page 6

Page 3 of Required Submission for Application Please indicate the term and grade of completion of the Phase 1 courses: PHASE I Pre-requisites Semester Completed FALL Lecture/Lab/Credit AHS 102 MEDICAL TERMINOLOGY 3-0-3 BIO 210 ANATOMY & PHYSIOLOGY I 3-3-4 BIO 110, 112 ** or BIO 112 BASIC A&P BIO 100 or HS Biology ENG 101 ENGLISH COMPOSITION I 3-0-3 ENG 100 or Placement HIM 103 INTRO TO HIM & CODING 3-0-3 12-3-13 SPRING BIO 211 ANATOMY & PHYSIOLOGY II 3-3-4 BIO 210 **If BIO 112, BIO 211 is not needed PSY 201 GENERAL PSYCHOLOGY 3-0-3 MAT 120 PROBABILITY AND STATISTICS 3-0-3 MAT 102 or Placement AHS 121 PHARMACOLOGY 2-0-2 BIO 110, 112, or 210 11-3-12 SUMMER SPC 205 PUBLIC SPEAKING 3-0-3 ENG 100 HUMANITY 3-0-3 6-0-6 PHASE II FALL HIM 110 HEALTH INFO SCIENCE I 2-3-3 Admission to Program HIM 115 MEDICAL RECORDS & LAW 2-0-2 Admission to Program HIM 130 BILLING AND REIMBURSEMENT 3-0-3 BIO 112 HIM 266 COMPUTERS IN HEALTHCARE 3-0-3 HIM 163 SUPERVISED CLINICAL I 0-9-3 Admission to Program 10-12-14 SPRING HIM 140 CURRENT PROCEDURAL TERM I 2-3-3 BIO 112, 210/211 HIM 216 CODING AND CLASSIFICATION 2-3-3 BIO 112, 210/211 HIM 135 MEDICAL PATHOLOGY 2-3-3 BIO 112, 210/211 HIM 265 SUPERVISORY PRINCIPLES 3-0-3 Admission to Program 9-9-12 SUMMER HIM 120 HEALTH INFO SCIENCE II 2-3-3 Admission to Program HIM 164 SUPERVISED CLINICAL II 0-9-3 Admission to Program HIM 225 CODING AND CLASSIFICATION II 2-3-3 HIM 216, 140, 130 4-15-6 & Grade Received Revised 02/24/2014 Page 7