Frontline Initiative Credentialing

The state of California has about 1000 intermediate care facilities for the mentally retarded (ICF/MRs), serving approximately 7,000 individuals. These programs are increasingly challenged by trying to find and keep qualified Direct Support Professionals (DSPs). In an effort to develop and maintain a high quality of services, California is working on a statewide standardized training program and competency test for DSPs (called Developmental Assistant [DA] in California).

The California Association of Health Facilities (CAHF) has taken the lead in proposing to its legislature that they create a competency-based training and certification program which would be overseen by the California Department of Health Services. The legislation would create a new position, Certified Developmental Assistants (CDA), which according to the proposed legislation, is defined as any person who, for compensation, performs basic care services directed at the safety, comfort, personal hygiene, or protection of [persons with developmental disabilities], and who is certified as having completed the requirements of the certification program. The legislation distinguishes services from those that by law may only be performed by a licensed nurse or a qualified mental retardation professional (QMRP, see page 7).

CAHF proposed that the certification program be modeled after the state’s Certified Nursing Aide training and Competency Exam Program as well as the one mandated in federal law. The proposed standardized CDA training includes a pre-certification training program, which consists of a) at least 60 hours classroom training on basic direct support skills, client safety and rights, the necessary supports for people with developmental disabilities, and b) 100 hours of supervised on-the-job training in clinical practice in a long-term care facility serving people with developmental disabilities under the supervision of a licensed nurse or a QMRP.

The classroom portion of the training program may be conducted by instructors who are employed by or under contract with the facility, or by another approved agency or educational institution. It is anticipated that the American Red Cross will be at least one approved provider of the classroom component. In addition, due to their record of creating excellent competency testing, they are to develop the state-mandated test in conjunction with CAHF and providers in the state, and will likely administer the test when complete.

Any person hired as a developmental assistant (DA) will be required to have certification within six months of employment. The certificate offers some benefits to the DA. For one, in California there are a substantial number of hours of training required for people in DA roles every time they start a new employment situation. This includes times when a person picks up a second part-time job, or moves from one agency to another, even though the services provided and the skills needed are essentially the same. The proposed certification is also proposed to be portable among providers in the state, which alleviates both CDAs and employers of the burden of repeated training. CAHF is also asking the Legislature to pass a 20- cent-per-hour wage increase to be given to CDAs upon successful certification. In addition, there are provisions for partial credit toward completion for those who start the certification process and have to stop temporarily (e.g., family emergency, birth, etc.) so that they can return without having to start at the beginning. 

CDAs will need to renew their certificate every two years by proving that they completed a minimum of 24 hours of specified continuing education as well as 36 hours of discretionary training provided by their employers. The bill also sets forth the procedures by which the California Department of Health Services shall have the authority to revoke, deny, suspend, or place on probation a CDA certificate. A statewide database will record and track certification information, which may be accessed by state employers so that they can assure a CDA is currently certified.

 Facilities currently absorb the cost of training. They will continue to do so but with the anticipation that they will have a better trained and more stable workforce which will translate to improved quality service for people being supported. With no major opposition and widespread support, the legislation is expected to be passed and enacted by January 2001.