Direct Care Worker Registry
The Iowa Direct Care Worker Registry functions under a 37-year-old law that first required nurse aides in nursing homes to be certified by completing a 75-hour training. That same law required every state to establish a Nurse Aide Registry, referred to as the Direct Care Worker Registry in Iowa.
Much has changed in 37 years when nursing homes or county homes were the only options for extended care. We’ve come a long way since then. After 37 years and the addition of many different levels of care that include assisted living, group homes, and in-home care, it is time to modernize the Registry to allow Direct Care Workers to have a permanent record of their training or credentials so they follow them from one workplace setting or population served to another without losing their eligibility to work or active status on the Registry.
Join us in supporting policy that will require the Department of Inspections, Appeals, and Licensing to include the Direct Care Worker Registry in their plans to place licensing boards into a single system.
Iowa Department of Management Boards and Commissions Review Committee Final Report (September 2023)
This document contains final report of the Board and Commission Review Committee with findings and recommendations.
Issue Brief:
Direct Care Workers (DCWs) Share Why Expanded DCW Registry Is Important to Them (2.5 minutes)
Discussion About Modernization of Direct Care Worker Registry Hosted by Iowa CareGivers (2022)
Modernization of the direct care worker registry and creation of a voluntary public portal of caregivers is something Iowa CareGivers has long advocated for. And now with American Rescue Plan Act funding, the work to establish the infrastructure needed to build and retain a strong direct care workforce can begin.
Direct Care Worker (DCW) Registry and Education Survey Reveals Information Gaps (2022)
Education of DCWs About the Purpose of the DCW Registry and Steps to Remain Active on the DCW Registry is Needed
It is important to note that Certified Nurse Aides (CNAs) who work in nursing homes do not have a state-approved continuing education standard that is linked to their maintaining their eligibility to work by being on the active DCW Registry. Nursing home providers are required to provide 12 hours of in-service for staff, but those hours are not considered continuing education and therefore, do NOT keep CNAs active on the DCW Registry. CNAs must work 8 hours in a 24-month period in state approved settings to retain their active status. The settings that qualify were expanded to certified hospitals, ambulatory surgery centers, home health agencies, and hospices in 2017. Employers in these additional settings can submit employment verification to Iowa Department of Inspections, Appeals, and Licensing to keep DCWs active on the Registry. However, many employers do not report employment which can be problematic for DCWs who may be transitioning to a different job or move to a different location in the state.
ISSUE: Direct Care/Service Workforce Central Data Base System (2017)
Currently, there does not exist, a state-based central data base system that maintains records of the training and/or credentials of all who work in direct care. Iowa Department of Inspections, Appeals, and Licensing (DIAL) is required by the federal government to manage the Iowa Nurse Aide/Direct Care Worker Registry. The Registry maintains a list of Certified Nursing Assistants who work in nursing homes only. Those working in other settings like assisted living, home care, and even hospitals do not have the option of being included on the Registry and record keeping is sketchy and fragmented. This lack of consistency creates challenges for those working in the field as well as their employers.
An issue paper on this topic has been prepared to shed light on the need for such a system. Those who work in the field deserve to have a system in place that will provide them with assurances that their training is valued enough to be part of a permanent record that can follow them from one place or person served to the next.
87% think they have a state-approved continuing education standard that keeps them active on the DCW Registry.
89% think the 12 hours of in-services their employer are required to provide each year are continuing education standards that keep them active on the DCW Registry.
“I was told to go work 8 hours in a nursing facility and then quit to meet the requirement to stay active on the DCW Registry. ”
Direct Care Worker Education and Certification
We’ve learned that many of you leave the field of direct care because you don’t receive enough education and training to do what is expected of you; some of you may lack opportunities for advancement within the fields of direct care; and the state and federal standards related to your education, training, or certification is not very clear or consistent. Some of you have said that you have lost your certification when you left one care setting to work in another. Work is being done to help make the system better for you, those you serve, and your employers. Direct Care Workers Should Not Lose Certification...... If They Don't Work For A Couple Of Years!! Federal Law Must Be Changed!!
If you have a story to share about losing your certification let us know.
Direct Care Worker Registry
“I see so much in-house training going on at facilities and when you leave you don’t take those credentials with you. You have to start all over and be retrained somewhere else. That would be awesome if you could put your in-house training on a database and be able to track it and carry it with you everywhere you go.”
- Michael Owens, Direct Support Professional