Continuing Care Assistant Program

What is the CCA Program

The CCA Program includes a number of key services focused on promoting quality education delivery and supports for Certified CCAs in Nova Scotia.  The Program services flow from the CCA Program Curriculum Standards which define the education preparation and from the CCA Registry which supports the CCA and counterparts and health care sector.  

CCA Certification is the education required for entry to practice to work as a direct care and support service provider in most DHW Continuing Care funded service providers.  CCA Certification is the education requirement for Care Team Aide (CTA) position in the acute care environment.  The CCA Program education prepares the learners to deliver either short or extended periods of assistance and support services to persons in various care settings, such as home care, long term care, acute care and other care settings. 

The diagram below illustrates the governance structure of the CCA Program and how the different CCA Program services connect. 

CCA Program Curriculum Standards

Central to the CCA Program is the CCA education (defined by the CCA Program Curriculum Standards) which outlines the knowledge, skills, and attitudes, and judgment required for a beginning practitioner upon entry to the field as a Certified CCA. The CCA is prepared through his/her education program to practice according to the CCA Scope of Practice.

Prior to the Continuing Care Assistant (CCA) Program there were numerous training programs available to the direct care and support service provider  in the province of Nova Scotia.  Due to these diverse training options, there were people working in this role with different titles and skill sets resulting in limited employment opportunities across health care sectors. As Nova Scotia moved toward a more fully integrated health system, consistency of education was required. 

The first edition of the CCA Program Curriculum Standards, introduced in 2000, was developed by a CCA Program Curriculum Development Committee made up of health care employers, educators, and government. After careful consideration, consultation, and evaluation of the current education, including future requirements for growth in this occupation, the core learning outcomes of the CCA Program stemmed from the amalgamation of three long standing Nova Scotia health care courses: the Department of Health’s Personal Care Workers (PCW) course, the Home Support Nova Scotia Association’s Home Support Workers (HSW) course, and the Nova Scotia Community College’s Home Health Aide/Home Healthcare Provider (HHP/HHA) course. Additional learning outcomes were added to the curriculum standards to prepare the workforce for the evolving needs of the Nova Scotia health care system.

A continued goal of the CCA Program is to offer the graduates more employment options while providing the client with improved care and assistance by qualified individuals that met provincially-established standards.  The standardized education meets the increasing complexities in care and allows for continuous monitoring and education growth to support the needs of the evolving health care system.

Since the CCA Program was introduced, the goal to remain current and relevant has been a priority. Review and revisions of the Curriculum Standards are initiated by the health care system’s need for the CCA’s competencies to evolve.  As a standard practice the review and revision process utilizes research; consultation with service providers, content experts, and other key stakeholders; and relies on the expertise of a project team and stakeholder steering committee. 

The revisions resulting in the September 2013 Curriculum Standards were triggered by the evolving CCA’s Scope of Practice and the expanding employment opportunities in other health care settings, particularly for the acute care settings, at the request of the District Health Authorities (DHA). The review and subsequent revision struck a balance between introducing and amalgamating new learning with the existing learning to adequately reflect the variety of care settings and the evolving Scope of Practice. 

The CCA Program Curriculum Standards meet and exceed the Canadian Educational Standards for Personal Care Providers released in June 2012, funded by Health Canada and prepared by The Association of Canadian Community Colleges (ACCC) and its affinity group, the Canadian Association of Continuing Care Educators (CACCE). For more information on these standards please visit the  

Standards Compliance Assessment

The CCA Standard Compliance Assessment (SCA) licensing process, initiated in 2010, ensures the CCA Program Standards (CCA Program Curriculum Standards and supplementary documents) are being delivered consistently throughout the province of Nova Scotia by licensed education providers. The CCA Program Standards include the learning outcomes and objectives, teaching and assessment strategies, and the conditions required to deliver the education. The Standards establish a framework for the consistent provincial delivery and the basis for the CCA Certification Exam.  
Prior to the SCA process each course delivery was approved individually.  As course deliveries increased, the process became time consuming and did not validate to a reliable degree the consistency of provincial delivery of the Curriculum Standards.  

The Standards Compliance Assessment (SCA) licensing process was developed by a working group consisting of CCA employers, educators, government, and CCAPAC representatives. The goal of the process is to increase the reliability of the Curriculum Standards being delivered consistently throughout the province of Nova Scotia.  Any education provider seeking a license to deliver the CCA Program must first successfully participate in the SCA licensing process. A license may be granted for one course intake to a maximum of three years depending on the results of the SCA.  Once a license is granted CCAPAC will continue to monitor the licensed provider and has an obligation to investigate indicators of non-compliance as required and, revise, or remove a license. 
The current SCA licensing process was approved for implementation in February 2014. As with any process, the SCA is not static. CCAPAC is committed to quality and integrity and will continue to grow and evolve the SCA process through evidence and evaluation. 
For details on the current process go to the For Educators page.

CCA Certification Exam

The Continuing Care Assistant (CCA) Certification Exam is used by CCA Program Advisory Committee (CCAPAC) to assess the competencies of a CCA graduate from a licensed education provider for Department of Health and Wellness (DHW) CCA Certification. The exam is used to provide reasonable assurance to employers and the public that an individual who has passed the exam has obtained the necessary knowledge, skills, and attitudes to perform in a competent manner in accordance with the CCA Scope of Practice.  The exam is aligned with the learning outcomes of the Curriculum Standards.
Exam development and administration is the responsibility of a CCA Certification Exam Committee who reports directly to CCAPAC.  The initial Exams were developed using an Exam Blueprint and questions (items) submitted by CCA educators, employers, and members of the Committee.   Candidate responses were analyzed and exam questions were revised as required.

As the CCA Program evolved and learning complexity increased, the CCAPAC and Exam Committee began to take further steps to ensure the exam is an effective and valued assessment tool for CCA Certification.   In 2010, the CCA Exam Committee invited a team of experts  to guide the Committee through a revision of the exam process.  With the help of the noted professionals the Exam Committee developed a policy and procedural structure for consistent development and administration of the Certification Exam.  The goal of the exam structure is to ensure the exam’s validity, reliability, fairness, and legal defensibility using the Standards for Educational and Psychological Testing  and the Standards for the Accreditation of Certification Programs  as the benchmark.  The policy and procedure structure includes: an Operations Manual, which includes a process for continuous monitoring and revision; CCA Certification Handbook for educators and exam candidates; an item bank and item analysis software to assist in the management of the exam; all of which contribute to a reliable, valid, fair and defensible process. 

For more details on the CCA Certification Exam see Writing the Certification Exam under Education. 

Recognizing Prior Learning Programs 

CCA Program Advisory Committee (CCAPAC) first embraced the Recognizing Prior Learning (RPL) philosophy in 2002 by setting up the CCA Equivalency process.  CCA Equivalency was the original RPL process for the Nova Scotia courses (PCW/HSW/HHP/HHA) amalgamated to become the CCA Program Curriculum Standards.  The three education curriculums were assessed and learning paths were established to meet CCA Certification. 

With the CCA Equivalency learning paths established CCAPAC saw a need to embrace the RPL philosophy in greater depth.  Dialogue started in 2002 to recognize on-the-job trained direct care and support services providers. In 2003 a partnership was formed   to create a Prior Learning Assessment & Recognition (PLAR) process.  In 2004 a pilot was conducted and recommendations were submitted to DHW in March 2005.   From there under the direction of CCAPAC, a tri-partnership  formed to implement the recommendations from the pilot project (Implementation of PLAR).   The project report was presented to CCAPAC in February 2007 and the recommendations for the PLAR process were adopted.  Both the CCA PLAR pilot (2005) and the CCA PLAR process (2008) were presented at the Canadian Association for Prior Learning Assessment (CAPLA).  

CCAPAC’s next step in the RPL journey was to establish a bank of learning paths from curriculums across Canada. In 2008, a DHW funded project produced 15 learning paths from across Canada.  This project established the Course Recognition process and incorporated the CCA Equivalencies learning paths.  Today the Course Recognition program has approximately 225 learning paths national and international from 31 curriculums.

In 2008, RN Navigators were retained to guide the participant through the RPL Process (facilitating the assessment, learning, and preparation for the CCA Certification exam). DHW provided funding for the RPL Navigators for 3 years. With a final funding grant in 2011, a three year plan for the RPL Program to become self-sustaining was launched. 

In 2009 CCAPAC once again presented on the CCA PLAR process at the CAPLA.  During this year the management of the Self-Directed Learning (SDL) transition from Home Support Nova Scotia Association (HSNSA) to the CCAPAC.  Initially the SDLs were developed by the HSNSA to support the health care employees gain CCA Certification through the RPL Program. In the fall of 2013, as part of the CCA Program Curriculum Standards revision, the SDL Modules were made available through the CCA Program website. 

In the fall of 2012, Nova Scotia Labour and Advanced Education (LAE) funded a project for the RPL Program PLAR Process to move to a more accessible venue via the CCA Program website. The project was completed in April 2013 and a successful pilot was conducted in the late spring.  
For more details on the RPL Program see the Education page. 

CCA Registry

For the first 10 years of the CCA Program, its main goal focused on education and certification standards, however, CCA supply and demand was also a relevant concern during this time.  A number of recruitment and retention activities and supply and demand studies strongly indicated a need to have a Registry to inform human resource planning for CCAs and their counterparts.  

In 2009 the CCAPAC initiated a working group to identify the components necessary to establish a Continuing Care Assistant Registry.  For the purpose of the Registry, CCA includes Certified CCAs and counterparts which refer to people working in the role of direct care and support services provider but not Certified CCAs as identified by the Department of Health and Wellness (DHW) Educational Requirements for Entry to Practice Policy.  The final report of the working group was submitted to DHW in March 2010.  The DHW accepted the recommendations and moved to develop a CCA Registry.  

The first two years for the Registry were funded by the DHW with the goal of becoming self-sustaining. To become self-sustainable an annual fee of $50.00 (plus HST) was implemented for the registration year starting November 1, 2012.  The fee would cover the costs of administering the Registry and provide perks to members with the members providing the future direction for the Registry. 

During the CCA Program’s strategic planning sessions, at the 2012 CCA Program Stakeholder’s Forum, stakeholders sent a strong message that the CCA Registry should be mandatory.  It is not within CCAPAC’s ability to make the Registry mandatory but CCAPAC has been working with DHW to investigate ways to accomplish this goal.  As a continued recognition of the importance of the Registry, in 2013 the DHW provided an additional grant to maintain the Registry operations while a sustainable structure is investigated. 

For more information on the Registry go to the CCA Registry page.