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I have worked 20 plus years in a medical and or special needs background. In the state of Mass I have held certificates (most expired) with P. S. R. (patient service rep which trained in 5 areas: CNA, diet technician, social services, physical therapy assistant, infection control. I have also previously held CNA, HHA, medication certificate, CPR, First Aid, Phlebotomy, Basic EMT. I have worked in both institutions and in private. I have done case management, conducted self advocacy meetings. I have also worked hospice; both private care and also through agencies.