New York State signed into law a bill that will permit home health aides with advanced training to administer medications. They will also be permitted to perform other advanced health tasks as long as they are under the supervision of a registered nurse. Nebraska, Idaho and Connecticut have already enacted such laws and other states are considering similar bills.
A New York State bill signed into law in November 2016 will come as a welcome relief for many family caregivers. On November 28, 2016 Governor Cuomo signed bill #A10707 that creates a new classification of home health attendant who can administer medications to clients. The new classification called Advanced Home Health Aide (AHHA) will permit many infirm and disabled people to remain in their homes rather than be confined to a nursing home.
Currently New York law does not permit home health aides to administer medications. The main duties of a home health attendant are to help infirm individuals with activities of daily living. These activities include dressing, bathing, mobility, toileting, eating, and transferring. Aides can also remind a patient to take her medicine. The aide can bring the medicines to her, but cannot put them in her mouth. Home health attendants are also not permitted to give injections or draw blood. Only a licensed nurse can perform these tasks. Unfortunately there are not an adequate number of visiting nurses who can make multiple daily home visits to patients. The only alternative home care patients have is to request a neighbor or family member come by to administer medicines.
Another alternative is to apply for the Consumer Directed Personal Assistance Program (CDPAP). CDPAP is a Medicaid program that permits an infirm person to hire and train someone to care for him and have Medicaid pay for the care. Under CDPAP, the appointed “aide” can perform tasks that are not traditionally assigned to a home health aide. They include giving medications, operating medical equipment, and administering injections. There is a down side to this program. The patient who appoints a personal assistant must be able to train and self-direct his own care. This excludes people with memory problems or persons with an inability to communicate their needs.
This new legislation will offer a solution for families with frail relatives who cannot self-direct care. This includes Alzheimer’s patients and other individuals with dementia. Many patients with memory disorders are placed in nursing homes because they cannot remember when to take their meds and cannot direct others. Patients with severe diabetes will also benefit. Many diabetics are unable to monitor their sugar level or give themselves insulin injections. The Advanced Home Health Aide will allow them to stay at home rather than enter a nursing home.
To become an Advanced Home Health Aide, an aide must have at least one-year home care experience and must complete a training program. The program will teach the aide advanced health tasks such as dispensing pre-packaged medication, giving insulin injections and administering emergency injections of epinephrine to avoid anaphylactic shock. Once the courses are completed the aide is permitted to perform advanced tasks as long as she is under the direct supervision of a registered nurse.
The new law is scheduled to go into effect in mid-2018. In the time before implementation New York’s Departments of Education and Health must determine the types of advanced tasks the AHHA can perform, develop a training curriculum, and create a graduation criteria. Finally the Department must initiate quality standards, estimate the cost of program development and create budget guidelines.
New York is not the first state to develop an advanced home health aide category. Nebraska, Idaho and Connecticut have passed similar laws. All three states require attendants to complete advanced courses and pass a written test before they can administer medications. Many other states are considering similar bills.
The trend to increase the responsibilities of home health aides will help the frail elderly and the disabled to stay in their own home rather than entering institutional care. This is one of several steps that shift the emphasis of long-term care from impersonal institution care to the comfort of home care. This new movement recognizes that older adults wish to live the remainder of their lives with dignity and in a surrounding that they love.
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