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New York state has adopted new law that establishes the advanced home health aide (AHHA) job designation. The AHHA program was first recommended in 2011.
Gov. Andrew Cuomo signed S. 8110/A.10707 into law on Nov. 28. The new law amends sections of Article 139 of the Education Law (relating to the practice of nursing), as well as provisions of Article 36 of the Public Health Law (relating to home care agencies).
What is an AHHA?
The new law defines an AHHA as a certified home health aide:
An AHHA is authorized to perform "advanced tasks" without violating the legal proscriptions against the unauthorized practice of nursing.
How are "advanced tasks" defined?
The new legislation adds a broad description of minimum "advanced tasks." These include the administration of medications that are routine, pre-filled and otherwise relatively easy to administer (which would not include medications that require injections (other than insulin/diabetes care injections and other specified injections, sterile procedures, or central line maintenance)).
The entity employing the AHHA will be required to establish a protocol to address drug diversion.
The Commissioners of Health and Education are directed to promulgate regulations to otherwise specify what will be included in "advanced tasks."
How are supervision, assignment and delivery of services addressed in the legislation?
The yet-to-be-promulgated regulations will further define the scope of supervision, assignment, and delivery of services, including the following:
What provisions relate to supervision of AHHAs?
A section of the new law authorizes RNs to assign and supervise the advanced tasks and includes additional requirements. Before assigning an advanced task, the RN must complete a nursing assessment and provide the AHHA written, individual-specific instructions for performing the task, as well as criteria to identify, report and respond to problems.
The RN has affirmative obligations to ensure assignments are made only where the advanced task is consistent with the plan of care, the AHHA has been provided with case-specific training from the RN, where the RN can personally verify the AHHA can perform the task safely and competently, effectively communicate with the patient and understand the patient's needs, and where the advanced home health care aide is willing to perform the task.
What entities will this program apply to?
The regulations will encompass the following entities:
The criminal background and fingerprinting requirements currently applicable to nursing homes, certified home health agencies, licensed home care services agencies and long-term home health care programs also will apply to prospective hospice workers. The regulations also will provide for reporting between the Departments of Education and Health on licensed practical nurses who are or have been AHHAs and on improper behavior by RNs who are supervising AHHAs.
What is the effective date of the legislation?
While the legislation references a report due Sept. 1, 2016, that will provide guidance on the advanced tasks that AHHAs will perform (and which presumably would be used as a basis for the regulations), the workgroup that is supposed to generate this report has not yet been formed (as the legislation had not been signed as of that date). It is expected that the workgroup now will be formed and the report will follow.
The significant sections of the legislation are effective in 18 months—however, no advanced tasks may be performed prior to the adoption of the regulations (including those addressing training and competency examinations). The legislation is deemed repealed as of March 31, 2023; a report is required on the implementation of the AHHAs program on or before Oct. 1, 2022.
Rosemary McKenna and Emily E. Whalen are attorneys with Jackson Lewis in Albany, N.Y. © Jackson Lewis. All rights reserved. Reposted with permission.
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