New York Codes, Rules and Regulations › Title 8 - EDUCATION DEPARTMENT › Chapter II - Regulations of the Commissioner › Subchapter B - Regulation of Professions › Part 64 - Nursing › Section 64.9 - Advanced Home Health Aides

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
				  Definitions. As used in this section:
(1)
				  Health services entity means a home care services agency licensed or certified
				  pursuant to article thirty-six of the public health law, a hospice program
				  certified pursuant to article forty of the public health law or an enhanced
				  assisted living residence licensed pursuant to article seven of the social
				  services law and certified pursuant to article forty-six B of the public health
				  law.
(2) RN means a registered
				  professional nurse who is licensed and registered to practice nursing pursuant
				  to article one hundred thirty-nine of the education law and is employed by a
				  health services entity to provide nursing services, including the direct
				  supervision of advanced home health aides or AHHAs, for clients of the health
				  services entity.
(3) Home care
				  services worker registry means the New York State home care services worker
				  registry that is maintained by the department of health pursuant to subdivision
				  (9) of section thirty-six hundred thirteen  of the public health law.
(4) Advanced home health aide or AHHA means a
				  certified home health aide who has met all requirements to perform advanced
				  tasks as set forth in subdivision (2) of section sixty-nine hundred eight  of
				  the education law and this section and is currently listed in the home care
				  services worker registry, as defined in paragraph (3) of this subdivision, as
				  having satisfied all applicable requirements for performing advanced tasks as
				  an advanced home health aide.
(5)
				  Routine medications means medications that are:
(i) prefilled or otherwise packaged in a
				  manner that promotes relative ease of administration;
(ii) routinely administered to a client with
				  stable health; and,
(iii)
				  administered by the following routes only:
(a) oral;
(b) sublingual;
(c) buccal;
(d) ophthalmic;
(e) otic;
(f) nasal;
(g) rectal;
(h) vaginal;
(i) topical; or,
(j) inhaled through the nose or mouth. Stable
				  health means that a client's physiologic status is not in flux and changes in
				  health status that require emergency or immediate medical intervention are not
				  expected or foreseeable.
(6) Advanced tasks mean health care tasks
				  delineated in subdivision (2) of section sixty-nine hundred eight  of the
				  education law and this section. Provided that if a health services entity has
				  established a systematic approach to address drug diversion, advanced tasks
				  shall include the following medication administration tasks:
(i) the administration of routine medications
				  as defined in paragraph (5) of this subdivision;
(ii) a subcutaneous or intramuscular
				  injection of low molecular weight heparin or medication prescribed to treat
				  diabetes; and,
(iii) the use of a
				  prefilled auto-injector of naloxone or epinephrine in an emergency. Advanced
				  tasks shall not include:
(i) converting or
				  calculating the dose of any medication or determining a client's need for
				  medications;
(ii) medication
				  administration through enteral feeding tubes, including, but not limited to,
				  gastrostomy or nasogastric tubes;
(iii) medication administration parenterally,
				  except for certain routine medications and injections as expressly provided for
				  in this paragraph;
(iv) tasks
				  involving the use of intravenous or subcutaneous infusion devices on a client;
(v) tasks involving the use of a
				  mechanical ventilator on a client;
(vi) tasks involving sterile or aseptic
				  technique, except for the administration of injections as expressly provided
				  for in this paragraph;
(vii) tasks
				  involving professional nursing judgment, observation, monitoring or assessment
				  of a client; and,
(viii) tasks that
				  are outside the scope of practice of a licensed practical nurse.
(7) Direct supervision
				  means the provision by an RN of training, guidance, direction and oversight
				  relating to the performance of advanced tasks by an AHHA, including periodic
				  assessment of the AHHA's performance of advanced tasks. Such direct supervision
				  shall be determined by the RN responsible for supervising such advanced tasks,
				  based upon the complexity of such advanced tasks, the skill and experience of
				  the AHHA assigned to perform the advances tasks, and the health status of the
				  client for whom the advanced tasks are being performed, provided th at, at a
				  minimum:
(i) the RN, while on duty, shall be
				  continuously available to speak with the AHHA by telephone and by other means
				  as appropriate and shall personally visit a client or arrange for another
				  qualified licensed health professional, such as another RN, to visit the client
				  whenever necessary to protect the health and safety of the client;
(ii) th e RN performs an initial and
				  thereafter regular and ongoing assessment of the client's needs;
(iii) the supervising RN or another
				  supervising RN shall visit the client no less than once every two weeks for the
				  purpose of supervising the services provided by the AHHA by, among other
				  things, personally observing, evaluating, and overseeing the provision of such
				  services.
(8) Client
				  means a patient, resident or other individual who receives nursing and possibly
				  other health services from a health services entity in accordance with articles
				  thirty-six, forty or forty-six-B of the public health law.
(9) Established systematic approach to
				  address drug diversion means that a health services entity has written policies
				  and procedures in place to prevent drug diversion and address suspected
				  incidents of drug diversion, which are periodically reviewed as part of the
				  entity's quality assurance program.
(10) Case mix complexity and geographic
				  considerations means the clinical complexity of the clients who are being
				  served and the geographic distance(s) RNs travel to supervise the AHHAs
				  providing services that should be considered when assigning AHHAs to care for
				  client s and for RN supervision.