New York Considering Advanced Home Health Aide Designation

New York has announced plans for an advanced home health aide program in the state and is currently taking comment from industry stakeholders.

Last week, the New York State Department of Education published proposed regulations for an advanced home health aide (AHHA) program in the state register. The AHHA program effectively allows home health aides with a special designation to perform advanced tasks, as long as they’ve undergone required training and are being supervised by registered nurses (RNs).

Advanced aides and supervising RNs must work for the same home care agency, hospice program or enhanced assisted living residence.


The posting of the proposed regulations in the state register follows a related emergency rule that went into effect on June 12. The New York State Department of Health, which worked collaboratively with the Department of Education, also released a proposed set of regulations at the end of May with overlapping provisions.

Proposed regulations permit home care agencies that have established polices and procedures to address drug diversion to perform certain advanced tasks related to medication administration, according to a summary compiled by the legal firm Hodgson Russ LLP. Agencies may only assign aides to perform advanced tasks for patients who are in stable health and have consented to receive them.

“The new regulations deal mostly with medications,” Roger Noyes, director of communications for the Home Care Association of New York State, told Home Health Care News in an email. “The real opportunity area seems to be for patients who are unable to self-administer medications, due to memory issues or the complexity of their medication needs.”


Advanced home health aides would not be allowed to perform advanced tasks for residents of a nursing home or patients in a hospital, clinic or outpatient health care facility.

The state’s efforts to create and oversee an AHHA program is in response to a 2016 law.

“Some patients may be receiving personal care from an aide but rely on a family member to help them with medications,” Noyes said. “Now, an aide could support these patients, providing relief for families who may live distantly, without triggering the needs for an RN or [licensed practical nurse] visit.”

The public comment period for the State Department of Education proposed regulations is set to close on Aug. 27. A public comment window for the Department of Health proposed regulations will expire July 30.

Despite the fact that the emergency rule regarding AHHAs is currently in effect, agencies will not be able to offer AHHA-provided advanced tasks until training programs are finalized and aides have been appropriately certified.

Agencies would likely welcome increased flexibility that comes with an advanced designation, Noyes said, but it’s still too early to fully understand all the details, including potential cost.

“A lot depends on how an agency opts to utilize this new designation,” Noyes said. “Right now, it’s unclear whether any potential new costs will outweigh the savings. It’s also unknown how [payers] and workforce dynamics will drive this cost calculation.”

The full text of the emergency regulation is available here.

Written by Robert Holly

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