NY State Senate Bill 2015-S5855A

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 29, 2016	print number 5855a
Feb 29, 2016	amend and recommit to higher education
Jan 06, 2016	referred to higher education
Jun 09, 2015	referred to rules

Bill Amendments

Original

A (Active)

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2015-S5855 - Details

Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6908, Ed L; amd §§206, 3602 & 3613, Pub Health L

2015-S5855 - Summary

Authorizes certain advanced home health aides to perform certain advanced tasks.

2015-S5855 - Sponsor Memo

                                 BILL NUMBER:  S5855

 TITLE OF BILL :

An act to amend the education law and the public health law, in
relation to authorizing certain advanced home health aides to perform
certain advanced tasks; and providing for the repeal of such
provisions upon expiration thereof

 PURPOSE OR GENERAL IDEA OF BILL :

This bill would provide an exemption to the Nurse Practice Act to
establish a program for "advanced home health aides" who would be
authorized to perform advanced tasks, including the administration of
medications, under the direct supervision of a registered professional
nurse.

 SUMMARY OF SPECIFIC PROVISIONS :

Section 1 of the bill would add an exemption to the Nurse Practice Act
to allow advanced home health aides, in accordance with regulations
developed by the Commissioner of Education in consultation with the
Commissioner of Health, to perform advanced tasks under the direct
supervision of a registered professional nurse. Such regulations shall
take into account the recommendations of a workgroup of stakeholders
convened by the Commissioner of Health, in consultation with the

Commissioner of Education.

Section 2 of the bill would require the Commissioner of Health to
notify the Commissioner of Education in any instance in which a
registered professional nurse engages in improper behavior while
supervising an advanced home health.

Section 3 of the bill would add a definition of "advanced home health
aide" to the Public Health Law and allow the Commissioner of Health to
promulgate regulations regarding such aides.

Section 4 of the bill would require the Department of Health to
indicate on the home care services worker registry when a home health
aide has satisfied all applicable training and recertification
requirements and has passed the applicable competency examinations
necessary to perform advanced tasks. Any limitation or revocation of
the advanced home health aide's authorization would also be indicated
on the registry.

Section 5 of the bill would direct the Commissioner of Health, in
consultation with the Commissioner of Education, to convene a
workgroup of stakeholders to provide guidance on the advanced tasks
which may be performed by advanced home health aides. A report would
be issued to the Governor and the Legislature setting forth the
recommendations of the workgroup.

Section 6 of the bill would direct the Commissioner of Health, in
consultation with the Commissioner of Education, to issue a report on
or before January 1, 2019 on the implementation of advanced home
health aides in the State.

Section 7 is the effective date and expiration date of the bill.

 JUSTIFICATION :

This legislation will help individuals with disabilities to transition
from institutional settings to home environments since such
individuals will have access to more affordable and additional home
care options. This legislation will also help the State draw down

federal funds under the Community First Choice Option under the
Affordable Care Act.

 PRIOR LEGISLATIVE HISTORY :

A10137 of 2014, referred to Higher Education.

 FISCAL IMPLICATIONS :

Unknown at this time.

 EFFECTIVE DATE :
Immediately.

2015-S5855 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5855

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              June 9, 2015
                               ___________

Introduced  by  Sen.  PARKER -- read twice and ordered printed, and when
  printed to be committed to the Committee on Rules

AN ACT to amend the education law and the public health law, in relation
  to authorizing certain advanced home health aides to  perform  certain
  advanced  tasks;  and providing for the repeal of such provisions upon
  expiration thereof

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph (v) of paragraph a of subdivision 1 of section
6908  of  the  education  law  is renumbered subparagraph (vi) and a new
subparagraph (v) is added to read as follows:
  (V) ADVANCED TASKS PROVIDED BY AN ADVANCED HOME HEALTH AIDE IN ACCORD-
ANCE WITH REGULATIONS DEVELOPED BY  THE  COMMISSIONER,  IN  CONSULTATION
WITH  THE COMMISSIONER OF HEALTH WHICH, AT A MINIMUM, SHALL: (1) SPECIFY
THE ADVANCED TASKS THAT MAY BE PERFORMED BY ADVANCED HOME  HEALTH  AIDES
PURSUANT TO THIS SUBPARAGRAPH, WHICH SHALL INCLUDE THE ADMINISTRATION OF
MEDICATIONS  WHICH  ARE ROUTINE AND PREFILLED OR OTHERWISE PACKAGED IN A
MANNER THAT PROMOTES RELATIVE  EASE  OF  ADMINISTRATION,  PROVIDED  THAT
ADMINISTRATION  OF  MEDICATIONS  BY  INJECTION,  STERILE PROCEDURES, AND
CENTRAL LINE MAINTENANCE SHALL BE PROHIBITED.    PROVIDED  HOWEVER  SUCH
PROHIBITION  SHALL  NOT APPLY TO INJECTIONS OF INSULIN FOR DIABETES CARE
OR TO INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN FOR DIABETES CARE,  AND
PROVIDED  FURTHER THAT A SYSTEM SHALL BE ESTABLISHED THAT ADDRESSES DRUG
DIVERSION; (2) SPECIFY THAT  PARTICIPATION  IN  THIS  PROGRAM  SHALL  BE
VOLUNTARY  AND  SUCH  ADVANCED TASKS PROVIDED BY AN ADVANCED HOME HEALTH
AIDE SHALL BE AT THE OPTION OF THE INDIVIDUAL; (3) PROVIDE THAT ADVANCED
TASKS PERFORMED BY ADVANCED HOME HEALTH  AIDES  MAY  BE  PERFORMED  ONLY
UNDER THE DIRECT SUPERVISION OF A REGISTERED PROFESSIONAL NURSE LICENSED
IN  NEW  YORK STATE AND EMPLOYED BY A HOME CARE SERVICES AGENCY LICENSED
OR CERTIFIED PURSUANT TO ARTICLE THIRTY-SIX OR HOSPICE PROGRAM CERTIFIED
PURSUANT TO ARTICLE FORTY OF THE PUBLIC HEALTH LAW, WHERE  SUCH  NURSING

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10526-02-5

S. 5855                             2

SUPERVISION  (A)  INCLUDES  TRAINING  AND  PERIODIC  ASSESSMENT  OF  THE
PERFORMANCE OF ADVANCED TASKS, (B) SHALL BE DETERMINED BY THE REGISTERED
PROFESSIONAL NURSE RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS BASED
UPON  THE COMPLEXITY OF SUCH ADVANCED TASKS, THE SKILL AND EXPERIENCE OF
THE ADVANCED HOME HEALTH AIDE, AND THE HEALTH STATUS OF  THE  INDIVIDUAL
FOR  WHOM  SUCH  ADVANCED  TASKS ARE BEING PERFORMED, AND (C) INCLUDES A
COMPREHENSIVE INITIAL AND THEREAFTER REGULAR AND ONGOING  ASSESSMENT  OF
THE  INDIVIDUAL'S NEEDS; PROVIDED THAT THE REGISTERED PROFESSIONAL NURSE
RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS SHALL VISIT  INDIVIDUALS
RECEIVING  ACUTE  SERVICES  NO  LESS THAN ONCE PER MONTH AND INDIVIDUALS
RECEIVING MAINTENANCE CARE NO  LESS  THAN  ONCE  EVERY  SIX  MONTHS  AND
PROVIDED FURTHER THAT A REGISTERED PROFESSIONAL NURSE SHALL BE AVAILABLE
BY  TELEPHONE  TO THE ADVANCED HOME HEALTH AIDE TWENTY-FOUR HOURS A DAY,
SEVEN DAYS A WEEK; THE COMMISSIONER OF  HEALTH  SHALL,  IN  CONSULTATION
WITH  THE  COMMISSIONER, DETERMINE APPROPRIATE STAFFING RATIOS TO ENSURE
ADEQUATE NURSING SUPERVISION THAT SHALL NOT EXCEED ONE FULL TIME  EQUIV-
ALENT  OF A REGISTERED PROFESSIONAL NURSE TO FIFTY INDIVIDUALS RECEIVING
SERVICES; (4) ESTABLISH A PROCESS BY  WHICH  A  REGISTERED  PROFESSIONAL
NURSE  MAY  DELEGATE  ADVANCED  TASKS  TO  AN  ADVANCED HOME HEALTH AIDE
PROVIDED THAT SUCH PROCESS SHALL INCLUDE, BUT  NOT  BE  LIMITED  TO  (A)
ALLOWING  DELEGATION  OF  ADVANCED TASKS TO AN ADVANCED HOME HEALTH AIDE
ONLY WHERE SUCH ADVANCED HOME HEALTH AIDE HAS DEMONSTRATED TO THE SATIS-
FACTION OF THE SUPERVISING REGISTERED PROFESSIONAL NURSE  COMPETENCY  IN
EVERY ADVANCED TASK THAT SUCH ADVANCED HOME HEALTH AIDE IS AUTHORIZED TO
PERFORM,  (B)  AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE
TO REVOKE ANY DELEGATED ADVANCED TASK FROM AN ADVANCED HOME HEALTH  AIDE
FOR  ANY  REASON,  AND  (C) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL
NURSES TO JOINTLY AGREE TO DELEGATE ADVANCED TASKS TO AN  ADVANCED  HOME
HEALTH  AIDE,  PROVIDED  FURTHER  THAT  ONLY ONE REGISTERED PROFESSIONAL
NURSE SHALL BE REQUIRED TO DETERMINE THE ADVANCED HOME HEALTH  AIDE  HAS
DEMONSTRATED  COMPETENCY  IN  THE  ADVANCED  TASK  TO  BE PERFORMED; (5)
PROVIDE THAT ADVANCED TASKS MAY BE PERFORMED ONLY IN ACCORDANCE WITH AND
PURSUANT TO AN AUTHORIZED PRACTITIONER'S ORDERED CARE; (6) PROVIDE  THAT
ONLY  A  HOME  HEALTH  AIDE WHO HAS AT LEAST ONE YEAR OF EXPERIENCE AS A
CERTIFIED HOME HEALTH AIDE, HAS COMPLETED  THE  REQUISITE  TRAINING  AND
DEMONSTRATED  COMPETENCIES OF AN ADVANCED HOME HEALTH AIDE AS DETERMINED
BY THE COMMISSIONER OF HEALTH,  HAS  SUCCESSFULLY  COMPLETED  COMPETENCY
EXAMINATIONS  SATISFACTORY  TO  AND DEVELOPED OR APPROVED BY THE COMMIS-
SIONER OF HEALTH AND MEETS OTHER APPROPRIATE  QUALIFICATIONS  AS  DETER-
MINED  BY  THE  COMMISSIONER  OF HEALTH MAY PERFORM ADVANCED TASKS AS AN
ADVANCED HOME HEALTH AIDE; (7) PROVIDE THAT ONLY AN  INDIVIDUAL  WHO  IS
LISTED  IN  THE HOME CARE SERVICES REGISTRY MAINTAINED BY THE DEPARTMENT
OF HEALTH PURSUANT TO SECTION THIRTY-SIX HUNDRED THIRTEEN OF THE  PUBLIC
HEALTH  LAW AS HAVING SATISFIED ALL APPLICABLE TRAINING REQUIREMENTS AND
HAVING PASSED THE APPLICABLE COMPETENCY EXAMINATIONS AND WHO MEETS OTHER
REQUIREMENTS AS SET FORTH IN REGULATIONS ISSUED BY THE  COMMISSIONER  OF
HEALTH  PURSUANT  TO SUBDIVISION SEVENTEEN OF SECTION THIRTY-SIX HUNDRED
TWO OF THE PUBLIC HEALTH LAW MAY PERFORM ADVANCED TASKS PURSUANT TO THIS
SUBPARAGRAPH AND MAY HOLD HIMSELF OR HERSELF OUT  AS  AN  ADVANCED  HOME
HEALTH  AIDE;  (8)  ESTABLISH  MINIMUM  STANDARDS  OF  TRAINING  FOR THE
PERFORMANCE OF ADVANCED TASKS BY ADVANCED HOME HEALTH  AIDES,  INCLUDING
(A) DIDACTIC TRAINING, (B) CLINICAL TRAINING, AND (C) A SUPERVISED CLIN-
ICAL  PRACTICUM  WITH STANDARDS SET FORTH BY THE COMMISSIONER OF HEALTH;
(9) PROVIDE THAT ADVANCED HOME HEALTH AIDES SHALL RECEIVE  CASE-SPECIFIC
TRAINING  ON THE ADVANCED TASKS TO BE ASSIGNED BY THE SUPERVISING NURSE,
PROVIDED THAT ADDITIONAL TRAINING SHALL TAKE PLACE  WHENEVER  ADDITIONAL

S. 5855                             3

ADVANCED  TASKS ARE ASSIGNED; (10) PROHIBIT AN ADVANCED HOME HEALTH AIDE
FROM HOLDING HIMSELF OR HERSELF  OUT,  OR  ACCEPTING  EMPLOYMENT  AS,  A
PERSON  LICENSED  TO PRACTICE NURSING UNDER THE PROVISIONS OF THIS ARTI-
CLE;  (11) PROVIDE THAT AN ADVANCED HOME HEALTH AIDE IS NOT REQUIRED NOR
PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS  OF  AN  INDIVIDUAL;
(12)  PROVIDE  THAT AN ADVANCED HOME HEALTH AIDE SHALL NOT BE AUTHORIZED
TO PERFORM ANY ADVANCED TASKS OR ACTIVITIES PURSUANT  TO  THIS  SUBPARA-
GRAPH  THAT  ARE  OUTSIDE  THE SCOPE OF PRACTICE OF A LICENSED PRACTICAL
NURSE OR ANY ADVANCED TASKS THAT HAVE NOT BEEN  APPROPRIATELY  DELEGATED
BY  THE  SUPERVISING REGISTERED PROFESSIONAL NURSE; (13) PROVIDE THAT AN
ADVANCED HOME HEALTH AIDE SHALL DOCUMENT  MEDICATION  ADMINISTRATION  TO
EACH  INDIVIDUAL  THROUGH THE USE OF A MEDICATION ADMINISTRATION RECORD;
(14) PROVIDE THAT THE SUPERVISING REGISTERED  PROFESSIONAL  NURSE  SHALL
RETAIN  THE  DISCRETION  TO  DECIDE  WHETHER TO ASSIGN ADVANCED TASKS TO
ADVANCED HOME HEALTH AIDES UNDER THIS  PROGRAM  AND  THE  ADVANCED  HOME
HEALTH  AIDE  SHALL RETAIN THE DISCRETION TO REFUSE A DELEGATED ADVANCED
TASK AND SHALL NOT BE SUBJECT TO COERCION OR THE THREAT OF  RETALIATION;
(15) NOTWITHSTANDING ANY PROVISIONS OF SECTIONS  SEVEN HUNDRED FORTY AND
SEVEN   HUNDRED  FORTY-ONE  OF  THE  LABOR  LAW  TO  THE  CONTRARY,  THE
PROTECTIONS PROVIDED IN SUCH SECTIONS SHALL APPLY TO INDIVIDUALS PROVID-
ING SUPERVISION OR ADVANCED TASKS PURSUANT  TO  THIS  SUBPARAGRAPH;  AND
(16)  PROVIDE THAT NO ADVANCED TASKS, OTHER THAN ADMINISTRATION OF MEDI-
CATION, MAY BE PERFORMED PRIOR TO JANUARY FIRST, TWO THOUSAND SEVENTEEN;
PROVIDED THAT IN DEVELOPING SUCH  REGULATIONS,  THE  COMMISSIONER  SHALL
TAKE  INTO  ACCOUNT  THE  RECOMMENDATIONS OF A WORKGROUP OF STAKEHOLDERS
CONVENED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE  COMMIS-
SIONER FOR THE PURPOSE OF PROVIDING GUIDANCE ON THE FOREGOING; OR
  S  2.  Section 206 of the public health law is amended by adding a new
subdivision 30 to read as follows:
  30.  THE COMMISSIONER SHALL NOTIFY THE COMMISSIONER  OF  EDUCATION  IN
ANY INSTANCE IN WHICH A REGISTERED PROFESSIONAL NURSE ENGAGES IN IMPROP-
ER  BEHAVIOR  WHILE SUPERVISING AN ADVANCED HOME HEALTH AIDE PURSUANT TO
SUBPARAGRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE
HUNDRED EIGHT OF THE EDUCATION LAW.
  S 3. Section 3602 of the public health law is amended by adding a  new
subdivision 17 to read as follows:
  17.  "ADVANCED  HOME  HEALTH  AIDES"  MEANS  HOME HEALTH AIDES WHO ARE
AUTHORIZED TO PERFORM ADVANCED TASKS AS DELINEATED IN  SUBPARAGRAPH  (V)
OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE HUNDRED EIGHT OF
THE  EDUCATION  LAW AND REGULATIONS ISSUED BY THE COMMISSIONER OF EDUCA-
TION RELATING THERETO. THE  COMMISSIONER  SHALL  PROMULGATE  REGULATIONS
REGARDING  SUCH AIDES, WHICH SHALL INCLUDE TRAINING, DEMONSTRATED COMPE-
TENCIES, COMPETENCY EXAMINATIONS, AND OTHER APPROPRIATE  QUALIFICATIONS,
AS  WELL  AS  A PROCESS FOR THE LIMITATION OR REVOCATION OF THE ADVANCED
HOME HEALTH AIDE'S AUTHORIZATION TO PERFORM ADVANCED TASKS IN  APPROPRI-
ATE CASES.
  S  4. Subdivision 9 of section 3613 of the public health law is renum-
bered subdivision 10 and a  new  subdivision  9  is  added  to  read  as
follows:
  9.  THE DEPARTMENT SHALL INDICATE WITHIN THE HOME CARE SERVICES WORKER
REGISTRY WHEN A HOME HEALTH AIDE HAS SATISFIED ALL  APPLICABLE  TRAINING
AND RECERTIFICATION REQUIREMENTS AND HAS PASSED THE APPLICABLE COMPETEN-
CY EXAMINATIONS NECESSARY TO PERFORM ADVANCED TASKS PURSUANT TO SUBPARA-
GRAPH  (V)  OF  PARAGRAPH  A  OF  SUBDIVISION  ONE OF SECTION SIXTY-NINE
HUNDRED EIGHT OF THE EDUCATION LAW AND REGULATIONS ISSUED  THERETO.  ANY

S. 5855                             4

LIMITATION  OR  REVOCATION  OF  THE ADVANCED HOME HEALTH AIDE'S AUTHORI-
ZATION ALSO SHALL BE INDICATED ON THE REGISTRY.
  S  5.  In  developing  regulations  required under subparagraph (v) of
paragraph a of subdivision 1 of section 6908 of the  education  law,  as
added  by  section  one of this act, the commissioner of education shall
take into consideration the recommendations of the workgroup  of  stake-
holders  convened  by  the commissioner of health to provide guidance on
the tasks which may be performed by advanced home health aides  pursuant
to  such  section  including, but not limited to, recommendations encom-
passing the following matters:
  (a) the advanced  tasks  that  appropriately  could  be  performed  by
advanced home health aides with appropriate training and supervision;
  (b) the types of medications that advanced home health aides should be
authorized to administer, including whether controlled substances should
be authorized;
  (c)  qualifications  that  must  be  satisfied by advanced home health
aides to perform such advanced tasks, including those related to experi-
ence, training, moral character, and examination requirements;
  (d) minimum training and education standards; and
  (e) adequate levels of supervision to be provided by nurses, including
adherence to existing requirements for comprehensive assessment and  any
additional  assessment that should be required, including when the indi-
vidual receiving advanced tasks performed by  an  advanced  home  health
aide experiences a significant change in condition.
  On  or  before  July  1,  2015,  the  commissioner of health shall, in
consultation with the commissioner of education, issue a report  to  the
governor  and  the  chairs  of the senate and assembly health and higher
education committees setting forth the recommendations of the workgroup.
  S 6. On or before January 1, 2019, the commissioner of  health  shall,
in  consultation  with  the commissioner of education, issue a report on
the implementation of advanced home health  aides  in  the  state.  Such
report shall include the number of advanced home health aides authorized
pursuant  to  this  act;  the types of advanced tasks that advanced home
health aides are performing; the number of individuals  who  were  moved
out  of  institutionalized  settings as a direct result of this act; the
extent to which advanced home health aides contributed to  the  improve-
ment  of  quality  care  of  these  individuals;  the  number of adverse
outcomes, including medication errors, that were reported to the depart-
ment of health; any reports of or issues with drug  diversion;  and  the
number of advanced home health aides who had their authorization limited
or  revoked.  Such  report shall provide recommendations to the governor
and the chairs of the senate and assembly health  and  higher  education
committees regarding the extension and/or alteration of these provisions
and  make  any  other  recommendations  related to the implementation of
advanced home health aides pursuant to this act.
  S 7. This act shall take effect immediately; provided that:
  a. section one of this act shall take effect January 1, 2016.   Effec-
tive  immediately,  the commissioner of education is authorized to adopt
or amend regulations necessary to implement the  provisions  of  section
one  of  this  act  on or before such effective date; provided, further,
that no advanced tasks shall be performed pursuant to the provisions  of
subparagraph  (v) of paragraph a of subdivision 1 of section 6908 of the
education law, as added by section one of this  act,  until  such  regu-
lations are adopted and except in conformance with such regulations; and
  b. this act shall expire and be deemed repealed June 30, 2019.

co-Sponsors

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2015-S5855A (ACTIVE) - Details

Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6908, Ed L; amd §§206, 3602 & 3613, Pub Health L

2015-S5855A (ACTIVE) - Summary

Authorizes certain advanced home health aides to perform certain advanced tasks.

2015-S5855A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S5855A

 TITLE OF BILL :

An act to amend the education law and the public health law, in
relation to authorizing certain advanced home health aides to perform
certain advanced tasks; and providing for the repeal of such
provisions upon expiration thereof

 PURPOSE OR GENERAL IDEA OF BILL :

This bill would provide an exemption to the Nurse Practice Act to
establish a program for "advanced home health aides" who would be
authorized to perform advanced tasks, including the administration of
medications, under the direct supervision of a registered professional
nurse.

 SUMMARY OF SPECIFIC PROVISIONS :

Section 1 of the bill would add an exemption to the Nurse Practice Act
to allow advanced home health aides, in accordance with regulations
developed by the Commissioner of Education in consultation with the
Commissioner of Health, to perform advanced tasks under the direct
supervision of a registered professional nurse. Such regulations shall
take into account the recommendations of a workgroup of stakeholders
convened by the Commissioner of Health, in consultation with the

Commissioner of Education.

Section 2 of the bill would require the Commissioner of Health to
notify the Commissioner of Education in any instance in which a
registered professional nurse engages in improper behavior while
supervising an advanced home health.

Section 3 of the bill would add a definition of "advanced home health
aide" to the Public Health Law and allow the Commissioner of Health to
promulgate regulations regarding such aides.

Section 4 of the bill would require the Department of Health to
indicate on the home care services worker registry when a home health
aide has satisfied all applicable training and recertification
requirements and has passed the applicable competency examinations
necessary to perform advanced tasks. Any limitation or revocation of
the advanced home health aide's authorization would also be indicated
on the registry.

Section 5 of the bill would direct the Commissioner of Health, in
consultation with the Commissioner of Education, to convene a
workgroup of stakeholders to provide guidance on the advanced tasks
which may be performed by advanced home health aides. A report would
be issued to the Governor and the Legislature setting forth the
recommendations of the workgroup.

Section 6 of the bill would direct the Commissioner of Health, in
consultation with the Commissioner of Education, to issue a report on
or before January 1, 2019 on the implementation of advanced home
health aides in the State.

Section 7 is the effective date and expiration date of the bill.

 JUSTIFICATION :

This legislation will help individuals with disabilities to transition
from institutional settings to home environments since such
individuals will have access to more affordable and additional home
care options. This legislation will also help the State draw down

federal funds under the Community First Choice Option under the
Affordable Care Act.

 PRIOR LEGISLATIVE HISTORY :

A10137 of 2014, referred to Higher Education.

 FISCAL IMPLICATIONS :

Unknown at this time.

 EFFECTIVE DATE :
Immediately.

2015-S5855A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5855--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              June 9, 2015
                               ___________

Introduced  by  Sens.  PARKER, BRESLIN, FUNKE, GALLIVAN, ORTT, ROBACH --
  read twice and ordered printed, and when printed to  be  committed  to
  the  Committee  on  Rules  --  recommitted  to the Committee on Higher
  Education in accordance with  Senate  Rule  6,  sec.  8  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the education law and the public health law, in relation
  to  authorizing  certain advanced home health aides to perform certain
  advanced tasks; and providing for the repeal of such  provisions  upon
  expiration thereof

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph (v) of paragraph a of subdivision 1 of section
6908 of the education law is renumbered  subparagraph  (vi)  and  a  new
subparagraph (v) is added to read as follows:
  (V) ADVANCED TASKS PROVIDED BY AN ADVANCED HOME HEALTH AIDE IN ACCORD-
ANCE  WITH  REGULATIONS  DEVELOPED  BY THE COMMISSIONER, IN CONSULTATION
WITH THE COMMISSIONER OF HEALTH WHICH, AT A MINIMUM, SHALL: (1)  SPECIFY
THE  ADVANCED  TASKS THAT MAY BE PERFORMED BY ADVANCED HOME HEALTH AIDES
PURSUANT TO THIS SUBPARAGRAPH, WHICH SHALL INCLUDE THE ADMINISTRATION OF
MEDICATIONS WHICH ARE ROUTINE AND PREFILLED OR OTHERWISE PACKAGED  IN  A
MANNER  THAT  PROMOTES  RELATIVE  EASE  OF ADMINISTRATION, PROVIDED THAT
ADMINISTRATION OF MEDICATIONS  BY  INJECTION,  STERILE  PROCEDURES,  AND
CENTRAL  LINE  MAINTENANCE  SHALL BE PROHIBITED.   PROVIDED HOWEVER SUCH
PROHIBITION SHALL NOT APPLY TO INJECTIONS OF INSULIN FOR  DIABETES  CARE
OR  TO INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN FOR DIABETES CARE, AND
PROVIDED FURTHER THAT A SYSTEM SHALL BE ESTABLISHED THAT ADDRESSES  DRUG
DIVERSION;  (2)  SPECIFY  THAT  PARTICIPATION  IN  THIS PROGRAM SHALL BE
VOLUNTARY AND SUCH ADVANCED TASKS PROVIDED BY AN  ADVANCED  HOME  HEALTH
AIDE SHALL BE AT THE OPTION OF THE INDIVIDUAL; (3) PROVIDE THAT ADVANCED
TASKS  PERFORMED  BY  ADVANCED  HOME  HEALTH AIDES MAY BE PERFORMED ONLY
UNDER THE DIRECT SUPERVISION OF A REGISTERED PROFESSIONAL NURSE LICENSED
IN NEW YORK STATE AND EMPLOYED BY A HOME CARE SERVICES  AGENCY  LICENSED
OR CERTIFIED PURSUANT TO ARTICLE THIRTY-SIX OR HOSPICE PROGRAM CERTIFIED

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10526-04-6

S. 5855--A                          2

PURSUANT  TO  ARTICLE FORTY OF THE PUBLIC HEALTH LAW, WHERE SUCH NURSING
SUPERVISION  (A)  INCLUDES  TRAINING  AND  PERIODIC  ASSESSMENT  OF  THE
PERFORMANCE OF ADVANCED TASKS, (B) SHALL BE DETERMINED BY THE REGISTERED
PROFESSIONAL NURSE RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS BASED
UPON  THE COMPLEXITY OF SUCH ADVANCED TASKS, THE SKILL AND EXPERIENCE OF
THE ADVANCED HOME HEALTH AIDE, AND THE HEALTH STATUS OF  THE  INDIVIDUAL
FOR  WHOM  SUCH  ADVANCED  TASKS ARE BEING PERFORMED, AND (C) INCLUDES A
COMPREHENSIVE INITIAL AND THEREAFTER REGULAR AND ONGOING  ASSESSMENT  OF
THE  INDIVIDUAL'S NEEDS; PROVIDED THAT THE REGISTERED PROFESSIONAL NURSE
RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS SHALL VISIT  INDIVIDUALS
RECEIVING  ACUTE  SERVICES  NO  LESS THAN ONCE PER MONTH AND INDIVIDUALS
RECEIVING MAINTENANCE CARE NO  LESS  THAN  ONCE  EVERY  SIX  MONTHS  AND
PROVIDED FURTHER THAT A REGISTERED PROFESSIONAL NURSE SHALL BE AVAILABLE
BY  TELEPHONE  TO THE ADVANCED HOME HEALTH AIDE TWENTY-FOUR HOURS A DAY,
SEVEN DAYS A WEEK; THE COMMISSIONER OF  HEALTH  SHALL,  IN  CONSULTATION
WITH  THE  COMMISSIONER, DETERMINE APPROPRIATE STAFFING RATIOS TO ENSURE
ADEQUATE NURSING SUPERVISION THAT SHALL NOT EXCEED ONE FULL TIME  EQUIV-
ALENT  OF A REGISTERED PROFESSIONAL NURSE TO FIFTY INDIVIDUALS RECEIVING
SERVICES; (4) ESTABLISH A PROCESS BY  WHICH  A  REGISTERED  PROFESSIONAL
NURSE  MAY  DELEGATE  ADVANCED  TASKS  TO  AN  ADVANCED HOME HEALTH AIDE
PROVIDED THAT SUCH PROCESS SHALL INCLUDE, BUT  NOT  BE  LIMITED  TO  (A)
ALLOWING  DELEGATION  OF  ADVANCED TASKS TO AN ADVANCED HOME HEALTH AIDE
ONLY WHERE SUCH ADVANCED HOME HEALTH AIDE HAS DEMONSTRATED TO THE SATIS-
FACTION OF THE SUPERVISING REGISTERED PROFESSIONAL NURSE  COMPETENCY  IN
EVERY ADVANCED TASK THAT SUCH ADVANCED HOME HEALTH AIDE IS AUTHORIZED TO
PERFORM,  (B)  AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE
TO REVOKE ANY DELEGATED ADVANCED TASK FROM AN ADVANCED HOME HEALTH  AIDE
FOR  ANY  REASON,  AND  (C) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL
NURSES TO JOINTLY AGREE TO DELEGATE ADVANCED TASKS TO AN  ADVANCED  HOME
HEALTH  AIDE,  PROVIDED  FURTHER  THAT  ONLY ONE REGISTERED PROFESSIONAL
NURSE SHALL BE REQUIRED TO DETERMINE THE ADVANCED HOME HEALTH  AIDE  HAS
DEMONSTRATED  COMPETENCY  IN  THE  ADVANCED  TASK  TO  BE PERFORMED; (5)
PROVIDE THAT ADVANCED TASKS MAY BE PERFORMED ONLY IN ACCORDANCE WITH AND
PURSUANT TO AN AUTHORIZED PRACTITIONER'S ORDERED CARE; (6) PROVIDE  THAT
ONLY  A  HOME  HEALTH  AIDE WHO HAS AT LEAST ONE YEAR OF EXPERIENCE AS A
CERTIFIED HOME HEALTH AIDE, HAS COMPLETED  THE  REQUISITE  TRAINING  AND
DEMONSTRATED  COMPETENCIES OF AN ADVANCED HOME HEALTH AIDE AS DETERMINED
BY THE COMMISSIONER OF HEALTH,  HAS  SUCCESSFULLY  COMPLETED  COMPETENCY
EXAMINATIONS  SATISFACTORY  TO  AND DEVELOPED OR APPROVED BY THE COMMIS-
SIONER OF HEALTH AND MEETS OTHER APPROPRIATE  QUALIFICATIONS  AS  DETER-
MINED  BY  THE  COMMISSIONER  OF HEALTH MAY PERFORM ADVANCED TASKS AS AN
ADVANCED HOME HEALTH AIDE; (7) PROVIDE THAT ONLY AN  INDIVIDUAL  WHO  IS
LISTED  IN  THE HOME CARE SERVICES REGISTRY MAINTAINED BY THE DEPARTMENT
OF HEALTH PURSUANT TO SECTION THIRTY-SIX HUNDRED THIRTEEN OF THE  PUBLIC
HEALTH  LAW AS HAVING SATISFIED ALL APPLICABLE TRAINING REQUIREMENTS AND
HAVING PASSED THE APPLICABLE COMPETENCY EXAMINATIONS AND WHO MEETS OTHER
REQUIREMENTS AS SET FORTH IN REGULATIONS ISSUED BY THE  COMMISSIONER  OF
HEALTH  PURSUANT  TO SUBDIVISION SEVENTEEN OF SECTION THIRTY-SIX HUNDRED
TWO OF THE PUBLIC HEALTH LAW MAY PERFORM ADVANCED TASKS PURSUANT TO THIS
SUBPARAGRAPH AND MAY HOLD HIMSELF OR HERSELF OUT  AS  AN  ADVANCED  HOME
HEALTH  AIDE;  (8)  ESTABLISH  MINIMUM  STANDARDS  OF  TRAINING  FOR THE
PERFORMANCE OF ADVANCED TASKS BY ADVANCED HOME HEALTH  AIDES,  INCLUDING
(A) DIDACTIC TRAINING, (B) CLINICAL TRAINING, AND (C) A SUPERVISED CLIN-
ICAL  PRACTICUM  WITH STANDARDS SET FORTH BY THE COMMISSIONER OF HEALTH;
(9) PROVIDE THAT ADVANCED HOME HEALTH AIDES SHALL RECEIVE  CASE-SPECIFIC
TRAINING  ON THE ADVANCED TASKS TO BE ASSIGNED BY THE SUPERVISING NURSE,

S. 5855--A                          3

PROVIDED THAT ADDITIONAL TRAINING SHALL TAKE PLACE  WHENEVER  ADDITIONAL
ADVANCED  TASKS ARE ASSIGNED; (10) PROHIBIT AN ADVANCED HOME HEALTH AIDE
FROM HOLDING HIMSELF OR HERSELF  OUT,  OR  ACCEPTING  EMPLOYMENT  AS,  A
PERSON  LICENSED  TO PRACTICE NURSING UNDER THE PROVISIONS OF THIS ARTI-
CLE; (11) PROVIDE THAT AN ADVANCED HOME HEALTH AIDE IS NOT REQUIRED  NOR
PERMITTED  TO  ASSESS  THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
(12) PROVIDE THAT AN ADVANCED HOME HEALTH AIDE SHALL NOT  BE  AUTHORIZED
TO  PERFORM  ANY  ADVANCED TASKS OR ACTIVITIES PURSUANT TO THIS SUBPARA-
GRAPH THAT ARE OUTSIDE THE SCOPE OF PRACTICE  OF  A  LICENSED  PRACTICAL
NURSE  OR  ANY ADVANCED TASKS THAT HAVE NOT BEEN APPROPRIATELY DELEGATED
BY THE SUPERVISING REGISTERED PROFESSIONAL NURSE; (13) PROVIDE  THAT  AN
ADVANCED  HOME  HEALTH  AIDE SHALL DOCUMENT MEDICATION ADMINISTRATION TO
EACH INDIVIDUAL THROUGH THE USE OF A MEDICATION  ADMINISTRATION  RECORD;
(14)  PROVIDE  THAT  THE SUPERVISING REGISTERED PROFESSIONAL NURSE SHALL
RETAIN THE DISCRETION TO DECIDE WHETHER  TO  ASSIGN  ADVANCED  TASKS  TO
ADVANCED  HOME  HEALTH  AIDES  UNDER  THIS PROGRAM AND THE ADVANCED HOME
HEALTH AIDE SHALL RETAIN THE DISCRETION TO REFUSE A  DELEGATED  ADVANCED
TASK  AND SHALL NOT BE SUBJECT TO COERCION OR THE THREAT OF RETALIATION;
(15) NOTWITHSTANDING ANY PROVISIONS OF SECTIONS  SEVEN HUNDRED FORTY AND
SEVEN  HUNDRED  FORTY-ONE  OF  THE  LABOR  LAW  TO  THE  CONTRARY,   THE
PROTECTIONS PROVIDED IN SUCH SECTIONS SHALL APPLY TO INDIVIDUALS PROVID-
ING  SUPERVISION  OR  ADVANCED  TASKS PURSUANT TO THIS SUBPARAGRAPH; AND
(16) PROVIDE THAT NO ADVANCED TASKS, OTHER THAN ADMINISTRATION OF  MEDI-
CATION,  MAY BE PERFORMED PRIOR TO JANUARY FIRST, TWO THOUSAND EIGHTEEN;
PROVIDED THAT IN DEVELOPING SUCH  REGULATIONS,  THE  COMMISSIONER  SHALL
TAKE  INTO  ACCOUNT  THE  RECOMMENDATIONS OF A WORKGROUP OF STAKEHOLDERS
CONVENED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE  COMMIS-
SIONER FOR THE PURPOSE OF PROVIDING GUIDANCE ON THE FOREGOING; OR
  S  2.  Section 206 of the public health law is amended by adding a new
subdivision 30 to read as follows:
  30.  THE COMMISSIONER SHALL NOTIFY THE COMMISSIONER  OF  EDUCATION  IN
ANY INSTANCE IN WHICH A REGISTERED PROFESSIONAL NURSE ENGAGES IN IMPROP-
ER  BEHAVIOR  WHILE SUPERVISING AN ADVANCED HOME HEALTH AIDE PURSUANT TO
SUBPARAGRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE
HUNDRED EIGHT OF THE EDUCATION LAW.
  S 3. Section 3602 of the public health law is amended by adding a  new
subdivision 17 to read as follows:
  17.  "ADVANCED  HOME  HEALTH  AIDES"  MEANS  HOME HEALTH AIDES WHO ARE
AUTHORIZED TO PERFORM ADVANCED TASKS AS DELINEATED IN  SUBPARAGRAPH  (V)
OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE HUNDRED EIGHT OF
THE  EDUCATION  LAW AND REGULATIONS ISSUED BY THE COMMISSIONER OF EDUCA-
TION RELATING THERETO. THE  COMMISSIONER  SHALL  PROMULGATE  REGULATIONS
REGARDING  SUCH AIDES, WHICH SHALL INCLUDE TRAINING, DEMONSTRATED COMPE-
TENCIES, COMPETENCY EXAMINATIONS, AND OTHER APPROPRIATE  QUALIFICATIONS,
AS  WELL  AS  A PROCESS FOR THE LIMITATION OR REVOCATION OF THE ADVANCED
HOME HEALTH AIDE'S AUTHORIZATION TO PERFORM ADVANCED TASKS IN  APPROPRI-
ATE CASES.
  S  4. Subdivision 9 of section 3613 of the public health law is renum-
bered subdivision 10 and a  new  subdivision  9  is  added  to  read  as
follows:
  9.  THE DEPARTMENT SHALL INDICATE WITHIN THE HOME CARE SERVICES WORKER
REGISTRY WHEN A HOME HEALTH AIDE HAS SATISFIED ALL  APPLICABLE  TRAINING
AND RECERTIFICATION REQUIREMENTS AND HAS PASSED THE APPLICABLE COMPETEN-
CY EXAMINATIONS NECESSARY TO PERFORM ADVANCED TASKS PURSUANT TO SUBPARA-
GRAPH  (V)  OF  PARAGRAPH  A  OF  SUBDIVISION  ONE OF SECTION SIXTY-NINE
HUNDRED EIGHT OF THE EDUCATION LAW AND REGULATIONS ISSUED  THERETO.  ANY

S. 5855--A                          4

LIMITATION  OR  REVOCATION  OF  THE ADVANCED HOME HEALTH AIDE'S AUTHORI-
ZATION ALSO SHALL BE INDICATED ON THE REGISTRY.
  S  5.  In  developing  regulations  required under subparagraph (v) of
paragraph a of subdivision 1 of section 6908 of the  education  law,  as
added  by  section  one of this act, the commissioner of education shall
take into consideration the recommendations of the workgroup  of  stake-
holders  convened  by  the commissioner of health to provide guidance on
the tasks which may be performed by advanced home health aides  pursuant
to  such  section  including, but not limited to, recommendations encom-
passing the following matters:
  (a) the advanced  tasks  that  appropriately  could  be  performed  by
advanced home health aides with appropriate training and supervision;
  (b) the types of medications that advanced home health aides should be
authorized to administer, including whether controlled substances should
be authorized;
  (c)  qualifications  that  must  be  satisfied by advanced home health
aides to perform such advanced tasks, including those related to experi-
ence, training, moral character, and examination requirements;
  (d) minimum training and education standards; and
  (e) adequate levels of supervision to be provided by nurses, including
adherence to existing requirements for comprehensive assessment and  any
additional  assessment that should be required, including when the indi-
vidual receiving advanced tasks performed by  an  advanced  home  health
aide experiences a significant change in condition.
  On  or  before  July  1,  2016,  the  commissioner of health shall, in
consultation with the commissioner of education, issue a report  to  the
governor  and  the  chairs  of the senate and assembly health and higher
education committees setting forth the recommendations of the workgroup.
  S 6. On or before January 1, 2020, the commissioner of  health  shall,
in  consultation  with  the commissioner of education, issue a report on
the implementation of advanced home health  aides  in  the  state.  Such
report shall include the number of advanced home health aides authorized
pursuant  to  this  act;  the types of advanced tasks that advanced home
health aides are performing; the number of individuals  who  were  moved
out  of  institutionalized  settings as a direct result of this act; the
extent to which advanced home health aides contributed to  the  improve-
ment  of  quality  care  of  these  individuals;  the  number of adverse
outcomes, including medication errors, that were reported to the depart-
ment of health; any reports of or issues with drug  diversion;  and  the
number of advanced home health aides who had their authorization limited
or  revoked.  Such  report shall provide recommendations to the governor
and the chairs of the senate and assembly health  and  higher  education
committees regarding the extension and/or alteration of these provisions
and  make  any  other  recommendations  related to the implementation of
advanced home health aides pursuant to this act.
  S 7. This act shall take effect immediately; provided that:
  a. section one of this act shall take effect January 1, 2017.   Effec-
tive  immediately,  the commissioner of education is authorized to adopt
or amend regulations necessary to implement the  provisions  of  section
one  of  this  act  on or before such effective date; provided, further,
that no advanced tasks shall be performed pursuant to the provisions  of
subparagraph  (v) of paragraph a of subdivision 1 of section 6908 of the
education law, as added by section one of this  act,  until  such  regu-
lations are adopted and except in conformance with such regulations; and
  b. this act shall expire and be deemed repealed June 30, 2020.

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Senate Bill S5855A

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Archive: Last Bill Status - In Senate Committee Higher Education Committee

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