Dear Legislator
A newly circulated bill-draft, making its way through the Legislature, would create an “advanced home health aide” designation in ways that are disastrous for home care providers, their staff and patients.
Home care employers support the “advanced home health aide” concept in theory. However, as currently drafted, this bill creates enormous financial, regulatory, safety and staffing vulnerabilities that must be immediately fixed.
For instance, versions of the bill are stuffed with unnecessary and oppressive nurse-staffing ratios for supervision of “advanced home health aide” tasks. Likewise, the bill also would trigger a host of new federal regulatory requirements, which mean more frequent and costly nurse supervision activities. These regulatory triggers, nurse-ratio requirements, and accompanying salary increases for “advanced home health aides” would collectively impose enormous new costs and administrative burdens.
Like other recent home care labor mandates, this bill includes absolutely no dedicated funding mechanism to offset these new costs, nor any assurances of managed care premium coverage to fill-in the cost gap for employers. This is unconscionable, given the cascade of wage and labor costs already being foisted onto the home care system at this time, such as new overtime and minimum wage requirements for home care.
Furthermore, the bill is devoid of any liability protections for nurses, who would have the discretion and responsibility to determine which aides are competent to assume additional tasks. It also raises major, unanswered questions as to how an aide is deemed eligible, and then properly trained, to assume these new tasks while offering no prerogative for employers to determine the suitability of employees for “advance home health aide” service.
When it comes to serving New York’s elderly, chronically ill, and disabled populations, these decisions and details must not be taken lightly.
In the strongest possible terms, I ask that you work with your colleagues to change this bill so that it protects and better supports employers, aides, and, above all, the integrity of quality patient care. These changes have already been submitted by the Home Care Association of New York State and must be included now before this bill takes another step forward in the process. Thank you.