Can a nurse delegate tasks to home care caregivers in New York?

In limited cases. New York lets Advanced Home Health Aides give routine prefilled or pre-packaged medications in the home, including insulin and other diabetes injections, under the direct supervision of an RN from a licensed home care agency or hospice. The RN must train and assess the aide, visit the client at least every two weeks and be reachable 24/7. Other home care aides cannot be delegated medication administration. Clients in the Consumer Directed Personal Assistance Program can instead direct their own aides to perform nursing tasks.

What conditions apply?

• Medication administration by unlicensed home care staff is limited to Advanced Home Health Aides (AHHAs) under Education Law 6908(2) and Education Department regulations
• The supervising RN must be employed by a licensed or certified home care services agency (PHL Article 36), a certified hospice, or an enhanced assisted living residence
• AHHAs may give routine medications that are prefilled or otherwise packaged for ease of administration; injections, sterile procedures and central line care are barred, except insulin and other diabetes injections, low molecular weight heparin, and prefilled naloxone and epinephrine auto-injectors for emergencies
• The RN trains and periodically assesses the aide, makes a comprehensive initial and ongoing assessment of the client, and visits at least once every two weeks
• An RN must be available by phone 24 hours a day, 7 days a week
• The employer must have a systematic approach to prevent drug diversion
• The AHHA authorization provisions are scheduled to sunset March 31, 2029

Is there an exception for self-directed care?

Education Law 6908 exempts domestic care by family, household members or friends, and paid caregivers in the Consumer Directed Personal Assistance Program (Social Services Law 365-f) who work under the instruction of a self-directing patient or family member, as determined by an RN.

What is the difference between medication reminders and administration?

Reminding a client to take their medicine, or handing them a container they open themselves, is usually treated as assistance. Giving the medicine, such as placing pills in the mouth, giving an injection or crushing tablets, is administration and generally needs a license or nurse delegation. Check your state's rule and the client's care plan.

What should you confirm with the state?

The advanced home health aide law is scheduled to expire March 31, 2029 unless extended.