The Department of Health (DOH) posted a Dear Administrator Letter (DAL) on May 9 th to provide clarification and guidance in response to questions regarding orientation, in-service, and annual performance evaluation requirements for aides employed by Licensed Home Care Services Agencies (LHCSAs) and Certified Home Health Agencies (CHHAs)/Long Term Home Health Care Programs (LTHHCPs). The DAL cites all the federal and state regulatory requirements for in-service and annual performance requirements for aides employed by LHCSAs and CHHAs.
In-service requirements: State and federal in-service education mandates include 12 hours per year for home health aides (HHAs) and 6 hours per year for personal care aides (PCAs). The in-service requirement begins from the aide’s date of hire/employment. Agencies have the discretion to fulfill the annual in-service requirements (6 hours or 12 hours as applicable) on either a calendar year basis or employment anniversary basis. However, it must be clearly stated in the agency’s in-service education policy.
The DAL states: “In-service training may be provided in a variety of settings and conducted by a variety of modalities or means. Training settings may include the patient’s home when the aide is furnishing care to the patient, agency location, or other appropriate locations. Modalities may include presentation, lecture, demonstration, videotape, webinar, and online trainings.” The DAL continues by describing the “musts” of all in-service education/trainings regardless of setting or modality.
Orientation requirements: Agencies are required to provide orientation for new staff (including aides) employed by the agency prior to provision of care. Orientation must be agency-specific and cannot be provided by other agencies. The DAL clarifies that the training conducted for purposes of orienting new aides does not count toward meeting the annual 6- or 12-hour aide in-service requirement.
Annual performance evaluation/review: The DAL states that “agencies are required to conduct an annual performance evaluation/review for each aide employed minimally every 12 months.” It must be conducted by an RN and must include an onsite home visit to the location where a patient is receiving care to observe and assess the aide while he or she is performing care. The DAL continues: “if a deficiency in aide services, competency, or skill is identified by the RN during the onsite visit, then the agency RN must conduct, and the aide must complete, a competency evaluation in any task for which the aide is not considered competent.” The aide must not perform any task without direct supervision by the RN until after he/she has received training in the task and successfully completed a subsequent evaluation.”
Personnel File: Documentation of the aide’s competencies must be included in the personnel file, and there must be evidence and documentation in each aide’s personnel file to support that the orientation, in-service, and annual performance evaluation requirements are met.
Training documentation: Agencies are required to record and maintain training files for each in-service offered regardless of modality. The files should be retained for at least six years. At a minimum, the following must be documented and maintained for each training/in-service offered: date; length of training; training location; training content, objectives, and goals; materials used; post-test; attendance list; proof of completion; and RN supervisory oversight and sign-off.
Any questions on whether aides are properly trained and supervised should be sent to homecare@health.ny.gov.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871