Download Are home health aides allowed to administer medication in your

Are home health aides allowed to administer medication in your
State, and if so, under what conditions?
PA - No. Aides in other provider settings are allowed to administer medications if they
case a course through our Dept. of Public Welfare.
NH - In NH the answer is yes and no. All home health aides in NH must be licensed
nursing assistants (formerly called CNAs). There are two levels of licensure— LNAs
and Medication LNAs. The latter must take an additional 50 hr course to be able to pass
meds. MNAs are not currently used in home health, but are not restricted from being
used in home care.
ID - Idaho has an Assistance with Medications course which is taught by an RN or
pharmacist. They have to be approved through the university and have a curriculum
orientation. This instructor then gets classes approved, requests specific cards, and
facilitates and 8 hour course to all Unlicensed Assistive Personnel. There is a standard
test proctored at the end of the course and a one time card issued. These cards are
required for all RALF, shelter home, DD, ICFMR, hospice, home health, etc. utilizing
UAPs (CNAs or non CNAs) assisting with meds.
NE - In Nebraska, home health aides are allowed to give meds if they have taken the
Medication Aide course, and have been checked off skill-wise with the individual
agency. The guidelines for the Medication Aide is such that each individual agency must
decide how they will use them, and then do the skills check off and of course, have
supporting documentation of the check off.
UT - In Utah they are allowed to assist taking meds but not to administer or setup the
meds. A nurse has to set up the meds first.
VA - No in Virginia
MA - In Mass, the Nurse Practice Act prohibits any delegation of med administration to
home health aides.
IN – Yes under these conditions: Medication assistance:
(a) through providing reminders or cues to take medication, the opening of preset
medication containers, and providing assistance in the handling or ingesting of
non-controlled substance medications, including eye drops, herbs, supplements,
and over-the-counter medications; and
(b) to an individual who is unable to accomplish the task due to an impairment
and who is:
(i) competent and has directed the services; or
(ii) incompetent and has the services directed by a competent individual who
may consent to healthcare for the impaired individual.
NY - Yes to self directing patients only *This activity can only be provided for a patient
who is self-directing; i.e. has the capability to make choices
about the activities of daily living, understands the impact of these choices and assumes
responsibility for the results of the choices. They are allowed to open containers, bring
medication to the patient, etc., but not remove it unless the patient is self directed.
WV – NO
NM - the answer is no at this time
NJ - In NJ the practice of Certified Home Health Aides administering medications is
strictly prohibited per regulation. However, I can share that at our recent annual meeting
the Executive Director of the NJ Division of Disability Services (Bill Ditto) and the CoDirector of the Rutgers Center for Health Policy (Susan Reinhard) announced the coming
of the Nurse Delegation Pilot Project.
KY - In Kentucky home health aides can only remind patients to take self
administered medications. They are not to administer meds.
WA - Washington State has several exceptions, as usual. In the in-home services
licensing law home health aides may assist with medications where the dose is
determined by an RN/LRN or family member. The assistance is limited to handing the
container, opening it if necessary and assisting the client to take the meds. Direct
administrating is not allowed.
The Board of Pharmacy as promulgated rules related to medication assistance in
community settings. I have attached those rules here.
We also have nurse delegation in which an RN may delegate a nursing task, including
administration of medications, to a home care or home health aide who is registered or
certified in the State. There are very specific rules related to nurse delegation in the
Nurse Practice Act 18.79 RCW. The administration of insulin is not allowed to be
delegated.
MT - In Montana, HH aides cannot administer meds; they can “assist” only. We do have
a statute allowing licensed medication aides, but it applies to assisted living facilities
only.
NC - The Home Care licensure rules in NC state that aides can: “assist client with selfadministration of medications which are ordered by a physician or other person
authorized by state law to prescribe”. So, the aides cannot administer the meds, they can
assist the client to take their own meds.
CT – No. Only "certified unlicensed personnel" in a licensed Residential Care Home are
permitted to administer meds (besides nurses). They have to go through training to
become certified. They are looking at potentially allowing this kind of model in assisted
living as well. This is an area of controversy as you can imagine.
FL – NO
MN - Class A Home Care & Hospice
A registered nurse may delegate the task of medication administration only to a HHA
after documentation of competency of task and orientation to client. Exclusions are
written to prohibit delegation of IV and any IM/Subq/Intradermal injections
OH - In Ohio, home health aides are not permitted to administer medications. Home
health aides may only assist an individual in the self-administration of medication.
AR - The HHA are not allowed to administer medicine in Arkansas...they can only
remind the patient.
TN - Tennessee does not allow home health aides to administer, only assist.
TX - In Texas, RNs may delegate administration of medications (including insulin) to an
unlicensed assistive personnel in an independent living environment when the client's
condition (for which the medication is given) is stable. This delegation is specific to the
UAP and to the client. Click here for the Board of Nurse Examiners rules specific to
delegation (ch 224 & 225). Nurses cannot be forced to delegate anything. They are
empowered to use their assessment, training, and judgment to determine when it is
appropriate.
Certified home health medication aides can administer medications in acute patient
conditions or environments.
Unlicensed persons (not limited to home health aides) can assist with administration of
medications without any RN supervision or delegation.
Below are the definitions for administration of medication and assistance with
administration of medications that are in our Home and Community Support Services
Agency licensure rules:
Administration of medication — The direct application of any medication by injection,
inhalation, ingestion, or any other means to the body of a client. The preparation of
medication is part of the administration of medication and is the act or process of
making ready a medication for administration, including the calculation of a
client's medication dosage; altering the form of the medication by crushing,
dissolving, or any other method; reconstitution of an injectable medication;
drawing an injectable medication into a syringe; preparing an intravenous
admixture; or any other act required to render the medication ready for
administration.
Assistance with self-administration of medication — Any needed ancillary aid
provided to a client in the client's self-administered medication or treatment
regimen, such as reminding a client to take a medication at the prescribed time,
opening and closing a medication container, pouring a predetermined quantity of
liquid to be ingested, returning a medication to the proper storage area, and
assisting in reordering medications from a pharmacy. Such ancillary aid includes
administration of any medication when the client has the cognitive ability to direct
the administration of their medication and would self-administer if not for a
functional limitation.
IL - Aides in Illinois are not permitted to administer medication.
NJ - the home health aides are under the NJ Board of Nursing. There is a current clause
that does not allow the home health aide to administer any medications. The aide may
only ‘assist’. However, the Board has granted a waiver that does allow Home Health
Aides who have taken a NJ Department of Health Certified Medication Aide course and
passed the competency exam, to administer a specific list of meds (including pre-drawn
insulin) under RN supervision in Assisted Living settings.
IA - In Iowa HCA’s are not allowed to administer medications. They can, however,
remind the client to take medications, and can apply some topical creams and do simple
dressing changes.
VT - home health aides are not permitted to administer medications. Home health aides
may only assist an individual in the self-administration of medication.
GA - home health aides are not permitted to administer medications. Home health aides
may only assist an individual in the self-administration of medication.
ND - North Dakota is very similar to that in Kentucky. Reminders regarding medications
are common. We can do specific delegation if the RN determines the patient condition is
stable and the CNA has the knowledge, skills, and abilities to administer the medication,
after training and completing skills checks specific to that individual and to a specific
medication. It is a complex and time consuming process, so is used infrequently. ND
does have Certified Medication Aides that complete an extensive education and training
program and can pass medications with RN oversight, but these are used in LTC facilities
rather than in the home setting.
LA - Nurse aides in Medicare certified home health agencies, are not allowed to
administer medications in Louisiana, under any circumstances. However personal care
attendants, who take care of only one disabled or medically fragile patient, for months
and years at a time, are able to administer medication and do other simple procedures for
that one patient. They require about 40 plus hours of training, some of which is basic
general stuff and some of which is patient specific.
MO - In Missouri HH aides may not administer medications, but may assist.
CA - In California, Certified Home Health Aides may assist patients with medications
which are ordinarily self administered but shall not administer medications of any kind.
HI – In Hawaii nurse delegation is only authorized in settings where a registered nurse
may not always be present. The rules are specific to which tasks can be delegated.
Rather than list each one, the primary policy is that the registered nurse is the responsible
entity for insuring that the UAP is competent to complete the task that is delegated. It is
not a carte blanche delegation.