Current through Register Vol. 46, No. 12, March 20, 2024
The governing authority or operator shall ensure for all
health care personnel:
(a) the
development and implementation of written personnel policies and procedures,
which are reviewed at least annually and revised as necessary;
(b)
(1) that
qualifications for advanced home health aides, home health aides, and personal
care aides as specified in section
700.2 of this Title are
met; and
(2) that the information
required by Public Health Law section
3613(3)(a)-(f) has been
entered into the home care services worker registry in accordance with Part 403
of this Title.
(c) that
the health status of all new personnel is assessed and documented prior to
assuming patient care duties. The assessment shall be of sufficient scope that no
person shall assume his/her duties unless he/she is free from a health impairment
which is of potential risk to the patient or which might interfere with the
performance of his/her duties, including the habituation or addiction to
depressants, stimulants, narcotics, alcohol or other drugs or substances which
may alter the individual's behavior;
(d) that a record of the following tests,
examinations or other required documentation is maintained for all personnel who
have direct patient contact:
(1) a certificate
of immunization against rubella which means:
(i) a document prepared by a physician,
physician assistant, specialist assistant, nurse practitioner, licensed midwife
or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this
Title, demonstrating serologic evidence of rubella antibodies;
(ii) a document indicating one dose of live
virus rubella vaccine was administered on or after the age of 12 months, showing
the product administered and the date of administration, and prepared by the
health practitioner who administered the immunization; or
(iii) a copy of the document described in
subparagraph (i) or (ii) of this paragraph which comes from a previous employer
or the school which the individual attended as a student;
(2) a certificate of immunization against
measles for all personnel born on or after January 1, 1957, which means:
(i) a document prepared by a physician,
physician assistant, specialist assistant, nurse practitioner, licensed midwife
or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this
Title, demonstrating serologic evidence of measles antibodies;
(ii) a document indicating two doses of live
virus measles vaccine were administered with the first dose administered on or
after the age of 12 months and the second dose administered more than 30 days
after the first dose but after 15 months of age showing the product administered
and the date of administration, and prepared by the health practitioner who
administered the immunization;
(iii)
a document indicating a diagnosis of the person as having had measles disease
prepared by the physician, physician assistant, specialist assistant, licensed
midwife or nurse practitioner who diagnosed the person's measles; or
(iv) a copy of the document described in
subparagraph (i), (ii) or (iii) of this paragraph which comes from a previous
employer or the school which the person attended as a student;
(3) a written statement, if
applicable, from any licensed physician, physician assistant, specialist
assistant, licensed midwife or nurse practitioner, which certifies that
immunization with measles and/or rubella vaccine may be detrimental to the
person's health. The requirements of paragraphs (1) and (2) of this subdivision
relating to measles and/or rubella immunization shall be inapplicable until such
immunization is found no longer to be detrimental to such person's health. The
nature and duration of the medical exemption must be stated in the individual's
personnel record and must be in accordance with generally accepted medical
standards (for example, the recommendations of the American Academy of Pediatrics
and the Immunization Practices Advisory Committee of the U.S. Department of
Health and Human Services);
(4) for
all personnel prior to employment or affiliation, except for personnel with no
clinical or patient contact responsibilities who are located in a building or
site with no patient care services, an initial individual tuberculosis (TB) risk
assessment, symptom evaluation, and TB test (either tuberculin skin test or Food
and Drug Administration (FDA) approved blood assay for the detection of latent
tuberculosis infection), and annual assessments thereafter. Positive findings
shall require appropriate clinical follow-up. The agency shall develop and
implement policies regarding follow-up of positive test results, including
procedures for facilitating and documenting treatment for latent TB infection
where indicated. Annual TB assessment shall include education, individual risk
assessment, and follow-up tests as indicated; and
(5) an annual, or more frequent if necessary,
health status assessment to assure that all personnel are free from any health
impairment that is of potential risk to the patient, family or to employees or
that may interfere with the performance of duties; and
(6) documentation of vaccination against
influenza, or wearing of a surgical or procedure mask during the influenza
season, for personnel who have not received the influenza vaccine for the current
influenza season, pursuant to section
2.59
of this Title.
(7) documentation of
COVID-19 vaccination or a valid medical exemption to such vaccination, pursuant
to section 2.61 of this Title, in accordance with applicable privacy laws, and
making such documentation available immediately upon request by the Department,
as well as any reasonable accommodation addressing such exemption.
(e) that personal identification is
produced by each applicant and verified by the agency prior to retention of an
applicant by the agency;
(f)
(1) that prior to patient contact, employment
history from previous employers, if applicable, and recommendations from other
persons unrelated to the applicant if not previously employed, are verified;
and
(2) a criminal history record
check to the extent required by Part 402 of this Title.
(g) that personnel records include
verifications of employment history and qualifications for the duties assigned
and, as appropriate, signed and dated applications for employment; records of
professional licenses and registrations; records of physical examinations and
health status assessments; performance evaluations; dates of employment,
resignations, dismissals, and other pertinent data provided that all
documentation and information pertaining to an employee's medical condition or
health status, including such records of physical examinations and health status
assessment shall be maintained separate and apart from the non-medical personnel
record information and shall be afforded the same confidential treatment given
patient medical records under section
766.6 of this
Part;
(h) that time and payment
records are kept for all personnel;
(i) that all personnel receive orientation to
the policies and procedures of the home care services agency operation and
in-service education necessary to perform his/her responsibilities. At a minimum:
(1) home health aides must participate in 12
hours of in-service education per year;
(2) personal care aides must participate in six
hours of in-service education per year; and
(3) advanced home health aide must participate
in 18 hours of in-service education per year which must include medication
management, infection control, and injection safety, and must be directly
supervised by a registered professional nurse;
(j) that there is a current written job
description for each position which delineates responsibilities and specific
education and experience requirements; and
(k) that an annual assessment of the
performance and effectiveness of all personnel is conducted including at least
one in-home visit to observe performance, if applicable;
(l)
(1) that
a program is implemented and enforced for the prevention of circumstances which
could result in an employee or patient/client becoming exposed to significant
risk body substances which could put them at significant risk of HIV or other
blood-borne pathogen infection during the provision of services, as defined in
sections
63.1 and
63.9
of this Title. Such a program shall include:
(i) use of scientifically accepted protective
barriers during job-related activities which involve, or may involve, exposure to
significant risk body substances. Such preventive action shall be taken by the
employee with each patient/client and shall constitute an essential element for
the prevention of bi-directional spread of HIV or other blood-borne
pathogen;
(ii) use of scientifically
accepted preventive practices during job-related activities which involve the use
of contaminated instruments or equipment which may cause puncture
injuries;
(iii) training at the time
of employment and yearly staff development programs on the use of protective
equipment, preventive practices, and circumstances which represent a significant
risk for all employees whose job-related tasks involve, or may involve, exposure
to significant risk body substances;
(iv) provision of personal protective equipment
for employees which is appropriate to the tasks being performed; and
(v) a system for monitoring preventive programs
to assure compliance and safety;
(2) that a policy/procedure is implemented and
enforced for the management of individuals who are exposed to significant risk
body substances under circumstances which constitute significant risk of
transmitting or contracting HIV or other blood-borne pathogen infection. The
policy/procedure shall include:
(i) a system for
reporting to a designated individual in the agency exposure thought to represent
a circumstance which constitutes significant risk of transmitting or contracting
HIV or other blood-borne pathogen infection;
(ii) evaluation of the circumstances of a
reported exposure and services for providing follow-up of the exposed individual
which includes:
(a) medical and epidemiological
assessment of the individual who is the source of the exposure, where that
individual is known and available;
(b) if indicated epidemiologically, HIV or
other blood-borne pathogen counseling and voluntary testing of the source
individual. Disclosure of the HIV status of the source individual can be made
with the express written consent of the protected individual, or a person
authorized pursuant to law to consent to health care for the protected individual
if such person lacks capacity to consent, or pursuant to court order, if the HIV
status is not known to the exposed individual;
(c) appropriate medical follow-up of the
exposed individual; and
(iii) assurances for protection of
confidentiality for those involved in reported exposures.
The amended version of this section by
New
York State Register October 4, 2023/Volume XLV, Issue 40, eff.
10/4/2023 is not yet
available.