Millions of Americans receive some form of in-home care every year. This type of long term care has become increasingly popular because it allows patients to receive personalized services within a familiar home setting, rather than undergoing the significant lifestyle changes associated with moving to an assisted living facility.

While a well-developed in-home care plan can be a life changing solution for many patients, the path to establishing that plan can be rather intimidating for those unfamiliar with their options. This article’s goal is to present readers with a better understanding of the in-home care options available to residents of New York State so they can confidently make informed decisions about their own care.

Certified Home Health Care Agencies vs. Licensed Home Care Services

In-home care services in New York State broadly fall into two categories: Certified Home Health Care Agencies (CHHA) and Licensed Home Care Service Agencies (LHCSA).

CHHCA services are funded through Medicare or other federal funding sources, and are meant to provide short-term support. These agencies hire, manage, and dispatch home health aides, nurses, and therapists to help a patient to manage a specific illness or injury.

Because the services provided by a CHHA are meant to address a specific ailment, a care recipient usually has minimal control over the scope of services provided, and those services end when the qualifying condition has been resolved.

While this type of service is generally provided at little or no cost, the qualifications for receiving care through a CHHA is considerably more strict.

An LHCSA organization provides in-home care through home health aides, nurses, and other medical professionals similar to a CHHA, however there are far fewer restrictions on the length of service or types of service provided to the client. This is because LHCSS services are not funded by the federal government, but instead paid for through either a patient’s insurance coverage or via out-of-pocket funds.

Both CHHA and LHCSA organizations are regulated by the New York State Department of Health, however CHHCA organizations are also partially governed by federal laws. It’s important to note that patients can receive services from both types of organizations simultaneously, typically with CHHA services addressing a specific medical concern, while LHCSA-supplied caregivers manage a patient’s more generalized needs.

Understanding Home Health Caregiver Terminology

Home Caregivers in New York State are divided into three titles based on their level of training and the tasks they can legally perform: Companions, Personal Care Attendants (PCA), and Home Health Aides (HHA). CHHA and LHCAS organizations in New York State employ all three of these types of caregivers.

Home health caregivers provide varying levels of support that allow a patient to complete “activities of daily living,” commonly called ADL’s. ADL’s are six key tasks an individual needs to be able to perform daily to maintain a baseline level of health and hygiene: toileting, bathing, dressing, ambulation, transfers, and eating.

Companion caregivers receive no specific medical training and are only legally able to provide “hands off” assistance to their clients. Companion caregivers provide assistance with light housekeeping and meal preparation, social companionship, and general guidance or supervision, like reminding a patient to take their medication (although they themselves cannot provide assistance in taking this medication.)

Personal Care Aides (PCA) receive 40 hours of classroom training in household management and basic patient care. PCA’s are not allowed to perform complex patient care tasks and are typically assigned to clients who are self-directing and need some hands-on support with the above mentioned activities. A PCA can perform the same duties as a Companion, but a Companion cannot perform the same duties as a PCA.

Home Health Aides (HHA) receive a total of 75 hours of home health care training, including 16 hours of hands-on training under the supervision of a Registered Nurse, typically in a residential care setting. While in a client’s home, an HHA will follow the directions of a client’s Registered Nurse Supervisor or similar health care management team and is expected to take on more of a lead role in the client’s care.  HHAs proactively assist clients who are not self-directing at all times or have more complex medical needs than are covered in a PCAs training program.  A Home Health Aide can perform the same duties as a Personal Care Aide however a Personal Care Aide cannot perform the same duties as a Home Health Aide.

Personal Care Aides or Home Health Aides?

Many home health care agencies staff both PCAs and HHAs to care for their clients, starting with PCAs and upgrading to HHAs as a client’s needs change.

While this strategy works on paper, SelectCare Home Health Care services take a different approach by only staffing Home Health Aides. We find that patients and caregivers often form a close bond, and losing a longtime PCA caregiver due to increased patient needs can be an extremely jarring experience for both client and staff. A small, consistent team working with the same client allows the caregiver staff to become familiar with the client’s unique needs and goals, making it easier to track important changes that a new caregiver might otherwise miss. This approach allows for improved continuity of care and is one of the best ways to ensure a client receives truly personalized service.

Hope you found this basic guide useful as you begin to consider care options for yourself or an older loved one. SelectCare offers its clients Home Health Aide, Licensed Practical Nurse and Registered Nurse services to ensure every family gets the support they need.

To learn more about home health care services with SelectCare, contact us today, read our client testimonials, or request a free in-home care guide.