Home Health Aide Requirements in Vermont

Vermont, like other states, has high need of home health aides. Those who work for Medicare-certified home health and hospice agencies are trained as nursing assistants and licensed as Licensed Nursing Assistants or LNAs. Workers sometimes perform some of the same duties for agencies that are private pay or that receive reimbursement through other programs. Formal requirements may be different. However, good training can lead to increased job satisfaction — as well as to a more competent and stable workforce.

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Vermont Home Health and Home Care Agencies

Vermont’s home health agencies are designed to provide clients with interim or short term medical services. This is in line with federal requirements for Medicare-certified agencies; Vermont home health agencies are certified. Each home health agency must provide skilled nursing and at least one other therapeutic service. This could be home health aides, physical therapy, occupational therapy, speech therapy, or medical social work. Agencies may provide other types of professional service such as mental health counseling or dietitian service. (In practice, home health agencies tend to provide quite a lot of services.)

Hospice services are provided for individuals in the final months of life. They also provide multiple services. Home health aide is a common one.

Home health agencies may accept different types of payment. A home health agency may employ unlicensed personnel to carry out services as appropriate. People who receive hospice through Medicaid are also served through Medicare-certified agencies.

Many of Vermont’s home health agencies are members of the Visiting Nurses Association of Vermont (http://humanservices.vermont.gov/community-partners/cp-home-health/). Bayada Home Health Care also operates agencies throughout Vermont.

Home health aides are also sought by employers other than certified home health agencies. Not all agencies that provide direct care workers are Medicare-certified. There are many people who need services — often long-term — because of disability, chronic condition, or advanced years. Sometimes providers are reimbursed through other governmental programs. Some Vermont children and youth, for example, receive personal attendant services because they lack the ability to carry out activities of daily living such as bathing, eating, and moving around independently. Many people, of course, self-pay for services they feel that their loved one needs.

Home Health Aide Duties

The scope of allowable duty is set at the state level. In Vermont, home health aide duties may include the following:

  • Assisting clients in getting in and out of bed and moving around
  • Assisting with activities of daily living
  • Carrying out nursing-related duties under nurse supervision
  • Assisting in treatment (as noted in the care plan)
  • Assisting during emergency situations

Generally the home health aide will be supervised by a registered nurse. In some cases, supervision will be by a therapist.

LNA/ HHA Training in Vermont

The LNA license is dependent on completing education and examination. Vermont nursing assistant programs are at least 80 hours and include at least 16 clinical hours. They may be offered by educational institutions, healthcare organizations, or private organizations that affiliate with healthcare organizations. They must be approved to provide nursing assistant training. A list of approved schools can be found on the website of the licensing authority (https://www.sec.state.vt.us/professional-regulation/list-of-professions/nursing/licensed-nursing-assistants.aspx).

Students must have at least 16 hours of education before they have direct contact with residents. This initial training includes safety, infection control, emergency procedures, interpersonal and communication skills, protection of rights and promotion of independence.

In most cases, a trainee will apply skills in a laboratory setting before applying them in actual clinical situations; there may be some exceptions. The student will be checked off on skills in the following areas:

  • Communication
  • Mobility/ ambulation
  • Supportive
  • Body mechanics
  • Transfers
  • Safety
  • Nutrition
  • Infection control
  • Bed making
  • Personal care
  • Oral care
  • Toileting
  • Catheter care
  • Vital signs

Bed making includes occupied and unoccupied beds. Communication encompasses a variety of skills, including communicating with people who have cognitive issues, hearing loss, or inability to communicate verbally; it also includes documentation and reporting. Ambulation/ mobility includes use of devices such as gait belt, wheelchair, and walker.

Vermont contracts with Pearson VUE for administration of its competency evaluation. The prospective nursing assistant will need to pass a written or oral examination and a skills evaluation. All candidates will demonstrate proper hand washing. They will have four other randomly selected skills to complete. The candidate handbook includes more than 20 skills that may be tested. It also includes a breakdown of steps that are to be demonstrated. Each candidate will have to demonstrate a skill that involves measurement. There are five possibilities; among them are radial pulse, respiration, and weight. Dressing someone with a weak arm, performing passive range of motion exercises for the shoulder, and feeding someone who can’t feed themselves are among the skills that don’t have a measurement component.

A nursing student (RN or LPN) may be eligible for licensure if he or she has completed comparable training; the individual will also need to pass competency evaluation.

An individual could be approved for testing following a review of out-of-state education.

Qualifying by Endorsement

An out-of-state nursing assistant with current credentialing may qualify for licensure by endorsement if he or she has worked for at least 50 days during the prior two year period.

The Application Process

Application instructions can be found on the website of the Vermont Secretary of State (https://www.sec.state.vt.us/professional-regulation/list-of-professions/nursing/licensed-nursing-assistants.aspx). The prospective licensee will also find a link to the online application process. The nursing assistant may receive an educational verification form from his or her school in a signed envelope. The school may, however, send this directly to the licensing authority.

Licensees are expected to work as LNAs for at least 50 days during each two-year renewal period. In some cases, the licensing agency may need a job description to know whether the person is indeed working as an LNA.

Career Outlook and Average Home Health Aide Salary in Vermont

Vermont home health aides enjoy an average hourly wage of $13.22.

Home health aide employment levels have been projected to increase by 22% in Vermont between 2014 and 2024.

Additional Resources

Nursing assistants are under the jurisdiction of the Board of Nursing (https://www.sec.state.vt.us/professional-regulation/list-of-professions/nursing.aspx).

Pearson VUE is an additional resource in the licensing process (http://www.vue.com/vt/nurseaides/).