New Jersey Nurse - April 2021

Page 16 New Jersey Nurse & Institute for Nursing Newsletter April 2021
Home Health Aides in New Jersey
Susan H. Weaver, PhD, RN, CRNI, NEA-BC, Edna Cadmus, PhD, RN, NEA-
BC, FAAN, and Pamela B. de Cordova, PhD, RN-BC
Until a loved one needs care, many of us do not think about the important
role of home health aides (HHA). The New Jersey (NJ) Board of Nursing certifies
HHAs, who are individuals employed by a home care agency and perform nursing
tasks delegated by a registered professional nurse (NJ Statutes Annotated, 45:11-
23(b)). For older adults, individuals with disabilities, chronic illnesses, or cognitive
impairment, the 56,862 HHAs in NJ provide essential hands-on patient care
related to activities of daily living.
With the aging U.S. population, the need for HHAs and personal care aides is
projected to grow 34 percent from 2019 to 2029, much faster than the average
for all occupations (Bureau of Labor Statistics, 2020). HHAs find their role
rewarding, as explained by a HHA, “Being a home health aide is a very rewarding
career because I get to make a difference in people’s lives daily and that is
fulfilling for me because that is my passion.” So, although HHAs find their career
rewarding, the increasing need for HHA is of special concern in NJ because of the
reported low salary, few full-time positions and irregular work schedule of HHAs
(Bureau of Labor Statistics, 2020; Hewko et al., 2015; Weng & Landes, 2017).
The NJ Board of Nursing sets the standards for HHA education and training
programs and maintains a registry of all individuals who have certification as a
HHA. To become a HHA in NJ you can obtain your certification by 1) completing
a HHA training program, 2) holding a certification as a nurse aide (CNA) and
completing an additional course, or 3) completing a clinical nursing course in a
RN or LPN nursing education program (N.J.A.C. 13:37-14.9). Interestingly, the
NJ Department of Health (DOH) is responsible for CNA licensing. In November
2020, Assemblywoman Huttle introduced a bill (A5037) which would require
the NJ Board of Nursing to establish dual certification for CNA and HHA and
transfers CNA licensing authority from DOH to Board of Nursing.
The NJ Collaborating Center for Nursing (NJCCN) has begun researching
information about the role of the HHAs in NJ. In the Fall of 2020, the NJCCN
distributed a survey to the 30,971 HHAs with an email address listed with the
NJ Board of Nursing. The 958 HHAs who responded to the survey were
primarily female (91%), Black/African American (44%), a high school graduate/
GED (33%), and had six to 20 years of HHA experience (45%). The average age
of the HHA respondents was 47, and the primary employment setting for the
majority of HHAs (38%) was a home care agency. Although the majority of HHA
respondents worked full-time, a slight majority (53%) of all HHAs do not receive
any benefits with their job.
The HHA respondents indicated how concerned (very concerned, somewhat
concerned, or not at all concerned) they were regarding their personal health
and safety, about injuries from lifting or transferring, about working when sick,
their stress and mental health, and about being required to work overtime. As
depicted in Figure 1, the majority of HHAs indicated they were very concerned
about working when sick (59%), about injuries from lifting or transferring (48%),
and their personal health and safety (47%). For the final question of the survey,
HHAs were asked if there is any additional information they would like to share
about their HHA job. The responses received from 262 HHA were aggregated
into categories and the most common categories were: Underpaid, love the work,
extremely rewarding, hard work, and need benefits.
As NJCCN continues to gather information about this important workforce,
NJ nurses are especially charged to continue to advocate, support, and recognize
the important work of HHAs in caring for patients. NJ needs to continue to
attract home health aides who are passionate about caring for the citizens of
NJ. However, we need to advocate for HHAs to ensure they receive an adequate
salary with benefits.
Figure 1
HHA concerns regarding their personal health and safety, injuries from lifting or
transferring, and working when sick.
References
A5037, State of New Jersey 219th Legislature. (2020). https://www.njleg.state.nj.us/
Bureau of Labor Statistics, U.S. Department of Labor (2020). Occupational Outlook
Handbook, Home Health Aides and Personal Care Aides, on the Internet at https://
www.bls.gov/ooh/healthcare/home-health-aides-and-personal-care-aides.htm
Hewko, S., Cooper, S., Huynh, H., Spiwek, T., Carleton, H., Reid, S., & Cummings,
G. (2015). Invisible no more: a scoping review of the health care aide workforce
literature. BMC Nursing, 14(38), 3-17. doi:10.1186/s12912-015-0090-x
NJ Administrative Code (N.J.A.C.), Title 13, Law and public safety, Chapter 37-13:37-14.9.
(2020). Retrieved from https://www.njconsumeraffairs.gov/regulations/Chapter-37-
New-Jersey-Board-of-Nursing.pdf
NJ Statutes Annotated, Title 45, Chapter 11, New Jersey Board of Nursing Statutes,
45:11-27 Retrieved on May 3, 2018 http://caring4you.net/laws1.html
Weng, S., & Landes, S. (2017). Culture and Language Discordance in the Workplace:
Evidence From the National Home Health Aide Survey. The Gerontologist, 57(5),
900–909. doi:10.1093/geront/gnw110
New Jersey Collaborating Center for Nursing:
The New Jersey Nursing Workforce Center
Established: December 12, 2002 by New Jersey (NJ) legislation P.L.
2002
Vision: To be the dominant voice on nursing workforce solutions for New
Jersey citizens.
NJCCN Board: Seventeen-member Board appointed by the
Governor, Senate President, or Speaker of the Assembly with members
recommended from the following organizations: New Jersey State Nurses
Association, Organization of Nurse Leaders NJ, NJ League for Nursing,
NJ Hospital Association, Health Care Association of NJ, Home Care
Association of NJ, Council of Baccalaureate and Higher Degree Programs,
Council of Associate Degree Programs, Association of Diploma Schools
of Professional Nursing, Practical Nurse Educators’ Council of NJ, and an
LPN and RN who provide direct patient care, and two consumers of health
care.
Board Chairperson: Laura Mularz, DNP, RN, APRN, ACNS-BC, NE-
BC, appointed by Speaker of the Assembly and representing Organization
of Nurse Leaders NJ.
Board Secretary: Donna Murray, MSN, RN, APN-C, WHNP-BC,
appointed by the Governor and representing NJ League for Nursing.
Executive Director: Edna Cadmus, PhD, RN, NEA-BC, FAAN
Reports: NJCCN is the primary source for data on the nursing workforce
with publication of an annual Nursing Data and Analysis Report.
Key Projects: Implementation of a state-wide acute care residency
program, and research studies on the LPN workforce and Home Health
Aide workforce
Location: Rutgers University, School of Nursing, Newark, NJ
Website: www.njccn.org
Twitter: @NJ_CCN