In Florida, the duties and requirements differ for Certified Nursing Assistants (CNA), Home Health Aides (HHA), and Homemakers and Companions.

The three types of agencies that provide home care services to elderly are Home Health Agencies, Nurse Registries, and Homemaker and Companion Services.

A Home Health Aide (HHA) is not licensed or certified by the state of Florida. A person can be trained as a home health aide by completing a course provided by a public vocational technical school or local private career education school. All private schools must be licensed by the Florida Department of Education. A certificate of completion may be obtained, but that is not the same as being certified by the state. There is no Florida state examination and certification for a Home Health Aide. A Home Health Aide may be self-employed working independently in Florida, or may work for a Home Health Agency or Nurse Registry. A Home Health Aide may perform personal hygiene and grooming care such as:

• Bathing and shampooing hair
• Dressing and grooming
• Maintaining mobility
• Oral hygiene
• Position, transfer and ambulation
• Nutrition and fluid intake

A Certified Nursing Assistant (CNA) in Florida is required to be certified by the State Board of Nursing, which includes passing a state examination. The Board of Nursing maintains a registry of all certified nursing assistants. According to Florida Rule 64B9-15.002, a certified nursing assistant may provide care related to the activities of daily living which includes hands on care of an individual only under the general supervision of a registered nurse or licensed practical nurse. Some CNA's work directly with the client’s physician.

In addition to the duties of an HHA such as:

• Bathing & shampooing hair,
• Dressing & grooming,
• Maintaining mobility,
• Nutrition & hydration, and
• Toileting,

A CNA may perform more comprehensive duties. They include but are not limited to:

• Assistive devices,
• Tasks associated with data gathering, such as measuring temperature, pulse, respiration, blood pressure, height, and weight,
• Reporting and documentation of food intake, urinary output, and measuring and recording emesis and liquid stool,
• Reporting and documentation of all nursing assistant services.

Homemaker, Companion, or Sitter Services for adults that are provided by any agency or individual for adults must be registered with the Agency for Health Care Administration (AHCA). Homemaker and companion services provide non-medical care and are defined by the Florida Statute 400.462.

• “Companion” or “Sitter” spends time with or cares for an elderly, handicapped, or convalescent individual and accompanies such individual on trips and outings and may prepare and serve meals to the individual. A companion may not provide hands-on personal care to a client.
• “Homemaker” duties include housekeeping chores, meal planning and preparation, shopping assistance, and routine household activities for an elderly, handicapped, or convalescent individual. A Homemaker may not provide hands-on personal care to a client.

A Home Health Agency must be licensed by the State of Florida and comply with rigorous rules. They may employ Registered Nurses, Licensed Practical Nurses, CNA’s, HHA’s, Homemaker & Companions and therapists such as Physical Therapists, Occupational Therapists., etc. They may also provide staffing services to schools and health care facilities.

A Nurse Registry must be licensed by the State of Florida and obtains healthcare-related contracts for RN’s, LPN’s, CNA’s, HHA’s, companions, or homemakers as independent contractors (Florida Statute 400.506). They contract with the health professionals to provide services to individual patients or to provide private duty or staffing services to health care facilities.

A Homemaker/Companion Agency must be registered with the AHCA. They may employ homemakers and companions but not CNA’s or HHA’s.

When looking for home care services in Florida, first decide what your needs are, ask the agency you are calling exactly what they are licensed to provide, and get referrals from satisfied clients.

Article authored by Karen Best Wright, B.S. SeniorPro Marketing