Establishes certification procedures for nurse aides employed in State licensed or State certified health care settings and medicare/medicaid facilities. (SD2)

A BILL FOR AN ACT

SECTION 1. The legislature recognizes that 42 United States Code sections 1395i-3 and 1396R require nurse aides working in nursing facilities participating in medicare and medicaid programs to be certified.

The purpose of this Act is to require all practicing nurse aides, working in state licensed or state certified health care settings, to be certified. Certifying these nurse aides will allow the department of commerce and consumer affairs, the department of human services, and the department of health to monitor and evaluate the quality and competency of these nurse aides practicing in the State.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§321-   Enforcement. (a) The department shall adopt rules pursuant to chapter 91 as related to investigation and actions taken against certified nurse aides.

(b) The director of health shall investigate allegations of abuse, neglect, and misappropriation of an individual's property by certified nurse aides pursuant to chapter 91, and shall:

SECTION 3. Chapter 346, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:

"§346-   Training programs. The director of human services shall be responsible for:

§346-   Enforcement. (a) The director of human services shall investigate allegations of abuse, neglect, and misappropriation of an individual or their property committed by a certified nurse aide that is employed in a health care setting that is licensed or certified pursuant to chapter 91.

(b) The director of human services shall provide the findings from the investigation under subsection (a) to the department of commerce and consumer affairs for the purposes of placement in the nurse aide registry."

SECTION 4. Chapter 457A, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:

"§457A-   Definitions. As used in this chapter, unless the context clearly indicates otherwise:

"Certified nurse aide" means a nurse aide who has met the requirements of this chapter.

"Director" means the director of commerce and consumer affairs.

"Medicare/medicaid nurse aide" means a certified nurse aide who works in a medicare or medicaid certified nursing facility.

"Nurse aide" means a person who performs a variety of duties relating to patients and patient care working under the supervision of a nurse, including but not limited to assisting patients in all activities of daily living such as serving and collecting food trays, and helping patients get out of bed, bathe, and dress. A nurse aide may also assist a nurse by changing bed linens, delivering messages, and sterilizing instruments.

§457A-   Medicare/medicaid nurse aide certification. (a) To be certified, an applicant shall successfully complete a nurse aide examination approved by the director.

(b) No person shall be permitted to take the examination who has not complied with the training requirements established by the director of human services in accordance with 42 United States Code §1395i-3 and §1396R.

(c) Reciprocity shall be granted to nurse aides who have completed a state-approved program where the requirements of that program meet both federal and state requirements.

(d) Nurse aides employed in medicare/medicaid certified nursing facilities shall meet both federal and state requirements.

(e) Maintenance requirements for recertification shall be on a biennial basis, including employment in a medicare/medicaid facility as required by federal and state law.

(f) No charge shall be imposed on nurse aides for the maintenance of the nurse aide registry.

(g) Any person who works in a medicare/medicaid nursing facility who holds a valid certificate to practice as a certified nurse aide in this State shall have the right to use the title "certified nurse aide" and the abbreviation "C.N.A.". No other person shall assume the title "certified nurse aide" or in any manner imply that the individual is a certified nurse aide except as provided in this chapter or use the abbreviation "C.N.A." or any other words, letters, signs, or devices to indicate that the person using the same is a certified nurse aide.

§457A-   Nurse aide certification for state licensed or state certified facilities. (a) This certification applies to nurse aides working in state licensed and state certified health settings other than a medicare/medicaid certified nursing facility.

(b) To be certified, an applicant shall successfully complete training in a state-approved training program and a nurse aide examination approved by the director.

(c) Fees may be imposed for services rendered to carry out the purposes of this section.

(d) Reciprocity shall be granted to qualified nurse aides who have completed a state-approved program where the requirements of that program are comparable to the requirements of this chapter.

(e) Maintenance requirements for recertification shall be on a biennial basis, including a recertification examination as approved by the department of human services.

(f) Any person who works in a state licensed or state certified health care setting and who holds a valid certificate to practice as a certified nurse aide in this State shall have the right to use the title "certified nurse aide" and the abbreviation "C.N.A.". No other person shall assume the title "certified nurse aide" or in any manner imply that the individual is a certified nurse aide except as provided in this chapter or use the abbreviation "C.N.A." or any other words, letters, signs, or devices to indicate that the person using the same is a certified nurse aide. This section shall not apply to medicare/medicaid nurse aides."

SECTION 5. Section 457A-1, Hawaii Revised Statutes, is amended to read as follows:

"§457A-1 Findings and purpose. (a) The legislature recognizes that 42 United States Code §1395i-3 and §1396R require nurse aides working in certified nursing facilities participating in medicare and medicaid programs to be certified.

(b) The legislature also recognizes that nurse aides who work in State licensed or State certified health care settings should be certified for the purpose of consumer safety and held to similar standards of competency and evaluation appropriate for these facilities. This chapter implements 42 United States Code §1395i-3 and §1396R and this chapter with respect to:

[(b) As used in this chapter, "nurse aide" means a person who performs a variety of duties relating to patients and patient care working under the supervision of a nurse, including but not limited to assisting patients in all activities of daily living such as serving and collecting food trays, and helping patients get out of bed, bathe, and dress. A nurse aide may also assist a nurse by changing bed linens, delivering messages, and sterilizing instruments.]"

SECTION 6. Section 457A-2, Hawaii Revised Statutes, is amended to read as follows:

"§457A-2 Implementation. (a) The director [of commerce and consumer affairs] shall implement the provisions of 42 United States Code §1395i-3 and §1396R and this chapter, as they relate only to establishing:

(b) The director of the department of health shall implement the provisions 42 United States Code §1395i-3 and §1396R and this chapter, as they relate to disciplining of nurse aides employed in health care settings licensed or certified by the department of health, certified under this chapter.

(c) The director of human services shall implement the provisions of 42 United States code §1395i-3 and §1396R and this chapter, as they relate to training programs for nurse aides and recertification, and to disciplining of nurse aides employed in health care settings licensed or certified by the department of human services, certified under this chapter."

SECTION 7. Section 457A-3, Hawaii Revised Statutes, is amended to read as follows:

"§457A-3 Power of director. (a) The director, in accordance with chapters 91 and 92, shall adopt rules that may be necessary to implement the provisions of this chapter and 42 United States Code §1395i-3 and §1396R, as well as the federal regulations adopted pursuant thereto, as they relate only to establishing:

(b) The director shall issue certificates to qualified nurse aides and shall be responsible for maintenance of an up-to-date nurse aide registry which shall include the names of certified nurse aides, their places of employment, and [disciplinary actions.] the information that is required to be reported by the department of health and the department of human services to the director pursuant to sections 321-   and 346-  . The director's role, with regard to certified nurse aides, [Disciplinary actions] shall be limited to the placement of substantiated findings from the department of health and the department of human services into the nurse aide registry [within ten working days of court settlement]."

SECTION 8. Any nurse aide employed in a State licensed or State certified health care setting and who has been recertified by June 30, 2006 may be recertified on a biennial basis under this chapter if the nurse aide passes, by December 31, 2007, a proficiency evaluation approved by the department of human services. If the nurse aide fails to pass the evaluation, the nurse aide shall instead apply for certification as a new applicant and undergo recertification as required under this chapter.

SECTION 9. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 10. This Act shall take effect on July 1, 2006.