Report Title:

Nurse aides

Description:

Certifies nurse aides who work in nursing facilities participating in medicare and medicaid programs and in other state licensed and certified health care settings.

THE SENATE	S.B. NO.	164
TWENTY-FOURTH LEGISLATURE, 2007
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO NURSE AIDES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The purpose of this Act is to provide for the certification and recertification of nurse aides who work in nursing facilities participating in medicare and medicaid programs and in other state licensed and certified health care settings.  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 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

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

(1) Approving training programs for the certification of nurse aides and ensuring that they comply with all applicable federal and state requirements;

(2) Approving and arranging for the recertification examinations for nurse aides who work in medicare/medicaid nursing facilities; and

(3) Approving the recertification process for nurse aides who work in other state health care settings.

(b)  As used in this section, the terms "nurse aide", "medicare/medicaid nursing facilities", and "state health care settings" mean the same as defined in chapter 457A."

     SECTION 3.  Chapter 457A, Hawaii Revised Statutes, is amended by adding two 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 is certified under the requirements of this chapter.

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

"medicare/medicaid nursing facilities" mean intermediate care facilities and skilled nursing facilities licensed pursuant to the provisions of section 321-11(10) and certified by the department of human services in accordance with 42 United States Code section 1395i-3 and section 1396r.

"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.

"State health care settings" mean:

     (1)  The hospitals, freestanding surgical outpatient facilities, skilled nursing facilities, intermediate care facilities, adult residential care homes, adult foster homes, assisted living facilities, special treatment facilities and programs, home health agencies, hospices, freestanding birthing facilities, adult day health centers, independent group residences, and therapeutic living programs that are licensed or certified pursuant to sections 321-11(10), 321-11.2, 321-14.5, 321-15.6, 321-15.62, 321-15.63 and 321-15.9; and

(2) The community care foster family homes certified pursuant to section 346-334.

§457A-   Nurse aide certification. (a)  A nurse aide who successfully completes a nurse aide examination shall be certified by the director.  The director shall approve all nurse aide examinations, and in the director's discretion may issue separate certifications for nurse aides who work in medicare/medicaid nursing facilities and state health care settings.

(b)  To be eligible to take the examination for certification, an applicant must successfully complete either:

(1) The training requirements established by the director of human services in accordance with 42 United States Code section 1395i-3 and section 1396r; or

(2) The training program approved by the_director of human services in accordance with section 346-   .

(c)  Reciprocity of certification shall be granted to a nurse aide who works in a medicare/medicaid nursing facility and has successfully completed a training program that meets the requirements of the federal or state requirements established by this chapter.

(d)  Reciprocity shall be granted to a nurse aide who works in a state health care setting and has completed a training program whose requirements are comparable to the requirements of this chapter.

(e)  The director shall renew the certification of nurse aides on a biennial basis.  The director shall establish minimum requirements and standards for recertification pursuant to this chapter, including the requirement that the nurse aide either:

(1) Be employed by a medicare/medicaid facility or state health care setting at the time of recertification; or

(2) Successfully complete a recertification examination approved by the department of human services.

(f)  Fees may be imposed for services rendered to carry out the purposes of this section, provided that no fee or charge shall be imposed on nurse aides for the maintenance of the nurse aide registry.

(g)  Any person 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, 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 except as provided in this chapter."

     SECTION 4.  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] §1396r require nurse aides working in nursing facilities participating in [Medicare] medicare and [Medicaid] medicaid programs to be certified.  The legislature also recognizes that nurse aides who work in other state licensed or certified health care settings should be certified for the purpose of consumer safety and should held to similar standards of competency and evaluation appropriate for these facilities.

(b)  This chapter implements 42 United States Code §1395i-3 and [§1396R with respect to:] §1396r and provides for the certification of nurse aides by:

     (1)  Establishing the State's regulatory scheme for certifying nurse aides;

     (2)  Defining the scope of regulation;

     (3)  Establishing standards for certification and biennial recertification; and

     (4)  Establishing an interagency agreement between the state agencies responsible for various aspects of the program.

     [(b)  As used in this chapter, "nurse aide" means a person who performs a variety of duties relating to patients and patient care 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 5.  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] §1396r and this chapter, as they relate [only] to establishing:

     (1)  The minimum requirements and standards necessary for certification as a nurse aide;

     (2)  Examination requirements, including the passing score;

     (3)  Maintenance requirements for continued certification on a biennial basis; and

     (4)  Implementation of a nurse aide registry.

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

(c)  The director of human services shall implement the provisions of 42 United States code section 1395i-3 and section 1396r and this chapter, as they relate to training programs for nurse aides, recertification and discipline of certified nurse aides employed in Medicare/Medicaid nursing facilities and state health care settings certified by the department of human services."

     SECTION 6.  Section 457A-3, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(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,] §1396r, as well as the federal regulations adopted pursuant thereto, as they relate only to establishing:

     (1)  The minimum requirements necessary for certification as a nurse aide;

     (2)  Examination requirements, including the passing score and provisions for contesting examination results;

     (3)  Maintenance requirements for continued certification; and

     (4)  Implementation and maintenance of a certified nurse aide registry."

     SECTION 7.  Any nurse aide employed in a state health care setting and who has been recertified by June 30, 2007 may be recertified on a biennial basis under this chapter if, on or before December 31, 2008, the nurse aide passes a proficiency evaluation approved by the department of human services. If the nurse aide fails to pass the proficiency evaluation by January 1, 2009, the nurse aide shall instead apply for certification as a new applicant and satisfy the certification requirements of chapter 457A.

     SECTION 8.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 9.  This Act shall take effect on July 1, 2007.

INTRODUCED BY:

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