Bill Text: NY A06250 | 2019-2020 | General Assembly | Introduced


Bill Title: Authorizes nursing home medication aides to administer medication in residential health care facilities in St. Lawrence county.

Spectrum: Partisan Bill (Republican 8-0)

Status: (Introduced) 2019-03-04 - referred to higher education [A06250 Detail]

Download: New_York-2019-A06250-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          6250
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                      March 4, 2019
                                       ___________
        Introduced  by M. of A. WALCZYK -- read once and referred to the Commit-
          tee on Higher Education
        AN ACT to amend the education law and the public health law, in relation
          to authorizing  certain  nursing  home  medication  aides  to  perform
          certain   advanced  tasks;  and  providing  for  the  repeal  of  such
          provisions upon expiration thereof
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Section  6908 of the education law is amended by adding a
     2  new subdivision 3 to read as follows:
     3    3. This article shall not be construed  as  prohibiting  the  adminis-
     4  tration of medication by a nursing home medication aide certified pursu-
     5  ant  to section twenty-eight hundred three-j of the public health law as
     6  added by chapter seven hundred seventeen of the laws of nineteen hundred
     7  eighty-nine in residential health care facilities, as defined in article
     8  twenty-eight of the public health law, in the county of St. Lawrence, in
     9  accordance with regulations developed by the commissioner, in  consulta-
    10  tion  with  the  commissioner of health.  At a minimum, such regulations
    11  shall:
    12    a. authorize the administration of medications which are  routine  and
    13  prefilled  or otherwise packaged in a manner that promotes relative ease
    14  of  administration,  provided  that  administration  of  medications  by
    15  injection shall be prohibited. Provided, however, such prohibition shall
    16  not  apply  to  injections  of  insulin or other injections for diabetes
    17  care, to injections of low molecular weight heparin, and  to  pre-filled
    18  auto-injections  of  epinephrine  for  emergency purposes, and provided,
    19  further, that entities employing nursing home medication aides  pursuant
    20  to  this  subdivision  shall  establish a systematic approach to address
    21  drug diversion;
    22    b. provide that medication administration by nursing  home  medication
    23  aides may be performed only under the direct supervision of a registered
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04974-01-9

        A. 6250                             2
     1  professional  nurse  licensed  in  New  York state, as set forth in this
     2  subdivision and subdivision eight of section sixty-nine hundred nine  of
     3  this  article, where such nurse is employed by a residential health care
     4  facility  licensed  or certified pursuant to the public health law. Such
     5  nursing supervision shall:
     6    (i) include training and periodic assessment  of  the  performance  of
     7  medication administration;
     8    (ii)  be  determined  by the registered professional nurse responsible
     9  for supervising such medication administration based upon the complexity
    10  of such medication administration, the skill and experience of the nurs-
    11  ing home medication aide, and the health status of  the  individual  for
    12  whom such medication administration is being performed;
    13    (iii) include a comprehensive initial and thereafter regular and ongo-
    14  ing assessment of the individual's needs;
    15    (iv)  include as a requirement that the supervising registered profes-
    16  sional nurse  shall  visit  individuals  receiving  medication  for  the
    17  purpose of supervising the medication administration provided by nursing
    18  home  medication  aides  and  include as a requirement that a registered
    19  professional nurse shall be available to  the  nursing  home  medication
    20  aide  twenty-four hours a day, seven days a week, provided that a regis-
    21  tered professional nurse shall  be  available  to  visit  an  individual
    22  receiving  medication  as  necessary to protect the health and safety of
    23  such individual; and
    24    (v) as shall be specified by the commissioner, be provided in a manner
    25  that takes into account individual care needs and  case  mix  complexity
    26  and  provide  that  the  number  of  individuals served by a supervising
    27  registered professional nurse is reasonable and prudent;
    28    c. establish a process by which a registered  professional  nurse  may
    29  assign medication administration to a nursing home medication aide. Such
    30  process shall include, but not be limited to:
    31    (i) allowing assignment of medication administration to a nursing home
    32  medication  aide only where such nursing home medication aide has demon-
    33  strated to the satisfaction of the supervising  registered  professional
    34  nurse  competency  in  medication  administration that such nursing home
    35  medication aide is authorized to perform, a willingness to perform  such
    36  medication administration, and the ability to effectively and efficient-
    37  ly  communicate  with the individual receiving medication and understand
    38  such individual's needs;
    39    (ii) prohibiting assignment of medication administration to a  nursing
    40  home medication aide if the individual receiving services declines to be
    41  served by a nursing home medication aide;
    42    (iii)  authorizing  the  supervising  registered professional nurse to
    43  revoke any assigned medication administration from a nursing home  medi-
    44  cation aide for any reason; and
    45    (iv)  authorizing  multiple  registered professional nurses to jointly
    46  agree to assign medication administration to a nursing  home  medication
    47  aide, provided further that only one registered professional nurse shall
    48  be  required to determine if the nursing home medication aide has demon-
    49  strated competency in the medication administration to be performed;
    50    d. provide that medication administration may  be  performed  only  in
    51  accordance  with  and  pursuant  to  an authorized health practitioner's
    52  ordered care;
    53    e. provide that only a certified  nursing  home  medication  aide  may
    54  perform medication administration as a nursing home medication aide when
    55  such aide has:

        A. 6250                             3
     1    (i)  at least one year of experience providing residential health care
     2  services;
     3    (ii) completed the requisite training and demonstrated competencies of
     4  a  nursing  home  medication  aide  as determined by the commissioner in
     5  consultation with the commissioner of health;
     6    (iii) successfully completed competency examinations  satisfactory  to
     7  the commissioner in consultation with the commissioner of health; and
     8    (iv)  meets  other  appropriate  qualifications  as  determined by the
     9  commissioner in consultation with the commissioner of health;
    10    f. provide that only an individual who has  satisfied  all  applicable
    11  training  requirements and having passed the applicable competency exam-
    12  inations and who meets other requirements as set  forth  in  regulations
    13  issued  by  the commissioner of health pursuant to the public health law
    14  may perform medication administration pursuant to this  subdivision  and
    15  may hold himself or herself out as a nursing home medication aide;
    16    g.  establish  minimum  standards  of  training for the performance of
    17  medication administration by nursing home  medication  aides,  including
    18  didactic  training, clinical training, and a supervised clinical practi-
    19  cum with standards set forth by the commissioner of health;
    20    h. provide that nursing home medication aides shall receive  case-spe-
    21  cific  training  on  the medication administration to be assigned by the
    22  supervising nurse, provided that additional training  shall  take  place
    23  whenever additional medication administration is assigned;
    24    i.  prohibit  a  nursing  home medication aide from holding himself or
    25  herself out, or accepting employment as, a person licensed  to  practice
    26  nursing under the provisions of this article;
    27    j.  provide  that  a  nursing home medication aide is not required nor
    28  permitted to assess the medication or medical needs of an individual;
    29    k. provide that a nursing home medication aide shall not be authorized
    30  to perform any activities pursuant to this subdivision that are  outside
    31  the  scope  of  practice  of a licensed practical nurse or that have not
    32  been appropriately assigned by the supervising  registered  professional
    33  nurse;
    34    l.  provide  that  a  nursing  home medication aide shall document all
    35  medication administration to each individual through the use of a  medi-
    36  cation administration record; and
    37    m.  provide  that  the supervising registered professional nurse shall
    38  retain the discretion to decide whether to  assign  medication  adminis-
    39  tration  to  nursing  home medication aides under this program and shall
    40  not be subject to coercion, retaliation, or the threat of retaliation.
    41    § 2. Section 6909 of the education law is  amended  by  adding  a  new
    42  subdivision 10 to read as follows:
    43    10.  A  registered professional nurse, while working for a residential
    44  health care facility licensed or certified pursuant to the public health
    45  law, may, in accordance with this subdivision, assign nursing home medi-
    46  cation aides to perform medication administration for individuals pursu-
    47  ant to the provisions of subdivision three of section sixty-nine hundred
    48  eight of this article and supervise nursing home  medication  aides  who
    49  perform assigned medication administration.
    50    (a)  Prior  to assigning or modifying an assignment to perform medica-
    51  tion administration, the registered professional nurse shall:
    52    (i) complete a nursing assessment to ascertain  the  client's  current
    53  health status and care needs; and
    54    (ii)  provide to the nursing home medication aide written, individual-
    55  specific instructions for performing the medication  administration  and

        A. 6250                             4
     1  criteria  for  identifying,  reporting  and  responding  to  problems or
     2  complications.
     3    (b)  The  registered  professional  nurse  shall not assign medication
     4  administration unless:
     5    (i) the medication administration to be assigned is consistent with an
     6  authorized health practitioner's ordered care;
     7    (ii) the registered professional nurse provides case specific training
     8  to the nursing home medication aide and  personally  verifies  that  the
     9  nursing  home  medication  aide  can  safely and competently perform the
    10  medication administration;
    11    (iii) the registered professional nurse determines  that  the  nursing
    12  home  medication  aide  is  willing  to perform such medication adminis-
    13  tration; and
    14    (iv) the registered professional nurse  determines  that  the  nursing
    15  home  medication aide is able to effectively and efficiently communicate
    16  with the individual receiving services and understand such  individual's
    17  needs.
    18    (c) The supervising registered professional nurse shall:
    19    (i)  visit  individuals receiving medication for the purpose of super-
    20  vising the medication administration provided by nursing home medication
    21  aides; and
    22    (ii) conduct regular and ongoing assessment of the individual's needs.
    23    § 3. Section 6906 of the education law is  amended  by  adding  a  new
    24  subdivision 10 to read as follows:
    25    (10)  In  conjunction with and as a condition of each triennial regis-
    26  tration, the department shall ask and a licensed practical  nurse  shall
    27  indicate  whether the licensed practical nurse is or has previously been
    28  authorized as a nursing home medication  aide  pursuant  to  subdivision
    29  three  of  section sixty-nine hundred eight of this article. The depart-
    30  ment shall provide responses to the department of health and the depart-
    31  ment of health shall include such  information  in  reports  related  to
    32  nursing home medication aides.
    33    §  4.  Section 206 of the public health law is amended by adding a new
    34  subdivision 31 to read as follows:
    35    31. The commissioner shall notify the commissioner of education in any
    36  instance in which a registered professional nurse  engages  in  improper
    37  behavior  while  supervising  a nursing home medication aide pursuant to
    38  subdivision three of section sixty-nine hundred eight of  the  education
    39  law.
    40    §  5. Section 2801 of the public health law is amended by adding a new
    41  subdivision 12 to read as follows:
    42    12. "Nursing home medication aides" means nursing home aides  who  are
    43  authorized  to perform medication administration as delineated in subdi-
    44  vision three of section sixty-nine hundred eight of  the  education  law
    45  and  regulations issued by the commissioner of education relating there-
    46  to. The commissioner shall promulgate regulations regarding such  aides,
    47  which  shall  include  a process for the limitation or revocation of the
    48  nursing home  medication  aide's  authorization  to  perform  medication
    49  administration in appropriate cases.
    50    §  6. Section 2803-j of the public health law, as added by chapter 717
    51  of the laws of 1989, is amended by adding a new subdivision 5 to read as
    52  follows:
    53    5. The department shall indicate within the nursing  home  nurse  aide
    54  registry  when  a  nursing  home nurse aide has satisfied all applicable
    55  training and recertification requirements and has passed the  applicable
    56  competency  examinations  necessary to perform medication administration

        A. 6250                             5
     1  pursuant to subdivision three of section sixty-nine hundred eight of the
     2  education law and regulations issued thereto. Any limitation or  revoca-
     3  tion  of  the nursing home medication aide's authorization also shall be
     4  indicated on the registry.
     5    §  7.  On or before October 1, 2025, the commissioner of health shall,
     6  in consultation with the commissioner of education, issue  a  report  on
     7  the  implementation  of nursing home medication aides in the state. Such
     8  report shall include the number of nursing home medication aides author-
     9  ized pursuant to this act; the number of nursing home nurse  aides  that
    10  became  authorized  to  perform medication administration; the number of
    11  nursing home medication aides that became registered as licensed practi-
    12  cal nurses; the types of medication that nursing home  medication  aides
    13  are  administering;  the  number of complaints pertaining to  medication
    14  administration provided by  nursing  home  medication  aides  that  were
    15  reported  to  the  department  of health; and the number of nursing home
    16  medication aides who had their authorization limited  or  revoked.  Such
    17  report  shall  provide recommendations to the governor and the chairs of
    18  the senate and assembly health and higher education committees regarding
    19  the implementation of nursing home medication  aides  pursuant  to  this
    20  act, and any recommendations related thereto.
    21    § 8. This act shall take effect immediately; provided that:
    22    a.  sections  one  and  three  of this act shall take effect two years
    23  after this act shall have  become  a  law.  Effective  immediately,  the
    24  commissioner  of  education  is authorized to adopt or amend regulations
    25  and take such other actions as are necessary to implement the provisions
    26  of sections one and two of this act on or before  such  effective  date;
    27  provided,  further, that no medication administration shall be performed
    28  pursuant to the provisions of subdivision three of section 6908  of  the
    29  education  law,  as  added by section one of this act, on or before such
    30  effective date; provided further, that  no    medication  administration
    31  shall  be  performed  pursuant to such provisions until such regulations
    32  are adopted and except in conformance with such regulations including in
    33  conformance with the provisions  of  such  regulations  related  to  the
    34  completion of nursing home medication aide training and the satisfaction
    35  of competency examination requirements.
    36    b. this act shall expire and be deemed repealed March 31, 2026.
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