2023 -- S 0100

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HUMAN SERVICES -- REGISTRATION OF NURSING ASSISTANTS

     Introduced By: Senator Walter S. Felag

     Date Introduced: February 01, 2023

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 23-17.9-2, 23-17.9-3 and 23-17.9-5 of the General Laws in Chapter

23-17.9 entitled "Registration of Nursing Assistants" are hereby amended to read as follows:

     23-17.9-2. Definitions — Supervision of nursing assistants — Inapplicability of

chapter.

     (a) As used in this chapter:

     (1) “Certifying agency” means the state department of health.

     (2) “Director” means the director of the state department of health, or his or her designee.

     (3) "Home care nursing assistant" is defined as a paraprofessional trained as an aide to a

nurse exclusively in a home care setting to give personal care and related health care and assistance

based on their level of preparation to homebound individuals who are sick, disabled, dependent, or

infirm. The director of the department of health shall, by regulation, license these paraprofessionals

as a separate licensure pursuant to this chapter rather than those licensed under § 23-17.9-2(4).

Home care nursing assistants shall be trained with a minimum of sixty (60) hours prior to licensing

examination and are exempt from training specific to any facility-based care.

     (3)(4) “Nursing assistant” is defined as a nurses’ aide, orderly, or home health aide who is

a paraprofessional trained to give personal care and related health care and assistance based on his

or her level of preparation to individuals who are sick, disabled, dependent, or infirmed and who

are residents of or who receive services from healthcare facilities licensed pursuant to chapter 17

of this title or receiving services from agencies licensed pursuant to chapter 17.7 of this title. The

director of the department of health may, by regulation, establish different levels of nursing

assistants.

     (b) Nursing assistants shall be supervised by professional (registered nurses) and other

appropriate professional members of a healthcare facility or physician.

     (c) Notwithstanding any provision of this chapter, nothing in this section shall apply to

those persons designated solely as personal-care attendants, or programs established and

administered for the purpose of providing personal-care-attendant service, established by chapter

8.1 of title 40.

     (d) No provision of this chapter shall apply to those persons who are actively matriculated

in a bachelor of science in nursing, associate degree program in nursing, an accredited licensed

practical nursing program, or registered nurse course of study in a national league for nursing

accredited nursing program, provided those persons have completed a minimum of two (2) clinical

courses and provided those individuals are supervised by a R.N.

     (e) No provision of this chapter or of the rules and regulations pertaining to Rhode Island

certificates of registration for nursing assistants, medication aides, and the approval of nursing

assistant and medication aide training programs, including the provisions related to medication

aides, shall apply to those persons who are actively matriculated in a bachelor of science in nursing,

associate degree program in nursing, an accredited licensed practical nursing program, or registered

nurse course of study in a national league for nursing accredited nursing program; provided, those

persons have completed a minimum of two (2) clinical courses and appropriate training in

medication administration and provided those individuals are supervised by a registered nurse.

     23-17.9-3. Training and competency evaluation program for levels of nursing

assistants.

     Standards for training and/or competency evaluation programs for nursing assistants and

exemptions for applicants from the requirements of training programs shall be consistent with

federal statutory and regulatory requirements and shall be defined according to the rules and

regulations promulgated by the department of health. The national standards pertaining to nursing

assistants, nurse aides-home health aides, and the national home caring council or its succeeding

agency, (model curriculum and teaching guide for the instruction of homemaker-home health aide)

and any other appropriate standards shall serve as guidelines in the development of regulatory

standards for other levels of nursing assistants as determined by the director. The department may

require a fee as set forth in § 23-1-54 as an application fee for biennial training and competency

evaluation program certification.

     23-17.9-5. Qualifying examination.

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     Nursing assistants as defined in § 23-17.9-2 who are employed or have had experience as

a nursing assistant prior to the enactment of this chapter, and the effective date of the regulations

promulgated in relation to this chapter, shall pass the appropriate level of examination administered

by the department approved by the director in lieu of the training program. Exempt from the

qualifying examination are home health aides/homemakers who have successfully passed the

qualifying examination and/or successfully completed an approved home health aide/homemaker

program under the provisions of chapter 17.7 of this title and the regulations promulgated in relation

to that chapter. Also exempt Exempt from the qualifying examination are classes of individuals,

regardless of employment setting, who are exempted from examination by federal statute or

regulations and these exemptions shall be defined according to rules and regulations promulgated

by the department of health. Successful completion of the qualifying examination and the

provisions of this section shall be deemed satisfactory for employment as a nursing assistant. Unless

exempted by rules and regulations promulgated by the department of health, each application must

be submitted with a processing fee as set forth in § 23-1-54 to be paid by the employing facility or

agency if the applicant has been continuously employed by the facility for six (6) months prior to

the application or by another responsible party as defined in rules and regulations promulgated by

the department of health consistent with federal statutory and/or regulatory requirements; but, if

the applicant is unemployed, to be submitted by the applicant. If the applicant shall be continuously

employed by the same facility for six (6) months after the application, then the fee shall be directly

refunded to the applicant by the facility or agency. If federal statutory or regulatory requirements

mandate that the certifying agency conduct an examination of manual skills proficiency as a

component of the examination process to meet minimal federal compliance, a manual skills

proficiency examination may be required by rules and regulations promulgated by the department

of health for all applicants not otherwise exempted from the examination requirements. If a manual

skills proficiency examination is required to be conducted by the certifying agency as a component

of the certifying examination, each application shall be accompanied by a fee as set forth in § 23-

1-54 to be paid by the employing facility or agency if the applicant has been continuously employed

by the facility for six (6) months prior to the application or by another responsible party as defined

in rules and regulations promulgated by the department of health consistent with federal statutory

and/or regulatory requirements; but, if the applicant is unemployed, to be submitted by the

applicant. If the applicant shall be continuously employed by the same facility for six (6) months

after the application, then the fee shall be directly refunded on a pro rata basis between months six

(6) and twelve (12) to the applicant by the facility or agency.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES -- REGISTRATION OF NURSING ASSISTANTS

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     This act would establish the position of home care nursing assistants, who are

paraprofessionals licensed by the department of health to work exclusively in home care and would

require training specific to home-based care for vulnerable homebound patients.

     This act would take effect upon passage.

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