S T A T E O F N E W Y O R K
________________________________________________________________________
7164--A
Cal. No. 378
I N S E N A T E
(PREFILED)
January 3, 2018
___________
Introduced by Sen. RITCHIE -- read twice and ordered printed, and when
printed to be committed to the Committee on Health -- reported favora-
bly from said committee, ordered to first and second report, ordered
to a third reading, passed by Senate and delivered to the Assembly,
recalled, vote reconsidered, restored to third reading, amended and
ordered reprinted, retaining its place in the order of third reading
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:
Section 1. Section 6908 of the education law is amended by adding a
new subdivision 3 to read as follows:
3. THIS ARTICLE SHALL NOT BE CONSTRUED AS PROHIBITING THE ADMINIS-
TRATION OF MEDICATION BY A NURSING HOME MEDICATION AIDE CERTIFIED PURSU-
ANT TO SECTION TWENTY-EIGHT HUNDRED THREE-J OF THE PUBLIC HEALTH LAW AS
ADDED BY CHAPTER SEVEN HUNDRED SEVENTEEN OF THE LAWS OF NINETEEN HUNDRED
EIGHTY-NINE IN RESIDENTIAL HEALTH CARE FACILITIES, AS DEFINED IN ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, IN THE COUNTY OF ST. LAWRENCE, IN
ACCORDANCE WITH REGULATIONS DEVELOPED BY THE COMMISSIONER, IN CONSULTA-
TION WITH THE COMMISSIONER OF HEALTH. AT A MINIMUM, SUCH REGULATIONS
SHALL:
A. AUTHORIZE THE ADMINISTRATION OF MEDICATIONS WHICH ARE ROUTINE AND
PREFILLED OR OTHERWISE PACKAGED IN A MANNER THAT PROMOTES RELATIVE EASE
OF ADMINISTRATION, PROVIDED THAT ADMINISTRATION OF MEDICATIONS BY
INJECTION SHALL BE PROHIBITED. PROVIDED, HOWEVER, SUCH PROHIBITION SHALL
NOT APPLY TO INJECTIONS OF INSULIN OR OTHER INJECTIONS FOR DIABETES
CARE, TO INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN, AND TO PRE-FILLED
AUTO-INJECTIONS OF EPINEPHRINE FOR EMERGENCY PURPOSES, AND PROVIDED,
FURTHER, THAT ENTITIES EMPLOYING NURSING HOME MEDICATION AIDES PURSUANT
TO THIS SUBDIVISION SHALL ESTABLISH A SYSTEMATIC APPROACH TO ADDRESS
DRUG DIVERSION;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10807-07-8
S. 7164--A 2
B. PROVIDE THAT MEDICATION ADMINISTRATION BY NURSING HOME MEDICATION
AIDES MAY BE PERFORMED ONLY UNDER THE DIRECT SUPERVISION OF A REGISTERED
PROFESSIONAL NURSE LICENSED IN NEW YORK STATE, AS SET FORTH IN THIS
SUBDIVISION AND SUBDIVISION EIGHT OF SECTION SIXTY-NINE HUNDRED NINE OF
THIS ARTICLE, WHERE SUCH NURSE IS EMPLOYED BY A RESIDENTIAL HEALTH CARE
FACILITY LICENSED OR CERTIFIED PURSUANT TO THE PUBLIC HEALTH LAW. SUCH
NURSING SUPERVISION SHALL:
(I) INCLUDE TRAINING AND PERIODIC ASSESSMENT OF THE PERFORMANCE OF
MEDICATION ADMINISTRATION;
(II) BE DETERMINED BY THE REGISTERED PROFESSIONAL NURSE RESPONSIBLE
FOR SUPERVISING SUCH MEDICATION ADMINISTRATION BASED UPON THE COMPLEXITY
OF SUCH MEDICATION ADMINISTRATION, THE SKILL AND EXPERIENCE OF THE NURS-
ING HOME MEDICATION AIDE, AND THE HEALTH STATUS OF THE INDIVIDUAL FOR
WHOM SUCH MEDICATION ADMINISTRATION IS BEING PERFORMED;
(III) INCLUDE A COMPREHENSIVE INITIAL AND THEREAFTER REGULAR AND ONGO-
ING ASSESSMENT OF THE INDIVIDUAL'S NEEDS;
(IV) INCLUDE AS A REQUIREMENT THAT THE SUPERVISING REGISTERED PROFES-
SIONAL NURSE SHALL VISIT INDIVIDUALS RECEIVING MEDICATION FOR THE
PURPOSE OF SUPERVISING THE MEDICATION ADMINISTRATION PROVIDED BY NURSING
HOME MEDICATION AIDES AND INCLUDE AS A REQUIREMENT THAT A REGISTERED
PROFESSIONAL NURSE SHALL BE AVAILABLE TO THE NURSING HOME MEDICATION
AIDE TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK, PROVIDED THAT A REGIS-
TERED PROFESSIONAL NURSE SHALL BE AVAILABLE TO VISIT AN INDIVIDUAL
RECEIVING MEDICATION AS NECESSARY TO PROTECT THE HEALTH AND SAFETY OF
SUCH INDIVIDUAL; AND
(V) AS SHALL BE SPECIFIED BY THE COMMISSIONER, BE PROVIDED IN A MANNER
THAT TAKES INTO ACCOUNT INDIVIDUAL CARE NEEDS AND CASE MIX COMPLEXITY
AND PROVIDE THAT THE NUMBER OF INDIVIDUALS SERVED BY A SUPERVISING
REGISTERED PROFESSIONAL NURSE IS REASONABLE AND PRUDENT;
C. ESTABLISH A PROCESS BY WHICH A REGISTERED PROFESSIONAL NURSE MAY
ASSIGN MEDICATION ADMINISTRATION TO A NURSING HOME MEDICATION AIDE. SUCH
PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(I) ALLOWING ASSIGNMENT OF MEDICATION ADMINISTRATION TO A NURSING HOME
MEDICATION AIDE ONLY WHERE SUCH NURSING HOME MEDICATION AIDE HAS DEMON-
STRATED TO THE SATISFACTION OF THE SUPERVISING REGISTERED PROFESSIONAL
NURSE COMPETENCY IN MEDICATION ADMINISTRATION THAT SUCH NURSING HOME
MEDICATION AIDE IS AUTHORIZED TO PERFORM, A WILLINGNESS TO PERFORM SUCH
MEDICATION ADMINISTRATION, AND THE ABILITY TO EFFECTIVELY AND EFFICIENT-
LY COMMUNICATE WITH THE INDIVIDUAL RECEIVING MEDICATION AND UNDERSTAND
SUCH INDIVIDUAL'S NEEDS;
(II) PROHIBITING ASSIGNMENT OF MEDICATION ADMINISTRATION TO A NURSING
HOME MEDICATION AIDE IF THE INDIVIDUAL RECEIVING SERVICES DECLINES TO BE
SERVED BY A NURSING HOME MEDICATION AIDE;
(III) AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE TO
REVOKE ANY ASSIGNED MEDICATION ADMINISTRATION FROM A NURSING HOME MEDI-
CATION AIDE FOR ANY REASON; AND
(IV) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL NURSES TO JOINTLY
AGREE TO ASSIGN MEDICATION ADMINISTRATION TO A NURSING HOME MEDICATION
AIDE, PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL NURSE SHALL
BE REQUIRED TO DETERMINE IF THE NURSING HOME MEDICATION AIDE HAS DEMON-
STRATED COMPETENCY IN THE MEDICATION ADMINISTRATION TO BE PERFORMED;
D. PROVIDE THAT MEDICATION ADMINISTRATION MAY BE PERFORMED ONLY IN
ACCORDANCE WITH AND PURSUANT TO AN AUTHORIZED HEALTH PRACTITIONER'S
ORDERED CARE;
S. 7164--A 3
E. PROVIDE THAT ONLY A CERTIFIED NURSING HOME MEDICATION AIDE MAY
PERFORM MEDICATION ADMINISTRATION AS A NURSING HOME MEDICATION AIDE WHEN
SUCH AIDE HAS:
(I) AT LEAST ONE YEAR OF EXPERIENCE PROVIDING RESIDENTIAL HEALTH CARE
SERVICES;
(II) COMPLETED THE REQUISITE TRAINING AND DEMONSTRATED COMPETENCIES OF
A NURSING HOME MEDICATION AIDE AS DETERMINED BY THE COMMISSIONER IN
CONSULTATION WITH THE COMMISSIONER OF HEALTH;
(III) SUCCESSFULLY COMPLETED COMPETENCY EXAMINATIONS SATISFACTORY TO
THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF HEALTH; AND
(IV) MEETS OTHER APPROPRIATE QUALIFICATIONS AS DETERMINED BY THE
COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF HEALTH;
F. PROVIDE THAT ONLY AN INDIVIDUAL WHO HAS SATISFIED ALL APPLICABLE
TRAINING REQUIREMENTS AND HAVING PASSED THE APPLICABLE COMPETENCY EXAM-
INATIONS AND WHO MEETS OTHER REQUIREMENTS AS SET FORTH IN REGULATIONS
ISSUED BY THE COMMISSIONER OF HEALTH PURSUANT TO THE PUBLIC HEALTH LAW
MAY PERFORM MEDICATION ADMINISTRATION PURSUANT TO THIS SUBDIVISION AND
MAY HOLD HIMSELF OR HERSELF OUT AS A NURSING HOME MEDICATION AIDE;
G. ESTABLISH MINIMUM STANDARDS OF TRAINING FOR THE PERFORMANCE OF
MEDICATION ADMINISTRATION BY NURSING HOME MEDICATION AIDES, INCLUDING
DIDACTIC TRAINING, CLINICAL TRAINING, AND A SUPERVISED CLINICAL PRACTI-
CUM WITH STANDARDS SET FORTH BY THE COMMISSIONER OF HEALTH;
H. PROVIDE THAT NURSING HOME MEDICATION AIDES SHALL RECEIVE CASE-SPE-
CIFIC TRAINING ON THE MEDICATION ADMINISTRATION TO BE ASSIGNED BY THE
SUPERVISING NURSE, PROVIDED THAT ADDITIONAL TRAINING SHALL TAKE PLACE
WHENEVER ADDITIONAL MEDICATION ADMINISTRATION IS ASSIGNED;
I. PROHIBIT A NURSING HOME MEDICATION AIDE FROM HOLDING HIMSELF OR
HERSELF OUT, OR ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE
NURSING UNDER THE PROVISIONS OF THIS ARTICLE;
J. PROVIDE THAT A NURSING HOME MEDICATION AIDE IS NOT REQUIRED NOR
PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
K. PROVIDE THAT A NURSING HOME MEDICATION AIDE SHALL NOT BE AUTHORIZED
TO PERFORM ANY ACTIVITIES PURSUANT TO THIS SUBDIVISION THAT ARE OUTSIDE
THE SCOPE OF PRACTICE OF A LICENSED PRACTICAL NURSE OR THAT HAVE NOT
BEEN APPROPRIATELY ASSIGNED BY THE SUPERVISING REGISTERED PROFESSIONAL
NURSE;
L. PROVIDE THAT A NURSING HOME MEDICATION AIDE SHALL DOCUMENT ALL
MEDICATION ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A MEDI-
CATION ADMINISTRATION RECORD; AND
M. PROVIDE THAT THE SUPERVISING REGISTERED PROFESSIONAL NURSE SHALL
RETAIN THE DISCRETION TO DECIDE WHETHER TO ASSIGN MEDICATION ADMINIS-
TRATION TO NURSING HOME MEDICATION AIDES UNDER THIS PROGRAM AND SHALL
NOT BE SUBJECT TO COERCION, RETALIATION, OR THE THREAT OF RETALIATION.
§ 2. Section 6909 of the education law is amended by adding a new
subdivision 9 to read as follows:
9. A REGISTERED PROFESSIONAL NURSE, WHILE WORKING FOR A RESIDENTIAL
HEALTH CARE FACILITY LICENSED OR CERTIFIED PURSUANT TO THE PUBLIC HEALTH
LAW, MAY, IN ACCORDANCE WITH THIS SUBDIVISION, ASSIGN NURSING HOME MEDI-
CATION AIDES TO PERFORM MEDICATION ADMINISTRATION FOR INDIVIDUALS PURSU-
ANT TO THE PROVISIONS OF SUBDIVISION THREE OF SECTION SIXTY-NINE HUNDRED
EIGHT OF THIS ARTICLE AND SUPERVISE NURSING HOME MEDICATION AIDES WHO
PERFORM ASSIGNED MEDICATION ADMINISTRATION.
(A) PRIOR TO ASSIGNING OR MODIFYING AN ASSIGNMENT TO PERFORM MEDICA-
TION ADMINISTRATION, THE REGISTERED PROFESSIONAL NURSE SHALL:
(I) COMPLETE A NURSING ASSESSMENT TO ASCERTAIN THE CLIENT'S CURRENT
HEALTH STATUS AND CARE NEEDS; AND
S. 7164--A 4
(II) PROVIDE TO THE NURSING HOME MEDICATION AIDE WRITTEN, INDIVIDUAL-
SPECIFIC INSTRUCTIONS FOR PERFORMING THE MEDICATION ADMINISTRATION AND
CRITERIA FOR IDENTIFYING, REPORTING AND RESPONDING TO PROBLEMS OR
COMPLICATIONS.
(B) THE REGISTERED PROFESSIONAL NURSE SHALL NOT ASSIGN MEDICATION
ADMINISTRATION UNLESS:
(I) THE MEDICATION ADMINISTRATION TO BE ASSIGNED IS CONSISTENT WITH AN
AUTHORIZED HEALTH PRACTITIONER'S ORDERED CARE;
(II) THE REGISTERED PROFESSIONAL NURSE PROVIDES CASE SPECIFIC TRAINING
TO THE NURSING HOME MEDICATION AIDE AND PERSONALLY VERIFIES THAT THE
NURSING HOME MEDICATION AIDE CAN SAFELY AND COMPETENTLY PERFORM THE
MEDICATION ADMINISTRATION;
(III) THE REGISTERED PROFESSIONAL NURSE DETERMINES THAT THE NURSING
HOME MEDICATION AIDE IS WILLING TO PERFORM SUCH MEDICATION ADMINIS-
TRATION; AND
(IV) THE REGISTERED PROFESSIONAL NURSE DETERMINES THAT THE NURSING
HOME MEDICATION AIDE IS ABLE TO EFFECTIVELY AND EFFICIENTLY COMMUNICATE
WITH THE INDIVIDUAL RECEIVING SERVICES AND UNDERSTAND SUCH INDIVIDUAL'S
NEEDS.
(C) THE SUPERVISING REGISTERED PROFESSIONAL NURSE SHALL:
(I) VISIT INDIVIDUALS RECEIVING MEDICATION FOR THE PURPOSE OF SUPER-
VISING THE MEDICATION ADMINISTRATION PROVIDED BY NURSING HOME MEDICATION
AIDES; AND
(II) CONDUCT REGULAR AND ONGOING ASSESSMENT OF THE INDIVIDUAL'S NEEDS.
§ 3. Section 6906 of the education law is amended by adding a new
subdivision 10 to read as follows:
(10) IN CONJUNCTION WITH AND AS A CONDITION OF EACH TRIENNIAL REGIS-
TRATION, THE DEPARTMENT SHALL ASK AND A LICENSED PRACTICAL NURSE SHALL
INDICATE WHETHER THE LICENSED PRACTICAL NURSE IS OR HAS PREVIOUSLY BEEN
AUTHORIZED AS A NURSING HOME MEDICATION AIDE PURSUANT TO SUBDIVISION
THREE OF SECTION SIXTY-NINE HUNDRED EIGHT OF THIS ARTICLE. THE DEPART-
MENT SHALL PROVIDE RESPONSES TO THE DEPARTMENT OF HEALTH AND THE DEPART-
MENT OF HEALTH SHALL INCLUDE SUCH INFORMATION IN REPORTS RELATED TO
NURSING HOME MEDICATION AIDES.
§ 4. Section 206 of the public health law is amended by adding a new
subdivision 31 to read as follows:
31. THE COMMISSIONER SHALL NOTIFY THE COMMISSIONER OF EDUCATION IN ANY
INSTANCE IN WHICH A REGISTERED PROFESSIONAL NURSE ENGAGES IN IMPROPER
BEHAVIOR WHILE SUPERVISING A NURSING HOME MEDICATION AIDE PURSUANT TO
SUBDIVISION THREE OF SECTION SIXTY-NINE HUNDRED EIGHT OF THE EDUCATION
LAW.
§ 5. Section 2801 of the public health law is amended by adding a new
subdivision 12 to read as follows:
12. "NURSING HOME MEDICATION AIDES" MEANS NURSING HOME AIDES WHO ARE
AUTHORIZED TO PERFORM MEDICATION ADMINISTRATION AS DELINEATED IN SUBDI-
VISION THREE OF SECTION SIXTY-NINE HUNDRED EIGHT OF THE EDUCATION LAW
AND REGULATIONS ISSUED BY THE COMMISSIONER OF EDUCATION RELATING THERE-
TO. THE COMMISSIONER SHALL PROMULGATE REGULATIONS REGARDING SUCH AIDES,
WHICH SHALL INCLUDE A PROCESS FOR THE LIMITATION OR REVOCATION OF THE
NURSING HOME MEDICATION AIDE'S AUTHORIZATION TO PERFORM MEDICATION
ADMINISTRATION IN APPROPRIATE CASES.
§ 6. Section 2803-j of the public health law, as added by chapter 717
of the laws of 1989, is amended by adding a new subdivision 5 to read as
follows:
5. THE DEPARTMENT SHALL INDICATE WITHIN THE NURSING HOME NURSE AIDE
REGISTRY WHEN A NURSING HOME NURSE AIDE HAS SATISFIED ALL APPLICABLE
S. 7164--A 5
TRAINING AND RECERTIFICATION REQUIREMENTS AND HAS PASSED THE APPLICABLE
COMPETENCY EXAMINATIONS NECESSARY TO PERFORM MEDICATION ADMINISTRATION
PURSUANT TO SUBDIVISION THREE OF SECTION SIXTY-NINE HUNDRED EIGHT OF THE
EDUCATION LAW AND REGULATIONS ISSUED THERETO. ANY LIMITATION OR REVOCA-
TION OF THE NURSING HOME MEDICATION AIDE'S AUTHORIZATION ALSO SHALL BE
INDICATED ON THE REGISTRY.
§ 7. On or before October 1, 2024, the commissioner of health shall,
in consultation with the commissioner of education, issue a report on
the implementation of nursing home medication aides in the state. Such
report shall include the number of nursing home medication aides author-
ized pursuant to this act; the number of nursing home nurse aides that
became authorized to perform medication administration; the number of
nursing home medication aides that became registered as licensed practi-
cal nurses; the types of medication that nursing home medication aides
are administering; the number of complaints pertaining to medication
administration provided by nursing home medication aides that were
reported to the department of health; and the number of nursing home
medication aides who had their authorization limited or revoked. Such
report shall provide recommendations to the governor and the chairs of
the senate and assembly health and higher education committees regarding
the implementation of nursing home medication aides pursuant to this
act, and any recommendations related thereto.
§ 8. This act shall take effect immediately; provided that:
a. sections one and three of this act shall take effect two years
after this act shall have become a law. Effective immediately, the
commissioner of education is authorized to adopt or amend regulations
and take such other actions as are necessary to implement the provisions
of sections one and two of this act on or before such effective date;
provided, further, that no medication administration shall be performed
pursuant to the provisions of subdivision three of section 6908 of the
education law, as added by section one of this act, on or before such
effective date; provided further, that no medication administration
shall be performed pursuant to such provisions until such regulations
are adopted and except in conformance with such regulations including in
conformance with the provisions of such regulations related to the
completion of nursing home medication aide training and the satisfaction
of competency examination requirements.
b. this act shall expire and be deemed repealed March 31, 2025.
