Bill Text: IL HB2423 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: Amends the Nursing Home Care Act. Provides that the Department of Public Health shall certify the Temporary Nursing Assistant Training Program that it implemented by emergency rule. Provides that the Department shall deem an individual who has completed a training program and competency assessment under the Temporary Nursing Assistant Training Program as satisfying the requirement of completing a nurse aide training and competency evaluation program approved by the State under specified eligibility provisions. Provides that a person shall be deemed to have completed the eligibility provisions if they have completed all nursing assistant training and competency evaluation program requirements and shall be placed on the State nurse aide registry as "active". Provides that temporary nursing assistants must enroll in an approved certified nursing assistant training program no later than 2 years after completion of the Temporary Nursing Assistant Training Program. Provides that, once enrolled in the certified nursing assistant training program, the individual may work as a nursing assistant in training and continue to practice the same skills he or she did as a temporary nursing assistant and new competencies he or she has learned in his or her certified nursing assistant training. Makes conforming changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-03-04 - Rule 19(a) / Re-referred to Rules Committee [HB2423 Detail]

Download: Illinois-2021-HB2423-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB2423 Introduced , by Rep. Robert Rita SYNOPSIS AS INTRODUCED:
210 ILCS 45/3-202.05
210 ILCS 45/3-206a new
Amends the Nursing Home Care Act. Provides that the Department of Public Health shall certify the Temporary Nursing Assistant Training Program that it implemented by emergency rule. Provides that the Department shall deem an individual who has completed a training program and competency assessment under the Temporary Nursing Assistant Training Program as satisfying the requirement of completing a nurse aide training and competency evaluation program approved by the State under specified eligibility provisions. Provides that a person shall be deemed to have completed the eligibility provisions if they have completed all nursing assistant training and competency evaluation program requirements and shall be placed on the State nurse aide registry as "active". Provides that temporary nursing assistants must enroll in an approved certified nursing assistant training program no later than 2 years after completion of the Temporary Nursing Assistant Training Program. Provides that, once enrolled in the certified nursing assistant training program, the individual may work as a nursing assistant in training and continue to practice the same skills he or she did as a temporary nursing assistant and new competencies he or she has learned in his or her certified nursing assistant training. Makes conforming changes.
LRB102 15042 SPS 20397 b
FISCAL NOTE ACT MAY APPLY
A BILL FOR
HB2423 LRB102 15042 SPS 20397 b
AN ACT concerning regulation.
WHEREAS, During the COVID-19 pandemic, federal and State
regulatory and statutory provisions have been waived to assist
in the hiring of temporary nurse assistants; and
WHEREAS, Individuals have served admirably and
compassionately in this capacity and have demonstrated through
accelerated training and experience competency to transition
to fully registered status as a nurse aide; and
WHEREAS, This program created 1,700 jobs in communities
where people found themselves out of work due to closures and
gave them a pathway to excel in the healthcare career ladder;
and
WHEREAS, Upon the cessation of the program on January
18th, 2021, many nursing homes have continued to receive
applications from a number of unemployed individuals wanting
to join the Temporary Nursing Assistant Training Program; and
WHEREAS, While nursing homes are experiencing shortages in
staff, State certification of the Program will provide
additional help to care for loved ones, create jobs, and
expand the need of increased workforce in the nursing home
sector as they transition into a certified nurse assistant
certification; and

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WHEREAS, Temporary nurse assistants are required to
successfully complete a State-approved training and evaluation
in order to be employed as a nurse aide in a skilled nursing
facility; and
WHEREAS, The purpose of this training is to ensure that
nurse aides have the education, practical knowledge, and
skills needed to care for residents of facilities
participating in the Medicare and Medicaid programs; and
WHEREAS, As a matter of public policy, the Temporary
Nursing Assistant Program should take into account training
and experience acquired during the COVID-19 pandemic to
transition these individuals to placement on the State's nurse
aide registry; therefore
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nursing Home Care Act is amended by
changing Section 3-202.05 and by adding Section 3-206a as
follows:
(210 ILCS 45/3-202.05)
Sec. 3-202.05. Staffing ratios effective July 1, 2010 and

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thereafter.
(a) For the purpose of computing staff to resident ratios,
direct care staff shall include:
(1) registered nurses;
(2) licensed practical nurses;
(3) certified nurse assistants;
(4) psychiatric services rehabilitation aides;
(5) rehabilitation and therapy aides;
(6) psychiatric services rehabilitation coordinators;
(7) assistant directors of nursing;
(8) 50% of the Director of Nurses' time; and
(9) 30% of the Social Services Directors' time; and .
(10) temporary nursing assistants in the Temporary
Nursing Assistants Training Program under Section 3-206a.
The Department shall, by rule, allow certain facilities
subject to 77 Ill. Admin. Code 300.4000 and following (Subpart
S) to utilize specialized clinical staff, as defined in rules,
to count towards the staffing ratios.
Within 120 days of the effective date of this amendatory
Act of the 97th General Assembly, the Department shall
promulgate rules specific to the staffing requirements for
facilities federally defined as Institutions for Mental
Disease. These rules shall recognize the unique nature of
individuals with chronic mental health conditions, shall
include minimum requirements for specialized clinical staff,
including clinical social workers, psychiatrists,

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psychologists, and direct care staff set forth in paragraphs
(4) through (6) and any other specialized staff which may be
utilized and deemed necessary to count toward staffing ratios.
Within 120 days of the effective date of this amendatory
Act of the 97th General Assembly, the Department shall
promulgate rules specific to the staffing requirements for
facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013. These rules shall recognize the
unique nature of individuals with chronic mental health
conditions, shall include minimum requirements for specialized
clinical staff, including clinical social workers,
psychiatrists, psychologists, and direct care staff set forth
in paragraphs (4) through (6) and any other specialized staff
which may be utilized and deemed necessary to count toward
staffing ratios.
(b) (Blank).
(b-5) For purposes of the minimum staffing ratios in this
Section, all residents shall be classified as requiring either
skilled care or intermediate care.
As used in this subsection:
"Intermediate care" means basic nursing care and other
restorative services under periodic medical direction.
"Skilled care" means skilled nursing care, continuous
skilled nursing observations, restorative nursing, and other
services under professional direction with frequent medical
supervision.

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(c) Facilities shall notify the Department within 60 days
after the effective date of this amendatory Act of the 96th
General Assembly, in a form and manner prescribed by the
Department, of the staffing ratios in effect on the effective
date of this amendatory Act of the 96th General Assembly for
both intermediate and skilled care and the number of residents
receiving each level of care.
(d)(1) (Blank).
(2) (Blank).
(3) (Blank).
(4) (Blank).
(5) Effective January 1, 2014, the minimum staffing ratios
shall be increased to 3.8 hours of nursing and personal care
each day for a resident needing skilled care and 2.5 hours of
nursing and personal care each day for a resident needing
intermediate care.
(e) Ninety days after the effective date of this
amendatory Act of the 97th General Assembly, a minimum of 25%
of nursing and personal care time shall be provided by
licensed nurses, with at least 10% of nursing and personal
care time provided by registered nurses. These minimum
requirements shall remain in effect until an acuity based
registered nurse requirement is promulgated by rule concurrent
with the adoption of the Resource Utilization Group
classification-based payment methodology, as provided in
Section 5-5.2 of the Illinois Public Aid Code. Registered

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nurses and licensed practical nurses employed by a facility in
excess of these requirements may be used to satisfy the
remaining 75% of the nursing and personal care time
requirements. Notwithstanding this subsection, no staffing
requirement in statute in effect on the effective date of this
amendatory Act of the 97th General Assembly shall be reduced
on account of this subsection.
(f) The Department shall submit proposed rules for
adoption by January 1, 2020 establishing a system for
determining compliance with minimum staffing set forth in this
Section and the requirements of 77 Ill. Adm. Code 300.1230
adjusted for any waivers granted under Section 3-303.1.
Compliance shall be determined quarterly by comparing the
number of hours provided per resident per day using the
Centers for Medicare and Medicaid Services' payroll-based
journal and the facility's daily census, broken down by
intermediate and skilled care as self-reported by the facility
to the Department on a quarterly basis. The Department shall
use the quarterly payroll-based journal and the self-reported
census to calculate the number of hours provided per resident
per day and compare this ratio to the minimum staffing
standards required under this Section, as impacted by any
waivers granted under Section 3-303.1. Discrepancies between
job titles contained in this Section and the payroll-based
journal shall be addressed by rule.
(g) The Department shall submit proposed rules for

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adoption by January 1, 2020 establishing monetary penalties
for facilities not in compliance with minimum staffing
standards under this Section. No monetary penalty may be
issued for noncompliance during the implementation period,
which shall be July 1, 2020 through September 30, 2020. If a
facility is found to be noncompliant during the implementation
period, the Department shall provide a written notice
identifying the staffing deficiencies and require the facility
to provide a sufficiently detailed correction plan to meet the
statutory minimum staffing levels. Monetary penalties shall be
imposed beginning no later than January 1, 2021 and quarterly
thereafter and shall be based on the latest quarter for which
the Department has data. Monetary penalties shall be
established based on a formula that calculates on a daily
basis the cost of wages and benefits for the missing staffing
hours. All notices of noncompliance shall include the
computations used to determine noncompliance and establishing
the variance between minimum staffing ratios and the
Department's computations. The penalty for the first offense
shall be 125% of the cost of wages and benefits for the missing
staffing hours. The penalty shall increase to 150% of the cost
of wages and benefits for the missing staffing hours for the
second offense and 200% the cost of wages and benefits for the
missing staffing hours for the third and all subsequent
offenses. The penalty shall be imposed regardless of whether
the facility has committed other violations of this Act during

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the same period that the staffing offense occurred. The
penalty may not be waived, but the Department shall have the
discretion to determine the gravity of the violation in
situations where there is no more than a 10% deviation from the
staffing requirements and make appropriate adjustments to the
penalty. The Department is granted discretion to waive the
penalty when unforeseen circumstances have occurred that
resulted in call-offs of scheduled staff. This provision shall
be applied no more than 6 times per quarter. Nothing in this
Section diminishes a facility's right to appeal.
(Source: P.A. 101-10, eff. 6-5-19.)
(210 ILCS 45/3-206a new)
Sec. 3-206a. Certification of temporary nursing
assistants.
(a) The Department shall certify the Temporary Nursing
Assistant Training Program that it implemented by emergency
rule under 77 Ill. Adm. Code 395.2.
(b) Notwithstanding the State-approved nurse aide training
programs, the Department shall deem an individual as
satisfying the requirement of completing a nurse aide training
and competency evaluation program approved by the State if:
(1) the individual successfully completed a training
program and competency assessment under the Temporary
Nursing Assistant Training Program, including online
training and an online examination;

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(2) the individual completed a minimum of 80 hours of
temporary nursing assistant or supervised practical nurse
aide training, on-the-job training apprenticeship, or
regular in-services nurse aide education during the
declared COVID-19 emergency under the supervision of a
licensed or registered nurse; or
(3) the individual's competency has been established
by one of the following:
(A) successful completion of the State temporary
nursing assistant examination;
(B) certification by a site administrator
responsible for assessing the individual's competency
skills as part of an approved apprenticeship program;
or
(C) through an assessment in all areas of required
nurse aide training as provided for in 42 CFR
483.152(b) by the hiring entity.
(c) Individuals who meet the eligibility provisions in
subsection (b) shall be deemed to have completed all nursing
assistant training and competency evaluation program
requirements and shall be placed on the State nurse aide
registry as "active".
(d) Temporary nursing assistants must enroll in an
approved certified nursing assistant training program within 2
years of completion of the Temporary Nursing Assistant
Training Program.

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The individual shall receive one hour of credit for every
hour employed as a temporary nursing assistant, up to 40
hours.
Once enrolled in the certified nursing assistant training
program, the individual may work as a nursing assistant in
training and continue to practice the same skills he or she did
as a temporary nursing assistant and new competencies he or
she has learned in his or her certified nursing assistant
training.
(e) The Department shall incorporate this Section as part
of the State-approved nurse aide training programs.