Bill Text: MS HB1057 | 2026 | Regular Session | Introduced
Bill Title: Nursing; authorize nurses to delegate medication administration to unlicensed assistive personnel in outpatient clinical settings under certain conditions.
Sponsorship: Partisan Bill (Republican 1)
Status: (Failed) 2026-02-03 - Died In Committee [HB1057 Detail]
Download: Mississippi-2026-HB1057-Introduced.html
2026 Regular Session
To: Public Health and Human Services
By: Representative Ford (73rd)
House Bill 1057
AN ACT TO AUTHORIZE REGISTERED NURSES AND ADVANCED PRACTICE REGISTERED NURSES LICENSED BY THE BOARD OF NURSING TO DELEGATE MEDICATION ADMINISTRATION TO UNLICENSED ASSISTIVE PERSONNEL IN OUTPATIENT CLINIC SETTINGS FOR PATIENTS WITH STABLE AND PREDICTABLE HEALTH CONDITIONS, PROVIDED THAT CERTAIN CONDITIONS ARE MET; TO REQUIRE THE REGISTERED NURSE OR ADVANCED PRACTICE REGISTERED NURSE TO PROVIDE DIRECT, IN-PERSON SUPERVISION OF THE UNLICENSED ASSISTIVE PERSONNEL; TO PROVIDE THAT THE REGISTERED NURSE OR ADVANCED PRACTICE REGISTERED NURSE RETAINS THE ACCOUNTABILITY FOR THE TOTAL NURSING AND ADVANCED PRACTICE NURSING CARE OF THE INDIVIDUAL; TO REQUIRE THAT THE DELEGATION OF MEDICATION ADMINISTRATION TO UNLICENSED ASSISTIVE PERSONNEL BE PERSON-SPECIFIC; TO REQUIRE THE UNLICENSED ASSISTIVE PERSONNEL TO BE ADEQUATELY TRAINED FOR THE TASK, TO HAVE DEMONSTRATED THAT THE TASK HAS BEEN LEARNED, TO BE ABLE TO PERFORM THE TASK SAFELY IN THE GIVEN NURSING SITUATION, AND TO HAVE APPROPRIATE SUPERVISION AVAILABLE DURING THE TASK IMPLEMENTATION; TO REQUIRE THAT THE DELEGATION OF MEDICATION ADMINISTRATION TO THE UNLICENSED ASSISTIVE PERSONNEL BE AN ESTABLISHED POLICY OF THE PRACTICE SETTING; TO PROHIBIT A REGISTERED NURSE OR ADVANCED PRACTICE REGISTERED NURSE FROM DELEGATING THE ADMINISTRATION OF CERTAIN DRUGS AND AGENTS; TO REQUIRE DOCUMENTED, FORMAL TRAINING OF UNLICENSED ASSISTIVE PERSONNEL BY A REGISTERED NURSE OR ADVANCED PRACTICE REGISTERED NURSE IN ORDER FOR THE NURSE TO BE AUTHORIZED BY THE BOARD TO DELEGATE MEDICATION ADMINISTRATION; TO AMEND SECTION 73-15-29, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT VIOLATIONS OF THIS ACT ARE GROUNDS FOR THE BOARD OF NURSING TO DISCIPLINE A NURSE; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Introduction. Registered nurses and advanced practice registered nurses licensed by the Board of Nursing may delegate medication administration in outpatient clinic settings for patients with stable and predictable health conditions under the specific conditions as provided for in this act. When delegating to unlicensed assistive personnel, the registered nurse or advanced practice registered nurse is authorizing the unlicensed assistive personnel to perform a task that is normally within the registered nurse's or advanced practice registered nurse's scope of practice. Before agreeing to delegate tasks including medication administration, the registered nurse or advanced practice registered nurse is responsible for understanding the rules of the board relative to delegating nursing care and for achieving the competence to delegate and supervise.
SECTION 2. Definitions. As used in this act, the following terms shall be defined as provided in this section, unless the context requires otherwise:
(a) "Administration of medication" or "medication administration" means removal of an individual dose from a previously dispensed or distributed, properly labeled container, verifying the dose and medication with the prescriber's order, giving the individual dose to the proper patient at the proper time by the proper route and promptly recording the time and dose given.
(b) "Delegation" means entrusting the performance of selected nursing tasks by the registered nurse or advanced practice registered nurse to other competent nursing personnel in selected situations. The registered nurse or advanced practice registered nurse retains the accountability for the total nursing care of the individual. The registered nurse or advanced practice registered nurse is responsible for and accountable to each consumer of nursing care for the quality of nursing care that he or she receives, regardless of whether the care is provided solely by the registered nurse/advanced practice registered nurse or by the registered nurse/advanced practice registered nurse in conjunction with other licensed or unlicensed assistive personnel.
(c) "Direct supervision" means the registered nurse or advanced practice registered nurse is physically present in the office or suite where the procedure, including medication administration, is being performed at all times that the unlicensed assistive personnel is on duty providing services. This term also includes ongoing oversight, follow-up and evaluation of the individual patient and the ongoing oversight, follow-up and evaluation of competency of the unlicensed assistive personnel.
(d) "Outpatient clinic setting" means a nonresidential facility that provides treatment for health conditions that is obtained on an outpatient basis, which allows patients to return to and function in their usual environment. This term does not include facilities such as hospitals, emergency rooms and ambulatory surgical centers.
(e) "Person-specific" means health care needs and related factors in order to meet the unique needs of the specific person receiving care.
(f) "Stable and predictable" means a situation in which the person's clinical and behavioral status is determined by a registered nurse or advanced practice registered nurse to be non-fluctuating and consistent. A stable and predictable condition involves long term health care needs that are recuperative in nature, do not require the regular scheduled presence or reassessment of a registered nurse or advanced practice registered nurse, and is not characterized by rapid changes.
(g) "Unlicensed assistive personnel" means an unlicensed individual who is trained to function in an assistive role to the registered nurse or advanced practice registered nurse in the provision of patient activities as delegated by the nurse. Unlicensed assistive personnel have no authority to provide nursing care, despite any education or training, without the delegation of such care and tasks from registered nurses or advanced practice registered nurses.
SECTION 3. Responsibilities. Registered nurses and advanced practice registered nurses licensed by the Board of Nursing may delegate medication administration in outpatient clinic settings provided that the following conditions are met:
(a) The registered nurse or advanced practice registered nurse has assessed the health status of the individual immediately before the delegation, and the patient's health condition is determined to be stable and predictable.
(b) The registered nurse or advanced practice registered nurse provides direct supervision and retains the accountability for the total nursing and advanced practice nursing care of the individual and retains the responsibility to:
(i) Assess the patient;
(ii) Develop and implement the plan of care;
(iii) Determine that the medication administration can be safely and legally delegated;
(iv) Ensure that the medication administration is properly documented in the patient's record;
(v) Ascertain the training and competency of the unlicensed assistive personnel to whom the registered nurse or advanced practice registered nurse delegates the administration of medication; and
(vi) Rescind the delegation if the patient's condition changes, it is determined that the unlicensed assistive personnel is not safe or competent to administer the medication, or as otherwise determined by the registered nurse or advanced practice registered nurse.
(i} Be adequately trained for the task;
(ii) Have demonstrated that the task has been learned;
(iii) Be able to perform the task safely in the given nursing situation;
(iv) Be safe for the person to carry out the task; and
(v) Have appropriate supervision available during the task implementation.
(d) The delegation of medication administration to the unlicensed assistive personnel must be an established policy of the practice setting and include all aspects of Section 7 of this act at a minimum. The policy must be written, recorded and available to all.
(e) The registered nurse or advanced practice registered nurse and the unlicensed assistive personnel must be employed by the same organization or otherwise be formally accountable to the same institution or organization.
SECTION 4. Prohibitions and exceptions. (1) A registered nurse or advanced practice registered nurse shall not delegate, under any circumstances, the administration of:
(a) Drugs given by the intravenous route;
(b) Blood and blood products;
(c) Investigational drugs;
(d) Cancer therapeutic agents;
(e) Total parenteral nutrition solutions;
(f) Drugs given through accessing an implanted device;
(g) Insulin;
(h) Oxygen;
(i) Controlled substances;
(j) Anesthetic agents other than simple anesthetics; or
(k) Any agents used in the provision of cosmetic and aesthetic dermatological procedures.
(2) The delegation of medication administration is person-specific and is in no way considered a certification or skill that authorizes the unlicensed assistive personnel to use the title or credentials of other professionals including licensed persons.
(3) This act does not apply to inpatient facilities, licensed emergency departments of a hospital, long-term care facilities, residential facilities, or any other facility in which a registered nurse is required to be present by statute or administrative rule.
(4) This act does not apply to nursing students enrolled in nursing programs approved by the Board of Nursing while practicing under the direct supervision of qualified faculty and preceptors.
(5) The registered nurse or advanced practice registered nurse shall not delegate medication administration or any other task if the intervention requires the registered nurse's or advanced practice registered nurse's judgment to safely alter the standard procedure in accordance with the needs of the patient; or requires the consideration of a number of factors in order to perform the procedure; or requires judgment to determine how to proceed from one (1) step to the next.
(6) The registered nurse or advanced practice registered nurse shall not delegate any responsibilities of delegating, including, but not limited to, all provisions in Section 3 of this act.
SECTION 5. Training. In order for a registered nurse or advanced practice registered nurse to be authorized by the board to delegate medication administration under this act, there must be documented, formal training performed by a registered nurse or advanced practice registered nurse of the unlicensed assistive personnel. The formal training of the unlicensed assistive personnel must include, at a minimum, didactic and demonstrated competency in:
(a) Legal aspects of administering medication;
(b) Medical terminology;
(c) Proper documentation;
(d) Principles and rights of medication administration;
(e) Administration techniques; and
(f) Patient consent.
SECTION 6. Organizational policy. Registered nurses or advanced practice registered nurses and facilities that allow for delegating medication administration to unlicensed assistive personnel are responsible for ensuring that there is an approved organizational policy in place that:
(a) Addresses and allows delegation of medication administration to unlicensed assistive personnel;
(b) Establishes and provides for formal processes for documenting and reporting medication errors as committed by the unlicensed assistive personnel. Such provisions must provide for remediation of the unlicensed assistive personnel, registered nurse or advanced practice registered nurse, and system as appropriate;
(c) Provides mechanisms for documenting in writing the training and ongoing competency of the unlicensed assistive personnel and ensures that the delegating registered nurse or advanced practice registered nurse has access to such competence information;
(d) Provides for a formally documented, written annual review and re-assessment of competency of the unlicensed assistive personnel on not less than an annual basis and ensures that the delegating registered nurse or advanced practice registered nurse has access to such competence information;
(e) Provides for and recognizes that the decision to delegate tasks including delegation of medication administration in any specific situation is at the final discretion of the registered nurse or advanced practice registered nurse who is providing direct and immediate care to the patient; and
(f) Provides for documentation and review of other pertinent procedures such as needle stick injuries, universal precautions and infection control.
SECTION 7. Limitations. All unlicensed assistive personnel who have been trained or otherwise recognized or authorized to administer medication in another jurisdiction or under the provisions of another statute or administrative rule in Mississippi must meet the provisions of this act in order to administer medication in outpatient clinic settings through the delegation from registered nurses and advanced practice registered nurses.
SECTION 8. Section 73-15-29, Mississippi Code of 1972, is amended as follows:
73-15-29. (1) The board shall have power to revoke, suspend or refuse to renew any license issued by the board, or to revoke or suspend any privilege to practice, or to deny an application for a license, or to fine, place on probation and/or discipline a licensee, in any manner specified in this article, upon proof that such person:
(a) Has committed fraud or deceit in securing or attempting to secure such license;
(b) Has been convicted of a felony, or a crime involving moral turpitude or has had accepted by a court a plea of nolo contendere to a felony or a crime involving moral turpitude (a certified copy of the judgment of the court of competent jurisdiction of such conviction or pleas shall be prima facie evidence of such conviction);
(c) Has negligently or willfully acted in a manner inconsistent with the health or safety of the persons under the licensee's care;
(d) Has had a license or privilege to practice as a registered nurse or a licensed practical nurse suspended or revoked in any jurisdiction, has voluntarily surrendered such license or privilege to practice in any jurisdiction, has been placed on probation as a registered nurse or licensed practical nurse in any jurisdiction or has been placed under a disciplinary order(s) in any manner as a registered nurse or licensed practical nurse in any jurisdiction, (a certified copy of the order of suspension, revocation, probation or disciplinary action shall be prima facie evidence of such action);
(e) Has negligently or willfully practiced nursing in a manner that fails to meet generally accepted standards of such nursing practice;
(f) Has negligently or willfully violated any order, rule or regulation of the board pertaining to nursing practice or licensure;
(g) Has falsified or in a repeatedly negligent manner made incorrect entries or failed to make essential entries on records;
(h) Is addicted to or dependent on alcohol or other habit-forming drugs or is a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effect, or has misappropriated any medication;
(i) Has a physical, mental or emotional condition that renders the licensee unable to perform nursing services or duties with reasonable skill and safety;
(j) Has engaged in any other conduct, whether of the same or of a different character from that specified in this article, that would constitute a crime as defined in Title 97 of the Mississippi Code of 1972, as now or hereafter amended, and that relates to such person's employment as a registered nurse or licensed practical nurse;
(k) Engages in conduct likely to deceive, defraud or harm the public;
(l) Engages in any unprofessional conduct as identified by the board in its rules;
(m) Has violated any provision of this article;
(n) Violation(s) of
the provisions of Sections 41-121-1 through 41-121-9 relating to deceptive
advertisement by health care practitioners; * * *
(o) Violation(s) of
any provision of Title 41, Chapter 141, Mississippi Code of 1972 * * *; or
(p) Violation(s) of any provision of Sections 1 through 7 of this act.
(2) When the board finds any person unqualified because of any of the grounds set forth in subsection (1) of this section, it may enter an order imposing one or more of the following penalties:
(a) Denying application for a license or other authorization to practice nursing or practical nursing;
(b) Administering a reprimand;
(c) Suspending or restricting the license or other authorization to practice as a registered nurse or licensed practical nurse for up to two (2) years without review;
(d) Revoking the license or other authorization to practice nursing or practical nursing;
(e) Requiring the disciplinee to submit to care, counseling or treatment by persons and/or agencies approved or designated by the board as a condition for initial, continued or renewed licensure or other authorization to practice nursing or practical nursing;
(f) Requiring the disciplinee to participate in a program of education prescribed by the board as a condition for initial, continued or renewed licensure or other authorization to practice;
(g) Requiring the disciplinee to practice under the supervision of a registered nurse for a specified period of time; or
(h) Imposing a fine not to exceed Five Hundred Dollars ($500.00).
(3) In addition to the grounds specified in subsection (1) of this section, the board shall be authorized to suspend the license or privilege to practice of any licensee for being out of compliance with an order for support, as defined in Section 93-11-153. The procedure for suspension of a license or privilege to practice for being out of compliance with an order for support, and the procedure for the reissuance or reinstatement of a license or privilege to practice suspended for that purpose, and the payment of any fees for the reissuance or reinstatement of a license or privilege to practice suspended for that purpose, shall be governed by Section 93-11-157 or 93-11-163, as the case may be. If there is any conflict between any provision of Section 93-11-157 or 93-11-163 and any provision of this article, the provisions of Section 93-11-157 or 93-11-163, as the case may be, shall control.
(4) If the public health, safety or welfare imperatively requires emergency action and the board incorporates a finding to that effect in an order, the board may order summary suspension of a license pending proceedings for revocation or other action. These proceedings shall be promptly instituted and determined by the board.
(5) The board may establish by rule an alternative to discipline program for licensees who have an impairment as a result of substance abuse or a mental health condition, which program shall include at least the following components:
(a) Participation in the program is voluntary with the licensee, and the licensee must enter the program before the board holds a disciplinary action hearing regarding the licensee;
(b) The full cost of participation in the program, including the cost of any care, counseling, treatment and/or education received by the licensee, shall be borne by the licensee;
(c) All of the procedures and records regarding the licensee's participation in the program shall be confidential, shall not be disclosed and shall be exempt from the provisions of the Mississippi Public Records Act of 1983; and
(d) A licensee may not participate in the program more often than one (1) time during any period of five (5) years or such longer period as set by the board.
(6) A nurse practitioner who provides a written certification as authorized under the Mississippi Medical Cannabis Act and in compliance with rules and regulations adopted thereunder shall not be subject to any disciplinary action under this section solely due to providing the written certification.
SECTION 9. This act shall take effect and be in force from and after July 1, 2026.
