Bill Text: NH HB484 | 2015 | Regular Session | Introduced
Bill Title: Relative to medication administration by licensed nursing assistants and relative to exemptions from regulation for certain nursing care and attendant care services.
Spectrum: Bipartisan Bill
Status: (Passed) 2015-07-15 - Signed by the Governor on 7/13/2015; Chapter 239; Effective Date 9/11/2015 [HB484 Detail]
Download: New_Hampshire-2015-HB484-Introduced.html
HB 484 - AS INTRODUCED
2015 SESSION
15-0483
10/09
HOUSE BILL 484
AN ACT relative to the board of nursing and exemptions from licensure by the board.
SPONSORS: Rep. Suzanne Smith, Graf 8; Rep. Ford, Graf 3; Rep. LeBrun, Hills 32; Rep. Emerson, Ches 11; Sen. Reagan, Dist 17; Sen. Woodburn, Dist 1
COMMITTEE: Executive Departments and Administration
This bill modifies definitions, adds requirements for registered nurse and license nurse assistant members appointed to the board of nursing, and adds exemptions from licensure for administration of medications by assistive personnel and for attendant care services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
15-0483
10/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fifteen
AN ACT relative to the board of nursing and exemptions from licensure by the board.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Nurse Practice Act; Definition; LNA. Amend RSA 326-B:2, IV to read as follows:
IV. “Licensed nursing assistant” or “LNA” means an individual who holds a current license to provide client care under the [direction] supervision of a registered nurse or licensed practical nurse.
2 Definition; Medication Nursing Assistant. Amend RSA 326-B:2, VI to read as follows:
VI. “Medication nursing assistant” means a licensed nursing assistant holding a currently valid certificate authorizing the [delegation] assignment to the nursing assistant of tasks of medication administration.
3 Definition; Nursing-Related Activities. Amend RSA 326-B:2, VIII to read as follows:
VIII. “Nursing-related activities” means client care provided by a licensed nursing assistant [directed] supervised by an APRN, an RN, or an LPN.
4 Board of Nursing; RN and LNA Members. Amend RSA 326-B:3, I-IV to read as follows:
I. The board of nursing shall comprise 11 members to be appointed by the governor with the consent of the council. Any interested individual, association, or entity may make recommendation to the governor. The members of the board shall include 5 registered nurses, one of whom shall be an advanced practice registered nurse and one of whom shall be active in the field of Medicaid home and community based care for the elderly or adults with disabilities, 2 licensed practical nurses, 2 licensed nursing assistants, one of whom shall be a medication licensed nursing assistant if possible, and 2 representative members of the public. The terms of members shall be staggered as determined by the governor and council. All terms shall be for 3 years, and no member of the board shall be appointed to more than 3 consecutive terms.
II. Each RN member shall be a resident of this state, licensed in good standing under the provisions of this chapter, and currently engaged in the practice of nursing as an RN and shall have no fewer than 5 years of experience as an RN, at least 3 of which shall have immediately preceded appointment. RN members of the board shall represent the various areas of nursing practice including education, administration, Medicaid home and community based care for the elderly or adults with disabilities, and clinical practice.
III. The LPN members of the board shall be residents of this state, licensed in good standing under the provisions of this chapter, and currently engaged in the practice of nursing and shall have had no fewer than 5 years of experience as an LPN, at least 3 of which shall have immediately preceded the date of appointment.
IV. The LNA members of the board shall be residents of this state, licensed in good standing under the provisions of this chapter, and currently engaged in nursing-related activities. These members shall have a minimum of 5 years of experience as an LNA, at least 3 of which shall have immediately preceded the date of their appointment. LNA members of the board shall represent the various areas of LNA practice including long-term care.
5 New Paragraph; Nurse Practice Act; Exemption Added. Amend RSA 326-B:43 by inserting after paragraph I the following new paragraph:
I-a. Nursing care provided by family and friends.
6 New Paragraphs; Exemptions Added. Amend RSA 326-B:43 by inserting after paragraph VIII the following new paragraphs:
IX. The administration of medications by assistive personnel, employed or under contract, who provide direct care to clients receiving services in residential care facilities, in adult day care agencies, or through home health care providers, each licensed under RSA 151, provided that a licensed nurse has delegated the task of medication administration and has done so in a manner that is consistent with generally accepted standards of nurse delegation. The commissioner of health and human services, in consultation with the board, shall adopt rules under RSA 541-A establishing standards for such delegation of medication administration for each facility licensing category and include in such rules any limitations on the number of delegations per assistive personnel, documentation requirements, and medication administration error reporting requirements.
(a) “Assistive personnel” includes any direct care worker who is not a licensed RN or LPN under RSA 326-B or otherwise licensed to administer medication.
(b) “Generally accepted standards for nurse delegation” includes, but is not limited to:
(1) An assessment by a licensed nurse to ensure the client’s condition is stable and the outcome of the task is predictable;
(2) Consideration of the complexity and risk of the task to be delegated, so as to ensure the task may be performed properly and safely by the assistive personnel;
(3) Assurance of the willingness of the assistive personnel to accept the delegation;
(4) Training of the assistive personnel and assessment of competency; and
(5) Ongoing supervision that is consistent with the complexity and skill level of the delegated task.
X. Consumer-directed attendant care services directed by or on behalf of an individual with a disability of any age who requires assistance with such services in order to live in his or her home and community, including a residential care facility. For the purpose of this paragraph,
(a) “Attendant care services” means assistance with any of the following:
(1) Activities of daily living;
(2) Instrumental activities of daily living; or
(3) Health maintenance activities.
(b) “Health maintenance activities” means activities that a licensed health care professional determines could be performed by the individual if the individual were physically able and may safely be performed in the home or community setting. Such activities include, but are not limited to, bowel and bladder care, routine ostomy care, medication administration, and wound care.
7 New Paragraph; Rulemaking; Commissioner of Health and Human Services; Residential Care and Health Facility Licensing. Amend RSA 151:9 by inserting after paragraph IX the following new paragraph:
X. The commissioner shall adopt rules under RSA 541-A, in consultation with the board of nursing, establishing standards for delegation of medication administration for each facility licensing category, as provided in RSA 326-B:43, IX.
8 Effective Date. This act shall take effect 60 days after its passage.
