Notice of Intended Action

Nurse aides—training and competency evaluation, 81.1, 81.16

Untitled document

ARC 3594C

HUMAN SERVICES DEPARTMENT[441]

Notice of Intended Action

Proposing rule making related to nurse aides and providing an opportunity

for public comment

The Department of Human Services hereby proposes to amend Chapter 81, "Nursing Facilities," Iowa Administrative Code.

Legal Authority for Rule Making

This rule making is proposed under the authority provided in Iowa Code section 135C.14(2) and 2017 Iowa Acts, House File 306.

State or Federal Law Implemented

This rule making implements, in whole or in part, Iowa Code section 135C.14(2) and 2017 Iowa Acts, House File 306.

Purpose and Summary

These administrative rule amendments add the use of online course curricula to meet the required minimum of 30 hours of classroom instruction and add a definition of "clock hour." Finally, these amendments add a process to allow a veteran to be deemed to satisfy the nurse aide training requirements based upon the training and experience acquired through the veteran's service.

Fiscal Impact

This rule making has no fiscal impact to the State of Iowa.

Jobs Impact

There is an impact on private sector jobs and employment opportunities. By allowing online training and deeming veterans satisfactory based on military training and experience, this rule making will increase the direct care worker workforce. With the increase in workforce, nursing facilities will be able to hire more staff to provide care to their residents and nursing facility staff are less likely to have to work shorthanded.

Waivers

Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).

Public Comment

Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m.on February 20, 2018. Comments should be directed to:

Harry Rossander

Bureau of Policy Coordination

Department of Human Services

Hoover Building, Fifth Floor

1305 East Walnut Street

Des Moines, Iowa 50319

Fax: 515.281.4980

Email: policyanalysis@dhs.state.ia.us

Public Hearing

No public hearing is scheduled at this time. An oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, an agency, or an association of 25 or more persons as provided in Iowa Code section 17A.4(1)"b."

Review by Administrative Rules Review Committee

The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee's meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

The following rule-making actions are proposed:

Item 1. Adopt the following new definition of "Clock hour" in rule 441—81.1(249A):

"Clock hour" means 60 minutes.

Item 2. Rescind subrule 81.16(1) and adopt the following new subrule in lieu thereof:

81.16(1) Deemed meeting of requirements. A nurse aide is deemed to satisfy the requirement of completing a nurse aide training and competency evaluation approved by the department of inspections and appeals if:

a. The nurse aide successfully completed a nurse aide training and competency evaluation program before July 1, 1989, and

(1)At least 60 clock hours were substituted for 75 clock hours, and the person has made up at least the difference in the number of clock hours in the program the person completed and 75 clock hours in supervised practical nurse aide training or in regular in-service nurse aide education, or

(2)The person was found to be competent (whether or not by the state) after completion of a nurse aide training of at least 100 clock hours' duration, or

(3)The person can demonstrate that the person served as a nurse aide at one or more facilities of the same employer in Iowa for at least 24 consecutive months before December 19, 1989, or

(4)The person completed, before July 1, 1989, a nurse aide training and competency evaluation program that the department of inspections and appeals determines would have met the requirements for approval at the time it was offered; or

b. The person is a veteran, an active duty service member, or a member of the reserve forces, who has:

(1)Successfully completed a U.S. military training program that includes a curriculum comparable to the nurse aide training program required by this rule and has documented successful completion of that program with either a diploma, certifications, or Form DD 214 showing completion of hospital corpsman or medical service specialist or equivalent training, and

(2)Provided documentation showing that the person has 75 clock hours of practical experience in a nurse aide role, which may include classroom instruction, prior equivalent experience, or a combination of the two, and

(3)Successfully completed the nurse aide training and competency examination.

Item 3. Amend subrule 81.16(3) as follows:

81.16(3) Requirements for approval of a nurse aide training and competency evaluation program. The department has designated the department of inspections and appeals to approve required nurse aide training and testing competency evaluation programs. Policies and procedures governing approval of the programs are set forth in these rules.

a. For a nurse aide training and competency evaluation program to be approved by the department of inspections and appeals, it, such program shall, at a minimum:

(1)Consist of no less than 75 clock hours of training., and

(2)Include at least the subjects specified in 81.16(3). 81.16(3)"b," and

(3)Include at least 15 hours of laboratory experience, 30 hours of didactic theory instruction, which may be provided in a classroom instruction (the first 16 hours of which must occur before the nurse aide has resident contact) and 30 hours of supervised clinical training. Supervised clinical training means training in a setting in which the trainee demonstrates knowledge while performing tasks on a resident under the general supervision of a registered nurse or licensed practical nurse. setting or through online course curricula, and

(4)Ensure that students do not independently perform any services for which they have not been trained and found proficient by the instructor. It shall also ensure that students who are providing services to residents are under the general supervision of a licensed nurse or a registered nurse. Include at least 15 hours of laboratory experience provided in a face-to-face environment that complements the didactic theory curricula, and

(5)Meet the following requirements for instructors who train nurse aides: Include 30 hours of supervised clinical training in a face-to-face environment and supervised by a department of inspections and appeals-approved instructor in a manner not inconsistent with the licensing requirements of the Iowa board of nursing, and

1.The training of nurse aides shall be performed by or under the general supervision of a registered nurse who possesses a minimum of two years of nursing experience, at least one year of which shall be in the provision of long-term care facility services.

2.Instructors shall be registered nurses and shall have completed a course in teaching adults or have experience teaching adults or supervising nurse aides.

3.In a facility-based program, when the director of nursing is a registered nurse, the training of nurse aides may be performed under the general supervision of the director of nursing for the facility. The director of nursing is prohibited from performing the actual training.

4.Other personnel from the health professions may supplement the instructor. Supplemental personnel shall have at least one year of experience in their fields.

5.The ratio of qualified trainers to students shall not exceed one instructor for every ten students in the clinical setting.

(6)Contain information regarding competency evaluation through written or oral and skills testing. Ensure that students do not independently perform any services for which they have not been trained and found proficient by the department of inspections and appeals-approved instructor, and

(7)Meet the following requirements for department of inspections and appeals-approved instructors who train nurse aides:

1.The training of nurse aides shall be performed by or under the general supervision of a registered nurse who possesses a minimum of two years of nursing experience, at least one year of which shall be in the provision of long-term care facility services.

2.Instructors shall be registered nurses and shall have completed a course in teaching adults or have experience teaching adults or supervising nurse aides.

3.In a facility-based program, when the director of nursing is a registered nurse, the training of nurse aides may be performed by registered nurses under the general supervision of the director of nursing for the facility. The director of nursing is prohibited from performing the actual training.

4.Other personnel from the health professions may supplement the instructor. Supplemental personnel shall have at least one year of experience in their fields.

5.The ratio of department of inspections and appeals-approved instructors to students shall not exceed one registered nurse, or licensed practical nurse functioning as an assistant to a registered nurse, who is in the proximate area in the clinical setting, for every ten students in the clinical setting, and

(8)Contain information regarding competency evaluation through written or oral examination and skills demonstration.

b. No change.

c. Prohibition of charges.

(1)No A nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide training and competency evaluation program or competency evaluation program may not be charged for any portion of the program including any fees for textbooks, or other required evaluation or course materials, or nurse aide competency evaluations.

(2)If a person who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not no later than 12 months after completing a nurse aide training and competency evaluation program or competency evaluation program, the facility shall reimburse the nurse aide for costs incurred in completing the program or competency evaluation on a pro rata basis during the period in which the person is employed as a nurse aide. The formula for paying the nurse aides on a pro rata basis shall be as follows:

1.Add all costs incurred by the aides nurse aide for the course, books, and tests competency evaluations.

2.Divide the total arrived at in No.1 paragraph "1" above by 12 to prorate the costs over a one-year period and establish a monthly rate.

3.The nurse aide shall be reimbursed the monthly rate each month the nurse aide works at the facility until one year from the time the nurse aide completed the course.

d. and e. No change.

Human Services Department

Closed For Comments

This notice is now closed for comments. Collection of comments closed on 2/20/2018.

Official Document

  • Nurse aides—training and competency evaluation, 81.1, 81.16
  • Published on 1/31/2018
  • 95 Views , 0 Comments
  • Notice of Intended Action

The official published PDF of this document is available from the Iowa General Assembly’s Administrative Rules page.

View Official PDF

View the Iowa Administrative Bulletin for 1/31/2018.

View Bulletin

Administrative Rule References

The following administrative rule references were added to this document. You may click a reference to view related notices.

Rule 441-81.1 Rule 441-81.16(1) Rule 441-81.16(3)

Keywords

The following keywords and tags were added to this document. You may click a keyword to view related notices.

Deemed meeting of requirements
Click To Comment