06 LC 33
1325S
The
Senate Health and Human Services Committee offered the following substitute to
SB 480:
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 26 of Title 43 of the Official Code of Georgia Annotated, relating
to nurses, so as to provide for the certification of qualified medication aides;
to provide for a short title; to provide legislative findings; to provide for
definitions; to provide for the delegation of certain nursing tasks; to provide
for powers and responsibilities of the Georgia Board of Examiners of Licensed
Practical Nurses; to provide for certification standards and requirements; to
provide for the issuance and renewal of certificates; to provide for permitted
and prohibited activities; to provide for requirements of community living
arrangements which utilize qualified medication aides; to provide for sanctions;
to provide for construction; to provide for automatic repeal; to provide for
related matters; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Chapter
26 of Title 43 of the Official Code of Georgia Annotated, relating to nurses, is
amended by adding a new article to read as follows:
"ARTICLE
3
43-26-50.
This
article shall be known and may be cited as the 'Georgia Qualified Medication
Aide Act.'
43-26-51.
The
purpose of this article is to protect, promote, and preserve the public health,
safety, and welfare through the delegation of certain activities performed by
registered professional nurses and licensed practical nurses to persons who are
certified as qualified medication aides and who are employed by and working in
community living arrangements established by the Department of Human Resources
pursuant to paragraphs (15) and (16) of subsection (b) of Code Section
37-1-20.
43-26-52.
As
used in this article, the term:
(1)
'Applicant' means any person seeking certification under this
article.
(2)
'Board' means the Georgia Board of Examiners of Licensed Practical Nurses
established pursuant to Article 2 of this chapter.
(3)
'Community living arrangement' means any residence, whether operated for profit
or not for profit, which undertakes through its ownership or management to
provide or arrange for the provision of daily personal services, support, care,
or treatment exclusively for two or more adults who are not related to the owner
or administrator by blood or marriage which is established by the Department of
Human Resources pursuant to paragraph (16) of subsection (b) of Code Section
37-1-20 and whose services are financially supported, in whole or part, by funds
authorized through the Division of Mental Health, Developmental Disabilities,
and Addictive Diseases of the Department of Human Resources. A community living
arrangement is also referred to as a 'residence.'
(4)
'Licensed practical nurse' means an individual who is licensed to practice
nursing under Article 2 of this chapter.
(5)
'Medication administration record' means a written record of medication ordered
for and received by a resident of a community living arrangement.
(6)
'Qualified medication aide' means a person who meets the qualifications
specified in this article and who is currently certified by the
board.
(7)
'Physician' means an individual who is licensed to practice medicine under
Article 2 of Chapter 34 of this title.
(8)
'Registered professional nurse' means an individual who is licensed to practice
nursing under Article 1 of this chapter.
(9)
'Resident' means an individual in a community living arrangement.
(10)
'Supervising nurse' means the registered professional nurse who is responsible
for the supervision of a qualified medication aide in a community living
arrangement.
(11)
'Supervision' means initial and ongoing direction, procedural guidance, and
observation and evaluation of the qualified medication aide by a registered
professional nurse.
43-26-53.
(a)
A registered professional nurse or a licensed practical nurse may delegate
certain nursing tasks, as set out in Code Section 43-26-56, to no more than 15
qualified medication aides who are working at and employed by community living
arrangements.
(b)
Certification as a qualified medication aide by the board shall constitute a
presumption that the qualified medication aide has acquired the necessary
knowledge, skills, and experience to perform the delegated nursing task with
reasonable skill and safety upon the residents of community living arrangements.
The presumption may be overcome or rebutted by evidence to the contrary,
including, but not limited to, the determination that deceptive or fraudulent
information was used to obtain certification as a qualified medication
aide.
43-26-54.
The
board shall have the power and responsibility to:
(1)
Determine the qualifications and fitness of applicants for certification as a
qualified medication aide and renewal of the certificate;
(2)
Adopt rules and regulations consistent with this article necessary to enable it
to carry into effect the provisions of this article, including disciplinary
rules;
(3)
Examine for, approve, issue, deny, revoke, suspend, and renew the certification
of qualified medication aide certificate holders and applicants under this
article;
(4)
Conduct hearings in accordance with the Georgia Administrative Procedure Act
regarding the regulation and enforcement of this article;
(5)
Regulate the acts and practices that are allowed or prohibited for qualified
medication aides, in accordance with the provisions of this
article;
(6)
Establish application, examination, and certification fees;
(7)
Establish requirements for the education and training of qualified medication
aides; and
(8)
Establish continuing education requirements.
43-26-55.
(a)
The board shall receive applications for certification to be qualified
medication aides in Georgia. Each applicant shall meet the following
qualifications:
(1)
Be at least 18 years of age;
(2)
Be able to read, write, speak, and understand the English language;
(3)
Have attained a high school diploma or a general educational development (GED)
diploma or the equivalent thereof;
(4)
Have satisfactory results from a fingerprint record check report conducted by
the Georgia Crime Information Center, as determined by the board. Application
for a certificate under this Code section shall constitute consent for
performance of a criminal background check. Each applicant who submits an
application to the board for certification agrees to provide the board with any
and all information necessary to run a criminal background check, including, but
not limited to, classifiable sets of fingerprints. The applicant shall be
responsible for all fees associated with the performance of a background
check;
(5)
Have completed a prescribed course of study in a qualified medication aide
program conducted by the Department of Technical and Adult Education;
(6)
Have successfully passed a board approved or administered competency exam for
qualified medication aides; and
(7)
Have met such other requirements as may be prescribed by the board.
(b)
Each qualified medication aide shall, in order to maintain certification, work
under the supervision of a registered professional nurse.
(c)
Certificates issued under this article shall be renewed biennially according to
schedules and fees approved by the board.
43-26-56.
(a)
The following tasks are permitted activities that may be delegated to a
qualified medication aide under supervision and are subject to the rules and
regulations promulgated by the board:
(1)
Administer physician ordered oral, ophthalmic, topical, otic, nasal, vaginal,
and rectal medications and medications by gastric ('G' or 'J')
tube;
(2)
Administer insulin under physician direction and protocol;
(3)
Administer medication via metered dose inhaler;
(4)
Conduct finger stick blood glucose testing following established
protocol;
(5)
Administer commercially prepared disposable enema as ordered by a
physician;
(6)
Administer treatment for skin conditions, including stage I and II decubitus
ulcers, following a designated protocol;
(7)
Assist residents in supervised self-administration of medication;
(8)
Record in the medication administration record all medications that the
qualified medication aide has personally administered, including a
resident́s
refusal to take medication; and
(9)
Observe and report to the supervising nurse any changes in the
resident́s
condition.
(b)
The board shall promulgate rules and regulations regarding the activities
permitted by this Code section and any other permitted activities, as
determined by the board, and those activities that the supervising nurse is
prohibited from delegating to a qualified medication aide and that the qualified
medication aide is prohibited from performing.
43-26-57.
A
community living arrangement which utilizes the services of a qualified
medication aide shall employ or contract with a registered professional nurse
who has responsibility for the supervision of the qualified medication aide. A
registered professional nurse under discipline, sanction, or restriction by the
Georgia Board of Nursing shall not provide supervision for a qualified
medication aide.
43-26-58.
(a)
The board shall have the authority to refuse to grant or to renew a certificate
to an applicant, to revoke the certificate of a certificate holder, or to
discipline a certificate holder upon a finding by the board that the applicant
or certificate holder has:
(1)
Been convicted of a felony, a crime involving moral turpitude, or any crime
violating a federal or state law relating to controlled substances or dangerous
drugs or marijuana in the courts of this state, any other state, territory, or
country, or in the courts of the United States, including, but not limited to, a
plea of nolo contendere entered to the charge, the granting of first offender
treatment without adjudication of guilt, or the withholding of adjudication of
guilt on the charges or crime;
(2)
Had a certificate to practice as a qualified medication aide revoked, suspended,
or annulled by any lawful certificating authority of any state or county, had
other disciplinary action taken by any lawful certificating authority for any
certification or licensure to practice a business or profession, including
refusal of certification or licensure, or was denied a certificate by any lawful
certificating authority;
(3)
Engaged in any unprofessional, unethical, deceptive, or deleterious conduct or
practice harmful to the public, which conduct or practice need not have resulted
in actual injury to any person. As used in this paragraph, the term
'unprofessional conduct' includes any departure from, or the failure to conform
to, the minimum standards of acceptable and prevailing practice as a qualified
medication aide;
(4)
Violated or attempted to violate a law or any lawfully promulgated rule or
regulation of the board, this state, any other state, the United States, or any
other lawful authority, without regard to whether the violation is criminally
punishable, which statute, law, or rule or regulation relates to or in part
regulates the practice of a qualified medication aide, when the qualified
medication aide or applicant knows or should have known that such action
violates such law or rule or regulation;
(5)
Violated a lawful order of the board previously entered by the board or the
order of any certifying or licensing authority; or
(6)
Displayed an inability to practice as a qualified medication aide with
reasonable skill and safety due to illness; use of alcohol, drugs, narcotics,
chemicals, or any other types of material; or as a result of any mental or
physical condition.
(A)
In enforcement of this paragraph, the board may, upon reasonable grounds,
require a certificate holder or applicant to submit to a mental or physical
examination by a board approved health care professional. The expense of such
mental or physical examination shall be borne by the certificate holder or
applicant. The results of such examination shall be admissible in any hearing
before the board, notwithstanding any claim of privilege under contrary law or
rule. Every certificate holder and applicant shall be deemed to have given such
persońs
consent to submit to such mental or physical examination and to have waived all
objections to the admissibility of the results in any hearing before the board
upon the grounds that the same constitutes a privileged communication. If a
certificate holder or applicant fails to submit to such an examination when
properly directed to do so by the board, unless such failure was due to
circumstances beyond that
persońs
control, the board may enter a final order upon proper notice, hearing, and
proof of such refusal. Any certificate holder or applicant who is prohibited
from practicing under this paragraph shall at reasonable intervals be afforded
an opportunity to demonstrate to the board that such person can resume or begin
to practice as a qualified medication aide with reasonable skill and
safety.
(B)
In enforcement of this paragraph, the board may, upon reasonable grounds, obtain
any and all records relating to the mental or physical condition of a
certificate holder or applicant, including psychiatric records; such records
shall be admissible in any hearing before the board, notwithstanding any
privilege under a contrary law or rule. Every person who is certificated in
this state or who shall file an application for said certificate shall be deemed
to have given such
persońs
consent to the
board́s
obtaining such records and to have waived all objections to the admissibility of
such records in any hearing before the board upon the grounds that the same
constitute a privileged communication.
(b)
Neither denial of an initial certificate, the issuance of a private reprimand,
nor the denial of a request for reinstatement of a certificate on the grounds
that the certificate holder or applicant has failed to meet the minimum
requirements shall be considered a contested case within the meaning of Chapter
13 of Title 50, the 'Georgia Administrative Procedure Act'; and notice and
hearing within the meaning of Chapter 13 of Title 50 shall not be required, but
the certificate holder or applicant shall be allowed to appear before the board
if he or she so requests.
43-26-59.
(a)
Nothing in this article shall be construed to limit or repeal Articles 1 and 2
of this chapter, relating to registered professional nurses and licensed
practical nurses, respectively.
(b)
Nothing in this article shall be construed to limit or repeal any existing
authority of a physician to delegate to a qualified person any acts, duties, or
functions which are otherwise permitted by law or established by
custom.
43-26-60.
This
article shall be repealed in its entirety on July 1,
2011."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.