I
106TH CONGRESS
2D SESSION
H. R. 5282
To establish a demonstration project to waive certain nurse training require-
ments for specially trained individuals who perform certain specific nurs-
ing-related tasks in Medicare and Medicaid nursing facilities.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 25, 2000
Mr. RYAN of Wisconsin introduced the following bill; which was referred to
the Committee on Ways and Means, and in addition to the Committee
on Commerce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned
A BILL
To establish a demonstration project to waive certain nurse
training requirements for specially trained individuals
who perform certain specific nursing-related tasks in
Medicare and Medicaid nursing facilities.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Medicare and Medicaid
Nursing Services Quality Improvement Demonstration Act
of 2000’’.
SEC. 2. DEMONSTRATION PROJECT TO WAIVE CERTAIN
NURSE TRAINING REQUIREMENTS FOR SPE-
CIALLY TRAINED INDIVIDUALS WHO PER-
FORM NURSING-RELATED TASKS IN MEDI-
CARE AND MEDICAID NURSING FACILITIES.
(a) ESTABLISHMENT.—The Secretary of Health and
Human Services shall establish a five-year demonstration
project under which, pursuant to subsection (c), nurse
aide training requirements (as defined in subsection
(g)(1)) are waived in up to five States in the case of spe-
cially trained individuals with respect to specific nursing
tasks (as defined in subsection (g)(2)).
(b) STATE PARTICIPATION.—
(1) ELIGIBILITY.—No State shall be eligible to
participate in the project unless the State—
(A) submits, in a form and manner speci-
fied by the Secretary, an application to partici-
pate in the project; and
(B) agrees to collect, maintain, and submit
such data as the Secretary deems necessary to
complete the reports required by subsection (e).
(2) PRIORITY
STATES.—The Secretary shall
give priority for participation in the project—
(A) first, to any priority State described in
subsection (g)(3)(A) that notifies the Secretary
(not later than 90 days after the date of enact-
ment of this Act) of its intention to seek to par-
ticipate in the project and submits a timely ap-
plication to participate in the project; and
(B) second, to any other priority State
that so notifies the Secretary and submits such
a timely application.
(c) TRAINING AND COMPETENCY REQUIREMENTS.—
Under the project, an individual who does not meet nurse
aide training requirements may perform a specific nursing
task for a resident of a skilled nursing facility or a nursing
facility covered under the medicare or medicaid program
under title XVIII or XIX of the Social Security Act in
a participating State if—
(1) the individual has successfully completed a
training and competency evaluation program, devel-
oped or approved by the State in which such facility
operates in consultation with the Secretary, relating
to the performance of such task;
(2) the individual is performing the task under
the supervision of a registered professional nurse, li-
censed practical nurse, or licensed vocational nurse;
(3) the resident does not have special needs re-
lating to the performance of such task for which
needs the individual has not received specific train-
ing; and
(4) the individual complies with any limitations
on performance of duties which may be established
by the State in which such facility operates.
(d) MINIMUM STAFFING REQUIREMENTS NOT AF-
FECTED.—Individuals performing a specific nursing task
under the project shall not count toward any minimum
nursing staffing requirements of section 1818 or 1919 of
the Social Security Act (42 U.S.C. 1395i–3, 1396r).
(e) ANNUAL REPORT TO CONGRESS.—During the pe-
riod of the project, the Secretary of Health and Human
Services shall submit an annual report to the Congress
providing an analysis comparing the well-being of resi-
dents receiving specific nursing services performed by indi-
viduals under the project with those receiving such serv-
ices performed by nurse aides. Such analysis shall employ
quality indicators determined by the Secretary, including
(with regard to specific nursing tasks related to providing
nutrition and hydration) nutrition and hydration levels,
unplanned weight loss or gain, and number of citations
for nutrition-related violations relating to such residents.
(f) TRANSITIONAL WAIVER.—The Secretary shall
waive nurse aide training requirements for nursing facili-
ties in a priority State in the same manner as under the
project during the period beginning on the date of enact-
ment of this Act and ending—