[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5282 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5282

 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.


_______________________________________________________________________


                    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 
                jurisdiction 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 Representatives 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 SPECIALLY TRAINED INDIVIDUALS WHO 
              PERFORM NURSING-RELATED TASKS IN MEDICARE 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 
specially 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 specified by the 
                Secretary, an application to participate 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 enactment of this 
                Act) of its intention to seek to participate in the 
                project and submits a timely application 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, developed 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, licensed 
        practical nurse, or licensed vocational nurse;
            (3) the resident does not have special needs relating to 
        the performance of such task for which needs the individual has 
        not received specific training; 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 Affected.--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 period 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 residents receiving specific nursing services performed by 
individuals under the project with those receiving such services 
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 facilities in a priority State in the 
same manner as under the project during the period beginning on the 
date of enactment of this Act and ending--
            (1) in the case of a State which fails to submit a timely 
        application for participation in the project, on the date such 
        application is due; or
            (2) in the case of a State which submits a timely 
        application for participation in the project, the date on which 
        the Secretary makes a final decision on the application.
    (g) Definitions.--In this section:
            (1) The term ``nurse aide training requirements'' means the 
        requirements of sections 1819(b)(5)(F) and 1919(b)(5)(F) of the 
        Social Security Act (42 U.S.C. 1395i-3(b)(5)(F) and 
        1396r(b)(5)(F)) relating to nurse aides.
            (2) The term ``nursing task'' means a nursing or nursing-
        related service described in section 1819(b)(5)(F) or 
        1919(b)(5)(F) of the Social Security Act (42 U.S.C. 1395i-
        3(b)(5)(F), 1396r(b)(5)(F)).
            (3) The term ``priority State'' means--
                    (A) Wisconsin, New York, North Dakota, Minnesota, 
                and Delaware; and
                    (B) any other State which, as of the date of 
                enactment of this Act, has established a project, 
                program, or policy to permit individuals who do not 
                meet nurse aide training requirements to perform one or 
                more specific nursing tasks.
            (4) The term ``project'' means the demonstration project 
        established in this section.
            (5) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
            (6) The term ``State'' has the meaning given such term for 
        purposes of title XIX of the Social Security Act.
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