Maryland 2024 2024 Regular Session

Maryland Senate Bill SB999 Engrossed / Bill

Filed 03/14/2024

                     
 
EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. 
        [Brackets] indicate matter deleted from existing law. 
         Underlining indicates amendments to bill. 
         Strike out indicates matter stricken from the bill by amendment or deleted from the law by 
amendment. 
          *sb0999*  
  
SENATE BILL 999 
J2   	4lr2458 
SB 370/23 – FIN   	CF HB 1125 
By: Senator Beidle 
Introduced and read first time: February 2, 2024 
Assigned to: Finance 
Committee Report: Favorable with amendments 
Senate action: Adopted 
Read second time: February 29, 2024 
 
CHAPTER ______ 
 
AN ACT concerning 1 
 
Certified Nursing Assistants – Licensing Requirements and Administrative 2 
Updates 3 
 
FOR the purpose of exempting an individual who practices as a certain nursing assistant 4 
for less than a certain number of months under federal regulations from the State’s 5 
certification requirement; altering the designation of, and licensure requirements 6 
for, certified nursing assistants and geriatric nursing assistants; requiring an 7 
applicant for certification as a certified nursing assistant to complete a nursing 8 
assistant competency evaluation; authorizing an approved acute care nursing 9 
assistant training program to request a waiver of certain federal requirements; and 10 
generally relating to the licensing of certified nursing assistants.  11 
 
BY repealing and reenacting, with amendments, 12 
 Article – Health – General 13 
Section 19–1410(b)(2)(vi), 19–1410.2, and 24–1901(e) 14 
 Annotated Code of Maryland 15 
 (2023 Replacement Volume) 16 
 
BY repealing and reenacting, without amendments, 17 
 Article – Health – General 18 
Section 24–1901(a) 19 
 Annotated Code of Maryland 20 
 (2023 Replacement Volume) 21 
 
BY repealing and reenacting, with amendments, 22  2 	SENATE BILL 999  
 
 
 Article – Health Occupations 1 
Section 8–6A–01, 8–6A–02(b) and (c), 8–6A–05, 8–6A–07(b) and (c), 8–6A–08(c) and 2 
(n), 8–6A–14, 8–701(c), and 8–703(a)(6) and (7) 3 
 Annotated Code of Maryland 4 
 (2021 Replacement Volume and 2023 Supplement) 5 
 
BY repealing and reenacting, without amendments, 6 
 Article – Health Occupations 7 
Section 8–6A–02(a) and 8–6A–07(a) 8 
 Annotated Code of Maryland 9 
 (2021 Replacement Volume and 2023 Supplement) 10 
 
BY repealing 11 
 Article – Health Occupations 12 
Section 8–703(a)(5) 13 
 Annotated Code of Maryland 14 
 (2021 Replacement Volume and 2023 Supplement) 15 
 
 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16 
That the Laws of Maryland read as follows: 17 
 
Article – Health – General 18 
 
19–1410. 19 
 
 (b) (2) Each nursing home shall establish a quality assurance committee and 20 
shall include at least the following members: 21 
 
 (vi) A [geriatric] CERTIFIED nursing [assistant] ASSISTANT–I. 22 
 
19–1410.2. 23 
 
 (a) In this section, “workplace safety” means the prevention of any physical 24 
assault or threatening behavior against an employee in a nursing home. 25 
 
 (b) This section applies to nursing homes that are licensed for 45 beds or more. 26 
 
 (c) Each nursing home shall assign to an appropriate committee the task of: 27 
 
 (1) Conducting an annual assessment of workplace safety issues; and 28 
 
 (2) Making recommendations to the nursing home for reducing workplace 29 
injuries. 30 
 
 (d) In conducting an annual assessment of workplace safety issues, the committee 31 
assigned to conduct the assessment under subsection (c)(1) of this section shall consult with 32   	SENATE BILL 999 	3 
 
 
[geriatric] CERTIFIED nursing assistants and other employees of the nursing home who 1 
are involved in assisting residents with activities of daily living. 2 
 
24–1901. 3 
 
 (a) In this subtitle the following words have the meanings indicated. 4 
 
 (e) “Nursing support staff” includes: 5 
 
 (1) A certified medication technician, as defined in [§ 8–6A–01(j)] §  6 
8–6A–01 of the Health Occupations Article; 7 
 
 (2) A certified medicine aide, as defined in [§ 8–6A–01(k)] § 8–6A–01 of 8 
the Health Occupations Article; AND 9 
 
 (3) A certified nursing assistant, as defined in [§ 8–6A–01(l)] § 8–6A–01 10 
of the Health Occupations Article[; and 11 
 
 (4) A geriatric nursing assistant, as defined in § 8–6A–01(o) of the Health 12 
Occupations Article].  13 
 
Article – Health Occupations 14 
 
8–6A–01. 15 
 
 (a) In this subtitle the following words have the meanings indicated. 16 
 
 (b) “Applicant” means, unless the context requires otherwise: 17 
 
 (1) An individual applying for an initial certificate by examination or 18 
endorsement; 19 
 
 (2) A certificate holder applying for renewal of a certificate; or 20 
 
 (3) An individual applying for reinstatement of a certificate in accordance 21 
with § 8–6A–10 of this subtitle. 22 
 
 (C) “APPROVED ACUTE CARE N URSING ASSISTANT TRA INING PROGRAM ” 23 
MEANS A COURSE OF TR AINING THAT MEETS TH E ACUTE CARE NURSING ASSISTANT 24 
CURRICULUM APPROVED BY THE BOARD. 25 
 
 [(c)] (D) (1) “Approved dialysis technician training program” means a course 26 
of training approved by the Board that: 27 
 
 (i) Prepares the applicant for national certification; 28 
  4 	SENATE BILL 999  
 
 
 (ii) Meets the requirements of 42 C.F.R. § 494.140(e)(3); and 1 
 
 (iii) Meets the requirements set by the Board in regulation. 2 
 
 (2) “Approved dialysis technician training program” includes the courses 3 
required for national certification as: 4 
 
 (i) A Certified Clinical Hemodialysis Technician by the Nephrology 5 
Nursing Certification Commission; 6 
 
 (ii) A Clinical Nephrology Technician by the National Nephrology 7 
Certification Organization; or 8 
 
 (iii) A Certified Hemodialysis Technician by the Board of Nephrology 9 
Examiners Nursing Technology. 10 
 
 [(d)] (E) “Approved medication technician training program” means a course of 11 
training approved by the Board that meets the basic medication technician core curriculum 12 
and the medication technician content training specific to the setting in which the 13 
medication technician will work. 14 
 
 [(e)] (F) “Approved nursing assistant training program” means a course of 15 
training that [meets]: 16 
 
 (1) MEETS the [basic nursing assistant curriculum prescribed and] 17 
REQUIREMENTS UNDER F EDERAL AND STATE LAW; AND 18 
 
 (2) IS approved by the Board. 19 
 
 [(f)] (G) “Board” means the State Board of Nursing. 20 
 
 [(g)] (H) “Certificate” means a certificate issued by the Board to practice as a 21 
certified nursing assistant, a certified dialysis technician, or a certified medication 22 
technician in the State. 23 
 
 [(h)] (I) “Certificate holder” means a certified nursing assistant, dialysis 24 
technician, or medication technician who has: 25 
 
 (1) An active certificate; 26 
 
 (2) An inactive certificate; 27 
 
 (3) A temporary certificate; 28 
 
 (4) An expired temporary certificate; 29 
   	SENATE BILL 999 	5 
 
 
 (5) An expired certificate; 1 
 
 (6) A lapsed certificate; 2 
 
 (7) A suspended certificate; or 3 
 
 (8) A certificate subject to a reprimand, probation, or suspension. 4 
 
 [(i)] (J) “Certified dialysis technician” means an individual who: 5 
 
 (1) Has completed a Board–approved dialysis technician program; and 6 
 
 (2) Is certified by the Board as a dialysis technician. 7 
 
 [(j)] (K) “Certified medication technician” means an individual who: 8 
 
 (1) Has completed a Board–approved medication technician training 9 
program; 10 
 
 (2) Is certified by the Board as a medication technician; and 11 
 
 (3) Subject to regulations adopted by the Board, routinely performs: 12 
 
 (i) Nursing tasks related to the administration of medication, 13 
delegated by a registered nurse, licensed practical nurse, or advanced practice nurse; or 14 
 
 (ii) Technical tasks related to the administration of medication 15 
delegated by a licensed certified midwife. 16 
 
 [(k)] (L) “Certified medicine aide” means a certified nursing assistant who [has]: 17 
 
 (1) HAS completed a Board –approved course in medication 18 
administration; AND 19 
 
 (2) IS CERTIFIED AS A MED ICINE AIDE BY THE BOARD. 20 
 
 [(l)] (M) (1) “Certified nursing assistant”[: 21 
 
 (1) Means] MEANS an individual regardless of title who, for compensation 22 
and subject to regulations adopted by the Board, routinely performs: 23 
 
 (i) Nursing tasks delegated by a registered nurse, licensed practical 24 
nurse, or advanced practice registered nurse; or 25 
 
 (ii) Technical tasks delegated by a licensed certified midwife[; and]. 26 
  6 	SENATE BILL 999  
 
 
 (2) [Does] “CERTIFIED NURSING ASS ISTANT” DOES not include a 1 
certified dialysis technician or a certified medication technician. 2 
 
 (N) (1) “CERTIFIED NURSING ASS ISTANT–I” MEANS A CERTIFIED 3 
NURSING ASSISTANT WH O MEETS THE REQUIREM ENTS SET BY THE BOARD AND 4 
UNDER FEDERAL LAW TO PRACTICE IN ANY SETT ING.  5 
 
 (2) “CERTIFIED NURSING ASS ISTANT–I” INCLUDES: 6 
 
 (I) A CERTIFIED NURSING AS SISTANT WHO WAS CERT IFIED AS 7 
A GERIATRIC NURSING ASSISTANT ON MAY 31, 2024 SEPTEMBER 30, 2025; 8 
 
 (II) A CERTIFIED MEDICINE A IDE; AND 9 
 
 (III) A CERTIFIED NURSING AS SISTANT WHO IS APPRO VED 10 
UNDER § 8–6A–05(C)(5) OF THIS SUBTITLE. 11 
 
 (O) “CERTIFIED NURSING ASS ISTANT–II” MEANS A CERTIFIED NU RSING 12 
ASSISTANT: 13 
 
 (1) WHO, ON MAY 31, 2024 SEPTEMBER 30, 2025, WAS CERTIFIED AS 14 
A NURSING ASSISTANT AND WAS NOT AUTHORIZ ED TO PRACTICE IN A NURSING 15 
FACILITY OR SKILLED NURSING FACILITY ; AND 16 
 
 (2) WHOSE AUTHORITY TO PR ACTICE IN A NURSING FACILITY OR 17 
SKILLED NURSING FACI LITY CONTINUES TO BE RESTRICTED BECAUSE T HE 18 
CERTIFIED NURSING AS SISTANT HAS NOT BEEN APPROVED AS A CERTIF IED 19 
NURSING ASSISTANT –I UNDER § 8–6A–05(C)(5) OF THIS SUBTITLE. 20 
 
 [(m)] (P) “Department” means the Maryland Department of Health. 21 
 
 [(n)] (Q) “Expired certificate” means a certificate that was not renewed before 22 
the expiration date of the certificate as established under § 8–6A–08(a) of this title. 23 
 
 [(o) “Geriatric nursing assistant” means a certified nursing assistant who has 24 
successfully completed the requirements for geriatric nursing assistant mandated under 25 
federal law and the regulations of the Board.] 26 
 
 [(p)] (R) “Lapsed certificate” means a certificate that was not renewed because 27 
a certificate holder failed to renew the certificate or otherwise did not meet the renewal 28 
requirements of this subtitle. 29 
 
 (S) “NURSING ASSISTANT COM PETENCY EVALUATION ” MEANS AN 30 
EXAMINATION APPROVED BY THE BOARD THAT: 31 
   	SENATE BILL 999 	7 
 
 
 (1) DETERMINES THE COMPET ENCY OF THE INDIVIDUA L TO 1 
PRACTICE AS A CERTIF IED NURSING ASSISTAN T–I; AND 2 
 
 (2) MEETS THE REQUIREMENT S UNDER FEDERAL LAW .  3 
 
8–6A–02. 4 
 
 (a) Subject to subsection (f) of this section and except as otherwise provided in 5 
this subtitle, an individual shall be certified by the Board to practice as a nursing assistant, 6 
dialysis technician, or medication technician before the individual may practice as a 7 
nursing assistant, dialysis technician, or medication technician in the State. 8 
 
 (b) This subtitle does not apply to an individual who: 9 
 
 (1) Practices a health occupation that the individual is authorized to 10 
practice under this article; 11 
 
 (2) Provides for the gratuitous care of friends, domestic partners, or family 12 
members; 13 
 
 (3) Performs nursing assistant tasks while a nursing student enrolled in 14 
an accredited nursing program and practicing under the direct supervision of qualified 15 
faculty or preceptors; 16 
 
 (4) Performs nursing assistant tasks as a student while[: 17 
 
 (i) 1. Enrolled in a Board–approved nursing assistant training 18 
program; and OR 19 
 
 2. ENROLLED IN AN ACUTE CARE NURSING ASSISTA NT 20 
TRAINING PROGRAM ; AND  21 
 
 (ii) Practicing under the direct supervision of qualified faculty or 22 
preceptors] ENROLLED IN AN ACCRE DITED NURSING PROGRAM AFTER THE 23 
SUCCESSFUL COMPLETIO N OF A PORTION OF AN APPROVED NURSING EDU CATION 24 
PROGRAM THAT THE BOARD DETERMINES MEET S THE REQUIREMENTS O F AN 25 
APPROVED NURSING ASS ISTANT TRAINING PROG RAM OR MEDICATION 26 
ADMINISTRATION COURS E;  27 
 
 (5) PERFORMS NURSING ASSISTANT TA SKS AS A STUDENT WHI LE 28 
ENROLLED IN AN ACCRE DITED NURSING PROGRA M AFTER THE SUCCESSF UL 29 
COMPLETION OF THE PO RTION OF THE APPROVE D NURSING EDUCATION PROGRAM 30 
THAT THE BOARD DETERMINES MEET S THE REQUIREMENTS O F AN APPROVED 31 
NURSING ASSISTANT TRAINING PROGRAM OR MEDICATION ADMINISTR ATION 32 
COURSE;  33  8 	SENATE BILL 999  
 
 
 
 (5) (6)  Performs medication technician tasks as a student while 1 
practicing under the direct supervision of qualified faculty; 2 
 
 (6) (7)  Performs dialysis technician tasks as a student while under the 3 
direct supervision of qualified faculty; [or] 4 
 
 (7) (8)  Works as a principal or school secretary, does not administer 5 
medication as a routine part of the position, and has completed training by the delegating 6 
nurse for the occasion where the individual may need to administer medication in the 7 
absence of the nurse or medication technician; OR 8 
 
 (8) (9) PRACTICES AS A CERTIF IED NURSING ASSISTAN T–I FOR 9 
LESS THAN 4 MONTHS IN ACCORDANCE WITH 42 C.F.R. § 483.35(D). 10 
 
 (c) [Nothing in this section shall] THIS SECTION DOES NOT preclude a 11 
registered nurse or licensed practical nurse from delegating a nursing or other technical 12 
task to an unlicensed individual [provided that IF acceptance of delegated nursing or other 13 
technical tasks does not become a routine part of the unlicensed individual’s job duties]. 14 
 
8–6A–05. 15 
 
 (a) The Board, IN COLLABORATION AFTER CONSULTATION WITH RELEVANT 16 
STAKEHOLDERS , shall adopt regulations establishing: 17 
 
 (1) [Categories of certified nursing assistants, including geriatric nursing 18 
assistants, home health aides, school health aides, individuals working in developmental 19 
disabilities administration facilities, and medicine aides; 20 
 
 (2)] Qualifications for [each category of] certified nursing [assistant] 21 
ASSISTANTS, INCLUDING CERTIFIED MEDICINE AIDES ; 22 
 
 [(3)] (2) Qualifications for certified dialysis technicians; 23 
 
 [(4)] (3) Qualifications for certified medication technicians; 24 
 
 [(5)] (4) Standards for qualification of applicants for certification, 25 
including the applicant’s criminal history, work record, and prohibitions against behavior 26 
which may be potentially harmful to patients; and 27 
 
 [(6)] (5) Standards for the online provision of didactic instruction in a 28 
nursing assistant training program that meets the requirements established by the Board. 29 
   	SENATE BILL 999 	9 
 
 
 (b) (1) To qualify for certification as a nursing assistant, a [nursing assistant 1 
in a specific category] CERTIFIED MEDICINE A IDE, a dialysis technician, or a medication 2 
technician, an applicant shall meet the requirements set by the Board. 3 
 
 (2) Requirements set by the Board under paragraph (1) of this subsection 4 
regarding qualifications for certification as a [geriatric nursing assistant] CERTIFIED 5 
NURSING ASSISTANT –I shall include provisions to allow an individual who has been 6 
practicing as a temporary nursing assistant, in accordance with the waiver of the 7 
requirements of 42 C.F.R. § 483.35(d) issued by the Centers for Medicare and Medicaid 8 
Services on March 6, 2020, to apply on–the–job experience as a nursing assistant toward 9 
the total number of training hours required for certification as a [geriatric nursing 10 
assistant] CERTIFIED NURSING AS SISTANT–I. 11 
 
 (c) (1) An applicant for a certificate shall: 12 
 
 (i) Submit an application to the Board on the form that the Board 13 
requires; 14 
 
 (ii) Provide evidence, as required by the Board, of successful 15 
completion of: 16 
 
 1. An approved nursing assistant training program OR 17 
APPROVED ACUTE CARE NURSING ASSISTANT TR AINING PROGRAM ; 18 
 
 2. An approved dialysis technician training program; 19 
 
 3. An approved course in medication administration; or 20 
 
 4. A portion of an approved nursing education program that 21 
the Board determines meets the requirements of [a] AN APPROVED nursing assistant 22 
training program or medication administration course; 23 
 
 (iii) Pay to the Board an application fee set by the Board; 24 
 
 (iv) Be of good moral character; 25 
 
 (v) Be at least 16 years old to apply for certification as a nursing 26 
assistant; 27 
 
 (vi) Be at least 18 years old to apply for certification as a dialysis 28 
technician; and 29 
 
 (vii) Be at least 18 years old to apply for certification as a medication 30 
technician. 31 
  10 	SENATE BILL 999  
 
 
 (2) Subject to paragraph (1) of this subsection, an applicant for certification 1 
as a certified nursing assistant or dialysis technician shall submit to the Board: 2 
 
 (i) A criminal history records check in accordance with § 8–303 of 3 
this title and § 8–6A–08(k) of this subtitle; and 4 
 
 (ii) On the form required by the Board, written, verified evidence 5 
that the requirement of item (i) of this paragraph is being met or has been met. 6 
 
 [(3) An applicant for certification as a certified medicine aide, in addition to 7 
the requirements under paragraph (1) of this subsection, shall submit an additional 8 
application to that effect to the Board on the form that the Board requires.] 9 
 
 (3) (I) AN APPLICANT FOR CERT IFICATION AS A CERTI FIED 10 
NURSING ASSISTANT SH ALL SUBMIT TO THE BOARD SATISFACTORY EV IDENCE OF 11 
PASSING A NURSING AS SISTANT COMPETENCY E VALUATION.  12 
 
 (II) AN APPLICANT WHO HAS COMPLETED AN APPROVE D ACUTE 13 
CARE NURSING ASSISTA NT TRAINING PROGRAM SHALL BE DEEMED TO H AVE 14 
FULFILLED THE CLASSR OOM AND CLINICAL STA NDARDS TO SIT FOR TH E NURSING 15 
ASSISTANT COMPETENCY EVALUATION.  16 
 
 (4) An applicant for a certificate may not: 17 
 
 (i) Have committed any act or omission that would be grounds for 18 
discipline or denial of certification under this subtitle; and 19 
 
 (ii) Have a record of abuse, negligence, misappropriation of a 20 
resident’s property, or any disciplinary action taken or pending in any other state or 21 
territory of the United States against the certification of the nursing assistant or 22 
medication technician in the state or territory. 23 
 
 (5) BEGINNING JUNE 1, 2024 OCTOBER 1, 2025, A CERTIFIED 24 
NURSING ASSISTANT –II MAY BE CERTIFIED AS A CERTIFIED NURSING ASSISTANT–I 25 
BY: 26 
 
 (I) SUBMITTING AN APPLICA TION TO THE BOARD ON THE 27 
FORM THAT THE BOARD REQUIRES ; AND  28 
 
 (II) PROVIDING SATISFACTOR Y EVIDENCE OF: 29 
 
 1. SUCCESSFUL COMPLETION OF AN APPROVED 30 
NURSING ASSISTANT TR AINING PROGRAM ; AND 31 
   	SENATE BILL 999 	11 
 
 
 2. PASSING A NURSING ASS ISTANT COMPETENCY 1 
EVALUATION.  2 
 
8–6A–07. 3 
 
 (a) Subject to subsection (f) of this section, the Board shall certify any applicant 4 
who meets the requirements of this subtitle. 5 
 
 (b) (1) The Board shall: 6 
 
 (i) Issue each new certified nursing assistant, dialysis technician, or 7 
medication technician a certificate number and [registration] certificate that indicates the 8 
initial certificate was issued by the Board; and 9 
 
 (ii) Electronically record each certificate in the Board’s database and 10 
on the Board’s website. 11 
 
 (2) Each certificate AVAILABLE THROUGH TH E BOARD’S WEBSITE shall 12 
include: 13 
 
 (i) Any expiration date;  14 
 
 (ii) The type of certificate; and 15 
 
 (iii) Any specific category of nursing assistant. 16 
 
 (c) An individual who has met the requirements for a certified nursing assistant 17 
ON OR AFTER JUNE 1, 2024 OCTOBER 1, 2025, shall be certified with the title of 18 
“certified nursing [assistant”] ASSISTANT–I”. 19 
 
8–6A–08. 20 
 
 (c) Before a certificate expires, a CERTIFIED nursing assistant periodically may 21 
renew it for an additional term, if the certificate holder: 22 
 
 (1) Otherwise is entitled to be certified; 23 
 
 (2) Submits to the Board a renewal application on the form that the Board 24 
requires; 25 
 
 (3) Pays to the Board a renewal fee set by the Board; and 26 
 
 (4) Provides satisfactory evidence of [completion of]: 27 
  12 	SENATE BILL 999  
 
 
 (i) COMPLETION OF 16 hours of active CERTIFIED nursing 1 
assistant practice within the 2–year period immediately preceding the date of expiration; 2 
or 3 
 
 (ii) If the CERTIFIED nursing assistant did not complete 16 hours of 4 
active practice as required under item (i) of this item, [an approved nursing assistant 5 
training program or an approved nursing assistant refresher training program] as required 6 
in regulations adopted by the Board in accordance with subsection (m) of this section: 7 
 
 1. SUCCESSFUL COMPLETION OF AN APPROVED 8 
NURSING ASSISTANT TR AINING PROGRAM; OR  9 
 
 2. PASSING A NURSING ASS ISTANT COMPETENCY 10 
EVALUATION . 11 
 
 (n) (1) The Board, IN AFTER CONSULTATION WITH RE LEVANT 12 
STAKEHOLDERS , shall adopt regulations to specify[: 13 
 
 (i) The] THE circumstances under which a nursing assistant, as a 14 
condition of renewal, is required to complete [either] an approved nursing assistant 15 
training program or [an approved nursing assistant refresher training program; and 16 
 
 (ii) The number of didactic instruction hours and clinical training 17 
hours the nursing assistant training program or nursing assistant refresher training 18 
program must have to be approved] PASS A NURSING ASSIS TANT COMPETENCY 19 
EXAMINATION . 20 
 
 (2) Regulations adopted under paragraph (1) of this subsection must be 21 
consistent with federal law. 22 
 
8–6A–14. 23 
 
 (a) The Board, in conjunction with the Maryland Higher Education Commission, 24 
shall approve each nursing assistant training program prior to its implementation and 25 
provide periodic survey of all programs in the State. 26 
 
 (b) The Board in conjunction with the Department, Maryland Higher Education 27 
Commission, and the affected industry shall develop regulations for nursing assistant 28 
training programs. 29 
 
 (c) The curriculum content for an approved nursing assistant training program 30 
shall include: 31 
   	SENATE BILL 999 	13 
 
 
 (1) Content [consistent with State licensing requirements in the Health – 1 
General Article and] THAT MEETS all federal requirements SET FORTH IN 42 C.F.R. § 2 
483.152; AND 3 
 
 (2) All basic skills required of a nursing assistant regardless of the setting 4 
of the practice[; and 5 
 
 (3) Any skills required for certification in a specific category]. 6 
 
 (d) Any additional clinical practice skills specific to a setting of practice shall be 7 
taught in that setting as a part of the employment training process in that setting. 8 
 
 (e) The Board may make survey visits from time to time, without prior notice, to 9 
all certified nursing assistant training programs. 10 
 
 [(f) The provisions of this section may not be interpreted to impose additional 11 
requirements for geriatric nursing assistants A CERTIFIED NURSING ASSISTANT–I 12 
beyond those required under federal law. 13 
 
 (g) (1) The Board shall approve the use of a nursing assistant training site by 14 
a nursing assistant training program within 45 days after the nursing assistant training 15 
program applies for approval if the nursing assistant training program had previously been 16 
approved to use the training site by the Board.] 17 
 
 (2) A NURSING ASSISTANT TR AINING PROGRAM UNDER PARAGRAPH 18 
(1) OF THIS SUBSECTION MA Y CONTINUE TO OPERAT E DURING THE APPROVA L 19 
PROCESS.  20 
 
 (F) AN APPROVED ACUTE CAR E NURSING ASSISTANT TRAINING PROGRAM 21 
MAY REQUEST A WAIVER OF THE FEDERAL REQUI REMENT UNDER 42 C.F.R. § 22 
483.152(C)(5) THAT INSTRUCTORS HAV E A MINIMUM OF 1 YEAR OF EXPERIENCE I N 23 
THE PROVISION OF LON G–TERM CARE FACILITY S ERVICES. 24 
 
8–701. 25 
 
 (c) [(1)] Except as otherwise provided in this title, an individual may not 26 
practice, attempt to practice, or offer to practice as a certified nursing assistant unless 27 
certified by the Board as a certified nursing assistant. 28 
 
 [(2) Except as otherwise provided in this title, an individual may not 29 
practice, attempt to practice, or offer to practice as a certified nursing assistant in a specific 30 
category unless certified by the Board as a certified nursing assistant in that category.] 31 
 
8–703. 32 
  14 	SENATE BILL 999  
 
 
 (a) [(5) Unless authorized to provide patient care in a specific category of 1 
certified nursing assistant, an individual may not represent to the public by title, by 2 
description of services, methods, or procedures, or otherwise, that the individual is 3 
authorized to provide care as a certified nursing assistant in a specific category in this 4 
State.] 5 
 
 [(6)] (5) Unless authorized to administer medication as a medication 6 
technician under this title, an individual may not represent to the public by title, by 7 
description of services, methods, or procedures, or otherwise, that the individual is 8 
authorized to administer medication as a certified medication technician in this State. 9 
 
 [(7)] (6) Unless authorized to administer medication as a medicine aide 10 
under this title, an individual may not represent to the public by title, by description of 11 
services, methods, or procedures, or otherwise, that the individual is authorized to 12 
administer medication as a certified medicine aide in this State. 13 
 
 SECTION 2. AND BE IT FURTHER ENACTED, That, on or before October 1, 2024 14 
June 1, 2025, the State Board of Nursing shall: 15 
 
 (1) notify individuals who possess a nursing assistant certification of the 16 
licensing requirements established under Section 1 of this Act; and 17 
 
 (2) in consultation with the Office of Health Care Quality, update 18 
regulations to conform with Section 1 of this Act. 19 
 
 SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 20 
effect June October 1, 2024 2025. 21 
 
 SECTION 4. AND BE IT FURTHER ENACTED, That, except as provided in Section 22 
3 of this Act, this Act shall take effect October 1, 2024.  23 
 
 
 
Approved: 
________________________________________________________________________________  
 Governor. 
________________________________________________________________________________  
         President of the Senate. 
________________________________________________________________________________  
  Speaker of the House of Delegates.