Legislation addresses patient care ratios in nursing care homes, reinstates CNA reciprocity policy

LANSING, Mich. —  Sen. Hoon-Yung Hopgood (D–Taylor) has introduced Senate Bills 285 and 286, which would address patient care ratios in nursing care homes by increasing patient contact hours, classifying requirements for Certified Nurse Aide (CNA) registration and training, and reinstating the CNA reciprocity policy. 

“These bills will allow for safer and healthier outcomes for the patients who desperately need long-term care assistance, as well as provide a more stable environment for those Certified Nurse Aides who are so needed in delivering those services,” Sen. Hopgood said.

Senate Bill 285 would define “Certified Nurse Aide” in the Public Health Code and would set safe patient care ratios for morning, afternoon and evening shifts for CNAs who work in nursing care homes.

In 2001, the U.S. Department of Health and Human Services released a report that included guidelines about the minimum staffing threshold below which quality of care would be compromised. This report recommended an optimal standard of approximately four hours of nursing care time be provided per patient per day, and found that staffing levels that fell below this minimum would put nursing home residents at risk. 

“Improved staffing ratios will not only help achieve a higher standard of care, but also can be cost-saving for the nursing home as well,” Sen. Hopgood said.

Senate Bill 286 would reinstate the Certified Nurse Aide reciprocity policy, which allowed CNAs from bordering states to work in Michigan under certain circumstances. In order for an out-of-state CNA to practice in Michigan, this bill would require a CNA to pass a nurse aide training program and competency exam approved by the Department of Licensing and Regulatory Affairs (LARA), or be in good standing in the bordering state — as verified through the state’s CNA registry.

SB 286 would also ensure that under both circumstances, the training standards received by CNAs from other states cannot be less than those of Michigan.

“This bill codifies a set of rigorous standards for the state’s CNA program, while also allowing qualified CNAs in neighboring states to work in Michigan,” Sen. Hopgood said. “This will help us address a staffing shortage and ensure patients receive excellent care.”

Under SB 286, CNAs would be authorized to practice in a variety of health care settings. Under federal law, they are restricted to working in long-term care facilities. In Michigan, CNAs are already practicing in hospital and home-based settings, but cannot be as closely regulated by the state due to not meeting the federal definition of a CNA. Updating the statute to reflect current practice will hold all CNAs to the same standard and allow LARA to monitor and investigate issues that arise in any health care setting.

Both bills have been referred to the Senate Health Policy Committee.