HB-5389, As Passed House, December 19, 2014HB-5389, As Passed Senate, December 19, 2014

SENATE SUBSTITUTE FOR

HOUSE BILL NO. 5389

     A bill to amend 1978 PA 368, entitled

"Public health code,"

(MCL 333.1101 to 333.25211) by adding section 21794.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 21794. (1) With the consent of the patient or the

patient's representative a nursing home may use a dining assistant

to provide feeding assistance to a patient who, based on the charge

nurse's assessment of the patient and the patient's most recent

plan of care, needs assistance or encouragement with eating and

drinking, but does not have complicated feeding problems,

including, but not limited to, difficulty swallowing, recurrent

lung aspirations, tube or parenteral feedings, or behavioral issues

that may compromise nutritional intake. The charge nurse's

assessment and plan of care must be documented in the patient's

medical record. For a patient who is assigned a dining assistant

and experiences an emergent change in condition, the charge nurse

shall perform a special assessment to monitor the appropriateness

of continued utilization of the dining assistant.

     (2) A nursing home that chooses to utilize dining assistants

shall provide individuals with training through a department-

approved training curriculum. The department and the long-term care

stakeholder advisory workgroup designated under section 20155(24)

shall develop a dining assistants training curriculum. The

department shall approve a dining assistants training curriculum

that meets the requirements of this subsection. In order to be

approved by the department, the dining assistants training

curriculum must include, at a minimum, 8 hours of course material

that covers all of the following:

     (a) Dining assistants program overview.

     (b) Patient rights.

     (c) Communication and interpersonal skills.

     (d) Appropriate responses to patient behavior.

     (e) Recognizing changes in patients.

     (f) Infection control.

     (g) Assistance with feeding and hydration.

     (h) Feeding techniques.

     (i) Safety and emergency procedures.

     (j) End of life.

     (3) An individual shall not provide feeding assistance as a

dining assistant in a nursing home unless he or she has

successfully completed a dining assistants training curriculum

described in subsection (2). A nursing home shall not employ or

allow an individual who is less than 17 years of age to provide

feeding assistance as a dining assistant.

     (4) A dining assistant shall work under the supervision of a

nurse. A dining assistant's sole purpose is to provide feeding

assistance to patients, and he or she shall not perform any other

nursing or nursing-related services, such as toileting or

transporting patients. A dining assistant is not nursing personnel

and a nursing home shall not include a dining assistant in

computing the ratio of patients to nursing personnel or use a

dining assistant to supplement or replace nursing personnel. If

approved by the charge nurse and subject to subsection (1), a

dining assistant may provide feeding assistance in a patient's room

if the patient is unable to go to or chooses not to dine in a

designated dining area. A nurse is not required to be physically

present within the patient's room during the feeding, but a nurse

must be immediately available. A dining assistant who is providing

feeding assistance to a patient in his or her room as provided

under this subsection must not be assigned to assist another

patient at the same time.

     (5) Dining assistants are subject to the criminal history

checks required under section 20173a.

     (6) A nursing home that utilizes dining assistants shall

maintain a written record of each individual used as a dining

assistant. The nursing home shall include in the written record, at

a minimum, the complete name and address of the individual, the

date the individual successfully completed the dining assistants

training curriculum, a copy of the written record of the

satisfactory completion of the training curriculum, and

documentation of the criminal history check.

     (7) This section does not prohibit a family member or friend

from providing feeding assistance to a patient within the nursing

home or require a friend or family member to complete the training

program prescribed under subsection (2). However, a nursing home

may offer to provide the dining assistants training curriculum to

family members and friends.

     (8) As used in this section:

     (a) "Dining assistant" means an individual who meets the

requirements of this section and who is only paid to provide

feeding assistance to nursing home patients by the nursing home or

who is used under an arrangement with another agency or

organization.

     (b) "Immediately available" means being capable of responding

to provide help if needed to the dining assistant at any time

either in person or by voice or call light system, radio,

telephone, pager, or other method of communication during a

feeding.

     (c) "Nurse" means an individual licensed as a registered

professional nurse or a licensed practical nurse under article 15

to engage in the practice of nursing.

     (d) "Under the supervision of a nurse" means that a nurse who

is overseeing the work of a dining assistant is physically present

in the nursing home and immediately available.