Two witnesses told the Ohio Joint Committee on Agency Rule Review on Thursday they oppose proposed Ohio Board of Nursing rules that would reduce training hours for medication aides and expand the circumstances in which aides may administer drugs.
The proposed rules, agency staff said, were written to implement changes made by Senate Bill 144 to the Ohio Revised Code, which sets a 30-clock-hour classroom requirement and 16 hours of supervised clinical practice for medication aide programs.
The witnesses said the proposed rules conflict with existing nursing standards and federal guidance and would end safeguards for nursing home residents.
Paul Dosey, a witness (no organizational affiliation provided), told the committee the proposals remove long-standing delegation and training requirements and “contradict” provisions of the Nurse Practice Act that, he said, require a nurse-led process in medication administration. “Under the new proposed rules, an RN must supervise the curriculum, but anyone can teach the class,” Dosey said, arguing that facilities would be allowed to design and test their own programs without Office of Board of Nursing oversight.
Sherry Gunasekara, who identified herself as a licensed nursing home administrator and a master’s-prepared nurse, told the committee the proposals would affect “thousands of nursing home residents across Ohio.” She said Ohio has more than 900 nursing homes and that the proposed changes would allow medication aides to give insulin and schedule II controlled substances in some circumstances and to administer PRN medications without a nurse present. “We are held by really high standards,” Gunasekara said. “Now they have a clear cut right to the fentanyl and all the drugs and they don't have to sit for a standardized training and testing.”
Ayesha Powell, supervising attorney and rule filer for the Ohio Board of Nursing, responded that the board updated its rules to match amendments in the Ohio Revised Code made by Senate Bill 144. “For a medication aide training program to be approved the program include 30 clock hours of instruction in medication administration and 16 hours of supervised clinical practice,” Powell said, citing the statutory language the board relied on in drafting the rules. Powell also cited the statutory provision that permits a medication aide to administer medications prescribed for “as needed” use regardless of whether the supervising nurse is present.
Committee members asked about safety concerns and whether the proposed rules conflict with other administrative rules that require a nurse to train or supervise nursing tasks. Powell said the board revised its rules to be consistent with the statutory changes; she said she could not speak for every board member about safety concerns.
No formal action or vote took place during the meeting on the proposed nursing rules. Committee members accepted testimony and asked the board’s representatives questions; they also reminded agencies to file regulatory reports and set the committee’s next meeting date. The record indicates the committee will continue review consistent with its standard process.
Why this matters: Witnesses said the changes would reduce standardized training and testing, alter supervision and delegation models, and increase safety risks cited in prior state reports and the federal Nursing Home Reform law (OBRA). The board says the rules implement the Legislature’s direction in Senate Bill 144. The committee has not yet made a recommendation or taken regulatory action.
What to watch next: The board may submit additional materials and the committee will consider the proposed rules in future meetings; agencies were reminded of reporting deadlines ahead of the committee's next session.