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A2207 1R FISCAL ESTIMATE
LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
ASSEMBLY, No. 2207
STATE OF NEW JERSEY
222nd LEGISLATURE
DATED: JUNE 30, 2026
SUMMARY
Synopsis:
The "Certified Medication Aide in Nursing Homes
Staffing Support Act;" authorizes certified medication aides to
administer medications to nursing home residents.
Type of Impact:
Potential annual increase in State expenditures and
revenues; potential annual increase in expenditures for county-operated
nursing homes.
Agencies Affected:
Department of Health; Department of Human Services;
county-operated nursing homes.
Office of
Legislative Services Estimate
Fiscal Impact
Annual
State Expenditure Increase
Indeterminate
State Revenue Increase
Indeterminate
Potential Local Expenditure Increase
Indeterminate
�
The Office of Legislative Services (OLS) determines that the
Department of Health may realize an indeterminate increase in annual
expenditures to process applications for certification as a medication aide
submitted by certified personal care assistants and homemaker-home health
aides.
�
Given that the number of certified personal care assistants and
certified homemaker-home health aides who may successfully complete the
training to become a certified medication aide and subsequently apply to the
department for certification as a medication aide is unknown, the OLS lacks the
informational basis to determine how the bill�s provisions would impact the
department�s administrative costs.
�
To the extent that the State�s nursing homes that accept Medicaid
patients are able to fill direct care staff vacancies with certified medication
aides, the facilities� staffing costs will increase, thereby potentially
placing upward pressure on NJ FamilyCare reimbursement rates in future years.� Any
future increase in State Medicaid expenditures will increase State revenues in
the form of federal Medicaid reimbursements.
�
Similarly, to the extent that county-operated nursing homes fill
direct care staff vacancies with certified medication aides, their staffing
costs may increase accordingly.�
BILL DESCRIPTION
����� The bill authorizes medication aides, who are
certified by the Department of Health to administer medications, as delegated
by and under the authority of a registered professional nurse, in State
licensed nursing homes.� Current law and regulations authorize certified
medication aides to practice in assisted living facilities, comprehensive
personal care homes, dementia care homes, and assisted living programs, but not
nursing homes.� The bill also codifies several requirements for certified
medication aides that are established under existing regulations found in the
New Jersey Administrative Code, including provisions requiring that:�
����� 1.� an individual seeking department certification as
a medication aide must first: a) be a nurse aide certified by the department
for employment in a long-term care facility; b) be a homemaker home health aide
certified by the Board of Nursing in the Department of Law and Public Safety�s
Division of Consumer Affairs, who also meets statutory requirements for
employment as a certified nurse aide in a long-term care facility; or, c) be a
personal care assistant certified by the Department of Health;
����� 2.� an individual seeking certification as a
medication aide in a nursing home must successfully complete a Department of
Health-approved training course on medication administration in a long term
care setting, and pass a department-designated standardized exam for personal
care assistants on medication administration;
����� 3.� the department conduct, at its own expense,
criminal history record background checks on applicants for initial and renewal
certification as medication aides, in addition to nurse aides and personal care
assistants; and�
����� 4.� the department establish a registry of certified
medication aides, in addition to the existing registries for department
certified nurse aides and personal care assistants.
FISCAL ANALYSIS
EXECUTIVE BRANCH
����� None received.
OFFICE OF LEGISLATIVE SERVICES
����� The OLS determines that the Department of Health may
realize an indeterminate increase in annual expenditures to process
applications for certification as a medication aide submitted by certified
personal care assistants and homemaker-home health aides.� Existing State law
and regulation precludes NJ FamilyCare reimbursement for personal care
assistant services provided in a nursing home setting.� Under current law, a
certified homemaker-home health aide is authorized to work for a �home care
services agency,� which includes a home health agency, an assisted living
program, a comprehensive personal care home, and an assisted living program,
but not a nursing home.��
����� To the extent that a higher number of the State�s
currently certified personal care assistants and homemaker-home health aides
newly apply to become certified medication aides in order to work in a nursing
home setting, the department�s administrative costs to review and process
applications, and ensure compliance with the provisions of the bill, could
increase by an indeterminate amount.� Given that the number of certified
personal care assistants and certified homemaker-home health aides that may
successfully complete the training to become a certified medication aide and
subsequently apply to the department for certification as a medication aide is
unknown, the OLS lacks the informational basis to determine how the bill�s
provisions may impact the department�s administrative costs.�
����� To the extent that the State�s nursing homes that
accept Medicaid patients are able to fill existing direct care staff vacancies
with certified medication aides, the facilities� staffing costs will increase,
thereby potentially placing upward pressure on NJ FamilyCare reimbursement
rates in future years.� Any future increase in State Medicaid expenditures will
increase State revenues in the form of federal Medicaid reimbursements.
����� Similarly, if county-operated nursing homes respond to
the bill�s provisions by filling direct care staff vacancies with certified
medication aides, their staffing costs may increase accordingly.�
����� According to the May 2024 Occupational Employment and
Wage Statistics (OEWS) Profiles issued by the United States Bureau of Labor
Statistics, the most recent data available, there were 31,310 nursing
assistants employed in the State.� Nationwide, 35 percent of all nursing
assistants were employed in a nursing home.� The OEWS Profile for home health
and personal care aides, which is a combined data category, shows 105,460
homemaker-home health aides and personal care assistants employed in the State
in May 2024.� The vast majority of home health and personal care aides,
nationwide, were employed by individuals and families (52 percent), followed by
home health care agencies (26 percent).� The OEWS Profile does not include data
specifically for medication aides.
Section:
Human Services
Analyst:
Anne Cappabianca
Senior Fiscal Analyst
Approved:
Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the
Office of Legislative Services due to the failure of the Executive Branch to
respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980,
c.67 (C.52:13B-6 et seq.).