Back to Tennessee

SB2427 • 2026

Nurses, Nursing

AN ACT to amend Tennessee Code Annotated, Title 63, Chapter 7, relative to medication aides.

Education Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Crowe, Littleton
Last action
2026-04-15
Official status
Transmitted to Governor for action.
Effective date
Not listed

Plain English Breakdown

The bill summary and text do not provide specific details about fees or training requirements beyond what is mentioned in the candidate explanation.

Medication Aide Certification Changes

This bill changes requirements for medication aide certification in Tennessee to allow nursing students and those with specific healthcare experience to qualify.

What This Bill Does

  • Changes the requirement that applicants pass a standardized exam within two attempts instead of just passing an exam.
  • Allows nursing school students who are doing well and have completed certain courses to get certified as medication aides.
  • Requires training programs for medication aides to ensure classes finish in at least 14 days but no more than 90 days from the start date.

Who It Names or Affects

  • Nursing students
  • Certified nurse aides and licensed occupational therapy assistants with specific experience

Terms To Know

Medication aide certificate
A document that allows someone to legally give medications in healthcare settings.
PACE
Program for All-Inclusive Care for the Elderly, a type of care facility.

Limits and Unknowns

  • The bill does not specify an effective date.
  • It is unclear how many people will be affected by these changes.
  • Details about fees and specific training requirements are left to future rules made by the board.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Amendment 1-0 to HB2351

Plain English: The amendment allows nursing boards to certify medication aides who are certified, licensed, or registered as medication aides in other states if those states have similar certification requirements.

  • Adds a new subsection (o) to Tennessee Code Annotated Section 63-7-127 that permits the board to grant certification to individuals from other states who meet equivalent certification standards.
  • Authorizes the nursing board to create rules for the application process and delegate authority to administrative staff to approve applications under these rules.
  • Permits the board to set an application fee to cover the costs of administering this new subsection.
  • The exact details of how the certification process will be implemented are not specified in the amendment text.
Amendment 1-0 to SB2427

Plain English: The amendment allows the nursing board to certify medication aides who are certified, licensed, or registered as medication aides in other states with similar requirements.

  • Adds a new subsection (o) to Section 63-7-127 of Tennessee Code Annotated that permits the nursing board to grant certification to individuals from other states if they meet certain criteria.
  • Authorizes the nursing board to create rules for the application process and delegate authority to administrative staff to approve applications under these new guidelines.
  • The amendment text does not specify exact fee amounts or procedural details, leaving those aspects open to future rule-making by the nursing board.

Bill History

  1. 2026-04-15 Tennessee General Assembly

    Transmitted to Governor for action.

  2. 2026-04-14 Tennessee General Assembly

    Signed by H. Speaker

  3. 2026-04-09 Tennessee General Assembly

    Signed by Senate Speaker

  4. 2026-04-08 Tennessee General Assembly

    Enrolled and ready for signatures

  5. 2026-04-08 Tennessee General Assembly

    Passed H., Ayes 95, Nays 0, PNV 0

  6. 2026-04-08 Tennessee General Assembly

    Am. withdrawn. (Amendment 1 - HA0748)

  7. 2026-04-08 Tennessee General Assembly

    Subst. for comp. HB.

  8. 2026-04-08 Tennessee General Assembly

    Sponsor(s) Added.

  9. 2026-04-08 Tennessee General Assembly

    Comp. SB subst.

  10. 2026-04-06 Tennessee General Assembly

    Rcvd. from S., held on H. desk.

  11. 2026-04-02 Tennessee General Assembly

    Engrossed; ready for transmission to House

  12. 2026-04-02 Tennessee General Assembly

    Passed Senate as amended, Ayes 31, Nays 0

  13. 2026-04-02 Tennessee General Assembly

    Senate adopted Amendment (Amendment 1 - SA0726)

  14. 2026-04-02 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/8/2026

  15. 2026-04-01 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/2/2026

  16. 2026-03-31 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/2/2026

  17. 2026-03-23 Tennessee General Assembly

    Rec. for pass. if am., ref. to Calendar & Rules Committee

  18. 2026-03-18 Tennessee General Assembly

    Placed on cal. Government Operations Committee for 3/23/2026

  19. 2026-03-17 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0

  20. 2026-03-17 Tennessee General Assembly

    Rec. for pass; ref to Government Operations Committee

  21. 2026-03-11 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/17/2026

  22. 2026-03-11 Tennessee General Assembly

    Action deferred in Senate Health and Welfare Committee to 3/18/2026

  23. 2026-03-11 Tennessee General Assembly

    Placed on cal. Health Committee for 3/17/2026

  24. 2026-03-10 Tennessee General Assembly

    No Action Taken

  25. 2026-03-04 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/11/2026

  26. 2026-03-04 Tennessee General Assembly

    Action deferred in Senate Health and Welfare Committee to 3/11/2026

  27. 2026-03-04 Tennessee General Assembly

    Placed on cal. Health Committee for 3/10/2026

  28. 2026-03-04 Tennessee General Assembly

    Rec. for pass by s/c ref. to Health Committee

  29. 2026-02-25 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/4/2026

  30. 2026-02-25 Tennessee General Assembly

    Placed on s/c cal Health Subcommittee for 3/4/2026

  31. 2026-02-05 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Health and Welfare Committee

  32. 2026-02-05 Tennessee General Assembly

    Assigned to s/c Health Subcommittee

  33. 2026-02-05 Tennessee General Assembly

    P2C, ref. to Health Committee - Government Operations for Review

  34. 2026-02-04 Tennessee General Assembly

    Intro., P1C.

  35. 2026-02-02 Tennessee General Assembly

    Introduced, Passed on First Consideration

  36. 2026-02-02 Tennessee General Assembly

    Filed for introduction

  37. 2026-02-02 Tennessee General Assembly

    Filed for introduction

Official Summary Text

In order to be eligible to receive a medication aide certificate from the board of nursing ("board"), present law requires an applicant to meet certain criteria. One such criteria is to have passed a standardized examination. This bill revises that spe
cific criteria to, instead, be that the applicant have a standardized knowledge and skill examination within a maximum of two attempts. Further, this bill requires the applicant to meet at least one of the following requirements:



Have practiced as a certified nurse aide for at least one year in a nursing home, assisted-care living facility, or a program for all-inclusive care for the elderly (PACE).


Have practiced as a licensed occupational therapy assistant for at least one year in a nursing home, assisted-care living facility, or a PACE.


Be a student in good standing enrolled in an approved school of nursing, as defined by the board of nursing.

Additionally, this bill also requires the board to issue a medication aide certificate to an applicant meeting the following alternative criteria for nursing school students:



The applicant is a student in good standing enrolled in an approved school of nursing, as defined by the board of nursing.


Has completed courses providing education regarding the basic nursing fundamentals and foundations, basic pharmacology, and medication administration portions of the nursing program with a sufficient passing grade.

MEDICATION AIDE TRAINING PROGRAMS

Present law requires a qualified entity seeking approval to provide a medication aide training program to apply to the board of nursing on a form prescribed and provided by the board, along with the applicable fee established by the board. The board mus
t approve the applicant if the applicant is a qualified entity, or a combination of qualified entities, and if the content of the course of instruction to be provided by the program meets the standards, specified by the board, and includes:



At least 60 hours of instruction, consisting of 40 classroom hours and 20 clinical hours. The board is to determine the standard minimum curriculum, which must include appropriate instruction to enable communication, attention to safety, knowledge of medications, and other factors as determined necessary by the board; and be completed either in person or through distance learning.


A supervised clinical practice component that includes an approved medication aide training program sufficient to assure that students are prepared to administer medications as a medication aide in a safe and effective manner and that (i) consists of 20 hours, including experience in tasks related to the administration of medication, and that is conducted under the direction and supervision of a licensed nurse; (ii) requires any licensed nursing home, assisted care living facility, or PACE participating in the training program to have a written agreement to provide licensed nurse supervision of the student; and (iii) requires supervision of a student engaged in medication administration by a licensed nurse.

This bill adds that the program must include arrangements to ensure a class of students completes the program in a minimum of 14 days but a maximum of 90 days from the start date of the class.

RULEMAKING GUIDELINES

Present law requires the board to adopt rules to implement present law provisions relative to medication aides. These rules must take effect no later than January 1, 2017, and must, at a minimum, establish or specify the following:



Fees, in an amount sufficient to cover the costs the board incurs in implementing the rules.


Procedures for renewal of medication aide certificates.


Grounds for discipline of applicants or certificate holders, or both.


Standards for approval of peer support programs for the holders of medication aide certificates.


Procedures for approval or denial of medication aide training programs.

This bill requires any rules adopted regarding the evaluation of a program's overall test taker examination pass rate must base the calculation on the number of students who successfully pass the standardized knowledge and skill examination within two at
tempts regardless of whether a candidate passes on the candidate's first or second attempt.

This bill authorizes the board, at its discretion, to grant certification to a person as a medication aide if:



The person is certified, licensed, or registered and in good standing in another state as a medication aide, or an equivalent title.


The requirements for approval in such other state are as stringent as required by this bill.

This bill authorizes the board to adopt rules regarding the administrative process for an individual to obtain certification as a medication aide. Such rules may delegate to administrative staff of the board of nursing the authority to approve an applic
ation from a person meeting the requirements of this bill.

ON APRIL 2, 2026, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2427, AS AMENDED.

AMENDMENT #1 authorizes the board to establish by rule and collect an application fee in an amount sufficient to cover the cost of administrating the provisions of the bill regarding licenses from other states.

Current Bill Text

Read the full stored bill text
HOUSE BILL 2351
By Littleton

SENATE BILL 2427
By Crowe
SB2427
012056
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 63,
Chapter 7, relative to medication aides.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 63-7-127(e), is amended by deleting
the subsection and substituting:
(e) To be eligible to receive a medication aide certificate, an applicant must:
(1) Be at least eighteen (18) years of age;
(2) Have completed the twelfth grade or its equivalent, or have
successfully passed the test for and received a high school equivalency
credential approved by the state board of education;
(3) Have successfully completed a course of instruction provided by a
training program approved by the board under subsection (i);
(4) Have passed a standardized knowledge and skill examination within
a maximum of two (2) attempts; and
(5) Meet one (1) of the following criteria:
(A) Have practiced as a certified nurse aide for at least one (1)
year in a nursing home, assisted-care living facility, or a program for all-
inclusive care for the elderly (PACE), as defined in § 56-2-121(b);
(B) Have practiced as a licensed occupational therapy assistant
for at least one (1) year in a nursing home, assisted-care living facility, or
a PACE, as defined in § 56-2-121(b); or
(C) Be a student in good standing enrolled in an approved school
of nursing, as defined by the board of nursing.

- 2 - 012056

SECTION 2. Tennessee Code Annotated, Section 63-7-127, is amended by deleting
subsection (f) and substituting:
(f)
(1) If an applicant meets the requirements of subsection (e), then the
board shall issue a medication aide certificate to the applicant.
(2) Notwithstanding subsection (e), the board shall issue a medication
aide certificate to an applicant meeting the following alternative criteria for
nursing school students:
(A) The applicant is a student in good standing enrolled in an
approved school of nursing, as defined by the board of nursing; and
(B) Has completed courses providing education regarding the
basic nursing fundamentals and foundations, basic pharmacology, and
medication administration portions of the nursing program with a sufficient
passing grade.
SECTION 3. Tennessee Code Annotated, Section 63-7-127(i)(2), is amended by adding
the following as a new subdivision:
(C) Arrangements to ensure a class of students completes the program in a
minimum of fourteen (14) days but a maximum of ninety (90) days from the start date of
the class.
SECTION 4. Tennessee Code Annotated, Section 63-7-127(l), is amended by adding
the following as a new subdivision:
(3) Any rules adopted regarding the evaluation of a program's overall test taker
examination pass rate must base the calculation on the number of students who
successfully pass the standardized knowledge and skill examination within two (2)

- 3 - 012056

attempts regardless of whether a candidate passes on the candidate's first or second
attempt.
SECTION 5. Tennessee Code Annotated, Section 63-7-127, is amended by adding the
following as a new subsection:
(o)
(1) The board, at its discretion, may grant certification to a person as a
medication aide if:
(A) The person is certified, licensed, or registered and in good
standing in another state as a medication aide, or an equivalent title; and
(B) The requirements for approval in such other state are as
stringent as required by this section.
(2) The board is authorized to adopt rules regarding the administrative
process for an individual to obtain certification as a medication aide pursuant to
this subsection (o). Such rules may delegate to administrative staff of the board
of nursing the authority to approve an application from a person meeting the
requirements of this subsection (o). The rules must be promulgated in
accordance with the Uniform Administrative Procedures Act, compiled in title 4,
chapter 5.
SECTION 6. For the purposes of promulgating rules, this act takes effect upon
becoming a law, the public welfare requiring it. For all other purposes, this act takes effect July
1, 2026, the public welfare requiring it.