HUMAN SERVICES DEPARTMENT
Docket 441—Chapter 81 Iowa Code section(s) or chapter(s) authorizing rulemaking: 249A State or federal law(s) implemented by the rulemaking: Iowa Code chapter 249A and 42 CFR Sections 483.151, 483.152, 483.154, and 483.156 A public hearing at which persons may present their views orally or in writing will be held as follows: September 23, 2026 10 a.m. Any interested person may submit written or oral comments concerning this Regulatory Analysis, which must be received by the Department of Health and Human Services no later than 4:30 p.m. on the date of the public hearing. Comments should be directed to: Victoria L. Daniels Department of Health and Human Services Lucas State Office Building 321 East 12th Street Des Moines, Iowa 50319 Phone: 515.829.6021 Email: compliancerules@hhs.iowa.gov This proposed rulemaking implements federal updates to the Nurse Aid Training and Competency Evaluation Programs (NATCEP) by amending Chapter 81 to update the date certain for internal references to 42 CFR Sections 483.151, 483.152, 483.154, and 483.156. This proposed rulemaking also restores a student-to-teacher ratio to help ensure the quality of clinical instruction provided to nurse aide trainees. The Centers for Medicare and Medicaid Services (CMS) issued a policy clarification memorandum in April 2026, updating training, supervision, and instructor qualifications for NATCEP. Because NATCEP is State‑approved under federal law (42 CFR Part 483, Subpart D), each State must update its own NATCEP regulations and approval processes to align with CMS’s clarified requirements. States are responsible for implementing these changes in their own statutes, rules, and program approvals. Iowa addresses CMS’s NATCEP requirements in Chapter 81 by referencing the applicable federal regulations with a date certain. The current date certain used in Chapter 81 is August 1, 2024. As such, there is a need to update that date certain to ensure that the new federal requirements apply. This proposed rulemaking also reinstates a student-to-teacher ratio of one registered nurse or licensed practical nurse assistant to every 15 students within a clinical training setting. This 1420
Proposed Rule
ia-26-264: Rent Reimbursement
Comment Period Closed
Public comment closed .
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