Certified Nursing Assistant or a Licensed Nursing Assistant…what do I do?

At the beginning of 2016, the Arizona State Board of Nursing made a decision to create two positions out of one for individuals desiring to become a Nursing Assistant. For decades, the position of a Certified Nursing Assistant has been the common recognition to describe the first level of professional licensure by the Board of Nursing. Why would the State Board want to make this change? The Board has been very transparent that the administrative and legal requirement to maintain the CNA Registry has been very expensive. Federal law requires that the registry requirements for CNAs should be free of any type of fees. This law, in effect, prevented the Board from recovering the associated costs to both manage and maintain the registry. Their solution was to create a legislative bill, send it to the State Legislature requesting that a new position be created called a Licensed Nursing Assistant. The bill still retains the Certified Nursing Assistant position but allows for fees to be attached to the LNA candidate both from an original submission for licensure as well as renewal of the LNA licensure. The bill was passed and has gone into State Law effective with applications received by the Board on July 1, 2016 and beyond. So what does this all mean for students desiring to become a CNA or, now, an LNA?

What is an LNA?

First and foremost, the LNA designation is not new. Other states use the same designation. For example, New Hampshire uses the LNA license designation. To receive an LNA license from the state of New Hampshire, one must apply for the license from the NH Board of Nursing, which charges $35. The NH Board requires a copy of the Graduation Certificate and grade results from the competency testing after the course is completed. The NH Board of Nursing then requires a criminal background check that is done through the Division of State Police, with a $55.25 fee. So, how will Arizona differ from New Hampshire?

What is the difference between CNA and LNA?

In Arizona, both the CNA and LNA candidate will take the same course and sit for the same State Board of Nursing Competency Exam. Upon passing the Board Exam, the successful candidate will be automatically entered into the CNA Registry and can begin working as a CNA almost immediately. That is pretty good, right? With the new LNA designation you now must make a decision. Do I want to remain a CNA? Or, do I want to become an LNA? Remaining as a CNA costs nothing. On renewing the CNA status after two (2) years and on your birthday also costs nothing plus you only need to indicate that you have worked 8 hours in the last two years doing CNA type duties. On the other hand, becoming an LNA will require a $50.00 application fee plus a $50.00 finger print background check fee administered by the Board. At present, if you decide to become an LNA, you must personally go to the Board (at this time there is nothing concrete that provides either an online, downloadable application that has been made available), complete an application, pay the $100.00 fee and then provide a completed fingerprint card (AMTI will roll our student’s fingerprints for free) and after 6 weeks (on average) with a positive result from the background check, you will be given an LNA license number that will be updated in the Registry. You are now an LNA! Upon renewing the license after two years and on your birthday, the Board will require a $50.00 fee plus proof that you have worked 160 hours doing LNA (same as CNA) type duties in the last 2 years. The Board’s original problem is solved.
Which should I choose, CNA or LNA?

So, in the new, post July 1, 2016 environment, you now will have a decision to make. Which one do I choose because they both sound the same, other than the name. After all, a CNA is a “person registered on the registry of nursing assistants to provide or assist in delivery of nursing related services under the supervision and direction of a licensed nurse.” While an LNA is the same verbiage other than you replace the word “registered” with the word “licensed”. You both will do the same thing. So are there any differences other than what was indicated as noted above? And the answer to that is yes. As a CNA, the Board will have limited oversight for you. Specifically on practice issues relating to Patient/Resident abuse, neglect or theft of property from a resident, the Board will get involved and will transition the issue to a State Agency for handling. For the LNA, not only the aforementioned issues will be handled by the Board but also any other issue that would come under Board authority would be investigated and adjudicated by the Board. To my understanding, that is it.
Are there other things to consider in making this decision, for example, will I achieve a hiring preference if I am an LNA versus a CNA? Will I get more per hour as an LNA versus a CNA? If I want to get into an LPN/RN program that previously required a CNA, will they now require an LNA? The Board does not know the answers to these questions and frankly, only the employers/nursing programs will know those answers when you go to apply. Will they feel better about your candidacy if they know that you have been background checked by the Board and come under their full oversight? Too soon to tell. However, the only thing that I do know is that all CNAs of record as of July 1 will be given an opportunity to remain a CNA or to elect to become an LNA at no cost. So, there are over 28,000 CNAs in Arizona. That could be a lot of new LNAs that employers have to respond to, if many decide to become an LNA. So, that could factor into your decision to remain a CNA or pay the fees to become an LNA. If you can’t make that decision today, you can always do it later by completing the LNA application, paying the fees, submitting a fingerprint card, waiting the 6 weeks and hopefully achieving your LNA license. AMTI will roll your fingerprints when you have made the decision to become an LNA.

How can I learn more about becoming an LNA?

Change is inevitable. As time goes on, answers to these questions will be more apparent. Please know that AMTI will always be here to provide as much information as we can and to assist you in any way to help you accomplish your registry or licensure process. Take a few moments to look at the FAQs that follow. Many of these questions have been raised by your fellow students. Whether you are a CNA or an LNA, the nursing team at AMTI will prepare you to provide the very best care because at the end of the day to the patient and their families, that is what truly matters.

FAQs from AMTI Students – LNA vs. CNA

  1. If I decide to become an LNA, since it is a “license”, will I need malpractice insurance? The LNA license is identical to the current CNA certificate except a fee is paid—therefore insurance decisions should not change.
  2. If I move to another state, is the process to transfer my Arizona LNA license the same? Persons with the LNA license would be eligible to receive any nursing assistant basic credential another state offers (each state has its own regulatory scheme—only a few states grant nursing assistant licenses). LNA as such, is only recognized in AZ.
  3. Will employers prefer an applicant is an LNA or a CNA? It is too soon to tell. Most employers are still in the process of learning about the LNA designation. Once the Board converts the 28,000 existing CNAs (their choice to remain a CNA or convert to an LNA), employer awareness and preference could change.
  4. If I submit my application to the Board prior to July 1, 2016, will I be grandfathered as an LNA? AMTI does not know this answer with certainty; however, our belief is that you will be given a choice to become an LNA. The Board’s policy is to offer all CNAs of record on July 1 the option of becoming an LNA at no charge. There is no guarantee that this will avoid the fee; but, to reduce the possibility…physically make sure the Board has your CNA application prior to July 1. Do not trust the postmark date. Individuals that submit their application on or after July 1, to become an LNA will need to complete the LNA application and pay the $100.00 in fees.

For additional questions, refer to the Arizona Board of Nursing FAQs.

Video: CNA and LNA – A New Regulatory Framework – Arizona State Board of Nursing