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S.B. 51

             1     

NURSE PRACTICE ACT AMENDMENTS

             2     
2002 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Sponsor: Paula F. Julander

             5      This act amends provisions related to occupations and professions. The act repeals the
             6      Health Care Assistant Registration Act. The act incorporates the Health Care Assistant
             7      Registration Act into the Nurse Practice Act. The act adds definitions to the Nurse Practice
             8      Act. The act amends the membership of the Board of Nursing. The act amends license
             9      classifications. The act amends license qualifications and requires all licensees or registered
             10      individuals under the Nurse Practice Act to submit to criminal background checks. The act
             11      provides for limited exemptions from registration for health care assistants. The act amends
             12      provisions related to grounds for denial of a license or registration, unlawful conduct, and
             13      disciplinary actions to incorporate health care assistants. The act makes technical
             14      amendments.
             15      This act affects sections of Utah Code Annotated 1953 as follows:
             16      AMENDS:
             17          58-31b-102, as enacted by Chapter 288, Laws of Utah 1998
             18          58-31b-201, as last amended by Chapter 314, Laws of Utah 2000
             19          58-31b-202, as enacted by Chapter 288, Laws of Utah 1998
             20          58-31b-301, as enacted by Chapter 288, Laws of Utah 1998
             21          58-31b-302, as last amended by Chapter 314, Laws of Utah 2000
             22          58-31b-308, as enacted by Chapters 189 and 288, Laws of Utah 1998
             23          58-31b-401, as last amended by Chapter 314, Laws of Utah 2000
             24          58-31b-402, as enacted by Chapter 288, Laws of Utah 1998
             25          58-31b-501, as enacted by Chapter 288, Laws of Utah 1998
             26          58-31b-503, as enacted by Chapter 288, Laws of Utah 1998
             27          58-31b-702, as enacted by Chapter 288, Laws of Utah 1998


             28          58-31b-701, as enacted by Chapter 288, Laws of Utah 1998
             29      ENACTS:
             30          58-31b-308.5, Utah Code Annotated 1953
             31      REPEALS:
             32          58-62-101, as enacted by Chapter 289, Laws of Utah 1994
             33          58-62-102, as last amended by Chapters 30 and 169, Laws of Utah 1998
             34          58-62-201, as last amended by Chapters 30 and 169, Laws of Utah 1998
             35          58-62-301, as enacted by Chapter 289, Laws of Utah 1994
             36          58-62-302, as enacted by Chapter 289, Laws of Utah 1994
             37          58-62-303, as enacted by Chapter 289, Laws of Utah 1994
             38          58-62-304, as last amended by Chapter 196, Laws of Utah 1997
             39          58-62-305, as enacted by Chapter 289, Laws of Utah 1994
             40          58-62-401, as enacted by Chapter 289, Laws of Utah 1994
             41          58-62-501, as enacted by Chapter 289, Laws of Utah 1994
             42          58-62-601, as enacted by Chapter 289, Laws of Utah 1994
             43          58-62-602, as enacted by Chapter 289, Laws of Utah 1994
             44          58-62-603, as enacted by Chapter 289, Laws of Utah 1994
             45      Be it enacted by the Legislature of the state of Utah:
             46          Section 1. Section 58-31b-102 is amended to read:
             47           58-31b-102. Definitions.
             48          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             49          (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
             50      omissions determined to constitute unprofessional or unlawful conduct in accordance with a fine
             51      schedule established by rule and as a result of an adjudicative proceeding conducted in accordance
             52      with Title 63, Chapter 46b, Administrative Procedures Act.
             53          (2) "Applicant" means a person who applies for licensure or registration under this chapter
             54      by submitting a completed application for licensure or registration and the required fees to the
             55      department.
             56          (3) "Approved education program" means a nursing education program that meets the
             57      minimum standards for educational programs established under this chapter and by division rule
             58      in collaboration with the board.


             59          (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
             60          (5) "Consultation and referral plan" means a written plan jointly developed by an advanced
             61      practice registered nurse and a consulting physician that permits the advanced practice registered
             62      nurse to prescribe schedule II-III controlled substances in consultation with the consulting
             63      physician.
             64          (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
             65      surgeon licensed in accordance with this title who has agreed to consult with an advanced practice
             66      registered nurse with a controlled substance license, a DEA registration number, and who will be
             67      prescribing schedule II-III controlled substances.
             68          (7) "Diagnosis" means the identification of and discrimination between physical and
             69      psychosocial signs and symptoms essential to the effective execution and management of health
             70      care.
             71          (8) "Examinee" means a person who applies to take or does take any examination required
             72      under this chapter for licensure.
             73          (9) "Health care assistant" means an individual who:
             74          (a) engages in the practice of a health care assistant; and
             75          (b) is subject to registration under this chapter and is not subject to registration, licensure,
             76      or certification under any other chapter of this title.
             77          [(9)] (10) "Licensee" means a person who is licensed or registered under this chapter.
             78          (11) "Practice as a health care assistant" means providing direct personal assistance or care
             79      for compensation to an individual who is ill, injured, infirm, developmentally or physically
             80      disabled, mentally disabled, or mentally retarded, and who is in a private residence or regulated
             81      facility.
             82          [(10)] (12) "Practice of nursing" means assisting individuals or groups to maintain or attain
             83      optimal health, implementing a strategy of care to accomplish defined goals and evaluating
             84      responses to care and treatment. The practice of nursing requires substantial specialized or general
             85      knowledge, judgment, and skill based upon principles of the biological, physical, behavioral, and
             86      social sciences, and includes:
             87          (a) initiating and maintaining comfort measures;
             88          (b) promoting and supporting human functions and responses;
             89          (c) establishing an environment conducive to well-being;


             90          (d) providing health counseling and teaching;
             91          (e) collaborating with health care professionals on aspects of the health care regimen;
             92          (f) performing delegated procedures only within the education, knowledge, judgment, and
             93      skill of the licensee; and
             94          (g) delegating nurse interventions that may be performed by others and are not in conflict
             95      with this chapter.
             96          [(11)] (13) (a) "Practice of nurse anesthesia" means the practice of nursing related to the
             97      provision of preoperative, intraoperative, and postoperative anesthesia care and related services
             98      upon the request of a physician, surgeon, or other licensed professional, who is acting within the
             99      scope of their practice, by a person licensed under this chapter as a certified registered nurse
             100      anesthetist and includes:
             101          (i) preanesthesia preparation and evaluation including:
             102          (A) performing a preanesthetic assessment of the patient;
             103          (B) ordering and evaluating appropriate lab and other studies to determine the health of
             104      the patient; and
             105          (C) selecting, ordering, or administering appropriate medications;
             106          (ii) anesthesia induction, maintenance, and emergence, including:
             107          (A) selecting and initiating the planned anesthetic technique;
             108          (B) selecting and administering anesthetics and adjunct drugs and fluids; and
             109          (C) administering general, regional, and local anesthesia;
             110          (iii) postanesthesia follow-up care, including:
             111          (A) evaluating the patient's response to anesthesia and implementing corrective actions;
             112      and
             113          (B) selecting, ordering, or administering the above medications and studies; and
             114          (iv) other related services within the scope of practice of a certified registered nurse
             115      anesthetist, including:
             116          (A) emergency airway management;
             117          (B) advanced cardiac life support; and
             118          (C) the establishment of peripheral, central, and arterial invasive lines.
             119          (b) Nothing in this section shall be construed as to require a certified registered nurse
             120      anesthetist to obtain an advance practice registered nurse license in order to select, administer, or


             121      provide preoperative, intraoperative, or postoperative anesthesia care and services.
             122          [(12)] (14) "Practice of practical nursing" means the performance of nursing acts in the
             123      generally recognized scope of practice of licensed practical nurses as defined by rule and as
             124      provided in this Subsection [(12)] (14) by a person licensed under this chapter as a licensed
             125      practical nurse and under the direction of a registered nurse, licensed physician, or other specified
             126      health care professional as defined by rule. Practical nursing acts include:
             127          (a) contributing to the assessment of the health status of individuals and groups;
             128          (b) participating in the development and modification of the strategy of care;
             129          (c) implementing appropriate aspects of the strategy of care;
             130          (d) maintaining safe and effective nursing care rendered to a patient directly or indirectly;
             131      and
             132          (e) participating in the evaluation of responses to interventions.
             133          [(13)] (15) "Practice of registered nursing" means performing acts of nursing as provided
             134      in this Subsection [(13)] (15) by a person licensed under this chapter as a registered nurse within
             135      the generally recognized scope of practice of registered nurses as defined by rule. Registered
             136      nursing acts include:
             137          (a) assessing the health status of individuals and groups;
             138          (b) identifying health care needs;
             139          (c) establishing goals to meet identified health care needs;
             140          (d) planning a strategy of care;
             141          (e) prescribing nursing interventions to implement the strategy of care;
             142          (f) implementing the strategy of care;
             143          (g) maintaining safe and effective nursing care that is rendered to a patient directly or
             144      indirectly;
             145          (h) evaluating responses to interventions;
             146          (i) teaching the theory and practice of nursing; and
             147          (j) managing and supervising the practice of nursing.
             148          [(14)] (16) "Practice of advanced practice registered nursing" means the practice of nursing
             149      within the generally recognized scope and standards of advanced practice registered nursing as
             150      defined by rule and consistent with professionally recognized preparation and education standards
             151      of an advanced practice registered nurse by a person licensed under this chapter as an advanced


             152      practice registered nurse. Advanced practice registered nursing includes:
             153          (a) maintenance and promotion of health and prevention of disease;
             154          (b) diagnosis, treatment, correction, consultation, and referral for common health
             155      problems; and
             156          (c) prescription or administration of prescription drugs or devices including:
             157          (i) local anesthesia;
             158          (ii) schedule IV-V controlled substances; and
             159          (iii) schedule II-III controlled substances in accordance with a consultation and referral
             160      plan.
             161          (17) "Regulated facility" means a health care facility subject to licensure under Title 26,
             162      Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:
             163          (a) the Utah State Hospital or the Utah State Developmental Center;
             164          (b) a residential treatment or residential support facility:
             165          (i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and Facilities;
             166      and
             167          (ii) serving people with disabilities, as defined by Department of Human Services rules;
             168      or
             169          (c) a covered health care facility as defined in Section 26-21-9.5 .
             170          [(15)] (18) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501 .
             171          [(16)] (19) "Unlicensed assistive personnel" means any unlicensed person, regardless of
             172      title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance with
             173      the standards of the profession.
             174          [(17)] (20) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-31b-502
             175      and as may be further defined by rule.
             176          Section 2. Section 58-31b-201 is amended to read:
             177           58-31b-201. Board.
             178          (1) There is created the Board of Nursing that consists of the following [nine] eleven
             179      members:
             180          (a) [seven] eight nurses in a manner as may be further defined in division rule; [and]
             181          (b) one registered health care assistant; and
             182          [(b)] (c) two members of the public.


             183          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             184          (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
             185      58-1-203 and shall:
             186          (a) (i) recommend to the division minimum standards for educational programs qualifying
             187      a person for licensure under this chapter;
             188          (ii) recommend to the division denial, approval, or withdrawal of approval regarding
             189      educational programs that meet or fail to meet the established minimum standards; and
             190          (iii) designate one of its members on a permanent or rotating basis to:
             191          (A) assist the division in reviewing complaints concerning the unlawful or unprofessional
             192      conduct of a licensee; and
             193          (B) advise the division in its investigation of these complaints.
             194          (b) A board member who has, under Subsection (3)(a)(iii), reviewed a complaint or
             195      advised in its investigation may be disqualified from participating with the board when the board
             196      serves as a presiding officer in an adjudicative proceeding concerning the complaint.
             197          (4) (a) The director shall appoint an individual to serve as the executive administrator of
             198      the Board of Nursing. Except when the board serves as a presiding officer in an adjudicative
             199      procedure, the executive administrator shall serve as an ex officio member of the board and shall
             200      represent the position of the division in matters considered by the board.
             201          (b) The executive administrator shall be a licensed registered nurse, shall have earned a
             202      masters degree in nursing, and shall have a minimum of five years of experience working in
             203      nursing administration or nursing education.
             204          Section 3. Section 58-31b-202 is amended to read:
             205           58-31b-202. Prescriptive Practice Peer Committee.
             206          (1) (a) There is created under Subsection 58-1-203 (6) the Prescriptive Practice Peer
             207      Committee.
             208          (b) The Prescriptive Practice Peer Committee shall:
             209          (i) advise the board of nursing regarding prescriptive practice issues;
             210          (ii) periodically audit and review the prescribing records of advanced practice registered
             211      nurses located on the Controlled Substance Data Bank on a schedule established by rule;
             212          (iii) recommend the scope of prescriptive practice authority of advanced practice registered
             213      nurses consistent with this chapter and with professionally accepted therapies and treatments;


             214          (iv) periodically review the current consultation and referral plans prepared in accordance
             215      with Subsection 58-31b-102 [(14)](16)(c)(iii) and evaluate compliance with the proposed plans;
             216      and
             217          (v) recommend disciplinary action.
             218          (c) The composition of this committee shall be:
             219          (i) two individuals who are licensed as advanced practice registered nurses who prescribe
             220      within their practice and possess a controlled substance license;
             221          (ii) two individuals licensed as physicians and surgeons or osteopathic physicians and
             222      surgeons; and
             223          (iii) one individual who is a pharmacologist.
             224          (2) The division, in collaboration with the board, may create other peer committees to the
             225      Board of Nursing pursuant to Subsection 58-1-203 (6) to make recommendations to the board
             226      regarding licensure, practice, and education issues.
             227          Section 4. Section 58-31b-301 is amended to read:
             228           58-31b-301. License or registration required - Classifications.
             229          (1) A license is required to engage in the practice of nursing, except as specifically
             230      provided in Sections 58-1-307 and 58-31b-308 .
             231          (2) The division shall issue to a person who qualifies under this chapter a license in the
             232      classification of:
             233          (a) licensed practical nurse;
             234          (b) registered nurse;
             235          (c) advanced practice registered nurse intern;
             236          (d) advanced practice registered nurse; and
             237          (e) certified registered nurse anesthetist.
             238          (3) An individual holding an advanced practice registered nurse license as of July 1, 1998,
             239      who cannot document the successful completion of advanced course work in patient assessment,
             240      diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be issued an
             241      "APRN - without prescriptive practice" license.
             242          (4) The division shall grant an advanced practice registered nurse license to any licensed
             243      advanced practice registered nurse currently holding prescriptive authority under any predecessor
             244      act on July 1, 1998.


             245          (5) (a) An individual shall be registered under this chapter in order to engage in practice
             246      as a health care assistant, except as provided in Sections 58-31b-308 and 58-31b-308.5 .
             247          (b) The division shall issue to a person who qualifies under this chapter a registration in
             248      the classification of health care assistant.
             249          Section 5. Section 58-31b-302 is amended to read:
             250           58-31b-302. Qualifications for licensure.
             251          (1) An applicant for licensure as a licensed practical nurse shall:
             252          (a) submit to the division an application in a form prescribed by the division;
             253          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             254          (c) have a high school diploma or its equivalent;
             255          (d) be in a condition of physical and mental health that will permit the applicant to practice
             256      safely as a licensed practical nurse;
             257          (e) have completed an approved practical nursing education program or an equivalent as
             258      determined by the board;
             259          (f) have passed the examinations as required by division rule made in collaboration with
             260      the board; and
             261          (g) meet with the board, if requested, to determine the applicant's qualifications for
             262      licensure.
             263          (2) An applicant for licensure as a registered nurse shall:
             264          (a) submit to the division an application form prescribed by the division;
             265          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             266          (c) have a high school diploma or its equivalent;
             267          (d) be in a condition of physical and mental health that will allow the applicant to practice
             268      safely as a registered nurse;
             269          (e) have completed an approved registered nursing education program;
             270          (f) have passed the examinations as required by division rule made in collaboration with
             271      the board; and
             272          (g) meet with the board, if requested, to determine the applicant's qualifications for
             273      licensure.
             274          (3) Applicants for licensure as an advanced practice registered nurse shall:
             275          (a) submit to the division an application on a form prescribed by the division;


             276          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             277          (c) be in a condition of physical and mental health which will allow the applicant to
             278      practice safely as an advanced practice registered nurse;
             279          (d) hold a current registered nurse license in good standing issued by the state or be
             280      qualified at the time for licensure as a registered nurse;
             281          (e) have earned a graduate degree in nursing or a related area of specialized knowledge as
             282      determined appropriate by the division in collaboration with the board;
             283          (f) have completed course work in patient assessment, diagnosis and treatment, and
             284      pharmacotherapeutics from an education program approved by the division in collaboration with
             285      the board;
             286          (g) have successfully completed clinical practice in psychiatric and mental health nursing,
             287      including psychotherapy as defined by division rule, after completion of the masters degree
             288      required for licensure, to practice within the psychiatric and mental health nursing specialty;
             289          (h) have passed the examinations as required by division rule made in collaboration with
             290      the board;
             291          (i) be currently certified by a program approved by the division in collaboration with the
             292      board and submit evidence satisfactory to the division of the certification; and
             293          (j) meet with the board, if requested, to determine the applicant's qualifications for
             294      licensure.
             295          (4) An applicant for licensure as a certified registered nurse anesthetist shall:
             296          (a) submit to the division an application on a form prescribed by the division;
             297          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             298          (c) be in a condition of physical and mental health which will allow the applicant to
             299      practice safely as a certified registered nurse anesthetist;
             300          (d) hold a current registered nurse license in good standing issued by the state or be
             301      qualified at the time for licensure as a registered nurse;
             302          (e) complete a nurse anesthesia program which is approved by the Council on
             303      Accreditation of Nurse Anesthesia Educational Programs;
             304          (f) be currently certified by a program approved by the division in collaboration with the
             305      board and submit evidence satisfactory to the division of the certification; and
             306          (g) meet with the board, if requested, to determine the applicant's qualifications for


             307      licensure.
             308          (5) An applicant for registration as a health care assistant shall:
             309          (a) submit an application in a form prescribed by the division;
             310          (b) pay a fee determined by the department under Section 63-38-3.2 ;
             311          (c) certify in writing that he is free from any physical, mental, or emotional condition that
             312      will or may reasonably be expected to prevent the applicant from practicing as a health care
             313      assistant in compliance with this chapter; and
             314          (d) may not, within five years immediately prior to application, have any substantiated
             315      allegations of abuse, neglect, or misappropriation of client property listed against him on the
             316      certified nurse assistant registry maintained by the State Office of Education or on a similar
             317      registry maintained in another state in compliance with 42 CFR 483.156.
             318          (6) An applicant for licensure or registration under this chapter:
             319          (a) is subject to a criminal background check maintained pursuant to Title 53, Chapter 10,
             320      Part 2, Bureau of Criminal Identification, at the applicant's expense; and
             321          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             322      sentences for all felony convictions five or more years prior to the date of filing an application for
             323      licensure or registration under this chapter.
             324          (7) For purposes of conducting the criminal background checks required in Subsection (6),
             325      the division shall have direct access to criminal background information maintained pursuant to
             326      Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             327          (8) (a) Any new nurse license or health care assistant registration issued under this section
             328      shall be conditional, pending completion of the criminal background check. If the criminal
             329      background check discloses the applicant has failed to accurately disclose a criminal history, the
             330      license or registration shall be immediately and automatically revoked.
             331          (b) Any person whose conditional license or registration has been revoked under
             332      Subsection (8)(a) shall be entitled to a postrevocation hearing to challenge the revocation. The
             333      hearing shall be conducted in accordance with Title 63, Chapter 46b, Administrative Procedures
             334      Act.
             335          Section 6. Section 58-31b-308 is amended to read:
             336           58-31b-308. Exemptions from licensure or registration.
             337          (1) In addition to the exemptions from licensure in Section 58-1-307 , the following


             338      persons may engage in acts included within the definition of the practice of nursing, subject to the
             339      stated circumstances and limitations, without being licensed under this chapter:
             340          (a) friends, family members, foster parents, or legal guardians of a patient performing
             341      gratuitous nursing care for the patient;
             342          (b) persons providing care in a medical emergency;
             343          (c) persons engaged in the practice of religious tenets of a church or religious
             344      denomination; and
             345          (d) after July 1, 2000, a person licensed to practice nursing by a jurisdiction that has joined
             346      the Nurse Licensure Compact to the extent permitted by Section 58-31c-102 .
             347          (2) Notwithstanding Subsection (1)(d), the division may, in accordance with Section
             348      58-31c-102 , limit or revoke practice privileges in this state of a person licensed to practice nursing
             349      by a jurisdiction that has joined the Nurse Licensing Compact.
             350          (3) In addition to the exemptions from licensure under Section 58-1-307 , the following
             351      individuals may engage in acts or practices included in the practice of a health care assistant,
             352      within the stated limitations, without being registered under this chapter:
             353          (a) an individual providing gratuitous care for another individual;
             354          (b) a volunteer, whether or not he receives token compensation other than salary or wages:
             355          (i) in programs sponsored or authorized by federal Public Law 93-113; or
             356          (ii) at any regulated facility; and
             357          (c) individuals providing:
             358          (i) services generally considered independent living activities such as preparing meals,
             359      shopping for personal items or groceries, managing money, using the telephone, performing
             360      housekeeping, and other similar activities not involving direct personal assistance and care as the
             361      division may define by rule; and
             362          (ii) child day care or baby-sitting, whether or not the services are subject to licensure under
             363      Title 26, Chapter 39, Utah Child Care Licensing Act; or
             364          (d) an individual employed on an intermittent basis to provide a specified limited period
             365      of care for an adult or child with disabilities needing regular daily care, in order to allow the
             366      relative or other person who is the adult or child's regular and unpaid caretaker respite from his or
             367      her caregiver duties regarding the adult or child.
             368          Section 7. Section 58-31b-308.5 is enacted to read:


             369          58-31b-308.5. Health assistant registration _ Classifications -- Temporary
             370      employment prior to registration.
             371          (1) An individual may temporarily engage in practice as a health care assistant for not
             372      more than ten consecutive days immediately after being initially employed in the state as a health
             373      care assistant, without having submitted a registration application under this chapter. The
             374      registration application shall be postmarked not later than the last day of the ten consecutive days
             375      referred to in this Subsection (1).
             376          (2) An individual may not practice as a health care assistant in this state for more than ten
             377      days without having submitted an application for registration.
             378          (3) If the application for registration is denied, the applicant shall cease practice in this
             379      state as a health care assistant upon receipt of notice of the denial.
             380          Section 8. Section 58-31b-401 is amended to read:
             381           58-31b-401. Grounds for denial of licensure or registration and disciplinary
             382      proceedings.
             383          (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the license
             384      of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee, to issue
             385      a public or private reprimand to a licensee, and to issue cease and desist orders shall be in
             386      accordance with Section 58-1-401 .
             387          (2) If a court of competent jurisdiction determines a nurse or health care assistant is an
             388      incapacitated person as defined in Section 75-1-201 or that he is mentally ill as defined in Section
             389      62A-12-202 , and unable to safely engage in the practice of nursing or the practice of a health care
             390      assistant, the director shall immediately suspend the license of the nurse or health care assistant
             391      upon the entry of the judgment of the court, without further proceedings under Title 63, Chapter
             392      46b, Administrative Procedures Act, regardless of whether an appeal from the court's ruling is
             393      pending. The director shall promptly notify the nurse or health care assistant, in writing, of the
             394      suspension.
             395          (3) (a) If the division and the majority of the board find reasonable cause to believe a nurse
             396      or health care assistant, who is not determined judicially to be an incapacitated person or to be
             397      mentally ill, is incapable of practicing nursing or the practice of a health care assistant with
             398      reasonable skill regarding the safety of patients, because of illness, excessive use of drugs or
             399      alcohol, or as a result of any mental or physical condition, the board shall recommend that the


             400      director file a petition with the division, and cause the petition to be served upon the nurse or
             401      health care assistant with a notice of hearing on the sole issue of the capacity of the nurse or health
             402      care assistant to competently, safely engage in the practice of nursing or the practice of a health
             403      care assistant.
             404          (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
             405      Administrative Procedures Act, except as provided in Subsection (4).
             406          (4) (a) Every nurse or health care assistant who accepts the privilege of being licensed
             407      under this chapter gives consent to:
             408          (i) submitting to an immediate mental or physical examination, at the nurse's or health care
             409      assistant's expense and by a division-approved practitioner selected by the nurse or health care
             410      assistant, when directed in writing by the division and a majority of the board to do so; and
             411          (ii) the admissibility of the reports of the examining practitioner's testimony or
             412      examination, and waives all objections on the ground the reports constitute a privileged
             413      communication.
             414          (b) The examination may be ordered by the division, with the consent of a majority of the
             415      board, only upon a finding of reasonable cause to believe:
             416          (i) the nurse or health care assistant is mentally ill or incapacitated or otherwise unable to
             417      practice nursing or health care assistance with reasonable skill and safety; and
             418          (ii) immediate action by the division and the board is necessary to prevent harm to the
             419      nurse's or health care assistant's patients or the general public.
             420          (c) (i) Failure of a nurse or health care assistant to submit to the examination ordered under
             421      this section is a ground for the division's immediate suspension of the nurse's or health care
             422      assistant's license by written order of the director.
             423          (ii) The division may enter the order of suspension without further compliance with Title
             424      63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to submit to
             425      the examination ordered under this section was due to circumstances beyond the control of the
             426      nurse or health care assistant and was not related directly to the illness or incapacity of the nurse
             427      or health care assistant.
             428          (5) (a) A nurse or health care assistant whose license is suspended under Subsection (2),
             429      (3), or (4)(c) has the right to a hearing to appeal the suspension within ten days after the license
             430      is suspended.


             431          (b) The hearing held under this Subsection (5) shall be conducted in accordance with
             432      Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists for
             433      the continuance of the order of suspension in order to prevent harm to the nurse's or health care
             434      assistant's patients or the general public.
             435          (6) A nurse or health care assistant whose license is revoked, suspended, or in any way
             436      restricted under this section may request the division and the board to consider, at reasonable
             437      intervals, evidence presented by the nurse or health care assistant, under procedures established
             438      by division rule, regarding any change in the nurse's or health care assistant's condition, to
             439      determine whether:
             440          (a) he is or is not able to safely and competently engage in the practice of nursing or the
             441      practice of a health care assistant; and
             442          (b) he is qualified to have his license to practice under this chapter restored completely or
             443      in part.
             444          (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the division
             445      to report current significant investigative information to the coordinated licensure information
             446      system for transmission to party states as required of the division by Article VII of the Nurse
             447      Licensure Compact in Section 58-31c-102 .
             448          (8) For purposes of this section and Section 58-31b-402 , "licensed" or "license" includes
             449      "registered" and "registration" under this chapter.
             450          Section 9. Section 58-31b-402 is amended to read:
             451           58-31b-402. Authority to assess penalty.
             452          (1) After a proceeding pursuant to Title 63, Chapter 46b, Administrative Procedures Act,
             453      and Title 58, Chapter 1, Division of Occupational and Professional Licensing Act, the division may
             454      impose an administrative penalty of up to $10,000 for unprofessional or unlawful conduct under
             455      this chapter in accordance with a fine schedule established by rule.
             456          (2) The assessment of a penalty under this section does not affect any other action the
             457      division is authorized to take regarding a license issued under this chapter.
             458          (3) The division may impose an administrative penalty of up to $500 for any violation of
             459      Subsection 58-31b-501 (1)(a) or [(2)] (b), consistent with Section 58-31b-503 .
             460          Section 10. Section 58-31b-501 is amended to read:
             461           58-31b-501. Unlawful conduct.


             462          (1) "Unlawful conduct" includes:
             463          [(1)] (a) using the following titles, names or initials, if the user is not properly licensed
             464      under this chapter:
             465          [(a)] (i) nurse;
             466          [(b)] (ii) licensed practical nurse, practical nurse, or L.P.N.;
             467          [(c)] (iii) registered nurse or R.N.;
             468          [(d)] (iv) registered nurse practitioner, N.P., or R.N.P.;
             469          [(e)] (v) registered nurse specialist, N.S., or R.N.S.;
             470          [(f)] (vi) registered psychiatric mental health nurse specialist;
             471          [(g)] (vii) advanced practice registered nurse;
             472          [(h)] (viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse
             473      anesthetist, or C.R.N.A.; or
             474          [(i)] (ix) other generally recognized names or titles used in the profession of nursing;
             475          [(2)] (b) using any other name, title, or initials that would cause a reasonable person to
             476      believe the user is licensed under this chapter if the user is not properly licensed under this chapter;
             477      and
             478          [(3)] (c) conducting a nursing education program in the state for the purpose of qualifying
             479      individuals to meet requirements for licensure under this chapter without the program having been
             480      approved under Section 58-31b-601 .
             481          (2) (a) An individual registered as a health care assistant under this chapter may use any
             482      title in his practice as a health care assistant, and an employer may assign a title to health care
             483      assistants it employs, if the title does not cause a reasonable person to believe the registrant is a
             484      licensee in any other license classification under this chapter and Title 58, Occupations and
             485      Professions.
             486          (b) If any issue is raised regarding a title under this section, the division shall determine
             487      if the title may be used for health care assistants.
             488          Section 11. Section 58-31b-503 is amended to read:
             489           58-31b-503. Penalty for unlawful conduct.
             490          (1) Any person who violates the unlawful conduct provision specifically defined in
             491      Subsection 58-1-501 (1)(a)(i) is guilty of a third degree felony.
             492          (2) Any person who violates any of the unlawful conduct provisions specifically defined


             493      in Subsections 58-1-501 (1)[(b)](a)(ii) through [(e)] (v) and 58-31b-501 [(3)](1)(c) is guilty of a
             494      class A misdemeanor.
             495          (3) Any person who violates any of the unlawful conduct provisions specifically defined
             496      in this chapter and not set forth in Subsection (1) or (2) is guilty of a class B misdemeanor.
             497          (4) Subject to Subsection (5), the division may assess administrative penalties in
             498      accordance with the provisions of Section 58-31b-402 for acts of unprofessional or unlawful
             499      conduct or any other appropriate administrative action in accordance with the provisions of Section
             500      58-31b-401 .
             501          (5) If a licensee has been convicted of violating Section 58-31b-501 prior to an
             502      administrative finding of a violation of the same section, the licensee may not be assessed an
             503      administrative penalty under this chapter for the same offense for which the conviction was
             504      obtained.
             505          Section 12. Section 58-31b-701 is amended to read:
             506           58-31b-701. Immunity from liability.
             507          A person licensed or registered under this chapter:
             508          (1) who provides emergency care in accordance with Section 78-11-22 is entitled to the
             509      immunity from civil liability provided under that section; and
             510          (2) is considered a health care provider under Chapter 13, Health Care Providers Immunity
             511      from Liability Act, and is entitled to the immunity from civil liability provided under that chapter.
             512          Section 13. Section 58-31b-702 is amended to read:
             513           58-31b-702. Reporting of disciplinary action -- Immunity from liability.
             514          (1) A licensed health care facility or organization or a professional society of nurses in the
             515      state that takes disciplinary action against a person licensed under this chapter relating to any of
             516      the following shall report the action in writing to the division within 30 days after the action is
             517      taken:
             518          (a) that person's professional acts or omissions as a licensed nurse or registered health care
             519      assistant;
             520          (b) that person's nursing competence or ability to practice nursing safely; or
             521          (c) that person's use of alcohol or drugs in an unlawful manner or to the extent the person
             522      is impaired in his ability to practice nursing or health care assistance safely.
             523          (2) Any person or organization furnishing information in accordance with this section is


             524      immune from liability to the extent that the information is furnished in good faith and without
             525      malice.
             526          Section 14. Repealer.
             527          This act repeals:
             528          Section 58-62-101, Title.
             529          Section 58-62-102, Definitions.
             530          Section 58-62-201, Board.
             531          Section 58-62-301, Registration -- Classifications -- Temporary employment prior to
             532      registration.
             533          Section 58-62-302, Registration qualifications.
             534          Section 58-62-303, Term of registration -- Expiration -- Renewal.
             535          Section 58-62-304, Exemptions from registration.
             536          Section 58-62-305, Registrant title.
             537          Section 58-62-401, Denial of registration -- Disciplinary proceedings.
             538          Section 58-62-501, Unlawful conduct -- Penalty.
             539          Section 58-62-601, Registry.
             540          Section 58-62-602, Notice of dismissal -- Division action.
             541          Section 58-62-603, Immunity from liability for reporting.




Legislative Review Note
    as of 12-18-01 8:57 AM


A limited legal review of this legislation raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel


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