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H.B. 227

This document includes House Committee Amendments incorporated into the bill on Wed, Feb 4, 2004 at 12:51 PM by chopkin. -->              1     




Sponsor: Jackie Biskupski

             5      Eric K. Hutchings
             6      David Litvack
             7      Peggy WallaceDon E. Bush
J. Morgan Philpot
Mike ThompsonTy McCartney
Glenn A. Donnelson              8     
             9      LONG TITLE
             10      General Description:
             11          This bill modifies the Occupations and Professions Code by enacting the Midwife
             12      Certification Act and makes related changes to the Health Care Providers Immunity
             13      from Liability Act.
             14      Highlighted Provisions:
             15          This bill:
             16          .    provides for certification of Direct-entry midwives by the Division of Occupational
             17      and Professional Licensing;
             18          .    provides for definitions relating to the practice of midwives;
             19          .    creates the Certified Direct-entry Midwife Board and sets forth its membership and
             20      duties;
             21          .    requires the division to establish a Certified Direct-entry Midwife Formulary
             22      Committee and a certified Direct-entry midwife formulary to define which
             23      prescription drugs and devices can be H [ prescribed ] OBTAINED h and administered by certified
             24      Direct-entry midwives and to provide guidelines for their use;
             25          .    provides for disciplinary action, including administrative penalties, against certified
             26      Direct-entry midwives;
             27          .    defines and provides penalties for unlawful and unprofessional conduct;
             28          .    sets standards for consultation, collaboration, referral, and transfer to or with other

             29      health care providers and sets standards for liability under those circumstances; and
             30          .    brings certified Direct-entry midwives within the scope of the Health Care
             31      Providers Immunity From Liability Act.
             32      Monies Appropriated in this Bill:
             33          None
             34      Other Special Clauses:
             35          None
             36      Utah Code Sections Affected:
             37      AMENDS:
             38          58-13-2, as last amended by Chapter 3, Laws of Utah 2003
             39          58-13-3, as last amended by Chapter 207, Laws of Utah 2003
             40          78-14-3, as last amended by Chapter 131, Laws of Utah 2002
             41      ENACTS:
             42          58-77-101, Utah Code Annotated 1953
             43          58-77-102, Utah Code Annotated 1953
             44          58-77-201, Utah Code Annotated 1953
             45          58-77-202, Utah Code Annotated 1953
             46          58-77-301, Utah Code Annotated 1953
             47          58-77-302, Utah Code Annotated 1953
             48          58-77-303, Utah Code Annotated 1953
             49          58-77-304, Utah Code Annotated 1953
             50          58-77-401, Utah Code Annotated 1953
             51          58-77-501, Utah Code Annotated 1953
             52          58-77-502, Utah Code Annotated 1953
             53          58-77-503, Utah Code Annotated 1953
             54          58-77-601, Utah Code Annotated 1953
             55          58-77-602, Utah Code Annotated 1953
             56          58-77-603, Utah Code Annotated 1953
             58      Be it enacted by the Legislature of the state of Utah:
             59          Section 1. Section 58-13-2 is amended to read:

             60           58-13-2. Emergency care rendered by licensee.
             61          (1) A person licensed or certified under Title 58, Occupations and Professions, to
             62      practice as any of the following health care professionals, who is under no legal duty to
             63      respond, and who in good faith renders emergency care at the scene of an emergency
             64      gratuitously and in good faith, is not liable for any civil damages as a result of any acts or
             65      omissions by the person in rendering the emergency care:
             66          (a) osteopathic physician;
             67          (b) physician and surgeon;
             68          (c) naturopathic physician;
             69          (d) dentist or dental hygienist;
             70          (e) chiropractic physician;
             71          (f) physician assistant;
             72          (g) optometrist;
             73          (h) nurse licensed under Section 58-31b-301 or 58-31c-102 ;
             74          (i) podiatrist;
             75          (j) certified nurse midwife;
             76          (k) respiratory therapist; [or]
             77          (l) pharmacist, pharmacy technician, and pharmacy intern[.]; or
             78          (m) Direct-entry midwife certified under Section 58-77-301 .
             79          (2) (a) This Subsection (2) applies to health care professionals:
             80          (i) described in Subsection (1);
             81          (ii) who are under no legal duty to respond to the circumstances described in
             82      Subsection (2)(b);
             83          (iii) who are acting within the scope of the health care professional's license, or within
             84      the scope of practice as modified under Subsection 58-1-307 (4); and
             85          (iv) who are acting in good faith without compensation or remuneration as defined in
             86      Subsection 58-13-3 (2).
             87          (b) A health care professional described in Subsection (2)(a) is not liable for any civil
             88      damages as a result of any acts or omissions by the health care professional in rendering care as
             89      a result of:
             90          (i) implementation of measures to control the causes of epidemic and communicable

             91      diseases and other conditions significantly affecting the public health or necessary to protect
             92      the public health as set out in Title 26A, Chapter 1, Local Health Departments;
             93          (ii) investigating and controlling suspected bioterrorism and disease as set out in Title
             94      26, Chapter 23b, Detection of Public Health Emergencies Act; and
             95          (iii) responding to a national, state, or local emergency, a public health emergency as
             96      defined in Section 26-23b-102 , or a declaration by the President of the United States or other
             97      federal official requesting public health-related activities.
             98          (3) The immunity in Subsection (2) is in addition to any immunity or protection in state
             99      or federal law that may apply.
             100          Section 2. Section 58-13-3 is amended to read:
             101           58-13-3. Qualified immunity -- Health professionals -- Charity care.
             102          (1) (a) (i) The Legislature finds many residents of this state do not receive medical care
             103      and preventive health care because they lack health insurance or because of financial
             104      difficulties or cost.
             105          (ii) The Legislature also finds that many physicians, charity health care facilities, and
             106      other health care professionals in this state would be willing to volunteer medical and allied
             107      services without compensation if they were not subject to the high exposure of liability
             108      connected with providing these services.
             109          (b) The Legislature therefore declares that its intention in enacting this section is to
             110      encourage the provision of uncompensated volunteer charity health care in exchange for a
             111      limitation on liability for the health care facilities and health care professionals who provide
             112      those volunteer services.
             113          (2) As used in this section:
             114          (a) "Health care facility" means any clinic or hospital, church, or organization whose
             115      primary purpose is to sponsor, promote, or organize uncompensated health care services for
             116      people unable to pay for health care services.
             117          (b) "Health care professional" means individuals licensed or certified under Title 58,
             118      Occupations and Professions, as physicians and surgeons, osteopaths, podiatrists, optometrists,
             119      chiropractors, dentists, dental hygienists, registered nurses, certified nurse midwives, [and]
             120      other nurses licensed under Section 58-31b-301 [.], and certified Direct-entry midwives.
             121          (c) "Remuneration or compensation":

             122          (i) (A) means direct or indirect receipt of any payment by the physician and surgeon,
             123      health care facility, other health care professional, or organization, on behalf of the patient,
             124      including payment or reimbursement under medicare or medicaid, or under the state program
             125      for the medically indigent on behalf of the patient; and
             126          (B) compensation, salary, or reimbursement to the health care professional from any
             127      source for the health care professional's services or time in volunteering to provide
             128      uncompensated health care; and
             129          (ii) does not mean any grant or donation to the health care facility used to offset direct
             130      costs associated with providing the uncompensated health care such as medical supplies or
             131      drugs.
             132          (3) A health care professional who provides health care treatment at or on behalf of a
             133      health care facility is not liable in a medical malpractice action if:
             134          (a) the treatment was within the scope of the health care professional's license under
             135      this title;
             136          (b) neither the health care professional nor the health care facility received
             137      compensation or remuneration for the treatment;
             138          (c) the acts or omissions of the health care professional were not grossly negligent or
             139      willful and wanton; and
             140          (d) prior to rendering services, the health care professional disclosed in writing to the
             141      patient, or if a minor, to the patient's parent or legal guardian, that the health care professional
             142      is providing the services without receiving remuneration or compensation and that in exchange
             143      for receiving uncompensated health care, the patient consents to waive any right to sue for
             144      professional negligence except for acts or omissions which are grossly negligent or are willful
             145      and wanton.
             146          (4) A health care facility which sponsors, promotes, or organizes the uncompensated
             147      care is not liable in a medical malpractice action for acts and omissions if:
             148          (a) the health care facility meets the requirements in Subsection (3)(b);
             149          (b) the acts and omissions of the health care facility were not grossly negligent or
             150      willful and wanton; and
             151          (c) the health care facility has posted, in a conspicuous place, a notice that in
             152      accordance with this section the health care facility is not liable for any civil damages for acts

             153      or omissions except for those acts or omissions that are grossly negligent or are willful and
             154      wanton.
             155          (5) Immunity from liability under this section does not extend to the use of general
             156      anesthesia or care that requires an overnight stay in a general acute or specialty hospital
             157      licensed under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
             158          Section 3. Section 58-77-101 is enacted to read:

Part 1. General Provisions

             161          58-77-101. Title.
             162          This chapter is known as the "Midwife Certification Act."
             163          Section 4. Section 58-77-102 is enacted to read:
             164          58-77-102. Definitions.
             165          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             166          (1) "Board" means the Certified Direct-entry Midwife Board created in Section
             167      58-77-201 .
             168          (2) "Certified Direct-entry midwife" means a person certified under this chapter.
             169          (3) "Client" means a woman under the care of a midwife and her fetus or newborn.
             170          (4) "Midwife" means an individual who is engaging in the practice of midwifery.
             171          (5) "Physician" means an individual licensed as a physician and surgeon, osteopathic
             172      physician, or naturopathic physician.
             173          (6) "Practice of midwifery" means practice that is in accordance with national
             174      professional midwifery standards and that is based upon the acquisition of clinical skills
             175      necessary for the care of essentially normal pregnant women and newborns, including
             176      antepartum, intrapartum, postpartum, newborn, and limited interconceptual care and includes:
             177          (a) obtaining an informed consent to provide services;
             178          (b) obtaining a health history including a physical examination;
             179          (c) developing a plan of care for a client;
             180          (d) evaluating the results of client care;
             181          (e) consulting and collaborating with and referring and transferring care to licensed
             182      health care professionals as is appropriate regarding the care of a client;
             183          (f) obtaining medications, as specified in this Subsection (6)(f) or by rule, to administer

             184      to clients, including:
             185          (i) prescription vitamins;
             186          (ii) Rho D immunolglobulin;
             187          (iii) CDC- or ACOG-recommended agents for Group B strep prophylaxis;
             188          (iv) sterile water;
             189          (v) IV fluids, excluding blood products;
             190          (vi) oxytocin (Pitocin) or methlergonvine maleate (Methergine) for use postpartum
             191      only;
             192          (vii) oxygen;
             193          (viii) local anesthetics for suturing an episiotomy or natural lacerations;
             194          (ix) vitamin K to prevent hemorrhagic disease of the newborn;
             195          (x) eye prophylaxis to prevent opthalmia neonatorum as required by law; and
             196          (xi) other medications that are not controlled substances as defined in Section 58-37-2
             197      and which are approved by the division in collaboration with the Certified Direct-entry
             198      Midwife Formulary Committee;
             199          (g) obtaining food, food extracts, dietary supplements as defined by the Federal Food,
             200      Drug, and Cosmetic Act, homeopathic remedies, plant substances that are not designated as
             201      prescription drugs or controlled substances, and over-the-counter medications to administer to
             202      clients;
             203          (h) obtaining and using appropriate equipment and devices such as Doppler, fetal
             204      monitor, blood pressure cuff, phlebotomy supplies, instruments, and sutures;
             205          (i) obtaining appropriate screening and testing, including laboratory tests, urinalysis,
             206      and ultrasound;
             207          (j) managing the antepartum period;
             208          (k) managing the intrapartum period including:
             209          (i) monitoring and evaluating the condition of mother and fetus;
             210          (ii) performing emergency episiotomy; and
             211          (iii) delivering in any out-of-hospital setting;
             212          (l) managing the postpartum period including:
             213          (i) suturing of episiotomy or first and second degree natural perineal and labial
             214      lacerations, including the administration of a local anesthetic; and

             215          (ii) managing hemorrhage, including the administration of Pitocin, Methergine, or IV
             216      fluids;
             217          (m) managing the newborn period including:
             218          (i) providing care for the newborn, including performing a normal newborn
             219      examination; and
             220          (ii) resuscitating a newborn;
             221          (n) providing the following limited interconceptual services:
             222          (i) breastfeeding support and counseling;
             223          (ii) family planning, limited to natural family planning, cervical caps and diaphragms;
             224      and
             225          (iii) pap smears, where all abnormal results are to be referred to a physician; and
             226          (o) executing the orders of a licensed health care professional, only within the
             227      education, knowledge, and skill of the midwife. H THE PRACTICE OF MIDWIFERY IS NOT
             228          (7) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-77-501 .
             229          (8) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-77-502 and as
             230      may be further defined by rule.
             231          Section 5. Section 58-77-201 is enacted to read:
Part 2. Board

             233          58-77-201. Board.
             234          (1) There is created the Certified Direct-entry Midwife Board consisting of four
             235      certified Direct-entry midwives and one member of the general public.
             236          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             237          (3) (a) The duties and responsibilities of the board shall be in accordance with Sections
             238      58-1-202 and 58-1-203 .
             239          (b) The board shall designate one of its members on a permanent or rotating basis to:
             240          (i) assist the division in reviewing complaints concerning the unlawful or
             241      unprofessional conduct of a certified Direct-entry midwife; and
             242          (ii) advise the division in its investigation of these complaints.
             243          (4) A board member who has, under Subsection (3), reviewed a complaint or advised
             244      in its investigation may be disqualified from participating with the board when the board serves
             245      as a presiding officer in an adjudicative proceeding concerning the complaint.

             246          (5) Faculty, board members, and other staff of Direct-entry midwifery learning
             247      institutions may serve on the board.
             248          Section 6. Section 58-77-202 is enacted to read:
             249          58-77-202. Certified Direct-entry Midwife Formulary Committee -- Adoption of
             250      certified Direct-entry midwife formulary.
             251          (1) The division shall establish a Certified Direct-entry Midwife Formulary Committee
             252      under Subsection 58-1-203 (1)(f) to make recommendations to the board and the division
             253      regarding the certified Direct-entry midwife formulary, including recommendations on which
             254      additional prescription drugs and devices are appropriate for the scope of practice of certified
             255      Direct-entry midwives and guidelines for their use.
             256          (2) The committee shall consist of five members as follows:
             257          (a) two certified Direct-entry midwives;
             258          (b) one licensed physician who has recent, within five years, professional experience
             259      consulting for and collaborating with Direct-entry midwives;
             260          (c) one certified nurse midwife who has recent, within five years, professional
             261      experience consulting for and collaborating with Direct-entry midwives; and
             262          (d) one licensed pharmacist.
             263          (3) The committee members shall:
             264          (a) be appointed by the director of the division; and
             265          (b) serve without compensation, travel costs, or per diem for their services.
             266          (4) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act, the
             267      division shall adopt by rule a certified Direct-entry midwife formulary which includes:
             268          (a) those additional prescription drugs or devices which may be obtained and
             269      administered by certified Direct-entry midwives as defined in Subsection 58-77-102 (6)(f)(xi);
             270      and
             271          (b) standards, conditions, and guidelines for use of the prescription drugs or devices
             272      included in the formulary.
             273          Section 7. Section 58-77-301 is enacted to read:
Part 3. Certification

             275          58-77-301. Certification classification.
             276          The division shall issue to a person who qualifies under this chapter a certification as a

             277      certified Direct-entry midwife.
             278          Section 8. Section 58-77-302 is enacted to read:
             279          58-77-302. Qualifications for certification.
             280          Each applicant for certification as a certified Direct-entry midwife shall:
             281          (1) submit an application in a form prescribed by the division;
             282          (2) pay a fee as determined by the department under Section 63-38-3.2 ;
             283          (3) be of good moral character;
             284          (4) hold a Certified Professional Midwife certificate in good standing with the North
             285      American Registry of Midwives or equivalent certification approved by the division in
             286      collaboration with the board;
             287          (5) hold current adult and infant CPR and newborn resuscitation certifications through
             288      an organization approved by the division in collaboration with the board; and
             289          (6) provide documentation of successful completion of an approved pharmacology
             290      course as defined by division rule.
             291          Section 9. Section 58-77-303 is enacted to read:
             292          58-77-303. Term of certification -- Expiration -- Renewal.
             293          (1) (a) The division shall issue each certification under this chapter in accordance with
             294      a two-year renewal cycle established by rule.
             295          (b) The division may by rule extend or shorten a renewal period by as much as one year
             296      to stagger the renewal cycles it administers.
             297          (2) Each certification automatically expires on the expiration date shown on the
             298      certification unless the individual renews it in accordance with Section 58-1-308 .
             299          (3) At the time of renewal, the certified Direct-entry midwife shall be in current
             300      compliance with the requirements of Section 58-77-302 .
             301          Section 10. Section 58-77-304 is enacted to read:
             302          58-77-304. Parents' rights.
             303          Nothing in this chapter abridges, limits, or changes in any way the right of parents to
             304      deliver their baby where, when, how, and with whom they choose, regardless of certification
             305      under this chapter.
             306          Section 11. Section 58-77-401 is enacted to read:
Part 4. Certification Denial and Discipline

             308          58-77-401. Grounds for denial of certification -- Disciplinary proceedings.
             309          Grounds for refusing to issue a certification to an applicant, for refusing to renew the
             310      certification, for revoking, suspending, restricting, or placing on probation the certification, for
             311      issuing a public or private reprimand, and for issuing a cease and desist order shall be in
             312      accordance with Section 58-1-401 .
             313          Section 12. Section 58-77-501 is enacted to read:
Part 5. Unlawful and Unprofessional Conduct -- Penalties

             315          58-77-501. Unlawful conduct.
             316           H (1) h In addition to the definition in Subsection 58-1-501 (1), "unlawful conduct" includes:
             317           H [ (1) ] (a) h representing or holding oneself out as a certified Direct-entry midwife when not
             318      certified under this chapter; and
             319           H [ (2) ] (b) h using prescription medications, except oxygen, while engaged in the practice of
             320      midwifery when not certified under this chapter.
             321          Section 13. Section 58-77-502 is enacted to read:
             322          58-77-502. Unprofessional conduct.
             323          In addition to the definition in Subsection 58-1-501 (2), "unprofessional conduct"
             324      includes:
             325          (1) engaging in any act or practice for which the certified Direct-entry midwife is not
             326      competent;
             327          (2) failing to obtain informed consent as described in Subsection 58-77-601 (1);
             328          (3) disregarding a client's dignity or right to privacy as to her person, condition,
             329      possessions, or medical record;
             330          (4) failing to file or record any medical report as required by law, impeding, or
             331      obstructing the filing or recording of such a report, or inducing another to fail to file or record
             332      such a report;
             333          (5) breaching a statutory, common law, regulatory, or ethical requirement of
             334      confidentiality with respect to a person who is a client, unless ordered by the court;
             335          (6) inappropriately delegating midwifery duties;
             336          (7) using advertising or an identification statement that is false, misleading, or
             337      deceptive;
             338          (8) using in combination with the term "midwife" the term "nurse" or another title,

             339      initial, or designation that falsely implies that the midwife is licensed as a certified nurse
             340      midwife, registered nurse, or licensed practical nurse; and
             341          (9) submitting a birth certificate known by the person to be false or fraudulent.
             342          Section 14. Section 58-77-503 is enacted to read:
             343          58-77-503. Penalty for unlawful conduct.
             344          A person who violates the unlawful conduct provisions defined in this chapter is guilty
             345      of a class A misdemeanor.
             346          Section 15. Section 58-77-601 is enacted to read:
Part 6. Standards of Practice

             348          58-77-601. Standards of practice.
             349          (1) (a) Prior to providing any services, a certified Direct-entry midwife must obtain H [ an ] A
             349a      WRITTEN h
             350      informed consent from a client.
             351          (b) The consent must include:
             352          (i) the name and certificate number of the midwife;
             353          (ii) the client's name, address, telephone number, and primary care provider, if the
             354      client has one; H [ and ]
             355           H [ (iii) ] (iv) h all sections required by the North American Registry of Midwives in its
             355a      informed
             356      consent guidelines H [ . ] ;
             356b      LIABILITY INSURANCE POLICY; AND
             357          (2) (a) The certified Direct-entry midwife must recommend to the client that she be
             358      evaluated by a physician or certified nurse midwife during the first trimester.
             359          (b) If the client refuses, the certified Direct-entry midwife must document the refusal
             360      and have the client sign another informed consent indicating the refusal to be evaluated by a
             361      physician or certified nurse midwife.
             362          (3) A certified Direct-entry midwife shall appropriately consult with, collaborate with,
             363      refer to, or recommend that a client transfer care to a licensed health care professional when the
             364      circumstances require that action in accordance with standards established by division rule.
             365          (4) If after a client has been informed that she has or may have a high-risk condition
             366      indicating the need for medical consultation, collaboration, referral, or transfer and the client
             367      chooses to decline, then the certified Direct-entry midwife shall:
             368          (a) continue to provide care for the client if the client signs a waiver of medical
             369      consultation, collaboration, referral, or transfer; or

             370          (b) terminate care in accordance with procedures established by division rule.
             371          (5) If transfer of care results from an emergency situation, the certified Direct-entry
             372      midwife shall initiate transfer by:
             373          (a) calling 911 and reporting the need for immediate transfer;
             374          (b) immediately transporting the client by private vehicle to the receiving provider; or
             375          (c) contacting the physician to whom the client will be transferred and following that
             376      physician's orders.
             376b      SERVICES. h
             377          Section 16. Section 58-77-602 is enacted to read:
             378          58-77-602. Immunity and liability.
             379          (1) If a midwife seeks to consult with, refer, or transfer a client to a physician, certified
             380      nurse midwife, or facility, the responsibility of the provider or facility for the client does not
             381      begin until the client is physically within the care of the provider or facility.
             382          (2) A physician or certified nurse midwife who examines a client in accordance with
             383      Subsection 58-77-601 (2) is only liable for the actual examination and cannot be held
             384      accountable for the client's decision to pursue an out-of-hospital birth or the services of a
             385      midwife.
             386          (3) (a) A physician or certified nurse midwife may, upon receiving a briefing H [ data ] h
             386a      from
             387      a midwife, issue a medical order for the midwife's client, without that client being an explicit
             388      patient of the physician or certified nurse midwife.
             389          (b) H [ The responsibility and liability for the briefing and the proper execution of the
             390      medical order is that of the midwife.

             391           H [ (c) ] (d) h The provider giving the order is responsible and liable only for the
             391a      appropriateness
             392      of the order given the data received.
             393           H [ (d) ] (e) h The issuing of an order for a midwife's client does not constitute a delegation of
             394      duties from the other provider to the midwife.
             395          Section 17. Section 58-77-603 is enacted to read:
             396          58-77-603. Prohibited practices.
             397          A midwife may not:
             398          (1) administer a prescription drug to a client, other than those specified in Subsection
             399      58-77-102 (6);
             400          (2) use forceps or a vacuum extractor, or effect any type of surgical delivery except for

             401      the cutting of an emergency episiotomy;
             402          (3) administer any type of epidural, spinal, or caudal anesthetic, or any type of narcotic
             403      analgesia; or
             404          (4) induce abortion.
             405          Section 18. Section 78-14-3 is amended to read:
             406           78-14-3. Definitions.
             407          As used in this chapter:
             408          (1) "Audiologist" means a person licensed to practice audiology under Title 58,
             409      Chapter 41, Speech-language Pathology and Audiology Licensing Act.
             410          (2) "Certified Direct-entry midwife" means a person certified under the Midwife
             411      Certification Act to practice midwifery as defined in Section 58-77-102 .
             412          [(2)] (3) "Certified social worker" means a person licensed to practice as a certified
             413      social worker under Section [ 58-60-305 ] 58-60-205 .
             414          [(3)] (4) "Chiropractic physician" means a person licensed to practice chiropractic
             415      under Title 58, Chapter 73, Chiropractic Physician Practice Act.
             416          [(4)] (5) "Clinical social worker" means a person licensed to practice as a clinical
             417      social worker under Section [ 58-60-305 ] 58-60-205 .
             418          [(5)] (6) "Commissioner" means the commissioner of insurance as provided in Section
             419      31A-2-102 .
             420          [(6)] (7) "Dental hygienist" means a person licensed to practice dental hygiene as
             421      defined in Section 58-69-102 .
             422          [(7)] (8) "Dentist" means a person licensed to practice dentistry as defined in Section
             423      58-69-102 .
             424          [(8)] (9) "Division" means the Division of Occupational and Professional Licensing
             425      created in Section 58-1-103 .
             426          [(9)] (10) "Future damages" includes damages for future medical treatment, care or
             427      custody, loss of future earnings, loss of bodily function, or future pain and suffering of the
             428      judgment creditor.
             429          [(10)] (11) "Health care" means any act or treatment performed or furnished, or which
             430      should have been performed or furnished, by any health care provider for, to, or on behalf of a
             431      patient during the patient's medical care, treatment, or confinement.

             432          [(11)] (12) "Health care facility" means general acute hospitals, specialty hospitals,
             433      home health agencies, hospices, nursing care facilities, assisted living facilities, birthing
             434      centers, ambulatory surgical facilities, small health care facilities, health care facilities owned
             435      or operated by health maintenance organizations, and end stage renal disease facilities.
             436          [(12)] (13) "Health care provider" includes any person, partnership, association,
             437      corporation, or other facility or institution who causes to be rendered or who renders health
             438      care or professional services as a hospital, health care facility, physician, registered nurse,
             439      licensed practical nurse, nurse midwife, certified Direct-entry midwife, dentist, dental
             440      hygienist, optometrist, clinical laboratory technologist, pharmacist, physical therapist,
             441      podiatric physician, psychologist, chiropractic physician, naturopathic physician, osteopathic
             442      physician, osteopathic physician and surgeon, audiologist, speech-language pathologist, clinical
             443      social worker, certified social worker, social service worker, marriage and family counselor,
             444      practitioner of obstetrics, or others rendering similar care and services relating to or arising out
             445      of the health needs of persons or groups of persons and officers, employees, or agents of any of
             446      the above acting in the course and scope of their employment.
             447          [(13)] (14) "Hospital" means a public or private institution licensed under Title 26,
             448      Chapter 21, Health Care Facility Licensing and Inspection Act.
             449          [(14)] (15) "Licensed practical nurse" means a person licensed to practice as a licensed
             450      practical nurse as provided in Section 58-31b-301 .
             451          [(15)] (16) "Malpractice action against a health care provider" means any action against
             452      a health care provider, whether in contract, tort, breach of warranty, wrongful death, or
             453      otherwise, based upon alleged personal injuries relating to or arising out of health care rendered
             454      or which should have been rendered by the health care provider.
             455          [(16)] (17) "Marriage and family therapist" means a person licensed to practice as a
             456      marriage therapist or family therapist under Section 58-60-405 and Section 58-60-305 .
             457          [(17)] (18) "Naturopathic physician" means a person licensed to practice naturopathy
             458      as defined in Section 58-71-102 .
             459          [(18)] (19) "Nurse[-] midwife" means a person licensed to engage in practice as a nurse
             460      midwife under Section 58-44a-301 .
             461          [(19)] (20) "Optometrist" means a person licensed to practice optometry under Title 58,
             462      Chapter 16a, Utah Optometry Practice Act.

             463          [(20)] (21) "Osteopathic physician" means a person licensed to practice osteopathy
             464      under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.
             465          [(21)] (22) "Patient" means a person who is under the care of a health care provider,
             466      under a contract, express or implied.
             467          [(22)] (23) "Pharmacist" means a person licensed to practice pharmacy as provided in
             468      Section 58-17a-301 .
             469          [(23)] (24) "Physical therapist" means a person licensed to practice physical therapy
             470      under Title 58, Chapter 24a, Physical Therapist Practice Act.
             471          [(24)] (25) "Physician" means a person licensed to practice medicine and surgery under
             472      Title 58, Chapter 67, Utah Medical Practice Act.
             473          [(25)] (26) "Podiatric physician" means a person licensed to practice podiatry under
             474      Title 58, Chapter 5a, Podiatric Physician Licensing Act.
             475          [(26)] (27) "Practitioner of obstetrics" means a person licensed to practice as a
             476      physician in this state under Title 58, Chapter 67, Utah Medical Practice Act, or under Title 58,
             477      Chapter 68, Utah Osteopathic Medical Practice Act.
             478          [(27)] (28) "Psychologist" means a person licensed under Title 58, Chapter 61,
             479      Psychologist Licensing Act, to practice psychology as defined in Section 58-61-102 .
             480          [(28)] (29) "Registered nurse" means a person licensed to practice professional nursing
             481      as provided in Section 58-31b-301 .
             482          [(29)] (30) "Representative" means the spouse, parent, guardian, trustee,
             483      attorney-in-fact, or other legal agent of the patient.
             484          [(30)] (31) "Social service worker" means a person licensed to practice as a social
             485      service worker under Section 58-60-205 .
             486          [(31)] (32) "Speech-language pathologist" means a person licensed to practice
             487      speech-language pathology under Title 58, Chapter 41, Speech-language Pathology and
             488      Audiology Licensing Act.
             489          [(32)] (33) "Tort" means any legal wrong, breach of duty, or negligent or unlawful act
             490      or omission proximately causing injury or damage to another.

Legislative Review Note
    as of 1-13-04 9:28 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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