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H.B. 70 Enrolled

                 

GERIATRIC CARE MANAGERS

                 
2004 GENERAL SESSION

                 
STATE OF UTAH

                 
Sponsor: Rebecca D. Lockhart

                 
                  LONG TITLE
                  General Description:
                      This bill amends the Nurse Practice Act to certify licensed practical nurses who have
                  additional training in long-term care nursing as geriatric care managers.
                  Highlighted Provisions:
                      This bill:
                      .    defines a geriatric care manager and the practice of geriatric care management;
                      .    creates a pilot program for certification of geriatric care managers;
                      .    specifies qualifications for geriatric care managers;
                      .    amends provisions related to unlawful conduct to incorporate geriatric care
                  managers;
                      .    establishes standards for geriatric care manager training;
                      .    sunsets the Geriatric Care Manager Pilot Program on July 1, 2007;
                      .    requires a study of the necessity of registered health care assistants; and
                      .    makes technical changes.
                  Monies Appropriated in this Bill:
                      None
                  Other Special Clauses:
                      None
                  Utah Code Sections Affected:
                  AMENDS:
                      58-31b-102, as last amended by Chapter 290, Laws of Utah 2002
                      58-31b-201, as last amended by Chapter 290, Laws of Utah 2002
                      58-31b-301, as last amended by Chapter 290, Laws of Utah 2002


                      58-31b-302, as last amended by Chapter 290, Laws of Utah 2002
                      58-31b-303, as last amended by Chapter 314, Laws of Utah 2000
                      58-31b-304, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-307, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-401, as last amended by Chapter 8, Laws of Utah 2002, Fifth Special Session
                      58-31b-501, as last amended by Chapter 290, Laws of Utah 2002
                      58-31b-502, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-601, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-701, as last amended by Chapter 290, Laws of Utah 2002
                  ENACTS:
                      58-31b-301.5, Utah Code Annotated 1953
                      63-55b-158, Utah Code Annotated 1953
                  Uncodified Material Affected:
                  ENACTS UNCODIFIED MATERIAL
                 
                  Be it enacted by the Legislature of the state of Utah:
                      Section 1. Section 58-31b-102 is amended to read:
                       58-31b-102. Definitions.
                      In addition to the definitions in Section 58-1-102 , as used in this chapter:
                      (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
                  omissions determined to constitute unprofessional or unlawful conduct in accordance with a fine
                  schedule established by rule and as a result of an adjudicative proceeding conducted in accordance
                  with Title 63, Chapter 46b, Administrative Procedures Act.
                      (2) "Applicant" means a person who applies for licensure or registration under this
                  chapter by submitting a completed application for licensure or registration and the required fees to
                  the department.
                      (3) "Approved education program" means a nursing education program that meets the
                  minimum standards for educational programs established under this chapter and by division rule in

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                  collaboration with the board.
                      (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
                      (5) "Consultation and referral plan" means a written plan jointly developed by an
                  advanced practice registered nurse and a consulting physician that permits the advanced practice
                  registered nurse to prescribe schedule II-III controlled substances in consultation with the
                  consulting physician.
                      (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
                  surgeon licensed in accordance with this title who has agreed to consult with an advanced practice
                  registered nurse with a controlled substance license, a DEA registration number, and who will be
                  prescribing schedule II-III controlled substances.
                      (7) "Diagnosis" means the identification of and discrimination between physical and
                  psychosocial signs and symptoms essential to the effective execution and management of health
                  care.
                      (8) "Examinee" means a person who applies to take or does take any examination
                  required under this chapter for licensure.
                      (9) "Health care assistant" means an individual who:
                      (a) engages in the practice of a health care assistant; and
                      (b) is subject to registration under this chapter and is not subject to registration, licensure,
                  or certification under any other chapter of this title.
                      (10) "Geriatric care manager" means a licensed practical nurse who has had additional
                  training in long-term care nursing and holds a current, valid certificate of completion from a
                  training course approved by the division in collaboration with the board, and is certified by the
                  division as a Licensed Practical Nurse - Geriatric Care Manager.
                      [(10)] (11) "Licensee" means a person who is licensed [or], registered, or certified under
                  this chapter.
                      (12) "Long-term care facility" means any of the following facilities licensed by the
                  Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
                  Inspection Act:

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                      (a) a nursing care facility;
                      (b) a small health care facility;
                      (c) an intermediate care facility for the mentally retarded;
                      (d) an assisted living facility Type I or II; or
                      (e) a designated swing bed unit in a general hospital.
                      [(11)] (13) "Practice as a health care assistant" means providing direct personal assistance
                  or care for compensation to an individual who is ill, injured, infirm, developmentally or physically
                  disabled, mentally disabled, or mentally retarded, and who is in a private residence or regulated
                  facility.
                      (14) "Practice of geriatric care management":
                      (a) means a licensed practical nurse with specialized knowledge of geriatric and
                  chronically ill patients residing in a long-term care facility as provided in Subsection
                  58-31b-302 (2); and
                      (b) includes an expanded scope of practice which may include:
                      (i) implementing a plan of care;
                      (ii) completing an assessment and evaluation of response to treatment; and
                      (iii) other tasks and skills as defined by division rule.
                      [(12)] (15) "Practice of nursing" means assisting individuals or groups to maintain or
                  attain optimal health, implementing a strategy of care to accomplish defined goals and evaluating
                  responses to care and treatment. The practice of nursing requires substantial specialized or
                  general knowledge, judgment, and skill based upon principles of the biological, physical,
                  behavioral, and social sciences, and includes:
                      (a) initiating and maintaining comfort measures;
                      (b) promoting and supporting human functions and responses;
                      (c) establishing an environment conducive to well-being;
                      (d) providing health counseling and teaching;
                      (e) collaborating with health care professionals on aspects of the health care regimen;
                      (f) performing delegated procedures only within the education, knowledge, judgment, and

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                  skill of the licensee; and
                      (g) delegating nurse interventions that may be performed by others and are not in conflict
                  with this chapter.
                      [(13)] (16) (a) "Practice of nurse anesthesia" means the practice of nursing related to the
                  provision of preoperative, intraoperative, and postoperative anesthesia care and related services
                  upon the request of a physician, surgeon, or other licensed professional, who is acting within the
                  scope of their practice, by a person licensed under this chapter as a certified registered nurse
                  anesthetist and includes:
                      (i) preanesthesia preparation and evaluation including:
                      (A) performing a preanesthetic assessment of the patient;
                      (B) ordering and evaluating appropriate lab and other studies to determine the health of
                  the patient; and
                      (C) selecting, ordering, or administering appropriate medications;
                      (ii) anesthesia induction, maintenance, and emergence, including:
                      (A) selecting and initiating the planned anesthetic technique;
                      (B) selecting and administering anesthetics and adjunct drugs and fluids; and
                      (C) administering general, regional, and local anesthesia;
                      (iii) postanesthesia follow-up care, including:
                      (A) evaluating the patient's response to anesthesia and implementing corrective actions;
                  and
                      (B) selecting, ordering, or administering the above medications and studies; and
                      (iv) other related services within the scope of practice of a certified registered nurse
                  anesthetist, including:
                      (A) emergency airway management;
                      (B) advanced cardiac life support; and
                      (C) the establishment of peripheral, central, and arterial invasive lines.
                      (b) Nothing in this section shall be construed as to require a certified registered nurse
                  anesthetist to obtain an advance practice registered nurse license in order to select, administer, or

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                  provide preoperative, intraoperative, or postoperative anesthesia care and services.
                      [(14)] (17) "Practice of practical nursing" means the performance of nursing acts in the
                  generally recognized scope of practice of licensed practical nurses as defined by rule and as
                  provided in this Subsection [(14)] (17) by a person licensed under this chapter as a licensed
                  practical nurse and under the direction of a registered nurse, licensed physician, or other specified
                  health care professional as defined by rule. Practical nursing acts include:
                      (a) contributing to the assessment of the health status of individuals and groups;
                      (b) participating in the development and modification of the strategy of care;
                      (c) implementing appropriate aspects of the strategy of care;
                      (d) maintaining safe and effective nursing care rendered to a patient directly or indirectly;
                  and
                      (e) participating in the evaluation of responses to interventions.
                      [(15)] (18) "Practice of registered nursing" means performing acts of nursing as provided
                  in this Subsection [(15)] (18) by a person licensed under this chapter as a registered nurse within
                  the generally recognized scope of practice of registered nurses as defined by rule. Registered
                  nursing acts include:
                      (a) assessing the health status of individuals and groups;
                      (b) identifying health care needs;
                      (c) establishing goals to meet identified health care needs;
                      (d) planning a strategy of care;
                      (e) prescribing nursing interventions to implement the strategy of care;
                      (f) implementing the strategy of care;
                      (g) maintaining safe and effective nursing care that is rendered to a patient directly or
                  indirectly;
                      (h) evaluating responses to interventions;
                      (i) teaching the theory and practice of nursing; and
                      (j) managing and supervising the practice of nursing.
                      [(16)] (19) "Practice of advanced practice registered nursing" means the practice of

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                  nursing within the generally recognized scope and standards of advanced practice registered
                  nursing as defined by rule and consistent with professionally recognized preparation and education
                  standards of an advanced practice registered nurse by a person licensed under this chapter as an
                  advanced practice registered nurse. Advanced practice registered nursing includes:
                      (a) maintenance and promotion of health and prevention of disease;
                      (b) diagnosis, treatment, correction, consultation, and referral for common health
                  problems; and
                      (c) prescription or administration of prescription drugs or devices including:
                      (i) local anesthesia;
                      (ii) schedule IV-V controlled substances; and
                      (iii) schedule II-III controlled substances in accordance with a consultation and referral
                  plan.
                      [(17)] (20) "Regulated facility" means a health care facility subject to licensure under Title
                  26, Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:
                      (a) the Utah State Hospital or the Utah State Developmental Center;
                      (b) a residential treatment or residential support facility:
                      (i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and Facilities;
                  and
                      (ii) serving people with disabilities, as defined by Department of Human Services rules; or
                      (c) a [covered] health care facility [as defined in Section 26-21-9.5 ] which is licensed or
                  certified under Title 26, Chapter 21.
                      [(18)] (21) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501 .
                      [(19)] (22) "Unlicensed assistive personnel" means any unlicensed person, regardless of
                  title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance with
                  the standards of the profession.
                      [(20)] (23) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-31b-502
                  and as may be further defined by rule.
                      Section 2. Section 58-31b-201 is amended to read:

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                       58-31b-201. Board.
                      (1) There is created the Board of Nursing that consists of the following eleven members:
                      (a) [eight] nine nurses in a manner as may be further defined in division rule; and
                      [(b) one registered health care assistant; and]
                      [(c)] (b) two members of the public.
                      (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
                      (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
                  58-1-203 and shall:
                      (a) (i) recommend to the division minimum standards for educational programs qualifying
                  a person for licensure, registration, or certification under this chapter;
                      (ii) recommend to the division denial, approval, or withdrawal of approval regarding
                  educational programs that meet or fail to meet the established minimum standards; and
                      (iii) designate one of its members on a permanent or rotating basis to:
                      (A) assist the division in reviewing complaints concerning the unlawful or unprofessional
                  conduct of a licensee; and
                      (B) advise the division in its investigation of these complaints.
                      (b) A board member who has, under Subsection (3)(a)(iii), reviewed a complaint or
                  advised in its investigation may be disqualified from participating with the board when the board
                  serves as a presiding officer in an adjudicative proceeding concerning the complaint.
                      (4) (a) The director shall appoint an individual to serve as the executive administrator of
                  the Board of Nursing. Except when the board serves as a presiding officer in an adjudicative
                  procedure, the executive administrator shall serve as an ex officio member of the board and shall
                  represent the position of the division in matters considered by the board.
                      (b) The executive administrator shall be a licensed registered nurse, shall have earned a
                  masters degree in nursing, and shall have a minimum of five years of experience working in
                  nursing administration or nursing education.
                      Section 3. Section 58-31b-301 is amended to read:
                       58-31b-301. License or certification required -- Classifications.

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                      (1) A license is required to engage in the practice of nursing, except as specifically
                  provided in Sections 58-1-307 and 58-31b-308 .
                      (2) The division shall issue to a person who qualifies under this chapter a license or
                  certification in the classification of:
                      (a) licensed practical nurse;
                      (b) licensed practical nurse - geriatric care manager;
                      [(b)] (c) registered nurse;
                      [(c)] (d) advanced practice registered nurse intern;
                      [(d)] (e) advanced practice registered nurse; and
                      [(e)] (f) certified registered nurse anesthetist.
                      (3) An individual holding an advanced practice registered nurse license as of July 1, 1998,
                  who cannot document the successful completion of advanced course work in patient assessment,
                  diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be issued an
                  "APRN - without prescriptive practice" license.
                      (4) The division shall grant an advanced practice registered nurse license to any licensed
                  advanced practice registered nurse currently holding prescriptive authority under any predecessor
                  act on July 1, 1998.
                      (5) (a) An individual shall be registered under this chapter in order to engage in practice
                  as a health care assistant, except as provided in Sections 58-31b-308 and 58-31b-308.5 .
                      (b) The division shall issue to a person who qualifies under this chapter a registration in
                  the classification of health care assistant.
                      Section 4. Section 58-31b-301.5 is enacted to read:
                      58-31b-301.5. Geriatric Care Manager Pilot Program.
                      (1) (a) The division shall establish a licensed practical nurse - Geriatric Care Manager
                  Pilot Program to determine the safety and efficiency of expanding the scope of practice for a
                  licensed practical nurse who meets the requirements of Subsection 58-31b-302 (2).
                      (b) The pilot program shall begin on July 1, 2004 and sunset in accordance with Section
                  63-55b-158 .

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                      (c) If the Legislature does not reauthorize the expanded scope of practice for geriatric
                  care managers after the sunset date in Section 63-55b-158 , an individual licensed and certified in
                  good standing as a geriatric care manager may continue to practice as a licensed practical nurse.
                      (2) If at any time the division determines the certification pilot program has become a
                  threat, or potential threat to the public health, safety, or welfare, the division may authorize
                  emergency rules to place the certification program in abeyance until the next legislative session.
                      Section 5. Section 58-31b-302 is amended to read:
                       58-31b-302. Qualifications for licensure or certification -- Criminal background
                  checks.
                      (1) An applicant for licensure as a licensed practical nurse shall:
                      (a) submit to the division an application in a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) have a high school diploma or its equivalent;
                      (d) be in a condition of physical and mental health that will permit the applicant to
                  practice safely as a licensed practical nurse;
                      (e) have completed an approved practical nursing education program or an equivalent as
                  determined by the board;
                      (f) have passed the examinations as required by division rule made in collaboration with
                  the board; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for
                  licensure.
                      (2) An applicant for certification as a licensed practical nurse - geriatric care manager
                  shall:
                      (a) submit an application to the division on a form prescribed by the division;
                      (b) pay a fee to the division as determined under Section 63-38-3.2 ;
                      (c) have a current license, in good standing, as a licensed practical nurse;
                      (d) have one year experience in a long-term care facility;
                      (e) be in a condition of physical and mental health that will permit the applicant to

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                  practice safely as a licensed practical nurse - geriatric care manager;
                      (f) have completed a division-approved geriatric care management education program or
                  an equivalent as determined by the division in collaboration with the board;
                      (g) have passed the examinations as required by division rule made in collaboration with
                  the board; and
                      (h) meet with the board, if requested, to determine the applicant's qualifications for
                  licensure.
                      [(2)] (3) An applicant for licensure as a registered nurse shall:
                      (a) submit to the division an application form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) have a high school diploma or its equivalent;
                      (d) be in a condition of physical and mental health that will allow the applicant to practice
                  safely as a registered nurse;
                      (e) have completed an approved registered nursing education program;
                      (f) have passed the examinations as required by division rule made in collaboration with
                  the board; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for
                  licensure.
                      [(3)] (4) Applicants for licensure as an advanced practice registered nurse shall:
                      (a) submit to the division an application on a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) be in a condition of physical and mental health which will allow the applicant to
                  practice safely as an advanced practice registered nurse;
                      (d) hold a current registered nurse license in good standing issued by the state or be
                  qualified at the time for licensure as a registered nurse;
                      (e) have earned a graduate degree in nursing or a related area of specialized knowledge as
                  determined appropriate by the division in collaboration with the board;
                      (f) have completed course work in patient assessment, diagnosis and treatment, and

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                  pharmacotherapeutics from an education program approved by the division in collaboration with
                  the board;
                      (g) have successfully completed clinical practice in psychiatric and mental health nursing,
                  including psychotherapy as defined by division rule, after completion of the masters degree
                  required for licensure, to practice within the psychiatric and mental health nursing specialty;
                      (h) have passed the examinations as required by division rule made in collaboration with
                  the board;
                      (i) be currently certified by a program approved by the division in collaboration with the
                  board and submit evidence satisfactory to the division of the certification; and
                      (j) meet with the board, if requested, to determine the applicant's qualifications for
                  licensure.
                      [(4)] (5) An applicant for licensure as a certified registered nurse anesthetist shall:
                      (a) submit to the division an application on a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) be in a condition of physical and mental health which will allow the applicant to
                  practice safely as a certified registered nurse anesthetist;
                      (d) hold a current registered nurse license in good standing issued by the state or be
                  qualified at the time for licensure as a registered nurse;
                      (e) complete a nurse anesthesia program which is approved by the Council on
                  Accreditation of Nurse Anesthesia Educational Programs;
                      (f) be currently certified by a program approved by the division in collaboration with the
                  board and submit evidence satisfactory to the division of the certification; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for
                  licensure.
                      [(5)] (6) An applicant for registration as a health care assistant shall:
                      (a) submit an application in a form prescribed by the division;
                      (b) pay a fee determined by the department under Section 63-38-3.2 ;
                      (c) certify in writing that he is free from any physical, mental, or emotional condition that

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                  will or may reasonably be expected to prevent the applicant from practicing as a health care
                  assistant in compliance with this chapter; and
                      (d) may not, within five years immediately prior to application, have any substantiated
                  allegations of abuse, neglect, or misappropriation of client property listed against him on the
                  certified nurse assistant registry maintained by the State Office of Education or on a similar
                  registry maintained in another state in compliance with 42 CFR 483.156.
                      [(6)] (7) An applicant for licensure [or], registration, or certification under this chapter:
                      (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
                  license application is filed and shall consent to a fingerprint background check by the Utah Bureau
                  of Criminal Identification and the Federal Bureau of Investigation regarding the application; and
                      (ii) the division shall request the Department of Public Safety to complete a Federal
                  Bureau of Investigation criminal background check for each applicant through the national
                  criminal history system (NCIC) or any successor system; and
                      (b) if convicted of one or more felonies, must receive an absolute discharge from the
                  sentences for all felony convictions five or more years prior to the date of filing an application for
                  licensure or registration under this chapter.
                      [(7)] (8) For purposes of conducting the criminal background checks required in
                  Subsection (6), the division shall have direct access to criminal background information
                  maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
                      [(8)] (9) (a) Any new nurse license or health care assistant registration issued under this
                  section shall be conditional, pending completion of the criminal background check. If the criminal
                  background check discloses the applicant has failed to accurately disclose a criminal history, the
                  license or registration shall be immediately and automatically revoked.
                      (b) Any person whose conditional license or registration has been revoked under
                  Subsection [(8)] (9)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
                  The hearing shall be conducted in accordance with Title 63, Chapter 46b, Administrative
                  Procedures Act.
                      Section 6. Section 58-31b-303 is amended to read:

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                       58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
                  programs.
                      An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
                  nursing education program not approved by the division in collaboration with the board must
                  comply with the requirements of this section.
                      (1) An applicant for licensure as a licensed practical nurse shall:
                      (a) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(e); and
                      (b) produce evidence acceptable to the division and the board that the nursing education
                  program completed by the applicant is equivalent to the minimum standards established by the
                  division in collaboration with the board for an approved licensed practical nursing education
                  program.
                      (2) An applicant for licensure as a registered nurse shall:
                      (a) meet all requirements of Subsection 58-31b-302 [(2)] (3), except Subsection [(2)]
                  (3)(e); and
                      (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
                  Examination; or
                      (ii) produce evidence acceptable to the division and the board that the applicant is
                  currently licensed as a registered nurse in one of the states, territories, or the District of Columbia
                  of the United States and has passed the NCLEX-RN examination.
                      Section 7. Section 58-31b-304 is amended to read:
                       58-31b-304. Qualifications for admission to the examinations.
                      (1) To be admitted to the examinations required for certification as a licensed practical
                  nurse - geriatric care manager, a person shall:
                      (a) submit an application on a form prescribed by the division;
                      (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
                      (c) meet all requirements of Subsection 58-31b-302 (2) except the passing of the
                  examination.
                      [(1)] (2) To be admitted to the examinations required for licensure as a practical nurse, a

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                  person shall:
                      (a) submit an application form prescribed by the division;
                      (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
                      (c) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(f).
                      [(2)] (3) To be admitted to the examinations required for licensure as a registered nurse, a
                  person shall:
                      (a) submit an application form prescribed by the division;
                      (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
                      (c) meet all the requirements of Subsection 58-31b-302 [(2)](3), except Subsection
                  [(2)](3)(f).
                      Section 8. Section 58-31b-307 is amended to read:
                       58-31b-307. Licensure by endorsement.
                      An applicant for licensure by endorsement as an advanced practice registered nurse under
                  the provisions of Section 58-1-302 shall also:
                      (1) demonstrate that the applicant has successfully engaged in active practice as an
                  advanced practice registered nurse for not less than 1,500 hours per year in not less than three of
                  the past five years immediately preceding the application for licensure; and
                      (2) demonstrate that the applicant has completed course work as required in Subsection
                  58-31b-302 [(3)] (4)(f).
                      Section 9. Section 58-31b-401 is amended to read:
                       58-31b-401. Grounds for denial of licensure or certification and disciplinary
                  proceedings.
                      (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the license
                  of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee, to issue
                  a public or private reprimand to a licensee, and to issue cease and desist orders shall be in
                  accordance with Section 58-1-401 .
                      (2) If a court of competent jurisdiction determines a nurse or health care assistant is an
                  incapacitated person as defined in Section 75-1-201 or that he is mentally ill as defined in Section

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                  62A-15-602 , and unable to safely engage in the practice of nursing or the practice of a health care
                  assistant, the director shall immediately suspend the license of the nurse or health care assistant
                  upon the entry of the judgment of the court, without further proceedings under Title 63, Chapter
                  46b, Administrative Procedures Act, regardless of whether an appeal from the court's ruling is
                  pending. The director shall promptly notify the nurse or health care assistant, in writing, of the
                  suspension.
                      (3) (a) If the division and the majority of the board find reasonable cause to believe a
                  nurse or health care assistant, who is not determined judicially to be an incapacitated person or to
                  be mentally ill, is incapable of practicing nursing or the practice of a health care assistant with
                  reasonable skill regarding the safety of patients, because of illness, excessive use of drugs or
                  alcohol, or as a result of any mental or physical condition, the board shall recommend that the
                  director file a petition with the division, and cause the petition to be served upon the nurse or
                  health care assistant with a notice of hearing on the sole issue of the capacity of the nurse or
                  health care assistant to competently, safely engage in the practice of nursing or the practice of a
                  health care assistant.
                      (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
                  Administrative Procedures Act, except as provided in Subsection (4).
                      (4) (a) Every nurse or health care assistant who accepts the privilege of being licensed
                  under this chapter gives consent to:
                      (i) submitting to an immediate mental or physical examination, at the nurse's or health
                  care assistant's expense and by a division-approved practitioner selected by the nurse or health
                  care assistant, when directed in writing by the division and a majority of the board to do so; and
                      (ii) the admissibility of the reports of the examining practitioner's testimony or
                  examination, and waives all objections on the ground the reports constitute a privileged
                  communication.
                      (b) The examination may be ordered by the division, with the consent of a majority of the
                  board, only upon a finding of reasonable cause to believe:
                      (i) the nurse or health care assistant is mentally ill or incapacitated or otherwise unable to

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                  practice nursing or health care assistance with reasonable skill and safety; and
                      (ii) immediate action by the division and the board is necessary to prevent harm to the
                  nurse's or health care assistant's patients or the general public.
                      (c) (i) Failure of a nurse or health care assistant to submit to the examination ordered
                  under this section is a ground for the division's immediate suspension of the nurse's or health care
                  assistant's license by written order of the director.
                      (ii) The division may enter the order of suspension without further compliance with Title
                  63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to submit to
                  the examination ordered under this section was due to circumstances beyond the control of the
                  nurse or health care assistant and was not related directly to the illness or incapacity of the nurse
                  or health care assistant.
                      (5) (a) A nurse or health care assistant whose license is suspended under Subsection (2),
                  (3), or (4)(c) has the right to a hearing to appeal the suspension within ten days after the license is
                  suspended.
                      (b) The hearing held under this Subsection (5) shall be conducted in accordance with
                  Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists for
                  the continuance of the order of suspension in order to prevent harm to the nurse's or health care
                  assistant's patients or the general public.
                      (6) A nurse or health care assistant whose license is revoked, suspended, or in any way
                  restricted under this section may request the division and the board to consider, at reasonable
                  intervals, evidence presented by the nurse or health care assistant, under procedures established by
                  division rule, regarding any change in the nurse's or health care assistant's condition, to determine
                  whether:
                      (a) he is or is not able to safely and competently engage in the practice of nursing or the
                  practice of a health care assistant; and
                      (b) he is qualified to have his license to practice under this chapter restored completely or
                  in part.
                      (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the division

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                  to report current significant investigative information to the coordinated licensure information
                  system for transmission to party states as required of the division by Article VII of the Nurse
                  Licensure Compact in Section 58-31c-102 .
                      (8) For purposes of this section and Section 58-31b-402 , "licensed" or "license" includes
                  "registered" [and] or "registration" and "certified" or "certification" under this chapter.
                      Section 10. Section 58-31b-501 is amended to read:
                       58-31b-501. Unlawful conduct.
                      (1) "Unlawful conduct" includes:
                      (a) using the following titles, names or initials, if the user is not properly licensed under
                  this chapter:
                      (i) nurse;
                      (ii) licensed practical nurse, practical nurse, or L.P.N.;
                      (iii) registered nurse or R.N.;
                      (iv) registered nurse practitioner, N.P., or R.N.P.;
                      (v) registered nurse specialist, N.S., or R.N.S.;
                      (vi) registered psychiatric mental health nurse specialist;
                      (vii) advanced practice registered nurse;
                      (viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist, or
                  C.R.N.A.; or
                      (ix) other generally recognized names or titles used in the profession of nursing;
                      (b) using any other name, title, or initials that would cause a reasonable person to believe
                  the user is licensed under this chapter if the user is not properly licensed under this chapter; and
                      (c) conducting a nursing education program in the state for the purpose of qualifying
                  individuals to meet requirements for licensure under this chapter without the program having been
                  approved under Section 58-31b-601 .
                      (2) (a) An individual registered as a health care assistant under this chapter may use any
                  title in his practice as a health care assistant, and an employer may assign a title to health care
                  assistants it employs, if the title does not cause a reasonable person to believe the registrant is a

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                  licensee in any other license classification under this chapter and Title 58, Occupations and
                  Professions.
                      (b) If any issue is raised regarding a title under this section, the division shall determine if
                  the title may be used for health care assistants.
                      (3) An individual licensed as a practical nurse who is certified as a geriatric care manager
                  under this chapter, may use the title "licensed practical nurse - geriatric care manager" or the
                  initials "LPN-GCM" to designate the additional training and certification.
                      Section 11. Section 58-31b-502 is amended to read:
                       58-31b-502. Unprofessional conduct.
                      "Unprofessional conduct" includes:
                      (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
                  diagnosis, personal effects, or any other matter about which the licensee is privileged to know
                  because of the licensee's position or practice as a nurse;
                      (2) failure to provide nursing service in a manner that demonstrates respect for the
                  patient's human dignity and unique personal character and needs without regard to the patient's
                  race, religion, ethnic background, socioeconomic status, age, sex, or the nature of the patient's
                  health problem;
                      (3) engaging in sexual relations with a patient during any:
                      (a) period when a generally recognized professional relationship exists between the nurse
                  and patient; or
                      (b) extended period when a patient has reasonable cause to believe a professional
                  relationship exists between the nurse and patient;
                      (4) (a) as a result of any circumstance under Subsection (3), exploiting or using
                  information about a patient or exploiting the licensee's professional relationship between the
                  licensee and the patient; or
                      (b) exploiting the patient by use of the licensee's knowledge of the patient obtained while
                  acting as a nurse;
                      (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;

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                      (6) unauthorized taking or personal use of nursing supplies from an employer;
                      (7) unauthorized taking or personal use of a patient's personal property;
                      (8) knowingly entering into any medical record any false or misleading information or
                  altering a medical record in any way for the purpose of concealing an act, omission, or record of
                  events, medical condition, or any other circumstance related to the patient and the medical or
                  nursing care provided;
                      (9) unlawful or inappropriate delegation of nursing care;
                      (10) failure to exercise appropriate supervision of persons providing patient care services
                  under supervision of the licensed nurse;
                      (11) employing or aiding and abetting the employment of an unqualified or unlicensed
                  person to practice as a nurse;
                      (12) failure to file or record any medical report as required by law, impeding or
                  obstructing the filing or recording of such a report, or inducing another to fail to file or record
                  such a report;
                      (13) breach of a statutory, common law, regulatory, or ethical requirement of
                  confidentiality with respect to a person who is a patient, unless ordered by a court;
                      (14) failure to pay a penalty imposed by the division; [and]
                      (15) prescribing a schedule II-III controlled substance without a consulting physician or
                  outside of a consultation and referral plan; [and]
                      (16) violating Section 58-31b-801 [.]; and
                      (17) practicing as a licensed practical nurse - geriatric care manager in a setting other than
                  a long-term care facility.
                      Section 12. Section 58-31b-601 is amended to read:
                       58-31b-601. Minimum standards for nursing programs and certification training
                  programs.
                      (1) A nursing education program shall be affiliated with an accredited institution of higher
                  education in order to be approved by the division.
                      (2) The minimum standards a nursing program shall meet to qualify graduates for

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                  licensure under this chapter shall be defined by division rule.
                      (3) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act, the
                  division shall make rules defining the minimum standards a licensed practical nurse - geriatric care
                  manager training program must meet to qualify a person for certification under this chapter as a
                  licensed practical nurse - geriatric care manager.
                      Section 13. Section 58-31b-701 is amended to read:
                       58-31b-701. Immunity from liability.
                      A person licensed [or], registered, or certified under this chapter:
                      (1) who provides emergency care in accordance with Section 78-11-22 is entitled to the
                  immunity from civil liability provided under that section; and
                      (2) is considered a health care provider under Chapter 13, Health Care Providers
                  Immunity from Liability Act, and is entitled to the immunity from civil liability provided under that
                  chapter.
                      Section 14. Section 63-55b-158 is enacted to read:
                      63-55b-158. Repeal dates - Title 58.
                      Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed July 1, 2007.
                      Section 15. Study of registered health care assistant.
                      It is the intent of the Legislature that the Division of Occupational and Professional
                  Licensing in cooperation with the Department of Health and the Department of Human Services,
                  including the Division of Aging and Adult services, study the necessity of the registered health
                  care assistant during the 2004 Interim and report its findings to the Health and Human Services
                  Interim Committee on or before its October interim committee meeting.

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