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First Substitute H.B. 70

Representative Rebecca D. Lockhart proposes the following substitute bill:


             1     
GERIATRIC CARE MANAGERS

             2     
2004 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Sponsor: Rebecca D. Lockhart

             5     
             6      LONG TITLE
             7      General Description:
             8          This bill amends the Nurse Practice Act to certify licensed practical nurses who have
             9      additional training in long-term care nursing as geriatric care managers.
             10      Highlighted Provisions:
             11          This bill:
             12          .    defines a geriatric care manager and the practice of geriatric care management;
             13          .    creates a pilot program for certification of geriatric care managers;
             14          .    specifies qualifications for geriatric care managers;
             15          .    amends provisions related to unlawful conduct to incorporate geriatric care
             16      managers;
             17          .    establishes standards for geriatric care manager training;
             18          .    sunsets the Geriatric Care Manager Pilot Program on July 1, 2007;
             19          .    requires a study of the necessity of registered health care assistants; and
             20          .    makes technical changes.
             21      Monies Appropriated in this Bill:
             22          None
             23      Other Special Clauses:
             24          None
             25      Utah Code Sections Affected:



             26      AMENDS:
             27          58-31b-102, as last amended by Chapter 290, Laws of Utah 2002
             28          58-31b-201, as last amended by Chapter 290, Laws of Utah 2002
             29          58-31b-301, as last amended by Chapter 290, Laws of Utah 2002
             30          58-31b-302, as last amended by Chapter 290, Laws of Utah 2002
             31          58-31b-303, as last amended by Chapter 314, Laws of Utah 2000
             32          58-31b-304, as enacted by Chapter 288, Laws of Utah 1998
             33          58-31b-307, as enacted by Chapter 288, Laws of Utah 1998
             34          58-31b-401, as last amended by Chapter 8, Laws of Utah 2002, Fifth Special Session
             35          58-31b-501, as last amended by Chapter 290, Laws of Utah 2002
             36          58-31b-502, as enacted by Chapter 288, Laws of Utah 1998
             37          58-31b-601, as enacted by Chapter 288, Laws of Utah 1998
             38          58-31b-701, as last amended by Chapter 290, Laws of Utah 2002
             39      ENACTS:
             40          58-31b-301.5, Utah Code Annotated 1953
             41          63-55b-158, Utah Code Annotated 1953
             42      Uncodified Material Affected:
             43      ENACTS UNCODIFIED MATERIAL
             44     
             45      Be it enacted by the Legislature of the state of Utah:
             46          Section 1. Section 58-31b-102 is amended to read:
             47           58-31b-102. Definitions.
             48          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             49          (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
             50      omissions determined to constitute unprofessional or unlawful conduct in accordance with a
             51      fine schedule established by rule and as a result of an adjudicative proceeding conducted in
             52      accordance with Title 63, Chapter 46b, Administrative Procedures Act.
             53          (2) "Applicant" means a person who applies for licensure or registration under this
             54      chapter by submitting a completed application for licensure or registration and the required fees
             55      to the department.
             56          (3) "Approved education program" means a nursing education program that meets the


             57      minimum standards for educational programs established under this chapter and by division
             58      rule in collaboration with the board.
             59          (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
             60          (5) "Consultation and referral plan" means a written plan jointly developed by an
             61      advanced practice registered nurse and a consulting physician that permits the advanced
             62      practice registered nurse to prescribe schedule II-III controlled substances in consultation with
             63      the consulting physician.
             64          (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
             65      surgeon licensed in accordance with this title who has agreed to consult with an advanced
             66      practice registered nurse with a controlled substance license, a DEA registration number, and
             67      who will be prescribing schedule II-III controlled substances.
             68          (7) "Diagnosis" means the identification of and discrimination between physical and
             69      psychosocial signs and symptoms essential to the effective execution and management of
             70      health care.
             71          (8) "Examinee" means a person who applies to take or does take any examination
             72      required under this chapter for licensure.
             73          (9) "Health care assistant" means an individual who:
             74          (a) engages in the practice of a health care assistant; and
             75          (b) is subject to registration under this chapter and is not subject to registration,
             76      licensure, or certification under any other chapter of this title.
             77          (10) "Geriatric care manager" means a licensed practical nurse who has had additional
             78      training in long-term care nursing and holds a current, valid certificate of completion from a
             79      training course approved by the division in collaboration with the board, and is certified by the
             80      division as a Licensed Practical Nurse - Geriatric Care Manager.
             81          [(10)] (11) "Licensee" means a person who is licensed [or], registered, or certified
             82      under this chapter.
             83          (12) "Long-term care facility" means any of the following facilities licensed by the
             84      Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
             85      Inspection Act:
             86          (a) a nursing care facility;
             87          (b) a small health care facility;


             88          (c) an intermediate care facility for the mentally retarded;
             89          (d) an assisted living facility Type I or II; or
             90          (e) a designated swing bed unit in a general hospital.
             91          [(11)] (13) "Practice as a health care assistant" means providing direct personal
             92      assistance or care for compensation to an individual who is ill, injured, infirm, developmentally
             93      or physically disabled, mentally disabled, or mentally retarded, and who is in a private
             94      residence or regulated facility.
             95          (14) "Practice of geriatric care management":
             96          (a) means a licensed practical nurse with specialized knowledge of geriatric and
             97      chronically ill patients residing in a long-term care facility as provided in Subsection
             98      58-31b-302 (2); and
             99          (b) includes an expanded scope of practice which may include:
             100          (i) implementing a plan of care;
             101          (ii) completing an assessment and evaluation of response to treatment; and
             102          (iii) other tasks and skills as defined by division rule.
             103          [(12)] (15) "Practice of nursing" means assisting individuals or groups to maintain or
             104      attain optimal health, implementing a strategy of care to accomplish defined goals and
             105      evaluating responses to care and treatment. The practice of nursing requires substantial
             106      specialized or general knowledge, judgment, and skill based upon principles of the biological,
             107      physical, behavioral, and social sciences, and includes:
             108          (a) initiating and maintaining comfort measures;
             109          (b) promoting and supporting human functions and responses;
             110          (c) establishing an environment conducive to well-being;
             111          (d) providing health counseling and teaching;
             112          (e) collaborating with health care professionals on aspects of the health care regimen;
             113          (f) performing delegated procedures only within the education, knowledge, judgment,
             114      and skill of the licensee; and
             115          (g) delegating nurse interventions that may be performed by others and are not in
             116      conflict with this chapter.
             117          [(13)] (16) (a) "Practice of nurse anesthesia" means the practice of nursing related to
             118      the provision of preoperative, intraoperative, and postoperative anesthesia care and related


             119      services upon the request of a physician, surgeon, or other licensed professional, who is acting
             120      within the scope of their practice, by a person licensed under this chapter as a certified
             121      registered nurse anesthetist and includes:
             122          (i) preanesthesia preparation and evaluation including:
             123          (A) performing a preanesthetic assessment of the patient;
             124          (B) ordering and evaluating appropriate lab and other studies to determine the health of
             125      the patient; and
             126          (C) selecting, ordering, or administering appropriate medications;
             127          (ii) anesthesia induction, maintenance, and emergence, including:
             128          (A) selecting and initiating the planned anesthetic technique;
             129          (B) selecting and administering anesthetics and adjunct drugs and fluids; and
             130          (C) administering general, regional, and local anesthesia;
             131          (iii) postanesthesia follow-up care, including:
             132          (A) evaluating the patient's response to anesthesia and implementing corrective
             133      actions; and
             134          (B) selecting, ordering, or administering the above medications and studies; and
             135          (iv) other related services within the scope of practice of a certified registered nurse
             136      anesthetist, including:
             137          (A) emergency airway management;
             138          (B) advanced cardiac life support; and
             139          (C) the establishment of peripheral, central, and arterial invasive lines.
             140          (b) Nothing in this section shall be construed as to require a certified registered nurse
             141      anesthetist to obtain an advance practice registered nurse license in order to select, administer,
             142      or provide preoperative, intraoperative, or postoperative anesthesia care and services.
             143          [(14)] (17) "Practice of practical nursing" means the performance of nursing acts in the
             144      generally recognized scope of practice of licensed practical nurses as defined by rule and as
             145      provided in this Subsection [(14)] (17) by a person licensed under this chapter as a licensed
             146      practical nurse and under the direction of a registered nurse, licensed physician, or other
             147      specified health care professional as defined by rule. Practical nursing acts include:
             148          (a) contributing to the assessment of the health status of individuals and groups;
             149          (b) participating in the development and modification of the strategy of care;


             150          (c) implementing appropriate aspects of the strategy of care;
             151          (d) maintaining safe and effective nursing care rendered to a patient directly or
             152      indirectly; and
             153          (e) participating in the evaluation of responses to interventions.
             154          [(15)] (18) "Practice of registered nursing" means performing acts of nursing as
             155      provided in this Subsection [(15)] (18) by a person licensed under this chapter as a registered
             156      nurse within the generally recognized scope of practice of registered nurses as defined by rule.
             157      Registered nursing acts include:
             158          (a) assessing the health status of individuals and groups;
             159          (b) identifying health care needs;
             160          (c) establishing goals to meet identified health care needs;
             161          (d) planning a strategy of care;
             162          (e) prescribing nursing interventions to implement the strategy of care;
             163          (f) implementing the strategy of care;
             164          (g) maintaining safe and effective nursing care that is rendered to a patient directly or
             165      indirectly;
             166          (h) evaluating responses to interventions;
             167          (i) teaching the theory and practice of nursing; and
             168          (j) managing and supervising the practice of nursing.
             169          [(16)] (19) "Practice of advanced practice registered nursing" means the practice of
             170      nursing within the generally recognized scope and standards of advanced practice registered
             171      nursing as defined by rule and consistent with professionally recognized preparation and
             172      education standards of an advanced practice registered nurse by a person licensed under this
             173      chapter as an advanced practice registered nurse. Advanced practice registered nursing
             174      includes:
             175          (a) maintenance and promotion of health and prevention of disease;
             176          (b) diagnosis, treatment, correction, consultation, and referral for common health
             177      problems; and
             178          (c) prescription or administration of prescription drugs or devices including:
             179          (i) local anesthesia;
             180          (ii) schedule IV-V controlled substances; and


             181          (iii) schedule II-III controlled substances in accordance with a consultation and referral
             182      plan.
             183          [(17)] (20) "Regulated facility" means a health care facility subject to licensure under
             184      Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:
             185          (a) the Utah State Hospital or the Utah State Developmental Center;
             186          (b) a residential treatment or residential support facility:
             187          (i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and
             188      Facilities; and
             189          (ii) serving people with disabilities, as defined by Department of Human Services
             190      rules; or
             191          (c) a [covered] health care facility [as defined in Section 26-21-9.5 ] which is licensed
             192      or certified under Title 26, Chapter 21.
             193          [(18)] (21) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501 .
             194          [(19)] (22) "Unlicensed assistive personnel" means any unlicensed person, regardless
             195      of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
             196      with the standards of the profession.
             197          [(20)] (23) "Unprofessional conduct" is as defined in Sections 58-1-501 and
             198      58-31b-502 and as may be further defined by rule.
             199          Section 2. Section 58-31b-201 is amended to read:
             200           58-31b-201. Board.
             201          (1) There is created the Board of Nursing that consists of the following eleven
             202      members:
             203          (a) [eight] nine nurses in a manner as may be further defined in division rule; and
             204          [(b) one registered health care assistant; and]
             205          [(c)] (b) two members of the public.
             206          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             207          (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
             208      58-1-203 and shall:
             209          (a) (i) recommend to the division minimum standards for educational programs
             210      qualifying a person for licensure, registration, or certification under this chapter;
             211          (ii) recommend to the division denial, approval, or withdrawal of approval regarding


             212      educational programs that meet or fail to meet the established minimum standards; and
             213          (iii) designate one of its members on a permanent or rotating basis to:
             214          (A) assist the division in reviewing complaints concerning the unlawful or
             215      unprofessional conduct of a licensee; and
             216          (B) advise the division in its investigation of these complaints.
             217          (b) A board member who has, under Subsection (3)(a)(iii), reviewed a complaint or
             218      advised in its investigation may be disqualified from participating with the board when the
             219      board serves as a presiding officer in an adjudicative proceeding concerning the complaint.
             220          (4) (a) The director shall appoint an individual to serve as the executive administrator
             221      of the Board of Nursing. Except when the board serves as a presiding officer in an adjudicative
             222      procedure, the executive administrator shall serve as an ex officio member of the board and
             223      shall represent the position of the division in matters considered by the board.
             224          (b) The executive administrator shall be a licensed registered nurse, shall have earned a
             225      masters degree in nursing, and shall have a minimum of five years of experience working in
             226      nursing administration or nursing education.
             227          Section 3. Section 58-31b-301 is amended to read:
             228           58-31b-301. License or certification required - Classifications.
             229          (1) A license is required to engage in the practice of nursing, except as specifically
             230      provided in Sections 58-1-307 and 58-31b-308 .
             231          (2) The division shall issue to a person who qualifies under this chapter a license or
             232      certification in the classification of:
             233          (a) licensed practical nurse;
             234          (b) licensed practical nurse - geriatric care manager;
             235          [(b)] (c) registered nurse;
             236          [(c)] (d) advanced practice registered nurse intern;
             237          [(d)] (e) advanced practice registered nurse; and
             238          [(e)] (f) certified registered nurse anesthetist.
             239          (3) An individual holding an advanced practice registered nurse license as of July 1,
             240      1998, who cannot document the successful completion of advanced course work in patient
             241      assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
             242      issued an "APRN - without prescriptive practice" license.


             243          (4) The division shall grant an advanced practice registered nurse license to any
             244      licensed advanced practice registered nurse currently holding prescriptive authority under any
             245      predecessor act on July 1, 1998.
             246          (5) (a) An individual shall be registered under this chapter in order to engage in
             247      practice as a health care assistant, except as provided in Sections 58-31b-308 and
             248      58-31b-308.5 .
             249          (b) The division shall issue to a person who qualifies under this chapter a registration
             250      in the classification of health care assistant.
             251          Section 4. Section 58-31b-301.5 is enacted to read:
             252          58-31b-301.5. Geriatric Care Manager Pilot Program.
             253          (1) (a) The division shall establish a licensed practical nurse - Geriatric Care Manager
             254      Pilot Program to determine the safety and efficiency of expanding the scope of practice for a
             255      licensed practical nurse who meets the requirements of Subsection 38-31b-302 (2).
             256          (b) The pilot program shall begin on July 1, 2004 and sunset in accordance with
             257      Section 63-55b-158 .
             258          (c) If the Legislature does not reauthorize the expanded scope of practice for geriatric
             259      care managers after the sunset date in Subsection 58-31b-302 (2), an individual licensed and
             260      certified in good standing as a geriatric care manager may continue to practice as a licensed
             261      practical nurse.
             262          (2) If at any time the division determines the certification pilot program has become a
             263      threat, or potential threat to the public health, safety, or welfare, the division may authorize
             264      emergency rules to place the certification program in abeyance until the next legislative
             265      session.
             266          Section 5. Section 58-31b-302 is amended to read:
             267           58-31b-302. Qualifications for licensure or certification -- Criminal background
             268      checks.
             269          (1) An applicant for licensure as a licensed practical nurse shall:
             270          (a) submit to the division an application in a form prescribed by the division;
             271          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             272          (c) have a high school diploma or its equivalent;
             273          (d) be in a condition of physical and mental health that will permit the applicant to


             274      practice safely as a licensed practical nurse;
             275          (e) have completed an approved practical nursing education program or an equivalent
             276      as determined by the board;
             277          (f) have passed the examinations as required by division rule made in collaboration
             278      with the board; and
             279          (g) meet with the board, if requested, to determine the applicant's qualifications for
             280      licensure.
             281          (2) An applicant for certification as a licensed practical nurse - geriatric care manager
             282      shall:
             283          (a) submit an application to the division on a form prescribed by the division;
             284          (b) pay a fee to the division as determined under Section 63-38-3.2 ;
             285          (c) have a current license, in good standing, as a licensed practical nurse;
             286          (d) have one year experience in a long-term care facility;
             287          (e) be in a condition of physical and mental health that will permit the applicant to
             288      practice safely as a licensed practical nurse - geriatric care manager;
             289          (f) have completed a division-approved geriatric care management education program
             290      or an equivalent as determined by the division in collaboration with the board;
             291          (g) have passed the examinations as required by division rule made in collaboration
             292      with the board; and
             293          (h) meet with the board, if requested, to determine the applicant's qualifications for
             294      licensure.
             295          [(2)] (3) An applicant for licensure as a registered nurse shall:
             296          (a) submit to the division an application form prescribed by the division;
             297          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             298          (c) have a high school diploma or its equivalent;
             299          (d) be in a condition of physical and mental health that will allow the applicant to
             300      practice safely as a registered nurse;
             301          (e) have completed an approved registered nursing education program;
             302          (f) have passed the examinations as required by division rule made in collaboration
             303      with the board; and
             304          (g) meet with the board, if requested, to determine the applicant's qualifications for


             305      licensure.
             306          [(3)] (4) Applicants for licensure as an advanced practice registered nurse shall:
             307          (a) submit to the division an application on a form prescribed by the division;
             308          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             309          (c) be in a condition of physical and mental health which will allow the applicant to
             310      practice safely as an advanced practice registered nurse;
             311          (d) hold a current registered nurse license in good standing issued by the state or be
             312      qualified at the time for licensure as a registered nurse;
             313          (e) have earned a graduate degree in nursing or a related area of specialized knowledge
             314      as determined appropriate by the division in collaboration with the board;
             315          (f) have completed course work in patient assessment, diagnosis and treatment, and
             316      pharmacotherapeutics from an education program approved by the division in collaboration
             317      with the board;
             318          (g) have successfully completed clinical practice in psychiatric and mental health
             319      nursing, including psychotherapy as defined by division rule, after completion of the masters
             320      degree required for licensure, to practice within the psychiatric and mental health nursing
             321      specialty;
             322          (h) have passed the examinations as required by division rule made in collaboration
             323      with the board;
             324          (i) be currently certified by a program approved by the division in collaboration with
             325      the board and submit evidence satisfactory to the division of the certification; and
             326          (j) meet with the board, if requested, to determine the applicant's qualifications for
             327      licensure.
             328          [(4)] (5) An applicant for licensure as a certified registered nurse anesthetist shall:
             329          (a) submit to the division an application on a form prescribed by the division;
             330          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             331          (c) be in a condition of physical and mental health which will allow the applicant to
             332      practice safely as a certified registered nurse anesthetist;
             333          (d) hold a current registered nurse license in good standing issued by the state or be
             334      qualified at the time for licensure as a registered nurse;
             335          (e) complete a nurse anesthesia program which is approved by the Council on


             336      Accreditation of Nurse Anesthesia Educational Programs;
             337          (f) be currently certified by a program approved by the division in collaboration with
             338      the board and submit evidence satisfactory to the division of the certification; and
             339          (g) meet with the board, if requested, to determine the applicant's qualifications for
             340      licensure.
             341          [(5)] (6) An applicant for registration as a health care assistant shall:
             342          (a) submit an application in a form prescribed by the division;
             343          (b) pay a fee determined by the department under Section 63-38-3.2 ;
             344          (c) certify in writing that he is free from any physical, mental, or emotional condition
             345      that will or may reasonably be expected to prevent the applicant from practicing as a health
             346      care assistant in compliance with this chapter; and
             347          (d) may not, within five years immediately prior to application, have any substantiated
             348      allegations of abuse, neglect, or misappropriation of client property listed against him on the
             349      certified nurse assistant registry maintained by the State Office of Education or on a similar
             350      registry maintained in another state in compliance with 42 CFR 483.156.
             351          [(6)] (7) An applicant for licensure [or], registration, or certification under this chapter:
             352          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             353      license application is filed and shall consent to a fingerprint background check by the Utah
             354      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
             355      application; and
             356          (ii) the division shall request the Department of Public Safety to complete a Federal
             357      Bureau of Investigation criminal background check for each applicant through the national
             358      criminal history system (NCIC) or any successor system; and
             359          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             360      sentences for all felony convictions five or more years prior to the date of filing an application
             361      for licensure or registration under this chapter.
             362          [(7)] (8) For purposes of conducting the criminal background checks required in
             363      Subsection (6), the division shall have direct access to criminal background information
             364      maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             365          [(8)] (9) (a) Any new nurse license or health care assistant registration issued under this
             366      section shall be conditional, pending completion of the criminal background check. If the


             367      criminal background check discloses the applicant has failed to accurately disclose a criminal
             368      history, the license or registration shall be immediately and automatically revoked.
             369          (b) Any person whose conditional license or registration has been revoked under
             370      Subsection [(8)] (9)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
             371      The hearing shall be conducted in accordance with Title 63, Chapter 46b, Administrative
             372      Procedures Act.
             373          Section 6. Section 58-31b-303 is amended to read:
             374           58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
             375      programs.
             376          An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
             377      nursing education program not approved by the division in collaboration with the board must
             378      comply with the requirements of this section.
             379          (1) An applicant for licensure as a licensed practical nurse shall:
             380          (a) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(e); and
             381          (b) produce evidence acceptable to the division and the board that the nursing
             382      education program completed by the applicant is equivalent to the minimum standards
             383      established by the division in collaboration with the board for an approved licensed practical
             384      nursing education program.
             385          (2) An applicant for licensure as a registered nurse shall:
             386          (a) meet all requirements of Subsection 58-31b-302 [(2)] (3), except Subsection [(2)]
             387      (3)(e); and
             388          (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
             389      Examination; or
             390          (ii) produce evidence acceptable to the division and the board that the applicant is
             391      currently licensed as a registered nurse in one of the states, territories, or the District of
             392      Columbia of the United States and has passed the NCLEX-RN examination.
             393          Section 7. Section 58-31b-304 is amended to read:
             394           58-31b-304. Qualifications for admission to the examinations.
             395          (1) To be admitted to the examinations required for certification as a licensed practical
             396      nurse - geriatric care manager, a person shall:
             397          (a) submit an application on a form prescribed by the division;


             398          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             399          (c) meet all requirements of Subsection 58-31b-302 (2) except the passing of the
             400      examination.
             401          [(1)] (2) To be admitted to the examinations required for licensure as a practical nurse,
             402      a person shall:
             403          (a) submit an application form prescribed by the division;
             404          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             405          (c) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(f).
             406          [(2)] (3) To be admitted to the examinations required for licensure as a registered
             407      nurse, a person shall:
             408          (a) submit an application form prescribed by the division;
             409          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             410          (c) meet all the requirements of Subsection 58-31b-302 [(2)](3), except Subsection
             411      [(2)](3)(f).
             412          Section 8. Section 58-31b-307 is amended to read:
             413           58-31b-307. Licensure by endorsement.
             414          An applicant for licensure by endorsement as an advanced practice registered nurse
             415      under the provisions of Section 58-1-302 shall also:
             416          (1) demonstrate that the applicant has successfully engaged in active practice as an
             417      advanced practice registered nurse for not less than 1,500 hours per year in not less than three
             418      of the past five years immediately preceding the application for licensure; and
             419          (2) demonstrate that the applicant has completed course work as required in Subsection
             420      58-31b-302 [(3)] (4)(f).
             421          Section 9. Section 58-31b-401 is amended to read:
             422           58-31b-401. Grounds for denial of licensure or certification and disciplinary
             423      proceedings.
             424          (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the
             425      license of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee,
             426      to issue a public or private reprimand to a licensee, and to issue cease and desist orders shall be
             427      in accordance with Section 58-1-401 .
             428          (2) If a court of competent jurisdiction determines a nurse or health care assistant is an


             429      incapacitated person as defined in Section 75-1-201 or that he is mentally ill as defined in
             430      Section 62A-15-602 , and unable to safely engage in the practice of nursing or the practice of a
             431      health care assistant, the director shall immediately suspend the license of the nurse or health
             432      care assistant upon the entry of the judgment of the court, without further proceedings under
             433      Title 63, Chapter 46b, Administrative Procedures Act, regardless of whether an appeal from the
             434      court's ruling is pending. The director shall promptly notify the nurse or health care assistant,
             435      in writing, of the suspension.
             436          (3) (a) If the division and the majority of the board find reasonable cause to believe a
             437      nurse or health care assistant, who is not determined judicially to be an incapacitated person or
             438      to be mentally ill, is incapable of practicing nursing or the practice of a health care assistant
             439      with reasonable skill regarding the safety of patients, because of illness, excessive use of drugs
             440      or alcohol, or as a result of any mental or physical condition, the board shall recommend that
             441      the director file a petition with the division, and cause the petition to be served upon the nurse
             442      or health care assistant with a notice of hearing on the sole issue of the capacity of the nurse or
             443      health care assistant to competently, safely engage in the practice of nursing or the practice of a
             444      health care assistant.
             445          (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
             446      Administrative Procedures Act, except as provided in Subsection (4).
             447          (4) (a) Every nurse or health care assistant who accepts the privilege of being licensed
             448      under this chapter gives consent to:
             449          (i) submitting to an immediate mental or physical examination, at the nurse's or health
             450      care assistant's expense and by a division-approved practitioner selected by the nurse or health
             451      care assistant, when directed in writing by the division and a majority of the board to do so; and
             452          (ii) the admissibility of the reports of the examining practitioner's testimony or
             453      examination, and waives all objections on the ground the reports constitute a privileged
             454      communication.
             455          (b) The examination may be ordered by the division, with the consent of a majority of
             456      the board, only upon a finding of reasonable cause to believe:
             457          (i) the nurse or health care assistant is mentally ill or incapacitated or otherwise unable
             458      to practice nursing or health care assistance with reasonable skill and safety; and
             459          (ii) immediate action by the division and the board is necessary to prevent harm to the


             460      nurse's or health care assistant's patients or the general public.
             461          (c) (i) Failure of a nurse or health care assistant to submit to the examination ordered
             462      under this section is a ground for the division's immediate suspension of the nurse's or health
             463      care assistant's license by written order of the director.
             464          (ii) The division may enter the order of suspension without further compliance with
             465      Title 63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to
             466      submit to the examination ordered under this section was due to circumstances beyond the
             467      control of the nurse or health care assistant and was not related directly to the illness or
             468      incapacity of the nurse or health care assistant.
             469          (5) (a) A nurse or health care assistant whose license is suspended under Subsection
             470      (2), (3), or (4)(c) has the right to a hearing to appeal the suspension within ten days after the
             471      license is suspended.
             472          (b) The hearing held under this Subsection (5) shall be conducted in accordance with
             473      Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists
             474      for the continuance of the order of suspension in order to prevent harm to the nurse's or health
             475      care assistant's patients or the general public.
             476          (6) A nurse or health care assistant whose license is revoked, suspended, or in any way
             477      restricted under this section may request the division and the board to consider, at reasonable
             478      intervals, evidence presented by the nurse or health care assistant, under procedures established
             479      by division rule, regarding any change in the nurse's or health care assistant's condition, to
             480      determine whether:
             481          (a) he is or is not able to safely and competently engage in the practice of nursing or the
             482      practice of a health care assistant; and
             483          (b) he is qualified to have his license to practice under this chapter restored completely
             484      or in part.
             485          (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the
             486      division to report current significant investigative information to the coordinated licensure
             487      information system for transmission to party states as required of the division by Article VII of
             488      the Nurse Licensure Compact in Section 58-31c-102 .
             489          (8) For purposes of this section and Section 58-31b-402 , "licensed" or "license"
             490      includes "registered" [and] or "registration" and "certified" or "certification" under this chapter.


             491          Section 10. Section 58-31b-501 is amended to read:
             492           58-31b-501. Unlawful conduct.
             493          (1) "Unlawful conduct" includes:
             494          (a) using the following titles, names or initials, if the user is not properly licensed
             495      under this chapter:
             496          (i) nurse;
             497          (ii) licensed practical nurse, practical nurse, or L.P.N.;
             498          (iii) registered nurse or R.N.;
             499          (iv) registered nurse practitioner, N.P., or R.N.P.;
             500          (v) registered nurse specialist, N.S., or R.N.S.;
             501          (vi) registered psychiatric mental health nurse specialist;
             502          (vii) advanced practice registered nurse;
             503          (viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist,
             504      or C.R.N.A.; or
             505          (ix) other generally recognized names or titles used in the profession of nursing;
             506          (b) using any other name, title, or initials that would cause a reasonable person to
             507      believe the user is licensed under this chapter if the user is not properly licensed under this
             508      chapter; and
             509          (c) conducting a nursing education program in the state for the purpose of qualifying
             510      individuals to meet requirements for licensure under this chapter without the program having
             511      been approved under Section 58-31b-601 .
             512          (2) (a) An individual registered as a health care assistant under this chapter may use
             513      any title in his practice as a health care assistant, and an employer may assign a title to health
             514      care assistants it employs, if the title does not cause a reasonable person to believe the
             515      registrant is a licensee in any other license classification under this chapter and Title 58,
             516      Occupations and Professions.
             517          (b) If any issue is raised regarding a title under this section, the division shall determine
             518      if the title may be used for health care assistants.
             519          (3) An individual licensed as a practical nurse who is certified as a geriatric care
             520      manager under this chapter, may use the title "licensed practical nurse - geriatric care manager"
             521      or the initials "LPN-GCM" to designate the additional training and certification.


             522          Section 11. Section 58-31b-502 is amended to read:
             523           58-31b-502. Unprofessional conduct.
             524          "Unprofessional conduct" includes:
             525          (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
             526      diagnosis, personal effects, or any other matter about which the licensee is privileged to know
             527      because of the licensee's position or practice as a nurse;
             528          (2) failure to provide nursing service in a manner that demonstrates respect for the
             529      patient's human dignity and unique personal character and needs without regard to the patient's
             530      race, religion, ethnic background, socioeconomic status, age, sex, or the nature of the patient's
             531      health problem;
             532          (3) engaging in sexual relations with a patient during any:
             533          (a) period when a generally recognized professional relationship exists between the
             534      nurse and patient; or
             535          (b) extended period when a patient has reasonable cause to believe a professional
             536      relationship exists between the nurse and patient;
             537          (4) (a) as a result of any circumstance under Subsection (3), exploiting or using
             538      information about a patient or exploiting the licensee's professional relationship between the
             539      licensee and the patient; or
             540          (b) exploiting the patient by use of the licensee's knowledge of the patient obtained
             541      while acting as a nurse;
             542          (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
             543          (6) unauthorized taking or personal use of nursing supplies from an employer;
             544          (7) unauthorized taking or personal use of a patient's personal property;
             545          (8) knowingly entering into any medical record any false or misleading information or
             546      altering a medical record in any way for the purpose of concealing an act, omission, or record
             547      of events, medical condition, or any other circumstance related to the patient and the medical or
             548      nursing care provided;
             549          (9) unlawful or inappropriate delegation of nursing care;
             550          (10) failure to exercise appropriate supervision of persons providing patient care
             551      services under supervision of the licensed nurse;
             552          (11) employing or aiding and abetting the employment of an unqualified or unlicensed


             553      person to practice as a nurse;
             554          (12) failure to file or record any medical report as required by law, impeding or
             555      obstructing the filing or recording of such a report, or inducing another to fail to file or record
             556      such a report;
             557          (13) breach of a statutory, common law, regulatory, or ethical requirement of
             558      confidentiality with respect to a person who is a patient, unless ordered by a court;
             559          (14) failure to pay a penalty imposed by the division; [and]
             560          (15) prescribing a schedule II-III controlled substance without a consulting physician or
             561      outside of a consultation and referral plan; [and]
             562          (16) violating Section 58-31b-801 [.]; and
             563          (17) practicing as a licensed practical nurse - geriatric care manager in a setting other
             564      than a long-term care facility.
             565          Section 12. Section 58-31b-601 is amended to read:
             566           58-31b-601. Minimum standards for nursing programs and certification training
             567      programs.
             568          (1) A nursing education program shall be affiliated with an accredited institution of
             569      higher education in order to be approved by the division.
             570          (2) The minimum standards a nursing program shall meet to qualify graduates for
             571      licensure under this chapter shall be defined by division rule.
             572          (3) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act, the
             573      division shall make rules defining the minimum standards a licensed practical nurse - geriatric
             574      care manager training program must meet to qualify a person for certification under this
             575      chapter as a licensed practical nurse - geriatric care manager.
             576          Section 13. Section 58-31b-701 is amended to read:
             577           58-31b-701. Immunity from liability.
             578          A person licensed [or], registered, or certified under this chapter:
             579          (1) who provides emergency care in accordance with Section 78-11-22 is entitled to the
             580      immunity from civil liability provided under that section; and
             581          (2) is considered a health care provider under Chapter 13, Health Care Providers
             582      Immunity from Liability Act, and is entitled to the immunity from civil liability provided under
             583      that chapter.


             584          Section 14. Section 63-55b-158 is enacted to read:
             585          63-55b-158. Repeal dates - Title 58.
             586          Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed July 1, 2007.
             587          Section 15. Study of registered health care assistant.
             588          It is the intent of the Legislature that the Division of Occupational and Professional
             589      Licensing in cooperation with the Department of Health and the Department of Human
             590      Services, including the Division of Aging and Adult services, study the necessity of the
             591      registered health care assistant during the 2004 Interim and report its findings to the Health and
             592      Human Services Interim Committee on or before its October interim committee meeting.


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