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S.B. 107

             1     

ADVANCED PRACTICE REGISTERED NURSE

             2     
MODIFICATIONS

             3     
2004 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Sponsor: Peter C. Knudson

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill enacts the Advanced Practice Registered Nurse Compact and makes
             10      modifications to related provisions dealing with advanced practice registered nurses.
             11      Highlighted Provisions:
             12          This bill:
             13          .    enacts a compact that ensures and encourages the cooperation of party states in the
             14      areas of APRN licensure/authority to practice and regulation, including promotion
             15      of uniform licensure requirements;
             16          .    provides, under the compact, for the recognition, limitation, and revoking of
             17      multistate advanced practice privileges;
             18          .    provides an application process, under the compact, for APRN licensure/authority to
             19      practice in a party state;
             20          .    provides, under the compact, for adverse action affecting the multistate advanced
             21      practice privilege;
             22          .    grants authority to the Division of Occupational and Professional Licensing, under
             23      the compact, to recover costs resulting from adverse actions taken against an APRN
             24      and issue cease and desist orders;
             25          .    provides, under the compact, for participation in a cooperative effort to create a
             26      coordinated licensure information system of all APRNs; and
             27          .    repeals licensure by endorsement as an advanced practice registered nurse.


             28      Monies Appropriated in this Bill:
             29          None
             30      Other Special Clauses:
             31          This bill takes effect on July 1, 2004.
             32      Utah Code Sections Affected:
             33      AMENDS:
             34          58-31b-302, as last amended by Chapter 290, Laws of Utah 2002
             35      ENACTS:
             36          58-31d-101, Utah Code Annotated 1953
             37          58-31d-102, Utah Code Annotated 1953
             38          58-31d-103, Utah Code Annotated 1953
             39      REPEALS:
             40          58-31b-307, as enacted by Chapter 288, Laws of Utah 1998
             41     
             42      Be it enacted by the Legislature of the state of Utah:
             43          Section 1. Section 58-31b-302 is amended to read:
             44           58-31b-302. Qualifications for licensure or registration -- Criminal background
             45      checks.
             46          (1) An applicant for licensure as a licensed practical nurse shall:
             47          (a) submit to the division an application in a form prescribed by the division;
             48          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             49          (c) have a high school diploma or its equivalent;
             50          (d) be in a condition of physical and mental health that will permit the applicant to
             51      practice safely as a licensed practical nurse;
             52          (e) have completed an approved practical nursing education program or an equivalent
             53      as determined by the board;
             54          (f) have passed the examinations as required by division rule made in collaboration
             55      with the board; and
             56          (g) meet with the board, if requested, to determine the applicant's qualifications for
             57      licensure.
             58          (2) An applicant for licensure as a registered nurse shall:


             59          (a) submit to the division an application form prescribed by the division;
             60          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             61          (c) have a high school diploma or its equivalent;
             62          (d) be in a condition of physical and mental health that will allow the applicant to
             63      practice safely as a registered nurse;
             64          (e) have completed an approved registered nursing education program;
             65          (f) have passed the examinations as required by division rule made in collaboration
             66      with the board; and
             67          (g) meet with the board, if requested, to determine the applicant's qualifications for
             68      licensure.
             69          (3) Applicants for licensure as an advanced practice registered nurse shall:
             70          (a) submit to the division an application on a form prescribed by the division;
             71          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             72          (c) be in a condition of physical and mental health which will allow the applicant to
             73      practice safely as an advanced practice registered nurse;
             74          (d) hold a current registered nurse license in good standing issued by the state or be
             75      qualified at the time for licensure as a registered nurse;
             76          (e) have earned a graduate degree in an advanced practice registered nurse nursing
             77      education program or a related area of specialized knowledge as determined appropriate by the
             78      division in collaboration with the board;
             79          (f) have completed course work in patient assessment, diagnosis and treatment, and
             80      pharmacotherapeutics from an education program approved by the division in collaboration
             81      with the board;
             82          (g) have successfully completed clinical practice in psychiatric and mental health
             83      nursing, including psychotherapy as defined by division rule, after completion of the masters
             84      degree required for licensure, to practice within the psychiatric and mental health nursing
             85      specialty;
             86          (h) have passed the examinations as required by division rule made in collaboration
             87      with the board;
             88          (i) be currently certified by a program approved by the division in collaboration with
             89      the board and submit evidence satisfactory to the division of the certification; and


             90          (j) meet with the board, if requested, to determine the applicant's qualifications for
             91      licensure.
             92          (4) An applicant for licensure as a certified registered nurse anesthetist shall:
             93          (a) submit to the division an application on a form prescribed by the division;
             94          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             95          (c) be in a condition of physical and mental health which will allow the applicant to
             96      practice safely as a certified registered nurse anesthetist;
             97          (d) hold a current registered nurse license in good standing issued by the state or be
             98      qualified at the time for licensure as a registered nurse;
             99          (e) complete a nurse anesthesia program which is approved by the Council on
             100      Accreditation of Nurse Anesthesia Educational Programs;
             101          (f) be currently certified by a program approved by the division in collaboration with
             102      the board and submit evidence satisfactory to the division of the certification; and
             103          (g) meet with the board, if requested, to determine the applicant's qualifications for
             104      licensure.
             105          (5) An applicant for registration as a health care assistant shall:
             106          (a) submit an application in a form prescribed by the division;
             107          (b) pay a fee determined by the department under Section 63-38-3.2 ;
             108          (c) certify in writing that he is free from any physical, mental, or emotional condition
             109      that will or may reasonably be expected to prevent the applicant from practicing as a health
             110      care assistant in compliance with this chapter; and
             111          (d) may not, within five years immediately prior to application, have any substantiated
             112      allegations of abuse, neglect, or misappropriation of client property listed against him on the
             113      certified nurse assistant registry maintained by the State Office of Education or on a similar
             114      registry maintained in another state in compliance with 42 CFR 483.156.
             115          (6) An applicant for licensure or registration under this chapter:
             116          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             117      license application is filed and shall consent to a fingerprint background check by the Utah
             118      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
             119      application; and
             120          (ii) the division shall request the Department of Public Safety to complete a Federal


             121      Bureau of Investigation criminal background check for each applicant through the national
             122      criminal history system (NCIC) or any successor system; and
             123          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             124      sentences for all felony convictions five or more years prior to the date of filing an application
             125      for licensure or registration under this chapter.
             126          (7) For purposes of conducting the criminal background checks required in Subsection
             127      (6), the division shall have direct access to criminal background information maintained
             128      pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             129          (8) (a) (i) Any new nurse license or health care assistant registration issued under this
             130      section shall be conditional, pending completion of the criminal background check.
             131          (ii) If the criminal background check discloses the applicant has failed to accurately
             132      disclose a criminal history, the license or registration shall be immediately and automatically
             133      revoked.
             134          (b) (i) Any person whose conditional license or registration has been revoked under
             135      Subsection (8)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
             136          (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
             137      Administrative Procedures Act.
             138          Section 2. Section 58-31d-101 is enacted to read:
             139     
CHAPTER 31d. ADVANCED PRACTICE REGISTERED NURSE COMPACT

             140          58-31d-101. Title.
             141          This chapter is known as the "Advanced Practice Registered Nurse Compact."
             142          Section 3. Section 58-31d-102 is enacted to read:
             143          58-31d-102. Advanced Practice Registered Nurse Compact.
             144          The Advanced Practice Registered Nurse Compact is hereby enacted and entered into
             145      with all other jurisdictions that legally join in the compact, which is, in form, substantially as
             146      follows:
             147     
Advanced Practice Registered Nurse Compact

             148     
ARTICLE I

             149     
Findings and Declaration of Purpose

             150          (1) The party states find that:
             151          (a) the health and safety of the public are affected by the degree of compliance with


             152      APRN licensure/authority to practice requirements and the effectiveness of enforcement
             153      activities related to state APRN licensure/authority to practice laws;
             154          (b) violations of APRN licensure/authority to practice and other laws regulating the
             155      practice of nursing may result in injury or harm to the public;
             156          (c) the expanded mobility of APRNs and the use of advanced communication
             157      technologies as part of our nation's health care delivery system require greater coordination and
             158      cooperation among states in the areas of APRN licensure/authority to practice and regulation;
             159          (d) new practice modalities and technology make compliance with individual state
             160      APRN licensure/authority to practice laws difficult and complex;
             161          (e) the current system of duplicative APRN licensure/authority to practice for APRNs
             162      practicing in multiple states is cumbersome and redundant to both APRNs and states;
             163          (f) uniformity of APRN requirements throughout the states promotes public safety and
             164      public health benefits; and
             165          (g) access to APRN services increases the public's access to health care, particularly in
             166      rural and underserved areas.
             167          (2) The general purposes of this compact are to:
             168          (a) facilitate the states' responsibilities to protect the public's health and safety;
             169          (b) ensure and encourage the cooperation of party states in the areas of APRN
             170      licensure/authority to practice and regulation, including promotion of uniform licensure
             171      requirements;
             172          (c) facilitate the exchange of information between party states in the areas of APRN
             173      regulation, investigation, and adverse actions;
             174          (d) promote compliance with the laws governing APRN practice in each jurisdiction;
             175      and
             176          (e) invest all party states with the authority to hold an APRN accountable for meeting
             177      all state practice laws in the state in which the patient is located at the time care is rendered
             178      through the mutual recognition of party state licenses.
             179     
ARTICLE II

             180     
Definitions

             181          As used in this compact:
             182          (1) "Advanced practice registered nurse" or "APRN" means a nurse anesthetist; nurse


             183      practitioner; nurse midwife; or clinical nurse specialist to the extent a party state licenses or
             184      grants authority to practice in that APRN role and title.
             185          (2) "Adverse action" means a home or remote state disciplinary action.
             186          (3) "Alternative program" means a voluntary, nondisciplinary monitoring program
             187      approved by a licensing board.
             188          (4) "APRN Licensure/Authority to Practice" means the regulatory mechanism used by
             189      a party state to grant legal authority to practice as an APRN.
             190          (5) "APRN Uniform Licensure/Authority to Practice Requirements" means those
             191      minimum uniform licensure, education, and examination requirements as agreed to by the
             192      compact administrators and adopted by licensing boards for the recognized APRN role and
             193      title.
             194          (6) "Coordinated licensure information system" means an integrated process for
             195      collecting, storing, and sharing information on APRN licensure/authority to practice and
             196      enforcement activities related to APRN licensure/authority to practice laws, which is
             197      administered by a nonprofit organization composed of and controlled by state licensing boards.
             198          (7) "Current significant investigative information" means:
             199          (a) investigative information that a licensing board, after a preliminary inquiry that
             200      includes notification and an opportunity for the APRN to respond if required by state law, has
             201      reason to believe is not groundless and, if proved true, would indicate more than a minor
             202      infraction; or
             203          (b) investigative information that indicates that the APRN represents an immediate
             204      threat to public health and safety regardless of whether the APRN has been notified and had an
             205      opportunity to respond.
             206          (8) "Home state" means the party state that is the APRN's primary state of residence.
             207          (9) "Home state action" means any administrative, civil, equitable, or criminal action
             208      permitted by the home state's laws which are imposed on an APRN by the home state's
             209      licensing board or other authority including actions against an individual's license/authority to
             210      practice such as: revocation, suspension, probation, or any other action which affects an
             211      APRN's authorization to practice.
             212          (10) "Licensing board" means a party state's regulatory body responsible for issuing
             213      APRN licensure/authority to practice.


             214          (11) (a) "Multistate advanced practice privilege" means current authority from a remote
             215      state permitting an APRN to practice in that state in the same role and title as the APRN is
             216      licensed/authorized to practice in the home state to the extent that the remote state laws
             217      recognize such APRN role and title.
             218          (b) A remote state has the authority, in accordance with existing state due process laws,
             219      to take actions against the APRN's privilege, including revocation, suspension, probation, or
             220      any other action that affects an APRN's multistate privilege to practice.
             221          (12) "Party state" means any state that has adopted this compact.
             222          (13) "Prescriptive authority" means the legal authority to prescribe medications and
             223      devices as defined by party state laws.
             224          (14) "Remote state" means a party state, other than the home state:
             225          (a) where the patient is located at the time APRN care is provided; or
             226          (b) in the case of APRN practice not involving a patient, in the party state where the
             227      recipient of APRN practice is located.
             228          (15) "Remote state action" means:
             229          (a) any administrative, civil, equitable, or criminal action permitted by a remote state's
             230      laws which are imposed on an APRN by the remote state's licensing board or other authority,
             231      including actions against an individual's multistate advanced practice privilege in the remote
             232      state; and
             233          (b) cease and desist and other injunctive or equitable orders issued by remote states or
             234      the licensing boards of those states.
             235          (16) "State" means a state, territory, or possession of the United States.
             236          (17) (a) "State practice laws" means a party state's laws and regulations that govern
             237      APRN practice, define the scope of advanced nursing practice including prescriptive authority,
             238      and create the methods and grounds for imposing discipline.
             239          (b) State practice laws do not include the requirements necessary to obtain and retain
             240      APRN licensure/authority to practice as an APRN, except for qualifications or requirements of
             241      the home state.
             242          (18) "Unencumbered" means that a state has no current disciplinary action against an
             243      APRN's license/authority to practice.
             244     
ARTICLE III


             245     
General Provisions and Jurisdiction

             246          (1) All party states shall participate in the Nurse Licensure Compact for registered
             247      nurses and licensed practical/vocational nurses in order to enter into the APRN Compact.
             248          (2) No state shall enter the APRN Compact until the state adopts, at a minimum, the
             249      APRN Uniform Licensure/Authority to Practice Requirements for each APRN role and title
             250      recognized by the state seeking to enter the APRN Compact.
             251          (3) (a) APRN Licensure/Authority to practice issued by a home state to a resident in
             252      that state will be recognized by each party state as authorizing a multistate advanced practice
             253      privilege to the extent that the role and title are recognized by each party state.
             254          (b) To obtain or retain APRN licensure/authority to practice as an APRN, an applicant
             255      must meet the home state's qualifications for authority or renewal of authority as well as all
             256      other applicable state laws.
             257          (4) (a) The APRN multistate advanced practice privilege does not include prescriptive
             258      authority, and does not affect any requirements imposed by states to grant to an APRN initial
             259      and continuing prescriptive authority according to state practice laws.
             260          (b) A party state may grant prescriptive authority to an individual on the basis of a
             261      multistate advanced practice privilege to the extent permitted by state practice laws.
             262          (5) (a) A party state may, in accordance with state due process laws, limit or revoke the
             263      multistate advanced practice privilege in the party state and may take any other necessary
             264      actions under the party state's applicable laws to protect the health and safety of the party state's
             265      citizens.
             266          (b) If a party state takes action, the party state shall promptly notify the administrator of
             267      the coordinated licensure information system.
             268          (c) The administrator of the coordinated licensure information system shall promptly
             269      notify the home state of any such actions by remote states.
             270          (6) (a) An APRN practicing in a party state must comply with the state practice laws of
             271      the state in which the patient is located at the time care is provided.
             272          (b) The APRN practice includes patient care and all advanced nursing practice defined
             273      by the party state's practice laws.
             274          (c) The APRN practice will subject an APRN to the jurisdiction of the licensing board,
             275      the courts, and the laws of the party state.


             276          (7) (a) Individuals not residing in a party state may apply for APRN licensure/authority
             277      to practice as an APRN under the laws of a party state.
             278          (b) The authority to practice granted to these individuals will not be recognized as
             279      granting the privilege to practice as an APRN in any other party state unless explicitly agreed to
             280      by that party state.
             281     
ARTICLE IV

             282     
Applications for APRN Licensure/Authority to Practice in a Party State

             283          (1) (a) Once an application for APRN licensure/authority to practice is submitted, a
             284      party state shall ascertain, through the Coordinated Licensure Information System, whether:
             285          (i) the applicant has held or is the holder of a nursing license/authority to practice
             286      issued by another state;
             287          (ii) the applicant has had a history of previous disciplinary action by any state;
             288          (iii) an encumbrance exists on any license/authority to practice; and
             289          (iv) any other adverse action by any other state has been taken against a
             290      license/authority to practice.
             291          (b) This information may be used in approving or denying an application for APRN
             292      licensure/authority to practice.
             293          (2) An APRN in a party state shall hold APRN licensure/authority to practice in only
             294      one party state at a time, issued by the home state.
             295          (3) (a) An APRN who intends to change primary state of residence may apply for
             296      APRN licensure/authority to practice in the new home state in advance of the change.
             297          (b) New licensure/authority to practice will not be issued by a party state until after an
             298      APRN provides evidence of change in primary state of residence satisfactory to the new home
             299      state's licensing board.
             300          (4) When an APRN changes primary state of residence by:
             301          (a) moving between two party states, and obtains APRN licensure/authority to practice
             302      from the new home state, the APRN licensure/authority to practice from the former home state
             303      is no longer valid;
             304          (b) moving from a nonparty state to a party state, and obtains APRN licensure/authority
             305      to practice from the new home state, the individual state license issued by the nonparty state is
             306      not affected and will remain in full force if so provided by the laws of the nonparty state;


             307          (c) moving from a party state to a nonparty state, the APRN licensure/authority to
             308      practice issued by the prior home state converts to an individual state license, valid only in the
             309      former home state, without the multistate licensure privilege to practice in other party states.
             310     
ARTICLE V

             311     
Adverse Actions

             312          In addition to the general provisions described in Article III, the following provisions
             313      apply:
             314          (1) (a) The licensing board of a remote state shall promptly report to the administrator
             315      of the coordinated licensure information system any remote state actions including the factual
             316      and legal basis for the action, if known.
             317          (b) The licensing board of a remote state shall also promptly report any significant,
             318      current investigative information yet to result in a remote state action.
             319          (c) The administrator of the coordinated licensure information system shall promptly
             320      notify the home state of any such reports.
             321          (2) (a) The licensing board of a party state shall have the authority to complete any
             322      pending investigations for an APRN who changes primary state of residence during the course
             323      of those investigations.
             324          (b) It shall also have the authority to take appropriate action, and shall promptly report
             325      the conclusions of the investigations to the administrator of the coordinated licensure
             326      information system.
             327          (c) The administrator of the coordinated licensure information system shall promptly
             328      notify the new home state of the actions.
             329          (3) (a) A remote state may take adverse action affecting the multistate advanced
             330      practice privilege to practice within that party state.
             331          (b) Only the home state shall have the power to impose adverse action against the
             332      APRN licensure/authority to practice issued by the home state.
             333          (4) (a) For purposes of imposing adverse action, the licensing board of the home state
             334      shall give the same priority and effect to reported conduct received from a remote state as it
             335      would if that conduct had occurred within the home state.
             336          (b) In so doing, it shall apply its own state laws to determine appropriate action.
             337          (5) The home state may take adverse action based on the factual findings of the remote


             338      state, so long as each state follows its own procedures for imposing the adverse action.
             339          (6) (a) Nothing in this compact shall override a party state's decision that participation
             340      in an alternative program may be used in lieu of adverse action and that the participation shall
             341      remain nonpublic if required by the party state's laws.
             342          (b) Party states must require APRNs who enter any alternative programs to agree not to
             343      practice in any other party state during the term of the alternative program without prior
             344      authorization from the other party state.
             345          (7) (a) All home state licensing board disciplinary orders, agreed or otherwise, which
             346      limit the scope of the APRN's practice or require monitoring of the APRN as a condition of the
             347      order, shall include the requirements that the APRN will limit the APRN's practice to the home
             348      state during the pendency of the order.
             349          (b) This requirement may allow the APRN to practice in other party states with prior
             350      written authorization from both the home state and party state licensing boards.
             351     
ARTICLE VI

             352     
Additional Authorities Invested in Party State Licensing Boards

             353          Notwithstanding any other powers, party state licensing boards shall have the authority
             354      to:
             355          (1) if otherwise permitted by state law, recover from the affected APRN the costs of
             356      investigations and disposition of cases resulting from any adverse action taken against that
             357      APRN;
             358          (2) (a) issue subpoenas for both hearings and investigations, which require the
             359      attendance and testimony of witnesses, and the production of evidence;
             360          (b) subpoenas issued by a licensing board in a party state for the attendance and
             361      testimony of witnesses, and/or the production of evidence from another party state shall be
             362      enforced in the latter state by any court of competent jurisdiction, according to the practice and
             363      procedure of that court applicable to subpoenas issued in proceedings pending before it;
             364          (c) the issuing authority shall pay any witness fees, travel expenses, mileage, and other
             365      fees required by the service statutes of the state where the witnesses or evidence or both are
             366      located;
             367          (3) issue cease and desist orders to limit or revoke an APRN's privilege or
             368      licensure/authority to practice in their state; and


             369          (4) promulgate uniform rules and regulations as provided for in Article VIII (3).
             370     
ARTICLE VII

             371     
Coordinated Licensure Information System

             372          (1) (a) All party states shall participate in a cooperative effort to create a coordinated
             373      database of all APRNs.
             374          (b) This system will include information on the APRN licensure/authority to practice
             375      and disciplinary history of each APRN, as contributed by party states, to assist in the
             376      coordination of APRN licensure/authority to practice and enforcement efforts.
             377          (2) Notwithstanding any other provision of law, all party states' licensing boards shall
             378      promptly report adverse actions, actions against multistate advanced practice privileges, any
             379      current significant investigative information yet to result in adverse action, denials of
             380      applications, and the reasons for those denials to the coordinated licensure information system.
             381          (3) Current significant investigative information shall be transmitted through the
             382      coordinated licensure information system only to party state licensing boards.
             383          (4) Notwithstanding any other provision of law, all party states' licensing boards
             384      contributing information to the coordinated licensure information system may designate
             385      information that may not be shared with nonparty states or disclosed to other entities or
             386      individuals without the express permission of the contributing state.
             387          (5) Any personally identifiable information obtained by a party state's licensing board
             388      from the coordinated licensure information system may not be shared with nonparty states or
             389      disclosed to other entities or individuals except to the extent permitted by the laws of the party
             390      state contributing the information.
             391          (6) Any information contributed to the coordinated licensure information system that is
             392      subsequently required to be expunged by the laws of the party state contributing that
             393      information shall also be expunged from the coordinated licensure information system.
             394          (7) The compact administrators, acting jointly with each other and in consultation with
             395      the administrator of the coordinated licensure information system, shall formulate necessary
             396      and proper procedures for the identification, collection, and exchange of information under this
             397      compact.
             398     
ARTICLE VIII

             399     
Compact Administration and Interchange of Information


             400          (1) The head of the licensing board, or his or her designee, of each party state shall be
             401      the administrator of this compact for his or her state.
             402          (2) The compact administrator of each party state shall furnish to the compact
             403      administrator of each other party state any information and documents including, but not
             404      limited to, a uniform data set of investigations, identifying information, licensure data, and
             405      disclosable alternative program participation information to facilitate the administration of this
             406      compact.
             407          (3) (a) Compact administrators shall have the authority to develop uniform rules to
             408      facilitate and coordinate implementation of this compact.
             409          (b) These uniform rules shall be adopted by party states, under the authority invested
             410      under Article VI (4).
             411     
ARTICLE IX

             412     
Immunity

             413          (1) No party state or the officers or employees or agents of a party state's licensing
             414      board who acts in accordance with the provisions of this compact shall be liable on account of
             415      any act or omission in good faith while engaged in the performance of their duties under this
             416      compact.
             417          (2) Good faith in this article shall not include willful misconduct, gross negligence, or
             418      recklessness.
             419     
ARTICLE X

             420     
Entry into Force, Withdrawal, and Amendment

             421          (1) (a) This compact shall enter into force and become effective as to any state when it
             422      has been enacted into the laws of that state.
             423          (b) Any party state may withdraw from this compact by enacting a statute repealing the
             424      compact, but no withdrawal shall take effect until six months after the withdrawing state has
             425      given notice of the withdrawal to the executive heads of all other party states.
             426          (2) No withdrawal shall affect the validity or applicability by the licensing boards of
             427      states remaining party to the compact of any report of adverse action occurring prior to the
             428      withdrawal.
             429          (3) Nothing contained in this compact shall be construed to invalidate or prevent any
             430      APRN licensure/authority to practice agreement or other cooperative arrangement between a


             431      party state and a nonparty state that is made in accordance with the other provisions of this
             432      compact.
             433          (4) (a) This compact may be amended by the party states.
             434          (b) No amendment to this compact shall become effective and binding upon the party
             435      states unless and until it is enacted into the laws of all party states.
             436     
ARTICLE XI

             437     
Construction and Severability

             438          (1) (a) This compact shall be liberally construed so as to effectuate its purposes.
             439          (b) The provisions of this compact shall be severable and if any phrase, clause,
             440      sentence, or provision of this compact is declared to be contrary to the constitution of any party
             441      state or of the United States or its applicability to any government, agency, person, or
             442      circumstance is held invalid, the validity of the remainder of this compact and its applicability
             443      to any government, agency, person, or circumstance shall not be affected thereby.
             444          (c) If this compact shall be held contrary to the constitution of any state party to the
             445      compact, the compact shall remain in full force and effect as to the remaining party states and
             446      in full force and effect as to the party state affected as to all severable matters.
             447          (2) (a) In the event party states find a need for settling disputes arising under this
             448      compact, the party states may submit the issues in dispute to an arbitration panel which will be
             449      comprised of an individual appointed by the compact administrator in the home state, an
             450      individual appointed by the compact administrator in the remote state involved, and an
             451      individual mutually agreed upon by the compact administrators of all the party states involved
             452      in the dispute.
             453          (b) The decision of a majority of the arbitrators shall be final and binding.
             454          Section 4. Section 58-31d-103 is enacted to read:
             455          58-31d-103. Rulemaking authority -- Enabling provisions.
             456          (1) The division may adopt rules necessary to implement Section 58-31d-102 .
             457          (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
             458      "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
             459          (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
             460      defined in Article II (1) of the compact includes an individual who is licensed to practice under
             461      Subsection 58-31b-302 (2)(d) as an advanced practice registered nurse.


             462          (4) An APRN practicing in this state under a multistate licensure privilege may only be
             463      granted prescriptive authority if that individual can document completion of graduate level
             464      course work in the following areas:
             465          (a) advanced health assessment;
             466          (b) pharmacotherapeutics; and
             467          (c) diagnosis and treatment.
             468          (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
             469      obtain prescriptive authority must:
             470          (i) meet all the requirements of Subsection (4) and this Subsection (5); and
             471          (ii) be placed on a registry with the division.
             472          (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
             473          (i) submit a form prescribed by the division;
             474          (ii) pay a fee; and
             475          (iii) if prescribing a controlled substance:
             476          (A) obtain a controlled substance license as required under Section 58-37-6 ; and
             477          (B) if prescribing a Schedule II or III controlled substance, have a consultation and
             478      referral plan with a physician licensed in Utah as required under Subsection
             479      58-31b-102(16)(c)(iii).
             480          Section 5. Repealer.
             481          This bill repeals:
             482          Section 58-31b-307, Licensure by endorsement.
             483          Section 6. Effective date.
             484          This bill takes effect on July 1, 2004.




Legislative Review Note
    as of 1-7-04 1:00 PM


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

Office of Legislative Research and General Counsel


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