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H.B. 243 Enrolled
LONG TITLE
General Description:
This bill amends the Nurse Practices Act to repeal provisions related to Geriatric Care
Managers.
Highlighted Provisions:
This bill:
. removes the reference to geriatric care managers in the following areas of the Nurse
Practices Act:
. definitions;
. qualifications for licensure;
. qualifications for admission to examinations;
. unprofessional conduct; and
. minimum standards for nursing programs; and
. repeals the pilot program for geriatric care managers.
Monies Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
58-31b-102, as last amended by Chapter 247, Laws of Utah 2004
58-31b-301, as last amended by Chapter 247, Laws of Utah 2004
58-31b-302, as last amended by Chapters 15 and 247, Laws of Utah 2004
58-31b-303, as last amended by Chapter 247, Laws of Utah 2004
58-31b-304, as last amended by Chapter 247, Laws of Utah 2004
58-31b-308, as last amended by Chapter 219, Laws of Utah 2003
58-31b-501, as last amended by Chapter 247, Laws of Utah 2004
58-31b-502, as last amended by Chapter 247, Laws of Utah 2004
58-31b-601, as last amended by Chapter 247, Laws of Utah 2004
58-31d-103, as enacted by Chapter 15, Laws of Utah 2004
63-55b-158, as enacted by Chapter 247, Laws of Utah 2004
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 58-31b-102 is amended to read:
58-31b-102. Definitions.
In addition to the definitions in Section 58-1-102 , as used in this chapter:
(1) "Administrative penalty" means a monetary fine imposed by the division for acts or
omissions determined to constitute unprofessional or unlawful conduct in accordance with a fine
schedule established by rule and as a result of an adjudicative proceeding conducted in
accordance with Title 63, Chapter 46b, Administrative Procedures Act.
(2) "Applicant" means a person who applies for licensure or registration under this
chapter by submitting a completed application for licensure or registration and the required fees
to the department.
(3) "Approved education program" means a nursing education program that meets the
minimum standards for educational programs established under this chapter and by division rule
in collaboration with the board.
(4) "Board" means the Board of Nursing created in Section 58-31b-201 .
(5) "Consultation and referral plan" means a written plan jointly developed by an
advanced practice registered nurse and a consulting physician that permits the advanced practice
registered nurse to prescribe schedule II-III controlled substances in consultation with the
consulting physician.
(6) "Consulting physician" means a physician and surgeon or osteopathic physician and
surgeon licensed in accordance with this title who has agreed to consult with an advanced
practice registered nurse with a controlled substance license, a DEA registration number, and
who will be prescribing schedule II-III controlled substances.
(7) "Diagnosis" means the identification of and discrimination between physical and
psychosocial signs and symptoms essential to the effective execution and management of health
care.
(8) "Examinee" means a person who applies to take or does take any examination
required under this chapter for licensure.
(9) "Health care assistant" means an individual who:
(a) engages in the practice of a health care assistant; and
(b) is subject to registration under this chapter and is not subject to registration,
licensure, or certification under any other chapter of this title.
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chapter.
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Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
Inspection Act:
(a) a nursing care facility;
(b) a small health care facility;
(c) an intermediate care facility for the mentally retarded;
(d) an assisted living facility Type I or II; or
(e) a designated swing bed unit in a general hospital.
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assistance or care for compensation to an individual who is ill, injured, infirm, developmentally
or physically disabled, mentally disabled, or mentally retarded, and who is in a private residence
or regulated facility.
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attain optimal health, implementing a strategy of care to accomplish defined goals and evaluating
responses to care and treatment. The practice of nursing requires substantial specialized or
general knowledge, judgment, and skill based upon principles of the biological, physical,
behavioral, and social sciences, and includes:
(a) initiating and maintaining comfort measures;
(b) promoting and supporting human functions and responses;
(c) establishing an environment conducive to well-being;
(d) providing health counseling and teaching;
(e) collaborating with health care professionals on aspects of the health care regimen;
(f) performing delegated procedures only within the education, knowledge, judgment,
and skill of the licensee; and
(g) delegating nurse interventions that may be performed by others and are not in conflict
with this chapter.
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provision of preoperative, intraoperative, and postoperative anesthesia care and related services
upon the request of a physician, surgeon, or other licensed professional, who is acting within the
scope of their practice, by a person licensed under this chapter as a certified registered nurse
anesthetist and includes:
(i) preanesthesia preparation and evaluation including:
(A) performing a preanesthetic assessment of the patient;
(B) ordering and evaluating appropriate lab and other studies to determine the health of
the patient; and
(C) selecting, ordering, or administering appropriate medications;
(ii) anesthesia induction, maintenance, and emergence, including:
(A) selecting and initiating the planned anesthetic technique;
(B) selecting and administering anesthetics and adjunct drugs and fluids; and
(C) administering general, regional, and local anesthesia;
(iii) postanesthesia follow-up care, including:
(A) evaluating the patient's response to anesthesia and implementing corrective actions;
and
(B) selecting, ordering, or administering the above medications and studies; and
(iv) other related services within the scope of practice of a certified registered nurse
anesthetist, including:
(A) emergency airway management;
(B) advanced cardiac life support; and
(C) the establishment of peripheral, central, and arterial invasive lines.
(b) Nothing in this section shall be construed as to require a certified registered nurse
anesthetist to obtain an advance practice registered nurse license in order to select, administer, or
provide preoperative, intraoperative, or postoperative anesthesia care and services.
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generally recognized scope of practice of licensed practical nurses as defined by rule and as
provided in this Subsection [
practical nurse and under the direction of a registered nurse, licensed physician, or other specified
health care professional as defined by rule. Practical nursing acts include:
(a) contributing to the assessment of the health status of individuals and groups;
(b) participating in the development and modification of the strategy of care;
(c) implementing appropriate aspects of the strategy of care;
(d) maintaining safe and effective nursing care rendered to a patient directly or indirectly;
and
(e) participating in the evaluation of responses to interventions.
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in this Subsection [
the generally recognized scope of practice of registered nurses as defined by rule. Registered
nursing acts include:
(a) assessing the health status of individuals and groups;
(b) identifying health care needs;
(c) establishing goals to meet identified health care needs;
(d) planning a strategy of care;
(e) prescribing nursing interventions to implement the strategy of care;
(f) implementing the strategy of care;
(g) maintaining safe and effective nursing care that is rendered to a patient directly or
indirectly;
(h) evaluating responses to interventions;
(i) teaching the theory and practice of nursing; and
(j) managing and supervising the practice of nursing.
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nursing within the generally recognized scope and standards of advanced practice registered
nursing as defined by rule and consistent with professionally recognized preparation and
education standards of an advanced practice registered nurse by a person licensed under this
chapter as an advanced practice registered nurse. Advanced practice registered nursing includes:
(a) maintenance and promotion of health and prevention of disease;
(b) diagnosis, treatment, correction, consultation, and referral for common health
problems; and
(c) prescription or administration of prescription drugs or devices including:
(i) local anesthesia;
(ii) schedule IV-V controlled substances; and
(iii) schedule II-III controlled substances in accordance with a consultation and referral
plan.
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Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:
(a) the Utah State Hospital or the Utah State Developmental Center;
(b) a residential treatment or residential support facility:
(i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and Facilities;
and
(ii) serving people with disabilities, as defined by Department of Human Services rules;
or
(c) a health care facility which is licensed or certified under Title 26, Chapter 21.
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title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance with
the standards of the profession.
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and as may be further defined by rule.
Section 2. Section 58-31b-301 is amended to read:
58-31b-301. License or certification required -- Classifications.
(1) A license is required to engage in the practice of nursing, except as specifically
provided in Sections 58-1-307 and 58-31b-308 .
(2) The division shall issue to a person who qualifies under this chapter a license or
certification in the classification of:
(a) licensed practical nurse;
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(3) An individual holding an advanced practice registered nurse license as of July 1,
1998, who cannot document the successful completion of advanced course work in patient
assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
issued an "APRN - without prescriptive practice" license.
(4) The division shall grant an advanced practice registered nurse license to any licensed
advanced practice registered nurse currently holding prescriptive authority under any predecessor
act on July 1, 1998.
(5) (a) An individual shall be registered under this chapter in order to engage in practice
as a health care assistant, except as provided in Sections 58-31b-308 and 58-31b-308.5 .
(b) The division shall issue to a person who qualifies under this chapter a registration in
the classification of health care assistant.
Section 3. Section 58-31b-302 is amended to read:
58-31b-302. Qualifications for licensure or certification -- Criminal background
checks.
(1) An applicant for licensure as a licensed practical nurse shall:
(a) submit to the division an application in a form prescribed by the division;
(b) pay to the division a fee determined under Section 63-38-3.2 ;
(c) have a high school diploma or its equivalent;
(d) be in a condition of physical and mental health that will permit the applicant to
practice safely as a licensed practical nurse;
(e) have completed an approved practical nursing education program or an equivalent as
determined by the board;
(f) have passed the examinations as required by division rule made in collaboration with
the board; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
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(a) submit to the division an application form prescribed by the division;
(b) pay to the division a fee determined under Section 63-38-3.2 ;
(c) have a high school diploma or its equivalent;
(d) be in a condition of physical and mental health that will allow the applicant to
practice safely as a registered nurse;
(e) have completed an approved registered nursing education program;
(f) have passed the examinations as required by division rule made in collaboration with
the board; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
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(a) submit to the division an application on a form prescribed by the division;
(b) pay to the division a fee determined under Section 63-38-3.2 ;
(c) be in a condition of physical and mental health which will allow the applicant to
practice safely as an advanced practice registered nurse;
(d) hold a current registered nurse license in good standing issued by the state or be
qualified at the time for licensure as a registered nurse;
(e) have earned a graduate degree in an advanced practice registered nurse nursing
education program or a related area of specialized knowledge as determined appropriate by the
division in collaboration with the board;
(f) have completed course work in patient assessment, diagnosis and treatment, and
pharmacotherapeutics from an education program approved by the division in collaboration with
the board;
(g) have successfully completed clinical practice in psychiatric and mental health
nursing, including psychotherapy as defined by division rule, after completion of the masters
degree required for licensure, to practice within the psychiatric and mental health nursing
specialty;
(h) have passed the examinations as required by division rule made in collaboration with
the board;
(i) be currently certified by a program approved by the division in collaboration with the
board and submit evidence satisfactory to the division of the certification; and
(j) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
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(a) submit to the division an application on a form prescribed by the division;
(b) pay to the division a fee determined under Section 63-38-3.2 ;
(c) be in a condition of physical and mental health which will allow the applicant to
practice safely as a certified registered nurse anesthetist;
(d) hold a current registered nurse license in good standing issued by the state or be
qualified at the time for licensure as a registered nurse;
(e) complete a nurse anesthesia program which is approved by the Council on
Accreditation of Nurse Anesthesia Educational Programs;
(f) be currently certified by a program approved by the division in collaboration with the
board and submit evidence satisfactory to the division of the certification; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
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(a) submit an application in a form prescribed by the division;
(b) pay a fee determined by the department under Section 63-38-3.2 ;
(c) certify in writing that he is free from any physical, mental, or emotional condition that
will or may reasonably be expected to prevent the applicant from practicing as a health care
assistant in compliance with this chapter; and
(d) may not, within five years immediately prior to application, have any substantiated
allegations of abuse, neglect, or misappropriation of client property listed against him on the
certified nurse assistant registry maintained by the State Office of Education or on a similar
registry maintained in another state in compliance with 42 CFR 483.156.
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(a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
license application is filed and shall consent to a fingerprint background check by the Utah
Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
application; and
(ii) the division shall request the Department of Public Safety to complete a Federal
Bureau of Investigation criminal background check for each applicant through the national
criminal history system (NCIC) or any successor system; and
(b) if convicted of one or more felonies, must receive an absolute discharge from the
sentences for all felony convictions five or more years prior to the date of filing an application for
licensure or registration under this chapter.
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Subsection (6), the division shall have direct access to criminal background information
maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
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this section shall be conditional, pending completion of the criminal background check.
(ii) If the criminal background check discloses the applicant has failed to accurately
disclose a criminal history, the license or registration shall be immediately and automatically
revoked.
(b) (i) Any person whose conditional license or registration has been revoked under
Subsection [
(ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
Administrative Procedures Act.
Section 4. Section 58-31b-303 is amended to read:
58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
programs.
An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
nursing education program not approved by the division in collaboration with the board must
comply with the requirements of this section.
(1) An applicant for licensure as a licensed practical nurse shall:
(a) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(e); and
(b) produce evidence acceptable to the division and the board that the nursing education
program completed by the applicant is equivalent to the minimum standards established by the
division in collaboration with the board for an approved licensed practical nursing education
program.
(2) An applicant for licensure as a registered nurse shall:
(a) meet all requirements of Subsection 58-31b-302 [
(2)(e); and
(b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
Examination; or
(ii) produce evidence acceptable to the division and the board that the applicant is
currently licensed as a registered nurse in one of the states, territories, or the District of Columbia
of the United States and has passed the NCLEX-RN examination.
Section 5. Section 58-31b-304 is amended to read:
58-31b-304. Qualifications for admission to the examinations.
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person shall:
(a) submit an application form prescribed by the division;
(b) pay a fee as determined by the division under Section 63-38-3.2 ; and
(c) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(f).
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a person shall:
(a) submit an application form prescribed by the division;
(b) pay a fee as determined by the division under Section 63-38-3.2 ; and
(c) meet all the requirements of Subsection 58-31b-302 [
(2)(f).
Section 6. Section 58-31b-308 is amended to read:
58-31b-308. Exemptions from licensure or registration.
(1) In addition to the exemptions from licensure in Section 58-1-307 , the following
persons may engage in acts included within the definition of the practice of nursing, subject to
the stated circumstances and limitations, without being licensed under this chapter:
(a) friends, family members, foster parents, or legal guardians of a patient performing
gratuitous nursing care for the patient;
(b) persons providing care in a medical emergency;
(c) persons engaged in the practice of religious tenets of a church or religious
denomination; and
(d) after July 1, 2000, a person licensed to practice nursing by a jurisdiction that has
joined the Nurse Licensure Compact to the extent permitted by Section 58-31c-102 .
(2) Notwithstanding Subsection (1)(d), the division may, in accordance with Section
58-31c-102 , limit or revoke practice privileges in this state of a person licensed to practice
nursing by a jurisdiction that has joined the Nurse Licensing Compact.
(3) In addition to the exemptions from licensure under Section 58-1-307 , the following
individuals may engage in acts or practices included in the practice of a health care assistant,
within the stated limitations, without being registered under this chapter:
(a) an individual providing gratuitous care for another individual;
(b) a volunteer, whether or not he receives token compensation other than salary or
wages:
(i) in programs sponsored or authorized by federal Public Law 93-113; or
(ii) at any regulated facility; and
(c) individuals providing:
(i) services generally considered independent living activities such as preparing meals,
shopping for personal items or groceries, managing money, using the telephone, performing
housekeeping, and other similar activities not involving direct personal assistance and care as the
division may define by rule; and
(ii) child day care or baby-sitting, whether or not the services are subject to licensure
under Title 26, Chapter 39, Utah Child Care Licensing Act;
(d) an individual employed on an intermittent basis to provide a specified limited period
of care for an adult or child with disabilities needing regular daily care, in order to allow the
relative or other person who is the adult or child's regular and unpaid caretaker respite from his or
her caregiver duties regarding the adult or child; or
(e) notwithstanding Subsection 58-31b-102 [
person who is self directing his personal care in his private residence.
Section 7. Section 58-31b-501 is amended to read:
58-31b-501. Unlawful conduct.
(1) "Unlawful conduct" includes:
(a) using the following titles, names or initials, if the user is not properly licensed under
this chapter:
(i) nurse;
(ii) licensed practical nurse, practical nurse, or L.P.N.;
(iii) registered nurse or R.N.;
(iv) registered nurse practitioner, N.P., or R.N.P.;
(v) registered nurse specialist, N.S., or R.N.S.;
(vi) registered psychiatric mental health nurse specialist;
(vii) advanced practice registered nurse;
(viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist,
or C.R.N.A.; or
(ix) other generally recognized names or titles used in the profession of nursing;
(b) using any other name, title, or initials that would cause a reasonable person to believe
the user is licensed under this chapter if the user is not properly licensed under this chapter; and
(c) conducting a nursing education program in the state for the purpose of qualifying
individuals to meet requirements for licensure under this chapter without the program having
been approved under Section 58-31b-601 .
(2) (a) An individual registered as a health care assistant under this chapter may use any
title in his practice as a health care assistant, and an employer may assign a title to health care
assistants it employs, if the title does not cause a reasonable person to believe the registrant is a
licensee in any other license classification under this chapter and Title 58, Occupations and
Professions.
(b) If any issue is raised regarding a title under this section, the division shall determine
if the title may be used for health care assistants.
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Section 8. Section 58-31b-502 is amended to read:
58-31b-502. Unprofessional conduct.
"Unprofessional conduct" includes:
(1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
diagnosis, personal effects, or any other matter about which the licensee is privileged to know
because of the licensee's position or practice as a nurse;
(2) failure to provide nursing service in a manner that demonstrates respect for the
patient's human dignity and unique personal character and needs without regard to the patient's
race, religion, ethnic background, socioeconomic status, age, sex, or the nature of the patient's
health problem;
(3) engaging in sexual relations with a patient during any:
(a) period when a generally recognized professional relationship exists between the nurse
and patient; or
(b) extended period when a patient has reasonable cause to believe a professional
relationship exists between the nurse and patient;
(4) (a) as a result of any circumstance under Subsection (3), exploiting or using
information about a patient or exploiting the licensee's professional relationship between the
licensee and the patient; or
(b) exploiting the patient by use of the licensee's knowledge of the patient obtained while
acting as a nurse;
(5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
(6) unauthorized taking or personal use of nursing supplies from an employer;
(7) unauthorized taking or personal use of a patient's personal property;
(8) knowingly entering into any medical record any false or misleading information or
altering a medical record in any way for the purpose of concealing an act, omission, or record of
events, medical condition, or any other circumstance related to the patient and the medical or
nursing care provided;
(9) unlawful or inappropriate delegation of nursing care;
(10) failure to exercise appropriate supervision of persons providing patient care services
under supervision of the licensed nurse;
(11) employing or aiding and abetting the employment of an unqualified or unlicensed
person to practice as a nurse;
(12) failure to file or record any medical report as required by law, impeding or
obstructing the filing or recording of such a report, or inducing another to fail to file or record
such a report;
(13) breach of a statutory, common law, regulatory, or ethical requirement of
confidentiality with respect to a person who is a patient, unless ordered by a court;
(14) failure to pay a penalty imposed by the division;
(15) prescribing a schedule II-III controlled substance without a consulting physician or
outside of a consultation and referral plan; and
(16) violating Section 58-31b-801 [
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Section 9. Section 58-31b-601 is amended to read:
58-31b-601. Minimum standards for nursing programs.
(1) A nursing education program shall be affiliated with an accredited institution of
higher education in order to be approved by the division.
(2) The minimum standards a nursing program shall meet to qualify graduates for
licensure under this chapter shall be defined by division rule.
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Section 10. Section 58-31d-103 is amended to read:
58-31d-103. Rulemaking authority -- Enabling provisions.
(1) The division may adopt rules necessary to implement Section 58-31d-102 .
(2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
"head of the licensing board" means the executive administrator of the Utah Board of Nursing.
(3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
defined in Article II (1) of the compact includes an individual who is licensed to practice under
Subsection [
(4) An APRN practicing in this state under a multistate licensure privilege may only be
granted prescriptive authority if that individual can document completion of graduate level
course work in the following areas:
(a) advanced health assessment;
(b) pharmacotherapeutics; and
(c) diagnosis and treatment.
(5) (a) An APRN practicing in this state under a multistate privilege who seeks to obtain
prescriptive authority must:
(i) meet all the requirements of Subsection (4) and this Subsection (5); and
(ii) be placed on a registry with the division.
(b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
(i) submit a form prescribed by the division;
(ii) pay a fee; and
(iii) if prescribing a controlled substance:
(A) obtain a controlled substance license as required under Section 58-37-6 ; and
(B) if prescribing a Schedule II or III controlled substance, have a consultation and
referral plan with a physician licensed in Utah as required under Subsection 58-31b-102 [
(17)(c)(iii).
Section 11. Section 63-55b-158 is amended to read:
63-55b-158. Repeal dates -- Title 58.
Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed [
May 2, 2005.
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