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H.B. 12

             1     

HEALTH CARE ASSISTANTS

             2     
2005 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Sponsor: Rebecca D. Lockhart

             5     
             6      LONG TITLE
             7      General Description:
             8          This bill repeals provisions related to health care assistants.
             9      Highlighted Provisions:
             10          This bill:
             11          .    repeals provisions in the Nurse Practice Act that requires the registration of health
             12      care assistants by the Division of Occupational and Professional Licensing;
             13          .    makes technical amendments; and
             14          .    makes conforming amendments in the Human Services Code.
             15      Monies Appropriated in this Bill:
             16          None
             17      Other Special Clauses:
             18          None
             19      Utah Code Sections Affected:
             20      AMENDS:
             21          58-31b-102, as last amended by Chapter 247, Laws of Utah 2004
             22          58-31b-201, as last amended by Chapter 247, Laws of Utah 2004
             23          58-31b-301, as last amended by Chapter 247, Laws of Utah 2004
             24          58-31b-302, as last amended by Chapters 15 and 247, Laws of Utah 2004
             25          58-31b-308, as last amended by Chapter 219, Laws of Utah 2003
             26          58-31b-401, as last amended by Chapter 247, Laws of Utah 2004
             27          58-31b-501, as last amended by Chapter 247, Laws of Utah 2004


             28          58-31b-702, as last amended by Chapter 290, Laws of Utah 2002
             29          58-31d-103, as enacted by Chapter 15, Laws of Utah 2004
             30          62A-3-311.1, as last amended by Chapter 108, Laws of Utah 2002
             31      REPEALS:
             32          58-31b-308.5, as enacted by Chapter 290, Laws of Utah 2002
             33     
             34      Be it enacted by the Legislature of the state of Utah:
             35          Section 1. Section 58-31b-102 is amended to read:
             36           58-31b-102. Definitions.
             37          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             38          (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
             39      omissions determined to constitute unprofessional or unlawful conduct in accordance with a
             40      fine schedule established by rule and as a result of an adjudicative proceeding conducted in
             41      accordance with Title 63, Chapter 46b, Administrative Procedures Act.
             42          (2) "Applicant" means a person who applies for licensure or [registration] certification
             43      under this chapter by submitting a completed application for licensure or [registration]
             44      certification and the required fees to the department.
             45          (3) "Approved education program" means a nursing education program that meets the
             46      minimum standards for educational programs established under this chapter and by division
             47      rule in collaboration with the board.
             48          (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
             49          (5) "Consultation and referral plan" means a written plan jointly developed by an
             50      advanced practice registered nurse and a consulting physician that permits the advanced
             51      practice registered nurse to prescribe schedule II-III controlled substances in consultation with
             52      the consulting physician.
             53          (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
             54      surgeon licensed in accordance with this title who has agreed to consult with an advanced
             55      practice registered nurse with a controlled substance license, a DEA registration number, and
             56      who will be prescribing schedule II-III controlled substances.
             57          (7) "Diagnosis" means the identification of and discrimination between physical and
             58      psychosocial signs and symptoms essential to the effective execution and management of


             59      health care.
             60          (8) "Examinee" means a person who applies to take or does take any examination
             61      required under this chapter for licensure.
             62          [(9) "Health care assistant" means an individual who:]
             63          [(a) engages in the practice of a health care assistant; and]
             64          [(b) is subject to registration under this chapter and is not subject to registration,
             65      licensure, or certification under any other chapter of this title.]
             66          [(10)] (9) "Geriatric care manager" means a licensed practical nurse who has had
             67      additional training in long-term care nursing and holds a current, valid certificate of completion
             68      from a training course approved by the division in collaboration with the board, and is certified
             69      by the division as a Licensed Practical Nurse - Geriatric Care Manager.
             70          [(11)] (10) "Licensee" means a person who is licensed[, registered,] or certified under
             71      this chapter.
             72          [(12)] (11) "Long-term care facility" means any of the following facilities licensed by
             73      the Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
             74      Inspection Act:
             75          (a) a nursing care facility;
             76          (b) a small health care facility;
             77          (c) an intermediate care facility for the mentally retarded;
             78          (d) an assisted living facility Type I or II; or
             79          (e) a designated swing bed unit in a general hospital.
             80          [(13) "Practice as a health care assistant" means providing direct personal assistance or
             81      care for compensation to an individual who is ill, injured, infirm, developmentally or physically
             82      disabled, mentally disabled, or mentally retarded, and who is in a private residence or regulated
             83      facility.]
             84          [(14)] (12) "Practice of geriatric care management":
             85          (a) means a licensed practical nurse with specialized knowledge of geriatric and
             86      chronically ill patients residing in a long-term care facility as provided in Subsection
             87      58-31b-302 (2); and
             88          (b) includes an expanded scope of practice which may include:
             89          (i) implementing a plan of care;


             90          (ii) completing an assessment and evaluation of response to treatment; and
             91          (iii) other tasks and skills as defined by division rule.
             92          [(15)] (13) "Practice of nursing" means assisting individuals or groups to maintain or
             93      attain optimal health, implementing a strategy of care to accomplish defined goals and
             94      evaluating responses to care and treatment. The practice of nursing requires substantial
             95      specialized or general knowledge, judgment, and skill based upon principles of the biological,
             96      physical, behavioral, and social sciences, and includes:
             97          (a) initiating and maintaining comfort measures;
             98          (b) promoting and supporting human functions and responses;
             99          (c) establishing an environment conducive to well-being;
             100          (d) providing health counseling and teaching;
             101          (e) collaborating with health care professionals on aspects of the health care regimen;
             102          (f) performing delegated procedures only within the education, knowledge, judgment,
             103      and skill of the licensee; and
             104          (g) delegating nurse interventions that may be performed by others and are not in
             105      conflict with this chapter.
             106          [(16)] (14) (a) "Practice of nurse anesthesia" means the practice of nursing related to
             107      the provision of preoperative, intraoperative, and postoperative anesthesia care and related
             108      services upon the request of a physician, surgeon, or other licensed professional, who is acting
             109      within the scope of their practice, by a person licensed under this chapter as a certified
             110      registered nurse anesthetist and includes:
             111          (i) preanesthesia preparation and evaluation including:
             112          (A) performing a preanesthetic assessment of the patient;
             113          (B) ordering and evaluating appropriate lab and other studies to determine the health of
             114      the patient; and
             115          (C) selecting, ordering, or administering appropriate medications;
             116          (ii) anesthesia induction, maintenance, and emergence, including:
             117          (A) selecting and initiating the planned anesthetic technique;
             118          (B) selecting and administering anesthetics and adjunct drugs and fluids; and
             119          (C) administering general, regional, and local anesthesia;
             120          (iii) postanesthesia follow-up care, including:


             121          (A) evaluating the patient's response to anesthesia and implementing corrective
             122      actions; and
             123          (B) selecting, ordering, or administering the above medications and studies; and
             124          (iv) other related services within the scope of practice of a certified registered nurse
             125      anesthetist, including:
             126          (A) emergency airway management;
             127          (B) advanced cardiac life support; and
             128          (C) the establishment of peripheral, central, and arterial invasive lines.
             129          (b) Nothing in this section shall be construed as to require a certified registered nurse
             130      anesthetist to obtain an advance practice registered nurse license in order to select, administer,
             131      or provide preoperative, intraoperative, or postoperative anesthesia care and services.
             132          [(17)] (15) "Practice of practical nursing" means the performance of nursing acts in the
             133      generally recognized scope of practice of licensed practical nurses as defined by rule and as
             134      provided in this Subsection [(17)] (15) by a person licensed under this chapter as a licensed
             135      practical nurse and under the direction of a registered nurse, licensed physician, or other
             136      specified health care professional as defined by rule. Practical nursing acts include:
             137          (a) contributing to the assessment of the health status of individuals and groups;
             138          (b) participating in the development and modification of the strategy of care;
             139          (c) implementing appropriate aspects of the strategy of care;
             140          (d) maintaining safe and effective nursing care rendered to a patient directly or
             141      indirectly; and
             142          (e) participating in the evaluation of responses to interventions.
             143          [(18)] (16) "Practice of registered nursing" means performing acts of nursing as
             144      provided in this Subsection [(18)] (16) by a person licensed under this chapter as a registered
             145      nurse within the generally recognized scope of practice of registered nurses as defined by rule.
             146      Registered nursing acts include:
             147          (a) assessing the health status of individuals and groups;
             148          (b) identifying health care needs;
             149          (c) establishing goals to meet identified health care needs;
             150          (d) planning a strategy of care;
             151          (e) prescribing nursing interventions to implement the strategy of care;


             152          (f) implementing the strategy of care;
             153          (g) maintaining safe and effective nursing care that is rendered to a patient directly or
             154      indirectly;
             155          (h) evaluating responses to interventions;
             156          (i) teaching the theory and practice of nursing; and
             157          (j) managing and supervising the practice of nursing.
             158          [(19)] (17) "Practice of advanced practice registered nursing" means the practice of
             159      nursing within the generally recognized scope and standards of advanced practice registered
             160      nursing as defined by rule and consistent with professionally recognized preparation and
             161      education standards of an advanced practice registered nurse by a person licensed under this
             162      chapter as an advanced practice registered nurse. Advanced practice registered nursing
             163      includes:
             164          (a) maintenance and promotion of health and prevention of disease;
             165          (b) diagnosis, treatment, correction, consultation, and referral for common health
             166      problems; and
             167          (c) prescription or administration of prescription drugs or devices including:
             168          (i) local anesthesia;
             169          (ii) schedule IV-V controlled substances; and
             170          (iii) schedule II-III controlled substances in accordance with a consultation and referral
             171      plan.
             172          [(20) "Regulated facility" means a health care facility subject to licensure under Title
             173      26, Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:]
             174          [(a) the Utah State Hospital or the Utah State Developmental Center;]
             175          [(b) a residential treatment or residential support facility:]
             176          [(i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and
             177      Facilities; and]
             178          [(ii) serving people with disabilities, as defined by Department of Human Services
             179      rules; or]
             180          [(c) a health care facility which is licensed or certified under Title 26, Chapter 21.]
             181          [(21)] (18) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501 .
             182          [(22)] (19) "Unlicensed assistive personnel" means any unlicensed person, regardless


             183      of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
             184      with the standards of the profession.
             185          [(23)] (20) "Unprofessional conduct" is as defined in Sections 58-1-501 and
             186      58-31b-502 and as may be further defined by rule.
             187          Section 2. Section 58-31b-201 is amended to read:
             188           58-31b-201. Board.
             189          (1) There is created the Board of Nursing that consists of the following eleven
             190      members:
             191          (a) nine nurses in a manner as may be further defined in division rule; and
             192          (b) two members of the public.
             193          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             194          (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
             195      58-1-203 and shall:
             196          (a) (i) recommend to the division minimum standards for educational programs
             197      qualifying a person for licensure[, registration,] or certification under this chapter;
             198          (ii) recommend to the division denial, approval, or withdrawal of approval regarding
             199      educational programs that meet or fail to meet the established minimum standards; and
             200          (iii) designate one of its members on a permanent or rotating basis to:
             201          (A) assist the division in reviewing complaints concerning the unlawful or
             202      unprofessional conduct of a licensee; and
             203          (B) advise the division in its investigation of these complaints.
             204          (b) A board member who has, under Subsection (3)(a)(iii), reviewed a complaint or
             205      advised in its investigation may be disqualified from participating with the board when the
             206      board serves as a presiding officer in an adjudicative proceeding concerning the complaint.
             207          (4) (a) The director shall appoint an individual to serve as the executive administrator
             208      of the Board of Nursing. Except when the board serves as a presiding officer in an adjudicative
             209      procedure, the executive administrator shall serve as an ex officio member of the board and
             210      shall represent the position of the division in matters considered by the board.
             211          (b) The executive administrator shall be a licensed registered nurse, shall have earned a
             212      masters degree in nursing, and shall have a minimum of five years of experience working in
             213      nursing administration or nursing education.


             214          Section 3. Section 58-31b-301 is amended to read:
             215           58-31b-301. License or certification required -- Classifications.
             216          (1) A license is required to engage in the practice of nursing, except as specifically
             217      provided in Sections 58-1-307 and 58-31b-308 .
             218          (2) The division shall issue to a person who qualifies under this chapter a license or
             219      certification in the classification of:
             220          (a) licensed practical nurse;
             221          (b) licensed practical nurse - geriatric care manager;
             222          (c) registered nurse;
             223          (d) advanced practice registered nurse intern;
             224          (e) advanced practice registered nurse; and
             225          (f) certified registered nurse anesthetist.
             226          (3) An individual holding an advanced practice registered nurse license as of July 1,
             227      1998, who cannot document the successful completion of advanced course work in patient
             228      assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
             229      issued an "APRN - without prescriptive practice" license.
             230          (4) The division shall grant an advanced practice registered nurse license to any
             231      licensed advanced practice registered nurse currently holding prescriptive authority under any
             232      predecessor act on July 1, 1998.
             233          [(5) (a) An individual shall be registered under this chapter in order to engage in
             234      practice as a health care assistant, except as provided in Sections 58-31b-308 and
             235      58-31b-308.5 .]
             236          [(b) The division shall issue to a person who qualifies under this chapter a registration
             237      in the classification of health care assistant.]
             238          Section 4. Section 58-31b-302 is amended to read:
             239           58-31b-302. Qualifications for licensure or certification -- Criminal background
             240      checks.
             241          (1) An applicant for licensure as a licensed practical nurse shall:
             242          (a) submit to the division an application in a form prescribed by the division;
             243          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             244          (c) have a high school diploma or its equivalent;


             245          (d) be in a condition of physical and mental health that will permit the applicant to
             246      practice safely as a licensed practical nurse;
             247          (e) have completed an approved practical nursing education program or an equivalent
             248      as determined by the board;
             249          (f) have passed the examinations as required by division rule made in collaboration
             250      with the board; and
             251          (g) meet with the board, if requested, to determine the applicant's qualifications for
             252      licensure.
             253          (2) An applicant for certification as a licensed practical nurse - geriatric care manager
             254      shall:
             255          (a) submit an application to the division on a form prescribed by the division;
             256          (b) pay a fee to the division as determined under Section 63-38-3.2 ;
             257          (c) have a current license, in good standing, as a licensed practical nurse;
             258          (d) have one year experience in a long-term care facility;
             259          (e) be in a condition of physical and mental health that will permit the applicant to
             260      practice safely as a licensed practical nurse - geriatric care manager;
             261          (f) have completed a division-approved geriatric care management education program
             262      or an equivalent as determined by the division in collaboration with the board;
             263          (g) have passed the examinations as required by division rule made in collaboration
             264      with the board; and
             265          (h) meet with the board, if requested, to determine the applicant's qualifications for
             266      licensure.
             267          (3) An applicant for licensure as a registered nurse shall:
             268          (a) submit to the division an application form prescribed by the division;
             269          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             270          (c) have a high school diploma or its equivalent;
             271          (d) be in a condition of physical and mental health that will allow the applicant to
             272      practice safely as a registered nurse;
             273          (e) have completed an approved registered nursing education program;
             274          (f) have passed the examinations as required by division rule made in collaboration
             275      with the board; and


             276          (g) meet with the board, if requested, to determine the applicant's qualifications for
             277      licensure.
             278          (4) Applicants for licensure as an advanced practice registered nurse shall:
             279          (a) submit to the division an application on a form prescribed by the division;
             280          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             281          (c) be in a condition of physical and mental health which will allow the applicant to
             282      practice safely as an advanced practice registered nurse;
             283          (d) hold a current registered nurse license in good standing issued by the state or be
             284      qualified at the time for licensure as a registered nurse;
             285          (e) have earned a graduate degree in an advanced practice registered nurse nursing
             286      education program or a related area of specialized knowledge as determined appropriate by the
             287      division in collaboration with the board;
             288          (f) have completed course work in patient assessment, diagnosis and treatment, and
             289      pharmacotherapeutics from an education program approved by the division in collaboration
             290      with the board;
             291          (g) have successfully completed clinical practice in psychiatric and mental health
             292      nursing, including psychotherapy as defined by division rule, after completion of the masters
             293      degree required for licensure, to practice within the psychiatric and mental health nursing
             294      specialty;
             295          (h) have passed the examinations as required by division rule made in collaboration
             296      with the board;
             297          (i) be currently certified by a program approved by the division in collaboration with
             298      the board and submit evidence satisfactory to the division of the certification; and
             299          (j) meet with the board, if requested, to determine the applicant's qualifications for
             300      licensure.
             301          (5) An applicant for licensure as a certified registered nurse anesthetist shall:
             302          (a) submit to the division an application on a form prescribed by the division;
             303          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             304          (c) be in a condition of physical and mental health which will allow the applicant to
             305      practice safely as a certified registered nurse anesthetist;
             306          (d) hold a current registered nurse license in good standing issued by the state or be


             307      qualified at the time for licensure as a registered nurse;
             308          (e) complete a nurse anesthesia program which is approved by the Council on
             309      Accreditation of Nurse Anesthesia Educational Programs;
             310          (f) be currently certified by a program approved by the division in collaboration with
             311      the board and submit evidence satisfactory to the division of the certification; and
             312          (g) meet with the board, if requested, to determine the applicant's qualifications for
             313      licensure.
             314          [(6) An applicant for registration as a health care assistant shall:]
             315          [(a) submit an application in a form prescribed by the division;]
             316          [(b) pay a fee determined by the department under Section 63-38-3.2 ;]
             317          [(c) certify in writing that he is free from any physical, mental, or emotional condition
             318      that will or may reasonably be expected to prevent the applicant from practicing as a health
             319      care assistant in compliance with this chapter; and]
             320          [(d) may not, within five years immediately prior to application, have any substantiated
             321      allegations of abuse, neglect, or misappropriation of client property listed against him on the
             322      certified nurse assistant registry maintained by the State Office of Education or on a similar
             323      registry maintained in another state in compliance with 42 CFR 483.156.]
             324          [(7)] (6) An applicant for licensure[, registration,] or certification under this chapter:
             325          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             326      license application is filed and shall consent to a fingerprint background check by the Utah
             327      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
             328      application; and
             329          (ii) the division shall request the Department of Public Safety to complete a Federal
             330      Bureau of Investigation criminal background check for each applicant through the national
             331      criminal history system (NCIC) or any successor system; and
             332          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             333      sentences for all felony convictions five or more years prior to the date of filing an application
             334      for licensure or [registration] certification under this chapter.
             335          [(8)] (7) For purposes of conducting the criminal background checks required in
             336      Subsection (6), the division shall have direct access to criminal background information
             337      maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.


             338          [(9)] (8) (a) (i) Any new nurse license [or health care assistant registration] issued
             339      under this section shall be conditional, pending completion of the criminal background check.
             340          (ii) If the criminal background check discloses the applicant has failed to accurately
             341      disclose a criminal history, the license or [registration] certification shall be immediately and
             342      automatically revoked.
             343          (b) (i) Any person whose conditional license or [registration] certification has been
             344      revoked under Subsection [(9)] (8)(a) shall be entitled to a postrevocation hearing to challenge
             345      the revocation.
             346          (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
             347      Administrative Procedures Act.
             348          Section 5. Section 58-31b-308 is amended to read:
             349           58-31b-308. Exemptions from licensure.
             350          (1) In addition to the exemptions from licensure in Section 58-1-307 , the following
             351      persons may engage in acts included within the definition of the practice of nursing, subject to
             352      the stated circumstances and limitations, without being licensed under this chapter:
             353          (a) friends, family members, foster parents, or legal guardians of a patient performing
             354      gratuitous nursing care for the patient;
             355          (b) persons providing care in a medical emergency;
             356          (c) persons engaged in the practice of religious tenets of a church or religious
             357      denomination; and
             358          (d) after July 1, 2000, a person licensed to practice nursing by a jurisdiction that has
             359      joined the Nurse Licensure Compact to the extent permitted by Section 58-31c-102 .
             360          (2) Notwithstanding Subsection (1)(d), the division may, in accordance with Section
             361      58-31c-102 , limit or revoke practice privileges in this state of a person licensed to practice
             362      nursing by a jurisdiction that has joined the Nurse Licensing Compact.
             363          [(3) In addition to the exemptions from licensure under Section 58-1-307 , the
             364      following individuals may engage in acts or practices included in the practice of a health care
             365      assistant, within the stated limitations, without being registered under this chapter:]
             366          [(a) an individual providing gratuitous care for another individual;]
             367          [(b) a volunteer, whether or not he receives token compensation other than salary or
             368      wages:]


             369          [(i) in programs sponsored or authorized by federal Public Law 93-113; or]
             370          [(ii) at any regulated facility; and]
             371          [(c) individuals providing:]
             372          [(i) services generally considered independent living activities such as preparing meals,
             373      shopping for personal items or groceries, managing money, using the telephone, performing
             374      housekeeping, and other similar activities not involving direct personal assistance and care as
             375      the division may define by rule; and]
             376          [(ii) child day care or baby-sitting, whether or not the services are subject to licensure
             377      under Title 26, Chapter 39, Utah Child Care Licensing Act;]
             378          [(d) an individual employed on an intermittent basis to provide a specified limited
             379      period of care for an adult or child with disabilities needing regular daily care, in order to allow
             380      the relative or other person who is the adult or child's regular and unpaid caretaker respite from
             381      his or her caregiver duties regarding the adult or child; or]
             382          [(e) notwithstanding Subsection 58-31b-102 (11) an individual employed by another
             383      person who is self directing his personal care in his private residence.]
             384          Section 6. Section 58-31b-401 is amended to read:
             385           58-31b-401. Grounds for denial of licensure or certification and disciplinary
             386      proceedings.
             387          (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the
             388      license of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee,
             389      to issue a public or private reprimand to a licensee, and to issue cease and desist orders shall be
             390      in accordance with Section 58-1-401 .
             391          (2) If a court of competent jurisdiction determines a nurse [or health care assistant] is
             392      an incapacitated person as defined in Section 75-1-201 or that he is mentally ill as defined in
             393      Section 62A-15-602 , and unable to safely engage in the practice of nursing [or the practice of a
             394      health care assistant], the director shall immediately suspend the license of the nurse [or health
             395      care assistant] upon the entry of the judgment of the court, without further proceedings under
             396      Title 63, Chapter 46b, Administrative Procedures Act, regardless of whether an appeal from the
             397      court's ruling is pending. The director shall promptly notify the nurse [or health care assistant,]
             398      in writing[,] of the suspension.
             399          (3) (a) If the division and the majority of the board find reasonable cause to believe a


             400      nurse [or health care assistant,] who is not determined judicially to be an incapacitated person
             401      or to be mentally ill, is incapable of practicing nursing [or the practice of a health care
             402      assistant] with reasonable skill regarding the safety of patients, because of illness, excessive
             403      use of drugs or alcohol, or as a result of any mental or physical condition, the board shall
             404      recommend that the director file a petition with the division, and cause the petition to be served
             405      upon the nurse [or health care assistant] with a notice of hearing on the sole issue of the
             406      capacity of the nurse [or health care assistant] to competently, safely engage in the practice of
             407      nursing [or the practice of a health care assistant].
             408          (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
             409      Administrative Procedures Act, except as provided in Subsection (4).
             410          (4) (a) Every nurse [or health care assistant] who accepts the privilege of being
             411      licensed under this chapter gives consent to:
             412          (i) submitting to an immediate mental or physical examination, at the nurse's [or health
             413      care assistant's] expense and by a division-approved practitioner selected by the nurse [or
             414      health care assistant,] when directed in writing by the division and a majority of the board to do
             415      so; and
             416          (ii) the admissibility of the reports of the examining practitioner's testimony or
             417      examination, and waives all objections on the ground the reports constitute a privileged
             418      communication.
             419          (b) The examination may be ordered by the division, with the consent of a majority of
             420      the board, only upon a finding of reasonable cause to believe:
             421          (i) the nurse [or health care assistant] is mentally ill or incapacitated or otherwise
             422      unable to practice nursing [or health care assistance] with reasonable skill and safety; and
             423          (ii) immediate action by the division and the board is necessary to prevent harm to the
             424      nurse's [or health care assistant's] patients or the general public.
             425          (c) (i) Failure of a nurse [or health care assistant] to submit to the examination ordered
             426      under this section is a ground for the division's immediate suspension of the nurse's [or health
             427      care assistant's] license by written order of the director.
             428          (ii) The division may enter the order of suspension without further compliance with
             429      Title 63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to
             430      submit to the examination ordered under this section was due to circumstances beyond the


             431      control of the nurse [or health care assistant] and was not related directly to the illness or
             432      incapacity of the nurse [or health care assistant].
             433          (5) (a) A nurse [or health care assistant] whose license is suspended under Subsection
             434      (2), (3), or (4)(c) has the right to a hearing to appeal the suspension within ten days after the
             435      license is suspended.
             436          (b) The hearing held under this Subsection (5) shall be conducted in accordance with
             437      Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists
             438      for the continuance of the order of suspension in order to prevent harm to the nurse's [or health
             439      care assistant's] patients or the general public.
             440          (6) A nurse [or health care assistant] whose license is revoked, suspended, or in any
             441      way restricted under this section may request the division and the board to consider, at
             442      reasonable intervals, evidence presented by the nurse [or health care assistant], under
             443      procedures established by division rule, regarding any change in the nurse's [or health care
             444      assistant's] condition, to determine whether:
             445          (a) he is or is not able to safely and competently engage in the practice of nursing [or
             446      the practice of a health care assistant]; and
             447          (b) he is qualified to have his license to practice under this chapter restored completely
             448      or in part.
             449          (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the
             450      division to report current significant investigative information to the coordinated licensure
             451      information system for transmission to party states as required of the division by Article VII of
             452      the Nurse Licensure Compact in Section 58-31c-102 .
             453          (8) For purposes of this section and Section 58-31b-402 , "licensed" or "license"
             454      includes ["registered" or "registration" and] "certified" or "certification" under this chapter.
             455          Section 7. Section 58-31b-501 is amended to read:
             456           58-31b-501. Unlawful conduct.
             457          (1) "Unlawful conduct" includes:
             458          (a) using the following titles, names or initials, if the user is not properly licensed
             459      under this chapter:
             460          (i) nurse;
             461          (ii) licensed practical nurse, practical nurse, or L.P.N.;


             462          (iii) registered nurse or R.N.;
             463          (iv) registered nurse practitioner, N.P., or R.N.P.;
             464          (v) registered nurse specialist, N.S., or R.N.S.;
             465          (vi) registered psychiatric mental health nurse specialist;
             466          (vii) advanced practice registered nurse;
             467          (viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist,
             468      or C.R.N.A.; or
             469          (ix) other generally recognized names or titles used in the profession of nursing;
             470          (b) using any other name, title, or initials that would cause a reasonable person to
             471      believe the user is licensed under this chapter if the user is not properly licensed under this
             472      chapter; and
             473          (c) conducting a nursing education program in the state for the purpose of qualifying
             474      individuals to meet requirements for licensure under this chapter without the program having
             475      been approved under Section 58-31b-601 .
             476          [(2) (a) An individual registered as a health care assistant under this chapter may use
             477      any title in his practice as a health care assistant, and an employer may assign a title to health
             478      care assistants it employs, if the title does not cause a reasonable person to believe the
             479      registrant is a licensee in any other license classification under this chapter and Title 58,
             480      Occupations and Professions.]
             481          [(b) If any issue is raised regarding a title under this section, the division shall
             482      determine if the title may be used for health care assistants.]
             483          [(3)] (2) An individual licensed as a practical nurse who is certified as a geriatric care
             484      manager under this chapter, may use the title "licensed practical nurse - geriatric care manager"
             485      or the initials "LPN-GCM" to designate the additional training and certification.
             486          Section 8. Section 58-31b-702 is amended to read:
             487           58-31b-702. Reporting of disciplinary action -- Immunity from liability.
             488          (1) A licensed health care facility or organization or a professional society of nurses in
             489      the state that takes disciplinary action against a person licensed under this chapter relating to
             490      any of the following shall report the action in writing to the division within 30 days after the
             491      action is taken:
             492          (a) that person's professional acts or omissions as a licensed nurse [or registered health


             493      care assistant];
             494          (b) that person's nursing competence or ability to practice nursing safely; or
             495          (c) that person's use of alcohol or drugs in an unlawful manner or to the extent the
             496      person is impaired in his ability to practice nursing [or health care assistance] safely.
             497          (2) Any person or organization furnishing information in accordance with this section
             498      is immune from liability to the extent that the information is furnished in good faith and
             499      without malice.
             500          Section 9. Section 58-31d-103 is amended to read:
             501           58-31d-103. Rulemaking authority -- Enabling provisions.
             502          (1) The division may adopt rules necessary to implement Section 58-31d-102 .
             503          (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
             504      "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
             505          (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
             506      defined in Article II (1) of the compact includes an individual who is licensed to practice under
             507      Subsection [ 58-31b-302 (2)(d)] 58-31b-301 (2)(e) as an advanced practice registered nurse.
             508          (4) An APRN practicing in this state under a multistate licensure privilege may only be
             509      granted prescriptive authority if that individual can document completion of graduate level
             510      course work in the following areas:
             511          (a) advanced health assessment;
             512          (b) pharmacotherapeutics; and
             513          (c) diagnosis and treatment.
             514          (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
             515      obtain prescriptive authority must:
             516          (i) meet all the requirements of Subsection (4) and this Subsection (5); and
             517          (ii) be placed on a registry with the division.
             518          (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
             519          (i) submit a form prescribed by the division;
             520          (ii) pay a fee; and
             521          (iii) if prescribing a controlled substance:
             522          (A) obtain a controlled substance license as required under Section 58-37-6 ; and
             523          (B) if prescribing a Schedule II or III controlled substance, have a consultation and


             524      referral plan with a physician licensed in Utah as required under Subsection
             525      58-31b-102 [(16)](17)(c)(iii).
             526          Section 10. Section 62A-3-311.1 is amended to read:
             527           62A-3-311.1. Statewide data base -- Restricted use and access.
             528          (1) The division shall maintain a data base for reports of vulnerable adult abuse,
             529      neglect, or exploitation made pursuant to this part.
             530          (2) The data base shall include:
             531          (a) the names and identifying data of the abused, neglected, or exploited adult and the
             532      reported abuser;
             533          (b) information regarding whether or not the abuse, neglect, or exploitation was
             534      substantiated or unsubstantiated; and
             535          (c) any other information that may be helpful in furthering the purposes of this part, as
             536      determined by the division, subject to the restrictions of Section 62A-3-306 .
             537          (3) Information obtained from the data base may be used only for:
             538          (a) compiling statistical summaries that do not include names or other identifying data;
             539          (b) granting or denying licenses or other grants of privilege by the department where
             540      identification as a possible adult abuser may be relevant to the privilege in question, in
             541      accordance with Subsection (4); and
             542          [(c) investigation and action by the Division of Occupational and Professional
             543      Licensing regarding registration of a health care assistant under Title 58, Chapter 62, Health
             544      Care Assistant Registration Act; and]
             545          [(d)] (c) licensing purposes by the Bureau of Licensing within the Department of
             546      Health, as provided for in Section 26-21-9.5 , in determining whether a person associated with a
             547      covered health care facility who provides direct care to vulnerable adults has a substantiated
             548      finding of vulnerable adult abuse, neglect, or exploitation if identification as a possible
             549      perpetrator is relevant to the employment activities of that person.
             550          (4) (a) A license or privilege may not be denied under Subsection (3) solely on the
             551      basis of information in the data base.
             552          (b) Before a license or privilege may be denied under Subsection (3), the department
             553      taking the action shall conduct a review and provide the person making application for the
             554      license or privilege with notice and an opportunity to be heard in accordance with Title 63,


             555      Chapter 46b, Administrative Procedures Act.
             556          Section 11. Repealer.
             557          This bill repeals:
             558          Section 58-31b-308.5, Health care assistant registration -- Temporary employment
             559      prior to registration.




Legislative Review Note
    as of 11-27-04 2:28 PM


Based on a limited legal review, this legislation has not been determined to have a high
probability of being held unconstitutional.

Office of Legislative Research and General Counsel


Interim Committee Note
    as of 12-07-04 1:59 PM


The Health and Human Services Interim Committee recommended this bill.


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