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H.B. 243
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6 LONG TITLE
7 General Description:
8 This bill amends the Nurse Practices Act to repeal provisions related to Geriatric Care
9 Managers.
10 Highlighted Provisions:
11 This bill:
12 . removes the reference to geriatric care managers in the following areas of the Nurse
13 Practices Act:
14 . definitions;
15 . qualifications for licensure;
16 . qualifications for admission to examinations;
17 . unprofessional conduct; and
18 . minimum standards for nursing programs; and
19 . repeals the pilot program for geriatric care managers.
20 Monies Appropriated in this Bill:
21 None
22 Other Special Clauses:
23 None
24 Utah Code Sections Affected:
25 AMENDS:
26 58-31b-102, as last amended by Chapter 247, Laws of Utah 2004
27 58-31b-301, as last amended by Chapter 247, Laws of Utah 2004
28 58-31b-302, as last amended by Chapters 15 and 247, Laws of Utah 2004
29 58-31b-303, as last amended by Chapter 247, Laws of Utah 2004
30 58-31b-304, as last amended by Chapter 247, Laws of Utah 2004
31 58-31b-308, as last amended by Chapter 219, Laws of Utah 2003
32 58-31b-501, as last amended by Chapter 247, Laws of Utah 2004
33 58-31b-502, as last amended by Chapter 247, Laws of Utah 2004
34 58-31b-601, as last amended by Chapter 247, Laws of Utah 2004
35 58-31d-103, as enacted by Chapter 15, Laws of Utah 2004
36 63-55b-158, as enacted by Chapter 247, Laws of Utah 2004
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38 Be it enacted by the Legislature of the state of Utah:
39 Section 1. Section 58-31b-102 is amended to read:
40 58-31b-102. Definitions.
41 In addition to the definitions in Section 58-1-102 , as used in this chapter:
42 (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
43 omissions determined to constitute unprofessional or unlawful conduct in accordance with a
44 fine schedule established by rule and as a result of an adjudicative proceeding conducted in
45 accordance with Title 63, Chapter 46b, Administrative Procedures Act.
46 (2) "Applicant" means a person who applies for licensure or registration under this
47 chapter by submitting a completed application for licensure or registration and the required fees
48 to the department.
49 (3) "Approved education program" means a nursing education program that meets the
50 minimum standards for educational programs established under this chapter and by division
51 rule in collaboration with the board.
52 (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
53 (5) "Consultation and referral plan" means a written plan jointly developed by an
54 advanced practice registered nurse and a consulting physician that permits the advanced
55 practice registered nurse to prescribe schedule II-III controlled substances in consultation with
56 the consulting physician.
57 (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
58 surgeon licensed in accordance with this title who has agreed to consult with an advanced
59 practice registered nurse with a controlled substance license, a DEA registration number, and
60 who will be prescribing schedule II-III controlled substances.
61 (7) "Diagnosis" means the identification of and discrimination between physical and
62 psychosocial signs and symptoms essential to the effective execution and management of
63 health care.
64 (8) "Examinee" means a person who applies to take or does take any examination
65 required under this chapter for licensure.
66 (9) "Health care assistant" means an individual who:
67 (a) engages in the practice of a health care assistant; and
68 (b) is subject to registration under this chapter and is not subject to registration,
69 licensure, or certification under any other chapter of this title.
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75 this chapter.
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77 the Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
78 Inspection Act:
79 (a) a nursing care facility;
80 (b) a small health care facility;
81 (c) an intermediate care facility for the mentally retarded;
82 (d) an assisted living facility Type I or II; or
83 (e) a designated swing bed unit in a general hospital.
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85 assistance or care for compensation to an individual who is ill, injured, infirm, developmentally
86 or physically disabled, mentally disabled, or mentally retarded, and who is in a private
87 residence or regulated facility.
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97 attain optimal health, implementing a strategy of care to accomplish defined goals and
98 evaluating responses to care and treatment. The practice of nursing requires substantial
99 specialized or general knowledge, judgment, and skill based upon principles of the biological,
100 physical, behavioral, and social sciences, and includes:
101 (a) initiating and maintaining comfort measures;
102 (b) promoting and supporting human functions and responses;
103 (c) establishing an environment conducive to well-being;
104 (d) providing health counseling and teaching;
105 (e) collaborating with health care professionals on aspects of the health care regimen;
106 (f) performing delegated procedures only within the education, knowledge, judgment,
107 and skill of the licensee; and
108 (g) delegating nurse interventions that may be performed by others and are not in
109 conflict with this chapter.
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111 the provision of preoperative, intraoperative, and postoperative anesthesia care and related
112 services upon the request of a physician, surgeon, or other licensed professional, who is acting
113 within the scope of their practice, by a person licensed under this chapter as a certified
114 registered nurse anesthetist and includes:
115 (i) preanesthesia preparation and evaluation including:
116 (A) performing a preanesthetic assessment of the patient;
117 (B) ordering and evaluating appropriate lab and other studies to determine the health of
118 the patient; and
119 (C) selecting, ordering, or administering appropriate medications;
120 (ii) anesthesia induction, maintenance, and emergence, including:
121 (A) selecting and initiating the planned anesthetic technique;
122 (B) selecting and administering anesthetics and adjunct drugs and fluids; and
123 (C) administering general, regional, and local anesthesia;
124 (iii) postanesthesia follow-up care, including:
125 (A) evaluating the patient's response to anesthesia and implementing corrective
126 actions; and
127 (B) selecting, ordering, or administering the above medications and studies; and
128 (iv) other related services within the scope of practice of a certified registered nurse
129 anesthetist, including:
130 (A) emergency airway management;
131 (B) advanced cardiac life support; and
132 (C) the establishment of peripheral, central, and arterial invasive lines.
133 (b) Nothing in this section shall be construed as to require a certified registered nurse
134 anesthetist to obtain an advance practice registered nurse license in order to select, administer,
135 or provide preoperative, intraoperative, or postoperative anesthesia care and services.
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137 generally recognized scope of practice of licensed practical nurses as defined by rule and as
138 provided in this Subsection [
139 practical nurse and under the direction of a registered nurse, licensed physician, or other
140 specified health care professional as defined by rule. Practical nursing acts include:
141 (a) contributing to the assessment of the health status of individuals and groups;
142 (b) participating in the development and modification of the strategy of care;
143 (c) implementing appropriate aspects of the strategy of care;
144 (d) maintaining safe and effective nursing care rendered to a patient directly or
145 indirectly; and
146 (e) participating in the evaluation of responses to interventions.
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148 provided in this Subsection [
149 nurse within the generally recognized scope of practice of registered nurses as defined by rule.
150 Registered nursing acts include:
151 (a) assessing the health status of individuals and groups;
152 (b) identifying health care needs;
153 (c) establishing goals to meet identified health care needs;
154 (d) planning a strategy of care;
155 (e) prescribing nursing interventions to implement the strategy of care;
156 (f) implementing the strategy of care;
157 (g) maintaining safe and effective nursing care that is rendered to a patient directly or
158 indirectly;
159 (h) evaluating responses to interventions;
160 (i) teaching the theory and practice of nursing; and
161 (j) managing and supervising the practice of nursing.
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163 nursing within the generally recognized scope and standards of advanced practice registered
164 nursing as defined by rule and consistent with professionally recognized preparation and
165 education standards of an advanced practice registered nurse by a person licensed under this
166 chapter as an advanced practice registered nurse. Advanced practice registered nursing
167 includes:
168 (a) maintenance and promotion of health and prevention of disease;
169 (b) diagnosis, treatment, correction, consultation, and referral for common health
170 problems; and
171 (c) prescription or administration of prescription drugs or devices including:
172 (i) local anesthesia;
173 (ii) schedule IV-V controlled substances; and
174 (iii) schedule II-III controlled substances in accordance with a consultation and referral
175 plan.
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177 Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act and does not include:
178 (a) the Utah State Hospital or the Utah State Developmental Center;
179 (b) a residential treatment or residential support facility:
180 (i) subject to licensure under Title 62A, Chapter 2, Licensure of Programs and
181 Facilities; and
182 (ii) serving people with disabilities, as defined by Department of Human Services
183 rules; or
184 (c) a health care facility which is licensed or certified under Title 26, Chapter 21.
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187 of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
188 with the standards of the profession.
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190 58-31b-502 and as may be further defined by rule.
191 Section 2. Section 58-31b-301 is amended to read:
192 58-31b-301. License or certification required -- Classifications.
193 (1) A license is required to engage in the practice of nursing, except as specifically
194 provided in Sections 58-1-307 and 58-31b-308 .
195 (2) The division shall issue to a person who qualifies under this chapter a license or
196 certification in the classification of:
197 (a) licensed practical nurse;
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203 (3) An individual holding an advanced practice registered nurse license as of July 1,
204 1998, who cannot document the successful completion of advanced course work in patient
205 assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
206 issued an "APRN - without prescriptive practice" license.
207 (4) The division shall grant an advanced practice registered nurse license to any
208 licensed advanced practice registered nurse currently holding prescriptive authority under any
209 predecessor act on July 1, 1998.
210 (5) (a) An individual shall be registered under this chapter in order to engage in
211 practice as a health care assistant, except as provided in Sections 58-31b-308 and
212 58-31b-308.5 .
213 (b) The division shall issue to a person who qualifies under this chapter a registration
214 in the classification of health care assistant.
215 Section 3. Section 58-31b-302 is amended to read:
216 58-31b-302. Qualifications for licensure or certification -- Criminal background
217 checks.
218 (1) An applicant for licensure as a licensed practical nurse shall:
219 (a) submit to the division an application in a form prescribed by the division;
220 (b) pay to the division a fee determined under Section 63-38-3.2 ;
221 (c) have a high school diploma or its equivalent;
222 (d) be in a condition of physical and mental health that will permit the applicant to
223 practice safely as a licensed practical nurse;
224 (e) have completed an approved practical nursing education program or an equivalent
225 as determined by the board;
226 (f) have passed the examinations as required by division rule made in collaboration
227 with the board; and
228 (g) meet with the board, if requested, to determine the applicant's qualifications for
229 licensure.
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245 (a) submit to the division an application form prescribed by the division;
246 (b) pay to the division a fee determined under Section 63-38-3.2 ;
247 (c) have a high school diploma or its equivalent;
248 (d) be in a condition of physical and mental health that will allow the applicant to
249 practice safely as a registered nurse;
250 (e) have completed an approved registered nursing education program;
251 (f) have passed the examinations as required by division rule made in collaboration
252 with the board; and
253 (g) meet with the board, if requested, to determine the applicant's qualifications for
254 licensure.
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256 (a) submit to the division an application on a form prescribed by the division;
257 (b) pay to the division a fee determined under Section 63-38-3.2 ;
258 (c) be in a condition of physical and mental health which will allow the applicant to
259 practice safely as an advanced practice registered nurse;
260 (d) hold a current registered nurse license in good standing issued by the state or be
261 qualified at the time for licensure as a registered nurse;
262 (e) have earned a graduate degree in an advanced practice registered nurse nursing
263 education program or a related area of specialized knowledge as determined appropriate by the
264 division in collaboration with the board;
265 (f) have completed course work in patient assessment, diagnosis and treatment, and
266 pharmacotherapeutics from an education program approved by the division in collaboration
267 with the board;
268 (g) have successfully completed clinical practice in psychiatric and mental health
269 nursing, including psychotherapy as defined by division rule, after completion of the masters
270 degree required for licensure, to practice within the psychiatric and mental health nursing
271 specialty;
272 (h) have passed the examinations as required by division rule made in collaboration
273 with the board;
274 (i) be currently certified by a program approved by the division in collaboration with
275 the board and submit evidence satisfactory to the division of the certification; and
276 (j) meet with the board, if requested, to determine the applicant's qualifications for
277 licensure.
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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 a certified registered nurse anesthetist;
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) complete a nurse anesthesia program which is approved by the Council on
286 Accreditation of Nurse Anesthesia Educational Programs;
287 (f) be currently certified by a program approved by the division in collaboration with
288 the board and submit evidence satisfactory to the division of the certification; and
289 (g) meet with the board, if requested, to determine the applicant's qualifications for
290 licensure.
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292 (a) submit an application in a form prescribed by the division;
293 (b) pay a fee determined by the department under Section 63-38-3.2 ;
294 (c) certify in writing that he is free from any physical, mental, or emotional condition
295 that will or may reasonably be expected to prevent the applicant from practicing as a health
296 care assistant in compliance with this chapter; and
297 (d) may not, within five years immediately prior to application, have any substantiated
298 allegations of abuse, neglect, or misappropriation of client property listed against him on the
299 certified nurse assistant registry maintained by the State Office of Education or on a similar
300 registry maintained in another state in compliance with 42 CFR 483.156.
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302 (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
303 license application is filed and shall consent to a fingerprint background check by the Utah
304 Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
305 application; and
306 (ii) the division shall request the Department of Public Safety to complete a Federal
307 Bureau of Investigation criminal background check for each applicant through the national
308 criminal history system (NCIC) or any successor system; and
309 (b) if convicted of one or more felonies, must receive an absolute discharge from the
310 sentences for all felony convictions five or more years prior to the date of filing an application
311 for licensure or registration under this chapter.
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313 Subsection (6), the division shall have direct access to criminal background information
314 maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
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316 this section shall be conditional, pending completion of the criminal background check.
317 (ii) If the criminal background check discloses the applicant has failed to accurately
318 disclose a criminal history, the license or registration shall be immediately and automatically
319 revoked.
320 (b) (i) Any person whose conditional license or registration has been revoked under
321 Subsection [
322 (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
323 Administrative Procedures Act.
324 Section 4. Section 58-31b-303 is amended to read:
325 58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
326 programs.
327 An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
328 nursing education program not approved by the division in collaboration with the board must
329 comply with the requirements of this section.
330 (1) An applicant for licensure as a licensed practical nurse shall:
331 (a) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(e); and
332 (b) produce evidence acceptable to the division and the board that the nursing
333 education program completed by the applicant is equivalent to the minimum standards
334 established by the division in collaboration with the board for an approved licensed practical
335 nursing education program.
336 (2) An applicant for licensure as a registered nurse shall:
337 (a) meet all requirements of Subsection 58-31b-302 [
338 (2)(e); and
339 (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
340 Examination; or
341 (ii) produce evidence acceptable to the division and the board that the applicant is
342 currently licensed as a registered nurse in one of the states, territories, or the District of
343 Columbia of the United States and has passed the NCLEX-RN examination.
344 Section 5. Section 58-31b-304 is amended to read:
345 58-31b-304. Qualifications for admission to the examinations.
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353 a person shall:
354 (a) submit an application form prescribed by the division;
355 (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
356 (c) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(f).
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358 nurse, a person shall:
359 (a) submit an application form prescribed by the division;
360 (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
361 (c) meet all the requirements of Subsection 58-31b-302 [
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363 Section 6. Section 58-31b-308 is amended to read:
364 58-31b-308. Exemptions from licensure or registration.
365 (1) In addition to the exemptions from licensure in Section 58-1-307 , the following
366 persons may engage in acts included within the definition of the practice of nursing, subject to
367 the stated circumstances and limitations, without being licensed under this chapter:
368 (a) friends, family members, foster parents, or legal guardians of a patient performing
369 gratuitous nursing care for the patient;
370 (b) persons providing care in a medical emergency;
371 (c) persons engaged in the practice of religious tenets of a church or religious
372 denomination; and
373 (d) after July 1, 2000, a person licensed to practice nursing by a jurisdiction that has
374 joined the Nurse Licensure Compact to the extent permitted by Section 58-31c-102 .
375 (2) Notwithstanding Subsection (1)(d), the division may, in accordance with Section
376 58-31c-102 , limit or revoke practice privileges in this state of a person licensed to practice
377 nursing by a jurisdiction that has joined the Nurse Licensing Compact.
378 (3) In addition to the exemptions from licensure under Section 58-1-307 , the following
379 individuals may engage in acts or practices included in the practice of a health care assistant,
380 within the stated limitations, without being registered under this chapter:
381 (a) an individual providing gratuitous care for another individual;
382 (b) a volunteer, whether or not he receives token compensation other than salary or
383 wages:
384 (i) in programs sponsored or authorized by federal Public Law 93-113; or
385 (ii) at any regulated facility; and
386 (c) individuals providing:
387 (i) services generally considered independent living activities such as preparing meals,
388 shopping for personal items or groceries, managing money, using the telephone, performing
389 housekeeping, and other similar activities not involving direct personal assistance and care as
390 the division may define by rule; and
391 (ii) child day care or baby-sitting, whether or not the services are subject to licensure
392 under Title 26, Chapter 39, Utah Child Care Licensing Act;
393 (d) an individual employed on an intermittent basis to provide a specified limited
394 period of care for an adult or child with disabilities needing regular daily care, in order to allow
395 the relative or other person who is the adult or child's regular and unpaid caretaker respite from
396 his or her caregiver duties regarding the adult or child; or
397 (e) notwithstanding Subsection 58-31b-102 [
398 another person who is self directing his personal care in his private residence.
399 Section 7. Section 58-31b-501 is amended to read:
400 58-31b-501. Unlawful conduct.
401 (1) "Unlawful conduct" includes:
402 (a) using the following titles, names or initials, if the user is not properly licensed
403 under this chapter:
404 (i) nurse;
405 (ii) licensed practical nurse, practical nurse, or L.P.N.;
406 (iii) registered nurse or R.N.;
407 (iv) registered nurse practitioner, N.P., or R.N.P.;
408 (v) registered nurse specialist, N.S., or R.N.S.;
409 (vi) registered psychiatric mental health nurse specialist;
410 (vii) advanced practice registered nurse;
411 (viii) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist,
412 or C.R.N.A.; or
413 (ix) other generally recognized names or titles used in the profession of nursing;
414 (b) using any other name, title, or initials that would cause a reasonable person to
415 believe the user is licensed under this chapter if the user is not properly licensed under this
416 chapter; and
417 (c) conducting a nursing education program in the state for the purpose of qualifying
418 individuals to meet requirements for licensure under this chapter without the program having
419 been approved under Section 58-31b-601 .
420 (2) (a) An individual registered as a health care assistant under this chapter may use
421 any title in his practice as a health care assistant, and an employer may assign a title to health
422 care assistants it employs, if the title does not cause a reasonable person to believe the
423 registrant is a licensee in any other license classification under this chapter and Title 58,
424 Occupations and Professions.
425 (b) If any issue is raised regarding a title under this section, the division shall determine
426 if the title may be used for health care assistants.
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430 Section 8. Section 58-31b-502 is amended to read:
431 58-31b-502. Unprofessional conduct.
432 "Unprofessional conduct" includes:
433 (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
434 diagnosis, personal effects, or any other matter about which the licensee is privileged to know
435 because of the licensee's position or practice as a nurse;
436 (2) failure to provide nursing service in a manner that demonstrates respect for the
437 patient's human dignity and unique personal character and needs without regard to the patient's
438 race, religion, ethnic background, socioeconomic status, age, sex, or the nature of the patient's
439 health problem;
440 (3) engaging in sexual relations with a patient during any:
441 (a) period when a generally recognized professional relationship exists between the
442 nurse and patient; or
443 (b) extended period when a patient has reasonable cause to believe a professional
444 relationship exists between the nurse and patient;
445 (4) (a) as a result of any circumstance under Subsection (3), exploiting or using
446 information about a patient or exploiting the licensee's professional relationship between the
447 licensee and the patient; or
448 (b) exploiting the patient by use of the licensee's knowledge of the patient obtained
449 while acting as a nurse;
450 (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
451 (6) unauthorized taking or personal use of nursing supplies from an employer;
452 (7) unauthorized taking or personal use of a patient's personal property;
453 (8) knowingly entering into any medical record any false or misleading information or
454 altering a medical record in any way for the purpose of concealing an act, omission, or record
455 of events, medical condition, or any other circumstance related to the patient and the medical or
456 nursing care provided;
457 (9) unlawful or inappropriate delegation of nursing care;
458 (10) failure to exercise appropriate supervision of persons providing patient care
459 services under supervision of the licensed nurse;
460 (11) employing or aiding and abetting the employment of an unqualified or unlicensed
461 person to practice as a nurse;
462 (12) failure to file or record any medical report as required by law, impeding or
463 obstructing the filing or recording of such a report, or inducing another to fail to file or record
464 such a report;
465 (13) breach of a statutory, common law, regulatory, or ethical requirement of
466 confidentiality with respect to a person who is a patient, unless ordered by a court;
467 (14) failure to pay a penalty imposed by the division;
468 (15) prescribing a schedule II-III controlled substance without a consulting physician or
469 outside of a consultation and referral plan; and
470 (16) violating Section 58-31b-801 [
471 [
472
473 Section 9. Section 58-31b-601 is amended to read:
474 58-31b-601. Minimum standards for nursing programs.
475 (1) A nursing education program shall be affiliated with an accredited institution of
476 higher education in order to be approved by the division.
477 (2) The minimum standards a nursing program shall meet to qualify graduates for
478 licensure under this chapter shall be defined by division rule.
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483 Section 10. Section 58-31d-103 is amended to read:
484 58-31d-103. Rulemaking authority -- Enabling provisions.
485 (1) The division may adopt rules necessary to implement Section 58-31d-102 .
486 (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
487 "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
488 (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
489 defined in Article II (1) of the compact includes an individual who is licensed to practice under
490 Subsection 58-31b-302 [
491 (4) An APRN practicing in this state under a multistate licensure privilege may only be
492 granted prescriptive authority if that individual can document completion of graduate level
493 course work in the following areas:
494 (a) advanced health assessment;
495 (b) pharmacotherapeutics; and
496 (c) diagnosis and treatment.
497 (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
498 obtain prescriptive authority must:
499 (i) meet all the requirements of Subsection (4) and this Subsection (5); and
500 (ii) be placed on a registry with the division.
501 (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
502 (i) submit a form prescribed by the division;
503 (ii) pay a fee; and
504 (iii) if prescribing a controlled substance:
505 (A) obtain a controlled substance license as required under Section 58-37-6 ; and
506 (B) if prescribing a Schedule II or III controlled substance, have a consultation and
507 referral plan with a physician licensed in Utah as required under Subsection 58-31b-102 [
508 (17)(c)(iii).
509 Section 11. Section 63-55b-158 is amended to read:
510 63-55b-158. Repeal dates -- Title 58.
511 Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed [
512 May 2, 2005.
Legislative Review Note
as of 1-27-05 4:16 PM
Based on a limited legal review, this legislation has not been determined to have a high
probability of being held unconstitutional.