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H.B. 137 Enrolled

             1     

MEDICATION AIDE CERTIFIED

             2     
2006 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Rebecca D. Lockhart

             5     
Senate Sponsor: Sheldon L. Killpack

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Nurse Practice Act to create a medication aide certified in
             10      long-term care facilities.
             11      Highlighted Provisions:
             12          This bill:
             13          .    defines a medication aide certified and the practice of a medication aide certified;
             14          .    creates a pilot program for the medication aide certified which sunsets on May 15,
             15      2010;
             16          .    establishes qualifications and training for a medication aide certified;
             17          .    amends provisions related to unlawful and unprofessional conduct; and
             18          .    makes technical changes.
             19      Monies Appropriated in this Bill:
             20          None
             21      Other Special Clauses:
             22          None
             23      Utah Code Sections Affected:
             24      AMENDS:
             25          58-31b-102, as last amended by Chapters 50 and 134, Laws of Utah 2005
             26          58-31b-301, as last amended by Chapters 50 and 134, Laws of Utah 2005
             27          58-31b-302, as last amended by Chapters 50 and 134, Laws of Utah 2005
             28          58-31b-303, as last amended by Chapter 134, Laws of Utah 2005
             29          58-31b-304, as last amended by Chapter 134, Laws of Utah 2005


             30          58-31b-305, as last amended by Chapter 268, Laws of Utah 2001
             31          58-31b-401, as last amended by Chapter 50, Laws of Utah 2005
             32          58-31b-501, as last amended by Chapters 50 and 134, Laws of Utah 2005
             33          58-31b-502, as last amended by Chapter 134, Laws of Utah 2005
             34          58-31b-503, as last amended by Chapter 290, Laws of Utah 2002
             35          58-31b-601, as last amended by Chapter 134, Laws of Utah 2005
             36          58-31d-103, as last amended by Chapters 50, 71 and 134, Laws of Utah 2005
             37          63-55b-158, as last amended by Chapter 134, Laws of Utah 2005
             38      ENACTS:
             39          58-31b-301.6, Utah Code Annotated 1953
             40     
             41      Be it enacted by the Legislature of the state of Utah:
             42          Section 1. Section 58-31b-102 is amended to read:
             43           58-31b-102. Definitions.
             44          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             45          (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
             46      omissions determined to constitute unprofessional or unlawful conduct in accordance with a
             47      fine schedule established by rule and as a result of an adjudicative proceeding conducted in
             48      accordance with Title 63, Chapter 46b, Administrative Procedures Act.
             49          (2) "Applicant" means a person who applies for licensure or certification under this
             50      chapter by submitting a completed application for licensure or certification and the required
             51      fees to the department.
             52          (3) "Approved education program" means a nursing education program that meets the
             53      minimum standards for educational programs established under this chapter and by division
             54      rule in collaboration with the board.
             55          (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
             56          (5) "Consultation and referral plan" means a written plan jointly developed by an
             57      advanced practice registered nurse and a consulting physician that permits the advanced


             58      practice registered nurse to prescribe schedule II-III controlled substances in consultation with
             59      the consulting physician.
             60          (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
             61      surgeon licensed in accordance with this title who has agreed to consult with an advanced
             62      practice registered nurse with a controlled substance license, a DEA registration number, and
             63      who will be prescribing schedule II-III controlled substances.
             64          (7) "Diagnosis" means the identification of and discrimination between physical and
             65      psychosocial signs and symptoms essential to the effective execution and management of
             66      health care.
             67          (8) "Examinee" means a person who applies to take or does take any examination
             68      required under this chapter for licensure.
             69          (9) "Licensee" means a person who is licensed or certified under this chapter.
             70          (10) "Long-term care facility" means any of the following facilities licensed by the
             71      Department of Health pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
             72      Inspection Act:
             73          (a) a nursing care facility;
             74          (b) a small health care facility;
             75          (c) an intermediate care facility for the mentally retarded;
             76          (d) an assisted living facility Type I or II; or
             77          (e) a designated swing bed unit in a general hospital.
             78          (11) "Medication aide certified" means a certified nurse aide who:
             79          (a) has a minimum of 2,000 hours experience working as a certified nurse aide;
             80          (b) has received a minimum of 40 hours of classroom and 20 hours of practical training
             81      that is approved by the division in collaboration with the board, in administering routine
             82      medications to patients or residents of long-term care facilities; and
             83          (c) is certified by the division as a medication aide certified.
             84          (12) (a) "Practice as a medication aide certified" means the limited practice of nursing
             85      under the supervision, as defined by the division by administrative rule, of a licensed nurse,


             86      involving routine patient care that requires minimal or limited specialized or general
             87      knowledge, judgment, and skill, to an individual who is ill, injured, infirm, developmentally or
             88      physically disabled, mentally disabled, or mentally retarded, and who is in a regulated
             89      long-term care facility.
             90          (b) "Practice as a medication aide certified" includes:
             91          (i) providing direct personal assistance or care; and
             92          (ii) administering routine medications to patients in accordance with a formulary and
             93      protocols to be defined by the division by rule.
             94          [(15)] (13) "Practice of advanced practice registered nursing" means the practice of
             95      nursing within the generally recognized scope and standards of advanced practice registered
             96      nursing as defined by rule and consistent with professionally recognized preparation and
             97      education standards of an advanced practice registered nurse by a person licensed under this
             98      chapter as an advanced practice registered nurse. Advanced practice registered nursing
             99      includes:
             100          (a) maintenance and promotion of health and prevention of disease;
             101          (b) diagnosis, treatment, correction, consultation, and referral for common health
             102      problems; and
             103          (c) prescription or administration of prescription drugs or devices including:
             104          (i) local anesthesia;
             105          (ii) schedule IV-V controlled substances; and
             106          (iii) schedule II-III controlled substances in accordance with a consultation and referral
             107      plan.
             108          [(12)] (14) (a) "Practice of nurse anesthesia" means the practice of nursing related to
             109      the provision of preoperative, intraoperative, and postoperative anesthesia care and related
             110      services upon the request of a physician, surgeon, or other licensed professional, who is acting
             111      within the scope of their practice, by a person licensed under this chapter as a certified
             112      registered nurse anesthetist and includes:
             113          (i) preanesthesia preparation and evaluation including:


             114          (A) performing a preanesthetic assessment of the patient;
             115          (B) ordering and evaluating appropriate lab and other studies to determine the health of
             116      the patient; and
             117          (C) selecting, ordering, or administering appropriate medications;
             118          (ii) anesthesia induction, maintenance, and emergence, including:
             119          (A) selecting and initiating the planned anesthetic technique;
             120          (B) selecting and administering anesthetics and adjunct drugs and fluids; and
             121          (C) administering general, regional, and local anesthesia;
             122          (iii) postanesthesia follow-up care, including:
             123          (A) evaluating the patient's response to anesthesia and implementing corrective
             124      actions; and
             125          (B) selecting, ordering, or administering the above medications and studies; and
             126          (iv) other related services within the scope of practice of a certified registered nurse
             127      anesthetist, including:
             128          (A) emergency airway management;
             129          (B) advanced cardiac life support; and
             130          (C) the establishment of peripheral, central, and arterial invasive lines.
             131          (b) Nothing in this section shall be construed as to require a certified registered nurse
             132      anesthetist to obtain an advance practice registered nurse license in order to select, administer,
             133      or provide preoperative, intraoperative, or postoperative anesthesia care and services.
             134          [(11)] (15) "Practice of nursing" means assisting individuals or groups to maintain or
             135      attain optimal health, implementing a strategy of care to accomplish defined goals and
             136      evaluating responses to care and treatment. The practice of nursing requires substantial
             137      specialized or general knowledge, judgment, and skill based upon principles of the biological,
             138      physical, behavioral, and social sciences, and includes:
             139          (a) initiating and maintaining comfort measures;
             140          (b) promoting and supporting human functions and responses;
             141          (c) establishing an environment conducive to well-being;


             142          (d) providing health counseling and teaching;
             143          (e) collaborating with health care professionals on aspects of the health care regimen;
             144          (f) performing delegated procedures only within the education, knowledge, judgment,
             145      and skill of the licensee; and
             146          (g) delegating nurse interventions that may be performed by others and are not in
             147      conflict with this chapter.
             148          [(13)] (16) "Practice of practical nursing" means the performance of nursing acts in the
             149      generally recognized scope of practice of licensed practical nurses as defined by rule and as
             150      provided in this Subsection [(13)] (16) by a person licensed under this chapter as a licensed
             151      practical nurse and under the direction of a registered nurse, licensed physician, or other
             152      specified health care professional as defined by rule. Practical nursing acts include:
             153          (a) contributing to the assessment of the health status of individuals and groups;
             154          (b) participating in the development and modification of the strategy of care;
             155          (c) implementing appropriate aspects of the strategy of care;
             156          (d) maintaining safe and effective nursing care rendered to a patient directly or
             157      indirectly; and
             158          (e) participating in the evaluation of responses to interventions.
             159          [(14)] (17) "Practice of registered nursing" means performing acts of nursing as
             160      provided in this Subsection [(14)] (17) by a person licensed under this chapter as a registered
             161      nurse within the generally recognized scope of practice of registered nurses as defined by rule.
             162      Registered nursing acts include:
             163          (a) assessing the health status of individuals and groups;
             164          (b) identifying health care needs;
             165          (c) establishing goals to meet identified health care needs;
             166          (d) planning a strategy of care;
             167          (e) prescribing nursing interventions to implement the strategy of care;
             168          (f) implementing the strategy of care;
             169          (g) maintaining safe and effective nursing care that is rendered to a patient directly or


             170      indirectly;
             171          (h) evaluating responses to interventions;
             172          (i) teaching the theory and practice of nursing; and
             173          (j) managing and supervising the practice of nursing.
             174          (18) "Routine medications":
             175          (a) means established medications administered to a medically stable individual as
             176      determined by a licensed health care practitioner or in consultation with a licensed medical
             177      practitioner; and
             178          (b) is limited to medications that are administered by the following routes:
             179          (i) oral;
             180          (ii) sublingual;
             181          (iii) buccal;
             182          (iv) eye;
             183          (v) ear;
             184          (vi) nasal;
             185          (vii) rectal;
             186          (viii) vaginal;
             187          (ix) skin ointments, topical including patches and transdermal;
             188          (x) gastronomy or jejunostomy tubes;
             189          (xi) premeasured medication delivered by aerosol/nebulizer; and
             190          (xii) medications delivered by metered hand-held inhalers.
             191          [(16)] (19) "Unlawful conduct" is as defined in Sections 58-1-501 and [ 58-31b-501.2 ]
             192      58-31b-501 .
             193          [(17)] (20) "Unlicensed assistive personnel" means any unlicensed person, regardless
             194      of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
             195      with the standards of the profession.
             196          [(18)] (21) "Unprofessional conduct" is as defined in Sections 58-1-501 and
             197      58-31b-502 and as may be further defined by rule.


             198          Section 2. Section 58-31b-301 is amended to read:
             199           58-31b-301. License or certification required -- Classifications.
             200          (1) A license is required to engage in the practice of nursing, except as specifically
             201      provided in Sections 58-1-307 and 58-31b-308 .
             202          (2) The division shall issue to a person who qualifies under this chapter a license or
             203      certification in the classification of:
             204          (a) licensed practical nurse;
             205          (b) registered nurse;
             206          (c) advanced practice registered nurse intern;
             207          (d) advanced practice registered nurse; [and]
             208          (e) certified registered nurse anesthetist[.]; and
             209          (f) medication aide certified.
             210          (3) An individual holding an advanced practice registered nurse license as of July 1,
             211      1998, who cannot document the successful completion of advanced course work in patient
             212      assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
             213      issued an "APRN - without prescriptive practice" license.
             214          (4) The division shall grant an advanced practice registered nurse license to any
             215      licensed advanced practice registered nurse currently holding prescriptive authority under any
             216      predecessor act on July 1, 1998.
             217          Section 3. Section 58-31b-301.6 is enacted to read:
             218          58-31b-301.6. Medication aide certified pilot program.
             219          (1) (a) The division shall establish a medication aide certified pilot program, limited to
             220      adult patients only, to determine the safety and efficiency of regulating medication aides
             221      certified.
             222          (b) The pilot program begins on January 1, 2007, and sunsets in accordance with
             223      Section 63-55b-158 .
             224          (c) The division shall collect data regarding the safety and efficiency of medication
             225      aides certified and shall make the data available to the public.


             226          (d) If the Legislature does not reauthorize the medication aides certified in accordance
             227      with Section 63-55b-158 , all certifications will automatically expire on the sunset date.
             228          (2) If at any time the division determines the certification pilot program has become a
             229      threat, or potential threat to the public health, safety, or welfare, the division may authorize
             230      emergency rules to place the certification program in abeyance until the next legislative
             231      session.
             232          Section 4. Section 58-31b-302 is amended to read:
             233           58-31b-302. Qualifications for licensure or certification -- Criminal background
             234      checks.
             235          (1) An applicant for certification as a medication aide shall:
             236          (a) submit an application to the division on a form prescribed by the division;
             237          (b) pay a fee to the division as determined under Section 63-38-3.2 ;
             238          (c) have a high school diploma or its equivalent;
             239          (d) have a current certification as a nurse aide, in good standing, from the Department
             240      of Health;
             241          (e) have a minimum of 2,000 hours of experience within the two years prior to
             242      application, working as a certified nurse aide in a long-term care facility;

             243          (f) obtain letters of recommendation from a long-term care facility administrator and
             244      one licensed nurse familiar with the applicant's work practices as a certified nurse aide;

             245          (g) be in a condition of physical and mental health that will permit the applicant to
             246      practice safely as a medication aide certified;

             247          (h) have completed an approved education program or an equivalent as determined by
             248      the division in collaboration with the board;

             249          (i) have passed the examinations as required by division rule made in collaboration
             250      with the board; and

             251          (j) meet with the board, if requested, to determine the applicant's qualifications for
             252      certification.

             253          [(1)] (2) An applicant for licensure as a licensed practical nurse shall:


             254          (a) submit to the division an application in a form prescribed by the division;
             255          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             256          (c) have a high school diploma or its equivalent;
             257          (d) be in a condition of physical and mental health that will permit the applicant to
             258      practice safely as a licensed practical nurse;
             259          (e) have completed an approved practical nursing education program or an equivalent
             260      as determined by the board;
             261          (f) have passed the examinations as required by division rule made in collaboration
             262      with the board; and
             263          (g) meet with the board, if requested, to determine the applicant's qualifications for
             264      licensure.
             265          [(2)] (3) An applicant for licensure as a registered nurse shall:
             266          (a) submit to the division an application form prescribed by the division;
             267          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             268          (c) have a high school diploma or its equivalent;
             269          (d) be in a condition of physical and mental health that will allow the applicant to
             270      practice safely as a registered nurse;
             271          (e) have completed an approved registered nursing education program;
             272          (f) have passed the examinations as required by division rule made in collaboration
             273      with the board; and
             274          (g) meet with the board, if requested, to determine the applicant's qualifications for
             275      licensure.
             276          [(3)] (4) Applicants for licensure as an advanced practice registered nurse shall:
             277          (a) submit to the division an application on a form prescribed by the division;
             278          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             279          (c) be in a condition of physical and mental health which will allow the applicant to
             280      practice safely as an advanced practice registered nurse;
             281          (d) hold a current registered nurse license in good standing issued by the state or be


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


             310          (g) meet with the board, if requested, to determine the applicant's qualifications for
             311      licensure.
             312          [(5)] (6) An applicant for licensure or certification under this chapter:
             313          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             314      license application is filed and shall consent to a fingerprint background check by the Utah
             315      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
             316      application; and
             317          (ii) the division shall request the Department of Public Safety to complete a Federal
             318      Bureau of Investigation criminal background check for each applicant through the national
             319      criminal history system (NCIC) or any successor system; and
             320          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             321      sentences for all felony convictions five or more years prior to the date of filing an application
             322      for licensure or certification under this chapter.
             323          [(6)] (7) For purposes of conducting the criminal background checks required in
             324      Subsection [(5)] (6), the division shall have direct access to criminal background information
             325      maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             326          [(7)] (8) (a) (i) Any new nurse license or certification issued under this section shall be
             327      conditional, pending completion of the criminal background check.
             328          (ii) If the criminal background check discloses the applicant has failed to accurately
             329      disclose a criminal history, the license or certification shall be immediately and automatically
             330      revoked.
             331          (b) (i) Any person whose conditional license or certification has been revoked under
             332      Subsection [(7)] (8)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
             333          (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
             334      Administrative Procedures Act.
             335          Section 5. Section 58-31b-303 is amended to read:
             336           58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
             337      programs.


             338          An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
             339      nursing education program not approved by the division in collaboration with the board must
             340      comply with the requirements of this section.
             341          (1) An applicant for licensure as a licensed practical nurse shall:
             342          (a) meet all requirements of Subsection 58-31b-302 [(1)](2), except Subsection [(1)]
             343      (2)(e); and
             344          (b) produce evidence acceptable to the division and the board that the nursing
             345      education program completed by the applicant is equivalent to the minimum standards
             346      established by the division in collaboration with the board for an approved licensed practical
             347      nursing education program.
             348          (2) An applicant for licensure as a registered nurse shall:
             349          (a) meet all requirements of Subsection 58-31b-302 [(2)] (3), except Subsection [(2)]
             350      (3)(e); and
             351          (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
             352      Examination; or
             353          (ii) produce evidence acceptable to the division and the board that the applicant is
             354      currently licensed as a registered nurse in one of the states, territories, or the District of
             355      Columbia of the United States and has passed the NCLEX-RN examination.
             356          Section 6. Section 58-31b-304 is amended to read:
             357           58-31b-304. Qualifications for admission to the examinations.
             358          (1) To be admitted to the examinations required for certification as a medication aide
             359      certified, a person shall:
             360          (a) submit an application on a form prescribed by the division;
             361          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             362          (c) meet all requirements of Subsection 58-31b-302 (1), except the passing of the
             363      examination.
             364          [(1)] (2) To be admitted to the examinations required for licensure as a practical nurse,
             365      a person shall:


             366          (a) submit an application form prescribed by the division;
             367          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             368          (c) meet all requirements of Subsection 58-31b-302 [(1)](2), except Subsection [(1)]
             369      (2)(f).
             370          [(2)] (3) To be admitted to the examinations required for licensure as a registered
             371      nurse, a person shall:
             372          (a) submit an application form prescribed by the division;
             373          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             374          (c) meet all the requirements of Subsection 58-31b-302 [(2)](3), except Subsection [(2)]
             375      (3)(f).
             376          Section 7. Section 58-31b-305 is amended to read:
             377           58-31b-305. Term of license -- Expiration -- Renewal.
             378          (1) The division shall issue each license or certification under this chapter in
             379      accordance with a two-year renewal cycle established by rule. The division may by rule extend
             380      or shorten a renewal period by as much as one year to stagger the renewal cycles it administers.
             381          (2) At the time of renewal, the licensee or person certified under this chapter shall
             382      show satisfactory evidence of each of the following renewal requirements:
             383          (a) complete and submit an application for renewal in a form prescribed by the division
             384      and pay the renewal fee determined under Section 63-38-3.2 ; and
             385          (b) meet continuing competency requirements as established by rule, which shall
             386      include continuing education requirements for medication aide certified established by the
             387      board and adopted by the division by rule.
             388          (3) In addition to the renewal requirements under Subsection (2), a person licensed as a
             389      advanced practice registered nurse shall be currently certified by a program approved by the
             390      division in collaboration with the board and submit evidence satisfactory to the division of that
             391      qualification or if licensed prior to July 1, 1992, meet the requirements established by rule.
             392          (4) In addition to the renewal requirements under Subsection (2), a person licensed as a
             393      certified registered nurse anesthetist shall be currently certified in anesthesia by a program


             394      approved by the division in collaboration with the board and submit evidence satisfactory to
             395      the division of the certification.
             396          (5) Each license or certification automatically expires on the expiration date shown on
             397      the license or certification unless renewed in accordance with Section 58-1-308 .
             398          Section 8. Section 58-31b-401 is amended to read:
             399           58-31b-401. Grounds for denial of licensure or certification and disciplinary
             400      proceedings.
             401          (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the
             402      license of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee,
             403      to issue a public or private reprimand to a licensee, and to issue cease and desist orders shall be
             404      in accordance with Section 58-1-401 .
             405          (2) If a court of competent jurisdiction determines a nurse is an incapacitated person as
             406      defined in Section 75-1-201 or that he is mentally ill as defined in Section 62A-15-602 , and
             407      unable to safely engage in the practice of nursing, the director shall immediately suspend the
             408      license of the nurse upon the entry of the judgment of the court, without further proceedings
             409      under Title 63, Chapter 46b, Administrative Procedures Act, regardless of whether an appeal
             410      from the court's ruling is pending. The director shall promptly notify the nurse in writing of the
             411      suspension.
             412          (3) (a) If the division and the majority of the board find reasonable cause to believe a
             413      nurse who is not determined judicially to be an incapacitated person or to be mentally ill, is
             414      incapable of practicing nursing with reasonable skill regarding the safety of patients, because of
             415      illness, excessive use of drugs or alcohol, or as a result of any mental or physical condition, the
             416      board shall recommend that the director file a petition with the division, and cause the petition
             417      to be served upon the nurse with a notice of hearing on the sole issue of the capacity of the
             418      nurse to competently, safely engage in the practice of nursing.
             419          (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
             420      Administrative Procedures Act, except as provided in Subsection (4).
             421          (4) (a) Every nurse who accepts the privilege of being licensed under this chapter gives


             422      consent to:
             423          (i) submitting to an immediate mental or physical examination, at the nurse's expense
             424      and by a division-approved practitioner selected by the nurse when directed in writing by the
             425      division and a majority of the board to do so; and
             426          (ii) the admissibility of the reports of the examining practitioner's testimony or
             427      examination, and waives all objections on the ground the reports constitute a privileged
             428      communication.
             429          (b) The examination may be ordered by the division, with the consent of a majority of
             430      the board, only upon a finding of reasonable cause to believe:
             431          (i) the nurse is mentally ill or incapacitated or otherwise unable to practice nursing with
             432      reasonable skill and safety; and
             433          (ii) immediate action by the division and the board is necessary to prevent harm to the
             434      nurse's patients or the general public.
             435          (c) (i) Failure of a nurse to submit to the examination ordered under this section is a
             436      ground for the division's immediate suspension of the nurse's license by written order of the
             437      director.
             438          (ii) The division may enter the order of suspension without further compliance with
             439      Title 63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to
             440      submit to the examination ordered under this section was due to circumstances beyond the
             441      control of the nurse and was not related directly to the illness or incapacity of the nurse.
             442          (5) (a) A nurse whose license is suspended under Subsection (2), (3), or (4)(c) has the
             443      right to a hearing to appeal the suspension within ten days after the license is suspended.
             444          (b) The hearing held under this Subsection (5) shall be conducted in accordance with
             445      Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists
             446      for the continuance of the order of suspension in order to prevent harm to the nurse's patients or
             447      the general public.
             448          (6) A nurse whose license is revoked, suspended, or in any way restricted under this
             449      section may request the division and the board to consider, at reasonable intervals, evidence


             450      presented by the nurse, under procedures established by division rule, regarding any change in
             451      the nurse's condition, to determine whether:
             452          (a) he is or is not able to safely and competently engage in the practice of nursing; and
             453          (b) he is qualified to have his license to practice under this chapter restored completely
             454      or in part.
             455          (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the
             456      division to report current significant investigative information to the coordinated licensure
             457      information system for transmission to party states as required of the division by Article VII of
             458      the Nurse Licensure Compact in Section 58-31c-102 .
             459          (8) For purposes of this section and Section 58-31b-402 [,]:
             460          (a) "licensed" or "license" includes "certified" or "certification" under this chapter[.];
             461      and
             462          (b) any terms or conditions applied to the word "nurse" in this section or Section
             463      58-31b-402 also apply to a medication aide certified.
             464          Section 9. Section 58-31b-501 is amended to read:
             465           58-31b-501. Unlawful conduct.
             466          "Unlawful conduct" includes:
             467          (1) using the following titles, names or initials, if the user is not properly licensed or
             468      certified under this chapter:
             469          (a) nurse;
             470          (b) licensed practical nurse, practical nurse, or L.P.N.;
             471          (c) medication aide certified, or M.A.C.;
             472          [(c)] (d) registered nurse or R.N.;
             473          [(d)] (e) registered nurse practitioner, N.P., or R.N.P.;
             474          [(e)] (f) registered nurse specialist, N.S., or R.N.S.;
             475          [(f)] (g) registered psychiatric mental health nurse specialist;
             476          [(g)] (h) advanced practice registered nurse;
             477          [(h)] (i) nurse anesthetist, certified nurse anesthetist, certified registered nurse


             478      anesthetist, or C.R.N.A.; or
             479          [(i)] (j) other generally recognized names or titles used in the profession of nursing;
             480          (2) (a) using any other name, title, or initials that would cause a reasonable person to
             481      believe the user is licensed or certified under this chapter if the user is not properly licensed or
             482      certified under this chapter; and
             483          (b) for purposes of Subsection (2)(a), it is unlawful conduct for a medication aide
             484      certified to use the term "nurse"; and
             485          (3) conducting a nursing education program in the state for the purpose of qualifying
             486      individuals to meet requirements for licensure under this chapter without the program having
             487      been approved under Section 58-31b-601 .
             488          Section 10. Section 58-31b-502 is amended to read:
             489           58-31b-502. Unprofessional conduct.
             490          "Unprofessional conduct" includes:
             491          (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
             492      diagnosis, personal effects, or any other matter about which the licensee is privileged to know
             493      because of the licensee's or person with a certification's position or practice as a nurse or
             494      practice as a medication aide certified;
             495          (2) failure to provide nursing service or service as a medication aide certified in a
             496      manner that demonstrates respect for the patient's human dignity and unique personal character
             497      and needs without regard to the patient's race, religion, ethnic background, socioeconomic
             498      status, age, sex, or the nature of the patient's health problem;
             499          (3) engaging in sexual relations with a patient during any:
             500          (a) period when a generally recognized professional relationship exists between the
             501      [nurse] person licensed or certified under this chapter and patient; or
             502          (b) extended period when a patient has reasonable cause to believe a professional
             503      relationship exists between the [nurse] person licensed or certified under the provisions of this
             504      chapter and the patient;
             505          (4) (a) as a result of any circumstance under Subsection (3), exploiting or using


             506      information about a patient or exploiting the licensee's or the person with a certification's
             507      professional relationship between the licensee or holder of a certification under this chapter and
             508      the patient; or
             509          (b) exploiting the patient by use of the licensee's or person with a certification's
             510      knowledge of the patient obtained while acting as a nurse or a medication aide certified;
             511          (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
             512          (6) unauthorized taking or personal use of nursing supplies from an employer;
             513          (7) unauthorized taking or personal use of a patient's personal property;
             514          (8) knowingly entering into any medical record any false or misleading information or
             515      altering a medical record in any way for the purpose of concealing an act, omission, or record
             516      of events, medical condition, or any other circumstance related to the patient and the medical or
             517      nursing care provided;
             518          (9) unlawful or inappropriate delegation of nursing care;
             519          (10) failure to exercise appropriate supervision of persons providing patient care
             520      services under supervision of the licensed nurse;
             521          (11) employing or aiding and abetting the employment of an unqualified or unlicensed
             522      person to practice as a nurse;
             523          (12) failure to file or record any medical report as required by law, impeding or
             524      obstructing the filing or recording of such a report, or inducing another to fail to file or record
             525      such a report;
             526          (13) breach of a statutory, common law, regulatory, or ethical requirement of
             527      confidentiality with respect to a person who is a patient, unless ordered by a court;
             528          (14) failure to pay a penalty imposed by the division;
             529          (15) prescribing a schedule II-III controlled substance without a consulting physician or
             530      outside of a consultation and referral plan; and
             531          (16) violating Section 58-31b-801 .
             532          Section 11. Section 58-31b-503 is amended to read:
             533           58-31b-503. Penalty for unlawful conduct.


             534          (1) Any person who violates the unlawful conduct provision specifically defined in
             535      Subsection 58-1-501 (1)(a)[(i)] is guilty of a third degree felony.
             536          (2) Any person who violates any of the unlawful conduct provisions specifically
             537      defined in Subsections 58-1-501 (1)[(a)(ii) through (v)] (b) through (f) and
             538      58-31b-501 (1)[(c)](d) is guilty of a class A misdemeanor.
             539          (3) Any person who violates any of the unlawful conduct provisions specifically
             540      defined in this chapter and not set forth in Subsection (1) or (2) is guilty of a class B
             541      misdemeanor.
             542          (4) Subject to Subsection (5), the division may assess administrative penalties in
             543      accordance with the provisions of Section 58-31b-402 for acts of unprofessional or unlawful
             544      conduct or any other appropriate administrative action in accordance with the provisions of
             545      Section 58-31b-401 .
             546          (5) If a licensee has been convicted of violating Section 58-31b-501 prior to an
             547      administrative finding of a violation of the same section, the licensee may not be assessed an
             548      administrative penalty under this chapter for the same offense for which the conviction was
             549      obtained.
             550          Section 12. Section 58-31b-601 is amended to read:
             551           58-31b-601. Minimum standards for nursing programs.
             552          (1) A nursing education program shall be affiliated with an accredited institution of
             553      higher education in order to be approved by the division.
             554          (2) The minimum standards a nursing program shall meet to qualify graduates for
             555      licensure under this chapter shall be defined by division rule.
             556          (3) (a) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act,
             557      the division shall make rules defining the minimum standards for a medication aide certified
             558      training program to qualify a person for certification under this chapter as a medication aide
             559      certified.
             560          (b) A medication aide certified training program shall include a minimum of 40 hours
             561      of classroom and 20 hours of practical training.


             562          Section 13. Section 58-31d-103 is amended to read:
             563           58-31d-103. Rulemaking authority -- Enabling provisions.
             564          (1) The division may adopt rules necessary to implement Section 58-31d-102 .
             565          (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
             566      "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
             567          (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
             568      defined in Article II (1) of the compact includes an individual who is licensed to practice under
             569      Subsection 58-31b-301 (2) as an advanced practice registered nurse.
             570          (4) An APRN practicing in this state under a multistate licensure privilege may only be
             571      granted prescriptive authority if that individual can document completion of graduate level
             572      course work in the following areas:
             573          (a) advanced health assessment;
             574          (b) pharmacotherapeutics; and
             575          (c) diagnosis and treatment.
             576          (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
             577      obtain prescriptive authority must:
             578          (i) meet all the requirements of Subsection (4) and this Subsection (5); and
             579          (ii) be placed on a registry with the division.
             580          (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
             581          (i) submit a form prescribed by the division;
             582          (ii) pay a fee; and
             583          (iii) if prescribing a controlled substance:
             584          (A) obtain a controlled substance license as required under Section 58-37-6 ; and
             585          (B) if prescribing a Schedule II or III controlled substance, have a consultation and
             586      referral plan with a physician licensed in Utah as required under Subsection 58-31b-102 [(15)]
             587      (13)(c)(iii).
             588          Section 14. Section 63-55b-158 is amended to read:
             589           63-55b-158. Repeal dates -- Title 58.


             590          [Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed May 2,
             591      2005.]
             592          Section 58-31b-301.6 , Medication Aide Certified Pilot Program, is repealed May 15,
             593      2010.


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