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H.B. 137

             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" means established medications administered to a medically
             175      stable individual as determined by a licensed health care practitioner or in consultation with a
             176      licensed medical practitioner.
             177          [(16)] (19) "Unlawful conduct" is as defined in Sections 58-1-501 and [ 58-31b-501.2 ]
             178      58-31b-501 .
             179          [(17)] (20) "Unlicensed assistive personnel" means any unlicensed person, regardless
             180      of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
             181      with the standards of the profession.
             182          [(18)] (21) "Unprofessional conduct" is as defined in Sections 58-1-501 and


             183      58-31b-502 and as may be further defined by rule.
             184          Section 2. Section 58-31b-301 is amended to read:
             185           58-31b-301. License or certification required -- Classifications.
             186          (1) A license is required to engage in the practice of nursing, except as specifically
             187      provided in Sections 58-1-307 and 58-31b-308 .
             188          (2) The division shall issue to a person who qualifies under this chapter a license or
             189      certification in the classification of:
             190          (a) licensed practical nurse;
             191          (b) registered nurse;
             192          (c) advanced practice registered nurse intern;
             193          (d) advanced practice registered nurse; [and]
             194          (e) certified registered nurse anesthetist[.]; and
             195          (f) medication aide certified.
             196          (3) An individual holding an advanced practice registered nurse license as of July 1,
             197      1998, who cannot document the successful completion of advanced course work in patient
             198      assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
             199      issued an "APRN - without prescriptive practice" license.
             200          (4) The division shall grant an advanced practice registered nurse license to any
             201      licensed advanced practice registered nurse currently holding prescriptive authority under any
             202      predecessor act on July 1, 1998.
             203          Section 3. Section 58-31b-301.6 is enacted to read:
             204          58-31b-301.6. Medication aide certified pilot program.
             205          (1) (a) The division shall establish a medication aide certified pilot program to
             206      determine the safety and efficiency of regulating medication aides certified.
             207          (b) The pilot program begins on January 1, 2007, and sunsets in accordance with
             208      Section 63-55b-158 .
             209          (c) The division shall collect data regarding the safety and efficiency of medication
             210      aides certified and shall make the data available to the public.
             211          (d) If the Legislature does not reauthorize the medication aides certified in accordance
             212      with Section 63-55b-158 , all certifications will automatically expire on the sunset date.
             213          (2) If at any time the division determines the certification pilot program has become a


             214      threat, or potential threat to the public health, safety, or welfare, the division may authorize
             215      emergency rules to place the certification program in abeyance until the next legislative
             216      session.
             217          Section 4. Section 58-31b-302 is amended to read:
             218           58-31b-302. Qualifications for licensure or certification -- Criminal background
             219      checks.
             220          (1) An applicant for certification as a medication aide shall:
             221          (a) submit an application to the division on a form prescribed by the division;
             222          (b) pay a fee to the division as determined under Section 63-38-3.2 ;
             223          (c) have a high school diploma or its equivalent;
             224          (d) have a current certification as a nurse aide, in good standing, from the Department
             225      of Health;
             226          (e) have a minimum of 2,000 hours of experience within the two years prior to
             227      application, working as a certified nurse aide in a long-term care facility;

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

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

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

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

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

             238          [(1)] (2) An applicant for licensure as a licensed practical nurse shall:
             239          (a) submit to the division an application in a form prescribed by the division;
             240          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             241          (c) have a high school diploma or its equivalent;
             242          (d) be in a condition of physical and mental health that will permit the applicant to
             243      practice safely as a licensed practical nurse;
             244          (e) have completed an approved practical nursing education program or an equivalent


             245      as determined by the board;
             246          (f) have passed the examinations as required by division rule made in collaboration
             247      with the board; and
             248          (g) meet with the board, if requested, to determine the applicant's qualifications for
             249      licensure.
             250          [(2)] (3) An applicant for licensure as a registered nurse shall:
             251          (a) submit to the division an application form prescribed by the division;
             252          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             253          (c) have a high school diploma or its equivalent;
             254          (d) be in a condition of physical and mental health that will allow the applicant to
             255      practice safely as a registered nurse;
             256          (e) have completed an approved registered nursing education program;
             257          (f) have passed the examinations as required by division rule made in collaboration
             258      with the board; and
             259          (g) meet with the board, if requested, to determine the applicant's qualifications for
             260      licensure.
             261          [(3)] (4) Applicants for licensure as an advanced practice registered nurse shall:
             262          (a) submit to the division an application on a form prescribed by the division;
             263          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             264          (c) be in a condition of physical and mental health which will allow the applicant to
             265      practice safely as an advanced practice registered nurse;
             266          (d) hold a current registered nurse license in good standing issued by the state or be
             267      qualified at the time for licensure as a registered nurse;
             268          (e) have earned a graduate degree in an advanced practice registered nurse nursing
             269      education program or a related area of specialized knowledge as determined appropriate by the
             270      division in collaboration with the board;
             271          (f) have completed course work in patient assessment, diagnosis and treatment, and
             272      pharmacotherapeutics from an education program approved by the division in collaboration
             273      with the board;
             274          (g) have successfully completed clinical practice in psychiatric and mental health
             275      nursing, including psychotherapy as defined by division rule, after completion of the masters


             276      degree required for licensure, to practice within the psychiatric and mental health nursing
             277      specialty;
             278          (h) have passed the examinations as required by division rule made in collaboration
             279      with the board;
             280          (i) be currently certified by a program approved by the division in collaboration with
             281      the board and submit evidence satisfactory to the division of the certification; and
             282          (j) meet with the board, if requested, to determine the applicant's qualifications for
             283      licensure.
             284          [(4)] (5) An applicant for licensure as a certified registered nurse anesthetist shall:
             285          (a) submit to the division an application on a form prescribed by the division;
             286          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             287          (c) be in a condition of physical and mental health which will allow the applicant to
             288      practice safely as a certified registered nurse anesthetist;
             289          (d) hold a current registered nurse license in good standing issued by the state or be
             290      qualified at the time for licensure as a registered nurse;
             291          (e) complete a nurse anesthesia program which is approved by the Council on
             292      Accreditation of Nurse Anesthesia Educational Programs;
             293          (f) be currently certified by a program approved by the division in collaboration with
             294      the board and submit evidence satisfactory to the division of the certification; and
             295          (g) meet with the board, if requested, to determine the applicant's qualifications for
             296      licensure.
             297          [(5)] (6) An applicant for licensure or certification under this chapter:
             298          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             299      license application is filed and shall consent to a fingerprint background check by the Utah
             300      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the
             301      application; and
             302          (ii) the division shall request the Department of Public Safety to complete a Federal
             303      Bureau of Investigation criminal background check for each applicant through the national
             304      criminal history system (NCIC) or any successor system; and
             305          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             306      sentences for all felony convictions five or more years prior to the date of filing an application


             307      for licensure or certification under this chapter.
             308          [(6)] (7) For purposes of conducting the criminal background checks required in
             309      Subsection [(5)] (6), the division shall have direct access to criminal background information
             310      maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             311          [(7)] (8) (a) (i) Any new nurse license or certification issued under this section shall be
             312      conditional, pending completion of the criminal background check.
             313          (ii) If the criminal background check discloses the applicant has failed to accurately
             314      disclose a criminal history, the license or certification shall be immediately and automatically
             315      revoked.
             316          (b) (i) Any person whose conditional license or certification has been revoked under
             317      Subsection [(7)] (8)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
             318          (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
             319      Administrative Procedures Act.
             320          Section 5. Section 58-31b-303 is amended to read:
             321           58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
             322      programs.
             323          An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
             324      nursing education program not approved by the division in collaboration with the board must
             325      comply with the requirements of this section.
             326          (1) An applicant for licensure as a licensed practical nurse shall:
             327          (a) meet all requirements of Subsection 58-31b-302 [(1)](2), except Subsection [(1)]
             328      (2)(e); and
             329          (b) produce evidence acceptable to the division and the board that the nursing
             330      education program completed by the applicant is equivalent to the minimum standards
             331      established by the division in collaboration with the board for an approved licensed practical
             332      nursing education program.
             333          (2) An applicant for licensure as a registered nurse shall:
             334          (a) meet all requirements of Subsection 58-31b-302 [(2)] (3), except Subsection [(2)]
             335      (3)(e); and
             336          (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
             337      Examination; or


             338          (ii) produce evidence acceptable to the division and the board that the applicant is
             339      currently licensed as a registered nurse in one of the states, territories, or the District of
             340      Columbia of the United States and has passed the NCLEX-RN examination.
             341          Section 6. Section 58-31b-304 is amended to read:
             342           58-31b-304. Qualifications for admission to the examinations.
             343          (1) To be admitted to the examinations required for certification as a medication aide
             344      certified, a person shall:
             345          (a) submit an application on a form prescribed by the division;
             346          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             347          (c) meet all requirements of Subsection 58-31b-302 (1), except the passing of the
             348      examination.
             349          [(1)] (2) To be admitted to the examinations required for licensure as a practical nurse,
             350      a person shall:
             351          (a) submit an application form prescribed by the division;
             352          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             353          (c) meet all requirements of Subsection 58-31b-302 [(1)](2), except Subsection [(1)]
             354      (2)(f).
             355          [(2)] (3) To be admitted to the examinations required for licensure as a registered
             356      nurse, a person shall:
             357          (a) submit an application form prescribed by the division;
             358          (b) pay a fee as determined by the division under Section 63-38-3.2 ; and
             359          (c) meet all the requirements of Subsection 58-31b-302 [(2)](3), except Subsection [(2)]
             360      (3)(f).
             361          Section 7. Section 58-31b-305 is amended to read:
             362           58-31b-305. Term of license -- Expiration -- Renewal.
             363          (1) The division shall issue each license or certification under this chapter in
             364      accordance with a two-year renewal cycle established by rule. The division may by rule extend
             365      or shorten a renewal period by as much as one year to stagger the renewal cycles it administers.
             366          (2) At the time of renewal, the licensee or person certified under this chapter shall
             367      show satisfactory evidence of each of the following renewal requirements:
             368          (a) complete and submit an application for renewal in a form prescribed by the division


             369      and pay the renewal fee determined under Section 63-38-3.2 ; and
             370          (b) meet continuing competency requirements as established by rule.
             371          (3) In addition to the renewal requirements under Subsection (2), a person licensed as a
             372      advanced practice registered nurse shall be currently certified by a program approved by the
             373      division in collaboration with the board and submit evidence satisfactory to the division of that
             374      qualification or if licensed prior to July 1, 1992, meet the requirements established by rule.
             375          (4) In addition to the renewal requirements under Subsection (2), a person licensed as a
             376      certified registered nurse anesthetist shall be currently certified in anesthesia by a program
             377      approved by the division in collaboration with the board and submit evidence satisfactory to
             378      the division of the certification.
             379          (5) Each license or certification automatically expires on the expiration date shown on
             380      the license or certification unless renewed in accordance with Section 58-1-308 .
             381          Section 8. Section 58-31b-401 is amended to read:
             382           58-31b-401. Grounds for denial of licensure or certification and disciplinary
             383      proceedings.
             384          (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the
             385      license of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee,
             386      to issue a public or private reprimand to a licensee, and to issue cease and desist orders shall be
             387      in accordance with Section 58-1-401 .
             388          (2) If a court of competent jurisdiction determines a nurse is an incapacitated person as
             389      defined in Section 75-1-201 or that he is mentally ill as defined in Section 62A-15-602 , and
             390      unable to safely engage in the practice of nursing, the director shall immediately suspend the
             391      license of the nurse upon the entry of the judgment of the court, without further proceedings
             392      under Title 63, Chapter 46b, Administrative Procedures Act, regardless of whether an appeal
             393      from the court's ruling is pending. The director shall promptly notify the nurse in writing of the
             394      suspension.
             395          (3) (a) If the division and the majority of the board find reasonable cause to believe a
             396      nurse who is not determined judicially to be an incapacitated person or to be mentally ill, is
             397      incapable of practicing nursing with reasonable skill regarding the safety of patients, because of
             398      illness, excessive use of drugs or alcohol, or as a result of any mental or physical condition, the
             399      board shall recommend that the director file a petition with the division, and cause the petition


             400      to be served upon the nurse with a notice of hearing on the sole issue of the capacity of the
             401      nurse to competently, safely engage in the practice of nursing.
             402          (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
             403      Administrative Procedures Act, except as provided in Subsection (4).
             404          (4) (a) Every nurse who accepts the privilege of being licensed under this chapter gives
             405      consent to:
             406          (i) submitting to an immediate mental or physical examination, at the nurse's expense
             407      and by a division-approved practitioner selected by the nurse when directed in writing by the
             408      division and a majority of the board to do so; and
             409          (ii) the admissibility of the reports of the examining practitioner's testimony or
             410      examination, and waives all objections on the ground the reports constitute a privileged
             411      communication.
             412          (b) The examination may be ordered by the division, with the consent of a majority of
             413      the board, only upon a finding of reasonable cause to believe:
             414          (i) the nurse is mentally ill or incapacitated or otherwise unable to practice nursing with
             415      reasonable skill and safety; and
             416          (ii) immediate action by the division and the board is necessary to prevent harm to the
             417      nurse's patients or the general public.
             418          (c) (i) Failure of a nurse to submit to the examination ordered under this section is a
             419      ground for the division's immediate suspension of the nurse's license by written order of the
             420      director.
             421          (ii) The division may enter the order of suspension without further compliance with
             422      Title 63, Chapter 46b, Administrative Procedures Act, unless the division finds the failure to
             423      submit to the examination ordered under this section was due to circumstances beyond the
             424      control of the nurse and was not related directly to the illness or incapacity of the nurse.
             425          (5) (a) A nurse whose license is suspended under Subsection (2), (3), or (4)(c) has the
             426      right to a hearing to appeal the suspension within ten days after the license is suspended.
             427          (b) The hearing held under this Subsection (5) shall be conducted in accordance with
             428      Sections 58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists
             429      for the continuance of the order of suspension in order to prevent harm to the nurse's patients or
             430      the general public.


             431          (6) A nurse whose license is revoked, suspended, or in any way restricted under this
             432      section may request the division and the board to consider, at reasonable intervals, evidence
             433      presented by the nurse, under procedures established by division rule, regarding any change in
             434      the nurse's condition, to determine whether:
             435          (a) he is or is not able to safely and competently engage in the practice of nursing; and
             436          (b) he is qualified to have his license to practice under this chapter restored completely
             437      or in part.
             438          (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the
             439      division to report current significant investigative information to the coordinated licensure
             440      information system for transmission to party states as required of the division by Article VII of
             441      the Nurse Licensure Compact in Section 58-31c-102 .
             442          (8) For purposes of this section and Section 58-31b-402 [,]:
             443          (a) "licensed" or "license" includes "certified" or "certification" under this chapter[.];
             444      and
             445          (b) "nurse" includes a medication aide certified.
             446          Section 9. Section 58-31b-501 is amended to read:
             447           58-31b-501. Unlawful conduct.
             448          "Unlawful conduct" includes:
             449          (1) using the following titles, names or initials, if the user is not properly licensed or
             450      certified under this chapter:
             451          (a) nurse;
             452          (b) licensed practical nurse, practical nurse, or L.P.N.;
             453          (c) medication aide certified, or M.A.C.;
             454          [(c)] (d) registered nurse or R.N.;
             455          [(d)] (e) registered nurse practitioner, N.P., or R.N.P.;
             456          [(e)] (f) registered nurse specialist, N.S., or R.N.S.;
             457          [(f)] (g) registered psychiatric mental health nurse specialist;
             458          [(g)] (h) advanced practice registered nurse;
             459          [(h)] (i) nurse anesthetist, certified nurse anesthetist, certified registered nurse
             460      anesthetist, or C.R.N.A.; or
             461          [(i)] (j) other generally recognized names or titles used in the profession of nursing;


             462          (2) using any other name, title, or initials that would cause a reasonable person to
             463      believe the user is licensed or certified under this chapter if the user is not properly licensed or
             464      certified under this chapter; and
             465          (3) conducting a nursing education program in the state for the purpose of qualifying
             466      individuals to meet requirements for licensure under this chapter without the program having
             467      been approved under Section 58-31b-601 .
             468          Section 10. Section 58-31b-502 is amended to read:
             469           58-31b-502. Unprofessional conduct.
             470          "Unprofessional conduct" includes:
             471          (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
             472      diagnosis, personal effects, or any other matter about which the licensee is privileged to know
             473      because of the licensee's or person with a certification's position or practice as a nurse or
             474      practice as a medication aide certified;
             475          (2) failure to provide nursing service or service as a medication aide certified in a
             476      manner that demonstrates respect for the patient's human dignity and unique personal character
             477      and needs without regard to the patient's race, religion, ethnic background, socioeconomic
             478      status, age, sex, or the nature of the patient's health problem;
             479          (3) engaging in sexual relations with a patient during any:
             480          (a) period when a generally recognized professional relationship exists between the
             481      [nurse] person licensed or certified under this chapter and patient; or
             482          (b) extended period when a patient has reasonable cause to believe a professional
             483      relationship exists between the [nurse] person licensed or certified under the provisions of this
             484      chapter and the patient;
             485          (4) (a) as a result of any circumstance under Subsection (3), exploiting or using
             486      information about a patient or exploiting the licensee's or the person with a certification's
             487      professional relationship between the licensee or holder of a certification under this chapter and
             488      the patient; or
             489          (b) exploiting the patient by use of the licensee's or person with a certification's
             490      knowledge of the patient obtained while acting as a nurse or a medication aide certified;
             491          (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
             492          (6) unauthorized taking or personal use of nursing supplies from an employer;


             493          (7) unauthorized taking or personal use of a patient's personal property;
             494          (8) knowingly entering into any medical record any false or misleading information or
             495      altering a medical record in any way for the purpose of concealing an act, omission, or record
             496      of events, medical condition, or any other circumstance related to the patient and the medical or
             497      nursing care provided;
             498          (9) unlawful or inappropriate delegation of nursing care;
             499          (10) failure to exercise appropriate supervision of persons providing patient care
             500      services under supervision of the licensed nurse;
             501          (11) employing or aiding and abetting the employment of an unqualified or unlicensed
             502      person to practice as a nurse;
             503          (12) failure to file or record any medical report as required by law, impeding or
             504      obstructing the filing or recording of such a report, or inducing another to fail to file or record
             505      such a report;
             506          (13) breach of a statutory, common law, regulatory, or ethical requirement of
             507      confidentiality with respect to a person who is a patient, unless ordered by a court;
             508          (14) failure to pay a penalty imposed by the division;
             509          (15) prescribing a schedule II-III controlled substance without a consulting physician or
             510      outside of a consultation and referral plan; and
             511          (16) violating Section 58-31b-801 .
             512          Section 11. Section 58-31b-503 is amended to read:
             513           58-31b-503. Penalty for unlawful conduct.
             514          (1) Any person who violates the unlawful conduct provision specifically defined in
             515      Subsection 58-1-501 (1)(a)[(i)] is guilty of a third degree felony.
             516          (2) Any person who violates any of the unlawful conduct provisions specifically
             517      defined in Subsections 58-1-501 (1)[(a)(ii) through (v)] (b) through (f) and
             518      58-31b-501 (1)[(c)](d) is guilty of a class A misdemeanor.
             519          (3) Any person who violates any of the unlawful conduct provisions specifically
             520      defined in this chapter and not set forth in Subsection (1) or (2) is guilty of a class B
             521      misdemeanor.
             522          (4) Subject to Subsection (5), the division may assess administrative penalties in
             523      accordance with the provisions of Section 58-31b-402 for acts of unprofessional or unlawful


             524      conduct or any other appropriate administrative action in accordance with the provisions of
             525      Section 58-31b-401 .
             526          (5) If a licensee has been convicted of violating Section 58-31b-501 prior to an
             527      administrative finding of a violation of the same section, the licensee may not be assessed an
             528      administrative penalty under this chapter for the same offense for which the conviction was
             529      obtained.
             530          Section 12. Section 58-31b-601 is amended to read:
             531           58-31b-601. Minimum standards for nursing programs.
             532          (1) A nursing education program shall be affiliated with an accredited institution of
             533      higher education in order to be approved by the division.
             534          (2) The minimum standards a nursing program shall meet to qualify graduates for
             535      licensure under this chapter shall be defined by division rule.
             536          (3) (a) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act,
             537      the division shall make rules defining the minimum standards a medication aide certified
             538      training program to qualify a person for certification under this chapter as a medication aide
             539      certified.
             540          (b) A medication aide certified training program shall include a minimum of 40 hours
             541      of classroom and 20 hours of practical training.
             542          Section 13. Section 58-31d-103 is amended to read:
             543           58-31d-103. Rulemaking authority -- Enabling provisions.
             544          (1) The division may adopt rules necessary to implement Section 58-31d-102 .
             545          (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
             546      "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
             547          (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
             548      defined in Article II (1) of the compact includes an individual who is licensed to practice under
             549      Subsection 58-31b-301 (2) as an advanced practice registered nurse.
             550          (4) An APRN practicing in this state under a multistate licensure privilege may only be
             551      granted prescriptive authority if that individual can document completion of graduate level
             552      course work in the following areas:
             553          (a) advanced health assessment;
             554          (b) pharmacotherapeutics; and


             555          (c) diagnosis and treatment.
             556          (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
             557      obtain prescriptive authority must:
             558          (i) meet all the requirements of Subsection (4) and this Subsection (5); and
             559          (ii) be placed on a registry with the division.
             560          (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:
             561          (i) submit a form prescribed by the division;
             562          (ii) pay a fee; and
             563          (iii) if prescribing a controlled substance:
             564          (A) obtain a controlled substance license as required under Section 58-37-6 ; and
             565          (B) if prescribing a Schedule II or III controlled substance, have a consultation and
             566      referral plan with a physician licensed in Utah as required under Subsection 58-31b-102 [(15)]
             567      (13)(c)(iii).
             568          Section 14. Section 63-55b-158 is amended to read:
             569           63-55b-158. Repeal dates -- Title 58.
             570          [Section 58-31b-301.5 , Geriatric Care Manager Pilot Program, is repealed May 2,
             571      2005.]
             572          Section 58-31b-301.6 , Medication Aide Certified Pilot Program, is repealed May 15,
             573      2010.




Legislative Review Note
    as of 12-13-05 1:56 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


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