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S.B. 45

This document includes Senate Committee Amendments incorporated into the bill on Fri, Feb 2, 2007 at 8:04 AM by rday. -->              1     

NURSING AMENDMENTS

             2     
2007 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Peter C. Knudson

             5     
House Sponsor: Bradley G. Last

             6     

             7      LONG TITLE
             8      General Description:
             9          This bill amends the Nurse Practice Act, the Advanced Practice Registered Nurse
             10      Compact, and the Nurse Midwife Practice Act.
             11      Highlighted Provisions:
             12          This bill:
             13          .    removes the definition of "practice of nurse anesthesia";
             14          .    removes the license classification of certified registered nurse anesthesia;
             15          .    creates the license classification of advanced practice registered nurse - without
             16      prescriptive authority;
             17          .    changes the license category for licensed nurse anesthetist with certain levels of
             18      training by July 1, 2007 to advanced practice registered nurses;
             19          .    changes the license category of nurse anesthetists who have not obtained certain
             20      training levels by July 1, 2007 to "APRN - without prescriptive practice";
             21          .    makes technical amendments necessary to remove references to licensed nurse
             22      anesthetists;
             23          .    adds certified nurse midwives to the list of APRN subject to the Advanced Practice
             24      Registered Nurse Compact; and
             25          .     beginning July 2010, amends the qualifications for licensure as a nurse midwife.
             26      Monies Appropriated in this Bill:
             27          None



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             28
     Other Special Clauses:
             29          None
             30      Utah Code Sections Affected:
             31      AMENDS:
             32          58-31b-102, as last amended by Chapter 291, Laws of Utah 2006
             33          58-31b-301, as last amended by Chapter 291, Laws of Utah 2006
             34          58-31b-302, as last amended by Chapter 291, Laws of Utah 2006
             35          58-31b-305, as last amended by Chapter 291, Laws of Utah 2006
             36          58-31d-103, as last amended by Chapter 291, Laws of Utah 2006
             37          58-44a-302, as last amended by Chapter 288, Laws of Utah 1998
             38     

             39      Be it enacted by the Legislature of the state of Utah:
             40          Section 1. Section 58-31b-102 is amended to read:
             41           58-31b-102. Definitions.
             42          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             43          (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
             44      omissions determined to constitute unprofessional or unlawful conduct in accordance with a
             45      fine schedule established by rule and as a result of an adjudicative proceeding conducted in
             46      accordance with Title 63, Chapter 46b, Administrative Procedures Act.
             47          (2) "Applicant" means a person who applies for licensure or certification under this
             48      chapter by submitting a completed application for licensure or certification and the required
             49      fees to the department.
             50          (3) "Approved education program" means a nursing education program that meets the
             51      minimum standards for educational programs established under this chapter and by division
             52      rule in collaboration with the board.
             53          (4) "Board" means the Board of Nursing created in Section 58-31b-201 .
             54          (5) "Consultation and referral plan" means a written plan jointly developed by an
             55      advanced practice registered nurse and a consulting physician that permits the advanced
             56      practice registered nurse to prescribe schedule II-III controlled substances in consultation with
             57      the consulting physician.
             58          (6) "Consulting physician" means a physician and surgeon or osteopathic physician and



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



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             90
         (ii) administering routine medications to patients in accordance with a formulary and
             91      protocols to be defined by the division by rule.
             92          (13) "Practice of advanced practice registered nursing" means the practice of nursing
             93      within the generally recognized scope and standards of advanced practice registered nursing as
             94      defined by rule and consistent with professionally recognized preparation and education
             95      standards of an advanced practice registered nurse by a person licensed under this chapter as an
             96      advanced practice registered nurse. Advanced practice registered nursing includes:
             97          (a) maintenance and promotion of health and prevention of disease;
             98          (b) diagnosis, treatment, correction, consultation, and referral for common health
             99      problems; [and]
             100          (c) prescription or administration of prescription drugs or devices including:
             101          (i) local anesthesia;
             102          (ii) schedule IV-V controlled substances; and
             103          (iii) schedule II-III controlled substances in accordance with a consultation and referral
             104      plan[.]; S. or .S
             105          (d) the provision of preoperative, intraoperative, and postoperative anesthesia care and
             106      related services S. upon the request of a licensed health care professional .S by an advanced
             106a      practice registered nurse specializing as a certified registered
             107      nurse anesthetist, including:
             108          (i) preanesthesia preparation and evaluation including:
             109          (A) performing a preanesthetic assessment of the patient;
             110          (B) ordering and evaluating appropriate lab and other studies to determine the health of
             111      the patient; and
             112          (C) selecting, ordering, or administering appropriate medications;
             113          (ii) anesthesia induction, maintenance, and emergence, including:
             114          (A) selecting and initiating the planned anesthetic technique;
             115          (B) selecting and administering anesthetics and adjunct drugs and fluids; and
             116          (C) administering general, regional, and local anesthesia;
             117          (iii) postanesthesia follow-up care, including:
             118          (A) evaluating the patient's response to anesthesia and implementing corrective
             119      actions; and
             120          (B) selecting, ordering, or administering the medications and studies listed in



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             121
     Subsection (13)(d); and
             122          (iv) other related services within the scope of practice of a certified registered nurse
             123      anesthetist, including:
             124          (A) emergency airway management;
             125          (B) advanced cardiac life support; and
             126          (C) the establishment of peripheral, central, and arterial invasive lines; and
             127           S. [ (e) nothing in this section shall be construed as to ] (iv) for purposes of Subsection
             127a      (13)(d), "upon the request of a licensed health care professional":
             127b          (A) means a health care professional practicing within the scope of the health care
             127c      professional's license, requests anesthesia services for a specific patient; and
             127d          (B) does not, .S require an advanced practice
             128      registered nurse specializing as a certified registered nurse anesthetist to enter into a
             129      consultation and referral plan or obtain S. additional .S authority to S. [ prescribe in order to ] .S
             129a      select, administer, or
             130      provide preoperative, intraoperative, or postoperative anesthesia care and services.
             131          [(14) (a) "Practice of nurse anesthesia" means the practice of nursing related to the
             132      provision of preoperative, intraoperative, and postoperative anesthesia care and related services
             133      upon the request of a physician, surgeon, or other licensed professional, who is acting within
             134      the scope of their practice, by a person licensed under this chapter as a certified registered nurse
             135      anesthetist and includes:]
             136          [(i) preanesthesia preparation and evaluation including:]
             137          [(A) performing a preanesthetic assessment of the patient;]
             138          [(B) ordering and evaluating appropriate lab and other studies to determine the health
             139      of the patient; and]
             140          [(C) selecting, ordering, or administering appropriate medications;]
             141          [(ii) anesthesia induction, maintenance, and emergence, including:]
             142          [(A) selecting and initiating the planned anesthetic technique;]
             143          [(B) selecting and administering anesthetics and adjunct drugs and fluids; and]
             144          [(C) administering general, regional, and local anesthesia;]
             145          [(iii) postanesthesia follow-up care, including:]
             146          [(A) evaluating the patient's response to anesthesia and implementing corrective
             147      actions; and]
             148          [(B) selecting, ordering, or administering the above medications and studies; and]
             149          [(iv) other related services within the scope of practice of a certified registered nurse
             150      anesthetist, including:]
             151          [(A) emergency airway management;]



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             152
         [(B) advanced cardiac life support; and]
             153          [(C) the establishment of peripheral, central, and arterial invasive lines.]
             154          [(b) Nothing in this section shall be construed as to require a certified registered nurse
             155      anesthetist to obtain an advance practice registered nurse license in order to select, administer,
             156      or provide preoperative, intraoperative, or postoperative anesthesia care and services.]
             157          [(15)] (14) "Practice of nursing" means assisting individuals or groups to maintain or
             158      attain optimal health, implementing a strategy of care to accomplish defined goals and
             159      evaluating responses to care and treatment. The practice of nursing requires substantial
             160      specialized or general knowledge, judgment, and skill based upon principles of the biological,
             161      physical, behavioral, and social sciences, and includes:
             162          (a) initiating and maintaining comfort measures;
             163          (b) promoting and supporting human functions and responses;
             164          (c) establishing an environment conducive to well-being;
             165          (d) providing health counseling and teaching;
             166          (e) collaborating with health care professionals on aspects of the health care regimen;
             167          (f) performing delegated procedures only within the education, knowledge, judgment,
             168      and skill of the licensee; and
             169          (g) delegating nurse interventions that may be performed by others and are not in
             170      conflict with this chapter.
             171          [(16)] (15) "Practice of practical nursing" means the performance of nursing acts in the
             172      generally recognized scope of practice of licensed practical nurses as defined by rule and as
             173      provided in this Subsection [(16)] (15) by a person licensed under this chapter as a licensed
             174      practical nurse and under the direction of a registered nurse, licensed physician, or other
             175      specified health care professional as defined by rule. Practical nursing acts include:
             176          (a) contributing to the assessment of the health status of individuals and groups;
             177          (b) participating in the development and modification of the strategy of care;
             178          (c) implementing appropriate aspects of the strategy of care;
             179          (d) maintaining safe and effective nursing care rendered to a patient directly or
             180      indirectly; and
             181          (e) participating in the evaluation of responses to interventions.
             182          [(17)] (16) "Practice of registered nursing" means performing acts of nursing as



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             183
     provided in this Subsection [(17)] (16) by a person licensed under this chapter as a registered
             184      nurse within the generally recognized scope of practice of registered nurses as defined by rule.
             185      Registered nursing acts include:
             186          (a) assessing the health status of individuals and groups;
             187          (b) identifying health care needs;
             188          (c) establishing goals to meet identified health care needs;
             189          (d) planning a strategy of care;
             190          (e) prescribing nursing interventions to implement the strategy of care;
             191          (f) implementing the strategy of care;
             192          (g) maintaining safe and effective nursing care that is rendered to a patient directly or
             193      indirectly;
             194          (h) evaluating responses to interventions;
             195          (i) teaching the theory and practice of nursing; and
             196          (j) managing and supervising the practice of nursing.
             197          [(18)] (17) "Routine medications":
             198          (a) means established medications administered to a medically stable individual as
             199      determined by a licensed health care practitioner or in consultation with a licensed medical
             200      practitioner; and
             201          (b) is limited to medications that are administered by the following routes:
             202          (i) oral;
             203          (ii) sublingual;
             204          (iii) buccal;
             205          (iv) eye;
             206          (v) ear;
             207          (vi) nasal;
             208          (vii) rectal;
             209          (viii) vaginal;
             210          (ix) skin ointments, topical including patches and transdermal;
             211          (x) gastronomy or jejunostomy tubes;
             212          (xi) premeasured medication delivered by aerosol/nebulizer; and
             213          (xii) medications delivered by metered hand-held inhalers.



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             214
         [(19)] (18) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501 .
             215          [(20)] (19) "Unlicensed assistive personnel" means any unlicensed person, regardless
             216      of title, to whom tasks are delegated by a licensed nurse as permitted by rule and in accordance
             217      with the standards of the profession.
             218          [(21)] (20) "Unprofessional conduct" is as defined in Sections 58-1-501 and
             219      58-31b-502 and as may be further defined by rule.
             220          Section 2. Section 58-31b-301 is amended to read:
             221           58-31b-301. License or certification required -- Classifications.
             222          (1) A license is required to engage in the practice of nursing, except as specifically
             223      provided in Sections 58-1-307 and 58-31b-308 .
             224          (2) The division shall issue to a person who qualifies under this chapter a license or
             225      certification in the classification of:
             226          (a) licensed practical nurse;
             227          (b) registered nurse;
             228          (c) advanced practice registered nurse intern;
             229          (d) advanced practice registered nurse;
             230          [(e) certified registered nurse anesthetist; and]
             231          (e) S. [ advanced practice registered nurse - CRNA;
             232          (f)
] .S
advanced practice registered nurse - CRNA without prescriptive practice; and
             233          [(f)] S. [ (g) ] (f) .S medication aide certified.
             234          (3) An individual holding an advanced practice registered nurse license as of July 1,
             235      1998, who cannot document the successful completion of advanced course work in patient
             236      assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
             237      issued an "APRN - without prescriptive practice" license.
             238          (4) The division shall grant an advanced practice registered nurse license to any
             239      licensed advanced practice registered nurse currently holding prescriptive authority under any
             240      predecessor act on July 1, 1998.
             241          (5) S. [ An individual holding a certified registered nurse anesthetist license as of July 1,
             242      2007, who can document the successful completion of advanced course work in patient
             243      assessment, diagnosis and treatment, and pharmacotherapeutics shall be issued an advanced
             244      practice registered nurse - CRNA license.
] .S



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             245
     S. [ (6) ] .S An individual holding a certified registered nurse anesthetist license as of July 1,
             246      2007, S. [ who cannot document the requirements of Subsection (5), ] .S shall be issued an "APRN
             247      CRNA - without prescriptive practice" license.
             248          Section 3. Section 58-31b-302 is amended to read:
             249           58-31b-302. Qualifications for licensure or certification -- Criminal background
             250      checks.
             251          (1) An applicant for certification as a medication aide shall:
             252          (a) submit an application to the division on a form prescribed by the division;
             253          (b) pay a fee to the division as determined under Section 63-38-3.2 ;
             254          (c) have a high school diploma or its equivalent;
             255          (d) have a current certification as a nurse aide, in good standing, from the Department
             256      of Health;
             257          (e) have a minimum of 2,000 hours of experience within the two years prior to
             258      application, working as a certified nurse aide in a long-term care facility;
             259          (f) obtain letters of recommendation from a long-term care facility administrator and
             260      one licensed nurse familiar with the applicant's work practices as a certified nurse aide;
             261          (g) be in a condition of physical and mental health that will permit the applicant to
             262      practice safely as a medication aide certified;
             263          (h) have completed an approved education program or an equivalent as determined by
             264      the division in collaboration with the board;
             265          (i) have passed the examinations as required by division rule made in collaboration
             266      with the board; and
             267          (j) meet with the board, if requested, to determine the applicant's qualifications for
             268      certification.
             269          (2) An applicant for licensure as a licensed practical nurse shall:
             270          (a) submit to the division an application in a form prescribed by the division;
             271          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             272          (c) have a high school diploma or its equivalent;
             273          (d) be in a condition of physical and mental health that will permit the applicant to
             274      practice safely as a licensed practical nurse;
             275          (e) have completed an approved practical nursing education program or an equivalent



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             276
     as determined by the board;
             277          (f) have passed the examinations as required by division rule made in collaboration
             278      with the board; and
             279          (g) meet with the board, if requested, to determine the applicant's qualifications for
             280      licensure.
             281          (3) An applicant for licensure as a registered nurse shall:
             282          (a) submit to the division an application form prescribed by the division;
             283          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             284          (c) have a high school diploma or its equivalent;
             285          (d) be in a condition of physical and mental health that will allow the applicant to
             286      practice safely as a registered nurse;
             287          (e) have completed an approved registered nursing education program;
             288          (f) have passed the examinations as required by division rule made in collaboration
             289      with the board; and
             290          (g) meet with the board, if requested, to determine the applicant's qualifications for
             291      licensure.
             292          (4) Applicants for licensure as an advanced practice registered nurse shall:
             293          (a) submit to the division an application on a form prescribed by the division;
             294          (b) pay to the division a fee determined under Section 63-38-3.2 ;
             295          (c) be in a condition of physical and mental health which will allow the applicant to
             296      practice safely as an advanced practice registered nurse;
             297          (d) hold a current registered nurse license in good standing issued by the state or be
             298      qualified at the time for licensure as a registered nurse;
             299          (e) (i) have earned a graduate degree in:
             300          (A) an advanced practice registered nurse nursing education program; or
             301          (B) a related area of specialized knowledge as determined appropriate by the division
             302      in collaboration with the board; or
             303          (ii) have completed a nurse anesthesia program in accordance with Subsection
             304      (4)(f)(ii);
             305          (f) have completed:
             306          (i) course work in patient assessment, diagnosis and treatment, and



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             307
     pharmacotherapeutics from an education program approved by the division in collaboration
             308      with the board; or
             309          (ii) a nurse anesthesia program which is approved by the Council on Accreditation of
             310      Nurse Anesthesia Educational Programs;
             311          (g) have successfully completed clinical practice in psychiatric and mental health
             312      nursing, including psychotherapy as defined by division rule, after completion of the masters
             313      degree required for licensure, to practice within the psychiatric and mental health nursing
             314      specialty;
             315          (h) have passed the examinations as required by division rule made in collaboration
             316      with the board;
             317          (i) be currently certified by a program approved by the division in collaboration with
             318      the board and submit evidence satisfactory to the division of the certification; and
             319          (j) meet with the board, if requested, to determine the applicant's qualifications for
             320      licensure.
             321          [(5) An applicant for licensure as a certified registered nurse anesthetist shall:]
             322          [(a) submit to the division an application on a form prescribed by the division;]
             323          [(b) pay to the division a fee determined under Section 63-38-3.2 ;]
             324          [(c) be in a condition of physical and mental health which will allow the applicant to
             325      practice safely as a certified registered nurse anesthetist;]
             326          [(d) hold a current registered nurse license in good standing issued by the state or be
             327      qualified at the time for licensure as a registered nurse;]
             328          [(e) complete a nurse anesthesia program which is approved by the Council on
             329      Accreditation of Nurse Anesthesia Educational Programs;]
             330          [(f) be currently certified by a program approved by the division in collaboration with
             331      the board and submit evidence satisfactory to the division of the certification; and]
             332          [(g) meet with the board, if requested, to determine the applicant's qualifications for
             333      licensure.]
             334          [(6)] (5) An applicant for licensure or certification under this chapter:
             335          (a) (i) shall submit fingerprint cards in a form acceptable to the division at the time the
             336      license application is filed and shall consent to a fingerprint background check by the Utah
             337      Bureau of Criminal Identification and the Federal Bureau of Investigation regarding the



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             338
     application; and
             339          (ii) the division shall request the Department of Public Safety to complete a Federal
             340      Bureau of Investigation criminal background check for each applicant through the national
             341      criminal history system (NCIC) or any successor system; and
             342          (b) if convicted of one or more felonies, must receive an absolute discharge from the
             343      sentences for all felony convictions five or more years prior to the date of filing an application
             344      for licensure or certification under this chapter.
             345          [(7)] (6) For purposes of conducting the criminal background checks required in
             346      Subsection [(6)] (5), the division shall have direct access to criminal background information
             347      maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
             348          [(8)] (7) (a) (i) Any new nurse license or certification issued under this section shall be
             349      conditional, pending completion of the criminal background check.
             350          (ii) If the criminal background check discloses the applicant has failed to accurately
             351      disclose a criminal history, the license or certification shall be immediately and automatically
             352      revoked.
             353          (b) (i) Any person whose conditional license or certification has been revoked under
             354      Subsection [(8)] (7)(a) shall be entitled to a postrevocation hearing to challenge the revocation.
             355          (ii) The hearing shall be conducted in accordance with Title 63, Chapter 46b,
             356      Administrative Procedures Act.
             357          Section 4. Section 58-31b-305 is amended to read:
             358           58-31b-305. Term of license -- Expiration -- Renewal.
             359          (1) The division shall issue each license or certification under this chapter in
             360      accordance with a two-year renewal cycle established by rule. The division may by rule extend
             361      or shorten a renewal period by as much as one year to stagger the renewal cycles it administers.
             362          (2) At the time of renewal, the licensee or person certified under this chapter shall
             363      show satisfactory evidence of each of the following renewal requirements:
             364          (a) complete and submit an application for renewal in a form prescribed by the division
             365      and pay the renewal fee determined under Section 63-38-3.2 ; and
             366          (b) meet continuing competency requirements as established by rule, which shall
             367      include continuing education requirements for medication aide certified established by the
             368      board and adopted by the division by rule.



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             369
         (3) In addition to the renewal requirements under Subsection (2), a person licensed as a
             370      advanced practice registered nurse shall be currently certified by a program approved by the
             371      division in collaboration with the board and submit evidence satisfactory to the division of that
             372      qualification or if licensed prior to July 1, 1992, meet the requirements established by rule.
             373          [(4) In addition to the renewal requirements under Subsection (2), a person licensed as
             374      a certified registered nurse anesthetist shall be currently certified in anesthesia by a program
             375      approved by the division in collaboration with the board and submit evidence satisfactory to
             376      the division of the certification.]
             377          [(5)] (4) Each license or certification automatically expires on the expiration date
             378      shown on the license or certification unless renewed in accordance with Section 58-1-308 .
             379          Section 5. Section 58-31d-103 is amended to read:
             380           58-31d-103. Rulemaking authority -- Enabling provisions.
             381          (1) The division may adopt rules necessary to implement Section 58-31d-102 .
             382          (2) As used in Article VIII (1) of the Advanced Practice Registered Nurse Compact,
             383      "head of the licensing board" means the executive administrator of the Utah Board of Nursing.
             384          (3) For purposes of the Advanced Practice Registered Nurse Compact, "APRN" as
             385      defined in Article II (1) of the compact includes an individual who is:
             386          (i) licensed to practice under Subsection 58-31b-301 (2) as an advanced practice
             387      registered nurse[.]; or
             388          (ii) licensed to practice under Section 58-44a-301 as a certified nurse midwife.
             389          (4) An APRN practicing in this state under a multistate licensure privilege may only be
             390      granted prescriptive authority if that individual can document completion of graduate level
             391      course work in the following areas:
             392          (a) advanced health assessment;
             393          (b) pharmacotherapeutics; and
             394          (c) diagnosis and treatment.
             395          (5) (a) An APRN practicing in this state under a multistate privilege who seeks to
             396      obtain prescriptive authority must:
             397          (i) meet all the requirements of Subsection (4) and this Subsection (5); and
             398          (ii) be placed on a registry with the division.
             399          (b) To be placed on a registry under Subsection (5)(a)(ii), an APRN must:



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             400
         (i) submit a form prescribed by the division;
             401          (ii) pay a fee; and
             402          (iii) if prescribing a controlled substance:
             403          (A) obtain a controlled substance license as required under Section 58-37-6 ; and
             404          (B) if prescribing a Schedule II or III controlled substance, have a consultation and
             405      referral plan with a physician licensed in Utah as required under Subsection
             406      58-31b-102 (13)(c)(iii) or 58-44a-102 (8)(b)(iii)(C).
             407          Section 6. Section 58-44a-302 is amended to read:
             408           58-44a-302. Qualifications for licensure.
             409          (1) An applicant for licensure as a nurse midwife shall:
             410          [(1)] (a) submit an application in a form as prescribed by the division;
             411          [(2)] (b) pay a fee as determined by the department under Section 63-38-3.2 ;
             412          [(3)] (c) be of good moral character;
             413          [(4)] (d) at the time of application for licensure hold a license in good standing as a
             414      registered nurse in Utah, or be at that time qualified for a license as a registered nurse under
             415      Title 58, Chapter 31b, Nurse Practice Act;
             416          [(5)] (e) have completed:
             417          [(a)] (i) a certified nurse midwifery education program accredited by the American
             418      College of Nurse Midwives and approved by the division; or
             419          [(b) have completed] (ii) a nurse midwifery education program located outside of the
             420      United States which is approved by the division and is equivalent to a program accredited by
             421      the American College of Nurse Midwives, as demonstrated by a graduate's being accepted to
             422      sit for the national certifying examination administered by the American College of Nurse
             423      Midwives or its designee; and
             424          [(6)] (f) have passed examinations established by the division rule in collaboration with
             425      the board within two years after completion of the approved education program required under
             426      Subsection [(5)] (1)(e).
             427          (2) For purposes of Subsection (1)(e), as of January 1, 2010, the accredited education
             428      program or it's equivalent must grant a graduate degree, including post-master's certificate, in
             429      nurse midwifery.



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Legislative Review Note
    as of 12-21-06 12:54 PM


Office of Legislative Research and General Counsel


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