Senator J. Stuart Adams proposes the following substitute bill:


1     
ADMINISTRATION OF ANESTHESIA AMENDMENTS

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Michael S. Kennedy

5     
Senate Sponsor: J. Stuart Adams

6     

7     LONG TITLE
8     General Description:
9           This bill amends professional licensing acts in the Division of Occupational and
10     Professional Licensing Act to require informed consent and certain patient monitoring
11     of patients who are sedated and establishes a database for adverse events.
12     Highlighted Provisions:
13          This bill:
14          ▸      requires the Department of Health to:
15               •     create a database of adverse events from the administration of sedation or
16     anesthesia in outpatient settings; and
17               •     publish a report regarding the number of adverse events by types of provider and
18     facility and submit a yearly report to the Health and Human Services Interim
19     Committee;
20          ▸     requires a health care provider who administers sedation intravenously to a patient
21     in an outpatient setting that is not an emergency department:
22               •     to obtain informed consent from the patient; and
23               •     to report adverse events from the sedation or anesthesia to the Department of
24     Health;
25          ▸     makes it unprofessional conduct to fail to report an adverse event from outpatient

26     sedation or anesthesia;
27          ▸     provides whistle blower protections to a health care provider who reports an adverse
28     event; and
29          ▸     requires a health care provider who administers sedation or anesthesia intravenously
30     to have access to a crash cart during the anesthesia procedure.
31     Money Appropriated in this Bill:
32          None
33     Other Special Clauses:
34          None
35     Utah Code Sections Affected:
36     AMENDS:
37          63I-1-226, as last amended by Laws of Utah 2016, Chapters 89, 170, 279, and 327
38          63I-1-258, as last amended by Laws of Utah 2016, Chapters 89 and 294
39     ENACTS:
40          26-1-40, Utah Code Annotated 1953
41          58-5a-502, Utah Code Annotated 1953
42          58-31b-502.5, Utah Code Annotated 1953
43          58-67-502.5, Utah Code Annotated 1953
44          58-68-502.5, Utah Code Annotated 1953
45          58-69-502.5, Utah Code Annotated 1953
46     

47     Be it enacted by the Legislature of the state of Utah:
48          Section 1. Section 26-1-40 is enacted to read:
49          26-1-40. Reports of anesthesia adverse events- whistle blower protections.
50          (1) (a) Beginning January 1, 2018, the department shall create a database of deaths and
51     adverse events from the administration of sedation or anesthesia in outpatient settings that are
52     not emergency departments in the state.
53          (b) The database required by Subsection (1)(a) shall include reports submitted by
54     health care providers under Sections 58-5a-502, 58-31b-502.5, 58-67-502.5, 58-68-502.5, and
55     58-69-502.5.
56          (2) The department shall adopt administrative rules under Title 63G, Chapter 3, Utah

57     Administrative Rulemaking Act, regarding:
58          (a) the format of the reports; and
59          (b) what constitutes a reportable adverse event, which shall include at least the
60     administration of intravenous sedation or anesthesia when there is:
61          (i) an escalation of care required for the patient; or
62          (ii) a rescue of a patient from a deeper level of sedation than was intended.
63          (3) (a) Information the department receives under this section that identifies a
64     particular individual is subject to Title 63G, Chapter 2, Government Records Access and
65     Management Act, and the federal Health Insurance Portability and Accountability Act of 1996.
66          (b) Beginning July 1, 2018, and on or before July 1 of each year thereafter, the
67     department shall:
68          (i) publicly report:
69          (A) the number of deaths and adverse events reported under Subsection (1);
70          (B) the type of health care providers, by license category and specialty, who submitted
71     reports under Subsection (1) and who administered the sedation or anesthesia that resulted in
72     an adverse event; and
73          (C) the type of facility in which the death or adverse event took place; and
74          (ii) submit a report to the Health and Human Services Interim Committee with the
75     information required by this Subsection (3).
76          (4) An employer of a health care provider who submits a report under this section may
77     not take an adverse employment action against the reporting health care provider if the
78     employment action is based on the provider submitting a report under this section.
79          (5) (a) This section sunsets in accordance with Section 63I-1-226.
80          (b) The sunset review of this section shall include an analysis of:
81          (i) the number and types of adverse events reported under this section;
82          (ii) the types of health care providers and locations involved in the adverse events;
83          (iii) the adequacy of sedation and anesthesia requirements in Sections 58-5a-502,
84     58-31b-502.5, 58-67-502.5, 58-68-502.5, and 58-69-502.5 related to the adverse events
85     reported under this section; and
86          (iv) the adequacy of the reporting requirements under this section and the need for
87     additional protections for health care providers who report events under this section.

88          Section 2. Section 58-5a-502 is enacted to read:
89     
Part 5. Unprofessional and Unlawful Conduct -- Penalties

90          58-5a-502. Unprofessional conduct.
91          In addition to unprofessional conduct as defined in Section 58-5a-102, it is
92     unprofessional conduct for an individual licensed under this chapter to administer sedation or
93     anesthesia intravenously to a patient in an outpatient setting that is not an emergency
94     department without:
95          (1) first obtaining consent from the patient in writing, which shall include:
96          (a) the type of sedation or anesthesia being administered;
97          (b) the identity and type of license or permit under this title of the person who is
98     performing the procedure for which the sedation or anesthesia will be administered;
99          (c) the identity and type of license or permit under this title of the person who will be
100     administering the sedation or anesthesia; and
101          (d) monitoring that will occur during the sedation or anesthesia, including monitoring
102     of the patient's oxygenation, ventilation and circulation;
103          (2) reporting any adverse event under Section 26-1-40; and
104          (3) having access during the procedure to an advanced cardiac life support crash cart
105     with equipment that is regularly maintained according to guidelines established by the
106     American Heart Association.
107          Section 3. Section 58-31b-502.5 is enacted to read:
108          58-31b-502.5. Anesthesia and sedation -- Unprofessional conduct.
109          In addition to unprofessional conduct as defined in Section 58-31b-502, it is
110     unprofessional conduct for an individual licensed under this chapter to administer sedation or
111     anesthesia intravenously to a patient in an outpatient setting that is not an emergency
112     department without:
113          (1) first obtaining consent from the patient in writing, which shall include:
114          (a) the type of sedation or anesthesia being administered;
115          (b) the identity and type of license or permit under this title of the person who is
116     performing the procedure for which the sedation or anesthesia will be administered;
117          (c) the identity and type of license or permit under this title of the person who will be
118     administering the sedation or anesthesia; and

119          (d) monitoring that will occur during the sedation or anesthesia, including monitoring
120     the patient's oxygenation, ventilation and circulation;
121          (2) reporting any adverse event under Section 26-1-40; and
122          (3) having access during the procedure to an advanced cardiac life support crash cart
123     with equipment that is regularly maintained according to guidelines established by the
124     American Heart Association.
125          Section 4. Section 58-67-502.5 is enacted to read:
126          58-67-502.5. Anesthesia and sedation -- Unprofessional conduct.
127          In addition to unprofessional conduct as defined in Section 58-67-502, it is
128     unprofessional conduct for an individual licensed under this chapter to administer sedation or
129     anesthesia intravenously to a patient in an outpatient setting that is not an emergency
130     department without:
131          (1) first obtaining consent from the patient in writing, which shall include:
132          (a) the type of sedation or anesthesia being administered;
133          (b) the identity and type of license or permit under this title of the person who is
134     performing the procedure for which the sedation or anesthesia will be administered;
135          (c) the identity and type of license or permit under this title of the person who will be
136     administering the sedation or anesthesia; and
137          (d) monitoring that will occur during the sedation or anesthesia, including monitoring
138     of the patient's oxygenation, ventilation and circulation;
139          (2) reporting any adverse event under Section 26-1-40; and
140          (3) having access during the procedure to an advanced cardiac life support crash cart
141     with equipment that is regularly maintained according to guidelines established by the
142     American Heart Association.
143          Section 5. Section 58-68-502.5 is enacted to read:
144          58-68-502.5. Anesthesia and sedation -- Unprofessional conduct.
145          In addition to unprofessional conduct as defined in Section 58-68-502, it is
146     unprofessional conduct for an individual licensed under this chapter to administer sedation or
147     anesthesia intravenously to a patient in an outpatient setting that is not an emergency
148     department without:
149          (1) first obtaining consent from the patient in writing, which shall include:

150          (a) the type of sedation or anesthesia being administered;
151          (b) the identity and type of license or permit under this title of the person who is
152     performing the procedure for which the sedation or anesthesia will be administered;
153          (c) the identity and type of license or permit under this title of the person who will be
154     administering the sedation or anesthesia; and
155          (d) monitoring that will occur during the sedation or anesthesia, including monitoring
156     of the patient's oxygenation, ventilation and circulation;
157          (2) reporting any adverse event under Section 26-1-40; and
158          (3) having access during the procedure to an advanced cardiac life support crash cart
159     with equipment that is regularly maintained according to guidelines established by the
160     American Heart Association.
161          Section 6. Section 58-69-502.5 is enacted to read:
162          58-69-502.5. Anesthesia and sedation -- Unprofessional conduct.
163          In addition to unprofessional conduct as defined in Section 58-68-502, it is
164     unprofessional conduct for an individual licensed under this chapter to administer sedation or
165     anesthesia intravenously to a patient in an outpatient setting that is not an emergency
166     department without:
167          (1) first obtaining consent from the patient in writing, which shall include:
168          (a) the type of sedation or anesthesia being administered;
169          (b) the identity and type of license or permit under this title of the person who is
170     performing the procedure for which the sedation or anesthesia will be administered;
171          (c) the identity and type of license or permit under this title of the person who will be
172     administering the sedation or anesthesia; and
173          (d) monitoring that will occur during the sedation or anesthesia, including monitoring
174     of the patient's oxygenation, ventilation and circulation;
175          (2) reporting any adverse event under Section 26-1-40; and
176          (3) having access during the procedure to an advanced cardiac life support crash cart
177     with equipment that is regularly maintained according to guidelines established by the
178     American Heart Association.
179          Section 7. Section 63I-1-226 is amended to read:
180          63I-1-226. Repeal dates, Title 26.

181          (1) Section 26-1-40 is repealed July 1, 2021.
182          [(1)] (2) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed
183     July 1, 2025.
184          [(2)] (3) Section 26-10-11 is repealed July 1, 2020.
185          [(3)] (4) Section 26-21-23, Licensing of non-Medicaid nursing care facility beds, is
186     repealed July 1, 2018.
187          [(4)] (5) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1,
188     2024.
189          [(5)] (6) Title 26, Chapter 36a, Hospital Provider Assessment Act, is repealed July 1,
190     2019.
191          [(6)] (7) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
192     2021.
193          [(7)] (8) Section 26-38-2.5 is repealed July 1, 2017.
194          [(8)] (9) Section 26-38-2.6 is repealed July 1, 2017.
195          [(9) Title 26, Chapter 52, Autism Treatment Account, is repealed July 1, 2016.]
196          (10) Title 26, Chapter 56, Hemp Extract Registration Act, is repealed July 1, 2021.
197          Section 8. Section 63I-1-258 is amended to read:
198          63I-1-258. Repeal dates, Title 58.
199          (1) Title 58, Chapter 13, Health Care Providers Immunity from Liability Act, is
200     repealed July 1, 2026.
201          (2) Title 58, Chapter 15, Health Facility Administrator Act, is repealed July 1, 2025.
202          (3) Title 58, Chapter 20a, Environmental Health Scientist Act, is repealed July 1, 2018.
203          (4) Section 58-37-4.3 is repealed July 1, 2021.
204          (5) Title 58, Chapter 40, Recreational Therapy Practice Act, is repealed July 1, 2023.
205          (6) Title 58, Chapter 41, Speech-Language Pathology and Audiology Licensing Act, is
206     repealed July 1, 2019.
207          (7) Title 58, Chapter 42a, Occupational Therapy Practice Act, is repealed July 1, 2025.
208          (8) Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act, is repealed July
209     1, 2023.
210          (9) Title 58, Chapter 47b, Massage Therapy Practice Act, is repealed July 1, 2024.
211          (10) Title 58, Chapter 61, Part 7, Behavior Analyst Licensing Act, is repealed July 1,

212     2026.
213          (11) Title 58, Chapter 72, Acupuncture Licensing Act, is repealed July 1, 2017.
214          (12) Title 58, Chapter 86, State Certification of Commercial Interior Designers Act, is
215     repealed July 1, 2021.
216          (13) The following sections are repealed on July 1, 2021:
217          (a) Section 58-5a-502;
218          (b) Section 58-31b-502.5;
219          (c) Section 58-67-502.5;
220          (d) Section 58-68-502.5; and
221          (e) Section 58-69-502.5.