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7 LONG TITLE
8 General Description:
9 This bill modifies provisions relating to physician assistants.
10 Highlighted Provisions:
11 This bill:
12 ▸ clarifies the scope of practice for physician assistants.
13 Money Appropriated in this Bill:
14 None
15 Other Special Clauses:
16 This bill provides a coordination clause.
17 Utah Code Sections Affected:
18 AMENDS:
19 26B-1-501, as renumbered and amended by Laws of Utah 2023, Chapter 305
20 26B-2-201, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
21 amended by Laws of Utah 2023, Chapter 305
22 26B-3-123, as last amended by Laws of Utah 2023, Chapter 295 and renumbered and
23 amended by Laws of Utah 2023, Chapter 306
24 26B-4-409, as renumbered and amended by Laws of Utah 2023, Chapter 307
25 26B-4-410, as renumbered and amended by Laws of Utah 2023, Chapter 307
26 26B-7-216, as renumbered and amended by Laws of Utah 2023, Chapter 308
27 26B-7-402, as renumbered and amended by Laws of Utah 2023, Chapter 308
28 26B-8-104, as renumbered and amended by Laws of Utah 2023, Chapter 306
29 26B-8-115, as renumbered and amended by Laws of Utah 2023, Chapter 306
30 26B-8-118, as renumbered and amended by Laws of Utah 2023, Chapter 306
31 53-2a-1601, as enacted by Laws of Utah 2022, Chapter 111
32 53-3-206, as last amended by Laws of Utah 2023, Chapter 391
33 53-3-220, as last amended by Laws of Utah 2023, Chapter 415
34 53G-6-204, as last amended by Laws of Utah 2023, Chapter 162
35 53G-6-603, as last amended by Laws of Utah 2022, Chapter 329
36 53G-9-403, as last amended by Laws of Utah 2022, Chapter 214
37 58-37c-3, as last amended by Laws of Utah 2015, Chapter 258
38 75-2a-104, as last amended by Laws of Utah 2009, Chapter 99
39 75-2a-106, as last amended by Laws of Utah 2023, Chapter 330
40 75-2a-117, as last amended by Laws of Utah 2009, Chapter 99
41 75-5-301.5, as enacted by Laws of Utah 2022, Chapter 358 and last amended by
42 Coordination Clause, Laws of Utah 2022, Chapter 358
43 75-5-303, as last amended by Laws of Utah 2018, Chapter 455
44 76-5-111, as last amended by Laws of Utah 2022, Chapter 181
45 Utah Code Sections Affected By Coordination Clause:
46 26B-7-402, as renumbered and amended by Laws of Utah 2023, Chapter 308
47
48 Be it enacted by the Legislature of the state of Utah:
49 Section 1. Section 26B-1-501 is amended to read:
50 26B-1-501. Definitions.
51 As used in this part:
52 (1) "Abuse" means the same as that term is defined in Section 80-1-102.
53 (2) "Child" means the same as that term is defined in Section 80-1-102.
54 (3) "Committee" means a fatality review committee that is formed under Section
55 26B-1-503 or 26B-1-504.
56 (4) "Dependency" means the same as that term is defined in Section 80-1-102.
57 (5) "Formal review" means a review of a death or a near fatality that is ordered under
58 Subsection 26B-1-502(6).
59 (6) "Near fatality" means alleged abuse or neglect that, as certified by a physician or
60 physician assistant, places a child in serious or critical condition.
61 (7) "Qualified individual" means an individual who:
62 (a) at the time that the individual dies, is a resident of a facility or program that is
63 owned or operated by the department or a division of the department;
64 (b) (i) is in the custody of the department or a division of the department; and
65 (ii) is placed in a residential placement by the department or a division of the
66 department;
67 (c) at the time that the individual dies, has an open case for the receipt of child welfare
68 services, including:
69 (i) an investigation for abuse, neglect, or dependency;
70 (ii) foster care;
71 (iii) in-home services; or
72 (iv) substitute care;
73 (d) had an open case for the receipt of child welfare services within one year before the
74 day on which the individual dies;
75 (e) was the subject of an accepted referral received by Adult Protective Services within
76 one year before the day on which the individual dies, if:
77 (i) the department or a division of the department is aware of the death; and
78 (ii) the death is reported as a homicide, suicide, or an undetermined cause;
79 (f) received services from, or under the direction of, the Division of Services for People
80 with Disabilities within one year before the day on which the individual dies, unless the
81 individual:
82 (i) lived in the individual's home at the time of death; and
83 (ii) the director of the Division of Continuous Quality and Improvement determines
84 that the death was not in any way related to services that were provided by, or under the
85 direction of, the department or a division of the department;
86 (g) dies within 60 days after the day on which the individual is discharged from the
87 Utah State Hospital, if the department is aware of the death;
88 (h) is a child who:
89 (i) suffers a near fatality; and
90 (ii) is the subject of an open case for the receipt of child welfare services within one
91 year before the day on which the child suffered the near fatality, including:
92 (A) an investigation for abuse, neglect, or dependency;
93 (B) foster care;
94 (C) in-home services; or
95 (D) substitute care; or
96 (i) is designated as a qualified individual by the executive director.
97 (8) "Neglect" means the same as that term is defined in Section 80-1-102.
98 (9) "Substitute care" means the same as that term is defined in Section 80-1-102.
99 Section 2. Section 26B-2-201 is amended to read:
100 26B-2-201. Definitions.
101 As used in this part:
102 (1) (a) "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
103 (b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
104 Section 76-7-301 or Section 76-71-101.
105 (2) "Activities of daily living" means essential activities including:
106 (a) dressing;
107 (b) eating;
108 (c) grooming;
109 (d) bathing;
110 (e) toileting;
111 (f) ambulation;
112 (g) transferring; and
113 (h) self-administration of medication.
114 (3) "Ambulatory surgical facility" means a freestanding facility, which provides
115 surgical services to patients not requiring hospitalization.
116 (4) "Assistance with activities of daily living" means providing of or arranging for the
117 provision of assistance with activities of daily living.
118 (5) (a) "Assisted living facility" means:
119 (i) a type I assisted living facility, which is a residential facility that provides assistance
120 with activities of daily living and social care to two or more residents who:
121 (A) require protected living arrangements; and
122 (B) are capable of achieving mobility sufficient to exit the facility without the
123 assistance of another person; and
124 (ii) a type II assisted living facility, which is a residential facility with a home-like
125 setting that provides an array of coordinated supportive personal and health care services
126 available 24 hours per day to residents who have been assessed under department rule to need
127 any of these services.
128 (b) Each resident in a type I or type II assisted living facility shall have a service plan
129 based on the assessment, which may include:
130 (i) specified services of intermittent nursing care;
131 (ii) administration of medication; and
132 (iii) support services promoting residents' independence and self-sufficiency.
133 (6) "Birthing center" means a facility that:
134 (a) receives maternal clients and provides care during pregnancy, delivery, and
135 immediately after delivery; and
136 (b) (i) is freestanding; or
137 (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
138 described in Subsection 26B-2-228(7).
139 (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
140 (8) "Consumer" means any person not primarily engaged in the provision of health care
141 to individuals or in the administration of facilities or institutions in which such care is provided
142 and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
143 the provision of health care, and does not receive, either directly or through his spouse, more
144 than 1/10 of his gross income from any entity or activity relating to health care.
145 (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
146 kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
147 (10) "Freestanding" means existing independently or physically separated from another
148 health care facility by fire walls and doors and administrated by separate staff with separate
149 records.
150 (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
151 and rehabilitative services to both inpatients and outpatients by or under the supervision of
152 physicians.
153 (12) "Governmental unit" means the state, or any county, municipality, or other
154 political subdivision or any department, division, board, or agency of the state, a county,
155 municipality, or other political subdivision.
156 (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
157 health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
158 centers, ambulatory surgical facilities, small health care facilities, abortion clinics, a clinic that
159 meets the definition of hospital under Section 76-7-301 or 76-71-201, facilities owned or
160 operated by health maintenance organizations, end stage renal disease facilities, and any other
161 health care facility which the committee designates by rule.
162 (b) "Health care facility" does not include the offices of private physicians or dentists,
163 whether for individual or group practice, except that it does include an abortion clinic.
164 (14) "Health maintenance organization" means an organization, organized under the
165 laws of any state which:
166 (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
167 (b) (i) provides or otherwise makes available to enrolled participants at least the
168 following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
169 emergency, and preventive services and out-of-area coverage;
170 (ii) is compensated, except for copayments, for the provision of the basic health
171 services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
172 periodic basis without regard to the date the health services are provided and which is fixed
173 without regard to the frequency, extent, or kind of health services actually provided; [
174 (iii) provides physicians' services primarily directly through physicians who are either
175 employees or partners of such organizations, or through arrangements with individual
176 physicians or one or more groups of physicians organized on a group practice or individual
177 practice basis[
178 (iv) provides physician assistant services.
179 (15) (a) "Home health agency" means an agency, organization, or facility or a
180 subdivision of an agency, organization, or facility which employs two or more direct care staff
181 persons who provide licensed nursing services, therapeutic services of physical therapy, speech
182 therapy, occupational therapy, medical social services, or home health aide services on a
183 visiting basis.
184 (b) "Home health agency" does not mean an individual who provides services under
185 the authority of a private license.
186 (16) "Hospice" means a program of care for the terminally ill and their families which
187 occurs in a home or in a health care facility and which provides medical, palliative,
188 psychological, spiritual, and supportive care and treatment.
189 (17) "Nursing care facility" means a health care facility, other than a general acute or
190 specialty hospital, constructed, licensed, and operated to provide patient living
191 accommodations, 24-hour staff availability, and at least two of the following patient services:
192 (a) a selection of patient care services, under the direction and supervision of a
193 registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
194 professional therapies to intermittent health-related or paraprofessional personal care services;
195 (b) a structured, supportive social living environment based on a professionally
196 designed and supervised treatment plan, oriented to the individual's habilitation or
197 rehabilitation needs; or
198 (c) a supervised living environment that provides support, training, or assistance with
199 individual activities of daily living.
200 (18) "Person" means any individual, firm, partnership, corporation, company,
201 association, or joint stock association, and the legal successor thereof.
202 (19) "Resident" means a person 21 years old or older who:
203 (a) as a result of physical or mental limitations or age requires or requests services
204 provided in an assisted living facility; and
205 (b) does not require intensive medical or nursing services as provided in a hospital or
206 nursing care facility.
207 (20) "Small health care facility" means a four to 16 bed facility that provides licensed
208 health care programs and services to residents.
209 (21) "Specialty hospital" means a facility which provides specialized diagnostic,
210 therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
211 hospital is licensed.
212 (22) "Substantial compliance" means in a department survey of a licensee, the
213 department determines there is an absence of deficiencies which would harm the physical
214 health, mental health, safety, or welfare of patients or residents of a licensee.
215 (23) "Type I abortion clinic" means a facility, including a physician's office, but not
216 including a general acute or specialty hospital, that:
217 (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
218 pregnancy; and
219 (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester
220 of pregnancy.
221 (24) "Type II abortion clinic" means a facility, including a physician's office, but not
222 including a general acute or specialty hospital, that:
223 (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
224 pregnancy; or
225 (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
226 pregnancy and after the first trimester of pregnancy.
227 Section 3. Section 26B-3-123 is amended to read:
228 26B-3-123. Reimbursement of telemedicine services and telepsychiatric
229 consultations.
230 (1) As used in this section:
231 (a) "Telehealth services" means the same as that term is defined in Section 26B-4-704.
232 (b) "Telemedicine services" means the same as that term is defined in Section
233 26B-4-704.
234 (c) "Telepsychiatric consultation" means a consultation between a physician or
235 physician assistant and a board certified psychiatrist, both of whom are licensed to engage in
236 the practice of medicine or physician assistant services in the state, that utilizes:
237 (i) the health records of the patient, provided from the patient or the referring physician
238 or physician assistant;
239 (ii) a written, evidence-based patient questionnaire; and
240 (iii) telehealth services that meet industry security and privacy standards, including
241 compliance with the:
242 (A) Health Insurance Portability and Accountability Act; and
243 (B) Health Information Technology for Economic and Clinical Health Act, Pub. L. No.
244 111-5, 123 Stat. 226, 467, as amended.
245 (2) This section applies to:
246 (a) a managed care organization that contracts with the Medicaid program; and
247 (b) a provider who is reimbursed for health care services under the Medicaid program.
248 (3) The Medicaid program shall reimburse for telemedicine services at the same rate
249 that the Medicaid program reimburses for other health care services.
250 (4) The Medicaid program shall reimburse for audio-only telehealth services as
251 specified by division rule.
252 (5) The Medicaid program shall reimburse for telepsychiatric consultations at a rate set
253 by the Medicaid program.
254 Section 4. Section 26B-4-409 is amended to read:
255 26B-4-409. Authority to obtain and use an epinephrine auto-injector or stock
256 albuterol.
257 (1) A qualified adult who is a teacher or other school employee at a public or private
258 primary or secondary school in the state, or a school nurse, may obtain from the school district
259 physician, the medical director of the local health department, or the local emergency medical
260 services director a prescription for:
261 (a) epinephrine auto-injectors for use in accordance with this part; or
262 (b) stock albuterol for use in accordance with this part.
263 (2) (a) A qualified adult may obtain an epinephrine auto-injector for use in accordance
264 with this part that is dispensed by:
265 (i) a pharmacist as provided under Section 58-17b-1004; or
266 (ii) a pharmacy intern as provided under Section 58-17b-1004.
267 (b) A qualified adult may obtain stock albuterol for use in accordance with this part
268 that is dispensed by:
269 (i) a pharmacist as provided under Section 58-17b-1004; or
270 (ii) a pharmacy intern as provided under Section 58-17b-1004.
271 (3) A qualified adult:
272 (a) may immediately administer an epinephrine auto-injector to a person exhibiting
273 potentially life-threatening symptoms of anaphylaxis when a physician or physician assistant is
274 not immediately available; and
275 (b) shall initiate emergency medical services or other appropriate medical follow-up in
276 accordance with the training materials retained under Section 26B-4-407 after administering an
277 epinephrine auto-injector.
278 (4) If a school nurse is not immediately available, a qualified adult:
279 (a) may immediately administer stock albuterol to an individual who:
280 (i) has a diagnosis of asthma by a health care provider;
281 (ii) has a current asthma action plan on file with the school; and
282 (iii) is showing symptoms of an asthma emergency as described in the student's asthma
283 action plan; and
284 (b) shall initiate appropriate medical follow-up in accordance with the training
285 materials retained under Section 26B-4-408 after administering stock albuterol.
286 (5) (a) A qualified entity that complies with Subsection (5)(b) or (c), may obtain a
287 supply of epinephrine auto-injectors or stock albuterol, respectively, from a pharmacist under
288 Section 58-17b-1004, or a pharmacy intern under Section 58-17b-1004 for:
289 (i) storing:
290 (A) the epinephrine auto-injectors on the qualified epinephrine auto-injector entity's
291 premises; and
292 (B) stock albuterol on the qualified stock albuterol entity's premises; and
293 (ii) use by a qualified adult in accordance with Subsection (3) or (4).
294 (b) A qualified epinephrine auto-injector entity shall:
295 (i) designate an individual to complete an initial and annual refresher training program
296 regarding the proper storage and emergency use of an epinephrine auto-injector available to a
297 qualified adult; and
298 (ii) store epinephrine auto-injectors in accordance with the standards established by the
299 department in Section 26B-4-411.
300 (c) A qualified stock albuterol entity shall:
301 (i) designate an individual to complete an initial and annual refresher training program
302 regarding the proper storage and emergency use of stock albuterol available to a qualified
303 adult; and
304 (ii) store stock albuterol in accordance with the standards established by the department
305 in Section 26B-4-411.
306 Section 5. Section 26B-4-410 is amended to read:
307 26B-4-410. Immunity from liability.
308 (1) The following, if acting in good faith, are not liable in any civil or criminal action
309 for any act taken or not taken under the authority of Sections 26B-4-406 through 26B-4-411
310 with respect to an anaphylactic reaction or asthma emergency:
311 (a) a qualified adult;
312 (b) a physician, physician assistant, pharmacist, or any other person or entity authorized
313 to prescribe or dispense prescription drugs;
314 (c) a person who conducts training described in Section 26B-4-407 or 26B-4-408;
315 (d) a qualified epinephrine auto-injector entity; and
316 (e) a qualified stock albuterol entity.
317 (2) Section 53G-9-502 does not apply to the administration of an epinephrine
318 auto-injector or stock albuterol in accordance with this part.
319 (3) This section does not eliminate, limit, or reduce any other immunity from liability
320 or defense against liability that may be available under state law.
321 Section 6. Section 26B-7-216 is amended to read:
322 26B-7-216. Serological testing of pregnant or recently delivered women.
323 (1) As used in this section, a "standard serological test" means a test for syphilis
324 approved by the department and made at an approved laboratory.
325 (2) (a) Every licensed physician [
326 pregnant or recently delivered woman for conditions relating to her pregnancy shall take or
327 cause to be taken a sample of blood of the woman at the time of first examination or within 10
328 days thereafter.
329 (b) The blood sample shall be submitted to an approved laboratory for a standard
330 serological test for syphilis.
331 (c) The provisions of this section do not apply to any female who objects thereto on the
332 grounds that she is a bona fide member of a specified, well recognized religious organization
333 whose teachings are contrary to the tests.
334 (3) (a) Every other person attending a pregnant or recently delivered woman, who is
335 not permitted by law to take blood samples, shall within 10 days from the time of first
336 attendance cause a sample of blood to be taken by a licensed physician or physician assistant.
337 (b) The blood sample shall be submitted to an approved laboratory for a standard
338 serological test for syphilis.
339 (4) (a) An approved laboratory is a laboratory approved by the department according to
340 its rules governing the approval of laboratories for the purpose of this title.
341 (b) In submitting the sample to the laboratory the physician or physician assistant shall
342 designate whether it is a prenatal test or a test following recent delivery.
343 (5) The laboratory shall transmit a detailed report of the standard serological test,
344 showing the result thereof to the physician or physician assistant.
345 The following section is affected by a coordination clause at the end of this bill.
346 Section 7. Section 26B-7-402 is amended to read:
347 26B-7-402. Minimum rules of sanitation established by department.
348 The department shall establish and enforce, or provide for the enforcement of minimum
349 rules of sanitation necessary to protect the public health. Such rules shall include, but not be
350 limited to, rules necessary for the design, construction, operation, maintenance, or expansion
351 of:
352 (1) restaurants and all places where food or drink is handled, sold or served to the
353 public;
354 (2) public swimming pools;
355 (3) public baths including saunas, spas, massage parlors, and suntan parlors;
356 (4) public bathing beaches;
357 (5) schools which are publicly or privately owned or operated;
358 (6) recreational resorts, camps, and vehicle parks;
359 (7) amusement parks and all other centers and places used for public gatherings;
360 (8) mobile home parks and highway rest stops;
361 (9) construction or labor camps;
362 (10) jails, prisons and other places of incarceration or confinement;
363 (11) hotels and motels;
364 (12) lodging houses and boarding houses;
365 (13) service stations;
366 (14) barbershops and beauty shops, including a facility in which one or more
367 individuals are engaged in:
368 (a) any of the practices licensed under Title 58, Chapter 11a, Cosmetology and
369 Associated Professions Licensing Act; or
370 (b) styling hair in accordance with the exemption from licensure described in [
371 Subsection 58-11a-304(13);
372 (15) physician [
373 (16) public buildings and grounds;
374 (17) public conveyances and terminals; and
375 (18) commercial tanning facilities.
376 Section 8. Section 26B-8-104 is amended to read:
377 26B-8-104. Birth certificates -- Execution and registration requirements.
378 (1) As used in this section, "birthing facility" means a general acute hospital or birthing
379 center as defined in Section 26B-2-201.
380 (2) For each live birth occurring in the state, a certificate shall be filed with the local
381 registrar for the district in which the birth occurred within 10 days following the birth. The
382 certificate shall be registered if it is completed and filed in accordance with this part.
383 (3) (a) For each live birth that occurs in a birthing facility, the administrator of the
384 birthing facility, or his designee, shall obtain and enter the information required under this part
385 on the certificate, securing the required signatures, and filing the certificate.
386 (b) (i) The date, time, place of birth, and required medical information shall be certified
387 by the birthing facility administrator or his designee.
388 (ii) The attending physician, physician assistant, or nurse midwife may sign the
389 certificate, but if the attending physician, physician assistant primarily responsible for
390 providing assistance to the mother at birth, or nurse midwife has not signed the certificate
391 within seven days of the date of birth, the birthing facility administrator or his designee shall
392 enter the attending physician's, physician assistant's, or nurse midwife's name and transmit the
393 certificate to the local registrar.
394 (iii) The information on the certificate about the parents shall be provided and certified
395 by the mother or father or, in their incapacity or absence, by a person with knowledge of the
396 facts.
397 (4) (a) For live births that occur outside a birthing facility, the birth certificate shall be
398 completed and filed by the physician, physician assistant, nurse, midwife, or other person
399 primarily responsible for providing assistance to the mother at the birth. If there is no such
400 person, either the presumed or declarant father shall complete and file the certificate. In his
401 absence, the mother shall complete and file the certificate, and in the event of her death or
402 disability, the owner or operator of the premises where the birth occurred shall do so.
403 (b) The certificate shall be completed as fully as possible and shall include the date,
404 time, and place of birth, the mother's name, and the signature of the person completing the
405 certificate.
406 (5) (a) For each live birth to an unmarried mother that occurs in a birthing facility, the
407 administrator or director of that facility, or his designee, shall:
408 (i) provide the birth mother and declarant father, if present, with:
409 (A) a voluntary declaration of paternity form published by the state registrar;
410 (B) oral and written notice to the birth mother and declarant father of the alternatives
411 to, the legal consequences of, and the rights and responsibilities that arise from signing the
412 declaration; and
413 (C) the opportunity to sign the declaration;
414 (ii) witness the signature of a birth mother or declarant father in accordance with
415 Section 78B-15-302 if the signature occurs at the facility;
416 (iii) enter the declarant father's information on the original birth certificate, but only if
417 the mother and declarant father have signed a voluntary declaration of paternity or a court or
418 administrative agency has issued an adjudication of paternity; and
419 (iv) file the completed declaration with the original birth certificate.
420 (b) If there is a presumed father, the voluntary declaration will only be valid if the
421 presumed father also signs the voluntary declaration.
422 (c) The state registrar shall file the information provided on the voluntary declaration
423 of paternity form with the original birth certificate and may provide certified copies of the
424 declaration of paternity as otherwise provided under Title 78B, Chapter 15, Utah Uniform
425 Parentage Act.
426 (6) (a) The state registrar shall publish a form for the voluntary declaration of paternity,
427 a description of the process for filing a voluntary declaration of paternity, and of the rights and
428 responsibilities established or effected by that filing, in accordance with Title 78B, Chapter 15,
429 Utah Uniform Parentage Act.
430 (b) Information regarding the form and services related to voluntary paternity
431 establishment shall be made available to birthing facilities and to any other entity or individual
432 upon request.
433 (7) The name of a declarant father may only be included on the birth certificate of a
434 child of unmarried parents if:
435 (a) the mother and declarant father have signed a voluntary declaration of paternity; or
436 (b) a court or administrative agency has issued an adjudication of paternity.
437 (8) Voluntary declarations of paternity, adjudications of paternity by judicial or
438 administrative agencies, and voluntary rescissions of paternity shall be filed with and
439 maintained by the state registrar for the purpose of comparing information with the state case
440 registry maintained by the Office of Recovery Services pursuant to Section 26B-9-104.
441 Section 9. Section 26B-8-115 is amended to read:
442 26B-8-115. Fetal death certificate -- Filing and registration requirements.
443 (1) A fetal death certificate shall be filed for each fetal death which occurs in this state.
444 The certificate shall be filed within five days after delivery with the local registrar or as
445 otherwise directed by the state registrar. The certificate shall be registered if it is completed and
446 filed in accordance with this part.
447 (2) When a dead fetus is delivered in an institution, the institution administrator or his
448 designated representative shall prepare and file the fetal death certificate. The attending
449 physician or physician assistant shall state in the certificate the cause of death and sign the
450 certificate.
451 (3) When a dead fetus is delivered outside an institution, the physician in attendance at
452 or immediately after delivery shall complete, sign, and file the fetal death certificate.
453 (4) When a fetal death occurs without medical attendance at or immediately after the
454 delivery or when inquiry is required by Part 2, Utah Medical Examiner, the medical examiner
455 shall investigate the cause of death and prepare and file the certificate of fetal death within five
456 days after taking charge of the case.
457 (5) When a fetal death occurs in a moving conveyance and the dead fetus is first
458 removed from the conveyance in this state or when a dead fetus is found in this state and the
459 place of death is unknown, the death shall be registered in this state. The place where the dead
460 fetus was first removed from the conveyance or found shall be considered the place of death.
461 (6) Final disposition of the dead fetus may not be made until the fetal death certificate
462 has been registered.
463 Section 10. Section 26B-8-118 is amended to read:
464 26B-8-118. Certificate of early term stillbirth.
465 (1) As used in this section, "early term stillborn child" means a product of human
466 conception, other than in the circumstances described in Subsection 76-7-301(1), that:
467 (a) is of at least 16 weeks' gestation but less than 20 weeks' gestation, calculated from
468 the day on which the mother's last normal menstrual period began to the day of delivery; and
469 (b) is not born alive.
470 (2) The state registrar shall issue a certificate of early term stillbirth to a parent of an
471 early term stillborn child if:
472 (a) the parent requests, on a form created by the state registrar, that the state registrar
473 register and issue a certificate of early term stillbirth for the early term stillborn child; and
474 (b) the parent files with the state registrar:
475 (i) (A) a signed statement from a physician, or physician assistant if a physician is not
476 in attendance at the delivery, confirming the delivery of the early term stillborn child; or
477 (B) an accurate copy of the parent's medical records related to the early term stillborn
478 child; and
479 (ii) any other record the state registrar determines, by rule made in accordance with
480 Title 63G, Chapter 3, Utah Administrative Rulemaking Act, is necessary for accurate
481 recordkeeping.
482 (3) The certificate of early term stillbirth described in Subsection (2) shall meet all of
483 the format and filing requirements of Section 26B-8-103.
484 (4) A person who prepares a certificate of early term stillbirth under this section shall
485 leave blank any references to an early term stillborn child's name if the early term stillborn
486 child's parent does not wish to provide a name for the early term stillborn child.
487 Section 11. Section 53-2a-1601 is amended to read:
488 53-2a-1601. Definitions.
489 As used in this part:
490 (1) "Emergency responder" includes a:
491 (a) firefighter;
492 (b) structural engineer;
493 (c) physician;
494 (d) physician assistant;
495 [
496 [
497 (2) "Emergency response team" means a group of emergency responders placed at the
498 direction, control, and funding of the Division of Emergency Management, in accordance with
499 an agreement between the Division of Emergency Management and a sponsoring agency and
500 the provisions of this part, to assist in urban search and rescue:
501 (a) in response to a disaster, emergency, or important event; or
502 (b) in anticipation of a forecasted severe weather event, a flood, or a planned important
503 event.
504 (3) "Emergency response team member" means an individual who is:
505 (a) an emergency responder;
506 (b) a member of an emergency response team; and
507 (c) acting within the scope of the individual's duties for an emergency response team.
508 (4) "Important event" includes an event attended by one or more officials of the United
509 States or one or more foreign dignitaries and where a large crowd has or is anticipated to
510 gather.
511 (5) "Sponsoring agency" means an entity in the state that executes a written agreement
512 to organize a National Urban Search and Rescue Response System task force as described in 44
513 C.F.R. Part 208 to assist the Federal Emergency Management Agency during a disaster or
514 emergency.
515 Section 12. Section 53-3-206 is amended to read:
516 53-3-206. Examination of applicant's physical and mental fitness to drive a motor
517 vehicle.
518 (1) The division shall examine every applicant for a license, including a test of the
519 applicant's:
520 (a) eyesight either:
521 (i) by the division; or
522 (ii) by allowing the applicant to furnish to the division a statement from a physician
523 licensed under Title 58, Chapter 67, Utah Medical Practice Act, a physician assistant licensed
524 under Title 58, Chapter 70A, Utah Physician Assistant Act, or an optometrist licensed under
525 Title 58, Chapter 16a, Utah Optometry Practice Act;
526 (b) ability to read and understand highway signs regulating, warning, and directing
527 traffic;
528 (c) ability to read and understand simple English used in highway traffic and
529 directional signs;
530 (d) knowledge of the state traffic laws;
531 (e) other physical and mental abilities the division finds necessary to determine the
532 applicant's fitness to drive a motor vehicle safely on the highways; and
533 (f) ability to exercise ordinary and responsible control driving a motor vehicle, as
534 determined by actual demonstration or other indicator.
535 (2) (a) Subject to Subsection (2)(d), and notwithstanding the provisions of Subsection
536 (1) or any other provision of law, the division shall allow an individual to take an examination
537 of the individual's knowledge of the state traffic laws in the individual's preferred language:
538 (i) if the individual is a refugee, an approved asylee, or a covered humanitarian parolee:
539 (A) the first time the individual applies for a limited-term license certificate; and
540 (B) the first time the individual applies for a renewal of a limited-term license
541 certificate; and
542 (ii) for any other individual applying for a class D license certificate:
543 (A) the first time the individual applies for a class D license certificate; and
544 (B) the first time the individual applies for a renewal of a class D license certificate.
545 (b) (i) Upon the second renewal of a refugee's, an approved asylee's, or a covered
546 humanitarian parolee's limited-term license certificate for a refugee, an approved asylee, or a
547 covered humanitarian parolee that has taken the knowledge exam in the individual's preferred
548 language under Subsection (2)(a), the division shall re-examine the individual's knowledge of
549 the state traffic laws in English.
550 (ii) Upon the second renewal of an individual's class D license certificate of an
551 individual who has taken the knowledge exam in the individual's preferred language under
552 Subsection (2)(a)(ii), the division shall re-examine the individual's knowledge of the state
553 traffic laws in English.
554 (c) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
555 division shall make rules establishing the procedures and requirements for the examination of
556 the individual's knowledge of the state traffic laws in the individual's preferred language.
557 (d) (i) Beginning on July 1, 2023, for a class D license certificate, except for a driving
558 privilege card issued under Section 53-3-207, the division shall administer the written
559 knowledge examination in as many languages as reasonably possible given budgetary and other
560 constraints.
561 (ii) If the division is unable to administer the written knowledge examination in a
562 particular language, an individual may take an examination with the assistance of a translator
563 approved by the division.
564 (iii) If an individual takes the examination with the assistance of a translator, the
565 individual is responsible for the costs of the translator.
566 (e) In order to provide the services described in Subsection (2)(d)(i), the division may
567 contract with a private vendor to provide the translation services or technology.
568 (3) (a) For an applicant for an original or a renewal of a class D license, other than a
569 driving privilege card or a limited term license certificate, the division shall provide the
570 examination of an individual's knowledge of the state traffic laws in five commonly spoken
571 languages in the state, other than English, as determined under Subsection (3)(c).
572 (b) An applicant for an original or a renewal of a class D license, other than a driving
573 privilege card or a limited term license certificate, may request to take the examination of the
574 individual's knowledge of the state traffic laws in a language other than English, if the
575 requested language is one of five commonly spoken languages in the state as determined under
576 Subsection (3)(c).
577 (c) (i) The Division of Multicultural Affairs created in Section 9-21-201 shall
578 recommend five commonly spoken languages in the state, other than English, for examination
579 of an individual's knowledge of the state traffic laws.
580 (ii) The division shall offer the examination of an individual's knowledge of the state
581 traffic laws in the five commonly spoken languages, other than English, recommended by the
582 Division of Multicultural Affairs created in Section 9-21-201.
583 (4) The division shall determine whether any facts exist that would bar granting a
584 license under Section 53-3-204.
585 (5) The division shall examine each applicant according to the class of license applied
586 for.
587 (6) An applicant for a CDL shall meet all additional requirements of Part 4, Uniform
588 Commercial Driver License Act, of this chapter.
589 (7) The division shall provide a report to the Transportation Interim Committee on or
590 before October 1, 2023, regarding the written knowledge examination in languages other than
591 English, including:
592 (a) costs associated with the program;
593 (b) the number of languages provided;
594 (c) the likelihood of adding additional languages in the future; and
595 (d) other information the division finds relevant.
596 Section 13. Section 53-3-220 is amended to read:
597 53-3-220. Offenses requiring mandatory revocation, denial, suspension, or
598 disqualification of license -- Offense requiring an extension of period -- Hearing --
599 Limited driving privileges.
600 (1) (a) The division shall immediately revoke or, when this chapter, Title 41, Chapter
601 6a, Traffic Code, or Section 76-5-303, specifically provides for denial, suspension, or
602 disqualification, the division shall deny, suspend, or disqualify the license of a person upon
603 receiving a record of the person's conviction for:
604 (i) manslaughter or negligent homicide resulting from driving a motor vehicle,
605 negligently operating a vehicle resulting in death under Section 76-5-207, or automobile
606 homicide involving using a handheld wireless communication device while driving under
607 Section 76-5-207.5;
608 (ii) driving or being in actual physical control of a motor vehicle while under the
609 influence of alcohol, any drug, or combination of them to a degree that renders the person
610 incapable of safely driving a motor vehicle as prohibited in Section 41-6a-502 or as prohibited
611 in an ordinance that complies with the requirements of Subsection 41-6a-510(1);
612 (iii) driving or being in actual physical control of a motor vehicle while having a blood
613 or breath alcohol content as prohibited in Section 41-6a-502 or as prohibited in an ordinance
614 that complies with the requirements of Subsection 41-6a-510(1);
615 (iv) perjury or the making of a false affidavit to the division under this chapter, Title
616 41, Motor Vehicles, or any other law of this state requiring the registration of motor vehicles or
617 regulating driving on highways;
618 (v) any felony under the motor vehicle laws of this state;
619 (vi) any other felony in which a motor vehicle is used to facilitate the offense;
620 (vii) failure to stop and render aid as required under the laws of this state if a motor
621 vehicle accident results in the death or personal injury of another;
622 (viii) two charges of reckless driving, impaired driving, or any combination of reckless
623 driving and impaired driving committed within a period of 12 months; but if upon a first
624 conviction of reckless driving or impaired driving the judge or justice recommends suspension
625 of the convicted person's license, the division may after a hearing suspend the license for a
626 period of three months;
627 (ix) failure to bring a motor vehicle to a stop at the command of a law enforcement
628 officer as required in Section 41-6a-210;
629 (x) any offense specified in Part 4, Uniform Commercial Driver License Act, that
630 requires disqualification;
631 (xi) a felony violation of Section 76-10-508 or 76-10-508.1 involving discharging or
632 allowing the discharge of a firearm from a vehicle;
633 (xii) using, allowing the use of, or causing to be used any explosive, chemical, or
634 incendiary device from a vehicle in violation of Subsection 76-10-306(4)(b);
635 (xiii) operating or being in actual physical control of a motor vehicle while having any
636 measurable controlled substance or metabolite of a controlled substance in the person's body in
637 violation of Section 41-6a-517;
638 (xiv) operating or being in actual physical control of a motor vehicle while having any
639 measurable or detectable amount of alcohol in the person's body in violation of Section
640 41-6a-530;
641 (xv) engaging in a motor vehicle speed contest or exhibition of speed on a highway in
642 violation of Section 41-6a-606;
643 (xvi) operating or being in actual physical control of a motor vehicle in this state
644 without an ignition interlock system in violation of Section 41-6a-518.2; or
645 (xvii) refusal of a chemical test under Subsection 41-6a-520.1(1).
646 (b) The division shall immediately revoke the license of a person upon receiving a
647 record of an adjudication under Section 80-6-701 for:
648 (i) a felony violation of Section 76-10-508 or 76-10-508.1 involving discharging or
649 allowing the discharge of a firearm from a vehicle; or
650 (ii) using, allowing the use of, or causing to be used any explosive, chemical, or
651 incendiary device from a vehicle in violation of Subsection 76-10-306(4)(b).
652 (c) (i) Except when action is taken under Section 53-3-219 for the same offense, upon
653 receiving a record of conviction, the division shall immediately suspend for six months the
654 license of the convicted person if the person was convicted of violating any one of the
655 following offenses while the person was an operator of a motor vehicle, and the court finds that
656 a driver license suspension is likely to reduce recidivism and is in the interest of public safety:
657 (A) Title 58, Chapter 37, Utah Controlled Substances Act;
658 (B) Title 58, Chapter 37a, Utah Drug Paraphernalia Act;
659 (C) Title 58, Chapter 37b, Imitation Controlled Substances Act;
660 (D) Title 58, Chapter 37c, Utah Controlled Substance Precursor Act;
661 (E) Title 58, Chapter 37d, Clandestine Drug Lab Act; or
662 (F) any criminal offense that prohibits possession, distribution, manufacture,
663 cultivation, sale, or transfer of any substance that is prohibited under the acts described in
664 Subsections (1)(c)(i)(A) through (E), or the attempt or conspiracy to possess, distribute,
665 manufacture, cultivate, sell, or transfer any substance that is prohibited under the acts described
666 in Subsections (1)(c)(i)(A) through (E).
667 (ii) Notwithstanding the provisions in Subsection (1)(c)(i), the division shall reinstate a
668 person's driving privilege before completion of the suspension period imposed under
669 Subsection (1)(c)(i) if the reporting court notifies the Driver License Division, in a manner
670 specified by the division, that the defendant is participating in or has successfully completed a
671 drug court program as defined in Section 78A-5-201.
672 (iii) If a person's driving privilege is reinstated under Subsection (1)(c)(ii), the person is
673 required to pay the license reinstatement fees under Subsection 53-3-105(26).
674 (iv) The court shall notify the division, in a manner specified by the division, if a
675 person fails to complete all requirements of the drug court program.
676 (v) Upon receiving the notification described in Subsection (1)(c)(iv), the division shall
677 suspend the person's driving privilege for a period of six months from the date of the notice,
678 and no days shall be subtracted from the six-month suspension period for which a driving
679 privilege was previously suspended under Subsection (1)(c)(i).
680 (d) (i) The division shall immediately suspend a person's driver license for conviction
681 of the offense of theft of motor vehicle fuel under Section 76-6-404.7 if the division receives:
682 (A) an order from the sentencing court requiring that the person's driver license be
683 suspended; and
684 (B) a record of the conviction.
685 (ii) An order of suspension under this section is at the discretion of the sentencing
686 court, and may not be for more than 90 days for each offense.
687 (e) (i) The division shall immediately suspend for one year the license of a person upon
688 receiving a record of:
689 (A) conviction for the first time for a violation under Section 32B-4-411; or
690 (B) an adjudication under Section 80-6-701 for a violation under Section 32B-4-411.
691 (ii) The division shall immediately suspend for a period of two years the license of a
692 person upon receiving a record of:
693 (A) (I) conviction for a second or subsequent violation under Section 32B-4-411; and
694 (II) the violation described in Subsection (1)(e)(ii)(A)(I) is within 10 years of a prior
695 conviction for a violation under Section 32B-4-411; or
696 (B) (I) a second or subsequent adjudication under Section 80-6-701 for a violation
697 under Section 32B-4-411; and
698 (II) the adjudication described in Subsection (1)(e)(ii)(B)(I) is within 10 years of a prior
699 adjudication under Section 80-6-701 for a violation under Section 32B-4-411.
700 (iii) Upon receipt of a record under Subsection (1)(e)(i) or (ii), the division shall:
701 (A) for a conviction or adjudication described in Subsection (1)(e)(i):
702 (I) impose a suspension for one year beginning on the date of conviction; or
703 (II) if the person is under the age of eligibility for a driver license, impose a suspension
704 that begins on the date of conviction and continues for one year beginning on the date of
705 eligibility for a driver license; or
706 (B) for a conviction or adjudication described in Subsection (1)(e)(ii):
707 (I) impose a suspension for a period of two years; or
708 (II) if the person is under the age of eligibility for a driver license, impose a suspension
709 that begins on the date of conviction and continues for two years beginning on the date of
710 eligibility for a driver license.
711 (iv) Upon receipt of the first order suspending a person's driving privileges under
712 Section 32B-4-411, the division shall reduce the suspension period under Subsection (1)(e)(i) if
713 ordered by the court in accordance with Subsection 32B-4-411(3)(a).
714 (v) Upon receipt of the second or subsequent order suspending a person's driving
715 privileges under Section 32B-4-411, the division shall reduce the suspension period under
716 Subsection (1)(e)(ii) if ordered by the court in accordance with Subsection 32B-4-411(3)(b).
717 (2) The division shall extend the period of the first denial, suspension, revocation, or
718 disqualification for an additional like period, to a maximum of one year for each subsequent
719 occurrence, upon receiving:
720 (a) a record of the conviction of any person on a charge of driving a motor vehicle
721 while the person's license is denied, suspended, revoked, or disqualified;
722 (b) a record of a conviction of the person for any violation of the motor vehicle law in
723 which the person was involved as a driver;
724 (c) a report of an arrest of the person for any violation of the motor vehicle law in
725 which the person was involved as a driver; or
726 (d) a report of an accident in which the person was involved as a driver.
727 (3) When the division receives a report under Subsection (2)(c) or (d) that a person is
728 driving while the person's license is denied, suspended, disqualified, or revoked, the person is
729 entitled to a hearing regarding the extension of the time of denial, suspension, disqualification,
730 or revocation originally imposed under Section 53-3-221.
731 (4) (a) The division may extend to a person the limited privilege of driving a motor
732 vehicle to and from the person's place of employment or within other specified limits on
733 recommendation of the judge in any case where a person is convicted of any of the offenses
734 referred to in Subsections (1) and (2) except:
735 (i) those offenses referred to in Subsections (1)(a)(i), (ii), (iii), (xi), (xii), (xiii), (1)(b),
736 and (1)(c)(i); and
737 (ii) those offenses referred to in Subsection (2) when the original denial, suspension,
738 revocation, or disqualification was imposed because of a violation of Section 41-6a-502,
739 41-6a-517, a local ordinance that complies with the requirements of Subsection 41-6a-510(1),
740 Section 41-6a-520, 41-6a-520.1, 76-5-102.1, or 76-5-207, or a criminal prohibition that the
741 person was charged with violating as a result of a plea bargain after having been originally
742 charged with violating one or more of these sections or ordinances, unless:
743 (A) the person has had the period of the first denial, suspension, revocation, or
744 disqualification extended for a period of at least three years;
745 (B) the division receives written verification from the person's primary care physician
746 or physician assistant that:
747 (I) to the physician's or physician assistant's knowledge the person has not used any
748 narcotic drug or other controlled substance except as prescribed by a licensed medical
749 practitioner within the last three years; and
750 (II) the physician or physician assistant is not aware of any physical, emotional, or
751 mental impairment that would affect the person's ability to operate a motor vehicle safely; and
752 (C) for a period of one year prior to the date of the request for a limited driving
753 privilege:
754 (I) the person has not been convicted of a violation of any motor vehicle law in which
755 the person was involved as the operator of the vehicle;
756 (II) the division has not received a report of an arrest for a violation of any motor
757 vehicle law in which the person was involved as the operator of the vehicle; and
758 (III) the division has not received a report of an accident in which the person was
759 involved as an operator of a vehicle.
760 (b) (i) Except as provided in Subsection (4)(b)(ii), the discretionary privilege
761 authorized in this Subsection (4):
762 (A) is limited to when undue hardship would result from a failure to grant the
763 privilege; and
764 (B) may be granted only once to any person during any single period of denial,
765 suspension, revocation, or disqualification, or extension of that denial, suspension, revocation,
766 or disqualification.
767 (ii) The discretionary privilege authorized in Subsection (4)(a)(ii):
768 (A) is limited to when the limited privilege is necessary for the person to commute to
769 school or work; and
770 (B) may be granted only once to any person during any single period of denial,
771 suspension, revocation, or disqualification, or extension of that denial, suspension, revocation,
772 or disqualification.
773 (c) A limited CDL may not be granted to a person disqualified under Part 4, Uniform
774 Commercial Driver License Act, or whose license has been revoked, suspended, cancelled, or
775 denied under this chapter.
776 Section 14. Section 53G-6-204 is amended to read:
777 53G-6-204. School-age children exempt from school attendance.
778 (1) (a) A local school board or charter school governing board may excuse a school-age
779 child from attendance for any of the following reasons:
780 (i) a school-age child over age 16 may receive a partial release from school to enter
781 employment, or attend a trade school, if the school-age child has completed grade 8; or
782 (ii) on an annual basis, a school-age child may receive a full release from attending a
783 public, regularly established private, or part-time school or class if:
784 (A) the school-age child has already completed the work required for graduation from
785 high school;
786 (B) the school-age child is in a physical or mental condition, certified by a competent
787 physician or physician assistant if required by the local school board or charter school
788 governing board, which renders attendance inexpedient and impracticable;
789 (C) proper influences and adequate opportunities for education are provided in
790 connection with the school-age child's employment; or
791 (D) the district superintendent or charter school governing board has determined that a
792 school-age child over the age of 16 is unable to profit from attendance at school because of
793 inability or a continuing negative attitude toward school regulations and discipline.
794 (b) A school-age child receiving a partial release from school under Subsection
795 (1)(a)(i) is required to attend:
796 (i) school part time as prescribed by the local school board or charter school governing
797 board; or
798 (ii) a home school part time.
799 (c) In each case, evidence of reasons for granting an exemption under Subsection (1)
800 must be sufficient to satisfy the local school board or charter school governing board.
801 (d) A local school board or charter school governing board that excuses a school-age
802 child from attendance as provided by this Subsection (1) shall issue a certificate that the child
803 is excused from attendance during the time specified on the certificate.
804 (2) (a) (i) As used in this Subsection (2)(a), "child abuse" means a criminal felony or
805 attempted felony offense of which an individual is convicted, or to which an individual pleads
806 guilty or no contest, for conduct that constitutes any of the following:
807 (A) child abuse under Section 76-5-109;
808 (B) aggravated child abuse under Section 76-5-109.2;
809 (C) child abandonment under Section 76-5-109.3;
810 (D) commission of domestic violence in the presence of a child under Section
811 76-5-114;
812 (E) child abuse homicide under Section 76-5-208;
813 (F) child kidnapping under Section 76-5-301.1;
814 (G) human trafficking of a child under Section 76-5-308.5;
815 (H) an offense described in Title 76, Chapter 5, Part 4, Sexual Offenses, or in Title 76,
816 Chapter 5b, Part 2, Sexual Exploitation, if the victim is under 18 years old;
817 (I) sexual exploitation of a minor under Section 76-5b-201;
818 (J) aggravated sexual exploitation of a minor under Section 76-5b-201.1; or
819 (K) an offense in another state that, if committed in this state, would constitute an
820 offense described in this Subsection (2)(a)(i).
821 (ii) Except as provided in Subsection (2)(a)(iii), a local school board shall excuse a
822 school-age child from attendance, if the school-age child's parent or legal guardian files a
823 signed and notarized affidavit with the school-age child's school district of residence, as
824 defined in Section 53G-6-302, that:
825 (A) the school-age child will attend a home school; and
826 (B) the parent or legal guardian assumes sole responsibility for the education of the
827 school-age child, except to the extent the school-age child is dual enrolled in a public school as
828 provided in Section 53G-6-702.
829 (iii) If a parent or legal guardian has been convicted of child abuse or if a court of
830 competent jurisdiction has made a substantiated finding of child abuse against the parent or
831 legal guardian:
832 (A) the parent or legal guardian may not assume responsibility for the education of a
833 school-age child under Subsection (2)(a)(ii); and
834 (B) the local school board may not accept the affidavit described in Subsection
835 (2)(a)(ii) from the parent or legal guardian or otherwise exempt the school-age child from
836 attendance under Subsection (2)(a)(ii) in relation to the parent's or legal guardian's intent to
837 home school the child.
838 (iv) Nothing in this Subsection (2)(a) affects the ability of another of a child's parents
839 or legal guardians who is not prohibited under Subsection (2)(a)(iii) to file the affidavit
840 described in Subsection (2)(a)(ii).
841 (b) A signed and notarized affidavit filed in accordance with Subsection (2)(a) shall
842 remain in effect as long as:
843 (i) the school-age child attends a home school;
844 (ii) the school district where the affidavit was filed remains the school-age child's
845 district of residence; and
846 (iii) the parent or legal guardian who filed the signed and notarized affidavit has not
847 been convicted of child abuse or been the subject of a substantiated finding of child abuse by a
848 court of competent jurisdiction.
849 (c) A parent or legal guardian of a school-age child who attends a home school is
850 solely responsible for:
851 (i) the selection of instructional materials and textbooks;
852 (ii) the time, place, and method of instruction; and
853 (iii) the evaluation of the home school instruction.
854 (d) A local school board may not:
855 (i) require a parent or legal guardian of a school-age child who attends a home school
856 to maintain records of instruction or attendance;
857 (ii) require credentials for individuals providing home school instruction;
858 (iii) inspect home school facilities; or
859 (iv) require standardized or other testing of home school students.
860 (e) Upon the request of a parent or legal guardian, a local school board shall identify
861 the knowledge, skills, and competencies a student is recommended to attain by grade level and
862 subject area to assist the parent or legal guardian in achieving college and career readiness
863 through home schooling.
864 (f) A local school board that excuses a school-age child from attendance under this
865 Subsection (2) shall annually issue a certificate stating that the school-age child is excused
866 from attendance for the specified school year.
867 (g) A local school board shall issue a certificate excusing a school-age child from
868 attendance:
869 (i) within 30 days after receipt of a signed and notarized affidavit filed by the
870 school-age child's parent or legal guardian under this Subsection (2); and
871 (ii) on or before August 1 each year thereafter unless:
872 (A) the school-age child enrolls in a school within the school district;
873 (B) the school-age child's parent or legal guardian notifies the school district that the
874 school-age child no longer attends a home school; or
875 (C) the school-age child's parent or legal guardian notifies the school district that the
876 school-age child's school district of residence has changed.
877 (3) A parent or legal guardian who is eligible to file and files a signed and notarized
878 affidavit under Subsection (2)(a) is exempt from the application of Subsections 53G-6-202(2),
879 (5), and (6).
880 (4) (a) Nothing in this section may be construed to prohibit or discourage voluntary
881 cooperation, resource sharing, or testing opportunities between a school or school district and a
882 parent or legal guardian of a child attending a home school.
883 (b) The exemptions in this section apply regardless of whether:
884 (i) a parent or legal guardian provides education instruction to the parent's or legal
885 guardian's child alone or in cooperation with other parents or legal guardians similarly
886 exempted under this section; or
887 (ii) the parent or legal guardian makes payment for educational services the parent's or
888 legal guardian's child receives.
889 Section 15. Section 53G-6-603 is amended to read:
890 53G-6-603. Requirement of birth certificate for enrollment of students --
891 Procedures.
892 (1) As used in this section:
893 (a) "Child trafficking" means human trafficking of a child in violation of Section
894 76-5-308.5.
895 (b) "Enroller" means an individual who enrolls a student in a public school.
896 (c) "Review team" means a team described in Subsection (4), assigned to determine a
897 student's biological age as described in this section.
898 (d) "Social service provider" means the same as that term is defined in Section
899 53E-3-524.
900 (2) Except as provided in Subsection (3), upon enrollment of a student for the first time
901 in a particular school, that school shall notify the enroller in writing that within 30 days the
902 enroller shall provide to the school either:
903 (a) a certified copy of the student's birth certificate; or
904 (b) (i) other reliable proof of the student's:
905 (A) identity;
906 (B) biological age; and
907 (C) relationship to the student's legally responsible individual; and
908 (ii) an affidavit explaining the enroller's inability to produce a copy of the student's
909 birth certificate.
910 (3) (a) If the documentation described in Subsection (2)(a) or (2)(b)(i) inaccurately
911 reflects the student's biological age, the enroller shall provide to the school:
912 (i) an affidavit explaining the reasons for the inaccuracy described in Subsection (3)(a);
913 and
914 (ii) except as provided in Subsection (4), supporting documentation that establishes the
915 student's biological age.
916 (b) The supporting documentation described in Subsection (3)(a)(ii) may include:
917 (i) a religious, hospital, [
918 student's date of birth;
919 (ii) an entry in a family religious text;
920 (iii) an adoption record;
921 (iv) previously verified school records;
922 (v) previously verified immunization records;
923 (vi) documentation from a social service provider; or
924 (vii) other legal documentation, including from a consulate, that reflects the student's
925 biological age.
926 (4) (a) If the supporting documentation described in Subsection (3)(b) is not available,
927 the school shall assign a review team to work with the enroller to determine the student's
928 biological age for an LEA to use for a student's enrollment and appropriate placement in a
929 public school.
930 (b) The review team described in Subsection (4)(a):
931 (i) may include:
932 (A) an appropriate district administrator;
933 (B) the student's teacher or teachers;
934 (C) the school principal;
935 (D) a school counselor;
936 (E) a school social worker;
937 (F) a school psychologist;
938 (G) a culturally competent and trauma-informed community representative;
939 (H) a school nurse or other school health specialist;
940 (I) an interpreter, if necessary; or
941 (J) a relevant educational equity administrator; and
942 (ii) shall include at least three members, at least one of which has completed the
943 instruction described in Subsection 53G-9-207(3)(a), no more than two years prior to the
944 member's appointment to the review team.
945 (c) In addition to any duty to comply with the mandatory reporting requirements
946 described in Sections 53E-6-701 and 62A-4a-403, a school shall report to local law
947 enforcement and to the division any sign of child trafficking that the review team identifies in
948 carrying out the review team's duties described in Subsection (4)(a).
949 Section 16. Section 53G-9-403 is amended to read:
950 53G-9-403. Personnel to perform health examination.
951 A local school board may use teachers or school nurses to conduct examinations
952 required under this part and licensed physicians or physician assistants as needed for medical
953 consultation related to those examinations.
954 Section 17. Section 58-37c-3 is amended to read:
955 58-37c-3. Definitions.
956 In addition to the definitions in Section 58-1-102, as used in this chapter:
957 (1) "Controlled substance precursor" includes a chemical reagent and means any of the
958 following:
959 (a) Phenyl-2-propanone;
960 (b) Methylamine;
961 (c) Ethylamine;
962 (d) D-lysergic acid;
963 (e) Ergotamine and its salts;
964 (f) Diethyl malonate;
965 (g) Malonic acid;
966 (h) Ethyl malonate;
967 (i) Barbituric acid;
968 (j) Piperidine and its salts;
969 (k) N-acetylanthranilic acid and its salts;
970 (l) Pyrrolidine;
971 (m) Phenylacetic acid and its salts;
972 (n) Anthranilic acid and its salts;
973 (o) Morpholine;
974 (p) Ephedrine;
975 (q) Pseudoephedrine;
976 (r) Norpseudoephedrine;
977 (s) Phenylpropanolamine;
978 (t) Benzyl cyanide;
979 (u) Ergonovine and its salts;
980 (v) 3,4-Methylenedioxyphenyl-2-propanone;
981 (w) propionic anhydride;
982 (x) Insosafrole;
983 (y) Safrole;
984 (z) Piperonal;
985 (aa) N-Methylephedrine;
986 (bb) N-ethylephedrine;
987 (cc) N-methylpseudoephedrine;
988 (dd) N-ethylpseudoephedrine;
989 (ee) Hydriotic acid;
990 (ff) gamma butyrolactone (GBL), including butyrolactone, 1,2 butanolide,
991 2-oxanolone, tetrahydro-2-furanone, dihydro-2(3H)-furanone, and tetramethylene glycol, but
992 not including gamma aminobutric acid (GABA);
993 (gg) 1,4 butanediol;
994 (hh) any salt, isomer, or salt of an isomer of the chemicals listed in Subsections (1)(a)
995 through (gg);
996 (ii) Crystal iodine;
997 (jj) Iodine at concentrations greater than 1.5% by weight in a solution or matrix;
998 (kk) Red phosphorous, except as provided in Section 58-37c-19.7;
999 (ll) anhydrous ammonia, except as provided in Section 58-37c-19.9;
1000 (mm) any controlled substance precursor listed under the provisions of the Federal
1001 Controlled Substances Act which is designated by the director under the emergency listing
1002 provisions set forth in Section 58-37c-14; and
1003 (nn) any chemical which is designated by the director under the emergency listing
1004 provisions set forth in Section 58-37c-14.
1005 (2) "Deliver," "delivery," "transfer," or "furnish" means the actual, constructive, or
1006 attempted transfer of a controlled substance precursor.
1007 (3) "Matrix" means something, as a substance, in which something else originates,
1008 develops, or is contained.
1009 (4) "Person" means any individual, group of individuals, proprietorship, partnership,
1010 joint venture, corporation, or organization of any type or kind.
1011 (5) "Practitioner" means a physician, physician assistant, dentist, podiatric physician,
1012 veterinarian, pharmacist, scientific investigator, pharmacy, hospital, pharmaceutical
1013 manufacturer, or other person licensed, registered, or otherwise permitted to distribute,
1014 dispense, conduct research with respect to, administer, or use in teaching or chemical analysis a
1015 controlled substance in the course of professional practice or research in this state.
1016 (6) (a) "Regulated distributor" means a person within the state who provides, sells,
1017 furnishes, transfers, or otherwise supplies a listed controlled substance precursor chemical in a
1018 regulated transaction.
1019 (b) "Regulated distributor" does not include any person excluded from regulation under
1020 this chapter.
1021 (7) (a) "Regulated purchaser" means any person within the state who receives a listed
1022 controlled substance precursor chemical in a regulated transaction.
1023 (b) "Regulated purchaser" does not include any person excluded from regulation under
1024 this chapter.
1025 (8) "Regulated transaction" means any actual, constructive or attempted:
1026 (a) transfer, distribution, delivery, or furnishing by a person within the state to another
1027 person within or outside of the state of a threshold amount of a listed precursor chemical; or
1028 (b) purchase or acquisition by any means by a person within the state from another
1029 person within or outside the state of a threshold amount of a listed precursor chemical.
1030 (9) "Retail distributor" means a grocery store, general merchandise store, drug store, or
1031 other entity or person whose activities as a distributor are limited almost exclusively to sales
1032 for personal use:
1033 (a) in both number of sales and volume of sales; and
1034 (b) either directly to walk-in customers or in face-to-face transactions by direct sales.
1035 (10) "Threshold amount of a listed precursor chemical" means any amount of a
1036 controlled substance precursor or a specified amount of a controlled substance precursor in a
1037 matrix; however, the division may exempt from the provisions of this chapter a specific
1038 controlled substance precursor in a specific amount and in certain types of transactions which
1039 provisions for exemption shall be defined by the division by rule adopted pursuant to Title
1040 63G, Chapter 3, Utah Administrative Rulemaking Act.
1041 (11) "Unlawful conduct" as defined in Section 58-1-501 includes knowingly and
1042 intentionally:
1043 (a) engaging in a regulated transaction without first being appropriately licensed or
1044 exempted from licensure under this chapter;
1045 (b) acting as a regulated distributor and selling, transferring, or in any other way
1046 conveying a controlled substance precursor to a person within the state who is not appropriately
1047 licensed or exempted from licensure as a regulated purchaser, or selling, transferring, or
1048 otherwise conveying a controlled substance precursor to a person outside of the state and
1049 failing to report the transaction as required;
1050 (c) acting as a regulated purchaser and purchasing or in any other way obtaining a
1051 controlled substance precursor from a person within the state who is not a licensed regulated
1052 distributor, or purchasing or otherwise obtaining a controlled substance precursor from a
1053 person outside of the state and failing to report the transaction as required;
1054 (d) engaging in a regulated transaction and failing to submit reports and keep required
1055 records of inventories required under the provisions of this chapter or rules adopted pursuant to
1056 this chapter;
1057 (e) making any false statement in any application for license, in any record to be kept,
1058 or on any report submitted as required under this chapter;
1059 (f) with the intent of causing the evasion of the recordkeeping or reporting
1060 requirements of this chapter and rules related to this chapter, receiving or distributing any listed
1061 controlled substance precursor chemical in any manner designed so that the making of records
1062 or filing of reports required under this chapter is not required;
1063 (g) failing to take immediate steps to comply with licensure, reporting, or
1064 recordkeeping requirements of this chapter because of lack of knowledge of those
1065 requirements, upon becoming informed of the requirements;
1066 (h) presenting false or fraudulent identification where or when receiving or purchasing
1067 a listed controlled substance precursor chemical;
1068 (i) creating a chemical mixture for the purpose of evading any licensure, reporting or
1069 recordkeeping requirement of this chapter or rules related to this chapter, or receiving a
1070 chemical mixture created for that purpose;
1071 (j) if the person is at least 18 years of age, employing, hiring, using, persuading,
1072 inducing, enticing, or coercing another person under 18 years of age to violate any provision of
1073 this chapter, or assisting in avoiding detection or apprehension for any violation of this chapter
1074 by any federal, state, or local law enforcement official; and
1075 (k) obtaining or attempting to obtain or to possess any controlled substance precursor
1076 or any combination of controlled substance precursors knowing or having a reasonable cause to
1077 believe that the controlled substance precursor is intended to be used in the unlawful
1078 manufacture of any controlled substance.
1079 (12) "Unprofessional conduct" as defined in Section 58-1-102 and as may be further
1080 defined by rule includes the following:
1081 (a) violation of any provision of this chapter, the Controlled Substance Act of this state
1082 or any other state, or the Federal Controlled Substance Act; and
1083 (b) refusing to allow agents or representatives of the division or authorized law
1084 enforcement personnel to inspect inventories or controlled substance precursors or records or
1085 reports relating to purchases and sales or distribution of controlled substance precursors as such
1086 records and reports are required under this chapter.
1087 Section 18. Section 75-2a-104 is amended to read:
1088 75-2a-104. Capacity to make health care decisions -- Presumption -- Overcoming
1089 presumption.
1090 (1) An adult is presumed to have:
1091 (a) health care decision making capacity; and
1092 (b) capacity to make or revoke an advance health care directive.
1093 (2) To overcome the presumption of capacity described in Subsection (1)(a), a
1094 physician, an APRN, or[
1095 examined the adult and assessed the adult's health care decision making capacity must:
1096 (a) find that the adult lacks health care decision making capacity;
1097 (b) record the finding in the adult's medical chart including an indication of whether
1098 the adult is likely to regain health care decision making capacity; and
1099 (c) make a reasonable effort to communicate the determination to:
1100 (i) the adult;
1101 (ii) other health care providers or health care facilities that the person who makes the
1102 finding would routinely inform of such a finding; and
1103 (iii) if the adult has a surrogate, any known surrogate.
1104 (3) (a) An adult who is found to lack health care decision making capacity in
1105 accordance with Subsection (2) may, at any time, challenge the finding by:
1106 (i) submitting to a health care provider a written notice stating that the adult disagrees
1107 with the physician's or physician assistant's finding; or
1108 (ii) orally informing the health care provider that the adult disagrees with the finding.
1109 (b) A health care provider who is informed of a challenge under Subsection (3)(a),
1110 shall, if the adult has a surrogate, promptly inform the surrogate of the adult's challenge.
1111 (c) A surrogate informed of a challenge to a finding under this section, or the adult if
1112 no surrogate is acting on the adult's behalf, shall inform the following of the adult's challenge:
1113 (i) any other health care providers involved in the adult's care; and
1114 (ii) the health care facility, if any, in which the adult is receiving care.
1115 (d) Unless otherwise ordered by a court, a finding, under Subsection (2), that the adult
1116 lacks health care decision making capacity, is not in effect if the adult challenges the finding
1117 under Subsection (3)(a).
1118 (e) If an adult does not challenge the finding described in Subsection (2), the health
1119 care provider and health care facility may rely on a surrogate, pursuant to the provisions of this
1120 chapter, to make health care decisions for the adult.
1121 (4) A health care provider or health care facility that relies on a surrogate to make
1122 decisions on behalf of an adult has an ongoing obligation to consider whether the adult
1123 continues to lack health care decision making capacity.
1124 (5) If at any time a health care provider finds, based on an examination and assessment,
1125 that the adult has regained health care decision making capacity, the health care provider shall
1126 record the results of the assessment in the adult's medical record, and the adult can direct the
1127 adult's own health care.
1128 [
1129
1130
1131 Section 19. Section 75-2a-106 is amended to read:
1132 75-2a-106. Emergency medical services -- POLST order.
1133 (1) A POLST order may be created by or on behalf of a person as described in this
1134 section.
1135 (2) A POLST order shall, in consultation with the person authorized to consent to the
1136 order pursuant to this section, be prepared by:
1137 (a) the physician, APRN, or[
1138 person to whom the POLST order relates; or
1139 (b) a health care provider who:
1140 (i) is acting under the supervision of a person described in Subsection (2)(a); and
1141 (ii) is:
1142 (A) a nurse, licensed under Title 58, Chapter 31b, Nurse Practice Act;
1143 (B) a physician assistant, licensed under Title 58, Chapter 70a, Utah Physician
1144 Assistant Act;
1145 (C) a mental health professional, licensed under Title 58, Chapter 60, Mental Health
1146 Professional Practice Act; or
1147 (D) another health care provider, designated by rule as described in Subsection (10).
1148 (3) A POLST order shall be signed:
1149 (a) personally, by the physician, APRN, or[
1150 assistant of the person to whom the POLST order relates; and
1151 (b) (i) if the person to whom the POLST order relates is an adult with health care
1152 decision making capacity, by:
1153 (A) the person; or
1154 (B) an adult who is directed by the person to sign the POLST order on behalf of the
1155 person;
1156 (ii) if the person to whom the POLST order relates is an adult who lacks health care
1157 decision making capacity, by:
1158 (A) the surrogate with the highest priority under Section 75-2a-111;
1159 (B) the majority of the class of surrogates with the highest priority under Section
1160 75-2a-111; or
1161 (C) a person directed to sign the POLST order by, and on behalf of, the persons
1162 described in Subsection (3)(b)(ii)(A) or (B); or
1163 (iii) if the person to whom the POLST order relates is a minor, by a parent or guardian
1164 of the minor.
1165 (4) If a POLST order relates to a minor and directs that life sustaining treatment be
1166 withheld or withdrawn from the minor, the order shall include a certification by two physicians
1167 that, in their clinical judgment, an order to withhold or withdraw life sustaining treatment is in
1168 the best interest of the minor.
1169 (5) A POLST order:
1170 (a) shall be in writing, on a form designated by the Department of Health and Human
1171 Services;
1172 (b) shall state the date on which the POLST order was made;
1173 (c) may specify the level of life sustaining care to be provided to the person to whom
1174 the order relates; and
1175 (d) may direct that life sustaining care be withheld or withdrawn from the person to
1176 whom the order relates.
1177 (6) A health care provider or emergency medical service provider, licensed or certified
1178 under Title 26B, Chapter 4, Part 1, Utah Emergency Medical Services System, is immune from
1179 civil or criminal liability, and is not subject to discipline for unprofessional conduct, for:
1180 (a) complying with a POLST order in good faith; or
1181 (b) providing life sustaining treatment to a person when a POLST order directs that the
1182 life sustaining treatment be withheld or withdrawn.
1183 (7) To the extent that the provisions of a POLST order described in this section conflict
1184 with the provisions of an advance health care directive made under Section 75-2a-107, the
1185 provisions of the POLST order take precedence.
1186 (8) An adult, or a parent or guardian of a minor, may revoke a POLST order by:
1187 (a) orally informing emergency service personnel;
1188 (b) writing "void" across the POLST order form;
1189 (c) burning, tearing, or otherwise destroying or defacing:
1190 (i) the POLST order form; or
1191 (ii) a bracelet or other evidence of the POLST order;
1192 (d) asking another adult to take the action described in this Subsection (8) on the
1193 person's behalf;
1194 (e) signing or directing another adult to sign a written revocation on the person's
1195 behalf;
1196 (f) stating, in the presence of an adult witness, that the person wishes to revoke the
1197 order; or
1198 (g) completing a new POLST order.
1199 (9) (a) Except as provided in Subsection (9)(c), a surrogate for an adult who lacks
1200 health care decision making capacity may only revoke a POLST order if the revocation is
1201 consistent with the substituted judgment standard.
1202 (b) Except as provided in Subsection (9)(c), a surrogate who has authority under this
1203 section to sign a POLST order may revoke a POLST order, in accordance with Subsection
1204 (9)(a), by:
1205 (i) signing a written revocation of the POLST order; or
1206 (ii) completing and signing a new POLST order.
1207 (c) A surrogate may not revoke a POLST order during the period of time beginning
1208 when an emergency service provider is contacted for assistance, and ending when the
1209 emergency ends.
1210 (10) (a) The Department of Health and Human Services shall make rules, in
1211 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to:
1212 (i) create the forms and systems described in this section; and
1213 (ii) develop uniform instructions for the form established in Section 75-2a-117.
1214 (b) The Department of Health and Human Services may make rules, in accordance
1215 with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to designate health care
1216 professionals, in addition to those described in Subsection (2)(b)(ii), who may prepare a
1217 POLST order.
1218 (c) The Department of Health and Human Services may assist others with training of
1219 health care professionals regarding this chapter.
1220 [
1221
1222
1223 [
1224 (i) the provisions of Title 46, Chapter 4, Uniform Electronic Transactions Act, apply to
1225 any signature required on the POLST order; and
1226 (ii) a verbal confirmation satisfies the requirement for a signature from an individual
1227 under Subsection (3)(b)(ii) or (iii), if:
1228 (A) requiring the individual described in Subsection (3)(b)(i)(B), (ii), or (iii) to sign the
1229 POLST order in person or electronically would require significant difficulty or expense; and
1230 (B) a licensed health care provider witnesses the verbal confirmation and signs the
1231 POLST order attesting that the health care provider witnessed the verbal confirmation.
1232 (b) The health care provider described in Subsection [
1233 (i) may not be the same individual who signs the POLST order under Subsection
1234 (3)(a); and
1235 (ii) shall verify, in accordance with HIPAA as defined in Section 26B-3-126, the
1236 identity of the individual who is providing the verbal confirmation.
1237 Section 20. Section 75-2a-117 is amended to read:
1238 75-2a-117. Optional form.
1239 (1) The form created in Subsection (2), or a substantially similar form, is presumed
1240 valid under this chapter.
1241 (2) The following form is presumed valid under Subsection (1):
1242
1243
1244 Part I: Allows you to name another person to make health care decisions for you when you
1245 cannot make decisions or speak for yourself.
1246 Part II: Allows you to record your wishes about health care in writing.
1247 Part III: Tells you how to revoke or change this directive.
1248 Part IV: Makes your directive legal.
1249 __________________________________________________________________________
1250
1251 Name: ____________________________________________________________________
1252 Street Address: _____________________________________________________________
1253 City, State, Zip Code:
1254 _____________________________________________________________
1255 Telephone: _________________________ Cell Phone: ____________________________
1256 Birth date: _____________
1257 ____________________________________________________________________________
1258
1259 A. No Agent
1260 If you do not want to name an agent: initial the box below, then go to Part II; do not name an
1261 agent in B or C below. No one can force you to name an agent.
1262 ______ I do not want to choose an agent.
1263 B. My Agent
1264 Agent's Name:
1265 ______________________________________________________________
1266 Street Address:
1267 ______________________________________________________________
1268 City, State, Zip Code:
1269 ______________________________________________________________
1270 Home Phone: ( ) _________ Cell Phone: ( ) _________ Work Phone: ( ) __________
1271 C. My Alternate Agent
1272 This person will serve as your agent if your agent, named above, is unable or unwilling to
1273 serve.
1274 Alternate Agent's Name:
1275 ______________________________________________________
1276 Street Address:
1277 ______________________________________________________________
1278 City, State, Zip Code:
1279 ______________________________________________________________
1280 Home Phone: ( ) _________ Cell Phone: ( ) _________ Work Phone: ( ) __________
1281 D. Agent's Authority
1282 If I cannot make decisions or speak for myself (in other words, after my physician or another
1283 authorized provider finds that I lack health care decision making capacity under Section
1284 75-2a-104 of the Advance Health Care Directive Act), my agent has the power to make any
1285 health care decision I could have made such as, but not limited to:
1286 • Consent to, refuse, or withdraw any health care. This may include care to prolong my life
1287 such as food and fluids by tube, use of antibiotics, CPR (cardiopulmonary resuscitation), and
1288 dialysis, and mental health care, such as convulsive therapy and psychoactive medications.
1289 This authority is subject to any limits in paragraph F of Part I or in Part II of this directive.
1290 • Hire and fire health care providers.
1291 • Ask questions and get answers from health care providers.
1292 • Consent to admission or transfer to a health care provider or health care facility, including a
1293 mental health facility, subject to any limits in paragraphs E and F of Part I.
1294 • Get copies of my medical records.
1295 • Ask for consultations or second opinions.
1296 My agent cannot force health care against my will, even if a physician has found that I lack
1297 health care decision making capacity.
1298 E. Other Authority
1299 My agent has the powers below ONLY IF I initial the "yes" option that precedes the statement.
1300 I authorize my agent to:
1301 YES _____ NO _____ Get copies of my medical records at any time, even when I can
1302 speak for myself.
1303 YES _____ NO _____ Admit me to a licensed health care facility, such as a hospital,
1304 nursing home, assisted living, or other facility for long-term placement other than convalescent
1305 or recuperative care.
1306 F. Limits/Expansion of Authority
1307 I wish to limit or expand the powers of my health care agent as follows:
1308 ____________________________________________________________________________
1309 ____________________________________________________________________________
1310 G. Nomination of Guardian
1311 Even though appointing an agent should help you avoid a guardianship, a guardianship may
1312 still be necessary. Initial the "YES" option if you want the court to appoint your agent or, if
1313 your agent is unable or unwilling to serve, your alternate agent, to serve as your guardian, if a
1314 guardianship is ever necessary.
1315 YES _____ NO _____
1316 I, being of sound mind and not acting under duress, fraud, or other undue influence, do hereby
1317 nominate my agent, or if my agent is unable or unwilling to serve, I hereby nominate my
1318 alternate agent, to serve as my guardian in the event that, after the date of this instrument, I
1319 become incapacitated.
1320 H. Consent to Participate in Medical Research
1321 YES _____ NO _____ I authorize my agent to consent to my participation in medical
1322 research or clinical trials, even if I may not benefit from the results.
1323 I. Organ Donation
1324 YES _____ NO _____ If I have not otherwise agreed to organ donation, my agent may
1325 consent to the donation of my organs for the purpose of organ transplantation.
1326 ____________________________________________________________________________
1327
1328 I want my health care providers to follow the instructions I give them when I am being treated,
1329 even if my instructions conflict with these or other advance directives. My health care
1330 providers should always provide health care to keep me as comfortable and functional as
1331 possible.
1332 Choose only one of the following options, numbered Option 1 through Option 4, by placing
1333 your initials before the numbered statement. Do not initial more than one option. If you do not
1334 wish to document end-of-life wishes, initial Option 4. You may choose to draw a line through
1335 the options that you are not choosing.
1336 Option 1
1337 ________ Initial
1338 I choose to let my agent decide. I have chosen my agent carefully. I have talked with my agent
1339 about my health care wishes. I trust my agent to make the health care decisions for me that I
1340 would make under the circumstances.
1341 Additional Comments:
1342 _____________________________________________________________________
1343 Option 2
1344 ________ Initial
1345 I choose to prolong life. Regardless of my condition or prognosis, I want my health care team
1346 to try to prolong my life as long as possible within the limits of generally accepted health care
1347 standards.
1348 Other:
1349 _____________________________________________________________________
1350 Option 3
1351 ________ Initial
1352 I choose not to receive care for the purpose of prolonging life, including food and fluids by
1353 tube, antibiotics, CPR, or dialysis being used to prolong my life. I always want comfort care
1354 and routine medical care that will keep me as comfortable and functional as possible, even if
1355 that care may prolong my life.
1356 If you choose this option, you must also choose either (a) or (b), below.
1357 ______ Initial
1358 (a) I put no limit on the ability of my health care provider or agent to withhold or withdraw
1359 life-sustaining care.
1360 If you selected (a), above, do not choose any options under (b).
1361 ______ Initial
1362 (b) My health care provider should withhold or withdraw life-sustaining care if at least one of
1363 the following initialed conditions is met:
1364 _____ I have a progressive illness that will cause death.
1365 _____ I am close to death and am unlikely to recover.
1366 _____ I cannot communicate and it is unlikely that my condition will improve.
1367 _____ I do not recognize my friends or family and it is unlikely that my condition will
1368 improve.
1369 _____ I am in a persistent vegetative state.
1370 Other:
1371 _____________________________________________________________________
1372 Option 4
1373 ________ Initial
1374 I do not wish to express preferences about health care wishes in this directive.
1375 Other:
1376 _____________________________________________________________________
1377 Additional instructions about your health care wishes:
1378 ____________________________________________________________________________
1379 ____________________________________________________________________________
1380 If you do not want emergency medical service providers to provide CPR or other life sustaining
1381 measures, you must work with a physician, physician assistant, or APRN to complete an order
1382 that reflects your wishes on a form approved by the Utah Department of Health and Human
1383 Services.
1384
1385 I may revoke or change this directive by:
1386 1. Writing "void" across the form, or burning, tearing, or otherwise destroying or defacing this
1387 document or directing another person to do the same on my behalf;
1388 2. Signing a written revocation of the directive, or directing another person to sign a
1389 revocation on my behalf;
1390 3. Stating that I wish to revoke the directive in the presence of a witness who: is 18 years of
1391 age or older; will not be appointed as my agent in a substitute directive; will not become a
1392 default surrogate if the directive is revoked; and signs and dates a written document confirming
1393 my statement; or
1394 4. Signing a new directive. (If you sign more than one Advance Health Care Directive, the
1395 most recent one applies.)
1396
1397 I sign this directive voluntarily. I understand the choices I have made and declare that I am
1398 emotionally and mentally competent to make this directive. My signature on this form revokes
1399 any living will or power of attorney form, naming a health care agent, that I have completed in
1400 the past.
1401 ____________________________________
1402 Date
1403 ________________________________________________
1404 Signature
1405 ____________________________________________________________________________
1406 City, County, and State of Residence
1407 I have witnessed the signing of this directive, I am 18 years of age or older, and I am not:
1408 1. related to the declarant by blood or marriage;
1409 2. entitled to any portion of the declarant's estate according to the laws of intestate succession
1410 of any state or jurisdiction or under any will or codicil of the declarant;
1411 3. a beneficiary of a life insurance policy, trust, qualified plan, pay on death account, or
1412 transfer on death deed that is held, owned, made, or established by, or on behalf of, the
1413 declarant;
1414 4. entitled to benefit financially upon the death of the declarant;
1415 5. entitled to a right to, or interest in, real or personal property upon the death of the declarant;
1416 6. directly financially responsible for the declarant's medical care;
1417 7. a health care provider who is providing care to the declarant or an administrator at a health
1418 care facility in which the declarant is receiving care; or
1419 8. the appointed agent or alternate agent.
1420 _____________________________________ __________________________________
1421 Signature of Witness Printed Name of Witness
1422 _____________________________________ ___________ _________ _________
1423 Street Address City State Zip Code
1424 If the witness is signing to confirm an oral directive, describe below the circumstances under
1425 which the directive was made.
1426 ____________________________________________________________________________
1427 ____________________________________________________________________________
1428 Section 21. Section 75-5-301.5 is amended to read:
1429 75-5-301.5. Rights of a person alleged to be incapacitated -- Rights of an
1430 incapacitated person.
1431 (1) Except as otherwise provided by this chapter or any other law, a person alleged to
1432 be incapacitated has the right to:
1433 (a) be represented by counsel before a guardianship is imposed and have counsel
1434 represent the person during the guardianship proceeding;
1435 (b) receive a copy of all documents filed in a guardianship proceeding;
1436 (c) have a relative, [
1437 about or raise any issue of concern on behalf of the person during the guardianship proceeding;
1438 (d) receive information about guardianships from the court; and
1439 (e) be treated with respect and dignity.
1440 (2) Except as otherwise provided by this chapter or any other law, an incapacitated
1441 person for whom a guardian is appointed has right to:
1442 (a) have counsel represent the incapacitated person at any time after the guardian is
1443 appointed;
1444 (b) have a relative, [
1445 about or raise any issue of concern on behalf of the person in any court hearing about the
1446 guardianship;
1447 (c) receive a copy of all documents filed in court regarding the guardianship;
1448 (d) receive information about guardianships from the court;
1449 (e) ask questions and express concerns or complaints about a guardian and the actions
1450 of a guardian to the court;
1451 (f) participate in developing an individualized plan for the incapacitated person's care,
1452 including:
1453 (i) managing the incapacitated person's assets and property;
1454 (ii) determining the incapacitated person's residence; and
1455 (iii) determining the services to be received by the incapacitated person;
1456 (g) be given consideration in regards to the incapacitated person's current and
1457 previously stated desires, preferences for health care and medical treatment, and religious and
1458 moral beliefs;
1459 (h) remain as independent as possible, including giving deference to the incapacitated
1460 person's preference for the incapacitated person's residence and standard of living:
1461 (i) as expressed or demonstrated before a determination of capacity was made; or
1462 (ii) as currently expressed or demonstrated by the incapacitated person if the preference
1463 is reasonable under the circumstances;
1464 (i) be granted the greatest degree of freedom possible that is consistent with the reasons
1465 for the guardianship;
1466 (j) be able to exercise control over all aspects of the incapacitated person's life that are
1467 not granted to the guardian in the order of appointment;
1468 (k) engage in any activity that the court has not expressly reserved for the guardian,
1469 including marriage or domestic partnership, traveling, working, or having a driver license;
1470 (l) be treated with respect and dignity;
1471 (m) be treated fairly by the incapacitated person's guardian;
1472 (n) maintain privacy and confidentiality in personal matters;
1473 (o) receive telephone calls and personal mail and associate with relatives and
1474 acquaintances unless the guardian and the court determine that the association should be
1475 restricted or prohibited in accordance with Section 75-5-312.5;
1476 (p) receive timely, effective, and appropriate health care and medical treatment that
1477 does not violate the incapacitated person's rights;
1478 (q) have all services provided by a guardian at a reasonable rate of compensation;
1479 (r) have a court review any request for payment by a guardian to avoid excessive or
1480 unnecessary fees or duplicative billing;
1481 (s) receive prudent financial management of the incapacitated person's property;
1482 (t) subject to Subsections 75-5-312(4)(h) and 75-5-417(4), receive a copy of an
1483 accounting report regarding the incapacitated person's estate that is submitted to the court by
1484 the guardian under Section 75-5-312 or the conservator under Section 75-5-417 if a conservator
1485 is appointed for the incapacitated person;
1486 (u) receive and control the incapacitated person's salary;
1487 (v) maintain a bank account and manage the incapacitated person's personal money;
1488 and
1489 (w) ask the court to:
1490 (i) review the management activity of a guardian if a dispute cannot be resolved
1491 regarding the guardian's management;
1492 (ii) continue to review the need for a guardianship or to modify or terminate a
1493 guardianship; and
1494 (iii) enter an order restoring the incapacitated person's capacity at the earliest possible
1495 time.
1496 (3) The rights of an incapacitated person under this section do not abrogate any remedy
1497 provided by law.
1498 (4) Any right described in this section may be:
1499 (a) addressed in a guardianship proceeding; or
1500 (b) enforced through a private cause of action.
1501 Section 22. Section 75-5-303 is amended to read:
1502 75-5-303. Procedure for court appointment of a guardian of an incapacitated
1503 person.
1504 (1) An incapacitated person or any person interested in the incapacitated person's
1505 welfare may petition for a finding of incapacity and appointment of a guardian.
1506 (2) (a) Upon the filing of a petition, the court shall set a date for hearing on the issues
1507 of incapacity.
1508 (b) Unless the allegedly incapacitated person has counsel of the person's own choice,
1509 the court shall appoint an attorney to represent the person in the proceeding the cost of which
1510 shall be paid by the person alleged to be incapacitated, unless the allegedly incapacitated
1511 person and the allegedly incapacitated person's parents are indigent.
1512 (c) If the court determines that the petition is without merit, the attorney fees and court
1513 costs shall be paid by the person filing the petition.
1514 (d) If the court appoints the petitioner or the petitioner's nominee as guardian of the
1515 incapacitated person, regardless of whether the nominee is specified in the moving petition or
1516 nominated during the proceedings, the petitioner shall be entitled to receive from the
1517 incapacitated person reasonable attorney fees and court costs incurred in bringing, prosecuting,
1518 or defending the petition.
1519 (3) The legal representation of the incapacitated person by an attorney shall terminate
1520 upon the appointment of a guardian, unless:
1521 (a) there are separate conservatorship proceedings still pending before the court
1522 subsequent to the appointment of a guardian;
1523 (b) there is a timely filed appeal of the appointment of the guardian or the
1524 determination of incapacity; or
1525 (c) upon an express finding of good cause, the court orders otherwise.
1526 (4) The person alleged to be incapacitated may be examined by a physician or
1527 physician assistant appointed by the court who shall submit a report in writing to the court and
1528 may be interviewed by a visitor sent by the court. The visitor also may interview the person
1529 seeking appointment as guardian, visit the present place of abode of the person alleged to be
1530 incapacitated and the place it is proposed that the person will be detained or reside if the
1531 requested appointment is made, conduct other investigations or observations as directed by the
1532 court, and submit a report in writing to the court.
1533 (5) (a) The person alleged to be incapacitated shall be present at the hearing in person
1534 and see or hear all evidence bearing upon the person's condition. If the person seeking the
1535 guardianship requests a waiver of presence of the person alleged to be incapacitated, the court
1536 shall order an investigation by a court visitor, the costs of which shall be paid by the person
1537 seeking the guardianship.
1538 (b) The investigation by a court visitor is not required if there is clear and convincing
1539 evidence from a physician that the person alleged to be incapacitated has:
1540 (i) fourth stage Alzheimer's Disease;
1541 (ii) extended comatosis; or
1542 (iii) (A) an intellectual disability; and
1543 (B) an intelligence quotient score under 25.
1544 (c) The person alleged to be incapacitated is entitled to be represented by counsel, to
1545 present evidence, to cross-examine witnesses, including the court-appointed physician and the
1546 visitor, and to trial by jury. The issue may be determined at a closed hearing without a jury if
1547 the person alleged to be incapacitated or the person's counsel so requests.
1548 (d) Counsel for the person alleged to be incapacitated, as defined in Subsection
1549 75-1-201(22), is not required if:
1550 (i) the person is the biological or adopted child of the petitioner;
1551 (ii) the value of the person's entire estate does not exceed $20,000 as established by an
1552 affidavit of the petitioner in accordance with Section 75-3-1201;
1553 (iii) the person appears in court with the petitioner;
1554 (iv) the person is given the opportunity to communicate, to the extent possible, the
1555 person's acceptance of the appointment of petitioner;
1556 (v) no attorney from the state court's list of attorneys who have volunteered to represent
1557 respondents in guardianship proceedings is able to provide counsel to the person within 60
1558 days of the date of the appointment described in Subsection (2);
1559 (vi) the court is satisfied that counsel is not necessary in order to protect the interests of
1560 the person; and
1561 (vii) the court appoints a visitor under Subsection (4).
1562 Section 23. Section 76-5-111 is amended to read:
1563 76-5-111. Abuse of a vulnerable adult -- Penalties.
1564 (1) (a) As used in this section:
1565 (i) "Abandonment" means a knowing or intentional action or inaction, including
1566 desertion, by a person acting as a caretaker for a vulnerable adult that leaves the vulnerable
1567 adult without the means or ability to obtain necessary food, clothing, shelter, or medical or
1568 other health care.
1569 (ii) "Abuse" means:
1570 (A) attempting to cause harm, intentionally or knowingly causing harm, or
1571 intentionally or knowingly placing another in fear of imminent harm;
1572 (B) causing physical injury by knowing or intentional acts or omissions;
1573 (C) unreasonable or inappropriate use of physical restraint, medication, or isolation that
1574 causes or is likely to cause harm to a vulnerable adult that is in conflict with a physician's or
1575 physician assistant's orders or used as an unauthorized substitute for treatment, unless that
1576 conduct furthers the health and safety of the vulnerable adult; or
1577 (D) deprivation of life-sustaining treatment, except:
1578 (I) as provided in Title 75, Chapter 2a, Advance Health Care Directive Act; or
1579 (II) when informed consent, as defined in this section, has been obtained.
1580 (iii) "Caretaker" means a person or public institution that is entrusted with or assumes
1581 the responsibility to provide a vulnerable adult with care, food, shelter, clothing, supervision,
1582 medical or other health care, or other necessities for pecuniary gain, by contract, or as a result
1583 of friendship, or in a position of trust and confidence with a vulnerable adult, including a
1584 relative, a household member, an attorney-in-fact, a neighbor, a person who is employed or
1585 who provides volunteer work, a court-appointed or voluntary guardian, or a person who
1586 contracts or is under court order to provide care.
1587 (iv) (A) "Dependent adult" means an individual 18 years old or older, who has a
1588 physical or mental impairment that restricts the individual's ability to carry out normal
1589 activities or to protect the individual's rights.
1590 (B) "Dependent adult" includes an individual who has physical or developmental
1591 disabilities or whose physical or mental capacity has substantially diminished because of age.
1592 (v) "Elder adult" means an individual 65 years old or older.
1593 (vi) "Exploitation" means an offense described in Section 76-5-111.3, 76-5-111.4, or
1594 76-5b-202.
1595 (vii) "Harm" means pain, mental anguish, emotional distress, hurt, physical or
1596 psychological damage, physical injury, suffering, or distress inflicted knowingly or
1597 intentionally.
1598 (viii) "Informed consent" means:
1599 (A) a written expression by the individual or authorized by the individual, stating that
1600 the individual fully understands the potential risks and benefits of the withdrawal of food,
1601 water, medication, medical services, shelter, cooling, heating, or other services necessary to
1602 maintain minimum physical or mental health, and that the individual desires that the services
1603 be withdrawn, except that a written expression is valid only if the individual is of sound mind
1604 when the consent is given, and the consent is witnessed by at least two individuals who do not
1605 benefit from the withdrawal of services; or
1606 (B) consent to withdraw food, water, medication, medical services, shelter, cooling,
1607 heating, or other services necessary to maintain minimum physical or mental health, as
1608 permitted by court order.
1609 (ix) (A) "Isolation" means knowingly or intentionally preventing a vulnerable adult
1610 from having contact with another person, unless the restriction of personal rights is authorized
1611 by court order, by:
1612 (I) preventing the vulnerable adult from communicating, visiting, interacting, or
1613 initiating interaction with others, including receiving or inviting visitors, mail, or telephone
1614 calls, contrary to the express wishes of the vulnerable adult, or communicating to a visitor that
1615 the vulnerable adult is not present or does not want to meet with or talk to the visitor, knowing
1616 that communication to be false;
1617 (II) physically restraining the vulnerable adult in order to prevent the vulnerable adult
1618 from meeting with a visitor; or
1619 (III) making false or misleading statements to the vulnerable adult in order to induce
1620 the vulnerable adult to refuse to receive communication from visitors or other family members.
1621 (B) "Isolation" does not include an act:
1622 (I) intended in good faith to protect the physical or mental welfare of the vulnerable
1623 adult; or
1624 (II) performed pursuant to the treatment plan or instructions of a physician, physician
1625 assistant, or other professional advisor of the vulnerable adult.
1626 (x) "Neglect" means:
1627 (A) failure of a caretaker to provide nutrition, clothing, shelter, supervision, personal
1628 care, or dental or other health care, or failure to provide protection from health and safety
1629 hazards or maltreatment;
1630 (B) failure of a caretaker to provide care to a vulnerable adult in a timely manner and
1631 with the degree of care that a reasonable person in a like position would exercise;
1632 (C) a pattern of conduct by a caretaker, without the vulnerable adult's informed
1633 consent, resulting in deprivation of food, water, medication, health care, shelter, cooling,
1634 heating, or other services necessary to maintain the vulnerable adult's well being;
1635 (D) intentional failure by a caretaker to carry out a prescribed treatment plan that
1636 results or could result in physical injury or physical harm; or
1637 (E) abandonment by a caretaker.
1638 (xi) (A) "Physical injury" includes damage to any bodily tissue caused by
1639 nontherapeutic conduct, to the extent that the tissue must undergo a healing process in order to
1640 be restored to a sound and healthy condition, or damage to any bodily tissue to the extent that
1641 the tissue cannot be restored to a sound and healthy condition.
1642 (B) "Physical injury" includes skin bruising, a dislocation, physical pain, illness,
1643 impairment of physical function, a pressure sore, bleeding, malnutrition, dehydration, a burn, a
1644 bone fracture, a subdural hematoma, soft tissue swelling, injury to any internal organ, or any
1645 other physical condition that imperils the health or welfare of the vulnerable adult and is not a
1646 serious physical injury as defined in this section.
1647 (xii) "Position of trust and confidence" means the position of a person who:
1648 (A) is a parent, spouse, adult child, or other relative of a vulnerable adult;
1649 (B) is a joint tenant or tenant in common with a vulnerable adult;
1650 (C) has a legal or fiduciary relationship with a vulnerable adult, including a
1651 court-appointed or voluntary guardian, trustee, attorney, attorney-in-fact, or conservator; or
1652 (D) is a caretaker of a vulnerable adult.
1653 (xiii) "Serious physical injury" means any physical injury or set of physical injuries
1654 that:
1655 (A) seriously impairs a vulnerable adult's health;
1656 (B) was caused by use of a dangerous weapon;
1657 (C) involves physical torture or causes serious emotional harm to a vulnerable adult; or
1658 (D) creates a reasonable risk of death.
1659 (xiv) "Vulnerable adult" means an elder adult, or a dependent adult who has a mental
1660 or physical impairment which substantially affects that individual's ability to:
1661 (A) provide personal protection;
1662 (B) provide necessities such as food, shelter, clothing, or medical or other health care;
1663 (C) obtain services necessary for health, safety, or welfare;
1664 (D) carry out the activities of daily living;
1665 (E) manage the adult's own resources; or
1666 (F) comprehend the nature and consequences of remaining in a situation of abuse,
1667 neglect, or exploitation.
1668 (b) Terms defined in Section 76-1-101.5 apply to this section.
1669 (2) An actor, including a caretaker, commits abuse of a vulnerable adult if the actor,
1670 under circumstances other than those likely to produce death or serious physical injury:
1671 (a) causes a vulnerable adult to suffer harm, abuse, or neglect;
1672 (b) having the care or custody of a vulnerable adult, causes or permits that vulnerable
1673 adult's person or health to be injured, abused, or neglected; or
1674 (c) causes or permits a vulnerable adult to be placed in a situation in which the
1675 vulnerable adult's person or health is endangered.
1676 (3) (a) A violation of Subsection (2):
1677 (i) is a class A misdemeanor if done intentionally or knowingly;
1678 (ii) is a class B misdemeanor if done recklessly; or
1679 (iii) is a class C misdemeanor if done with criminal negligence.
1680 (b) Notwithstanding Subsection (3)(a), a violation of Subsection (2) that is based on
1681 isolation of a vulnerable adult is a third degree felony.
1682 (4) (a) It does not constitute a defense to a prosecution for a violation of this section
1683 that the actor did not know the age of the vulnerable adult.
1684 (b) An adult is not considered abused, neglected, or a vulnerable adult for the reason
1685 that the adult has chosen to rely solely upon religious, nonmedical forms of healing in lieu of
1686 medical care.
1687 (5) If an actor, including a caretaker, violates this section by willfully isolating a
1688 vulnerable adult, in addition to the penalties under Subsection (3), the court may require that
1689 the actor:
1690 (a) undergo appropriate counseling as a condition of the sentence; and
1691 (b) pay for the costs of the ordered counseling.
1692 Section 24. Effective date.
1693 This bill takes effect on May 1, 2024.
1694 Section 25. Coordinating S.B. 24 with H.B. 403 - Technical amendment.
1695 If S.B. 24, Physician Assistant Practice Amendments, and H.B. 403, Body Art Facility
1696 Amendments, both pass and become law, the Legislature intends that, on May 1, 2024,
1697 Subsection 26B-7-402(15) be amended to read:
1698 " (15) [
1699 dentist;".