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S.B. 157 Enrolled

                 

NURSING PRACTICE AMENDMENTS

                 
2000 GENERAL SESSION

                 
STATE OF UTAH

                 
Sponsor: Paula F. Julander

                  AN ACT RELATING TO OCCUPATIONS AND PROFESSIONS; AMENDING THE
                  MAKE-UP OF THE BOARD OF NURSING; ELIMINATING THE STATUTORY
                  REQUIREMENT THAT EXAMINATIONS BE TAKEN WITHIN A PRESCRIBED TIME
                  PERIOD; AMENDING THE LICENSING REQUIREMENTS OF A NURSE WHO
                  GRADUATES FROM A NONAPPROVED NURSING PROGRAM; AMENDING THE
                  RENEWAL REQUIREMENTS OF ADVANCED PRACTICE REGISTERED NURSES;
                  AMENDING THE ADMINISTRATIVE PROCEDURES FOR SUSPENDING A LICENSE
                  BECAUSE OF IMPAIRMENT; AMENDING THE QUALITY REVIEW PROGRAM
                  REQUIRED OF NURSES AND NURSE MIDWIVES; AND PROVIDING AN EFFECTIVE
                  DATE.
                  This act affects sections of Utah Code Annotated 1953 as follows:
                  AMENDS:
                      58-31b-201, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-302, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-303, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-305, as enacted by Chapter 288, Laws of Utah 1998
                      58-31b-401, as last amended by Chapter 65, Laws of Utah 1999
                      58-44a-303, as last amended by Chapter 288, Laws of Utah 1998
                  Be it enacted by the Legislature of the state of Utah:
                      Section 1. Section 58-31b-201 is amended to read:
                       58-31b-201. Board.
                      (1) There is created the Board of Nursing that consists of the following [13] nine
                  members[, whose appointments shall provide broad representation of the various interests and
                  constituencies in the nursing profession]:
                      [(a) six persons licensed as registered nurses:]

                      [(i) three of whom are actively involved in approved nursing education programs and
                  represent various types of education programs; and]
                      [(ii) one of whom is employed in a nursing administrative position within a licensed health
                  care facility;]
                      [(b) two persons licensed as licensed practical nurses;]
                      [(c) three persons licensed as advanced practice registered nurses or certified registered nurse
                  anesthetists, one of whom also holds a controlled substance license; and]
                      [(d) two members of the public who are not licensed health care providers.]
                      (a) seven nurses in a manner as may be further defined in division rule; and
                      (b) two members of the public.
                      (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
                      (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
                  58-1-203 and shall:
                      (a) (i) recommend to the division minimum standards for educational programs qualifying a
                  person for licensure under this chapter;
                      (ii) recommend to the division denial, approval, or withdrawal of approval regarding
                  educational programs that meet or fail to meet the established minimum standards; and
                      (iii) designate one of its members on a permanent or rotating basis to:
                      (A) assist the division in reviewing complaints concerning the unlawful or unprofessional
                  conduct of a licensee; and
                      (B) advise the division in its investigation of these complaints.
                      (b) A board member who has, under Subsection (3)(a)(iii), reviewed a complaint or advised
                  in its investigation may be disqualified from participating with the board when the board serves as a
                  presiding officer in an adjudicative proceeding concerning the complaint.
                      (4) (a) The director shall appoint an individual to serve as the executive administrator of the
                  Board of Nursing. Except when the board serves as a presiding officer in an adjudicative procedure,
                  the executive administrator shall serve as an ex officio member of the board and shall represent the
                  position of the division in matters considered by the board.

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                      (b) The executive administrator shall be a licensed registered nurse, shall have earned a
                  masters degree in nursing, and shall have a minimum of five years of experience working in nursing
                  administration or nursing education.
                      Section 2. Section 58-31b-302 is amended to read:
                       58-31b-302. Qualifications for licensure.
                      (1) An applicant for licensure as a licensed practical nurse shall:
                      (a) submit to the division an application in a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) have a high school diploma or its equivalent;
                      (d) be in a condition of physical and mental health that will permit the applicant to practice
                  safely as a licensed practical nurse;
                      (e) have completed an approved practical nursing education program or an equivalent as
                  determined by the board;
                      (f) have passed the examinations [prescribed] as required by division rule made in
                  collaboration with the board [within two years after completion of the approved practical nursing
                  education program required under Subsection (1)(e) and within three years of the date of application
                  for a Utah license]; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for licensure.
                      (2) An applicant for licensure as a registered nurse shall:
                      (a) submit to the division an application form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) have a high school diploma or its equivalent;
                      (d) be in a condition of physical and mental health that will allow the applicant to practice
                  safely as a registered nurse;
                      (e) have completed an approved registered nursing education program;
                      (f) have passed the examinations [prescribed] as required by division rule made in
                  collaboration with the board [within two years after completion of the approved registered nursing
                  education program required under Subsection (2)(e) and within three years of the date of application

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                  for a Utah license]; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for licensure.
                      (3) Applicants for licensure as an advanced practice registered nurse shall:
                      (a) submit to the division an application on a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) be in a condition of physical and mental health which will allow the applicant to practice
                  safely as an advanced practice registered nurse;
                      (d) hold a current registered nurse license in good standing issued by the state or be qualified
                  at the time for licensure as a registered nurse;
                      (e) have earned a graduate degree in nursing or a related area of specialized knowledge as
                  determined appropriate by the division in collaboration with the board;
                      (f) have completed course work in patient assessment, diagnosis and treatment, and
                  pharmacotherapeutics from an education program approved by the division in collaboration with the
                  board;
                      (g) have successfully completed clinical practice in psychiatric and mental health nursing,
                  including psychotherapy as defined by division rule, after completion of the masters degree required
                  for licensure, to practice within the psychiatric and mental health nursing specialty;
                      (h) have passed the examinations [prescribed] as required by division rule made in
                  collaboration with the board [within two years after completion of the approved education program
                  required under Subsection (3)(f)];
                      (i) be currently certified by a program approved by the division in collaboration with the
                  board and submit evidence satisfactory to the division of the certification; and
                      (j) meet with the board, if requested, to determine the applicant's qualifications for licensure.
                      (4) An applicant for licensure as a certified registered nurse anesthetist shall:
                      (a) submit to the division an application on a form prescribed by the division;
                      (b) pay to the division a fee determined under Section 63-38-3.2 ;
                      (c) be in a condition of physical and mental health which will allow the applicant to practice
                  safely as a certified registered nurse anesthetist;

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                      (d) hold a current registered nurse license in good standing issued by the state or be qualified
                  at the time for licensure as a registered nurse;
                      (e) complete a nurse anesthesia program which is approved by the Council on Accreditation
                  of Nurse Anesthesia Educational Programs;
                      (f) be currently certified by a program approved by the division in collaboration with the
                  board and submit evidence satisfactory to the division of the certification; and
                      (g) meet with the board, if requested, to determine the applicant's qualifications for licensure.
                      Section 3. Section 58-31b-303 is amended to read:
                       58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
                  programs.
                      An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
                  nursing education program not approved by the division in collaboration with the board must comply
                  with the requirements of this section.
                      (1) An applicant for licensure as a licensed practical nurse shall:
                      (a) meet all requirements of Subsection 58-31b-302 (1), except Subsection (1)(e); and
                      (b) produce evidence acceptable to the division and the board that the nursing education
                  program completed by the applicant is equivalent to the minimum standards established by the
                  division in collaboration with the board for an approved licensed practical nursing education program.
                      (2) An applicant for licensure as a registered nurse shall:
                      (a) meet all requirements of Subsection 58-31b-302 (2), except Subsection (2)(e); and
                      (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
                  Examination; or
                      (ii) produce evidence acceptable to the division and the board that the applicant is currently
                  licensed as a registered nurse in one of the states, territories, or the District of Columbia of the United
                  States and has [practiced satisfactorily as a licensed registered nurse in that jurisdiction for a period
                  of not less than 4,000 hours] passed the NCLEX-RN examination.
                      Section 4. Section 58-31b-305 is amended to read:
                       58-31b-305. Term of license -- Expiration -- Renewal.

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                      (1) The division shall issue each license under this chapter in accordance with a two-year
                  renewal cycle established by rule. The division may by rule extend or shorten a renewal period by
                  as much as one year to stagger the renewal cycles it administers.
                      (2) At the time of renewal, the licensee shall show satisfactory evidence of each of the
                  following renewal requirements:
                      (a) complete and submit an application for renewal in a form prescribed by the division and
                  pay the renewal fee determined under Section 63-38-3.2 ; and
                      (b) meet continuing competency requirements as established by rule.
                      (3) In addition to the renewal requirements under Subsection (2), a person licensed as a
                  advanced practice registered nurse shall:
                      (a) be currently certified by a program approved by the division in collaboration with the
                  board and submit evidence satisfactory to the division of that qualification or if licensed prior to July
                  1, 1992, meet the requirements established by rule; and
                      (b) as a condition precedent for license renewal commencing on and after July 1, 1999,
                  actively participate on a continuing basis in a quality review program based on criteria established by
                  the division by rule in collaboration with the board. [A quality review program shall be:]
                      [(i) based in a hospital or other licensed health care facility, as defined in Section 26-21-2 ,
                  at which the licensee regularly engages in practice; or]
                      [(ii) conducted by or under the direction of:]
                      [(A) a professional association approved by the division in collaboration with the board; or]
                      [(B) another organization approved by the division in collaboration with the board as defined
                  by division rule.]
                      (4) In addition to the renewal requirements under Subsection (2), a person licensed as a
                  certified registered nurse anesthetist shall:
                      (a) actively participate on a continuing regular basis in an anesthesia quality assurance
                  program approved by the division in collaboration with the board and submit evidence satisfactory
                  to the division of the participation; and
                      (b) be currently certified in anesthesia by a program approved by the division in collaboration

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                  with the board and submit evidence satisfactory to the division of the certification.
                      (5) Each license automatically expires on the expiration date shown on the license unless
                  renewed in accordance with Section 58-1-308 .
                      Section 5. Section 58-31b-401 is amended to read:
                       58-31b-401. Grounds for denial of licensure and disciplinary proceedings.
                      (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the license of
                  a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee, to issue a
                  public or private reprimand to a licensee, and to issue cease and desist orders shall be in accordance
                  with Section 58-1-401 .
                      [(2) (a) If a court of competent jurisdiction determines that a nurse is an "incapacitated
                  person" as defined in Section 75-1-201 , the director shall suspend the license of the nurse upon entry
                  of the judgment, regardless of the pendency of an appeal.]
                      [(b) If it appears to the board that there is reasonable cause to believe that a nurse, even
                  though the nurse has not been judicially determined to be incompetent, mentally incompetent, or
                  incapable, is unable to practice nursing with reasonable skill and safety to patients because of illness,
                  drunkenness, excessive use of drugs, narcotics, chemical, or any other type of material, or as a result
                  of any mental or physical condition, a complaint in the name of the board shall be served upon the
                  nurse for hearing on the sole issue of the capacity of the nurse to conduct properly the practice of
                  nursing.]
                      [(c) (i) Failure of a nurse to submit to a mental or physical examination within 30 days when
                  directed by the board in connection with a hearing instituted under Subsection (2)(b) constitutes
                  grounds for immediate suspension of the nurse's license, unless the failure was due to circumstances
                  beyond the control of the nurse.]
                      [(ii) A licensee who submits to an examination under this Subsection (2) waives all objections
                  to the admissibility of an examining physician's testimony or examination report on the ground that
                  they constitute a privileged communication.]
                      [(iii) The director may enter an order of suspension of the license without the taking of
                  testimony or the presentation of evidence upon a finding of reasonable cause to believe that an order

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                  of suspension is necessary to protect the public health, safety, or welfare, if a hearing is scheduled to
                  occur within 30 days of the order of suspension.]
                      [(d) A nurse whose license is suspended under Subsection (2) shall, at reasonable intervals
                  defined by rule, be afforded the opportunity to demonstrate that the nurse can resume the competent
                  practice of nursing with reasonable skill and safety to patients.]
                      (2) If a court of competent jurisdiction determines a nurse is an incapacitated person as
                  defined in Section 75-1-201 or that he is mentally ill as defined in Section 62A-12-202 , and unable
                  to safely engage in the practice of nursing, the director shall immediately suspend the license of the
                  nurse upon the entry of the judgment of the court, without further proceedings under Title 63,
                  Chapter 46b, Administrative Procedures Act, regardless of whether an appeal from the court's ruling
                  is pending. The director shall promptly notify the nurse, in writing, of the suspension.
                      (3) (a) If the division and the majority of the board find reasonable cause to believe a nurse,
                  who is not determined judicially to be an incapacitated person or to be mentally ill, is incapable of
                  practicing nursing with reasonable skill regarding the safety of patients, because of illness, excessive
                  use of drugs or alcohol, or as a result of any mental or physical condition, the board shall recommend
                  that the director file a petition with the division, and cause the petition to be served upon the nurse
                  with a notice of hearing on the sole issue of the capacity of the nurse to competently, safely engage
                  in the practice of nursing.
                      (b) The hearing shall be conducted under Section 58-1-109 and Title 63, Chapter 46b,
                  Administrative Procedures Act, except as provided in Subsection (4).
                      (4) (a) Every nurse who accepts the privilege of being licensed under this chapter gives
                  consent to:
                      (i) submitting to an immediate mental or physical examination, at the nurse's expense and by
                  a division-approved practitioner selected by the nurse, when directed in writing by the division and
                  a majority of the board to do so; and
                      (ii) the admissibility of the reports of the examining practitioner's testimony or examination,
                  and waives all objections on the ground the reports constitute a privileged communication.
                      (b) The examination may be ordered by the division, with the consent of a majority of the

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                  board, only upon a finding of reasonable cause to believe:
                      (i) the nurse is mentally ill or incapacitated or otherwise unable to practice nursing with
                  reasonable skill and safety; and
                      (ii) immediate action by the division and the board is necessary to prevent harm to the nurse's
                  patients or the general public.
                      (c) (i) Failure of a nurse to submit to the examination ordered under this section is a ground
                  for the division's immediate suspension of the nurse's license by written order of the director.
                      (ii) The division may enter the order of suspension without further compliance with Title 63,
                  Chapter 46b, Administrative Procedures Act, unless the division finds the failure to submit to the
                  examination ordered under this section was due to circumstances beyond the control of the nurse and
                  was not related directly to the illness or incapacity of the nurse.
                      (5) (a) A nurse whose license is suspended under Subsection (2), (3), or (4)(c) has the right
                  to a hearing to appeal the suspension within ten days after the license is suspended.
                      (b) The hearing held under this Subsection (5) shall be conducted in accordance with Sections
                  58-1-108 and 58-1-109 for the sole purpose of determining if sufficient basis exists for the
                  continuance of the order of suspension in order to prevent harm to the nurse's patients or the general
                  public.
                      (6) A nurse whose license is revoked, suspended, or in any way restricted under this section
                  may request the division and the board to consider, at reasonable intervals, evidence presented by the
                  nurse, under procedures established by division rule, regarding any change in the nurse's condition,
                  to determine whether:
                      (a) he is or is not able to safely and competently engage in the practice of nursing; and
                      (b) he is qualified to have his license to practice under this chapter restored completely or in
                  part.
                      [(3)] (7) Nothing in Section 63-2-206 may be construed as limiting the authority of the
                  division to report current significant investigative information to the coordinated licensure information
                  system for transmission to party states as required of the division by Article VII of the Nurse
                  Licensure Compact in Section 58-31c-102 .

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                      Section 6. Section 58-44a-303 is amended to read:
                       58-44a-303. Term of license -- Expiration -- Renewal.
                      (1) (a) Each license issued under this chapter shall be issued in accordance with a two-year
                  renewal cycle established by rule.
                      (b) A renewal period may be extended or shortened by as much as one year to maintain
                  established renewal cycles or to change an established renewal cycle.
                      (2) At the time of renewal, the licensee shall:
                      (a) hold a valid certification from the American College of Nurse Midwives Certification
                  Council, Inc.;
                      (b) have met continuing competency requirements defined by the division rule in                   collaboration
                  with the board; and
                      (c) as a condition precedent for license renewal commencing on and after July 1, 1999,
                  actively participate on a continuing basis in a quality review program based on criteria established by
                  the division by rule in collaboration with the board. [A quality review program shall be:]
                      [(i) based in a hospital or other licensed health care facility, as defined in Section 26-21-2 ,
                  at which the licensee regularly engages in practice; or]
                      [(ii) conducted by or under the direction of:]
                      [(A) a professional association approved by the division in collaboration with the board; or]
                      [(B) another organization approved by the division in collaboration with the board as defined
                  by division rule.]
                      Section 7. Effective date.
                      This act takes effect on July 1, 2000.

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