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H.B. 160
This document includes Senate Committee Amendments incorporated into the bill on Thu,
Feb 13, 2003 at 4:30 PM by rday. -->
1
EMERGENCY HEALTH RESPONSE
2
AMENDMENTS
3
2003 GENERAL SESSION
4
STATE OF UTAH
5
Sponsor: Marda Dillree
6
This act amends professional licensing provisions, the powers and duties of local health
7
departments, and provisions related to immunity from liability for governmental entities
8
and certain professionals. The act establishes exceptions to certain licensing standards
9
when a national, state, or local emergency is declared. The act amends certain
10
prescription drug dispensing rules when emergencies are declared. The act authorizes
11
local departments of health to investigate suspected bioterrorism and diseases and to
12
provide public health assistance in a declared emergency. The act provides limited
13
immunity from civil damages for governmental entities and certain health professionals
14
responding to a declared emergency. This act has an immediate effective date.
15
This act affects sections of Utah Code Annotated 1953 as follows:
16
AMENDS:
17
26A-1-114, as last amended by Chapter 249, Laws of Utah 2002
18
58-1-307, as last amended by Chapter 63, Laws of Utah 2001
19
58-13-2, as last amended by Chapter 160, Laws of Utah 2000
20
58-17a-620, as enacted by Chapter 247, Laws of Utah 1996
21
63-30-3, as last amended by Chapters 15 and 248, Laws of Utah 1991
22
78-11-22, as last amended by Chapter 211, Laws of Utah 1987
23
Be it enacted by the Legislature of the state of Utah:
24
Section 1.
Section
26A-1-114
is amended to read:
25
26A-1-114. Powers and duties of departments.
26
(1) A local health department may:
27
(a) subject to the provisions in Section
26A-1-108
, enforce state laws, local ordinances,
28
department rules, and local health department standards and regulations relating to public
29
health and sanitation, including the plumbing code adopted by the Division of Occupational
30
and Professional Licensing under Section
58-56-4
and under Title 26, Chapter 15a, Food
31
Safety Manager Certification Act, in all incorporated and unincorporated areas served by the
32
local health department;
33
(b) establish, maintain, and enforce isolation and quarantine, and exercise physical
34
control over property and over individuals as the local health department finds necessary for
35
the protection of the public health;
36
(c) establish and maintain medical, environmental, occupational, and other laboratory
37
services considered necessary or proper for the protection of the public health;
38
(d) establish and operate reasonable health programs or measures not in conflict with
39
state law that:
40
(i) are necessary or desirable for the promotion or protection of the public health and
41
the control of disease; or
42
(ii) may be necessary to ameliorate the major risk factors associated with the major
43
causes of injury, sickness, death, and disability in the state;
44
(e) close theaters, schools, and other public places and prohibit gatherings of people
45
when necessary to protect the public health;
46
(f) abate nuisances or eliminate sources of filth and infectious and communicable
47
diseases affecting the public health and bill the owner or other person in charge of the premises
48
upon which this nuisance occurs for the cost of abatement;
49
(g) make necessary sanitary and health investigations and inspections on its own
50
initiative or in cooperation with the Department of Health or Environmental Quality, or both,
51
as to any matters affecting the public health;
52
(h) pursuant to county ordinance or interlocal agreement:
53
(i) establish and collect appropriate fees for the performance of services and operation
54
of authorized or required programs and duties;
55
(ii) accept, use, and administer all federal, state, or private donations or grants of funds,
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property, services, or materials for public health purposes; and
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(iii) make agreements not in conflict with state law that are conditional to receiving a
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donation or grant;
59
(i) prepare, publish, and disseminate information necessary to inform and advise the
60
public concerning:
61
(i) the health and wellness of the population, specific hazards, and risk factors that may
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adversely affect the health and wellness of the population; and
63
(ii) specific activities individuals and institutions can engage in to promote and protect
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the health and wellness of the population;
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(j) investigate the causes of morbidity and mortality;
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(k) issue notices and orders necessary to carry out this part;
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(l) conduct studies to identify injury problems, establish injury control systems,
68
develop standards for the correction and prevention of future occurrences, and provide public
69
information and instruction to special high risk groups;
70
(m) cooperate with boards created under Section
19-1-106
to enforce laws and rules
71
within the jurisdiction of the boards; [and]
72
(n) cooperate with the state health department, the Department of Corrections, the
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Administrative Office of the Courts, the Division of Youth Corrections, and the Crime Victims
74
Reparations Board to conduct testing for HIV infection of convicted sexual offenders and any
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victims of a sexual offense[.];
76
(o) investigate suspected bioterrorism and disease pursuant to Section
26-23b-108
; and
77
(p) provide public health assistance in response to a national, state, or local emergency,
78
a public health emergency as defined in Section
26-23b-102
, or a declaration by the President
79
of the United States or other federal official requesting public health-related activities.
80
(2) The local health department shall:
81
(a) establish programs or measures to promote and protect the health and general
82
wellness of the people within the boundaries of the local health department;
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(b) investigate infectious and other diseases of public health importance and implement
84
measures to control the causes of epidemic and communicable diseases and other conditions
85
significantly affecting the public health which may include involuntary testing of convicted
86
sexual offenders for the HIV infection pursuant to Section
76-5-502
and voluntary testing of
87
victims of sexual offenses for HIV infection pursuant to Section
76-5-503
;
88
(c) cooperate with the department in matters pertaining to the public health and in the
89
administration of state health laws; and
90
(d) coordinate implementation of environmental programs to maximize efficient use of
91
resources by developing with the Department of Environmental Quality a Comprehensive
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Environmental Service Delivery Plan that:
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(i) recognizes that the Department of Environmental Quality and local health
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departments are the foundation for providing environmental health programs in the state;
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(ii) delineates the responsibilities of the department and each local health department
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for the efficient delivery of environmental programs using federal, state, and local authorities,
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responsibilities, and resources;
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(iii) provides for the delegation of authority and pass through of funding to local health
99
departments for environmental programs, to the extent allowed by applicable law, identified in
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the plan, and requested by the local health department; and
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(iv) is reviewed and updated annually.
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(3) The local health department has the following duties regarding public and private
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schools within its boundaries:
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(a) enforce all ordinances, standards, and regulations pertaining to the public health of
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persons attending public and private schools;
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(b) exclude from school attendance any person, including teachers, who is suffering
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from any communicable or infectious disease, whether acute or chronic, if the person is likely
108
to convey the disease to those in attendance; and
109
(c) (i) make regular inspections of the health-related condition of all school buildings
110
and premises;
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(ii) report the inspections on forms furnished by the department to those responsible for
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the condition and provide instructions for correction of any conditions that impair or endanger
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the health or life of those attending the schools; and
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(iii) provide a copy of the report to the department at the time the report is made.
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(4) If those responsible for the health-related condition of the school buildings and
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premises do not carry out any instructions for corrections provided in a report in Subsection
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(3)(c), the local health board shall cause the conditions to be corrected at the expense of the
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persons responsible.
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(5) The local health department may exercise incidental authority as necessary to carry
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out the provisions and purposes of this part.
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Section 2.
Section
58-1-307
is amended to read:
122
58-1-307. Exemptions from licensure.
123
(1) Except as otherwise provided by statute or rule, the following persons may engage
124
in the practice of their occupation or profession, subject to the stated circumstances and
125
limitations, without being licensed under this title:
126
(a) a person serving in the armed forces of the United States, the United States Public
127
Health Service, the United States Department of Veterans Affairs, or other federal agencies
128
while engaged in activities regulated under this chapter as a part of employment with that
129
federal agency if the person holds a valid license to practice a regulated occupation or
130
profession issued by any other state or jurisdiction recognized by the division;
131
(b) a student engaged in activities constituting the practice of a regulated occupation or
132
profession while in training in a recognized school approved by the division to the extent the
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activities are supervised by qualified faculty, staff, or designee and the activities are a defined
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part of the training program;
135
(c) an individual engaged in an internship, residency, preceptorship, postceptorship,
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fellowship, apprenticeship, or on-the-job training program approved by the division while
137
under the supervision of qualified persons;
138
(d) an individual residing in another state and licensed to practice a regulated
139
occupation or profession in that state, who is called in for a consultation by an individual
140
licensed in this state, and the services provided are limited to that consultation;
141
(e) an individual who is invited by a recognized school, association, society, or other
142
body approved by the division to conduct a lecture, clinic, or demonstration of the practice of a
143
regulated occupation or profession if the individual does not establish a place of business or
144
regularly engage in the practice of the regulated occupation or profession in this state;
145
(f) an individual licensed under the laws of this state, other than under this title, to
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practice or engage in an occupation or profession, while engaged in the lawful, professional,
147
and competent practice of that occupation or profession;
148
(g) an individual licensed in a health care profession in another state who performs that
149
profession while attending to the immediate needs of a patient for a reasonable period during
150
which the patient is being transported from outside of this state, into this state, or through this
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state;
152
(h) an individual licensed in another state or country who is in this state temporarily to
153
attend to the needs of an athletic team or group, except that the practitioner may only attend to
154
the needs of the athletic team or group, including all individuals who travel with the team or
155
group in any capacity except as a spectator;
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(i) an individual licensed and in good standing in another state, who is in this state:
157
(i) temporarily, under the invitation and control of a sponsoring entity;
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(ii) for a reason associated with a special purpose event, based upon needs that may
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exceed the ability of this state to address through its licensees, as determined by the division;
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and
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(iii) for a limited period of time not to exceed the duration of that event, together with
162
any necessary preparatory and conclusionary periods. The requirements of Section
163
63A-10-105
do not apply to exemptions authorized by the division pursuant to this Subsection
164
(1)(i);
165
(j) an individual who:
166
(i) is certified as an athletic trainer by the National Athletic Trainers Association Board
167
of Certification or another entity approved by the division;
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(ii) is employed or officially associated with an educational institution, a professional
169
sports organization, or a bona fide amateur sports organization; and
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(iii) only provides athletic training services:
171
(A) to athletes of the educational institution or sports organization to which the
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individual is employed or officially associated;
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(B) at an official athletic training, practice, or competition site; and
174
(C) that are within the scope of the individual's certification; and
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(k) a law enforcement officer, as defined under Section
53-13-103
, who:
176
(i) is operating a voice stress analyzer in the course of the officer's full-time
177
employment with a federal, state, or local law enforcement agency;
178
(ii) has completed the manufacturer's training course and is certified by the
179
manufacturer to operate that voice stress analyzer; and
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(iii) is operating the voice stress analyzer in accordance with Section
58-64-601
,
181
regarding deception detection instruments.
182
(2) A practitioner temporarily in this state who is exempted from licensure under
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Subsection (1) shall comply with each requirement of the licensing jurisdiction from which the
184
practitioner derives authority to practice. Violation of any limitation imposed by this section
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constitutes grounds for removal of exempt status, denial of license, or other disciplinary
186
proceedings.
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(3) An individual who is licensed under a specific chapter of this title to practice or
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engage in an occupation or profession may engage in the lawful, professional, and competent
189
practice of that occupation or profession without additional licensure under other chapters of
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this title, except as otherwise provided by this title.
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(4) Upon the declaration of a national, state, or local emergency, a public health
192
emergency as defined in Section
26-23b-102
, or a declaration by the President of the United
193
States or other federal official requesting public health-related activities, the division in
194
collaboration with the board may:
195
(a) suspend the requirements for permanent or temporary licensure of persons who are
196
licensed in another state. Persons exempt under this Subsection (4)(a) shall be exempt from
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licensure for the duration of the emergency while engaged in the scope of practice for which
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they are licensed in the other state[.];
199
(b) modify, under the circumstances described in Subsections (4) and (5), the scope of
200
practice restrictions under this title for persons who are licensed under this title as:
201
(i) a physician under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah
202
Osteopathic Medical Practice Act;
203
(ii) a nurse under Chapter 31b, Nurse Practice Act, or Chapter 31c, Nurse Licensure
204
Compact;
205
(iii) a certified nurse midwife under Chapter 44a, Nurse Midwife Practice Act;
206
(iv) a pharmacist, pharmacy technician, or pharmacy intern under Chapter 17a,
207
Pharmacy Practice Act;
208
(v) a respiratory therapist under Chapter 57, Respiratory Care Practices Act; and
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(vi) a dentist and dental hygienist under Chapter 69, Dentist and Dental Hygienist
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Practice Act;
211
(c) suspend the requirements for licensure under this title and modify the scope of
212
practice in the circumstances described in Subsections (4) and (5) for medical services
213
personnel or paramedics h
REQUIRED TO BE
h certified under h
SECTION 26-8a-302
h h [
Title 26,
213a
Chapter 8a, Utah Emergency Medical
] h
214
h [
Services System Act
] h ; and
215
(d) suspend requirements in Subsections
58-17a-620
(3) through (6) which require
216
certain prescriptive procedures.
217
(5) Persons exempt under h [
Subsections (4)(a) and
]
SUBSECTION (4)
h (c) and persons
217a
operating under
218
modified scope of practice provisions under Subsection (4)(b):
219
(a) shall be exempt from licensure or subject to modified scope of practice for the
220
duration of the emergency;
221
(b) must be engaged in the distribution of medicines or medical devises in response to
222
the emergency or declaration; and
223
(c) must be employed by or volunteering for a local or state department of health.
224
Section 3.
Section
58-13-2
is amended to read:
225
58-13-2. Emergency care rendered by licensee.
226
(1) A person licensed under Title 58, Occupations and Professions, to practice as any
227
of the following health care professionals, who is under no legal duty to respond, and who in
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good faith renders emergency care at the scene of an emergency gratuitously and in good faith,
229
is not liable for any civil damages as a result of any acts or omissions by the person in
230
rendering the emergency care:
231
[(1)] (a) osteopathic physician;
232
[(2)] (b) physician and surgeon;
233
[(3) naturopath;]
234
(c) naturopathic physician;
235
[(4)] (d) dentist or dental hygienist;
236
[(5)] (e) chiropractic physician;
237
[(6)] (f) physician assistant;
238
[(7)] (g) optometrist; [or]
239
[(8)] (h) nurse licensed under Section
58-31b-301
[.] or
58-31c-102
;
240
(i) podiatrist;
241
(j) certified nurse h [
midwives
]
MIDWIFE
h ;
242
(k) respiratory h [
therapists
]
THERAPIST
h ; or
243
(l) pharmacist, pharmacy h [
technicians
]
TECHNICIAN
h , and pharmacy h [
interns
]
243a
INTERN
h .
244
(2) (a) This Subsection (2) applies to health care professionals:
245
(i) described in Subsection (1);
246
(ii) who are under no legal duty to respond to the circumstances described in
247
Subsection (2)(b);
248
(iii) who are acting within the scope of the health care professional's license, or within
249
the scope of practice as modified under Subsection
58-1-307
(4); and
250
(iv) who are acting in good faith without compensation or remuneration as defined in
251
Subsection
58-13-3
(2).
252
(b) A health care professional described in Subsection (2)(a) is not liable for any civil
253
damages as a result of any acts or omissions by the health care professional in rendering care as
254
a result of:
255
(i) implementation of measures to control the causes of epidemic and communicable
256
diseases and other conditions significantly affecting the public health or necessary to protect
257
the public health as set out in Title 26A, Chapter 1, Local Health Departments;
258
(ii) investigating and controlling suspected bioterrorism and disease as set out in Title
259
26, Chapter 23b, Detection of Public Health Emergencies Act; and
260
(iii) responding to a national, state, or local emergency, a public health emergency as
261
defined in Section
26-23b-102
, or a declaration by the President of the United States or other
262
federal official requesting public health-related activities.
262a
S
(3) THE IMMUNITY IN SUBSECTION (2) IS IN ADDITION TO ANY IMMUNITY OR PROTECTION IN
262b
STATE OR FEDERAL LAW THAT MAY APPLY.
s
263
Section 4.
Section
58-17a-620
is amended to read:
264
58-17a-620. Prescriptions issued within the public health system.
265
(1) As used in this section:
266
(a) "Department of Health" means the state Department of Health created in Section
267
26-1-4
.
268
(b) "Health department" means either the Department of Health or a local health
269
department.
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(c) "Local health departments" means the local health departments created in Title
271
26A, Chapter 1, Local Health Departments.
272
(2) A health department may implement the prescription, distribution, dispensing,
273
compounding, and administering procedure under Subsection (3) for prescription drugs, other
274
than controlled substances, for use in:
275
(a) clinics providing:
276
[(a)] (i) sexually transmitted disease treatment;
277
[(b)] (ii) fluoride treatment; [or]
277a
h
(iii) TUBERCULOSIS OR LATENT TUBERCULOSIS TREATMENT;
h
278
[(c)] h [
(iii)
]
(iv)
h travel immunization h
OR MEDICATION
h [.]; or
279
h [
(iv)
]
(v)
h immunization; or
280
(b) responses to bioterrorism, epidemic or pandemic disease, or a public health
281
emergency as defined in Section
26-23b-102
, a national, state, or local emergency, or a
282
declaration by the President of the United States or other federal official requesting public
283
health-related activities.
284
(3) The following prescription, distribution, dispensing, compounding, and
285
administering procedure shall be carried out in accordance with the requirements of Subsection
286
(4) and may be used only in the clinics listed under Subsection (2)(a) or in response to
287
emergencies or declarations under Subsection (2)(b):
288
(a) a physician writes and signs a prescription for prescription drugs, other than
289
controlled substances, without the name and address of the patient and without the date the
290
prescription is provided to the patient; [and]
291
(b) the physician authorizes a [registered nurse] person licensed under Chapter 31b,
292
Nurse Practice Act, Chapter 70, Physician Assistant Act, or Chapter 31c, Nurse Licensure
293
Compact, employed by the health department to complete the prescription written under
294
Subsection (3)(a) by inserting the patient's name and address, and the date the prescription is
295
provided to the patient, in accordance with the physician's standing written orders and a written
296
health department protocol approved by the physician and the medical director of the state
297
Department of Health[.]; and
298
(c) a person licensed under Chapter 31b, Nurse Practice Act, Chapter 70, Physician
299
Assistant Act, or Chapter 31c, Nurse Licensure Compact, employed by a health department
300
personally administers the drugs or medicines other than controlled substances pursuant to a
301
prescription issued in compliance with this section in order to supply the immediate needs of
302
the patient.
303
(4) When allowing prescriptions to be written, or prescription drugs other than
304
controlled substances to be distributed, dispensed, compounded, or administered, under
305
Subsection (3), the health department shall employ a physician who:
306
(a) assumes specific responsibility for all prescriptions issued in his name under the
307
procedure in Subsection (3) by the health department; and
308
(b) enters into a written signed agreement with the health department, which agreement
309
is approved by the division and states:
310
(i) the terms and conditions under which the physician will prepare and sign
311
prescriptions that do not include the name and address of the patient and the date the
312
prescription is provided to the patient;
313
(ii) the methods which will be used to ensure the signed prescriptions are secure and
314
not available for unauthorized use;
315
(iii) the minimum qualifications and training of a [registered nurse] a person described
316
in Subsection (3)(b) authorized by the physician and department to complete and provide
317
prescriptions to a patient;
318
(iv) under what conditions prescriptions completed by an authorized [registered nurse]
319
person will be provided to a patient in accordance with standing orders and written protocols,
320
and the specific prescription drugs for which prescriptions may be written;
321
(v) the manner in which the physician will audit and review the records of patients
322
receiving prescriptions; and
323
(vi) the manner in which records of prescriptions issued will be maintained for audit by
324
the physician and division.
325
(5) The health department shall file and maintain with the division a current copy of all
326
agreements signed by physicians under Subsection (4).
327
(6) (a) All prescription forms to be used by a physician and health department in
328
accordance with this section shall be serially numbered according to a numbering system
329
assigned to that health department by the division.
330
(b) All prescriptions issued shall contain all information required under this chapter
331
and rules adopted under this chapter.
332
Section 5.
Section
63-30-3
is amended to read:
333
63-30-3. Immunity of governmental entities from suit.
334
(1) Except as may be otherwise provided in this chapter, all governmental entities are
335
immune from suit for any injury which results from the exercise of a governmental function,
336
governmentally-owned hospital, nursing home, or other governmental health care facility, and
337
from an approved medical, nursing, or other professional health care clinical training program
338
conducted in either public or private facilities.
339
(2) Subsections (2)(a) through (c) are unique or essential core governmental functions
340
and, notwithstanding the waiver of immunity provisions of Section
63-30-10
, governmental
341
entities, political subdivisions, and their officers and employees are immune from suit for any
342
injury or damage resulting from the implementation of or the failure to:
343
(a) implement measures to control the causes of epidemic and communicable diseases
344
and other conditions significantly affecting the public health or necessary to protect the public
345
health as set out in Title 26A, Chapter 1, Local Health Departments;
346
(b) investigate and control suspected bioterrorism and disease as set out in Title 26,
347
Chapter 23b, Detection of Public Health Emergencies Act; and
348
(c) respond to a national, state, or local emergency, a public health emergency as
349
defined in Section
26-23b-102
, or a declaration by the President of the United States or other
350
federal official requesting public health-related activities.
351
[(2)] (3) (a) For the purposes of this chapter only, the following state medical programs
352
and services performed at a state-owned university hospital are unique or essential to the core
353
of governmental activity in this state and are considered to be governmental functions:
354
(i) care of a patient referred by another hospital or physician because of the high risk
355
nature of the patient's medical condition;
356
(ii) high risk care or procedures available in Utah only at a state-owned university
357
hospital or provided in Utah only by physicians employed at a state-owned university acting in
358
the scope of their employment;
359
(iii) care of patients who cannot receive appropriate medical care or treatment at
360
another medical facility in Utah; and
361
(iv) any other service or procedure performed at a state-owned university hospital or by
362
physicians employed at a state-owned university acting in the scope of their employment that a
363
court finds is unique or essential to the core of governmental activity in this state.
364
(b) If any claim under this Subsection (3) exceeds the limits established in Section
365
63-30-34
, the claimant may submit the excess claim to the Board of Examiners and the
366
Legislature under Title 63, Chapter 6.
367
[(3)] (4) The management of flood waters and other natural disasters and the
368
construction, repair, and operation of flood and storm systems by governmental entities are
369
considered to be governmental functions, and governmental entities and their officers and
370
employees are immune from suit for any injury or damage resulting from those activities.
371
[(4)] (5) Officers and employees of a Children's Justice Center are immune from suit
372
for any injury which results from their joint intergovernmental functions at a center created in
373
Title 62A, Chapter 4a, Child and Family Services.
374
Section 6.
Section
78-11-22
is amended to read:
375
78-11-22. Good Samaritan Act.
376
(1) A person who renders emergency care at or near the scene of, or during an
377
emergency, gratuitously and in good faith, is not liable for any civil damages or penalties as a
378
result of any act or omission by the person rendering the emergency care, unless the person is
379
grossly negligent or caused the emergency. As used in this section, "emergency" means an
380
unexpected occurrence involving injury, threat of injury, or illness to a person or the public,
381
including motor vehicle accidents, disasters, actual or threatened discharges, removal, or
382
disposal of hazardous materials, and other accidents or events of a similar nature. "Emergency
383
care" includes actual assistance or advice offered to avoid, mitigate, or attempt to mitigate the
384
effects of an emergency.
385
(2) A person who gratuitously, and in good faith, assists governmental agencies or
386
political subdivisions in the activities described in Subsections (2)(a) through (c) is not liable
387
for any civil damages or penalties as a result of any act or omission unless the person rendering
388
assistance is grossly negligent:
389
(a) implementation of measures to control the causes of epidemic and communicable
390
diseases and other conditions significantly affecting the public health, or necessary to protect
391
the public health as set out in Title 26A, Chapter 1, Local Health Departments;
392
(b) investigating and controlling suspected bioterrorism and disease as set out in Title
393
26, Chapter 23b, Detection of Public Health Emergencies Act; and
394
(c) responding to a national, state, or local emergency, a public health emergency as
395
defined in Section
26-23b-102
, or a declaration by the President of the United States or other
396
federal official requesting public health-related activities.
396a
S
(3) THE IMMUNITY IN SUBSECTION (2) IS IN ADDITION TO ANY IMMUNITY OR PROTECTION IN
396b
STATE OR FEDERAL LAW THAT MAY APPLY.
s
397
Section 7. Effective date.
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If approved by two-thirds of all the members elected to each house, this act takes effect
399
upon approval by the governor, or the day following the constitutional time limit of Utah
400
Constitution Article VII, Section 8, without the governor's signature, or in the case of a veto,
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the date of veto override.
Legislative Review Note
as of 1-30-03 9:19 AM
A limited legal review of this legislation raises no obvious constitutional or statutory concerns.