Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                               H.B. 240
Approved for Filing: C. Williams 6
          6 01-10-24 3:10 PM 6
                  CERTIFIED NURSING ASSISTANT AMENDMENTS
                                       2024 GENERAL SESSION
                                            STATE OF UTAH
                                 Chief Sponsor: A. Cory Maloy
                                  Senate Sponsor: ____________
 6
 LONG TITLE
 General Description:
        This bill modifies provisions related to certified nursing assistants.
 Highlighted Provisions:
        This bill:
        < allows an individual seeking a certified nursing assistant certification to complete
 the training requirement at certain health care facilities; and
        < makes technical changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
        26B-2-202, as renumbered and amended by Laws of Utah 2023, Chapter 305
        58-31b-102, as last amended by Laws of Utah 2023, Chapters 223, 329
        58-31b-302, as last amended by Laws of Utah 2023, Chapters 223, 284
24
 Be it enacted by the Legislature of the state of Utah:
                                                                                                     H.B. 240
        Section 1. Section 26B-2-202 is amended to read:
        26B-2-202. Duties of department.
     *HB0240*
           H.B. 240                                                                    01-10-24 3:10 PM
          (1) The department shall:
          (a) enforce rules established pursuant to this part;
          (b) authorize an agent of the department to conduct inspections of health care facilities
 pursuant to this part;
          (c) collect information authorized by the committee that may be necessary to ensure
 that adequate health care facilities are available to the public;
          (d) collect and credit fees for licenses as free revenue;
          (e) collect and credit fees for conducting plan reviews as dedicated credits;
          (f) (i) collect and credit fees for conducting clearance under Sections 26B-2-239 and
 26B-2-240; and
          (ii) beginning July 1, 2012:
          (A) up to $105,000 of the fees collected under Subsection (1)(f)(i) are dedicated
 credits; and
          (B) the fees collected for background checks under Subsection 26B-2-240(6) and
 Subsection 26B-2-241(4) shall be transferred to the Department of Public Safety to reimburse
 the Department of Public Safety for its costs in conducting the federal background checks;
          (g) designate an executive secretary from within the department to assist the committee
 in carrying out its powers and responsibilities;
          (h) establish reasonable standards for criminal background checks by public and
 private entities;
          (i) recognize those public and private entities that meet the standards established
 pursuant to Subsection (1)(h); [and]
          (j) establish and maintain a certification for certified nursing assistants that:
          (i) complies with the Omnibus Budget Reconciliation Act of 1987, Pub. L. No.
 100-203; and
          (ii) allows an individual to fulfill the supervised training requirement while working in    º
53a   [:
          (A) a nursing care facility;
          (B) a general acute hospital; or
          (C) any other] any »       health care facility   º , including a nursing care facility, a
56a general acute hospital, and an assisted living facility, »          the department determines would not
56b violate the
 Omnibus Budget Reconciliation Act of 1987, Pub. L. No. 100-203; and
          [(j)] (k) provide necessary administrative and staff support to the committee.
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       01-10-24 3:10 PM                                                                       H.B. 240
        (2) The department may:
        (a) exercise all incidental powers necessary to carry out the purposes of this part;
        (b) review architectural plans and specifications of proposed health care facilities or
 renovations of health care facilities to ensure that the plans and specifications conform to rules
 established by the committee; and
        (c) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
 make rules as necessary to implement the provisions of this part.
        Section 2. Section 58-31b-102 is amended to read:
        58-31b-102. Definitions.
        In addition to the definitions in Section 58-1-102, as used in this chapter:
        (1) "Administrative penalty" means a monetary fine or citation imposed by the division
 for acts or omissions determined to be unprofessional or unlawful conduct in accordance with a
 fine schedule established by division rule made in accordance with Title 63G, Chapter 3, Utah
 Administrative Rulemaking Act, and as a result of an adjudicative proceeding conducted in
 accordance with Title 63G, Chapter 4, Administrative Procedures Act.
        (2) "Applicant" means an individual who applies for licensure or certification under
 this chapter by submitting a completed application for licensure or certification and the
 required fees to the department.
        (3) "Approved education program" means a nursing education program that is
 accredited by an accrediting body for nursing education that is approved by the United States
 Department of Education.
        (4) "Board" means the Board of Nursing created in Section 58-31b-201.
        (5) "Diagnosis" means the identification of and discrimination between physical and
 psychosocial signs and symptoms essential to the effective execution and management of
 health care.
        (6) "Examinee" means an individual who applies to take or does take any examination
 required under this chapter for licensure.
        (7) "Licensee" means an individual who is licensed or certified under this chapter.
        (8) "Long-term care facility" means any of the following facilities licensed by the
 Department of Health and Human Services pursuant to Title 26B, Chapter 2, Part 2, Health
 Care Facility Licensing and Inspection:
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        H.B. 240                                                                       01-10-24 3:10 PM
         (a) a nursing care facility;
         (b) a small health care facility;
         (c) an intermediate care facility for people with an intellectual disability;
         (d) an assisted living facility Type I or II; or
         (e) a designated swing bed unit in a general hospital.
         (9) "Medication aide certified" means a certified [nurse aide] nursing assistant who:
         (a) has a minimum of 2,000 hours experience working as a certified [nurse aide]
 nursing assistant;
         (b) has received a minimum of 60 hours of classroom and 40 hours of practical training
 that is approved by the division in collaboration with the board, in administering routine
 medications to patients or residents of long-term care facilities; and
         (c) is certified by the division as a medication aide certified.
         (10) (a) "Practice as a medication aide certified" means the limited practice of nursing
 under the supervision, as defined by the division by rule made in accordance with Title 63G,
 Chapter 3, Utah Administrative Rulemaking Act, of a licensed nurse, involving routine patient
 care that requires minimal or limited specialized or general knowledge, judgment, and skill, to
 an individual who:
         (i) is ill, injured, infirm, has a physical, mental, developmental, or intellectual
 disability; and
         (ii) is in a regulated long-term care facility.
         (b) "Practice as a medication aide certified":
         (i) includes:
         (A) providing direct personal assistance or care; and
         (B) administering routine medications to patients in accordance with a formulary and
 protocols to be defined by the division by rule made in accordance with Title 63G, Chapter 3,
 Utah Administrative Rulemaking Act; and
         (ii) does not include assisting a resident of an assisted living facility, a long term care
 facility, or an intermediate care facility for people with an intellectual disability to self
 administer a medication, as regulated by the Department of Health and Human Services by rule
 made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
         (11) "Practice of advanced practice registered nursing" means the practice of nursing
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        01-10-24 3:10 PM                                                                       H.B. 240
 within the generally recognized scope and standards of advanced practice registered nursing as
 defined by rule and consistent with professionally recognized preparation and education
 standards of an advanced practice registered nurse by a person licensed under this chapter as an
 advanced practice registered nurse. "Practice of advanced practice registered nursing" includes:
        (a) maintenance and promotion of health and prevention of disease;
        (b) diagnosis, treatment, correction, consultation, and referral;
        (c) prescription or administration of prescription drugs or devices including:
        (i) local anesthesia;
        (ii) Schedule III-V controlled substances; and
        (iii) Schedule II controlled substances; or
        (d) the provision of preoperative, intraoperative, and postoperative anesthesia care and
 related services upon the request of a licensed health care professional by an advanced practice
 registered nurse specializing as a certified registered nurse anesthetist, including:
        (i) preanesthesia preparation and evaluation including:
        (A) performing a preanesthetic assessment of the patient;
        (B) ordering and evaluating appropriate lab and other studies to determine the health of
 the patient; and
        (C) selecting, ordering, or administering appropriate medications;
        (ii) anesthesia induction, maintenance, and emergence, including:
        (A) selecting and initiating the planned anesthetic technique;
        (B) selecting and administering anesthetics and adjunct drugs and fluids; and
        (C) administering general, regional, and local anesthesia;
        (iii) postanesthesia follow-up care, including:
        (A) evaluating the patient's response to anesthesia and implementing corrective
 actions; and
        (B) selecting, ordering, or administering the medications and studies listed in this
 Subsection (11)(d);
        (iv) other related services within the scope of practice of a certified registered nurse
 anesthetist, including:
        (A) emergency airway management;
        (B) advanced cardiac life support; and
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        H.B. 240                                                                     01-10-24 3:10 PM
         (C) the establishment of peripheral, central, and arterial invasive lines; and
         (v) for purposes of this Subsection (11)(d), "upon the request of a licensed health care
 professional":
         (A) means a health care professional practicing within the scope of the health care
 professional's license, requests anesthesia services for a specific patient; and
         (B) does not require an advanced practice registered nurse specializing as a certified
 registered nurse anesthetist to obtain additional authority to select, administer, or provide
 preoperative, intraoperative, or postoperative anesthesia care and services.
         (12) "Practice of nursing" means assisting individuals or groups to maintain or attain
 optimal health, implementing a strategy of care to accomplish defined goals and evaluating
 responses to care and treatment, and requires substantial specialized or general knowledge,
 judgment, and skill based upon principles of the biological, physical, behavioral, and social
 sciences. "Practice of nursing" includes:
         (a) initiating and maintaining comfort measures;
         (b) promoting and supporting human functions and responses;
         (c) establishing an environment conducive to well-being;
         (d) providing health counseling and teaching;
         (e) collaborating with health care professionals on aspects of the health care regimen;
         (f) performing delegated procedures only within the education, knowledge, judgment,
 and skill of the licensee;
         (g) delegating nursing tasks that may be performed by others, including an unlicensed
 assistive personnel; and
         (h) supervising an individual to whom a task is delegated under Subsection (12)(g) as
 the individual performs the task.
         (13) "Practice of practical nursing" means the performance of nursing acts in the
 generally recognized scope of practice of licensed practical nurses as defined by division rule
 made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, and as
 provided in this Subsection (13) by an individual licensed under this chapter as a licensed
 practical nurse and under the direction of a registered nurse, licensed physician, or other
 specified health care professional as defined by division rule made in accordance with Title
 63G, Chapter 3, Utah Administrative Rulemaking Act. Practical nursing acts include:
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        01-10-24 3:10 PM                                                                          H.B. 240
         (a) contributing to the assessment of the health status of individuals and groups;
         (b) participating in the development and modification of the strategy of care;
         (c) implementing appropriate aspects of the strategy of care;
         (d) maintaining safe and effective nursing care rendered to a patient directly or
 indirectly; and
         (e) participating in the evaluation of responses to interventions.
         (14) "Practice of registered nursing" means performing acts of nursing as provided in
 this Subsection (14) by an individual licensed under this chapter as a registered nurse within
 the generally recognized scope of practice of registered nurses as defined by division rule made
 in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act. Registered
 nursing acts include:
         (a) assessing the health status of individuals and groups;
         (b) identifying health care needs;
         (c) establishing goals to meet identified health care needs;
         (d) planning a strategy of care;
         (e) prescribing nursing interventions to implement the strategy of care;
         (f) implementing the strategy of care;
         (g) maintaining safe and effective nursing care that is rendered to a patient directly or
 indirectly;
         (h) evaluating responses to interventions;
         (i) teaching the theory and practice of nursing; and
         (j) managing and supervising the practice of nursing.
         (15) "Registered nurse apprentice" means an individual licensed under Subsection
 58-31b-301(2)(b) who is learning and engaging in the practice of registered nursing under the
 indirect supervision of an individual licensed under:
         (a) Subsection 58-31b-301(2)(c), (e), or (f);
         (b) Chapter 67, Utah Medical Practice Act; or
         (c) Chapter 68, Utah Osteopathic Medical Practice Act.
         (16) "Routine medications":
         (a) means established medications administered to a medically stable individual as
 determined by a licensed health care practitioner or in consultation with a licensed medical
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        H.B. 240                                                                   01-10-24 3:10 PM
 practitioner; and
        (b) is limited to medications that are administered by the following routes:
        (i) oral;
        (ii) sublingual;
        (iii) buccal;
        (iv) eye;
        (v) ear;
        (vi) nasal;
        (vii) rectal;
        (viii) vaginal;
        (ix) skin ointments, topical including patches and transdermal;
        (x) premeasured medication delivered by aerosol/nebulizer; and
        (xi) medications delivered by metered hand-held inhalers.
        (17) "Unlawful conduct" means the same as that term is defined in Sections 58-1-501
 and 58-31b-501.
        (18) "Unlicensed assistive personnel" means any unlicensed individual, regardless of
 title, who is delegated a task by a licensed nurse as permitted by division rule made in
 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, and the standards
 of the profession.
        (19) "Unprofessional conduct" means the same as that term is defined in Sections
 58-1-501 and 58-31b-502 and as may be further defined by division rule made in accordance
 with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
        Section 3. Section 58-31b-302 is amended to read:
        58-31b-302. Qualifications for licensure or certification -- Criminal background
 checks.
        (1) An appli