Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                            H.B. 361
Approved for Filing: C. Williams 6
          6 01-23-24 9:02 AM 6
                 NURSING EDUCATION PROGRAM AMENDMENTS
                                     2024 GENERAL SESSION
                                          STATE OF UTAH
                             Chief Sponsor: Rosemary T. Lesser
                                Senate Sponsor: ____________
 6
 LONG TITLE
 General Description:
        This bill makes amendments related to nursing education programs.
 Highlighted Provisions:
        This bill:
        < amends definitions;
        < modifies Board of Nursing duties;
        < requires nursing education programs to meet minimum education standards in order
 for the education program to qualify graduates of the program for the various
 nursing licenses; and
        < requires the Division of Professional Licensing to post national exam pass rates.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
        58-31b-102, as last amended by Laws of Utah 2023, Chapters 223, 329
        58-31b-201, as last amended by Laws of Utah 2018, Chapter 318
                                                                                                  H.B. 361
        58-31b-601, as last amended by Laws of Utah 2022, Chapter 382
27
     *HB0361*
       H.B. 361                                                                    01-23-24 9:02 AM
 Be it enacted by the Legislature of the state of Utah:
        Section 1. 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)] (3) "Board" means the Board of Nursing created in Section 58-31b-201.
        [(5)] (4) "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)] (5) "Examinee" means an individual who applies to take or does take any
 examination required under this chapter for licensure.
        [(7)] (6) "Licensee" means an individual who is licensed or certified under this chapter.
        [(8)] (7) "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:
        (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)] (8) "Medication aide certified" means a certified nurse aide who:
                                                      -2-
       01-23-24 9:02 AM                                                                              H.B. 361
         (a) has a minimum of 2,000 hours experience working as a certified nurse aide;
         (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)] (9) (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)] (10) "Practice of advanced practice registered nursing" means the practice of
 nursing 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;
                                                       -3-
        H.B. 361                                                                    01-23-24 9:02 AM
        (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)] (10)(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
        (C) the establishment of peripheral, central, and arterial invasive lines; and
        (v) for purposes of this Subsection [(11)(d)] (10)(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
                                                       -4-
        01-23-24 9:02 AM                                                                          H.B. 361
 registered nurse anesthetist to obtain additional authority to select, administer, or provide
 preoperative, intraoperative, or postoperative anesthesia care and services.
         [(12)] (11) "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)]
 (11)(g) as the individual performs the task.
         [(13)] (12) "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)] (12) 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:
         (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.
                                                      -5-
        H.B. 361                                                                    01-23-24 9:02 AM
         [(14)] (13) "Practice of registered nursing" means performing acts of nursing as
 provided in this Subsection [(14)] (13) 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)] (14) "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)] (15) "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
 practitioner; and
         (b) is limited to medications that are administered by the following routes:
         (i) oral;
         (ii) sublingual;
         (iii) buccal;
         (iv) eye;
                                                       -6-
        01-23-24 9:02 AM                                                                        H.B. 361
        (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)] (16) "Unlawful conduct" means the same as that term is defined in Sections
 58-1-501 and 58-31b-501.
        [(18)] (17) "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)] (18) "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 2. 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 11 members:
        (a) nine 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 or certification 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]
                                                      -7-
        H.B. 361                                                                   01-23-24 9:02 AM
        [(B) advise the division in its investigation of these complaints.]
        [(b)] (3) The board shall:
        (a) carry out the duties and responsibilities in Sections 58-1-202 and 58-1-203;
        (b) consult with the division regarding the duties described in Section 58-31b-601; and
        (c) designate one member on a permanent or rotating basis to:
        (i) assist the division in reviewing complaints concerning the unlawful or
 unprofessional conduct of an individual licensed under this chapter; and
        (ii) advise the division in investigating a complaint.
        (4) A board member who has, under Subsection [(3)(a)(iii),] (3)(c), 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.
        Section 3. Section 58-31b-601 is amended to read:
        58-31b-601. Minimum standards for nursing programs to qualify graduates --
 Temporary approval to qualify graduates for licensure -- Minimum standards for
 medication aide training to qualify persons for certification -- Posting requirement.
        [(1) Except as provided in Subsections (2) and (3), to qualify as an approved education
 program for the purpose of qualifying graduates for licensure under this chapter, a nursing
 education program shall be accredited by an accrediting body for nursing education that is
 recognized by the United States Department of Education.]
        [(2) (a) The division, in consultation with the board, may approve a nursing education
 program for up to five years, for the purpose of qualifying graduates for licensure under this
 chapter, if the program:]
        [(i) holds candidacy or is in the process of applying for candidacy for the accreditation
238