Bill Summary – FastDemocracy

Enrolled Copy                                                                         S.B. 24
                  PHYSICIAN ASSISTANT PRACTICE AMENDMENTS
                                          2024 GENERAL SESSION
                                               STATE OF UTAH
                                     Chief Sponsor: Curtis S. Bramble House Sponsor: A. Cory Maloy
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  LONG TITLE
  General Description:
     This bill modifies provisions relating to physician assistants.
  Highlighted Provisions:
     This bill:
     ▸ clarifies the scope of practice for physician assistants.
  Money Appropriated in this Bill:
     None
  Other Special Clauses:
     This bill provides a coordination clause.
  Utah Code Sections Affected:
  AMENDS:
     26B-1-501, as renumbered and amended by Laws of Utah 2023, Chapter 305
     26B-2-201, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
     amended by Laws of Utah 2023, Chapter 305
     26B-3-123, as last amended by Laws of Utah 2023, Chapter 295 and renumbered and
     amended by Laws of Utah 2023, Chapter 306
     26B-4-409, as renumbered and amended by Laws of Utah 2023, Chapter 307
     26B-4-410, as renumbered and amended by Laws of Utah 2023, Chapter 307
     26B-7-216, as renumbered and amended by Laws of Utah 2023, Chapter 308
     26B-7-402, as renumbered and amended by Laws of Utah 2023, Chapter 308
     26B-8-104, as renumbered and amended by Laws of Utah 2023, Chapter 306
     26B-8-115, as renumbered and amended by Laws of Utah 2023, Chapter 306
     26B-8-118, as renumbered and amended by Laws of Utah 2023, Chapter 306
     53-2a-1601, as enacted by Laws of Utah 2022, Chapter 111
     53-3-206, as last amended by Laws of Utah 2023, Chapter 391
     S.B. 24                                                                                 Enrolled Copy
       53-3-220, as last amended by Laws of Utah 2023, Chapter 415
       53G-6-204, as last amended by Laws of Utah 2023, Chapter 162
       53G-6-603, as last amended by Laws of Utah 2022, Chapter 329
       53G-9-403, as last amended by Laws of Utah 2022, Chapter 214
       58-37c-3, as last amended by Laws of Utah 2015, Chapter 258
       75-2a-104, as last amended by Laws of Utah 2009, Chapter 99
       75-2a-106, as last amended by Laws of Utah 2023, Chapter 330
       75-2a-117, as last amended by Laws of Utah 2009, Chapter 99
       75-5-301.5, as enacted by Laws of Utah 2022, Chapter 358 and last amended by
       Coordination Clause, Laws of Utah 2022, Chapter 358
       75-5-303, as last amended by Laws of Utah 2018, Chapter 455
       76-5-111, as last amended by Laws of Utah 2022, Chapter 181
   Utah Code Sections affected by Coordination Clause:
       26B-7-402, as renumbered and amended by Laws of Utah 2023, Chapter 308
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   Be it enacted by the Legislature of the state of Utah:
           Section 1. Section 26B-1-501 is amended to read:
           26B-1-501 . Definitions.
           As used in this part:
   (1) "Abuse" means the same as that term is defined in Section 80-1-102.
   (2) "Child" means the same as that term is defined in Section 80-1-102.
   (3) "Committee" means a fatality review committee that is formed under Section 26B-1-503
       or 26B-1-504.
   (4) "Dependency" means the same as that term is defined in Section 80-1-102.
   (5) "Formal review" means a review of a death or a near fatality that is ordered under
       Subsection 26B-1-502(6).
   (6) "Near fatality" means alleged abuse or neglect that, as certified by a physician or
       physician assistant, places a child in serious or critical condition.
   (7) "Qualified individual" means an individual who:
       (a) at the time that the individual dies, is a resident of a facility or program that is owned
             or operated by the department or a division of the department;
       (b) (i) is in the custody of the department or a division of the department; and
             (ii) is placed in a residential placement by the department or a division of the
                  department;
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     Enrolled Copy                                                                                      S.B. 24
      (c) at the time that the individual dies, has an open case for the receipt of child welfare
          services, including:
          (i) an investigation for abuse, neglect, or dependency;
          (ii) foster care;
          (iii) in-home services; or
          (iv) substitute care;
      (d) had an open case for the receipt of child welfare services within one year before the
          day on which the individual dies;
      (e) was the subject of an accepted referral received by Adult Protective Services within
          one year before the day on which the individual dies, if:
          (i) the department or a division of the department is aware of the death; and
          (ii) the death is reported as a homicide, suicide, or an undetermined cause;
      (f) received services from, or under the direction of, the Division of Services for People
          with Disabilities within one year before the day on which the individual dies, unless
          the individual:
          (i) lived in the individual's home at the time of death; and
          (ii) the director of the Division of Continuous Quality and Improvement determines
              that the death was not in any way related to services that were provided by, or
              under the direction of, the department or a division of the department;
      (g) dies within 60 days after the day on which the individual is discharged from the Utah
          State Hospital, if the department is aware of the death;
      (h) is a child who:
          (i) suffers a near fatality; and
          (ii) is the subject of an open case for the receipt of child welfare services within one
              year before the day on which the child suffered the near fatality, including:
              (A) an investigation for abuse, neglect, or dependency;
              (B) foster care;
              (C) in-home services; or
              (D) substitute care; or
      (i) is designated as a qualified individual by the executive director.
  (8) "Neglect" means the same as that term is defined in Section 80-1-102.
  (9) "Substitute care" means the same as that term is defined in Section 80-1-102.
        Section 2. Section 26B-2-201 is amended to read:
        26B-2-201 . Definitions.
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      S.B. 24                                                                                     Enrolled Copy
           As used in this part:
   (1) (a) "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
       (b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
             Section 76-7-301 or Section 76-71-101.
   (2) "Activities of daily living" means essential activities including:
       (a) dressing;
       (b) eating;
       (c) grooming;
       (d) bathing;
       (e) toileting;
       (f) ambulation;
       (g) transferring; and
       (h) self-administration of medication.
   (3) "Ambulatory surgical facility" means a freestanding facility, which provides surgical
       services to patients not requiring hospitalization.
   (4) "Assistance with activities of daily living" means providing of or arranging for the
       provision of assistance with activities of daily living.
   (5) (a) "Assisted living facility" means:
             (i) a type I assisted living facility, which is a residential facility that provides
                  assistance with activities of daily living and social care to two or more residents
                  who:
                  (A) require protected living arrangements; and
                  (B) are capable of achieving mobility sufficient to exit the facility without the
                      assistance of another person; and
             (ii) a type II assisted living facility, which is a residential facility with a home-like
                  setting that provides an array of coordinated supportive personal and health care
                  services available 24 hours per day to residents who have been assessed under
                  department rule to need any of these services.
       (b) Each resident in a type I or type II assisted living facility shall have a service plan
             based on the assessment, which may include:
             (i) specified services of intermittent nursing care;
             (ii) administration of medication; and
             (iii) support services promoting residents' independence and self-sufficiency.
   (6) "Birthing center" means a facility that:
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      Enrolled Copy                                                                                       S.B. 24
      (a) receives maternal clients and provides care during pregnancy, delivery, and
          immediately after delivery; and
      (b) (i) is freestanding; or
          (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
              described in Subsection 26B-2-228(7).
  (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
  (8) "Consumer" means any person not primarily engaged in the provision of health care to
      individuals or in the administration of facilities or institutions in which such care is
      provided and who does not hold a fiduciary position, or have a fiduciary interest in any
      entity involved in the provision of health care, and does not receive, either directly or
      through his spouse, more than 1/10 of his gross income from any entity or activity
      relating to health care.
  (9) "End stage renal disease facility" means a facility which furnishes staff-assisted kidney
      dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
  (10) "Freestanding" means existing independently or physically separated from another
      health care facility by fire walls and doors and administrated by separate staff with
      separate records.
  (11) "General acute hospital" means a facility which provides diagnostic, therapeutic, and
      rehabilitative services to both inpatients and outpatients by or under the supervision of
      physicians.
  (12) "Governmental unit" means the state, or any county, municipality, or other political
      subdivision or any department, division, board, or agency of the state, a county,
      municipality, or other political subdivision.
  (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
      health agencies, hospices, nursing care facilities, residential-assisted living facilities,
      birthing centers, ambulatory surgical facilities, small health care facilities, abortion
      clinics, a clinic that meets the definition of hospital under Section 76-7-301 or
      76-71-201, facilities owned or operated by health maintenance organizations, end
      stage renal disease facilities, and any other health care facility which the committee
      designates by rule.
      (b) "Health care facility" does not include the offices of private physicians or dentists,
          whether for individual or group practice, except that it does include an abortion clinic.
  (14) "Health maintenance organization" means an organization, organized under the laws of
      any state which:
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      S.B. 24                                                                                   Enrolled Copy
       (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
       (b) (i) provides or otherwise makes available to enrolled participants at least the
           following basic health care services: usual physician services, hospitalization,
           laboratory, x-ray, emergency, and preventive services and out-of-area coverage;
           (ii) is compensated, except for copayments, for the provision of the basic health
               services listed in Subsection (14)(b)(i) to enrolled participants by a payment
               which is paid on a periodic basis without regard to the date the health services are
               provided and which is fixed without regard to the frequency, extent, or kind of
               health services actually provided;[ and]
           (iii) provides physicians' services primarily directly through physicians who are
               either employees or partners of such organizations, or through arrangements with
               individual physicians or one or more groups of physicians organized on a group
               practice or individual practice basis[.] ; and
           (iv) provides physician assistant services.
   (15) (a) "Home health agency" means an agency, organization, or facility or a
       subdivision of an agency, organization, or facility which employs two or more direct
       care staff persons who provide licensed nursing services, therapeutic services of
       physical therapy, speech therapy, occupational therapy, medical social services, or
       home health aide services on a visiting basis.
       (b) "Home health agency" does not mean an individual who provides services under the
           authority of a private license.
   (16) "Hospice" means a program of care for the terminally ill and their families which
       occurs in a home or in a health care facility and which provides medical, palliative,
       psychological, spiritual, and supportive care and treatment.
   (17) "Nursing care facility" means a health care facility, other than a general acute or
       specialty hospital, constructed, licensed, and operated to provide patient living
       accommodations, 24-hour staff availability, and at least two of the following patient
       services:
       (a) a selection of patient care services, under the direction and supervision of a registered
           nurse, ranging from continuous medical, skilled nursing, psychological, or other
           professional therapies to intermittent health-related or paraprofessional personal care
           services;
       (b) a structured, supportive social living environment based on a professionally designed
           and supervised treatment plan, oriented to the individual's habilitation or
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      Enrolled Copy                                                                                   S.B. 24
          rehabilitation needs; or
      (c) a supervised living environment that provides support, training, or assistance with
          individual activities of daily living.
  (18) "Person" means any individual, firm, partnership, corporation, company, association,
      or joint stock association, and the legal successor thereof.
  (19) "Resident" means a person 21 years old or older who:
      (a) as a result of physical or mental limitations or age requires or requests services
          provided in an assisted living facility; and
      (b) does not require intensive medical or nursing services as provided in a hospital or
          nursing care facility.
  (20) "Small health care facility" means a four to 16 bed facility that provides licensed
      health care programs and services to residents.
  (21) "Specialty hospital" means a facility which provides specialized diagnostic,
      therapeutic, or rehabilitative services in the recognized specialty or specialties for which
      the hospital is licensed.
  (22) "Substantial compliance" means in a department survey of a licensee, the department
      determines there is an absence of deficiencies which would harm the physical health,
      mental health, safety, or welfare of patients or residents of a licensee.
  (23) "Type I abortion clinic" means a facility, including a physician's office, but not
      including a general acute or specialty hospital, that:
      (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
          pregnancy; and
      (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester of
          pregnancy.
  (24) "Type II abortion clinic" means a facility, including a physician's office, but not
      including a general acute or specialty hospital, that:
      (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
          pregnancy; or
      (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
          pregnancy and after the first trimester of pregnancy.
        Section 3. Section 26B-3-123 is amended to read:
        26B-3-123 . Reimbursement of telemedicine services and telepsychiatric
  consultations.
  (1) As used in this section:
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      S.B. 24                                                                                 Enrolled Copy
       (a) "Telehealth services" means the same as that term is defined in Section 26B-4-704.
       (b) "Telemedicine services" means the same as that term is defined in Section 26B-4-704.
       (c) "Telepsychiatric consultation" means a consul