Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 316 (2022GS)

Sponsor

Rep. Welton, D.

Final action

Governor Signed 3/23/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• allows a medical assistant to administer vaccines under the general supervision of a physician; and
• makes technical changes.

Every vote on this bill

Bill text

MEDICAL ASSISTANT AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Douglas R. Welton
Senate Sponsor: 
Michael S. Kennedy
LONG TITLE
General Description:
This bill allows a medical assistant to administer vaccines.
Highlighted Provisions:
This bill:
▸ allows a medical assistant to administer vaccines under the general supervision of a
physician; and
▸ makes technical changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
58-67-102
, as last amended by Laws of Utah 2017, Chapter 299
58-67-305
, as last amended by Laws of Utah 2018, Chapter 35
58-68-102
, as last amended by Laws of Utah 2017, Chapter 299
58-68-305
, as last amended by Laws of Utah 2018, Chapter 35
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
58-67-102
 is amended to read:
58-67-102.
Definitions.
In addition to the definitions in Section 
58-1-102
, as used in this chapter:
(1) 
(a)
 "Ablative procedure" means a procedure that is expected to excise, vaporize,
disintegrate, or remove living tissue, including the use of carbon dioxide lasers and erbium:
YAG lasers[
, and excluding hair removal
].
(b) "Ablative procedure" does not include hair removal.
(2) "ACGME" means the Accreditation Council for Graduate Medical Education of the
American Medical Association.
(3) "Administrative penalty" means a monetary fine or citation imposed by the division
for acts or omissions determined to constitute unprofessional or unlawful conduct, in
accordance with a fine schedule established by the division in collaboration with the board, as a
result of an adjudicative proceeding conducted in accordance with Title 63G, Chapter 4,
Administrative Procedures Act.
(4) "Associate physician" means an individual licensed under Section 
58-67-302.8
.
(5) "Board" means the Physicians Licensing Board created in Section 
58-67-201
.
(6) "Collaborating physician" means an individual licensed under Section 
58-67-302
who enters into a collaborative practice arrangement with an associate physician.
(7) "Collaborative practice arrangement" means the arrangement described in Section
58-67-807
.
(8) (a) "Cosmetic medical device" means tissue altering energy based devices that have
the potential for altering living tissue and that are used to perform ablative or nonablative
procedures, such as American National Standards Institute (ANSI) designated Class IIIb and
Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic devices, and
excludes ANSI designated Class IIIa and lower powered devices.
(b) Notwithstanding Subsection (8)(a), if an ANSI designated Class IIIa and lower
powered device is being used to perform an ablative procedure, the device is included in the
definition of cosmetic medical device under Subsection (8)(a).
(9) "Cosmetic medical procedure":
(a) includes the use of cosmetic medical devices to perform ablative or nonablative
procedures; and
(b) does not include a treatment of the ocular globe such as refractive surgery.
(10) "Diagnose" means:
(a) to examine in any manner another person, parts of a person's body, substances,
fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
body, to determine the source, nature, kind, or extent of a disease or other physical or mental
condition;
(b) to attempt to conduct an examination or determination described under Subsection
(10)(a);
(c) to hold oneself out as making or to represent that one is making an examination or
determination as described in Subsection (10)(a); or
(d) to make an examination or determination as described in Subsection (10)(a) upon
or from information supplied directly or indirectly by another person, whether or not in the
presence of the person making or attempting the diagnosis or examination.
(11) "LCME" means the Liaison Committee on Medical Education of the American
Medical Association.
(12) "Medical assistant" means an unlicensed individual [
working under the indirect
supervision of a licensed physician and surgeon and engaged in specific tasks assigned by the
licensed physician and surgeon in accordance with the standards and ethics of the profession.
]
who may perform tasks as described in Subsection 
58-67-305
(6).
(13) "Medically underserved area" means a geographic area in which there is a
shortage of primary care health services for residents, as determined by the Department of
Health.
(14) "Medically underserved population" means a specified group of people living in a
defined geographic area with a shortage of primary care health services, as determined by the
Department of Health.
(15) (a) (i) "Nonablative procedure" means a procedure that is expected or intended to
alter living tissue, but is not intended or expected to excise, vaporize, disintegrate, or remove
living tissue.
(ii) Notwithstanding Subsection (15)(a)(i), nonablative procedure includes hair
removal.
(b) "Nonablative procedure" does not include:
(i) a superficial procedure as defined in Section 
58-1-102
;
(ii) the application of permanent make-up; or
(iii) the use of photo therapy and lasers for neuromusculoskeletal treatments that are
performed by an individual licensed under this title who is acting within the individual's scope
of practice.
(16) "Physician" means both physicians and surgeons licensed under Section
58-67-301
, Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
Section 
58-68-301
, Utah Osteopathic Medical Practice Act.
(17) (a) "Practice of medicine" means:
(i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
or imaginary, including to perform cosmetic medical procedures, or to attempt to do so, by any
means or instrumentality, and by an individual in Utah or outside the state upon or for any
human within the state;
(ii) when a person not licensed as a physician directs a licensee under this chapter to
withhold or alter the health care services that the licensee has ordered;
(iii) to maintain an office or place of business for the purpose of doing any of the acts
described in Subsection (17)(a) whether or not for compensation; or
(iv) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
treatment of human diseases or conditions in any printed material, stationery, letterhead,
envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
"physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
designations in any manner which might cause a reasonable person to believe the individual
using the designation is a licensed physician and surgeon, and if the party using the designation
is not a licensed physician and surgeon, the designation must additionally contain the
description of the branch of the healing arts for which the person has a license, provided that an
individual who has received an earned degree of doctor of medicine degree but is not a licensed
physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
(b) The practice of medicine does not include:
(i) except for an ablative medical procedure as provided in Subsection (17)(b)(ii), the
conduct described in Subsection (17)(a)(i) that is performed in accordance with a license issued
under another chapter of this title;
(ii) an ablative cosmetic medical procedure if the scope of practice for the person
performing the ablative cosmetic medical procedure includes the authority to operate or
perform a surgical procedure; or
(iii) conduct under Subsection 
58-67-501
(2).
(18) "Prescription device" means an instrument, apparatus, implement, machine,
contrivance, implant, in vitro reagent, or other similar or related article, and any component
part or accessory, which is required under federal or state law to be prescribed by a practitioner
and dispensed by or through a person or entity licensed under this chapter or exempt from
licensure under this chapter.
(19) "Prescription drug" means a drug that is required by federal or state law or rule to
be dispensed only by prescription or is restricted to administration only by practitioners.
(20) "SPEX" means the Special Purpose Examination of the Federation of State
Medical Boards.
(21) "Unlawful conduct" means the same as that term is defined in Sections 
58-1-501
and 
58-67-501
.
(22) "Unprofessional conduct" means the same as that term is defined in Sections
58-1-501
 and 
58-67-502
, and as may be further defined by division rule.
Section 2. Section 
58-67-305
 is amended to read:
58-67-305.
Exemptions from licensure.
In addition to the exemptions from licensure in Section 
58-1-307
, the following
individuals may engage in the described acts or practices without being licensed under this
chapter:
(1) an individual rendering aid in an emergency, when no fee or other consideration of
value for the service is charged, received, expected, or contemplated;
(2) an individual administering a domestic or family remedy;
(3) (a) (i) a person engaged in the sale of vitamins, health foods, dietary supplements,
herbs, or other products of nature, the sale of which is not otherwise prohibited by state or
federal law; and
(ii) a person acting in good faith for religious reasons, as a matter of conscience, or
based on a personal belief, when obtaining or providing any information regarding health care
and the use of any product under Subsection (3)(a)(i); and
(b) Subsection (3)(a) does not:
(i) allow a person to diagnose any human disease, ailment, injury, infirmity, deformity,
pain, or other condition; or
(ii) prohibit providing truthful and non-misleading information regarding any of the
products under Subsection (3)(a)(i);
(4) a person engaged in good faith in the practice of the religious tenets of any church
or religious belief, without the use of prescription drugs;
(5) an individual authorized by the Department of Health under Section 
26-1-30
, to
draw blood pursuant to Subsection 
41-6a-523
(1)(a)(vi), 
53-10-405
(2)(a)(vi),
72-10-502
(5)(a)(vi), or 
77-23-213
(3)(a)(vi);
[
(6) a medical assistant while working under the indirect supervision of a licensed
physician and surgeon, to the extent the medical assistant:
]
[
(a) is engaged in tasks appropriately delegated by the supervisor in accordance with
the standards and ethics of the practice of medicine;
]
[
(b) does not perform surgical procedures;
]
[
(c) does not prescribe prescription medications;
]
[
(d) does not administer anesthesia, anesthesia does not mean a local anesthetic for
minor procedural use; and
]
[
(e) does not engage in other medical practices or procedures as defined by division
rule in collaboration with the board;
]
(6) a medical assistant:
(a) administering a vaccine under the general supervision of a physician; or
(b) under the indirect supervision of a physician, engaging in tasks appropriately
delegated by the physician in accordance with the standards and ethics of the practice of
medicine, except for:
(i) performing surgical procedures;
(ii) prescribing prescription medications;
(iii) administering anesthesia other than for a local anesthetic for minor procedural use;
or
(iv) engaging in other medical practices or procedures as defined by division rule in
collaboration with the board;
(7) an individual engaging in the practice of medicine when:
(a) the individual is licensed in good standing as a physician in another state with no
licensing action pending and no less than 10 years of professional experience;
(b) the services are rendered as a public service and for a noncommercial purpose;
(c) no fee or other consideration of value is charged, received, expected, or
contemplated for the services rendered beyond an amount necessary to cover the proportionate
cost of malpractice insurance; and
(d) the individual does not otherwise engage in unlawful or unprofessional conduct;
(8) an individual providing expert testimony in a legal proceeding; and
(9) an individual who is invited by a school, association, society, or other body
approved by the division to conduct a clinic or demonstration of the practice of medicine in
which patients are treated, if:
(a) the individual does not establish a place of business in this state;
(b) the individual does not regularly engage in the practice of medicine in this state;
(c) the individual holds a current license in good standing to practice medicine issued
by another state, district or territory of the United States, or Canada;
(d) the primary purpose of the event is the training of others in the practice of
medicine; and
(e) neither the patient nor an insurer is billed for the services performed.
Section 3. Section 
58-68-102
 is amended to read:
58-68-102.
Definitions.
In addition to the definitions in Section 
58-1-102
, as used in this chapter:
(1) 
(a)
 "Ablative procedure" means a procedure that is expected to excise, vaporize,
disintegrate, or remove living tissue, including the use of carbon dioxide lasers and erbium:
YAG lasers[
, and excluding hair removal
].
(b) "Ablative procedure" does not include hair removal.
(2) "ACGME" means the Accreditation Council for Graduate Medical Education of the
American Medical Association.
(3) "Administrative penalty" means a monetary fine imposed by the division for acts or
omissions determined to constitute unprofessional or unlawful conduct, as a result of an
adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
Procedures Act.
(4) "AOA" means the American Osteopathic Association.
(5) "Associate physician" means an individual licensed under Section 
58-68-302.5
.
(6) "Board" means the Osteopathic Physician and Surgeon's Licensing Board created in
Section 
58-68-201
.
(7) "Collaborating physician" means an individual licensed under Section 
58-68-302
who enters into a collaborative practice arrangement with an associate physician.
(8) "Collaborative practice arrangement" means the arrangement described in Section
58-68-807
.
(9) (a) "Cosmetic medical device" means tissue altering energy based devices that have
the potential for altering living tissue and that are used to perform ablative or nonablative
procedures, such as American National Standards Institute (ANSI) designated Class IIIb and
Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic devices and
excludes ANSI designated Class IIIa and lower powered devices.
(b) Notwithstanding Subsection (9)(a), if an ANSI designated Class IIIa and lower
powered device is being used to perform an ablative procedure, the device is included in the
definition of cosmetic medical device under Subsection (9)(a).
(10) "Cosmetic medical procedure":
(a) includes the use of cosmetic medical devices to perform ablative or nonablative
procedures; and
(b) does not include a treatment of the ocular globe such as refractive surgery.
(11) "Diagnose" means:
(a) to examine in any manner another person, parts of a person's body, substances,
fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
body, to determine the source, nature, kind, or extent of a disease or other physical or mental
condition;
(b) to attempt to conduct an examination or determination described under Subsection
(11)(a);
(c) to hold oneself out as making or to represent that one is making an examination or
determination as described in Subsection (11)(a); or
(d) to make an examination or determination as described in Subsection (11)(a) upon
or from information supplied directly or indirectly by another person, whether or not in the
presence of the person making or attempting the diagnosis or examination.
(12) "Medical assistant" means an unlicensed individual [
working under the indirect
supervision of a licensed osteopathic physician and surgeon and engaged in specific tasks
assigned by the licensed osteopathic physician and surgeon in accordance with the standards
and ethics of the profession.
] 
who may perform tasks as described in Subsection 
58-68-305
(6).
(13) "Medically underserved area" means a geographic area in which there is a
shortage of primary care health services for residents, as determined by the Department of
Health.
(14) "Medically underserved population" means a specified group of people living in a
defined geographic area with a shortage of primary care health services, as determined by the
Department of Health.
(15) (a) (i) "Nonablative procedure" means a procedure that is expected or intended to
alter living tissue, but is not expected or intended to excise, vaporize, disintegrate, or remove
living tissue.
(ii) Notwithstanding Subsection (15)(a)(i), nonablative procedure includes hair
removal.
(b) "Nonablative procedure" does not include:
(i) a superficial procedure as defined in Section 
58-1-102
;
(ii) the application of permanent make-up; or
(iii) the use of photo therapy lasers for neuromusculoskeletal treatments that are
preformed by an individual licensed under this title who is acting within the individual's scope
of practice.
(16) "Physician" means both physicians and surgeons licensed under Section
58-67-301
, Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
Section 
58-68-301
, Utah Osteopathic Medical Practice Act.
(17) (a) "Practice of osteopathic medicine" means:
(i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
is based upon emphasis of the importance of the musculoskeletal system and manipulative
therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
state upon or for any human within the state;
(ii) when a person not licensed as a physician directs a licensee under this chapter to
withhold or alter the health care services that the licensee has ordered;
(iii) to maintain an office or place of business for the purpose of doing any of the acts
described in Subsection (17)(a) whether or not for compensation; or
(iv) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
treatment of human diseases or conditions, in any printed material, stationery, letterhead,
envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic medicine,"
"osteopathic physician," "osteopathic surgeon," "osteopathic physician and surgeon," "Dr.,"
"D.O.," or any combination of these designations in any manner which might cause a
reasonable person to believe the individual using the designation is a licensed osteopathic
physician, and if the party using the designation is not a licensed osteopathic physician, the
designation must additionally contain the description of the branch of the healing arts for which
the person has a license, provided that an individual who has received an earned degree of
doctor of osteopathic medicine but is not a licensed osteopathic physician and surgeon in Utah
may use the designation "D.O." if it is followed by "Not Licensed" or "Not Licensed in Utah"
in the same size and style of lettering.
(b) The practice of osteopathic medicine does not include:
(i) except for an ablative medical procedure as provided in Subsection (17)(b)(ii), the
conduct described in Subsection (17)(a)(i) that is performed in accordance with a license issued
under another chapter of this title;
(ii) an ablative cosmetic medical procedure if the scope of practice for the person
performing the ablative cosmetic medical procedure includes the authority to operate or
perform a surgical procedure; or
(iii) conduct under Subsection 
58-68-501
(2).
(18) "Prescription device" means an instrument, apparatus, implement, machine,
contrivance, implant, in vitro reagent, or other similar or related article, and any component
part or accessory, which is required under federal or state law to be prescribed by a practitioner
and dispensed by or through a person or entity licensed under this chapter or exempt from
licensure under this chapter.
(19) "Prescription drug" means a drug that is required by federal or state law or rule to
be dispensed only by prescription or is restricted to administration only by practitioners.
(20) "SPEX" means the Special Purpose Examination of the Federation of State
Medical Boards.
(21) "Unlawful conduct" means the same as that term is defined in Sections 
58-1-501
and 
58-68-501
.
(22) "Unprofessional conduct" means the same as that term is defined in Sections
58-1-501
 and 
58-68-502
 and as may be further defined by division rule.
Section 4. Section 
58-68-305
 is amended to read:
58-68-305.
Exemptions from licensure.
In addition to the exemptions from licensure in Section 
58-1-307
, the following
individuals may engage in the described acts or practices without being licensed under this
chapter:
(1) an individual rendering aid in an emergency, when no fee or other consideration of
value for the service is charged, received, expected, or contemplated;
(2) an individual administering a domestic or family remedy;
(3) (a) (i) a person engaged in the lawful sale of vitamins, health foods, dietary
supplements, herbs, or other products of nature, the sale of which is not otherwise prohibited
by state or federal law; and
(ii) a person acting in good faith for religious reasons, as a matter of conscience, or
based on a personal belief, when obtaining or providing any information regarding health care
and the use of any product under Subsection (3)(a)(i); and
(b) Subsection (3)(a) does not:
(i) permit a person to diagnose any human disease, ailment, injury, infirmity,
deformity, pain, or other condition; or
(ii) prohibit providing truthful and non-misleading information regarding any of the
products under Subsection (3)(a)(i);
(4) a person engaged in good faith in the practice of the religious tenets of any church
or religious belief without the use of prescription drugs;
(5) an individual authorized by the Department of Health under Section 
26-1-30
, to
draw blood pursuant to Subsection 
41-6a-523
(1)(a)(vi), 
53-10-405
(2)(a)(vi),
72-10-502
(5)(a)(vi), or 
77-23-213
(3)(a)(vi);
[
(6) a medical assistant while working under the indirect supervision of a licensed
osteopathic physician, to the extent the medical assistant:
]
[
(a) is engaged in tasks appropriately delegated by the supervisor in accordance with
the standards and ethics of the practice of medicine;
]
[
(b) does not perform surgical procedures;
]
[
(c) does not prescribe prescription medications;
]
[
(d) does not administer anesthesia, anesthesia does not mean a local anesthetic for
minor procedural use; and
]
[
(e) does not engage in other medical practices or procedures as defined by division
rule in collaboration with the board;
]
(6) a medical assistant:
(a) administering a vaccine under the general supervision of a physician; or
(b) under the indirect supervision of a physician, engaging in tasks appropriately
delegated by the physician in accordance with the standards and ethics of the practice of
medicine, except for:
(i) performing surgical procedures;
(ii) prescribing prescription medications;
(iii) administering anesthesia other than a local anesthetic for minor procedural use; or
(iv) engaging in other medical practices or procedures as defined by division rule in
collaboration with the board;
(7) an individual engaging in the practice of osteopathic medicine when:
(a) the individual is licensed in good standing as an osteopathic physician in another
state with no licensing action pending and no less than 10 years of professional experience;
(b) the services are rendered as a public service and for a noncommercial purpose;
(c) no fee or other consideration of value is charged, received, expected, or
contemplated for the services rendered beyond an amount necessary to cover the proportionate
cost of malpractice insurance; and
(d) the individual does not otherwise engage in unlawful or unprofessional conduct;
(8) an individual providing expert testimony in a legal proceeding; and
(9) an individual who is invited by a school, association, society, or other body
approved by the division in collaboration with the board to conduct a clinic or demonstration of
the practice of medicine in which patients are treated, if:
(a) the individual does not establish a place of business in this state;
(b) the individual does not regularly engage in the practice of medicine in this state;
(c) the individual holds a current license in good standing to practice medicine issued
by another state, district or territory of the United States, or Canada;
(d) the primary purpose of the event is the training of others in the practice of
medicine; and
(e) neither the patient nor an insurer is billed for the services performed.