Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 101 (2022GS)

Sponsor

Sen. Vickers, E.

Final action

Governor Signed 3/23/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• allows the Division of Occupational and Professional Licensing to issue a license for a registered nurse apprentice;
• creates requirements for the license; and
• makes technical changes.

Every vote on this bill

Bill text

NURSE APPRENTICE LICENSING ACT
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Evan J. Vickers
House Sponsor: 
Steve Eliason
LONG TITLE
General Description:
This bill creates a license for registered nurse apprentices.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ allows the Division of Occupational and Professional Licensing to issue a license
for a registered nurse apprentice;
▸ creates requirements for the license; and
▸ makes technical changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-4-2
, as last amended by Laws of Utah 2021, Chapter 297
26-61a-104
, as last amended by Laws of Utah 2020, Chapter 12
58-31b-102
, as last amended by Laws of Utah 2021, Chapter 263
58-31b-301
, as last amended by Laws of Utah 2007, Chapter 57
58-31b-302
, as last amended by Laws of Utah 2018, Chapter 318
58-31b-303
, as last amended by Laws of Utah 2006, Chapter 291
58-31b-304
, as last amended by Laws of Utah 2009, Chapter 183
75-2a-103
, as last amended by Laws of Utah 2021, Chapter 223
ENACTS:
58-31b-306.1
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-4-2
 is amended to read:
26-4-2.
Definitions.
As used in this chapter:
(1) "Dead body" [
is as
] 
means the same as that term is
 defined in Section 
26-2-2
.
(2) 
(a)
 "Death by violence" means death that resulted by the decedent's exposure to
physical, mechanical, or chemical forces[
, and
]
.
(b) "Death by violence"
 includes death [
which
] 
that
 appears to have been due to
homicide, death [
which
] 
that
 occurred during or in an attempt to commit rape, mayhem,
kidnapping, robbery, burglary, housebreaking, extortion, or blackmail accompanied by threats
of violence, assault with a dangerous weapon, assault with intent to commit any offense
punishable by imprisonment for more than one year, arson punishable by imprisonment for
more than one year, or any attempt to commit any of the foregoing offenses.
(3) "Immediate relative" means an individual's spouse, child, parent, sibling,
grandparent, or grandchild.
(4) "Health care professional" means any of the following while acting in a
professional capacity:
(a) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title
58, Chapter 68, Utah Osteopathic Medical Practice Act;
(b) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician Assistant
Act; or
(c) an advance practice registered nurse licensed under Subsection
58-31b-301
(2)[
(d)
]
(e)
.
(5) "Medical examiner" means the state medical examiner appointed pursuant to
Section 
26-4-4
 or a deputy appointed by the medical examiner.
(6) "Medical examiner record" means:
(a) all information that the medical examiner obtains regarding a decedent; and
(b) reports that the medical examiner makes regarding a decedent.
(7) "Regional pathologist" means a trained pathologist licensed to practice medicine
and surgery in the state, appointed by the medical examiner pursuant to Subsection 
26-4-4
(3).
(8) "Sudden death while in apparent good health" means apparently instantaneous
death without obvious natural cause, death during or following an unexplained syncope or
coma, or death during an acute or unexplained rapidly fatal illness.
(9) "Sudden infant death syndrome" means the death of a child who was thought to be
in good health or whose terminal illness appeared to be so mild that the possibility of a fatal
outcome was not anticipated.
(10) "Suicide" means death caused by an intentional and voluntary act of an individual
who understands the physical nature of the act and intends by such act to accomplish
self-destruction.
(11) "Unattended death" means a death that occurs more than 365 days after the day on
which a health care professional examined or treated the deceased individual for any purpose,
including writing a prescription.
(12) (a) "Unavailable for postmortem investigation" means that a dead body is:
(i) transported out of state;
(ii) buried at sea;
(iii) cremated;
(iv) processed by alkaline hydrolysis; or
(v) otherwise made unavailable to the medical examiner for postmortem investigation
or autopsy.
(b) "Unavailable for postmortem investigation" does not include embalming or burial
of a dead body pursuant to the requirements of law.
(13) "Within the scope of the decedent's employment" means all acts reasonably
necessary or incident to the performance of work, including matters of personal convenience
and comfort not in conflict with specific instructions.
Section 2. Section 
26-61a-104
 is amended to read:
26-61a-104.
Qualifying condition.
(1) By designating a particular condition under Subsection (2) for which the use of
medical cannabis to treat symptoms is decriminalized, the Legislature does not conclusively
state that:
(a) current scientific evidence clearly supports the efficacy of a medical cannabis
treatment for the condition; or
(b) a medical cannabis treatment will treat, cure, or positively affect the condition.
(2) For the purposes of this chapter, each of the following conditions is a qualifying
condition:
(a) HIV or acquired immune deficiency syndrome;
(b) Alzheimer's disease;
(c) amyotrophic lateral sclerosis;
(d) cancer;
(e) cachexia;
(f) persistent nausea that is not significantly responsive to traditional treatment, except
for nausea related to:
(i) pregnancy;
(ii) cannabis-induced cyclical vomiting syndrome; or
(iii) cannabinoid hyperemesis syndrome;
(g) Crohn's disease or ulcerative colitis;
(h) epilepsy or debilitating seizures;
(i) multiple sclerosis or persistent and debilitating muscle spasms;
(j) post-traumatic stress disorder that is being treated and monitored by a licensed
mental health therapist, as that term is defined in Section 
58-60-102
, and that:
(i) has been diagnosed by a healthcare provider or mental health provider employed or
contracted by the United States Veterans Administration, evidenced by copies of medical
records from the United States Veterans Administration that are included as part of the
qualified medical provider's pre-treatment assessment and medical record documentation; or
(ii) has been diagnosed or confirmed, through face-to-face or telehealth evaluation of
the patient, by a provider who is:
(A) a licensed board-eligible or board-certified psychiatrist;
(B) a licensed psychologist with a master's-level degree;
(C) a licensed clinical social worker with a master's-level degree; or
(D) a licensed advanced practice registered nurse who is qualified to practice within
the psychiatric mental health nursing speciality and who has completed the clinical practice
requirements in psychiatric mental health nursing, including in psychotherapy, in accordance
with Subsection 
58-31b-302
[
(4)
]
(5)
(g);
(k) autism;
(l) a terminal illness when the patient's remaining life expectancy is less than six
months;
(m) a condition resulting in the individual receiving hospice care;
(n) a rare condition or disease that:
(i) affects less than 200,000 individuals in the United States, as defined in Section 526
of the Federal Food, Drug, and Cosmetic Act; and
(ii) is not adequately managed despite treatment attempts using:
(A) conventional medications other than opioids or opiates; or
(B) physical interventions;
(o) pain lasting longer than two weeks that is not adequately managed, in the qualified
medical provider's opinion, despite treatment attempts using:
(i) conventional medications other than opioids or opiates; or
(ii) physical interventions; and
(p) a condition that the Compassionate Use Board approves under Section 
26-61a-105
,
on an individual, case-by-case basis.
Section 3. 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 pursuant to Title 26, Chapter 21, Health Care Facility Licensing and
Inspection Act:
(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 who:
(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) (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 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
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) Subject to Section 
58-31b-803
, 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); [
and
]
(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), "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:
(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.
[
(15)
] 
(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
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.
[
(16)
] 
(17)
 "Unlawful conduct" means the same as that term is defined in Sections
58-1-501
 and 
58-31b-501
.
[
(17)
] 
(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.
[
(18)
] 
(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 4. Section 
58-31b-301
 is amended to read:
58-31b-301.
License or certification required -- Classifications.
(1) A license is required to engage in the practice of nursing, except as specifically
provided in Sections 
58-1-307
 and 
58-31b-308
.
(2) The division shall issue to [
a person
] 
an individual
 who qualifies under this chapter
a license or certification in the classification of:
(a) licensed practical nurse;
(b) registered nurse apprentice;
[
(b)
] 
(c)
 registered nurse;
[
(c)
] 
(d)
 advanced practice registered nurse intern;
[
(d)
] 
(e)
 advanced practice registered nurse;
[
(e)
] 
(f)
 advanced practice registered nurse - CRNA without prescriptive practice; and
[
(f)
] 
(g)
 medication aide certified.
(3) An individual holding an advanced practice registered nurse license as of July 1,
1998, who cannot document the successful completion of advanced course work in patient
assessment, diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be
issued an "APRN - without prescriptive practice" license.
(4) The division shall grant an advanced practice registered nurse license to any
licensed advanced practice registered nurse currently holding prescriptive authority under any
predecessor act [
on July 1, 1998
].
(5) An individual holding a certified registered nurse anesthetist license as of July 1,
2007, shall be issued an "APRN - CRNA - without prescriptive practice" license.
Section 5. Section 
58-31b-302
 is amended to read:
58-31b-302.
Qualifications for licensure or certification -- Criminal background
checks.
(1) An applicant for certification as a medication aide shall:
(a) submit an application to the division on a form prescribed by the division;
(b) pay a fee to the division as determined under Section 
63J-1-504
;
(c) have a high school diploma or its equivalent;
(d) have a current certification as a nurse aide, in good standing, from the Department
of Health;
(e) have a minimum of 2,000 hours of experience within the two years prior to
application, working as a certified nurse aide in a long-term care facility;
(f) obtain letters of recommendation from a long-term care facility administrator and
one licensed nurse familiar with the applicant's work practices as a certified nurse aide;
(g) be in a condition of physical and mental health that will permit the applicant to
practice safely as a medication aide certified;
(h) have completed an approved education program or an equivalent as determined by
the division in collaboration with the board;
(i) have passed the examinations as required by division rule made in collaboration
with the board; and
(j) meet with the board, if requested, to determine the applicant's qualifications for
certification.
(2) An applicant for licensure as a licensed practical nurse shall:
(a) submit to the division an application in a form prescribed by the division;
(b) pay to the division a fee determined under Section 
63J-1-504
;
(c) have a high school diploma or its equivalent;
(d) be in a condition of physical and mental health that will permit the applicant to
practice safely as a licensed practical nurse;
(e) have completed an approved practical nursing education program or an equivalent
as determined by the board;
(f) have passed the examinations as required by division rule made in collaboration
with the board; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
(3) An applicant for a registered nurse apprentice license shall:
(a) submit to the division an application form prescribed by the division;
(b) pay to the division a fee determined under Section 
63J-1-504
;
(c) have a high school diploma or its equivalent;
(d) be in a condition of physical and mental health that will allow the applicant to
practice safely as a registered nurse apprentice;
(e) as determined by an approved registered nursing education program, be:
(i) in good standing with the program; and
(ii) in the last semester, quarter, or competency experience;
(f) have written permission from the program in which the applicant is enrolled; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
[
(3)
] 
(4)
 An applicant for licensure as a registered nurse shall:
(a) submit to the division an application form prescribed by the division;
(b) pay to the division a fee determined under Section 
63J-1-504
;
(c) have a high school diploma or its equivalent;
(d) be in a condition of physical and mental health that will allow the applicant to
practice safely as a registered nurse;
(e) have completed an approved registered nursing education program;
(f) have passed the examinations as required by division rule made in collaboration
with the board; and
(g) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
[
(4)
] 
(5)
 Applicants for licensure as an advanced practice registered nurse shall:
(a) submit to the division an application on a form prescribed by the division;
(b) pay to the division a fee determined under Section 
63J-1-504
;
(c) be in a condition of physical and mental health which will allow the applicant to
practice safely as an advanced practice registered nurse;
(d) hold a current registered nurse license in good standing issued by the state or be
qualified at the time for licensure as a registered nurse;
(e) (i) have earned a graduate degree in:
(A) an advanced practice registered nurse nursing education program; or
(B) a related area of specialized knowledge as determined appropriate by the division
in collaboration with the board; or
(ii) have completed a nurse anesthesia program in accordance with Subsection
[
(4)
]
(5)
(f)(ii);
(f) have completed:
(i) course work in patient assessment, diagnosis and treatment, and
pharmacotherapeutics from an education program approved by the division in collaboration
with the board; or
(ii) a nurse anesthesia program which is approved by the Council on Accreditation of
Nurse Anesthesia Educational Programs;
(g) to practice within the psychiatric mental health nursing specialty, demonstrate, as
described in division rule, that the applicant, after completion of a doctorate or master's degree
required for licensure, is in the process of completing the applicant's clinical practice
requirements in psychiatric mental health nursing, including in psychotherapy;
(h) have passed the examinations as required by division rule made in collaboration
with the board;
(i) be currently certified by a program approved by the division in collaboration with
the board and submit evidence satisfactory to the division of the certification; and
(j) meet with the board, if requested, to determine the applicant's qualifications for
licensure.
[
(5)
] 
(6)
 For each applicant for licensure or certification under this chapter 
except an
applicant under Subsection 
58-31b-301
(2)(b)
:
(a) the applicant shall:
(i) submit fingerprint cards in a form acceptable to the division at the time the
application is filed; and
(ii) consent to a fingerprint background check conducted by the Bureau of Criminal
Identification and the Federal Bureau of Investigation regarding the application;
(b) the division shall:
(i) in addition to other fees authorized by this chapter, collect from each applicant
submitting fingerprints in accordance with this section the fee that the Bureau of Criminal
Identification is authorized to collect for the services provided under Section 
53-10-108
 and the
fee charged by the Federal Bureau of Investigation for fingerprint processing for the purpose of
obtaining federal criminal history record information;
(ii) submit from each applicant the fingerprint card and the fees described in this
Subsection [
(5)
] 
(6)
(b) to the Bureau of Criminal Identification; and
(iii) obtain and retain in division records a signed waiver approved by the Bureau of
Criminal Identification in accordance with Section 
53-10-108
 for each applicant; and
(c) the Bureau of Criminal Identification shall, in accordance with the requirements of
Section 
53-10-108
:
(i) check the fingerprints submitted under Subsection [
(5)
] 
(6)
(b) against the applicable
state and regional criminal records databases;
(ii) forward the fingerprints to the Federal Bureau of Investigation for a national
criminal history background check; and
(iii) provide the results from the state, regional, and nationwide criminal history
background checks to the division.
[
(6)
] 
(7)
 For purposes of conducting the criminal background checks required in
Subsection [
(5)
] 
(6)
, the division shall have direct access to criminal background information
maintained pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
[
(7)
] 
(8)
 (a) (i) Any new nurse license or certification issued under this section shall be
conditional, pending completion of the criminal background check.
(ii) Notwithstanding Title 63G, Chapter 4, Administrative Procedures Act, if the
criminal background check discloses the applicant has failed to accurately disclose a criminal
history, the license or certification shall be immediately and automatically revoked upon notice
to the licensee by the division.
(b) (i) [
A person
] 
An individual
 whose conditional license or certification has been
revoked under Subsection [
(7)
] 
(8)
(a) is entitled to a postrevocation hearing to challenge the
revocation.
(ii) A postrevocation hearing shall be conducted in accordance with Title 63G, Chapter
4, Administrative Procedures Act.
[
(8)
] 
(9)
 If [
a person
] 
an individual
 has been charged with a violent felony, as defined
in Subsection 
76-3-203.5
(1)(c), and, as a result, the [
person
] 
individual
 has been convicted,
entered a plea of guilty or nolo contendere, or entered a plea of guilty or nolo contendere held
in abeyance pending the successful completion of probation, the [
person
] 
individual
 is
disqualified for licensure under this chapter and:
(a) if the [
person
] 
individual
 is licensed under this chapter, the division:
(i) shall act upon the license as required under Section 
58-1-401
; and
(ii) may not renew or subsequently issue a license to the [
person
] 
individual
 under this
chapter; and
(b) if the [
person
] 
individual
 is not licensed under this chapter, the division may not
issue a license to the [
person
] 
individual
 under this chapter.
[
(9)
] 
(10)
 If [
a person
] 
an individual
 has been charged with a felony other than a
violent felony, as defined in Subsection 
76-3-203.5
(1)(c), and, as a result, the [
person
]
individual
 has been convicted, entered a plea of guilty or nolo contendere, or entered a plea of
guilty or nolo contendere held in abeyance pending the successful completion of probation, the
division shall determine whether the felony disqualifies the [
person
] 
individual
 for licensure
under this chapter and act upon the license, as required, in accordance with Section 
58-1-401
.
[
(10)
] 
(11)
 The division may not disseminate outside of the division any criminal
history record information that the division obtains from the Bureau of Criminal Identification
or the Federal Bureau of Investigation under the criminal background check requirements of
this section.
Section 6. Section 
58-31b-303
 is amended to read:
58-31b-303.
Qualifications for licensure -- Graduates of nonapproved nursing
programs.
An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
nursing education program not approved by the division in collaboration with the board must
comply with the requirements of this section.
(1) An applicant for licensure as a licensed practical nurse shall:
(a) meet all requirements of Subsection 
58-31b-302
(2), except Subsection (2)(e); and
(b) produce evidence acceptable to the division and the board that the nursing
education program completed by the applicant is equivalent to the minimum standards
established by the division in collaboration with the board for an approved licensed practical
nursing education program.
(2) An applicant for licensure as a registered nurse shall:
(a) meet all requirements of Subsection 
58-31b-302
[
(3)
]
(4)
, except Subsection [
(3)
]
(4)
(e); and
(b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)
Examination; or
(ii) produce evidence acceptable to the division and the board that the applicant is
currently licensed as a registered nurse in one of the states, territories, or the District of
Columbia of the United States and has passed the NCLEX-RN examination.
Section 7. Section 
58-31b-304
 is amended to read:
58-31b-304.
Qualifications for admission to the examinations.
(1) To be admitted to the examinations required for certification as a medication aide
certified, [
a person
] 
an individual
 shall:
(a) submit an application on a form prescribed by the division;
(b) pay a fee as determined by the division under Section 
63J-1-504
; and
(c) meet all requirements of Subsection 
58-31b-302
(1), except [
the passing of the
examination
] 
Subsection (1)(i)
.
(2) To be admitted to the examinations required for licensure as a practical nurse, [
a
person
] 
an individual
 shall:
(a) submit an application form prescribed by the division;
(b) pay a fee as determined by the division under Section 
63J-1-504
; and
(c) meet all requirements of Subsection 
58-31b-302
(2), except Subsection (2)(f).
(3) To be admitted to the examinations required for licensure as a registered nurse, [
a
person
] 
an individual
 shall:
(a) submit an application form prescribed by the division;
(b) pay a fee as determined by the division under Section 
63J-1-504
; and
(c) meet all the requirements of Subsection 
58-31b-302
[
(3)
]
(4)
, except Subsection
[
(3)
]
(4)
(f).
Section 8. Section 
58-31b-306.1
 is enacted to read:
 58-31b-306.1.
Registered nurse apprentice license.
(1) The division shall issue a registered nurse apprentice license to an individual who
meets the qualifications under Subsection 
58-31b-302
(3).
(2) Unless the division extends the license for a specified period of time by written
notification provided to the individual, the license expires on the earlier of:
(a) one year from the day on which the license is issued;
(b) after the division receives notice from the examination agency that the individual
failed to take or pass the examinations described in Subsection 
58-31b-302
(4)(f), the day on
which the division notifies the applicant that the license is expired; or
(c) the day on which the division issues the individual a license as a registered nurse.
(3) A license described in Subsection (1) is:
(a) valid only in Utah; and
(b) not an eligible license under Chapter 31e, Nurse Licensure Compact - Revised.
(4) The division may make rules to administer the license described in Subsection (1)
in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
Section 9. Section 
75-2a-103
 is amended to read:
75-2a-103.
Definitions.
As used in this chapter:
(1) "Adult" means [
a person
] 
an individual
 who is:
(a) at least 18 years of age; or
(b) an emancipated minor.
(2) "Advance health care directive":
(a) includes:
(i) a designation of an agent to make health care decisions for an adult when the adult
cannot make or communicate health care decisions; or
(ii) an expression of preferences about health care decisions;
(b) may take one of the following forms:
(i) a written document, voluntarily executed by an adult in accordance with the
requirements of this chapter; or
(ii) a witnessed oral statement, made in accordance with the requirements of this
chapter; and
(c) does not include a POLST order.
(3) "Agent" means [
a person
] 
an adult
 designated in an advance health care directive to
make health care decisions for the declarant.
(4) "APRN" means [
a person
] 
an individual
 who is:
(a) certified or licensed as an advance practice registered nurse under Subsection
58-31b-301
(2)[
(d)
]
(e)
;
(b) an independent practitioner;
(c) acting under a consultation and referral plan with a physician; and
(d) acting within the scope of practice for that [
person
] 
individual
, as provided by law,
rule, and specialized certification and training in that [
person's
] 
individual's
 area of practice.
(5) "Best interest" means that the benefits to the person resulting from a treatment
outweigh the burdens to the person resulting from the treatment, taking into account:
(a) the effect of the treatment on the physical, emotional, and cognitive functions of the
person;
(b) the degree of physical pain or discomfort caused to the person by the treatment or
the withholding or withdrawal of treatment;
(c) the degree to which the person's medical condition, the treatment, or the
withholding or withdrawal of treatment, result in a severe and continuing impairment of the
dignity of the person by subjecting the person to humiliation and dependency;
(d) the effect of the treatment on the life expectancy of the person;
(e) the prognosis of the person for recovery with and without the treatment;
(f) the risks, side effects, and benefits of the treatment, or the withholding or
withdrawal of treatment; and
(g) the religious beliefs and basic values of the person receiving treatment, to the extent
these may assist the decision maker in determining the best interest.
(6) "Capacity to appoint an agent" means that the adult understands the consequences
of appointing a particular person as agent.
(7) "Declarant" means an adult who has completed and signed or directed the signing
of an advance health care directive.
(8) "Default surrogate" means the adult who may make decisions for an individual
when either:
(a) an agent or guardian has not been appointed; or
(b) an agent is not able, available, or willing to make decisions for an adult.
(9) "Emergency medical services provider" means a person [
who
] 
that
 is licensed,
designated, or certified under Title 26, Chapter 8a, Utah Emergency Medical Services System
Act.
(10) "Generally accepted health care standards":
(a) is defined only for the purpose of:
(i) this chapter and does not define the standard of care for any other purpose under
Utah law; and
(ii) enabling health care providers to interpret the statutory form set forth in Section
75-2a-117
; and
(b) means the standard of care that justifies a provider in declining to provide life
sustaining care because the proposed life sustaining care:
(i) will not prevent or reduce the deterioration in the health or functional status of [
a
person
] 
an individual
;
(ii) will not prevent the impending death of [
a person
] 
an individual
; or
(iii) will impose more burden on the [
person
] 
individual
 than any expected benefit to
the person.
(11) "Health care" means any care, treatment, service, or procedure to improve,
maintain, diagnose, or otherwise affect [
a person's
] 
an individual's
 physical or mental
condition.
(12) "Health care decision":
(a) means a decision about an adult's health care made by, or on behalf of, an adult, that
is communicated to a health care provider;
(b) includes:
(i) selection and discharge of a health care provider and a health care facility;
(ii) approval or disapproval of diagnostic tests, procedures, programs of medication,
and orders not to resuscitate; and
(iii) directions to provide, withhold, or withdraw artificial nutrition and hydration and
all other forms of health care; and
(c) does not include decisions about an adult's financial affairs or social interactions
other than as indirectly affected by the health care decision.
(13) "Health care decision making capacity" means an adult's ability to make an
informed decision about receiving or refusing health care, including:
(a) the ability to understand the nature, extent, or probable consequences of health
status and health care alternatives;
(b) the ability to make a rational evaluation of the burdens, risks, benefits, and
alternatives of accepting or rejecting health care; and
(c) the ability to communicate a decision.
(14) "Health care facility" means:
(a) a health care facility as defined in Title 26, Chapter 21, Health Care Facility
Licensing and Inspection Act; and
(b) private offices of physicians, dentists, and other health care providers licensed to
provide health care under Title 58, Occupations and Professions.
(15) "Health care provider" [
is as
] 
means the same as that term is
 defined in Section
78B-3-403
, except that [
it
] 
"health care provider"
 does not include an emergency medical
services provider.
(16) (a) "Life sustaining care" means any medical intervention, including procedures,
administration of medication, or use of a medical device, that maintains life by sustaining,
restoring, or supplanting a vital function.
(b) "Life sustaining care" does not include care provided for the purpose of keeping [
a
person
] 
an individual
 comfortable.
(17) "Minor" means [
a person
] 
an individual
 who:
(a) is under 18 years old; and
(b) is not an emancipated minor.
(18) "Physician" means a physician and surgeon or osteopathic surgeon licensed under
Title 58, Chapter 67, Utah Medical Practice Act or Chapter 68, Utah Osteopathic Medical
Practice Act.
(19) "Physician assistant" means [
a person
] 
an individual
 licensed as a physician
assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
(20) "POLST order" means an order, on a form designated by the Department of Health
under Section 
75-2a-106
[
(5)(a)
], that gives direction to health care providers, health care
facilities, and emergency medical services providers regarding the specific health care
decisions of the [
person
] 
individual
 to whom the order relates.
(21) "Reasonably available" means:
(a) readily able to be contacted without undue effort; and
(b) willing and able to act in a timely manner considering the urgency of the
circumstances.
(22) "Substituted judgment" means the standard to be applied by a surrogate when
making a health care decision for an adult who previously had the capacity to make health care
decisions, which requires the surrogate to consider:
(a) specific preferences expressed by the adult:
(i) when the adult had the capacity to make health care decisions; and
(ii) at the time the decision is being made;
(b) the surrogate's understanding of the adult's health care preferences;
(c) the surrogate's understanding of what the adult would have wanted under the
circumstances; and
(d) to the extent that the preferences described in Subsections (22)(a) through (c) are
unknown, the best interest of the adult.
(23) "Surrogate" means a health care decision maker who is:
(a) an appointed agent;
(b) a default surrogate under the provisions of Section 
75-2a-108
; or
(c) a guardian.