Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 240 (2024GS)

Sponsor

Rep. Maloy, A. Cory

Final action

House/ filed 3/1/2024

Outcome

Failed / filed without passage

Summary

What it does

• This bill:
• allows an individual seeking a certified nursing assistant certification to complete the training requirement at certain health care facilities; and
• makes technical changes.

Every vote on this bill

Bill text

CERTIFIED NURSING ASSISTANT AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: A. Cory Maloy
Senate Sponsor: 
____________
LONG TITLE
General Description:
This bill modifies provisions related to certified nursing assistants.
Highlighted Provisions:
This bill:
▸ allows an individual seeking a certified nursing assistant certification to complete
the training requirement at certain health care facilities; and
▸ makes technical changes. 
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26B-2-202
, as renumbered and amended by Laws of Utah 2023, Chapter 305
58-31b-102
, as last amended by Laws of Utah 2023, Chapters 223, 329
58-31b-302
, as last amended by Laws of Utah 2023, Chapters 223, 284
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26B-2-202
 is amended to read:
26B-2-202.
Duties of department.
(1) The department shall:
(a) enforce rules established pursuant to this part;
(b) authorize an agent of the department to conduct inspections of health care facilities
pursuant to this part;
(c) collect information authorized by the committee that may be necessary to ensure
that adequate health care facilities are available to the public;
(d) collect and credit fees for licenses as free revenue;
(e) collect and credit fees for conducting plan reviews as dedicated credits;
(f) (i) collect and credit fees for conducting clearance under Sections 
26B-2-239
 and
26B-2-240
; and
(ii) beginning July 1, 2012:
(A) up to $105,000 of the fees collected under Subsection (1)(f)(i) are dedicated
credits; and
(B) the fees collected for background checks under Subsection 
26B-2-240
(6) and
Subsection 
26B-2-241
(4) shall be transferred to the Department of Public Safety to reimburse
the Department of Public Safety for its costs in conducting the federal background checks;
(g) designate an executive secretary from within the department to assist the committee
in carrying out its powers and responsibilities;
(h) establish reasonable standards for criminal background checks by public and
private entities;
(i) recognize those public and private entities that meet the standards established
pursuant to Subsection (1)(h); [
and
]
(j) establish and maintain a certification for certified nursing assistants that:
(i) complies with the Omnibus Budget Reconciliation Act of 1987, Pub. L. No.
100-203; and
(ii) allows an individual to fulfill the supervised training requirement while working in:
(A) a nursing care facility;
(B) a general acute hospital; or
(C) any other health care facility the department determines would not violate the
Omnibus Budget Reconciliation Act of 1987, Pub. L. No. 100-203; and
[
(j)
] 
(k)
 provide necessary administrative and staff support to the committee.
(2) The department may:
(a) exercise all incidental powers necessary to carry out the purposes of this part;
(b) review architectural plans and specifications of proposed health care facilities or
renovations of health care facilities to ensure that the plans and specifications conform to rules
established by the committee; and
(c) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, 
make rules as necessary to implement the provisions of this part.
Section 2. Section 
58-31b-102
 is amended to read:
58-31b-102.
Definitions.
In addition to the definitions in Section 
58-1-102
, as used in this chapter:
(1) "Administrative penalty" means a monetary fine or citation imposed by the division
for acts or omissions determined to be unprofessional or unlawful conduct in accordance with a
fine schedule established by division rule made in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act, and as a result of an adjudicative proceeding conducted in
accordance with Title 63G, Chapter 4, Administrative Procedures Act.
(2) "Applicant" means an individual who applies for licensure or certification under
this chapter by submitting a completed application for licensure or certification and the
required fees to the department.
(3) "Approved education program" means a nursing education program that is
accredited by an accrediting body for nursing education that is approved by the United States
Department of Education.
(4) "Board" means the Board of Nursing created in Section 
58-31b-201
.
(5) "Diagnosis" means the identification of and discrimination between physical and
psychosocial signs and symptoms essential to the effective execution and management of
health care.
(6) "Examinee" means an individual who applies to take or does take any examination
required under this chapter for licensure.
(7) "Licensee" means an individual who is licensed or certified under this chapter.
(8) "Long-term care facility" means any of the following facilities licensed by the
Department of Health and Human Services pursuant to Title 26B, Chapter 2, Part 2, Health
Care Facility Licensing and Inspection:
(a) a nursing care facility;
(b) a small health care facility;
(c) an intermediate care facility for people with an intellectual disability;
(d) an assisted living facility Type I or II; or
(e) a designated swing bed unit in a general hospital.
(9) "Medication aide certified" means a certified [
nurse aide
] 
nursing assistant
 who:
(a) has a minimum of 2,000 hours experience working as a certified [
nurse aide
]
nursing assistant
;
(b) has received a minimum of 60 hours of classroom and 40 hours of practical training
that is approved by the division in collaboration with the board, in administering routine
medications to patients or residents of long-term care facilities; and
(c) is certified by the division as a medication aide certified.
(10) (a) "Practice as a medication aide certified" means the limited practice of nursing
under the supervision, as defined by the division by rule made in accordance with Title 63G,
Chapter 3, Utah Administrative Rulemaking Act, of a licensed nurse, involving routine patient
care that requires minimal or limited specialized or general knowledge, judgment, and skill, to
an individual who:
(i) is ill, injured, infirm, has a physical, mental, developmental, or intellectual
disability; and
(ii) is in a regulated long-term care facility.
(b) "Practice as a medication aide certified":
(i) includes:
(A) providing direct personal assistance or care; and
(B) administering routine medications to patients in accordance with a formulary and
protocols to be defined by the division by rule made in accordance with Title 63G, Chapter 3,
Utah Administrative Rulemaking Act; and
(ii) does not include assisting a resident of an assisted living facility, a long term care
facility, or an intermediate care facility for people with an intellectual disability to self
administer a medication, as regulated by the Department of Health and Human Services by rule
made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(11) "Practice of advanced practice registered nursing" means the practice of nursing
within the generally recognized scope and standards of advanced practice registered nursing as
defined by rule and consistent with professionally recognized preparation and education
standards of an advanced practice registered nurse by a person licensed under this chapter as an
advanced practice registered nurse. "Practice of advanced practice registered nursing" includes:
(a) maintenance and promotion of health and prevention of disease;
(b) diagnosis, treatment, correction, consultation, and referral;
(c) prescription or administration of prescription drugs or devices including:
(i) local anesthesia;
(ii) Schedule III-V controlled substances; and
(iii) Schedule II controlled substances; or
(d) the provision of preoperative, intraoperative, and postoperative anesthesia care and
related services upon the request of a licensed health care professional by an advanced practice
registered nurse specializing as a certified registered nurse anesthetist, including:
(i) preanesthesia preparation and evaluation including:
(A) performing a preanesthetic assessment of the patient;
(B) ordering and evaluating appropriate lab and other studies to determine the health of
the patient; and
(C) selecting, ordering, or administering appropriate medications;
(ii) anesthesia induction, maintenance, and emergence, including:
(A) selecting and initiating the planned anesthetic technique;
(B) selecting and administering anesthetics and adjunct drugs and fluids; and
(C) administering general, regional, and local anesthesia;
(iii) postanesthesia follow-up care, including:
(A) evaluating the patient's response to anesthesia and implementing corrective
actions; and
(B) selecting, ordering, or administering the medications and studies listed in this
Subsection (11)(d);
(iv) other related services within the scope of practice of a certified registered nurse
anesthetist, including:
(A) emergency airway management;
(B) advanced cardiac life support; and
(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.
(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.
(17) "Unlawful conduct" means the same as that term is defined in Sections 
58-1-501
and 
58-31b-501
.
(18) "Unlicensed assistive personnel" means any unlicensed individual, regardless of
title, who is delegated a task by a licensed nurse as permitted by division rule made in
accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, and the standards
of the profession.
(19) "Unprofessional conduct" means the same as that term is defined in Sections
58-1-501
 and 
58-31b-502
 and as may be further defined by division rule made in accordance
with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
Section 3. Section 
58-31b-302
 is amended to read:
58-31b-302.
Qualifications for licensure or certification -- Criminal background
checks.
(1) An 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
] 
nursing assistant
, in good standing,
from the Department of Health and Human Services;
(e) have a minimum of 2,000 hours of experience within the two years prior to
application, working as a certified [
nurse aide
] 
nursing assistant
 in a long-term care facility or
another health care facility that is designated by the division in collaboration with the board;
(f) obtain letters of recommendation from a health care facility administrator and one
licensed nurse familiar with the applicant's work practices as a certified [
nurse aide
] 
nursing
assistant
;
(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.
(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.
(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
(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.
(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 (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 (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.
(7) For purposes of conducting the criminal background checks required in Subsection
(6), the division shall have direct access to criminal background information maintained
pursuant to Title 53, Chapter 10, Part 2, Bureau of Criminal Identification.
(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) An individual whose conditional license or certification has been revoked under
Subsection (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.
(9) If an individual has been charged with a violent felony, as defined in Subsection
76-3-203.5
(1)(c), and, as a result, the 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 act upon the license as required under
Section 
58-1-401
.
(10) If 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 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 individual for licensure under this chapter and act upon the
license, as required, in accordance with Section 
58-1-401
.
(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 4. 
Effective date.
This bill takes effect on May 1, 2024.