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HOUSE BILL NO. 662

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H0662.................................................by HEALTH AND WELFARE
NURSING PRACTICES ACT - Amends, adds to and repeals existing law regarding
the Idaho Nursing Practices Act to provide definitions, to provide
membership and powers of the Board of Nursing, to provide for
qualifications for a license for advanced practice professional nursing, to
provide qualifications and fees, to provide unlawful conduct and to create
an advisory committee to the board.

02/11    House intro - 1st rdg - to printing
02/12    Rpt prt - to 2nd rdg
02/13    2nd rdg - to 3rd rdg
02/17    3rd rdg - PASSED - 66-0-4
      AYES -- Alltus, Barraclough, Barrett, Bell, Bieter, Bivens,
      Black(15), Boe, Bruneel, Callister, Campbell, Chase, Clark, Crane,
      Crow, Cuddy, Deal, Denney, Ellsworth, Field(13), Field(20), Gagner,
      Geddes, Gould, Hadley, Hansen, Henbest, Hornbeck, Jaquet, Jones(9),
      Jones(22), Jones(20), Judd, Kellogg, Kempton, Kendell, Kjellander,
      Kunz, Lake, Linford, Loertscher, Mader, Marley, McKague, Meyer,
      Miller, Mortensen, Newcomb, Pischner, Pomeroy, Reynolds, Richman,
      Ridinger, Robison, Sali, Schaefer, Stevenson, Stoicheff, Taylor,
      Tilman, Tippets, Trail, Watson, Wheeler, Wood, Zimmermann
      NAYS -- None
      Absent and excused -- Black(23), Stone, Stubbs, Mr Speaker
    Floor Sponsors - Henbest, Black(15)
    Title apvd - to Senate
02/18    Senate intro - 1st rdg - to Health/Wel
03/02    Rpt out - rec d/p - to 2nd rdg
03/03    2nd rdg - to 3rd rdg
03/16    3rd rdg - PASSED - 35-0-0
      AYES -- Andreason, Boatright, Branch, Bunderson, Burtenshaw, Cameron,
      Crow, Danielson, Darrington, Diede, Dunklin, Frasure, Geddes, Hansen,
      Hawkins, Ingram, Ipsen, Keough, King, Lee, McLaughlin, Noh, Parry,
      Richardson, Riggs, Risch, Sandy, Schroeder, Sorensen, Stennett,
      Sweeney, Thorne, Twiggs, Wheeler, Whitworth
      NAYS -- None
      Absent and excused -- None
    Floor Sponsor - Crow, Sorensen, Danielson
    Title apvd - to House
03/17    To enrol
03/17    Rpt enrol - Sp signed
03/18    Pres signed - to Governor
03/19    Governor signed
         Session Law Chapter 118
         Effective: 07/01/98

Bill Text

H0662


                                                                        
 ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
Fifty-fourth Legislature                 Second Regular Session - 1998
                                                                        

                             IN THE HOUSE OF REPRESENTATIVES

                                    HOUSE BILL NO. 662

                             BY HEALTH AND WELFARE COMMITTEE

 1                                        AN ACT
 2    RELATING TO THE IDAHO NURSING PRACTICE ACT; AMENDING  SECTION  54-1402,  IDAHO
 3        CODE,  TO  PROVIDE DEFINITIONS AND TO MAKE TECHNICAL CORRECTIONS; AMENDING
 4        SECTION 54-1403, IDAHO CODE, TO PROVIDE MEMBERSHIP OF THE BOARD OF NURSING
 5        AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 54-1404,  IDAHO  CODE,
 6        TO PROVIDE POWERS OF THE BOARD OF NURSING; AMENDING SECTION 54-1407, IDAHO
 7        CODE,   TO  REDESIGNATE  THE  SECTION  AND  TO MAKE TECHNICAL CORRECTIONS;
 8        AMENDING SECTION 54-1408, IDAHO CODE, TO REDESIGNATE THE  SECTION  AND  TO
 9        MAKE  TECHNICAL CORRECTIONS; AMENDING CHAPTER 14, TITLE 54, IDAHO CODE, BY
10        THE ADDITION OF A NEW SECTION 54-1409, IDAHO CODE, TO PROVIDE FOR LICENSES
11        FOR ADVANCED PRACTICE PROFESSIONAL NURSING AND TO  PROVIDE  QUALIFICATIONS
12        AND FEES; AMENDING SECTION 54-1409, IDAHO CODE, TO REDESIGNATE THE SECTION
13        AND  TO  MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 54-1410, IDAHO CODE,
14        TO REDESIGNATE THE SECTION;  AMENDING  SECTION  54-1411,  IDAHO  CODE,  TO
15        REDESIGNATE  THE SECTION AND TO MAKE A TECHNICAL CORRECTION; AMENDING SEC-
16        TION 54-1412, IDAHO CODE, TO REDESIGNATE THE SECTION AND TO MAKE TECHNICAL
17        CORRECTIONS; AMENDING SECTION 54-1413, IDAHO  CODE,  TO  PROVIDE  UNLAWFUL
18        CONDUCT,  TO  REDESIGNATE  THE  SECTION AND TO MAKE TECHNICAL CORRECTIONS;
19        AMENDING SECTION 54-1414, IDAHO CODE, TO REDESIGNATE THE  SECTION  AND  TO
20        MAKE  TECHNICAL CORRECTIONS; AMENDING CHAPTER 14, TITLE 54, IDAHO CODE, BY
21        THE ADDITION OF A NEW SECTION 54-1417, IDAHO CODE, TO CREATE  AN  ADVISORY
22        COMMITTEE  TO  THE BOARD AND TO PROVIDE APPOINTMENT OF MEMBERS AND DUTIES;
23        REPEALING SECTION 54-1415, IDAHO CODE; AND AMENDING SECTION 54-1814, IDAHO
24        CODE, TO REQUIRE SUPERVISION  OF  CERTIFIED  NURSE-MIDWIVES  AND  CLINICAL
25        NURSE SPECIALISTS AND TO MAKE A TECHNICAL CORRECTION.

26    Be It Enacted by the Legislature of the State of Idaho:

27        SECTION  1.  That  Section 54-1402, Idaho Code, be, and the same is hereby
28    amended to read as follows:

29        54-1402.  DEFINITIONS. As used in this act:
30         (1) "Advanced practice  professional  nurse"  means  a  professional
31    nurse  licensed in this state who has gained additional specialized knowledge,
32    skills and experience through a nationally  accredited  program  of  study  as
33    defined  herein  and is authorized to perform advanced nursing practice, which
34    may include the  prescribing,  administering  and  dispensing  of  therapeutic
35    pharmacologic  agents, as defined by board rules. An advanced practice profes-
36    sional nurse shall perform only those acts as provided herein  and  for  which
37    the  individual  is  educationally  prepared.  Advanced  practice professional
38    nurses shall include certified  nurse-midwives,  clinical  nurse  specialists,
39    nurse practitioners, and registered nurse anesthetists as defined in this sub-
40    section. 
41          (a)  "Certified  nurse-midwife" means a licensed professional nurse
42        who has graduated from a nationally  accredited  nurse-midwifery  program,
43        passed  a  qualifying examination recognized by the board, and has current


                                          2

 1        initial certification or current recertification from a national organiza-
 2        tion recognized by the board.  Certified  nurse-midwives  who  meet  these
 3        qualifying  requirements and are licensed by the board, may manage women's
 4        health care, which may include pharmacologic and  nonpharmacologic  thera-
 5        peutic  and  corrective measures which focus on pregnancy, childbirth, the
 6        postpartum period, care of the  newborn,  reproductive  and  gynecological
 7        needs  of  well  women as defined by the rules of the board. The certified
 8        nurse-midwife shall practice with physician supervision, consultation  and
 9        collaborative  management and appropriate referral. The physician shall be
10        licensed pursuant to chapter 18, title 54, Idaho Code.
11        (b)  "Clinical nurse specialist" means a licensed professional  nurse  who
12        has  graduated  from  a  nationally accredited graduate program in nursing
13        with a clinical focus, passed a qualifying examination recognized  by  the
14        board,  and  has  current initial certification or current recertification
15        from a national group recognized by the board. Clinical nurse  specialists
16        who  meet  these qualifying requirements and are licensed by the board may
17        practice as expert clinicians in a particular specialty or subspecialty of
18        nursing practice. The clinical nurse  specialist  provides  direct  client
19        care,  which  may include assessing, diagnosing, planning, and prescribing
20        pharmacologic and nonpharmacologic therapeutic  and  corrective  measures,
21        health promotion and preventive care within this specialized area of prac-
22        tice,  as  defined  by  rules  of the board. The clinical nurse specialist
23        shall practice with physician supervision, consultation and  collaborative
24        management and appropriate referral.  The physician shall be licensed pur-
25        suant to chapter 18, title 54, Idaho Code.
26        (c)  "Nurse  practitioner"  means  a  licensed  professional nurse who has
27        graduated from a nationally accredited nurse practitioner program,  passed
28        a  qualifying examination recognized by the board, and has current initial
29        certification or current recertification from a national group  recognized
30        by  the board. Any person authorized by the board to practice nursing as a
31        nurse practitioner in this state as of July 1, 1998, shall be licensed  as
32        a  nurse practitioner under the provisions of this act and shall be eligi-
33        ble for renewal of such license under the conditions  and  standards  pre-
34        scribed  in  this  act.  Nurse  practitioners  who  meet  these qualifying
35        requirements and are licensed  by  the  board  may  perform  comprehensive
36        health  assessments, diagnosis, health promotion and the direct management
37        of acute and chronic illness and disease which may include the prescribing
38        of pharmacologic and nonpharmacologic treatments as defined  by  rules  of
39        the  board.  The nurse practitioner shall practice with physician supervi-
40        sion, consultation and collaborative management and appropriate  referral.
41        The  physician  shall  be licensed pursuant to chapter 18, title 54, Idaho
42        Code.
43        (d)  "Registered nurse anesthetist" means a  licensed  professional  nurse
44        who  has  graduated from a nationally accredited nurse anesthesia program,
45        passed a qualifying examination recognized by the board and,  has  current
46        initial  certification  or  current  recertification from a national group
47        recognized by the board. Registered  nurse  anesthetists  who  meet  these
48        qualifying  requirements and are licensed by the board, may, in collabora-
49        tion with a physician, dentist or podiatrist  authorized  to  practice  in
50        Idaho,  provide  anesthesia  care  services as defined by the rules of the
51        board. The scope of  practice  for  registered  nurse  anesthetists  shall
52        incorporate  acts identified in board rules, including selecting, ordering
53        and administering medications appropriate for  rendering  anesthesia  care
54        services. 
55        ( a  2 )  "Board" means the board of nursing.


                                          3

 1         (3)  "Licensed practical nurse" means a person who practices nursing
 2    by:
 3        (a)  Functioning  at  the  direction  of  a  licensed  professional nurse,
 4        licensed physician, or licensed dentist;
 5        (b)  Contributing to the assessment of the health  status  of  individuals
 6        and groups of individuals;
 7        (c)  Participating  in the development and modification of the strategy of
 8        care;
 9        (d)  Implementing the appropriate aspects  of  the  strategy  of  care  as
10        defined  by  the board, including administering medications and treatments
11        as prescribed by those health care providers authorized to prescribe medi-
12        cation;
13        (e)  Maintaining safe and effective  nursing  care  rendered  directly  or
14        indirectly;
15        (f)  Participating in the evaluation of responses to interventions; and
16        (g)  Delegating  nursing interventions that may be performed by others and
17        that do not conflict with this act.
18        (4)  "Licensed professional nurse" means a person  who  practices  nursing
19    by:
20        (a)  Assessing the health status of individuals and groups of individuals;
21        (b)  Identifying  health care problems that are amenable to nursing inter-
22        vention;
23        (c)  Establishing goals to meet identified health care needs;
24        (d)  Planning a strategy of care;
25        (e)  Prescribing nursing interventions to implement the strategy of care;
26        (f)  Implementing  the   strategy   of   care,   including   administering
27        medications  and  treatments  as prescribed by those health care providers
28        authorized to prescribe medication;
29        (g)  Authorizing nursing interventions that may be performed by others and
30        that do not conflict with this act;
31        (h)  Maintaining safe and effective  nursing  care  rendered  directly  or
32        indirectly;
33        (i)  Evaluating responses to interventions;
34        (j)  Teaching the theory and practice of nursing;
35        (k)  Managing the practice of nursing; and
36        (l)  Collaborating  with  other  health professionals in the management of
37        health care.
38        (5)  "Nursing education program" means a course of instruction offered and
39    conducted to prepare persons for the practice of nursing, or to  increase  the
40    knowledge and skills of the practicing nurse. 
41        (  b    6  )  "Practice  of nursing" means assisting
42    individuals or groups of individuals to promote, maintain or  restore  optimal
43    health  throughout  the  life process by assessing and evaluating their health
44    status, planning and implementing a strategy of  care  to  accomplish  defined
45    goals, and evaluating responses to care and treatment.
46          (1)  "Licensed  professional  nurse"  means  a person who practices
47        nursing by:
48             a.  Assessing the health status of individuals and groups of individ-
49             uals;
50             b.  Identifying health care problems that  are  amenable  to  nursing
51             intervention;
52             c.  Establishing goals to meet identified health care needs;
53             d.  Planning a strategy of care;
54             e.  Prescribing  nursing  interventions  to implement the strategy of
55             care;


                                          4

 1             f.  Implementing  the  strategy  of  care,  including   administering
 2             medications  and  treatments  as  prescribed  by  those  health  care
 3             providers authorized to prescribe medication;
 4             g.  Authorizing nursing interventions that may be performed by others
 5             and that do not conflict with this act;
 6             h.  Maintaining  safe and effective nursing care rendered directly or
 7             indirectly;
 8             i.  Evaluating responses to interventions;
 9             j.  Teaching the theory and practice of nursing;
10             k.  Managing the practice of nursing; and
11             l.  Collaborating with other health professionals in  the  management
12             of health care.
13        (2)  "Licensed practical nurse" means a person who practices nursing by:
14             a.  Functioning  at  the  direction of a licensed professional nurse,
15             licensed physician, or licensed dentist;
16             b.  Contributing to the assessment of the health status of  individu-
17             als and groups of individuals;
18             c.  Participating in the development and modification of the strategy
19             of care;
20             d.  Implementing  the  appropriate aspects of the strategy of care as
21             defined by the board, including administering medications and  treat-
22             ments as prescribed by those health care providers authorized to pre-
23             scribe medication;
24             e.  Maintaining  safe and effective nursing care rendered directly or
25             indirectly;
26             f.  Participating in the evaluation of  responses  to  interventions;
27             and
28             g.  Delegating  nursing interventions that may be performed by others
29             and that do not conflict with this act.
30        (c)  "Nursing education program" means a course of instruction offered and
31    conducted to prepare persons for the practice of nursing, or to  increase  the
32    knowledge and skills of the practicing nurse.
33        (d)  "Nurse  practitioner" means a licensed professional nurse having spe-
34    cialized skill, knowledge and experience  authorized, by rules jointly promul-
35    gated by the Idaho state board of medicine and the Idaho board of nursing  and
36    implemented by the Idaho board of nursing, to perform designated acts of medi-
37    cal diagnosis, prescription of medical therapeutic and corrective measures and
38    delivery of medications. 
39          (e)  "Registered  nurse  anesthetist" means a licensed professional
40    nurse who has graduated from a nationally accredited nurse anesthesia program,
41    passed a qualifying examination recognized by the Idaho board of nursing  and,
42    has  current  initial  certification  or current active recertification from a
43    national group recognized by the board of nursing. Registered  nurse  anesthe-
44    tists  who meet these qualifying requirements and are registered by the board,
45    may, in collaboration with a physician, dentist or  podiatrist  authorized  to
46    practice  in  Idaho,  provide anesthesia care services as defined by the rules
47    promulgated by the board of nursing. The  scope  of  practice  for  registered
48    nurse  anesthetists  shall  incorporate  acts  identified  in board of nursing
49    rules, including selecting, ordering and administering medications,  appropri-
50    ate for rendering anesthesia care services. 

51        SECTION  2.  That  Section 54-1403, Idaho Code, be, and the same is hereby
52    amended to read as follows:

53        54-1403.  BOARD OF NURSING. ( a   1  )  Appointment,


                                          5

 1    Removal  and Term of Office.  There is hereby created within the department of
 2    self-governing agencies the board of nursing for the state of  Idaho  composed
 3    of  seven   nine  ( 7  9 ) members
 4    appointed  by the governor. Membership of the board shall consist of  the
 5    following: 
 6         (a)    four   five  ( 4 
 7        5 ) persons licensed to  practice  professional  nursing  in  Idaho,
 8          of  whom  three (3) shall be educated at the associate degree level
 9        provided that one (1) of these may be a diploma nurse, and two (2) of whom
10        shall be educated at the baccalaureate, master's or doctoral level; 
11         (b)   two (2) persons licensed to practice  practical  nursing
12        in Idaho ;
13        (c)  one (1) person licensed as an advanced practice nurse;  and
14          (d)   one (1) person who is a lay person to health care occu-
15        pations.
16    In making appointments to the board,  consideration  shall  be  given  to  the
17    board's  responsibility  in  areas  of  education and practice. Members of the
18    board of nursing and of the advisory council  for  licensed  practical  nurses
19    holding  office  under prior law on the effective date of this act shall serve
20    as members of the board created herein until expiration  of  their  respective
21    terms  and, as those terms expire or become vacant, the governor shall appoint
22    such other persons as will constitute a complete board as  herein  prescribed.
23      The  two  (2)  members  appointed to reach the full membership provided
24    herein shall be persons licensed to practice professional nursing educated  at
25    the associate degree level. Persons may be reappointed to the board so long as
26    they  meet  the  qualifications  of the position to which they were originally
27    appointed. In the event that a member has attained  an  additional  degree  of
28    education,  they may not be reappointed to represent the board position desig-
29    nated for another specific degree of education.  Upon expiration of  any
30    term  or creation of any vacancy, the board shall notify the governor thereof,
31    who then shall make such appointment or fill such vacancy  within  sixty  (60)
32    days.  Appointments  shall be for terms of three (3) years except appointments
33    to vacancies which shall be for the unexpired term  being  filled.  No  member
34    shall  be  appointed  for more than two (2) terms. The governor may remove any
35    member from the board for neglect of any duty required by law or for  incompe-
36    tency or unprofessional or dishonorable conduct.
37        (  b    2 )  Qualifications of members. No person is
38    qualified for appointment hereunder unless that person is  a  citizen  of  the
39    United  States  and  a  resident of the state of Idaho. Members required to be
40    licensed hereunder shall not be qualified for appointment to the board  unless
41    actively engaged in some field of nursing in Idaho at the time of appointment.
42    No  person  is qualified for appointment as the lay member of the board if the
43    person or his spouse is licensed in any health  occupation;  is  an  employee,
44    officer or agent of or has any financial interest in any health care facility,
45    institution,  or association or any insurance company authorized to underwrite
46    health care insurance; or is engaged in the governance and  administration  of
47    any health care facility, institution or association.
48        ( c  3 )  Conduct of business.  The board shall meet
49    at such times as required to conduct the business of the board and shall annu-
50    ally  elect from its members a chairman, vice chairman and such other officers
51    as may be desirable.  Four   Five   ( 4 
52    5 ) members shall constitute a quorum and the vote of a majority of mem-
53    bers present at a meeting wherein a quorum  is  present  shall  determine  the
54    action of the board. Each member of the board shall be compensated as provided
55    by section 59-509(g), Idaho Code.


                                          6

 1        SECTION  3.  That  Section 54-1404, Idaho Code, be, and the same is hereby
 2    amended to read as follows:

 3        54-1404.  BOARD OF NURSING -- POWERS AND DUTIES. The board shall have  all
 4    powers  and  duties  necessary  and  incident  to regulation of nursing and to
 5    enforcement of this act, including but not limited to, the power and duty:
 6        (1)   t  T o license qualified persons for  practice
 7    of  nursing in Idaho; to renew licenses; to limit, restrict, amend, deny, sus-
 8    pend or revoke licenses; and to accept the voluntary surrender of a license;
 9        (2)   t  T o establish standards,  criteria,  condi-
10    tions  and  requirements for licensure and to investigate and determine eligi-
11    bility and qualifications for licensure, and to  administer  examinations  for
12    licensure;
13        (3)    t    T  o  establish standards of conduct and
14    practice and to regulate the use of titles, abbreviations and designations for
15    the practice of nursing;
16        (4)   t  T  o  establish  standards,  criteria,  and
17    requirements  for  curricula  for  nursing education programs and to evaluate,
18    survey, review and approve nursing education programs subject  to  the  provi-
19    sions of section 54-1406, Idaho Code;
20        (5)    t  T o evaluate continuing competency of per-
21    sons licensed pursuant to this  act  and  to  develop   standards  which  will
22    advance  the  competency of licensees in accordance with developing scientific
23    understanding and methods relating to the practice of nursing;
24        (6)   t  T o receive and collect license and renewal
25    fees assessed pursuant to this act and to assess, receive  and  collect  addi-
26    tional reasonable fees for  approval of nurse practitioners,  
27    the    administration of examinations, investigations and evaluations of
28    applicants, issuance of temporary licenses, duplication  and  verification  of
29    records,  surveying and evaluating nursing education programs, and administra-
30    tive fines not to exceed one hundred dollars ($100) for each count or separate
31    offense of practicing nursing without current licensure, to  be  deposited  in
32    the state board of nursing account in the manner provided by this act;
33        (7)    t  T o employ personnel necessary to adminis-
34    ter this act and rules promulgated pursuant to this act and perform such other
35    duties as the board may require.  Such personnel shall  include  an  executive
36    director,  who shall be currently licensed to practice professional nursing in
37    Idaho and who shall not be a member of the board;
38        (8)   t  T o maintain a record of board proceedings,
39    annually report to the governor and maintain a public register  of  names  and
40    addresses of licensed nurses;
41        (9)    t  T o make, adopt and publish rules pursuant
42    to chapter 52, title 67, Idaho Code, as may be  necessary  or  appropriate  to
43    carry out the provisions and purposes of this act.

44        SECTION  4.  That  Section 54-1407, Idaho Code, be, and the same is hereby
45    amended to read as follows:

46        54-140 7  8  .  LICENSE  FOR  PROFESSIONAL  NURSING.
47    (  a    1  ) Qualifications. To qualify for a license to
48    practice professional nursing, a person must:
49        ( 1  a )   h  H  ave  success-
50        fully  completed  the  basic    professional   curriculum of an
51        approved  professional  nursing education program; and
52        ( 2  b )   p  P ass an  exami-


                                          7

 1        nation  adopted  and  used  by the board to measure knowledge and judgment
 2        essential for safe practice of professional nursing or have a professional
 3        or registered nurse license in good standing, without restriction or limi-
 4        tation, issued upon successful similar examination, approved by the board,
 5        conducted in another state, territory or foreign country; and
 6        ( 3  c )   b  B  e  of  suffi-
 7        ciently  sound  physical and mental health as will not impair or interfere
 8        with the ability to practice nursing.
 9        ( b  2 )  Fees. A qualified applicant shall be enti-
10    tled to a license to practice professional nursing upon payment of  a  license
11    fee to the board in an amount designated by the board not less than forty-five
12    dollars ($45.00) nor more than ninety dollars ($90.00).

13        SECTION  5.  That  Section 54-1408, Idaho Code, be, and the same is hereby
14    amended to read as follows:

15        54-140 8  7 .  LICENSE FOR PRACTICAL NURSING. (
16    a  1 ) Qualifications. To qualify for a license  to  practice
17    practical nursing a person must:
18        (  1   a )   h  H ave success-
19        fully completed the basic curriculum of  an  approved  eleven  (11)  month
20        practical nursing education program or its equivalent; and
21        (  2  b )   p  P ass an exami-
22        nation adopted and used by the board to  measure  knowledge  and  judgment
23        essential for safe practice of practical nursing or have a practical nurs-
24        ing  license  in  good standing, without restriction or limitation, issued
25        upon successful similar examination, approved by the board,  conducted  in
26        another  state,  territory  or  foreign   county   country
27        ; and
28        ( 3  c )   b  B  e  of  suffi-
29        ciently  sound  physical and mental health as will not impair or interfere
30        with the ability to practice nursing.
31        ( b  2 )  Fees. A qualified applicant shall be enti-
32    tled to a license to practice practical nursing upon payment of a license  fee
33    to  the board in an amount designated by the board not less than forty dollars
34    ($40.00) nor more than eighty-five dollars ($85.00).

35        SECTION 6.  That Chapter 14, Title 54, Idaho Code, be,  and  the  same  is
36    hereby  amended  by  the addition thereto of a  NEW SECTION , to be
37    known and designated as Section 54-1409, Idaho Code, and to read as follows:

38        54-1409.  LICENSE FOR ADVANCED PRACTICE PROFESSIONAL NURSING. (1) Qualifi-
39    cations. To qualify for a license to practice advanced  practice  professional
40    nursing, a person must:
41        (a)  Be currently licensed as a professional nurse in Idaho; and
42        (b)  Have  successfully  completed  an  approved advanced practice profes-
43        sional nursing education program that meets the board requirements for the
44        category of advanced nursing practice for which the applicant  is  seeking
45        licensure; and
46        (c)  Have passed a qualifying examination recognized by the board and have
47        current  initial  certification or current recertification from a national
48        group recognized by the board; and
49        (d)  Be of sufficiently sound physical  and  mental  health  as  will  not
50        impair or interfere with the ability to practice nursing.
51        (2)  Fees.  A  qualified applicant shall be entitled to a license to prac-


                                          8

 1    tice advanced practice professional nursing upon payment of a license  fee  to
 2    the  board  in an amount designated by the board not less than forty-five dol-
 3    lars ($45.00) nor more than ninety dollars ($90.00).

 4        SECTION 7.  That Section 54-1409, Idaho Code, be, and the same  is  hereby
 5    amended to read as follows:

 6        54-14  09  10 .  TEMPORARY LICENSE.  (1) 
 7    The board may issue temporary licenses to:
 8        ( 1  a )   g   G  raduates  of
 9        approved  nursing  education  programs seeking to qualify for licensure by
10        this act; or
11        ( 2  b )   p    P  ersons  who
12        have not actively engaged in the practice of nursing in any state for more
13        than three (3) years immediately prior to application for licensure.
14          (2)    Temporary licenses shall be issued upon such terms and
15    conditions as the board may determine necessary to insure safe  and  qualified
16    performance  of  nursing  functions.   The  board shall define the nature, the
17    scope and period of practice permissible under the temporary license.

18        SECTION 8.  That Section 54-1410, Idaho Code, be, and the same  is  hereby
19    amended to read as follows:

20        54-141  0    1  .  RENEWAL  OF LICENSE. Each license
21    issued pursuant to this act shall be valid from the date of  its  issue  until
22    the  first  renewal date thereafter.  No license shall be valid unless renewed
23    each and every two (2) years on the renewal dates fixed  by  the  board.   The
24    board  may impose a renewal fee in an amount not less than twenty-five dollars
25    ($25.00) nor more than fifty dollars ($50.00).

26        SECTION 9.  That Section 54-1411, Idaho Code, be, and the same  is  hereby
27    amended to read as follows:

28        54-141  1   2 .  EXCEPTIONS TO LICENSE REQUIREMENTS.
29    This act shall not be construed to require licensure or to prohibit the  prac-
30    tice  of  nursing  by  persons assisting in an emergency, students enrolled in
31    approved nursing education programs performing functions  incident  to  formal
32    instruction,  nurses  licensed  by  another  state,  territory  or country and
33    employed by the United States government performing official  duties,  persons
34    rendering  nursing  services  or care of the sick when done in connection with
35    the practice of the religious tenets of any church by adherents  thereof,  and
36    by such other persons as may be exempt from licensure by rules  and regu-
37    lations  of the board. Nothing shall be construed as prohibiting the use
38    of  medical  attendants  by  the  department of correction at its correctional
39    institutions.

40        SECTION 10.  That Section 54-1412, Idaho Code, be, and the same is  hereby
41    amended to read as follows:

42        54-141   2    3  .  DISCIPLINARY  ACTION.  (  a
43     1 ) Grounds for discipline. The board shall have  the  power
44    to deny any application for or renewal of license, to revoke, suspend or amend
45    any  license issued pursuant to this act and to limit or restrict the practice
46    of any licensee, upon a determination by the board that the person:
47        ( 1  a )   m  M ade, or caused


                                          9

 1        to be made, a false, fraudulent or forged statement or  representation  in
 2        procuring or attempting to procure a license to practice nursing; or
 3        ( 2  b )   p  P racticed nurs-
 4        ing under a false or assumed name; or
 5        ( 3  c )   i  I s convicted of
 6        a felony or of any offense involving moral turpitude; or
 7        (  4  d )   i  I s or has been
 8        grossly negligent or reckless in performing nursing functions; or
 9        ( 5  e )   h  H abitually uses
10        alcoholic beverages or narcotic, hypnotic or hallucinogenic drugs; or
11        ( 6  f )   i  I  s  physically
12        or mentally unfit to practice nursing; or
13        (  7    g )   v  V iolates the
14        provisions of this act or rules  and regulations  and standards
15        of conduct and practice as may be adopted by the board; or
16        ( 8   h  )    o    O  therwise
17        engages  in  conduct of a character likely to deceive, defraud or endanger
18        patients or the public; or
19        ( 9  i )    h    H  as  had  a
20        license  to  practice  nursing suspended or revoked in any jurisdiction. A
21        certified copy of the order of suspension or  revocation  shall  be  prima
22        facie evidence of such suspension or revocation.
23        (  b  2 )   (a)   Proceedings. The execu-
24        tive director shall conduct such investigations and initiate such proceed-
25        ings as necessary to insure compliance with this section.  The  board  may
26        accept  the voluntary surrender of a license from any nurse under investi-
27        gation and accordingly enter an order revoking or suspending such  license
28        and/or imposing such conditions, limitations, or restrictions on the prac-
29        tice  of  any  such  nurse  as may be appropriate in the discretion of the
30        board. Otherwise, every person subject to disciplinary  proceedings  shall
31        be  afforded  an opportunity for hearing after reasonable notice. All pro-
32        ceedings hereunder shall be in accordance with chapter 52, title 67, Idaho
33        Code.
34         (b)   Hearings shall be conducted by the board or  by  persons
35        appointed by the board to conduct hearings and receive evidence. The board
36        and  any person duly appointed by the board to conduct hearings shall have
37        all powers as are necessary and incident to orderly and effective  receipt
38        of  evidence including, but not limited to, the power to administer oaths,
39        and to compel by subpoena attendance of witnesses and production of books,
40        records and things at the hearing or at a deposition taken by a  party  in
41        accordance  with  the  Idaho  rules of civil procedure. Any party shall be
42        entitled to the use of subpoena upon application therefor.
43         (c)   In the event any person fails to comply with a  subpoena
44        personally  served  upon him or refuses to testify to any matter regarding
45        which he may be lawfully interrogated, the board shall petition  the  dis-
46        trict  court in the county where such failure or refusal occurred or where
47        such person resides, to enforce such subpoena or  compel  such  testimony.
48        Proceedings  before  the  district court shall be for contempt in the same
49        nature as contempt of court for failure or refusal to comply with an order
50        of the court and the court shall have the same powers to secure compliance
51        with subpoena and testimony or to impose penalties as in contempt of court
52        proceedings.
53        ( c  3 )  Probation/Subsequent review. Any order  of
54    the board entered under this section may be withheld or suspended for a proba-
55    tionary  period to be fixed by the board upon such terms and conditions as may


                                          10

 1    be appropriate in order to regulate, monitor and/or supervise the practice  of
 2    nursing  by the licensee subject to such order for the prescribed probationary
 3    period. Any order of the board entered under this section  may  be  withdrawn,
 4    reversed,  modified  or  amended  upon  a showing by the person subject to the
 5    order that the grounds for discipline no longer exist or that he is  rehabili-
 6    tated,  qualified  and competent to practice nursing and that he is not likely
 7    to violate this act or rules  and regulations  adopted hereunder in
 8    the future.  The board may, as a condition to withdrawal, reversal,  modifica-
 9    tion  or  amendment of the order, require the person to pay all or part of the
10    costs incurred by the board in proceedings upon which the order was entered.

11        SECTION 11.  That Section 54-1413, Idaho Code, be, and the same is  hereby
12    amended to read as follows:

13        54-141 3  4 .  UNLAWFUL CONDUCT -- PENALTIES. (
14    a    1  )  It  shall be unlawful for any person, corporation,
15    association or other legal entity to:
16        ( 1  a )  Practice nursing in this state  without  a
17        current license unless exempt from licensure by this act; or
18        (  2    b  )  Falsify  or  forge any application for
19        licensure, license, renewal of license or certification required  by  this
20        act; or
21        (  3   c )  Falsely represent by use of any designa-
22        tion, title, or statement, that he is licensed pursuant to this act; or
23        ( 4  d )  Falsely represent, by use of any  designa-
24        tion,  title or statement, that a school or course is approved pursuant to
25        this act; or
26        ( 5  e  )  Employ  unlicensed  persons  to  practice
27        nursing  in  this state unless the person is exempt from licensure by this
28        act;  or 
29        ( 6  f )  Aid, assist or  encourage  any  person  to
30        violate this act ; or  . 
31          (7)  Fail to report semiannually upon request, the names of profes-
32        sional and practical nurses employed. 
33        ( b  2 )  Any person  violating  the  provisions  of
34    this  section shall be guilty of a misdemeanor and shall be punishable by fine
35    not to exceed three hundred dollars ($300) or by imprisonment  not  to  exceed
36    six (6) months or both such fine and imprisonment.

37        SECTION  12.  That Section 54-1414, Idaho Code, be, and the same is hereby
38    amended to read as follows:

39        54-141 4  5 .  EXISTING LICENSES. Any person holding
40    a license to practice nursing in this state on  the date this act becomes
41    effective   March 23, 1977,  shall be recognized as  licensed
42    hereunder  and shall be subject to all provisions of this act. The rules 
43    and regulations  of the board in effect at the time of enactment of this
44    act, and the fees fixed by the statute repealed by this act  shall  remain  in
45    full force and effect until the board has adopted supplemental rules  and
46    regulations  pursuant to this act.

47        SECTION  13.  That  Chapter  14, Title 54, Idaho Code, be, and the same is
48    hereby amended by the addition thereto of a  NEW SECTION  ,  to  be
49    known and designated as Section 54-1417, Idaho Code, and to read as follows:


                                          11

 1        54-1417.  ADVISORY  COMMITTEE  TO  THE  BOARD. There is hereby created and
 2    established an advisory committee to  the  board  on  issues  related  to  the
 3    advanced  practice of nursing of certified nurse midwives, clinical nurse spe-
 4    cialists and nurse practitioners.
 5        (1)  The committee shall consist of five  (5)  members:  two  (2)  persons
 6    licensed to practice advanced practice nursing in the state of Idaho appointed
 7    by  the board of nursing; two (2) persons licensed to practice medicine in the
 8    state of Idaho appointed by the board of nursing from a list of nominees  sup-
 9    plied  by the board of medicine; and one (1) person licensed to practice phar-
10    macy in the state of Idaho appointed by the board of nursing from  a  list  of
11    nominees  supplied by the board of pharmacy. Each member shall serve a term of
12    two (2) years to expire on June 30 in the last year of the member's term, pro-
13    vided that the board may appoint three (3) of the original committee  members,
14    one  (1) advance practice nurse, one (1) physician and one (1) pharmacist to a
15    one (1) time three (3) year term.
16        (2)  The committee shall meet quarterly or at such times as may be  deter-
17    mined by the committee or the board to be necessary.
18        (3)  The  committee  shall  (a) respond to questions posed by the board or
19    board staff regarding  advanced  practice  nursing;  (b)  consider  nonroutine
20    applications  for  advanced practice nursing licenses and make recommendations
21    to the board; (c) review complaints against advanced practice nurses and  make
22    recommendations  to  the  board;  (d)  consider  applications for prescriptive
23    authority and make recommendations to the board;  and  (e)  recommend  to  the
24    board  the scope of practice of advanced practice nurses, using national stan-
25    dards as a guideline.
26        (4)  The committee's recommendations, using national standards as a guide-
27    line, may be adopted, rejected or modified by the  board,  provided  that  the
28    board  shall  not expand the scope of practice or prescriptive authority of an
29    advanced practice nurse beyond that recommended by the advisory committee.

30        SECTION 14.  That Section 54-1415, Idaho Code, be, and the same is  hereby
31    repealed.

32        SECTION  15.  That Section 54-1814, Idaho Code, be, and the same is hereby
33    amended to read as follows:

34        54-1814.  GROUNDS FOR MEDICAL DISCIPLINE. Every person licensed  to  prac-
35    tice  medicine  or  registered  as  an extern, intern, resident or physician's
36    assistant in this state is subject to discipline by the board pursuant to  the
37    procedures  and  powers set forth in section 54-1806A, Idaho Code, upon any of
38    the following grounds:
39        (1)  Conviction of a felony, or a crime involving moral turpitude, or  the
40    entering  of  a  plea  of guilty or the finding of guilt by a jury or court of
41    commission of a felony or a crime involving moral turpitude.
42        (2)  Use of false, fraudulent or forged statements or documents,  diplomas
43    or  credentials in connection with any licensing or other requirements of this
44    act.
45        (3)  Practicing medicine under a false or assumed  name  in  this  or  any
46    other state.
47        (4)  Advertising  the  practice  of medicine in any unethical or unprofes-
48    sional manner.
49        (5)  Knowingly aiding or abetting any person to practice medicine  who  is
50    not authorized to practice medicine as provided in this chapter.
51        (6)  Performing  or  procuring  an unlawful abortion or aiding or abetting
52    the performing or procuring of an unlawful abortion.


                                          12

 1        (7)  The provision of health care which fails  to  meet  the  standard  of
 2    health  care  provided  by other qualified physicians in the same community or
 3    similar communities, taking into account  his  training,  experience  and  the
 4    degree of expertise to which he holds himself out to the public.
 5        (8)  Division  of  fees  or  gifts or agreement to split or divide fees or
 6    gifts received for professional services with any person, institution or  cor-
 7    poration in exchange for referral.
 8        (9)  Giving  or receiving or aiding or abetting the giving or receiving of
 9    rebates, either directly or indirectly.
10        (10) Inability to obtain or renew a license to practice medicine, or revo-
11    cation of, or suspension of a license to practice medicine by any other state,
12    territory, district of the United States or Canada, unless  it  can  be  shown
13    that  such  action was not related to the competence of the person to practice
14    medicine or to any conduct designated herein.
15        (11) Prescribing  or  furnishing  narcotic  or  hallucinogenic  drugs   to
16    addicted  persons  to  maintain  their  addictions  and level of usage without
17    attempting to treat the primary condition requiring the use of narcotics.
18        (12) Prescribing or furnishing narcotic, hypnotic, hallucinogenic,  stimu-
19    lating  or  dangerous drugs for other than treatment of any disease, injury or
20    medical condition.
21        (13) Failure to safeguard the confidentiality of medical records or  other
22    medical information pertaining to identifiable patients, except as required or
23    authorized by law.
24        (14) The  direct  promotion  by a physician of the sale of drugs, devices,
25    appliances or goods to a patient that are unnecessary and not medically  indi-
26    cated.
27        (15) Abandonment of a patient.
28        (16) Wilfully  and  intentionally representing that a manifestly incurable
29    disease or injury or other manifestly incurable condition can  be  permanently
30    cured.
31        (17) Failure  to  supervise the activities of externs, interns, residents,
32    nurse practitioners , certified nurse-midwives, clinical  nurse  special-
33    ists,   or physician's assistants .   as required by the
34    registration documentation of this chapter. 
35        (18) Practicing medicine when a license pursuant to this chapter  is  sus-
36    pended, revoked or inactive.
37        (19) Practicing  medicine in violation of a voluntary restriction or terms
38    of probation pursuant to this chapter.
39        (20) Refusing to divulge to the  board  upon  demand  the  means,  method,
40    device or instrumentality used in the treatment of a disease, injury, ailment,
41    or infirmity.
42        (21) Commission  of any act constituting a felony or commission of any act
43    constituting a crime involving moral turpitude.
44        (22) Engaging in any conduct which constitutes an abuse or exploitation of
45    a patient arising out of the trust and confidence placed in the  physician  by
46    the patient.

Statement of Purpose / Fiscal Impact

    





                           STATEMENT OF PURPOSE
    
                                RS 08006C1
    
    The purpose of this legislation is to define and regulate the 
    advanced practice of professional nursing. This bill defines 
    an "advanced practice professional nurse" and further defines 
    three of the four categories of advanced practice nursing: 
    clinical nurse specialist, certified nurse midwife and nurse 
    practitioner. The fourth category of advanced practice 
    professional nursing, registered nurse anesthetist, is 
    presently defined in the Nursing Practice Act. This bill also 
    renumbers several sections for ease of reference.
    
                                FISCAL NOTE
    
    None to the General Fund. Any costs to be offset by 
    appropriate licensing fees.
    
    Contact: Sandra Evans, 334-3110, Board of 
    Nursing
    
    STATEMENT OF PURPOSE/FISCAL NOTE
    
    H 662