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H0659aa...............................................by HEALTH AND WELFARE
NURSES - Amends existing law to remove physician supervision requirements
applicable to certified nurse midwives, clinical nurse specialists and
nurse practitioners; and to require peer review for renewal of license.
02/11 House intro - 1st rdg - to printing
02/12 Rpt prt - to Health/Wel
02/19 Rpt out - to Gen Ord
02/20 Rpt out amen - to engros
02/23 Rpt engros - 1st rdg - to 2nd rdg as amen
02/24 2nd rdg - to 3rd rdg as amen
02/26 3rd rdg as amen - PASSED - 59-3-8
AYES -- Andersen, Barraclough, Barrett, Bauer, Bayer, Bell, Block,
Boe, Bolz, Bradford, Campbell, Cannon, Clark, Collins, Crow, Cuddy,
Denney, Douglas, Eberle, Edmunson, Ellsworth, Eskridge, Field(18),
Field(23), Gagner, Garrett, Harwood, Henbest, Jaquet, Jones, Kellogg,
Kulczyk, Lake, Langford, Langhorst, Martinez, McGeachin, McKague,
Miller, Mitchell, Moyle, Nielsen, Pasley-Stuart, Raybould, Ridinger,
Ringo, Roberts, Robison, Sali, Sayler, Shepherd, Skippen, Smith(30),
Smylie, Snodgrass, Stevenson, Trail, Wills, Wood
NAYS -- Ring, Rydalch, Shirley
Absent and excused -- Bedke, Black, Deal, Meyer, Naccarato, Schaefer,
Smith(24), Mr. Speaker
Floor Sponsor - Henbest
Title apvd - to Senate
02/27 Senate intro - 1st rdg - to Health/Wel
03/12 Rpt out - rec d/p - to 2nd rdg
03/15 2nd rdg - to 3rd rdg
03/19 3rd rdg - PASSED - 27-5-3
AYES -- Andreason, Brandt, Bunderson, Burkett(Maxand), Burtenshaw,
Calabretta, Cameron, Compton, Gannon, Geddes, Goedde, Hill, Ingram,
Kennedy, Keough, Little, Lodge, Malepeai, Marley, Noble, Pearce,
Sorensen, Stegner, Stennett, Sweet, Werk, Williams
NAYS -- Bailey, Darrington, Davis, McKenzie, Richardson
Absent and excused -- McWilliams, Noh, Schroeder
Floor Sponsor - Sorensen
Title apvd - to House
03/20 To enrol - Rpt enrol - Sp signed - Pres signed
03/22 To Governor
03/23 Governor signed
Session Law Chapter 262
Effective: 07/01/04
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-seventh Legislature Second Regular Session - 2004
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 659
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO THE IDAHO BOARD OF NURSING; AMENDING SECTION 54-1402, IDAHO CODE,
3 TO REMOVE PHYSICIAN SUPERVISION REQUIREMENTS APPLICABLE TO CERTIFIED NURSE
4 MIDWIVES, CLINICAL NURSE SPECIALISTS, NURSE PRACTITIONERS, AND REGISTERED
5 NURSE ANESTHETISTS.
6 Be It Enacted by the Legislature of the State of Idaho:
7 SECTION 1. That Section 54-1402, Idaho Code, be, and the same is hereby
8 amended to read as follows:
9 54-1402. DEFINITIONS. As used in this act:
10 (1) "Advanced practice professional nurse" means a professional nurse
11 licensed in this state who has gained additional specialized knowledge, skills
12 and experience through a nationally accredited program of study as defined
13 herein and is authorized to perform advanced nursing practice, which may
14 include the prescribing, administering and dispensing of therapeutic
15 pharmacologic agents, as defined by board rules. An advanced practice profes-
16 sional nurse shall perform only those acts as provided herein and for which
17 the individual is educationally prepared. Advanced practice professional
18 nurses shall include certified nurse-midwives, clinical nurse specialists,
19 nurse practitioners, and registered nurse anesthetists as defined in this sub-
20 section.
21 (a) "Certified nurse-midwife" means a licensed professional nurse who has
22 graduated from a nationally accredited nurse-midwifery program, passed a
23 qualifying examination recognized by the board, and has current initial
24 certification or current recertification from a national organization rec-
25 ognized by the board. Certified nurse-midwives who meet these qualifying
26 requirements and are licensed by the board, may manage women's health
27 care, which may include pharmacologic and nonpharmacologic therapeutic and
28 corrective measures which focus on pregnancy, childbirth, the postpartum
29 period, care of the newborn, reproductive and gynecological needs of well
30 women as defined by the rules of the board. The certified nurse-midwife
31 shall practice with physician supervision, consultation and collaborative
32 management and appropriate referral. The physician shall be licensed pur-
33 suant to chapter 18, title 54, Idaho Code.
34 (b) "Clinical nurse specialist" means a licensed professional nurse who
35 has graduated from a nationally accredited graduate program in nursing
36 with a clinical focus, passed a qualifying examination recognized by the
37 board, and has current initial certification or current recertification
38 from a national group recognized by the board. Clinical nurse specialists
39 who meet these qualifying requirements and are licensed by the board may
40 practice as expert clinicians in a particular specialty or subspecialty of
41 nursing practice. The clinical nurse specialist provides direct client
42 care, which may include assessing, diagnosing, planning, and prescribing
43 pharmacologic and nonpharmacologic therapeutic and corrective measures,
2
1 health promotion and preventive care within this specialized area of prac-
2 tice, as defined by rules of the board. The clinical nurse specialist
3 shall practice with physician supervision, consultation and collaborative
4 management and appropriate referral. The physician shall be licensed pur-
5 suant to chapter 18, title 54, Idaho Code.
6 (c) "Nurse practitioner" means a licensed professional nurse who has
7 graduated from a nationally accredited nurse practitioner program, passed
8 a qualifying examination recognized by the board, and has current initial
9 certification or current recertification from a national group recognized
10 by the board. Any person authorized by the board to practice nursing as a
11 nurse practitioner in this state as of July 1, 1998, shall be licensed as
12 a nurse practitioner under the provisions of this act and shall be eligi-
13 ble for renewal of such license under the conditions and standards pre-
14 scribed in this act. Nurse practitioners who meet these qualifying
15 requirements and are licensed by the board may perform comprehensive
16 health assessments, diagnosis, health promotion and the direct management
17 of acute and chronic illness and disease which may include the prescribing
18 of pharmacologic and nonpharmacologic treatments as defined by rules of
19 the board. The nurse practitioner shall practice with physician supervi-
20 sion, consultation and collaborative management and appropriate referral.
21 The physician shall be licensed pursuant to chapter 18, title 54, Idaho
22 Code.
23 (d) "Registered nurse anesthetist" means a licensed professional nurse
24 who has graduated from a nationally accredited nurse anesthesia program,
25 passed a qualifying examination recognized by the board and, has current
26 initial certification or current recertification from a national group
27 recognized by the board. Registered nurse anesthetists who meet these
28 qualifying requirements and are licensed by the board, may, in collabora-
29 tion with a physician, dentist or podiatrist authorized to practice in
30 Idaho, provide anesthesia care services as defined by the rules of the
31 board. The scope of practice for registered nurse anesthetists shall
32 incorporate acts identified in board rules, including selecting, ordering
33 and administering medications appropriate for rendering anesthesia care
34 services.
35 (2) "Board" means the board of nursing.
36 (3) "Licensed practical nurse" means a person who practices nursing by:
37 (a) Functioning at the direction of a licensed professional nurse,
38 licensed physician, or licensed dentist;
39 (b) Contributing to the assessment of the health status of individuals
40 and groups of individuals;
41 (c) Participating in the development and modification of the strategy of
42 care;
43 (d) Implementing the appropriate aspects of the strategy of care as
44 defined by the board, including administering medications and treatments
45 as prescribed by those health care providers authorized to prescribe medi-
46 cation;
47 (e) Maintaining safe and effective nursing care rendered directly or
48 indirectly;
49 (f) Participating in the evaluation of responses to interventions; and
50 (g) Delegating nursing interventions that may be performed by others and
51 that do not conflict with this act.
52 (4) "Licensed professional nurse" means a person who practices nursing
53 by:
54 (a) Assessing the health status of individuals and groups of individuals;
55 (b) Identifying health care problems that are amenable to nursing inter-
3
1 vention;
2 (c) Establishing goals to meet identified health care needs;
3 (d) Planning a strategy of care;
4 (e) Prescribing nursing interventions to implement the strategy of care;
5 (f) Implementing the strategy of care, including administering
6 medications and treatments as prescribed by those health care providers
7 authorized to prescribe medication;
8 (g) Authorizing nursing interventions that may be performed by others and
9 that do not conflict with this act;
10 (h) Maintaining safe and effective nursing care rendered directly or
11 indirectly;
12 (i) Evaluating responses to interventions;
13 (j) Teaching the theory and practice of nursing;
14 (k) Managing the practice of nursing; and
15 (l) Collaborating with other health professionals in the management of
16 health care.
17 (5) "Nursing education program" means a course of instruction offered and
18 conducted to prepare persons for the practice of nursing, or to increase the
19 knowledge and skills of the practicing nurse.
20 (6) "Practice of nursing" means assisting individuals or groups of indi-
21 viduals to promote, maintain or restore optimal health throughout the life
22 process by assessing and evaluating their health status, planning and imple-
23 menting a strategy of care to accomplish defined goals, and evaluating
24 responses to care and treatment.
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-seventh Legislature Second Regular Session - 2004
Moved by Henbest
Seconded by Martinez
IN THE HOUSE OF REPRESENTATIVES
HOUSE AMENDMENTS TO H.B. NO. 659
1 AMENDMENTS TO SECTION 1
2 On page 1 of the printed bill, in line 33, following "Code." insert: "The
3 certified nurse midwife collaborates with other health professionals in pro-
4 viding health care."; on page 2, in line 5, following "Code." insert: "The
5 clinical nurse specialist collaborates with other health professionals in pro-
6 viding health care."; in line 22, following "Code." insert: "The nurse practi-
7 tioner collaborates with other health professionals in providing health
8 care."; in line 28, delete ", in collabora-", delete line 29 and in line 30,
9 delete "Idaho," and insert: ", in collaboration with a physician, dentist or
10 podiatrist authorized to practice in Idaho,".
11 AMENDMENT TO THE BILL
12 On page 3, following line 24, insert:
13 "SECTION 2. That Section 54-1411, Idaho Code, be, and the same is hereby
14 amended to read as follows:
15 54-1411. RENEWAL AND REINSTATEMENT OF LICENSE. (1) Renewal. Each license
16 issued pursuant to this chapter shall be valid from the date of its issue
17 until the first renewal date thereafter.
18 (a) No license shall be valid unless renewed each and every two (2) years
19 on the renewal dates fixed by the board.
20 (b) The board may impose a renewal fee in an amount not to exceed one
21 hundred dollars ($100).
22 (c) A license that is not timely renewed is a lapsed license.
23 (2) Certified nurse midwives, clinical nurse specialists and nurse prac-
24 titioners desiring license renewal must provide proof, satisfactory to the
25 board, of the applicant's competence to practice by documenting completion of
26 a peer review process.
27 (3) Reinstatement. A person whose license has lapsed, or who holds an
28 emeritus status license in good standing, or whose license has been revoked,
29 suspended, limited, conditioned or otherwise sanctioned by the board, may
30 apply for reinstatement of the license to active and unrestricted status. A
31 licensee's ability to apply for reinstatement may be subject to time con-
32 straints imposed by board rule or by the terms of a disciplinary order. An
33 applicant for reinstatement must:
34 (a) Pay a reinstatement fee in an amount not to exceed one hundred dol-
35 lars ($100).
36 (b) Submit a completed reinstatement application and provide proof, sat-
37 isfactory to the board, of the applicant's competency to practice.
38 (c) Document compliance with the terms and conditions set forth in any
39 order of the board as a condition of reinstatement.".
40 CORRECTIONS TO TITLE
41 On page 1, in line 4, following "SPECIALISTS" delete "," and insert:
2
1 "AND"; and following "PRACTITIONERS" delete the remainder of the line and
2 delete all of line 5, and insert: "AND TO PROVIDE FOR COLLABORATION WITH OTHER
3 HEALTH PROFESSIONALS; AND AMENDING SECTION 54-1411, IDAHO CODE, TO REQUIRE
4 PEER REVIEW FOR RENEWAL OF LICENSE.".
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-seventh Legislature Second Regular Session - 2004
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 659, As Amended
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO THE IDAHO BOARD OF NURSING; AMENDING SECTION 54-1402, IDAHO CODE,
3 TO REMOVE PHYSICIAN SUPERVISION REQUIREMENTS APPLICABLE TO CERTIFIED NURSE
4 MIDWIVES, CLINICAL NURSE SPECIALISTS AND NURSE PRACTITIONERS AND TO PRO-
5 VIDE FOR COLLABORATION WITH OTHER HEALTH PROFESSIONALS; AND AMENDING SEC-
6 TION 54-1411, IDAHO CODE, TO REQUIRE PEER REVIEW FOR RENEWAL OF LICENSE.
7 Be It Enacted by the Legislature of the State of Idaho:
8 SECTION 1. That Section 54-1402, Idaho Code, be, and the same is hereby
9 amended to read as follows:
10 54-1402. DEFINITIONS. As used in this act:
11 (1) "Advanced practice professional nurse" means a professional nurse
12 licensed in this state who has gained additional specialized knowledge, skills
13 and experience through a nationally accredited program of study as defined
14 herein and is authorized to perform advanced nursing practice, which may
15 include the prescribing, administering and dispensing of therapeutic
16 pharmacologic agents, as defined by board rules. An advanced practice profes-
17 sional nurse shall perform only those acts as provided herein and for which
18 the individual is educationally prepared. Advanced practice professional
19 nurses shall include certified nurse-midwives, clinical nurse specialists,
20 nurse practitioners, and registered nurse anesthetists as defined in this sub-
21 section.
22 (a) "Certified nurse-midwife" means a licensed professional nurse who has
23 graduated from a nationally accredited nurse-midwifery program, passed a
24 qualifying examination recognized by the board, and has current initial
25 certification or current recertification from a national organization rec-
26 ognized by the board. Certified nurse-midwives who meet these qualifying
27 requirements and are licensed by the board, may manage women's health
28 care, which may include pharmacologic and nonpharmacologic therapeutic and
29 corrective measures which focus on pregnancy, childbirth, the postpartum
30 period, care of the newborn, reproductive and gynecological needs of well
31 women as defined by the rules of the board. The certified nurse-midwife
32 shall practice with physician supervision, consultation and collaborative
33 management and appropriate referral. The physician shall be licensed pur-
34 suant to chapter 18, title 54, Idaho Code. The certified nurse midwife
35 collaborates with other health professionals in providing health care.
36 (b) "Clinical nurse specialist" means a licensed professional nurse who
37 has graduated from a nationally accredited graduate program in nursing
38 with a clinical focus, passed a qualifying examination recognized by the
39 board, and has current initial certification or current recertification
40 from a national group recognized by the board. Clinical nurse specialists
41 who meet these qualifying requirements and are licensed by the board may
42 practice as expert clinicians in a particular specialty or subspecialty of
43 nursing practice. The clinical nurse specialist provides direct client
2
1 care, which may include assessing, diagnosing, planning, and prescribing
2 pharmacologic and nonpharmacologic therapeutic and corrective measures,
3 health promotion and preventive care within this specialized area of prac-
4 tice, as defined by rules of the board. The clinical nurse specialist
5 shall practice with physician supervision, consultation and collaborative
6 management and appropriate referral. The physician shall be licensed pur-
7 suant to chapter 18, title 54, Idaho Code. The clinical nurse specialist
8 collaborates with other health professionals in providing health care.
9 (c) "Nurse practitioner" means a licensed professional nurse who has
10 graduated from a nationally accredited nurse practitioner program, passed
11 a qualifying examination recognized by the board, and has current initial
12 certification or current recertification from a national group recognized
13 by the board. Any person authorized by the board to practice nursing as a
14 nurse practitioner in this state as of July 1, 1998, shall be licensed as
15 a nurse practitioner under the provisions of this act and shall be eligi-
16 ble for renewal of such license under the conditions and standards pre-
17 scribed in this act. Nurse practitioners who meet these qualifying
18 requirements and are licensed by the board may perform comprehensive
19 health assessments, diagnosis, health promotion and the direct management
20 of acute and chronic illness and disease which may include the prescribing
21 of pharmacologic and nonpharmacologic treatments as defined by rules of
22 the board. The nurse practitioner shall practice with physician supervi-
23 sion, consultation and collaborative management and appropriate referral.
24 The physician shall be licensed pursuant to chapter 18, title 54, Idaho
25 Code. The nurse practitioner collaborates with other health professionals
26 in providing health care.
27 (d) "Registered nurse anesthetist" means a licensed professional nurse
28 who has graduated from a nationally accredited nurse anesthesia program,
29 passed a qualifying examination recognized by the board and, has current
30 initial certification or current recertification from a national group
31 recognized by the board. Registered nurse anesthetists who meet these
32 qualifying requirements and are licensed by the board, may, in collabora-
33 tion with a physician, dentist or podiatrist authorized to practice in
34 Idaho, provide anesthesia care services as defined by the rules of the
35 board. The scope of practice for registered nurse anesthetists shall
36 incorporate acts identified in board rules, including selecting, ordering
37 and administering medications appropriate for rendering anesthesia care
38 services.
39 (2) "Board" means the board of nursing.
40 (3) "Licensed practical nurse" means a person who practices nursing by:
41 (a) Functioning at the direction of a licensed professional nurse,
42 licensed physician, or licensed dentist;
43 (b) Contributing to the assessment of the health status of individuals
44 and groups of individuals;
45 (c) Participating in the development and modification of the strategy of
46 care;
47 (d) Implementing the appropriate aspects of the strategy of care as
48 defined by the board, including administering medications and treatments
49 as prescribed by those health care providers authorized to prescribe medi-
50 cation;
51 (e) Maintaining safe and effective nursing care rendered directly or
52 indirectly;
53 (f) Participating in the evaluation of responses to interventions; and
54 (g) Delegating nursing interventions that may be performed by others and
55 that do not conflict with this act.
3
1 (4) "Licensed professional nurse" means a person who practices nursing
2 by:
3 (a) Assessing the health status of individuals and groups of individuals;
4 (b) Identifying health care problems that are amenable to nursing inter-
5 vention;
6 (c) Establishing goals to meet identified health care needs;
7 (d) Planning a strategy of care;
8 (e) Prescribing nursing interventions to implement the strategy of care;
9 (f) Implementing the strategy of care, including administering
10 medications and treatments as prescribed by those health care providers
11 authorized to prescribe medication;
12 (g) Authorizing nursing interventions that may be performed by others and
13 that do not conflict with this act;
14 (h) Maintaining safe and effective nursing care rendered directly or
15 indirectly;
16 (i) Evaluating responses to interventions;
17 (j) Teaching the theory and practice of nursing;
18 (k) Managing the practice of nursing; and
19 (l) Collaborating with other health professionals in the management of
20 health care.
21 (5) "Nursing education program" means a course of instruction offered and
22 conducted to prepare persons for the practice of nursing, or to increase the
23 knowledge and skills of the practicing nurse.
24 (6) "Practice of nursing" means assisting individuals or groups of indi-
25 viduals to promote, maintain or restore optimal health throughout the life
26 process by assessing and evaluating their health status, planning and imple-
27 menting a strategy of care to accomplish defined goals, and evaluating
28 responses to care and treatment.
29 SECTION 2. That Section 54-1411, Idaho Code, be, and the same is hereby
30 amended to read as follows:
31 54-1411. RENEWAL AND REINSTATEMENT OF LICENSE. (1) Renewal. Each license
32 issued pursuant to this chapter shall be valid from the date of its issue
33 until the first renewal date thereafter.
34 (a) No license shall be valid unless renewed each and every two (2) years
35 on the renewal dates fixed by the board.
36 (b) The board may impose a renewal fee in an amount not to exceed one
37 hundred dollars ($100).
38 (c) A license that is not timely renewed is a lapsed license.
39 (2) Certified nurse midwives, clinical nurse specialists and nurse prac-
40 titioners desiring license renewal must provide proof, satisfactory to the
41 board, of the applicant's competence to practice by documenting completion of
42 a peer review process.
43 (3) Reinstatement. A person whose license has lapsed, or who holds an
44 emeritus status license in good standing, or whose license has been revoked,
45 suspended, limited, conditioned or otherwise sanctioned by the board, may
46 apply for reinstatement of the license to active and unrestricted status. A
47 licensee's ability to apply for reinstatement may be subject to time con-
48 straints imposed by board rule or by the terms of a disciplinary order. An
49 applicant for reinstatement must:
50 (a) Pay a reinstatement fee in an amount not to exceed one hundred dol-
51 lars ($100).
52 (b) Submit a completed reinstatement application and provide proof, sat-
53 isfactory to the board, of the applicant's competency to practice.
4
1 (c) Document compliance with the terms and conditions set forth in any
2 order of the board as a condition of reinstatement.
REPRINT REPRINT REPRINT
STATEMENT OF PURPOSE
RS 13994
This legislation clarifies the current relationship between
advanced practice professional nurses (APPNs) and physicians.
FISCAL IMPACT
There is no impact to the general fund.
Contact
Name: Randy Hudspeth, RN, NP
Phone: 367-6883
STATEMENT OF PURPOSE/FISCAL NOTE H 659