2004 Legislation
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HOUSE BILL NO. 701 – Nursing assistants, licensure

HOUSE BILL NO. 701

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H0701.................................................by HEALTH AND WELFARE
NURSING ASSISTANTS - Amends existing law to define "nursing assistant"; and
to require licensure of nursing assistants by the Board of Nursing on and
after July 1, 2006.
                                                                        
02/16    House intro - 1st rdg - to printing
02/17    Rpt prt - to Health/Wel

Bill Text


                                                                        
                                                                        
  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-seventh Legislature                 Second Regular Session - 2004
                                                                        
                                                                        
                              IN THE HOUSE OF REPRESENTATIVES
                                                                        
                                     HOUSE BILL NO. 701
                                                                        
                              BY HEALTH AND WELFARE COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO THE IDAHO BOARD OF NURSING; AMENDING SECTION 54-1402, IDAHO  CODE,
  3        TO  DEFINE  "NURSING ASSISTANT"; AND AMENDING SECTION 54-1404, IDAHO CODE,
  4        TO REQUIRE LICENSURE BY THE BOARD OF NURSING OF NURSING ASSISTANTS ON  AND
  5        AFTER JULY 1, 2006.
                                                                        
  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 assistant" refers to a person who,  regardless  of  practice
 18    setting,  engages in the practice of nursing and who is not otherwise licensed
 19    to practice nursing or exempt from licensure pursuant to this chapter.
 20        (6)  "Nursing education program" means a course of instruction offered and
 21    conducted to prepare persons for the practice of nursing, or to  increase  the
 22    knowledge and skills of the practicing nurse.
 23        (67)  "Practice of nursing" means assisting individuals or groups of indi-
 24    viduals  to  promote,  maintain  or restore optimal health throughout the life
 25    process by assessing and evaluating their health status, planning  and  imple-
 26    menting  a  strategy  of  care  to  accomplish  defined  goals, and evaluating
 27    responses to care and treatment.
                                                                        
 28        SECTION 2.  That Section 54-1404, Idaho Code, be, and the same  is  hereby
 29    amended to read as follows:
                                                                        
 30        54-1404.  BOARD  OF NURSING -- POWERS AND DUTIES. The board shall have all
 31    powers and duties necessary and incident  to  regulation  of  nursing  and  to
 32    enforcement of this act, including but not limited to, the power and duty:
 33        (1)  To  license  qualified  persons  for practice of nursing in Idaho; to
 34    renew licenses; to limit, restrict, amend, deny, suspend or  revoke  licenses;
 35    and to accept the voluntary surrender of a license;
 36        (2)  To  establish  standards,  criteria,  conditions and requirements for
 37    licensure and to investigate and determine eligibility and qualifications  for
 38    licensure, and to administer examinations for licensure;
 39        (3)  To  establish  standards  of conduct and practice and to regulate the
 40    use of titles, abbreviations and designations for the practice of nursing;
 41        (4)  To establish standards, criteria, and requirements for curricula  for
 42    nursing education programs and to evaluate, survey, review and approve nursing
 43    education programs subject to the provisions of section 54-1406, Idaho Code;
 44        (5)  To  evaluate  continuing  competency  of persons licensed pursuant to
 45    this act and to develop standards which will advance the competency of  licen-
 46    sees in accordance with developing scientific understanding and methods relat-
 47    ing to the practice of nursing;
 48        (6)  To  require,  on and after July 1, 2006, the licensure of all nursing
 49    assistants practicing in Idaho; to promulgate rules, such as those  set  forth
 50    in  paragraphs  (1)  through  (4)  of  this section, establishing a regulatory
 51    structure for nursing assistant licensure; and to require payment of a fee  of
 52    not  more  than  fifty  dollars  ($50.00)  for  each initial nursing assistant
 53    license and a fee not to exceed thirty  dollars  ($30.00)  for  each  biennial
                                                                        
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  1    nursing assistant license renewal;
  2        (7)  To  receive and collect license and renewal fees assessed pursuant to
  3    this act and to assess, receive and collect additional reasonable fees for the
  4    administration  of examinations, investigations and evaluations of applicants,
  5    issuance of temporary licenses, duplication and verification of records,  sur-
  6    veying and evaluating nursing education programs, and administrative fines not
  7    to  exceed  one  hundred  dollars ($100) for each count or separate offense of
  8    practicing nursing without current licensure, to be  deposited  in  the  state
  9    board of nursing account in the manner provided by this act;
 10        (78)  To  employ personnel necessary to administer this act and rules pro-
 11    mulgated pursuant to this act and perform such other duties as the  board  may
 12    require. Such personnel shall include an executive director, who shall be cur-
 13    rently licensed to practice professional nursing in Idaho and who shall not be
 14    a member of the board;
 15        (89)  To  maintain  a  record of board proceedings, annually report to the
 16    governor and maintain a public register of names  and  addresses  of  licensed
 17    nurses;
 18        (910) To enter into interstate compacts, contracts or agreements to facil-
 19    itate the practice and regulation of nursing in this state;
 20        (101) To  make,  adopt and publish rules pursuant to chapter 52, title 67,
 21    Idaho Code, as may be necessary or appropriate to carry out the provisions and
 22    purposes of this act.

Statement of Purpose / Fiscal Impact


                     STATEMENT  OF  PURPOSE
                           RS 13454C2

This bill mandates the licensure of all nurse aides practicing in
Idaho and authorizes the Board of Nursing to promulgate rules
regarding that licensure, including education and training
requirements, and to establish fees for initial licensure and
renewal.  This legislation will provide a framework for education
and testing of nurse aides to assure that individuals who are
assisting in the provision of health care-related services have
appropriate training for that task.



                         FISCAL  IMPACT

There is no fiscal impact to the General Fund.  The fiscal impact
to the Board of Nursing dedicated fund includes costs related to
personnel, operating, and capital.  The Board anticipates the need
for 2.5 additional FTEs to manage processes related to licensure,
education, practice, and discipline for the estimated 12,000 to
15,000 nursing assistants who will be licensed as a result of this
legislation.  The Board anticipates one-time start-up costs for
equipment and furnishings to support additional personnel and
ongoing costs for salaries and benefits, and for program operation
and administration.  Fees will be asked for initial licensure and
for renewal of licensure to partially offset the expenses to be
incurred.  It is anticipated that fees for initial licensure will
be not more than $50 and for biennial renewal of licensure will be
not more than $30.  
     
Total estimated expenses:  $18,000 one-time;  $180,000/year
ongoing;  Total estimated revenue:  $180,000/year; Total fiscal
impact:  $18,000 one-time expenses


CONTACT   
Name:     Sandra Evans
Agency:   Board of Nursing
Phone:    334-3110 ext 26

Statement of Purpose/Fiscal Impact                 H 701