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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
]]]] 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 4 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 (1 01) 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 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