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House Engrossed Senate Bill |
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State of Arizona Senate Fifty-second Legislature Second Regular Session 2016
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CHAPTER 282
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SENATE BILL 1444 |
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AN ACT
amending section 32‑1606, arizona revised statutes, as amended by laws 2015, chapter 262, section 4; Amending sections 32‑1632, 32-1634, 32-1637 and 32‑1639, Arizona Revised Statutes; amending section 32-1646, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 10; amending section 32-1648, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 12; amending sections 32-1650.06, 32‑1664, 32-1669 and 32-3206, Arizona Revised Statutes; relating to health professionals.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1606, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 4, is amended to read:
32-1606. Powers and duties of board
A. The board may:
1. Adopt and revise rules necessary to carry into effect this chapter.
2. Publish advisory opinions regarding registered and practical nursing practice and nursing education.
3. Issue limited licenses or certificates if it determines that an applicant or licensee cannot function safely in a specific setting or within the full scope of practice.
4. Refer criminal violations of this chapter to the appropriate law enforcement agency.
5. Establish a confidential program for the monitoring of licensees who are chemically dependent and who enroll in rehabilitation programs that meet the criteria established by the board. The board may take further action if the licensee refuses to enter into a stipulated agreement or fails to comply with its terms. In order to protect the public health and safety, the confidentiality requirements of this paragraph do not apply if the licensee does not comply with the stipulated agreement.
6. On the applicant's or regulated party's request, establish a payment schedule with the applicant or regulated party.
7. Provide education regarding board functions.
8. Collect or assist in the collection of workforce data.
9. Adopt rules for conducting pilot programs consistent with public safety for innovative applications in nursing practice, education and regulation.
10. Grant retirement status on request to retired nurses who are or were licensed under this chapter, who have no open complaint or investigation pending against them and who are not subject to discipline.
11. Accept and spend federal monies and private grants, gifts, contributions and devises to assist in carrying out the purposes of this chapter. These monies do not revert to the state general fund at the end of the fiscal year.
B. The board shall:
1. Approve regulated training and educational programs that meet the requirements of this chapter and rules adopted by the board.
2. By rule, establish approval and reapproval processes for nursing and nursing assistant training programs that meet the requirements of this chapter and board rules.
3. Prepare and maintain a list of approved nursing programs for the preparation of registered and practical nurses whose graduates are eligible for licensing under this chapter as registered nurses or as practical nurses if they satisfy the other requirements of this chapter and board rules.
4. Examine qualified registered and practical nurse applicants.
5. License and renew the licenses of qualified registered and practical nurse applicants and licensed nursing assistants who are not qualified to be licensed by the executive director.
6. Adopt a seal, which the executive director shall keep.
7. Keep a record of all proceedings.
8. For proper cause, deny or rescind approval of a regulated training or educational program for failure to comply with this chapter or the rules of the board.
9. Adopt rules for the approval of credential evaluation services that evaluate the qualifications of applicants who graduated from an international nursing program.
10. Determine and administer appropriate disciplinary action against all regulated parties who are found guilty of violating this chapter or rules adopted by the board.
11. Perform functions necessary to carry out the requirements of nursing assistant and nurse aide training and competency evaluation program as set forth in the omnibus budget reconciliation act of 1987 (P.L. 100‑203; 101 Stat. 1330), as amended by the medicare catastrophic coverage act of 1988 (P.L. 100‑360; 102 Stat. 683). These functions shall include:
(a) Testing and registration of certified nursing assistants.
(b) Testing and licensing of licensed nursing assistants.
(c) Maintaining a list of board approved board‑approved training programs.
(d) Maintaining a registry of nursing assistants for all certified nursing assistants and licensed nursing assistants.
(e) Assessing fees.
12. Adopt rules establishing those acts that may be performed by a registered nurse practitioner in collaboration with a licensed physician, except that the board does not have authority to decide scope of practice relating to abortion as defined in section 36‑2151.
13. Adopt rules establishing educational requirements for the certification of school nurses.
14. Publish copies of board rules and distribute these copies on request.
15. Require each applicant for initial licensure or certification to submit a full set of fingerprints to the board for the purpose of obtaining a state and federal criminal records check pursuant to section 41‑1750 and Public Law 92‑544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation.
16. except for a licensee who has been convicted of a felony that has been designated a misdemeanor pursuant to section 13‑604, revoke a license of a person, revoke the multistate licensure privilege of a person pursuant to section 32‑1669 or not issue a license or renewal to an applicant who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing an application pursuant to this chapter.
17. Establish standards for approving and reapproving nurse practitioner and clinical nurse specialist programs and provide for surveys of nurse practitioner and clinical nurse specialist programs as it deems necessary.
18. Provide the licensing authorities of health care institutions, facilities and homes any information the board receives regarding practices that place a patient's health at risk.
19. Limit the multistate licensure privilege of any person who holds or applies for a license in this state pursuant to section 32‑1668.
20. Adopt rules to establish competency standards for obtaining and maintaining a license.
21. Adopt rules for the qualification and certification of clinical nurse specialists.
22. Adopt rules for approval and reapproval of refresher courses for nurses who are not currently practicing.
23. Maintain a list of approved medication assistant training programs.
24. Test and certify medication assistants.
25. Maintain a registry and disciplinary record of medication assistants who are certified pursuant to this chapter.
C. The board may conduct an investigation on receipt of information that indicates that a person or regulated party may have violated this chapter or a rule adopted pursuant to this chapter. Following the investigation, the board may take disciplinary action pursuant to this chapter.
D. The board may limit, revoke or suspend the privilege of a nurse to practice in this state granted pursuant to section 32‑1668.
E. Failure to comply with any final order of the board, including an order of censure or probation, is cause for suspension or revocation of a license or a certificate.
F. The president or a member of the board designated by the president may administer oaths in transacting the business of the board.
Sec. 2. Section 32-1632, Arizona Revised Statutes, is amended to read:
32-1632. Qualifications of registered nurse; application for license
An applicant for a license to practice as a registered nurse shall file with the board a verified written application accompanied by the prescribed fee and shall submit satisfactory proof that the applicant:
1. The applicant has completed satisfactorily the basic curriculum in an approved registered nursing program and holds a diploma or degree from that program.
2. The applicant, if convicted of one or more felonies, has received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing an application pursuant to this chapter.
3. If the applicant has been convicted of a felony pursuant to section 13‑604, the court has entered judgment of conviction for a class 1 misdemeanor.
Sec. 3. Section 32-1634, Arizona Revised Statutes, is amended to read:
32-1634. Licensing out‑of‑state registered nurses
A. The board may issue a license to practice registered nursing to an applicant who has been duly licensed or registered as a registered nurse in another state or a territory of the United States if in the opinion of the board the applicant meets the qualifications required of a registered nurse in this state pursuant to sections 32‑1632 and 32‑1633.
B. The board shall not issue a license to an applicant who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing the application.
Sec. 4. Section 32-1637, Arizona Revised Statutes, is amended to read:
32-1637. Qualifications of practical nurse; application for license
An applicant for a license to practice as and assume the title of a licensed practical nurse shall file with the board a verified written application accompanied by the prescribed fee and shall submit satisfactory proof that the applicant:
1. Has satisfactorily completed the basic curriculum in an approved practical or professional nursing program and holds a diploma, certificate or degree from that program.
2. If convicted of one or more felonies, has received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing the application.
Sec. 5. Section 32-1639, Arizona Revised Statutes, is amended to read:
32-1639. Licensing out‑of‑state practical nurses
A. The board may issue a license to practice as a practical nurse to an applicant who has been duly licensed as a practical nurse, or licensed to perform similar services and duties under a different title, in another state or territory of the United States, if in the opinion of the board the applicant meets qualifications required of a licensed practical nurse in this state.
B. The board shall not issue a license to practice practical nursing to an applicant who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing an application.
Sec. 6. Section 32-1646, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 10, is amended to read:
32-1646. Licensed nursing assistants; certified nursing assistants; board powers
A. In the regulation of licensed nursing assistants, the board may:
1. Investigate allegations of violation violations of this article and refer criminal violations of this article to the appropriate law enforcement agency.
2. File a letter of concern if the board believes there is insufficient evidence to support direct action against the licensed nursing assistant's license but sufficient evidence for the board to notify the licensed nursing assistant of its concern.
3. Deny a license or refuse to renew a license or take disciplinary action if a licensed nursing assistant commits an act of unprofessional conduct.
4. Issue a temporary licensed nursing assistant license to an applicant who meets the qualifications for licensure specified in section 32‑1645. The license expires six months after the date of issuance and may be renewed at the discretion of the board.
5. In addition to any other disciplinary action it may take, impose a civil penalty of not more than one thousand dollars for each violation of this chapter.
B. The board shall revoke a license of a person or not issue or renew a license to an applicant who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years prior to the date of filing an application pursuant to this chapter.
C. In the regulation of certified nursing assistants the board may:
1. Investigate allegations of abuse, neglect or misappropriation of property and refer criminal violations to the appropriate law enforcement agency.
2. File a letter of concern if the board believes there is insufficient evidence to support direct action against the certified nursing assistant's registration but sufficient evidence for the board to notify the nursing assistant of its concern.
3. Pursuant to the omnibus budget reconciliation act of 1987 (P.L. 100‑203; 101 Stat. 1330), as amended by the medicare catastrophic coverage act of 1988 (P.L. 100‑360; 102 Stat. 683), indicate on the registration the existence of any substantiated complaints against the certified nursing assistant in compliance with title 41, chapter 6, article 10.
Sec. 7. Section 32-1648, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 12, is amended to read:
32-1648. Licensed nursing assistants; certified nursing assistants; acceptance of out‑of‑state licenses
A. The board may issue a license to a nursing assistant who has a current certificate or an equivalent document issued by another state if the board receives an application pursuant to section 32‑1645 and determines that the applicant meets the qualifications of this article.
B. The board shall not issue a license to an applicant under subsection A of this section who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years prior to the date of filing the application.
C. The board may register a person as a certified nursing assistant who has been listed on the nursing assistant registry maintained in another state if the nursing assistant provides to the board current proof of registration or an equivalent document issued by another state and the board receives an application pursuant to section 32‑1645 and determines that the applicant meets the qualifications of this article.
Sec. 8. Section 32-1650.06, Arizona Revised Statutes, is amended to read:
32-1650.06. Certified medication assistants; disciplinary actions; civil penalties; revocation or denial of certificate
A. In regulating medication assistants, the board may:
1. Refer criminal violations to the appropriate law enforcement agency.
2. File a letter of concern if the board believes there is insufficient evidence to support direct action against a medication assistant's certificate but sufficient evidence for the board to notify a medication assistant of its concern.
3. Issue a decree of censure for a violation of this chapter or board rules.
4. Deny certification or recertification or take disciplinary action if a medication assistant commits an act of unprofessional conduct.
5. In addition to any other disciplinary action it may take, impose a civil penalty of not more than one thousand dollars.
B. The board shall revoke a certificate or deny an application for certification or recertification of a person who has one or more felony convictions and who has not received an absolute discharge from the sentences for all felony convictions five three or more years before the date of filing an application pursuant to this chapter.
Sec. 9. Section 32-1664, Arizona Revised Statutes, is amended to read:
32-1664. Investigation; hearing; notice
A. In connection with an investigation, the board or its duly authorized agents or employees may obtain any documents, reports, records, papers, books and materials, including hospital records, medical staff records and medical staff review committee records, or any other physical evidence that indicates that a person or regulated party may have violated this chapter or a rule adopted pursuant to this chapter:
1. By entering the premises, at any reasonable time, and inspecting and copying materials in the possession of a regulated party that relate to nursing competence, unprofessional conduct or mental or physical ability of a licensee to safely practice nursing.
2. By issuing a subpoena under the board's seal to require the attendance and testimony of witnesses or to demand the production for examination or copying of documents or any other physical evidence. Within five days after a person is served with a subpoena, that person may petition the board to revoke, limit or modify the subpoena. The board shall do so if in its opinion the evidence required does not relate to unlawful practices covered by this chapter, is not relevant to the charge that is the subject matter of the hearing or investigation or does not describe with sufficient particularity the physical evidence whose production is required.
3. By submitting a written request for the information.
4. In the case of an applicant's or a regulated party's personal medical records, as defined in section 12‑2291, by any means permitted by this section if the board either:
(a) Obtains from the applicant or regulated party, or the health care decision maker of the applicant or regulated party, a written authorization that satisfies the requirements of title 12, chapter 13, article 7.1.
(b) Reasonably believes that the records relate to information already in the board's possession regarding the competence, unprofessional conduct or mental or physical ability of the applicant or regulated party as it pertains to safe practice. If the board adopts a substantive policy statement pursuant to section 41‑1091, it may authorize the executive director, or a designee in the absence of the executive director, to make the determination of reasonable belief.
B. A regulated party and a health care institution as defined in section 36‑401 shall, and any other person may, report to the board any information the licensee, certificate holder, health care institution or individual may have that appears to show that a regulated party or applicant is, was or may be a threat to the public health or safety.
C. The board retains jurisdiction to proceed with an investigation or a disciplinary proceeding against a regulated party whose license or certificate expired not more than five years before the board initiates the investigation.
D. Any regulated party, health care institution or other person that reports or provides information to the board in good faith is not subject to civil liability. If requested the board shall not disclose the name of the reporter unless the information is essential to proceedings conducted pursuant to this section.
E. Any regulated party or person who is subject to an investigation may obtain representation by counsel.
F. On determination of reasonable cause, the board, or if delegated by the board the executive director, may require a licensee, certificate holder or applicant to undergo at the expense of the licensee, certificate holder or applicant any combination of mental, physical or psychological examinations, assessments or skills evaluations necessary to determine the person's competence or ability to practice safely. These examinations may include bodily fluid testing and other examinations known to detect the presence of alcohol or drugs. If the executive director orders the licensee, applicant or certificate holder to undertake an examination, assessment or evaluation pursuant to this subsection, and the licensee, certificate holder or applicant fails to affirm to the board in writing within fifteen days after receipt of the notice of the order that the licensee, certificate holder or applicant intends to comply with the order, the executive director shall refer the matter to the board to permit the board to determine whether to issue an order pursuant to this subsection. At each regular meeting of the board the executive director shall report to the board data concerning orders issued by the executive director pursuant to this subsection since the last regular meeting of the board and any other data requested by the board.
G. The board shall provide the investigative report if requested pursuant to section 32‑3206.
G. H. If after completing its investigation the board finds that the information provided pursuant to this section is not of sufficient seriousness to merit disciplinary action against the regulated party or applicant, it may take either of the following actions:
1. Dismiss if in the opinion of the board the information is without merit.
2. File a letter of concern if in the opinion of the board there is insufficient evidence to support disciplinary action against the regulated party or applicant but sufficient evidence for the board to notify the regulated party or applicant of its concern.
H. I. Except as provided pursuant to section 32‑1663, subsection F and subsection I J of this section, if the investigation in the opinion of the board reveals reasonable grounds to support the charge, the regulated party is entitled to an administrative hearing pursuant to title 41, chapter 6, article 10. If notice of the hearing is served by certified mail, service is complete on the date the notice is placed in the mail.
I. J. A regulated party shall respond in writing to the board within thirty days after notice of the hearing is served as prescribed in subsection H i of this section. The board may consider a regulated party's failure to respond within this time as an admission by default to the allegations stated in the complaint. The board may then take disciplinary actions allowed by this chapter without conducting a hearing.
J. K. An administrative law judge or a panel of board members may conduct hearings pursuant to this section.
K. L. In any matters pending before it, the board may issue subpoenas under its seal to compel the attendance of witnesses.
L. M. Patient records, including clinical records, medical reports, laboratory statements and reports, any file, film, other report or oral statement relating to diagnostic findings or treatment of patients, any information from which a patient or a patient's family might be identified or information received and records kept by the board as a result of the investigation procedure outlined in this chapter are not available to the public and are not subject to discovery in civil or criminal proceedings.
M. N. Hospital records, medical staff records, medical staff review committee records, testimony concerning these records and proceedings related to the creation of these records shall not be available to the public. They shall be kept confidential by the board and shall be subject to the same provisions concerning discovery and use in legal actions as are the original records in the possession and control of hospitals, their medical staffs and their medical staff review committees. The board shall use these records and testimony during the course of investigations and proceedings pursuant to this chapter.
N. O. If the regulated party is found to have committed an act of unprofessional conduct or to have violated this chapter or a rule adopted pursuant to this chapter, the board may take disciplinary action.
O. P. The board may subsequently issue a denied license or certificate and may reissue a revoked or voluntarily surrendered license or certificate.
P. Q. On application by the board to any superior court judge, a person who without just cause fails to comply with a subpoena issued pursuant to this section may be ordered by the judge to comply with the subpoena and punished by the court for failing to comply. Subpoenas shall be served by regular or certified mail or in the manner required by the Arizona rules of civil procedure.
Q. R. The board may share investigative information that is confidential under subsections L M and M N of this section with other state, federal and international health care agencies and with state, federal and international law enforcement authorities if the recipient is subject to confidentiality requirements similar to those established by this section. A disclosure made by the board pursuant to this subsection is not a waiver of the confidentiality requirements established by this section.
Sec. 10. Section 32-1669, Arizona Revised Statutes, is amended to read:
32-1669. Nurse licensure compact; board jurisdiction; notification requirements; withdrawal from compact
A. A person who is extended the privilege to practice in this state pursuant to the compact adopted pursuant to section 32‑1668 is subject to the same disciplinary requirements prescribed in this chapter, and the board's investigative and disciplinary powers and procedures apply to a person who practices in this state pursuant to this compact.
B. A person who is extended the privilege to practice in this state pursuant to the compact adopted pursuant to section 32-1668 may use the title that is prescribed in section 32‑1636 and that is appropriate to the person's qualifications.
C. A person who wishes to engage in the practice of nursing in this state pursuant to the compact adopted pursuant to section 32‑1668 must notify the board if that person has had a license to practice a health care profession denied, suspended or revoked in another jurisdiction within the past five years or if that person has been convicted of a felony for which the person did not receive an absolute discharge from the sentences at least five three years before the date on which the person applies to practice nursing in this state pursuant to the compact. A person who violates this subsection commits an act of unprofessional conduct.
D. The governor may withdraw this state from the compact adopted pursuant to section 32‑1668 if the board notifies the governor that another state that is a party to the compact has changed its licensure requirements to make them substantially lower than the requirements of this state.
Sec. 11. Section 32-3206, Arizona Revised Statutes, is amended to read:
32-3206. Disciplinary action; information; disclosure
A. At least ten business days before a meeting of a health profession regulatory board to review the status of an investigation, the board shall provide notice of the meeting to the health professional, including notice of the opportunity for the health professional to request a copy of the report concerning the investigation.
A. B. At least ten business days before a disciplinary interview or a hearing, if the board does not hold a disciplinary interview, the health profession regulatory board shall notify the health professional and, at that person's request, the board shall provide the health professional or the health professional's attorney with the information listed in this section. The board shall provide the following information:
1. Any review conducted by an expert or consultant providing an evaluation of or opinion on the allegations.
2. Any records on the patient obtained by the board from other health care providers.
3. The results of any evaluations or tests of the health professional conducted at the board's direction.
4. Any other factual information that the board will use in making its determination.
B. C. A person who obtains information from the board pursuant to this section may not release it to any other person or entity or use it in any proceeding or action except in connection with the board's review of the investigation, the disciplinary interview and any administrative proceedings or appeals related to the disciplinary interview or hearing. A person who violates this subsection commits an act of unprofessional conduct.
C. D. The board may charge the health professional or the health professional's attorney for the cost of providing the information received up to the fee for making a copy of each page as prescribed by section 12‑284, subsection A.
Sec. 12. Effective date
Section 32‑1606, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 4 and this act, section 32‑1646, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 10 and this act and section 32‑1648, Arizona Revised Statutes, as amended by Laws 2015, chapter 262, section 12 and this act are effective from and after June 30, 2016.
APPROVED BY THE GOVERNOR MAY 17, 2016.
FILED IN THE OFFICE OF THE SECRETARY OF STATE MAY 17, 2016.