Arizona 2024 Regular Session

Arizona House Bill HB2424 Compare Versions

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1-House Engrossed licensed health aides State of Arizona House of Representatives Fifty-sixth Legislature Second Regular Session 2024 CHAPTER 95 HOUSE BILL 2424 An Act amending sections 32-1601 and 32-1645, Arizona Revised Statutes; relating to the Arizona state board of nursing. (TEXT OF BILL BEGINS ON NEXT PAGE)
1+House Engrossed licensed health aides State of Arizona House of Representatives Fifty-sixth Legislature Second Regular Session 2024 HOUSE BILL 2424 An Act amending sections 32-1601 and 32-1645, Arizona Revised Statutes; relating to the Arizona state board of nursing. (TEXT OF BILL BEGINS ON NEXT PAGE)
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66- Be it enacted by the Legislature of the State of Arizona: Section 1. Section 32-1601, Arizona Revised Statutes, is amended to read: START_STATUTE32-1601. Definitions In this chapter, unless the context otherwise requires: 1. "Absolute discharge from the sentence" means completion of any sentence, including imprisonment, probation, parole, community supervision or any form of court supervision. 2. "Appropriate health care professional" means a licensed health care professional whose scope of practice, education, experience, training and accreditation are appropriate for the situation or condition of the patient who is the subject of a consultation or referral. 3. "Approval" means that a regulated training or educational program to prepare persons for licensure, certification or registration has met standards established by the board. 4. "Board" means the Arizona state board of nursing. 5. "Certified nurse midwife" means a registered nurse who: (a) Is certified by the board. (b) Has completed a nurse midwife education program approved or recognized by the board and educational requirements prescribed by the board by rule. (c) Holds a national certification as a certified nurse midwife from a national certifying body recognized by the board. (d) Has an expanded scope of practice in providing health care services for women from adolescence to beyond menopause, including antepartum, intrapartum, postpartum, reproductive, gynecologic and primary care, for normal newborns during the first twenty-eight days of life and for men for the treatment of sexually transmitted diseases. The expanded scope of practice under this subdivision includes: (i) Assessing patients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level. (ii) Managing the physical and psychosocial health care of patients. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment. (iv) Making independent decisions in solving complex patient care problems. (v) Diagnosing, performing diagnostic and therapeutic procedures and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances, within the scope of the certified nurse midwife practice after meeting requirements established by the board. (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. (vii) Delegating to a medical assistant pursuant to section 32-1456. (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a certified nurse midwife. 6. "Certified nursing assistant" means a person who is registered on the registry of nursing assistants pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Certified nursing assistant does not include a person who: (a) Is a licensed health care professional. (b) Volunteers to provide nursing assistant services without monetary compensation. (c) Is a licensed nursing assistant. 7. "Certified registered nurse" means a registered nurse who has been certified by a national nursing credentialing agency recognized by the board. 8. "Certified registered nurse anesthetist" means a registered nurse who meets the requirements of section 32-1634.03 and who practices pursuant to the requirements of section 32-1634.04. 9. "Clinical nurse specialist" means a registered nurse who: (a) Is certified by the board as a clinical nurse specialist. (b) Holds a graduate degree with a major in nursing and completes educational requirements as prescribed by the board by rule. (c) Is nationally certified as a clinical nurse specialist or, if certification is not available, provides proof of competence to the board. (d) Has an expanded scope of practice based on advanced education in a clinical nursing specialty that includes: (i) Assessing clients, synthesizing and analyzing data and understanding and applying nursing principles at an advanced level. (ii) Managing directly and indirectly a client's physical and psychosocial health status. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting appropriate nursing interventions. (iv) Developing, planning and guiding programs of care for populations of patients. (v) Making independent nursing decisions to solve complex client care problems. (vi) Using research skills and acquiring and applying critical new knowledge and technologies to nursing practice. (vii) Prescribing and dispensing durable medical equipment. (viii) Consulting with or referring a client to other health care providers based on assessment of the client's health status and needs. (ix) Facilitating collaboration with other disciplines to attain the desired client outcome across the continuum of care. (x) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a clinical nurse specialist. (xi) Prescribing, ordering and dispensing pharmacological agents subject to the requirements and limits specified in section 32-1651. 10. "Conditional license" or "conditional approval" means a license or approval that specifies the conditions under which the regulated party is allowed to practice or to operate and that is prescribed by the board pursuant to section 32-1644 or 32-1663. 11. "Delegation" means transferring to a competent individual the authority to perform a selected nursing task in a designated situation in which the nurse making the delegation retains accountability for the delegation. 12. "Disciplinary action" means a regulatory sanction of a license, certificate or approval pursuant to this chapter in any combination of the following: (a) A civil penalty for each violation of this chapter, not to exceed $1,000 for each violation. (b) Restitution made to an aggrieved party. (c) A decree of censure. (d) A conditional license or a conditional approval that fixed a period and terms of probation. (e) Limited licensure. (f) Suspension of a license, a certificate or an approval. (g) Voluntary surrender of a license, a certificate or an approval. (h) Revocation of a license, a certificate or an approval. 13. "Health care institution" has the same meaning prescribed in section 36-401. 14. "Licensed health aide" means a person who: (a) Is licensed pursuant to this chapter to provide or to assist in providing nursing-related services authorized pursuant to section 36-2939. (b) Is the parent, guardian or family member by affinity or consanguinity of the Arizona long-term care system member receiving services who may provide licensed health aide services only to that member and only consistent with that member's plan of care. (c) Has a scope of practice that is the same as a licensed nursing assistant and may also provide medication administration, tracheostomy care, and enteral care and routine ventilator care and therapy and any other tasks approved by the board in rule. (d) Has supervision requirements that are the same as a certified nursing assistant. 15. "Licensed nursing assistant" means a person who is licensed pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Licensed nursing assistant does not include a person who: (a) Is a licensed health care professional. (b) Volunteers to provide nursing assistant services without monetary compensation. (c) Is a certified nursing assistant. 16. "Licensee" means a person who is licensed pursuant to this chapter or in a party state as defined in section 32-1668. 17. "Limited license" means a license that restricts the scope or setting of a licensee's practice. 18. "Medication order" means a written or verbal communication given by a certified registered nurse anesthetist to a health care professional to administer a drug or medication, including controlled substances. 19. "Practical nurse" means a person who holds a practical nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege and who practices practical nursing as defined in this section. 20. "Practical nursing" includes the following activities that are performed under the supervision of a physician or a registered nurse: (a) Contributing to the assessment of the health status of individuals and groups. (b) Participating in the development and modification of the strategy of care. (c) Implementing aspects of the strategy of care within the nurse's scope of practice. (d) Maintaining safe and effective nursing care that is rendered directly or indirectly. (e) Participating in the evaluation of responses to interventions. (f) Delegating nursing activities within the scope of practice of a practical nurse. (g) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a practical nurse. 21. "Presence" means within the same health care institution or office as specified in section 32-1634.04, subsection A, and available as necessary. 22. "Registered nurse" or "professional nurse" means a person who practices registered nursing and who holds a registered nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege. 23. "Registered nurse practitioner" means a registered nurse who: (a) Is certified by the board. (b) Has completed a nurse practitioner education program approved or recognized by the board and educational requirements prescribed by the board by rule. (c) If applying for certification after July 1, 2004, holds national certification as a nurse practitioner from a national certifying body recognized by the board. (d) Has an expanded scope of practice within a specialty area that includes: (i) Assessing clients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level. (ii) Managing the physical and psychosocial health status of patients. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment. (iv) Making independent decisions in solving complex patient care problems. (v) Diagnosing, performing diagnostic and therapeutic procedures, and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances within the scope of registered nurse practitioner practice on meeting the requirements established by the board. (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. (vii) Delegating to a medical assistant pursuant to section 32-1456. (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a nurse practitioner. 24. "Registered nursing" includes the following: (a) Diagnosing and treating human responses to actual or potential health problems. (b) Assisting individuals and groups to maintain or attain optimal health by implementing a strategy of care to accomplish defined goals and evaluating responses to care and treatment. (c) Assessing the health status of individuals and groups. (d) Establishing a nursing diagnosis. (e) Establishing goals to meet identified health care needs. (f) Prescribing nursing interventions to implement a strategy of care. (g) Delegating nursing interventions to others who are qualified to do so. (h) Providing for the maintenance of safe and effective nursing care that is rendered directly or indirectly. (i) Evaluating responses to interventions. (j) Teaching nursing knowledge and skills. (k) Managing and supervising the practice of nursing. (l) Consulting and coordinating with other health care professionals in the management of health care. (m) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a registered nurse. 25. "Registry of nursing assistants" means the nursing assistants registry maintained by the board 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). 26. "Regulated party" means any person or entity that is licensed, certified, registered, recognized or approved pursuant to this chapter. 27. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere: (a) Committing fraud or deceit in obtaining, attempting to obtain or renewing a license or a certificate issued pursuant to this chapter. (b) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission. (c) Aiding or abetting in a criminal abortion or attempting, agreeing or offering to procure or assist in a criminal abortion. (d) Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public. (e) Being mentally incompetent or physically unsafe to a degree that is or might be harmful or dangerous to the health of a patient or the public. (f) Having a license, certificate, permit or registration to practice a health care profession denied, suspended, conditioned, limited or revoked in another jurisdiction and not reinstated by that jurisdiction. (g) Wilfully or repeatedly violating a provision of this chapter or a rule adopted pursuant to this chapter. (h) Committing an act that deceives, defrauds or harms the public. (i) Failing to comply with a stipulated agreement, consent agreement or board order. (j) Violating this chapter or a rule that is adopted by the board pursuant to this chapter. (k) Failing to report to the board any evidence that a registered or practical nurse or a nursing assistant is or may be: (i) Incompetent to practice. (ii) Guilty of unprofessional conduct. (iii) Mentally or physically unable to safely practice nursing or to perform nursing-related duties. A nurse who is providing therapeutic counseling for a nurse who is in a drug rehabilitation program is required to report that nurse only if the nurse providing therapeutic counseling has personal knowledge that patient safety is being jeopardized. (l) Failing to self-report a conviction for a felony or undesignated offense within ten days after the conviction. (m) Cheating or assisting another to cheat on a licensure or certification examination. END_STATUTE Sec. 2. Section 32-1645, Arizona Revised Statutes, is amended to read: START_STATUTE32-1645. Licensed nursing assistants; certified nursing assistants; licensed health aides; qualifications A. A person who wishes to practice as a licensed nursing assistant shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant shall also submit a verified statement that indicates whether the applicant has been convicted of a felony and, if convicted of one or more felonies, indicates the date of absolute discharge from the sentences for all felony convictions. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Satisfactorily completed the basic curriculum of a program approved by the board. 2. Received a valid certificate from a training program approved by the board. 3. Satisfactorily completed a competency examination pursuant to section 32-1647. B. A person who wishes to practice as a certified nursing assistant shall file a verified form prescribed by the board and authorized by the omnibus budget reconciliation act of 1987 (P.L. 100-123; 101 Stat. 1330), as amended by the medicare catastrophic coverage act of 1988 (P.L. 100-360; 102 Stat. 683). The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Satisfactorily completed the basic curriculum of a program approved by the board. 2. Received a valid certificate from a training program approved by the board. 3. Satisfactorily completed the nursing assistant competency examinations pursuant to section 32-1647. C. A person who wishes to practice as a licensed health aide shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant may allow the applicant's prospective employer to discuss the application with the board. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Is a parent, guardian or family member of an individual who is under twenty-one years of age and who is eligible to receive continuous skilled nursing or skilled nursing respite care services pursuant to section 36-2939, subsection G. 2. Satisfactorily completed the basic curriculum of and received a valid certificate from a training program approved by the board that includes medication administration, tracheostomy care, enteral care and therapy for persons under twenty-one years of age, and any other tasks approved by the board. 3. Satisfactorily completed a competency examination approved by the board. D. A person who wishes to practice as a certified nursing assistant or a licensed nursing assistant shall be at least sixteen years of age. END_STATUTE
67+ Be it enacted by the Legislature of the State of Arizona: Section 1. Section 32-1601, Arizona Revised Statutes, is amended to read: START_STATUTE32-1601. Definitions In this chapter, unless the context otherwise requires: 1. "Absolute discharge from the sentence" means completion of any sentence, including imprisonment, probation, parole, community supervision or any form of court supervision. 2. "Appropriate health care professional" means a licensed health care professional whose scope of practice, education, experience, training and accreditation are appropriate for the situation or condition of the patient who is the subject of a consultation or referral. 3. "Approval" means that a regulated training or educational program to prepare persons for licensure, certification or registration has met standards established by the board. 4. "Board" means the Arizona state board of nursing. 5. "Certified nurse midwife" means a registered nurse who: (a) Is certified by the board. (b) Has completed a nurse midwife education program approved or recognized by the board and educational requirements prescribed by the board by rule. (c) Holds a national certification as a certified nurse midwife from a national certifying body recognized by the board. (d) Has an expanded scope of practice in providing health care services for women from adolescence to beyond menopause, including antepartum, intrapartum, postpartum, reproductive, gynecologic and primary care, for normal newborns during the first twenty-eight days of life and for men for the treatment of sexually transmitted diseases. The expanded scope of practice under this subdivision includes: (i) Assessing patients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level. (ii) Managing the physical and psychosocial health care of patients. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment. (iv) Making independent decisions in solving complex patient care problems. (v) Diagnosing, performing diagnostic and therapeutic procedures and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances, within the scope of the certified nurse midwife practice after meeting requirements established by the board. (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. (vii) Delegating to a medical assistant pursuant to section 32-1456. (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a certified nurse midwife. 6. "Certified nursing assistant" means a person who is registered on the registry of nursing assistants pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Certified nursing assistant does not include a person who: (a) Is a licensed health care professional. (b) Volunteers to provide nursing assistant services without monetary compensation. (c) Is a licensed nursing assistant. 7. "Certified registered nurse" means a registered nurse who has been certified by a national nursing credentialing agency recognized by the board. 8. "Certified registered nurse anesthetist" means a registered nurse who meets the requirements of section 32-1634.03 and who practices pursuant to the requirements of section 32-1634.04. 9. "Clinical nurse specialist" means a registered nurse who: (a) Is certified by the board as a clinical nurse specialist. (b) Holds a graduate degree with a major in nursing and completes educational requirements as prescribed by the board by rule. (c) Is nationally certified as a clinical nurse specialist or, if certification is not available, provides proof of competence to the board. (d) Has an expanded scope of practice based on advanced education in a clinical nursing specialty that includes: (i) Assessing clients, synthesizing and analyzing data and understanding and applying nursing principles at an advanced level. (ii) Managing directly and indirectly a client's physical and psychosocial health status. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting appropriate nursing interventions. (iv) Developing, planning and guiding programs of care for populations of patients. (v) Making independent nursing decisions to solve complex client care problems. (vi) Using research skills and acquiring and applying critical new knowledge and technologies to nursing practice. (vii) Prescribing and dispensing durable medical equipment. (viii) Consulting with or referring a client to other health care providers based on assessment of the client's health status and needs. (ix) Facilitating collaboration with other disciplines to attain the desired client outcome across the continuum of care. (x) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a clinical nurse specialist. (xi) Prescribing, ordering and dispensing pharmacological agents subject to the requirements and limits specified in section 32-1651. 10. "Conditional license" or "conditional approval" means a license or approval that specifies the conditions under which the regulated party is allowed to practice or to operate and that is prescribed by the board pursuant to section 32-1644 or 32-1663. 11. "Delegation" means transferring to a competent individual the authority to perform a selected nursing task in a designated situation in which the nurse making the delegation retains accountability for the delegation. 12. "Disciplinary action" means a regulatory sanction of a license, certificate or approval pursuant to this chapter in any combination of the following: (a) A civil penalty for each violation of this chapter, not to exceed $1,000 for each violation. (b) Restitution made to an aggrieved party. (c) A decree of censure. (d) A conditional license or a conditional approval that fixed a period and terms of probation. (e) Limited licensure. (f) Suspension of a license, a certificate or an approval. (g) Voluntary surrender of a license, a certificate or an approval. (h) Revocation of a license, a certificate or an approval. 13. "Health care institution" has the same meaning prescribed in section 36-401. 14. "Licensed health aide" means a person who: (a) Is licensed pursuant to this chapter to provide or to assist in providing nursing-related services authorized pursuant to section 36-2939. (b) Is the parent, guardian or family member by affinity or consanguinity of the Arizona long-term care system member receiving services who may provide licensed health aide services only to that member and only consistent with that member's plan of care. (c) Has a scope of practice that is the same as a licensed nursing assistant and may also provide medication administration, tracheostomy care, and enteral care and routine ventilator care and therapy and any other tasks approved by the board in rule. (d) Has supervision requirements that are the same as a certified nursing assistant. 15. "Licensed nursing assistant" means a person who is licensed pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Licensed nursing assistant does not include a person who: (a) Is a licensed health care professional. (b) Volunteers to provide nursing assistant services without monetary compensation. (c) Is a certified nursing assistant. 16. "Licensee" means a person who is licensed pursuant to this chapter or in a party state as defined in section 32-1668. 17. "Limited license" means a license that restricts the scope or setting of a licensee's practice. 18. "Medication order" means a written or verbal communication given by a certified registered nurse anesthetist to a health care professional to administer a drug or medication, including controlled substances. 19. "Practical nurse" means a person who holds a practical nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege and who practices practical nursing as defined in this section. 20. "Practical nursing" includes the following activities that are performed under the supervision of a physician or a registered nurse: (a) Contributing to the assessment of the health status of individuals and groups. (b) Participating in the development and modification of the strategy of care. (c) Implementing aspects of the strategy of care within the nurse's scope of practice. (d) Maintaining safe and effective nursing care that is rendered directly or indirectly. (e) Participating in the evaluation of responses to interventions. (f) Delegating nursing activities within the scope of practice of a practical nurse. (g) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a practical nurse. 21. "Presence" means within the same health care institution or office as specified in section 32-1634.04, subsection A, and available as necessary. 22. "Registered nurse" or "professional nurse" means a person who practices registered nursing and who holds a registered nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege. 23. "Registered nurse practitioner" means a registered nurse who: (a) Is certified by the board. (b) Has completed a nurse practitioner education program approved or recognized by the board and educational requirements prescribed by the board by rule. (c) If applying for certification after July 1, 2004, holds national certification as a nurse practitioner from a national certifying body recognized by the board. (d) Has an expanded scope of practice within a specialty area that includes: (i) Assessing clients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level. (ii) Managing the physical and psychosocial health status of patients. (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment. (iv) Making independent decisions in solving complex patient care problems. (v) Diagnosing, performing diagnostic and therapeutic procedures, and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances within the scope of registered nurse practitioner practice on meeting the requirements established by the board. (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. (vii) Delegating to a medical assistant pursuant to section 32-1456. (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a nurse practitioner. 24. "Registered nursing" includes the following: (a) Diagnosing and treating human responses to actual or potential health problems. (b) Assisting individuals and groups to maintain or attain optimal health by implementing a strategy of care to accomplish defined goals and evaluating responses to care and treatment. (c) Assessing the health status of individuals and groups. (d) Establishing a nursing diagnosis. (e) Establishing goals to meet identified health care needs. (f) Prescribing nursing interventions to implement a strategy of care. (g) Delegating nursing interventions to others who are qualified to do so. (h) Providing for the maintenance of safe and effective nursing care that is rendered directly or indirectly. (i) Evaluating responses to interventions. (j) Teaching nursing knowledge and skills. (k) Managing and supervising the practice of nursing. (l) Consulting and coordinating with other health care professionals in the management of health care. (m) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a registered nurse. 25. "Registry of nursing assistants" means the nursing assistants registry maintained by the board 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). 26. "Regulated party" means any person or entity that is licensed, certified, registered, recognized or approved pursuant to this chapter. 27. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere: (a) Committing fraud or deceit in obtaining, attempting to obtain or renewing a license or a certificate issued pursuant to this chapter. (b) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission. (c) Aiding or abetting in a criminal abortion or attempting, agreeing or offering to procure or assist in a criminal abortion. (d) Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public. (e) Being mentally incompetent or physically unsafe to a degree that is or might be harmful or dangerous to the health of a patient or the public. (f) Having a license, certificate, permit or registration to practice a health care profession denied, suspended, conditioned, limited or revoked in another jurisdiction and not reinstated by that jurisdiction. (g) Wilfully or repeatedly violating a provision of this chapter or a rule adopted pursuant to this chapter. (h) Committing an act that deceives, defrauds or harms the public. (i) Failing to comply with a stipulated agreement, consent agreement or board order. (j) Violating this chapter or a rule that is adopted by the board pursuant to this chapter. (k) Failing to report to the board any evidence that a registered or practical nurse or a nursing assistant is or may be: (i) Incompetent to practice. (ii) Guilty of unprofessional conduct. (iii) Mentally or physically unable to safely practice nursing or to perform nursing-related duties. A nurse who is providing therapeutic counseling for a nurse who is in a drug rehabilitation program is required to report that nurse only if the nurse providing therapeutic counseling has personal knowledge that patient safety is being jeopardized. (l) Failing to self-report a conviction for a felony or undesignated offense within ten days after the conviction. (m) Cheating or assisting another to cheat on a licensure or certification examination. END_STATUTE Sec. 2. Section 32-1645, Arizona Revised Statutes, is amended to read: START_STATUTE32-1645. Licensed nursing assistants; certified nursing assistants; licensed health aides; qualifications A. A person who wishes to practice as a licensed nursing assistant shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant shall also submit a verified statement that indicates whether the applicant has been convicted of a felony and, if convicted of one or more felonies, indicates the date of absolute discharge from the sentences for all felony convictions. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Satisfactorily completed the basic curriculum of a program approved by the board. 2. Received a valid certificate from a training program approved by the board. 3. Satisfactorily completed a competency examination pursuant to section 32-1647. B. A person who wishes to practice as a certified nursing assistant shall file a verified form prescribed by the board and authorized by the omnibus budget reconciliation act of 1987 (P.L. 100-123; 101 Stat. 1330), as amended by the medicare catastrophic coverage act of 1988 (P.L. 100-360; 102 Stat. 683). The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Satisfactorily completed the basic curriculum of a program approved by the board. 2. Received a valid certificate from a training program approved by the board. 3. Satisfactorily completed the nursing assistant competency examinations pursuant to section 32-1647. C. A person who wishes to practice as a licensed health aide shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant may allow the applicant's prospective employer to discuss the application with the board. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following: 1. Is a parent, guardian or family member of an individual who is under twenty-one years of age and who is eligible to receive continuous skilled nursing or skilled nursing respite care services pursuant to section 36-2939, subsection G. 2. Satisfactorily completed the basic curriculum of and received a valid certificate from a training program approved by the board that includes medication administration, tracheostomy care, enteral care and therapy for persons under twenty-one years of age, and any other tasks approved by the board. 3. Satisfactorily completed a competency examination approved by the board. D. A person who wishes to practice as a certified nursing assistant or a licensed nursing assistant shall be at least sixteen years of age. END_STATUTE Sec. 3. Exemption from rulemaking Notwithstanding any other law, for the purposes of this act, the Arizona health care cost containment system, the Arizona board of nursing and the department of economic security are exempt from the rulemaking requirements of title 41, chapters 6 and 6.1, Arizona Revised Statutes, for one year after the effective date of this act.
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6869 Be it enacted by the Legislature of the State of Arizona:
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7071 Section 1. Section 32-1601, Arizona Revised Statutes, is amended to read:
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7273 START_STATUTE32-1601. Definitions
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7475 In this chapter, unless the context otherwise requires:
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7677 1. "Absolute discharge from the sentence" means completion of any sentence, including imprisonment, probation, parole, community supervision or any form of court supervision.
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7879 2. "Appropriate health care professional" means a licensed health care professional whose scope of practice, education, experience, training and accreditation are appropriate for the situation or condition of the patient who is the subject of a consultation or referral.
7980
8081 3. "Approval" means that a regulated training or educational program to prepare persons for licensure, certification or registration has met standards established by the board.
8182
8283 4. "Board" means the Arizona state board of nursing.
8384
8485 5. "Certified nurse midwife" means a registered nurse who:
8586
8687 (a) Is certified by the board.
8788
8889 (b) Has completed a nurse midwife education program approved or recognized by the board and educational requirements prescribed by the board by rule.
8990
9091 (c) Holds a national certification as a certified nurse midwife from a national certifying body recognized by the board.
9192
9293 (d) Has an expanded scope of practice in providing health care services for women from adolescence to beyond menopause, including antepartum, intrapartum, postpartum, reproductive, gynecologic and primary care, for normal newborns during the first twenty-eight days of life and for men for the treatment of sexually transmitted diseases. The expanded scope of practice under this subdivision includes:
9394
9495 (i) Assessing patients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level.
9596
9697 (ii) Managing the physical and psychosocial health care of patients.
9798
9899 (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment.
99100
100101 (iv) Making independent decisions in solving complex patient care problems.
101102
102103 (v) Diagnosing, performing diagnostic and therapeutic procedures and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances, within the scope of the certified nurse midwife practice after meeting requirements established by the board.
103104
104105 (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient.
105106
106107 (vii) Delegating to a medical assistant pursuant to section 32-1456.
107108
108109 (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a certified nurse midwife.
109110
110111 6. "Certified nursing assistant" means a person who is registered on the registry of nursing assistants pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Certified nursing assistant does not include a person who:
111112
112113 (a) Is a licensed health care professional.
113114
114115 (b) Volunteers to provide nursing assistant services without monetary compensation.
115116
116117 (c) Is a licensed nursing assistant.
117118
118119 7. "Certified registered nurse" means a registered nurse who has been certified by a national nursing credentialing agency recognized by the board.
119120
120121 8. "Certified registered nurse anesthetist" means a registered nurse who meets the requirements of section 32-1634.03 and who practices pursuant to the requirements of section 32-1634.04.
121122
122123 9. "Clinical nurse specialist" means a registered nurse who:
123124
124125 (a) Is certified by the board as a clinical nurse specialist.
125126
126127 (b) Holds a graduate degree with a major in nursing and completes educational requirements as prescribed by the board by rule.
127128
128129 (c) Is nationally certified as a clinical nurse specialist or, if certification is not available, provides proof of competence to the board.
129130
130131 (d) Has an expanded scope of practice based on advanced education in a clinical nursing specialty that includes:
131132
132133 (i) Assessing clients, synthesizing and analyzing data and understanding and applying nursing principles at an advanced level.
133134
134135 (ii) Managing directly and indirectly a client's physical and psychosocial health status.
135136
136137 (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting appropriate nursing interventions.
137138
138139 (iv) Developing, planning and guiding programs of care for populations of patients.
139140
140141 (v) Making independent nursing decisions to solve complex client care problems.
141142
142143 (vi) Using research skills and acquiring and applying critical new knowledge and technologies to nursing practice.
143144
144145 (vii) Prescribing and dispensing durable medical equipment.
145146
146147 (viii) Consulting with or referring a client to other health care providers based on assessment of the client's health status and needs.
147148
148149 (ix) Facilitating collaboration with other disciplines to attain the desired client outcome across the continuum of care.
149150
150151 (x) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a clinical nurse specialist.
151152
152153 (xi) Prescribing, ordering and dispensing pharmacological agents subject to the requirements and limits specified in section 32-1651.
153154
154155 10. "Conditional license" or "conditional approval" means a license or approval that specifies the conditions under which the regulated party is allowed to practice or to operate and that is prescribed by the board pursuant to section 32-1644 or 32-1663.
155156
156157 11. "Delegation" means transferring to a competent individual the authority to perform a selected nursing task in a designated situation in which the nurse making the delegation retains accountability for the delegation.
157158
158159 12. "Disciplinary action" means a regulatory sanction of a license, certificate or approval pursuant to this chapter in any combination of the following:
159160
160161 (a) A civil penalty for each violation of this chapter, not to exceed $1,000 for each violation.
161162
162163 (b) Restitution made to an aggrieved party.
163164
164165 (c) A decree of censure.
165166
166167 (d) A conditional license or a conditional approval that fixed a period and terms of probation.
167168
168169 (e) Limited licensure.
169170
170171 (f) Suspension of a license, a certificate or an approval.
171172
172173 (g) Voluntary surrender of a license, a certificate or an approval.
173174
174175 (h) Revocation of a license, a certificate or an approval.
175176
176177 13. "Health care institution" has the same meaning prescribed in section 36-401.
177178
178179 14. "Licensed health aide" means a person who:
179180
180181 (a) Is licensed pursuant to this chapter to provide or to assist in providing nursing-related services authorized pursuant to section 36-2939.
181182
182183 (b) Is the parent, guardian or family member by affinity or consanguinity of the Arizona long-term care system member receiving services who may provide licensed health aide services only to that member and only consistent with that member's plan of care.
183184
184185 (c) Has a scope of practice that is the same as a licensed nursing assistant and may also provide medication administration, tracheostomy care, and enteral care and routine ventilator care and therapy and any other tasks approved by the board in rule.
185186
186187 (d) Has supervision requirements that are the same as a certified nursing assistant.
187188
188189 15. "Licensed nursing assistant" means a person who is licensed pursuant to this chapter to provide or assist in delivering nursing or nursing-related services under the supervision and direction of a licensed nursing staff member. Licensed nursing assistant does not include a person who:
189190
190191 (a) Is a licensed health care professional.
191192
192193 (b) Volunteers to provide nursing assistant services without monetary compensation.
193194
194195 (c) Is a certified nursing assistant.
195196
196197 16. "Licensee" means a person who is licensed pursuant to this chapter or in a party state as defined in section 32-1668.
197198
198199 17. "Limited license" means a license that restricts the scope or setting of a licensee's practice.
199200
200201 18. "Medication order" means a written or verbal communication given by a certified registered nurse anesthetist to a health care professional to administer a drug or medication, including controlled substances.
201202
202203 19. "Practical nurse" means a person who holds a practical nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege and who practices practical nursing as defined in this section.
203204
204205 20. "Practical nursing" includes the following activities that are performed under the supervision of a physician or a registered nurse:
205206
206207 (a) Contributing to the assessment of the health status of individuals and groups.
207208
208209 (b) Participating in the development and modification of the strategy of care.
209210
210211 (c) Implementing aspects of the strategy of care within the nurse's scope of practice.
211212
212213 (d) Maintaining safe and effective nursing care that is rendered directly or indirectly.
213214
214215 (e) Participating in the evaluation of responses to interventions.
215216
216217 (f) Delegating nursing activities within the scope of practice of a practical nurse.
217218
218219 (g) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a practical nurse.
219220
220221 21. "Presence" means within the same health care institution or office as specified in section 32-1634.04, subsection A, and available as necessary.
221222
222223 22. "Registered nurse" or "professional nurse" means a person who practices registered nursing and who holds a registered nurse license issued pursuant to this chapter or pursuant to a multistate compact privilege.
223224
224225 23. "Registered nurse practitioner" means a registered nurse who:
225226
226227 (a) Is certified by the board.
227228
228229 (b) Has completed a nurse practitioner education program approved or recognized by the board and educational requirements prescribed by the board by rule.
229230
230231 (c) If applying for certification after July 1, 2004, holds national certification as a nurse practitioner from a national certifying body recognized by the board.
231232
232233 (d) Has an expanded scope of practice within a specialty area that includes:
233234
234235 (i) Assessing clients, synthesizing and analyzing data and understanding and applying principles of health care at an advanced level.
235236
236237 (ii) Managing the physical and psychosocial health status of patients.
237238
238239 (iii) Analyzing multiple sources of data, identifying alternative possibilities as to the nature of a health care problem and selecting, implementing and evaluating appropriate treatment.
239240
240241 (iv) Making independent decisions in solving complex patient care problems.
241242
242243 (v) Diagnosing, performing diagnostic and therapeutic procedures, and prescribing, administering and dispensing therapeutic measures, including legend drugs, medical devices and controlled substances within the scope of registered nurse practitioner practice on meeting the requirements established by the board.
243244
244245 (vi) Recognizing the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient.
245246
246247 (vii) Delegating to a medical assistant pursuant to section 32-1456.
247248
248249 (viii) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a nurse practitioner.
249250
250251 24. "Registered nursing" includes the following:
251252
252253 (a) Diagnosing and treating human responses to actual or potential health problems.
253254
254255 (b) Assisting individuals and groups to maintain or attain optimal health by implementing a strategy of care to accomplish defined goals and evaluating responses to care and treatment.
255256
256257 (c) Assessing the health status of individuals and groups.
257258
258259 (d) Establishing a nursing diagnosis.
259260
260261 (e) Establishing goals to meet identified health care needs.
261262
262263 (f) Prescribing nursing interventions to implement a strategy of care.
263264
264265 (g) Delegating nursing interventions to others who are qualified to do so.
265266
266267 (h) Providing for the maintenance of safe and effective nursing care that is rendered directly or indirectly.
267268
268269 (i) Evaluating responses to interventions.
269270
270271 (j) Teaching nursing knowledge and skills.
271272
272273 (k) Managing and supervising the practice of nursing.
273274
274275 (l) Consulting and coordinating with other health care professionals in the management of health care.
275276
276277 (m) Performing additional acts that require education and training as prescribed by the board and that are recognized by the nursing profession as proper to be performed by a registered nurse.
277278
278279 25. "Registry of nursing assistants" means the nursing assistants registry maintained by the board 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).
279280
280281 26. "Regulated party" means any person or entity that is licensed, certified, registered, recognized or approved pursuant to this chapter.
281282
282283 27. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere:
283284
284285 (a) Committing fraud or deceit in obtaining, attempting to obtain or renewing a license or a certificate issued pursuant to this chapter.
285286
286287 (b) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission.
287288
288289 (c) Aiding or abetting in a criminal abortion or attempting, agreeing or offering to procure or assist in a criminal abortion.
289290
290291 (d) Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public.
291292
292293 (e) Being mentally incompetent or physically unsafe to a degree that is or might be harmful or dangerous to the health of a patient or the public.
293294
294295 (f) Having a license, certificate, permit or registration to practice a health care profession denied, suspended, conditioned, limited or revoked in another jurisdiction and not reinstated by that jurisdiction.
295296
296297 (g) Wilfully or repeatedly violating a provision of this chapter or a rule adopted pursuant to this chapter.
297298
298299 (h) Committing an act that deceives, defrauds or harms the public.
299300
300301 (i) Failing to comply with a stipulated agreement, consent agreement or board order.
301302
302303 (j) Violating this chapter or a rule that is adopted by the board pursuant to this chapter.
303304
304305 (k) Failing to report to the board any evidence that a registered or practical nurse or a nursing assistant is or may be:
305306
306307 (i) Incompetent to practice.
307308
308309 (ii) Guilty of unprofessional conduct.
309310
310311 (iii) Mentally or physically unable to safely practice nursing or to perform nursing-related duties. A nurse who is providing therapeutic counseling for a nurse who is in a drug rehabilitation program is required to report that nurse only if the nurse providing therapeutic counseling has personal knowledge that patient safety is being jeopardized.
311312
312313 (l) Failing to self-report a conviction for a felony or undesignated offense within ten days after the conviction.
313314
314315 (m) Cheating or assisting another to cheat on a licensure or certification examination. END_STATUTE
315316
316317 Sec. 2. Section 32-1645, Arizona Revised Statutes, is amended to read:
317318
318319 START_STATUTE32-1645. Licensed nursing assistants; certified nursing assistants; licensed health aides; qualifications
319320
320321 A. A person who wishes to practice as a licensed nursing assistant shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant shall also submit a verified statement that indicates whether the applicant has been convicted of a felony and, if convicted of one or more felonies, indicates the date of absolute discharge from the sentences for all felony convictions. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following:
321322
322323 1. Satisfactorily completed the basic curriculum of a program approved by the board.
323324
324325 2. Received a valid certificate from a training program approved by the board.
325326
326327 3. Satisfactorily completed a competency examination pursuant to section 32-1647.
327328
328329 B. A person who wishes to practice as a certified nursing assistant shall file a verified form prescribed by the board and authorized by the omnibus budget reconciliation act of 1987 (P.L. 100-123; 101 Stat. 1330), as amended by the medicare catastrophic coverage act of 1988 (P.L. 100-360; 102 Stat. 683). The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following:
329330
330331 1. Satisfactorily completed the basic curriculum of a program approved by the board.
331332
332333 2. Received a valid certificate from a training program approved by the board.
333334
334335 3. Satisfactorily completed the nursing assistant competency examinations pursuant to section 32-1647.
335336
336337 C. A person who wishes to practice as a licensed health aide shall file a verified application on a form prescribed by the board and accompanied by the fee required pursuant to section 32-1643. The applicant may allow the applicant's prospective employer to discuss the application with the board. The applicant shall also submit proof satisfactory to the board that the applicant meets all of the following:
337338
338339 1. Is a parent, guardian or family member of an individual who is under twenty-one years of age and who is eligible to receive continuous skilled nursing or skilled nursing respite care services pursuant to section 36-2939, subsection G.
339340
340341 2. Satisfactorily completed the basic curriculum of and received a valid certificate from a training program approved by the board that includes medication administration, tracheostomy care, enteral care and therapy for persons under twenty-one years of age, and any other tasks approved by the board.
341342
342343 3. Satisfactorily completed a competency examination approved by the board.
343344
344345 D. A person who wishes to practice as a certified nursing assistant or a licensed nursing assistant shall be at least sixteen years of age. END_STATUTE
345346
346- APPROVED BY THE GOVERNOR APRIL 8, 2024. FILED IN THE OFFICE OF THE SECRETARY OF STATE APRIL 8, 2024.
347+Sec. 3. Exemption from rulemaking
347348
348-
349-
350-
351-
352-
353-
354-APPROVED BY THE GOVERNOR APRIL 8, 2024.
355-
356-
357-
358-FILED IN THE OFFICE OF THE SECRETARY OF STATE APRIL 8, 2024.
349+Notwithstanding any other law, for the purposes of this act, the Arizona health care cost containment system, the Arizona board of nursing and the department of economic security are exempt from the rulemaking requirements of title 41, chapters 6 and 6.1, Arizona Revised Statutes, for one year after the effective date of this act.