ARIZONA STATE SENATE
Phoenix, Arizona
board of nursing;
omnibus
Purpose
Makes numerous modifications to the statutes governing the Board of Nursing (Board). Contains a Proposition 108 clause.
Background
The Board regulates registered nurses (RNs) and licensed practical nurses (LPNs) through licensure. In addition, the Board is responsible for certifying nursing assistants (CNAs). As of January 2002, approximately 47,070 RNs, including 2,263 RNs who are certified as advanced practice nurses, 9,196 LPNs and 18,395 CNAs practice in Arizona.
In 1997, the National Council of State Boards of Nursing adopted a model act for the mutual recognition for nursing regulation, which allows a nurse to have one license in the state of residency and have a multi-state licensure privilege in other party states as long as the nurse complies with the states’ practice laws and regulations. Last year, Arizona codified the model act. S.B. 1265 makes additional changes to the Nursing Practice Act to comply with the Nurse Licensure Compact (Compact).
Board Member Compensation
Board member compensation has not increased since 1993. S.B. 1265 increases the member compensation from $100 to $200 per day. The Board maintains increasing the compensation will attract more applicants for Board positions, thus, increasing the Governor’s ability to select the most appropriate candidates.
Approval
of Nursing Programs
Currently, the Board is only authorized to approve nurse practitioner programs before a program is operating. There is no mechanism for continuous oversight of these programs, which may change after the Board’s approval. In addition, there is no oversight for programs preparing clinical nurse specialists and certified registered nurse anesthetists. S.B. 1265 establishes standards and surveys for the review of advanced practice nursing programs.
Currently, the Board may discipline nurses who fail to renew their licenses. Nurses who inadvertently forget to renew their licenses or notify the Board of a change in address receive disciplinary action. According to the Board, this disciplinary action is reported to the national data bank and may unduly penalize the nurse for an unintentional act of omission not related to patient care. Rather than impose discipline for the failure to renew a license, S.B. 1265 allows the Board to fine nurses that are not considered high risk to public health, safety and welfare.
S.B. 1265 also increases the cap on the CNA certification card fee from $25 to $50 dollars. The Board estimates an increase in revenue associated with this increase of an additional $32,000 to $71,000. There is a cost relating to the provision increasing compensation for members. This cost is approximately $26,400 and impacts the board of nursing fund.
Provisions
Increased Fees, Compensation and
New Civil Penalties
1. Increases compensation for members from $100 to $200 per day.
2. Increases the maximum fee for a CNA renewal certification card from $25 to $50.
3. Allows the Board to impose a civil penalty up to $1,000 on nurses who are not considered high risk to public health, safety and welfare instead of taking disciplinary action.
4. Specifies failure to pay a civil penalty or schedule payment within 30 days of a notice constitutes an act of unprofessional conduct and is subject to disciplinary action.
5. Requires the Board to deposit civil penalties in the state general fund.
Powers of the Board
6. Allows the Executive Director to issue temporary advance practice certificates and single state and multi-state licenses.
7. Allows the Executive Director to accept the revocation of a license or certificate to resolve a pending complaint that constitutes a disciplinary action.
8. Authorizes the Board to establish standards for approving nurse practitioner and clinical nurse specialist programs.
9. Requires the Board to provide licensing authorities of health care institutions any information it receives regarding practices that place a patient’s health at risk.
10. Requires the Board to adopt rules on competency standards for obtaining and maintaining a license.
11. Repeals the requirement of the Board to consult with the Board of Education when establishing education requirements for school nurses.
12. Clarifies fingerprinting and background checks for initial licensure are not subject to legislative appropriation.
13. Allows the Board to issue a temporary license to practice as a licensed practical nurse if the applicant has not worked or been employed in nursing for at least five years.
14. Allows the Board to issue a temporary advanced practice certificate to a professional nurse who holds an unencumbered temporary license and who meets the requirements for certification.
Multi-state Licensure Privilege
15. Authorizes the Board to revoke the multi-state licensure privilege of a person for felony convictions and limit the multi-state licensure privilege without discipline.
16. Allows the Board to limit, revoke or suspend the multi-state privilege of a nurse to practice in Arizona pursuant to the Compact.
17. Excludes out-of-state nurses under the Compact from the Board’s register.
18. Allows nurses with multi-state privileges to use the approved professional titles and protects the titles “nurse” and “practical nurse”.
Approval of Nursing Programs
19. Allows the Board to approve all new nurse practitioner and clinical nurse specialist programs and requires each program to prove it maintains the Board’s standards.
20. Requires the Board to approve nursing programs that meet the standards.
21. Allows the Board to take action against programs that do not comply with the standards.
22. Restricts the Board’s authority over approved nurse practitioner or clinical nurse specialist program unless the program is part of a graduate program in nursing that is accredited by a Board recognized agency.
25. Authorizes,
after an opportunity to request an administration hearing, the Board to limit,
suspend or revoke a nurse’s multi-state privilege for unprofessional conduct.
Foreign Graduate Professional
Nurses Licensure
26. Adds qualifications for foreign graduate professional nurse applicants who are not licensed in another state and do not meet the examination requirement.
27. Adds qualifications for foreign graduate professional nurse applicants who are licensed in another state or have met the examination requirement.
Miscellaneous
28. Provides definitions.
29. Eliminates obsolete language.
30. Makes conforming and technical changes.
31. Contains a Proposition 108 clause.
32. Becomes effective on signature of the Governor.
Prepared by Senate Staff
February 8, 2002