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HB2408 - 572R - H Ver
House Engrossed
nursing board;
regulatory actions; expungement
State of Arizona
House of Representatives
Fifty-seventh Legislature
Second Regular Session
2026
HOUSE BILL 2408
AN
ACT
Amending sections 32-1601, 32-1606,
32-1644 and 32-1664, Arizona Revised Statutes; amending Title 32,
chapter 15, article 3, Arizona Revised Statutes, by adding sections 32-1664.01,
32-1664.02, 32-1664.03, 32-1664.04 and 32-1664.05; relating to the
Arizona state board of nursing.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it
enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1601, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1601.
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
that is
approved or recognized by the board and educational
requirements
that are
prescribed by the board by rule.
(c) Holds a national certification as a certified
nurse midwife from a national certifying body
that is
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
certified nurse midwife'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
certified
nurse
midwife
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
that is
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
that are
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
fixes
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, 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
that is
approved or recognized by the board and
educational requirements
that are
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
that is
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
registered nurse practitioner'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
REGISTERED
nurse
practitioner
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
REGISTERED
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)
Committing
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
nurse,
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.
(
n
) Engaging in
sexual conduct with a current patient or with a former patient within six
months after the last treatment unless the patient was the licensee's spouse at
the time of the contact or, immediately preceding the nurse-patient
relationship, was in a dating or engagement relationship with the licensee. For
the purposes of this subdivision, "sexual conduct" includes:
(
i
) Engaging in
or soliciting a sexual relationship, whether consensual or nonconsensual.
(
ii
) Making
sexual advances, requesting sexual favors or engaging in any other verbal
conduct or physical contact of a sexual nature.
(
iii
) Intentionally
viewing a completely or partially disrobed patient in the course of treatment
if the viewing is not related to patient diagnosis or treatment under current
practice standards.
END_STATUTE
Sec. 2. Section 32-1606, Arizona Revised Statutes, is amended to read:
START_STATUTE
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 monitoring
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 collecting workforce data.
9. Adopt rules to conduct 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 to prepare registered nurses 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 nurse and practical
nurse applicants.
5. License and renew the licenses of qualified
registered nurse 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 to approve 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 the 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 registering certified nursing
assistants.
(b) Testing and licensing licensed nursing
assistants.
(c) Maintaining a list of 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 acts that may be
performed by a registered nurse practitioner or certified nurse midwife, 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 that prohibit registered nurse
practitioners, clinical nurse specialists or certified nurse midwives from
dispensing a schedule II controlled substance that is an opioid, except for an
implantable device or an opioid that is for medication-assisted treatment
for substance use disorders or as provided in section 32-3248.03.
14. Adopt rules establishing educational
requirements to certify school nurses.
15. Publish copies of board rules and distribute
these copies on request.
16. 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.
17. 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 three or more
years before the date of filing an application pursuant to this chapter.
18. Establish standards to approve and reapprove
registered nurse practitioner and clinical nurse specialist programs and
provide for surveys of registered nurse practitioner and clinical nurse
specialist programs as the board deems necessary.
19. Provide the licensing authorities of health care
institutions, facilities and homes with any information the board receives
regarding practices that place a patient's health at risk.
20. Limit the multistate licensure privilege of any
person who holds or applies for a license in this state pursuant to section 32-1668.
21. Adopt rules to establish competency standards
for obtaining and maintaining a license.
22. Adopt rules to qualify and certify clinical
nurse specialists.
23. Adopt rules to approve and reapprove refresher
courses for nurses who are not currently practicing.
24. Maintain a list of approved medication assistant
training programs.
25. Test and certify medication assistants.
26. Maintain a registry and disciplinary record of
medication assistants who are certified pursuant to this chapter.
27. Adopt rules to establish the requirements for a
clinical nurse specialist to prescribe and dispense drugs and devices
consistent with section 32-1651 and within the clinical nurse
specialist's population or disease focus.
28. Issue registrations to administer general
anesthesia and sedation in dental offices and dental clinics pursuant to
section 32-1272 to certified registered nurse anesthetists who have
national board certification in anesthesiology.
29. Post all written substantive
policies in a clearly identifiable section on the board's public website.
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.
END_STATUTE
Sec. 3. Section 32-1644, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1644.
Approval of nursing schools and nursing programs; application;
maintenance of standards
A. The board shall approve all new prelicensure
nursing,
registered
nurse
practitioner and clinical nurse specialist programs pursuant to this
section. A postsecondary educational institution or school in this
state that is accredited by an accrediting agency recognized by the United
States department of education desiring to conduct a registered nursing,
practical nursing,
registered
nurse
practitioner or clinical nurse specialist program shall apply to the board for
approval and submit satisfactory proof that
it
the institution or school
is
prepared to meet and maintain the minimum standards prescribed by this chapter
and board rules.
B. The board or its authorized agent shall conduct a
survey of the institution or program applying for approval and shall submit a
written report of its findings to the board. If the board determines that the
program meets the requirements prescribed in its rules,
it
the board
shall approve the
applicant as either a registered nursing program, practical nursing program,
registered
nurse practitioner
program or clinical nurse specialist program in a specialty area.
C. A nursing program approved by the board may also
be accredited by a national nursing accrediting agency recognized by the board.
If a prelicensure nursing program is accredited by a national nursing
accrediting agency recognized by the board, the board does not have authority
over
it
the program
unless any of
the following occurs:
1. The board receives a complaint about the program
relating to patient safety.
2. The program falls below the
standards prescribed by the board in its rules.
3.
2.
The
program loses its accreditation by a national nursing accrediting agency
recognized by the board.
4.
3.
The
program allows its accreditation by a national nursing accrediting agency
recognized by the board to lapse.
D. From time to time the board, through its
authorized employees or representatives, may resurvey all approved programs in
the
this
state and shall file written reports of these resurveys with the
board. If the board determines that an approved nursing program is
not maintaining the required standards,
it
the board
shall
immediately
give written notice to the program specifying the defects. If the
defects are not corrected within
a reasonable
the
time
as determined
prescribed
by the board
by rule
, the board may take either of the
following actions:
1. Approve the program but restrict the program's
ability to admit new students until the program complies with board standards.
2. Remove the program from the list of approved
nursing programs until the program complies with board standards.
E. All approved nursing programs shall maintain
accurate and current records showing in full the theoretical and practical
courses given to each student.
F. The board does not have regulatory authority over
the following approved
registered
nurse
practitioner or clinical nurse specialist programs unless the conditions
prescribed in subsection C
of this section
are met:
1. A
registered
nurse practitioner or clinical nurse specialist program
that is part of a graduate program in nursing accredited by an agency
recognized by the board if the program was surveyed as part of the graduate
program accreditation.
2. A
registered
nurse practitioner or clinical nurse specialist program
that is accredited by an agency recognized by the board.
END_STATUTE
Sec. 4. Section 32-1664, Arizona Revised
Statutes, is amended to read:
START_STATUTE
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 the 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 allowed 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. If a death or an incident requiring emergency
medical response occurs in a dental office or dental clinic during the
administration of or recovery from general anesthesia or sedation by a
certified registered nurse anesthetist, the certified registered nurse
anesthetist shall, and any other person may, report the death or incident to
the board within seven business days after the occurrence.
D. 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.
E. 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.
F. Any regulated party or person who is subject to
an investigation may obtain representation by counsel.
G. 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 allow 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.
H. The board shall provide the investigative report
if requested pursuant to section 32-3206.
I. 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.
J. Except as provided pursuant to section 32-1663,
subsection F and subsection K 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.
K. A regulated party shall respond in writing to the
board within thirty days after notice of the hearing is served as prescribed in
subsection J 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.
L. An administrative law judge or a panel of board
members may conduct hearings pursuant to this section.
M. In any matters pending before it, the board may
issue subpoenas under its seal to compel the attendance of witnesses.
N. 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.
O. 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.
P. 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.
Q. The board may subsequently issue a denied license
or certificate and may reissue a revoked or voluntarily surrendered license or
certificate.
R. 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.
S. The board may share investigative information
that is confidential under subsections N and O 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.
T. The arizona state board of nursing
shall transfer, within five business days, any complaint it receives against a
nursing program or nursing school to the state board for private postsecondary
education, the Arizona board of regents or the community college district
governing board, as applicable.
END_STATUTE
Sec. 5. Title
32, chapter 15, article 3, Arizona Revised Statutes, is amended by adding
sections 32-1664.01, 32-1664.02, 32-1664.03, 32-1664.04 and 32-1664.05,
to read:
START_STATUTE
32-1664.01.
Investigation of complaints; confidentiality; limits; notice;
evaluations; timeframe; definition
A. Notwithstanding any other
provision of this chapter or chapter 32 of this title to the contrary:
1. Except as set forth in paragraph 3
of this subsection, the board shall require complainants to identify themselves
in the complaint and make themselves available for an evidentiary
interview. Complainants may request that their identity remain
confidential during the investigatory process. If the investigatory
process results in a determination that a violation of law may have occurred,
the respondent is entitled to review the complete investigatory file, including
the identity of the complainant except as provided in paragraph 2 of this
subsection.
2. The board, on finding cause that a
complainant may reasonably fear retaliation or be endangered if the
complainant's identity is revealed or if the complaint directly impacts patient
safety, may continue to maintain the complainant's confidentiality from the
licensee until the conclusion of the administrative process. The
board may conduct a closed evidentiary hearing if the complainant requests that
the complainant's identity remain private and the board has a reasonable basis to
conduct the hearing. �A complainant's anonymity may continue until evidence by
the complainant is required at an administrative proceeding pursuant to title
41 or a legal proceeding.
3. The board may take action on a
complaint if the complainant refuses to identify himself or herself only if the
board has sufficient information that a violation may have occurred within its
jurisdiction that directly impacts the safety of patients without the testimony
of the anonymous complainant.
4. The board shall limit an
investigation of a complaint to those investigative subjects and actions that
are relevant and material
to the issues raised in the complaint and that would reasonably be
taken to investigate the issues in the complaint.� This paragraph does not
prohibit the board from investigating any issue or evidence of unprofessional
conduct that is discovered or brought to the attention of the board during the
investigation of the original complaint.
5. On reasonable belief that a crime
has been committed, the board shall report the alleged criminal conduct to the
appropriate criminal justice agency.� If the board has a reasonable belief that
conduct by a licensed, permitted or certificated individual or other entity
over which the board does not have jurisdiction may violate the law or codes of
conduct, the board shall report the conduct to the appropriate state regulatory
board or state agency that the board reasonably believes has jurisdiction over the
licensee, permittee or certificate holder or other entity.
6. THE BOARD SHALL IMPLEMENT A POLICY
PRIORITIZING COMPLAINTS BASED ON THE HARM TO A PATIENT OR POTENTIALLY TO THE
PUBLIC. The board shall assign the highest priority to cOMPLAINTS ALLEGING
SEXUAL MISCONDUCT WITH A PATIENT, CRIMINAL ASSAULT OR THEFT OR PROVIDING
SERVICES WHILE UNDER THE INFLUENCE OF ANY ILLEGAL OR LEGAL SUBSTANCE THAT
IMPAIRS THE LICENSEE OR CERTIFICATE HOLDER.
7. The board shall provide the
respondent with a written notice
STATING that there is an
open investigation,
the substance of the complaint, that
the respondent has the right to be represented by legal counsel and that the
respondent has at least fifteen business days after receiving the written
notice before the board requires a response. The written notice shall also
inform the respondent that the board may use any statement the respondent makes
against the respondent. The respondent may waive the fifteen-day
time frame by written communication.
8. If the board determines that a
psychological, psychiatric or other medical evaluation of the licensee or
certificate holder is essential for the board to make a decision regarding a
complaint and orders the licensee or certificate holder to obtain an
evaluation, and the licensee or certificate holder requests that the evaluation
be made by a professional other than the professional recommended by the board,
the board or its designee may accept and approve an evaluation from a
professional who has the credentials, training
, expertise
and impartiality required to address the issues the board
has requested in its order. The board may not require the licensee or
certificate holder to be evaluated only by a professional whose name is
provided in a list by the board to the licensee or certificate holder.
9. Within one hundred eighty days
after the board receives a complaint against a licensee or certificate holder,
the board shall do one of the following:
(
a
) Submit the
investigation for review.
(
b
) Administratively
dismiss the complaint if the board finds it is unsubstantiated.
(
c
) Report a
determination either that the complaint investigation cannot be reasonably
completed within one hundred eighty days due to the complexity of the matter
, the
RESPONDENT'S REQUEST FOR additional time
to respond or
CAUSING delays in the investigation
or the failure of a person or entity to timely respond to a board
subpoena. If this determination is made, the board, within the one
hundred eighty-day period, shall take one of the following actions:
(
i
) Continue
the investigation for an additional one hundred days to complete the
investigation and proceed with the administrative procedure to submit the
complaint for final board review and action.
(
ii
) Administratively
dismiss the complaint without prejudice.� If the board administratively
dismisses the complaint without prejudice, the board may reopen the
investigation only if the board receives additional evidence, information or
testimony sufficient to conclude the investigation
within
two years after the administrative dismissal as described in this ITEM.
10. If another health profession
regulatory board or a criminal justice agency is investigating the circumstances
alleged in a complaint, the time frames prescribed in paragraph 9 of this
subsection are suspended until the investigation is completed.
B. For the purposes of this section,
"without prejudice" means that the board may open another complaint
based on the same set of facts of a complaint that has been dismissed if
additional evidence or information becomes available to substantiate the
complaint.
END_STATUTE
START_STATUTE
32-1664.02.
Investigative files; access; confidentiality; definition
A. Notwithstanding any provision of
this chapter or chapter 32 of this title to the contrary:
1. The board shall provide notice to
a respondent at least fifteen business days before a meeting of the board to
review the status of an investigation.� The board shall provide the respondent
with access to the investigative file by either of the following methods at the
discretion of the respondent:
(
a
) Allow the respondent to review the file at the board
office and receive copies.
(
b
) Provide the file to the respondent or the respondent's
attorney by electronic transmission.
2. A person who obtains information
from the board pursuant to this section may not release the information to any
other person or entity or use the information in any proceeding or action
except in connection with the board's review of the investigation, the
disciplinary interview and any administrative proceeding or appeal related to
the disciplinary interview or hearing. A person who violates this paragraph
commits an act of unprofessional conduct.
3. The board may not make an
administrative dismissal or nondisciplinary remedial action publicly available
or report the action to the national practitioner data bank, consistent with
federal law.
B. For the purposes of this section,
"investigative file" includes:
1. Any witness or complainant
statement and any documentary evidence obtained during the investigation.
2. Any review conducted by an expert
or consultant providing an evaluation of or opinion on the allegations.
3. Any records on the patient
obtained by the board from other health care providers.
4. The results of any evaluation or
test of the licensee or certificate holder conducted at the board's direction.
5. Any other factual information that
the board will use in making its determination.
6. Any recommendation to the board
for the disposition of the investigation.
END_STATUTE
START_STATUTE
32-1664.03.
Burden of proof
Except for disciplinary matters brought pursuant
to section 32-1601, paragraph 27, subdivision (
n
),
the board has the burden of proof by clear and convincing evidence for
disciplinary matters brought pursuant to this chapter.
END_STATUTE
START_STATUTE
32-1664.04.
Disciplinary actions; expungement; exceptions
NOTWITHSTANDING ANY OTHER PROVISION OF THIS
chapter to the contrary:
1. The board may grant a request for
expungement of a disciplinary action previously imposed against a licensee or
certificate holder, whether formal or informal, only as authorized by this
section. The board may grant an expungement of a disciplinary action only once
for a licensee or certificate holder.
2. Any request for expungement
pursuant to this section shall be made in writing and shall comply with this
section.
3. Any
disciplinary action arising from the failure to timely renew a license or
certificate, the failure to complete continuing education or a documentation
error shall be expunged by the board if all of the following apply:
(
a
) The disciplinary action is at least two years old.
(
b
) The terms of the disciplinary action have been met.
(
c
) There have
been no subsequent violations of any other provisions of this chapter or the
rules adopted pursuant to this chapter.
4. Except as provided in paragraph 5
of this section, for any other disciplinary action not identified in paragraph
3 of this section, the board may expunge a disciplinary action if all of the
following apply:
(
a
) The
disciplinary action at issue is at least five years old.
(
b
) The terms
of the disciplinary action have been met.
(
c
) There have
been no subsequent violations of any other provisions of this chapter or the
rules adopted pursuant to this chapter.
(
d
) The
licensee or certificate holder has had a total of not more than two
disciplinary actions imposed
, including the disciplinary
action for which expungement is requested, by the board or any other regulatory
board or authority from this state or any other state.
5. The board may not grant a request
for expungement if any of the following applies
to the
disciplinary action for which expungement is requested:
(
a
) The
disciplinary action was based on a criminal conviction resulting from:
(
i
) Assault,
abuse, fraud or any other felonious conduct that resulted in physical or
financial harm to or the death of an individual.
(
ii
) Attempted
murder, assault, abuse or fraud.
(
b
) the
licensee or certificate holder Assaulted or abused a patient.
(
c
) The
licensee's or certificate holder's conduct caused harm or death to a patient.
(
d
) The
licensee or certificate holder committed sexual misconduct with a patient.
(
e
) The
licensee or certificate holder was practicing while impaired.
(
f
) The
licensee or certificate holder committed fraud or falsified records in a health
care setting.
6. The board shall report an
expungement under this section to any national database to which the board
previously reported the disciplinary action.
7. A licensee or certificate holder
is not required to report an expunged disciplinary action on any future
application for issuance or renewal of a license, permit or certificate to any
regulatory board or agency in this state.
END_STATUTE
START_STATUTE
32-1664.05.
Board liability; damages
Notwithstanding
any other law, if the board does not comply with this chapter, a licensee or
certificate holder or the subject of a board investigation who was damaged by
the board's failure to comply with this chapter may seek damages, including
attorney fees, in a civil legal PROCEEDING.�
A board
member or staff member may be held personally liable only if the person's
conduct was reckless, malicious or wilful.
END_STATUTE