SB0222

SENATE BILL 222

54th legislature - STATE OF NEW MEXICO - first session, 2019

INTRODUCED BY

William P. Soules

AN ACT

RELATING TO PROFESSIONAL LICENSURE; AMENDING AND ENACTING SECTIONS OF THE NURSING PRACTICE ACT; PROVIDING FOR TRANSITION OF BOARD COMPOSITION.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

SECTION 1. Section 61-3-6 NMSA 1978 (being Laws 1973, Chapter 149, Section 2, as amended) is amended to read:

"61-3-6. ADMINISTRATION OF ANESTHETICS.--

A. It is unlawful for any person, other than a person licensed in New Mexico to practice medicine, osteopathy or dentistry or a currently licensed certified registered nurse anesthetist, to administer anesthetics to any person. Nothing in this section prohibits a person currently licensed pursuant to the Nursing Practice Act from:

(1) using hypnosis; [or from]

(2) administering local anesthetics or moderate sedation; or

(3) administering procedural sedation when necessary and when the nurse:

(a) has received and possesses specialized nursing knowledge, judgment, skill and current clinical competence to manage the nursing care of the patient receiving procedural sedation;

(b) is currently trained with demonstrated proficiency in an accredited body of knowledge on airway management and advanced cardiac life support for adults, pediatric patients or neonates that is appropriate to the population being treated;

(c) has no other responsibilities during or after the procedure that would compromise the nurse's ability to adequately monitor the patient during procedural sedation or analgesia; and

(d) ensures that a qualified airway specialist is readily available during and after the procedure for respiratory emergencies and who is not the person performing the procedure. A qualified airway specialist is trained in and maintains a current competency in endotracheal intubation for the specific population being treated, including a certified registered nurse anesthetist, an anesthesiologist, an emergency physician, a paramedic, a respiratory therapist or a registered nurse.

B. A nurse shall not administer moderate or procedural sedation if the nurse assesses the administration of sedatives or other medication and determines that it would be unsafe under the circumstances."

SECTION 2. Section 61-3-8 NMSA 1978 (being Laws 1968, Chapter 44, Section 5, as amended by Laws 1991, Chapter 189, Section 3 and also by Laws 1991, Chapter 190, Section 5) is amended to read:

"61-3-8. BOARD CREATED--MEMBERS--QUALIFICATIONS--TERMS--

VACANCIES--REMOVAL.--

A. There is created a seven-member "board of nursing". The board shall consist of [four]:

(1) five licensed nurses, including:

(a) one nurse who preferably has knowledge of the educational preparation of pre-licensure students;

(b) one nurse who is knowledgeable regarding advanced practice nursing; and

[three] (2) two members who shall represent the public and shall not:

(a) have been licensed as registered or licensed practical nurses [nor shall the public members];

(b) have any significant financial interest, direct or indirect, in the nursing profession [regulated]; and

B. Not more than two board members shall be appointed from any one county, and not more than two registered nurse members shall be from any one field of nursing.

C. Members of the board shall be appointed by the governor for staggered terms of [four] three years each.

D. Nurse members shall be appointed from lists submitted to the governor by any generally recognized organization of nurses in this state.

E. Appointments shall be made [in such manner] so that the terms of no more than [two] three board members expire on July 1 of each year. Vacancies shall be filled by appointment by the governor for the unexpired term within sixty days of the vacancy. Board members shall serve until their successors have been appointed and qualified.

[B.] F. Members of the board shall be citizens of the United States and residents of this state. Registered nurse members shall be licensed in this state, shall have had, since graduation, at least five years' experience in nursing, shall be currently engaged in professional nursing and shall have been actively engaged in professional nursing for at least three years immediately preceding appointment or reappointment. The licensed practical nurse member shall be licensed in this state, shall have been graduated from an approved licensed practical nursing education program, shall have been licensed by examination, shall have had at least five years' experience since graduation, shall be currently engaged in licensed practical nursing and shall have been actively engaged in licensed practical nursing for at least three years immediately preceding appointment or reappointment.

[C.] G. No board member shall serve more than two full or partial terms, consecutive or otherwise.

[D.] H. Any board member failing to attend seventy percent of meeting days annually, either regular or special, shall automatically be removed as a member of the board.

[E.] I. The governor may remove any member from the board for neglect of any duty required by law, for incompetency or for unprofessional or dishonorable conduct, in accordance with regulations prescribed by the board.

[F.] J. In the event of a vacancy on the board for any reason, the secretary of the board shall immediately notify the governor, the board members and any generally recognized nursing organization of the vacancy, the reason for its occurrence and the action taken by the board, so as to expedite the appointment of a new board member."

SECTION 3. Section 61-3-10 NMSA 1978 (being Laws 1968, Chapter 44, Section 7, as amended by Laws 2003, Chapter 276, Section 4 and by Laws 2003, Chapter 307, Section 7) is amended to read:

"61-3-10. POWERS--DUTIES.--The board:

A. shall adopt and revise [such] rules [and regulations] as may be necessary to enable it to carry into effect the provisions of the Nursing Practice Act and to maintain high standards of practice;

B. shall prescribe standards and approve curricula for educational programs preparing persons for licensure under the Nursing Practice Act;

C. shall provide for surveys of educational programs preparing persons for licensure under the Nursing Practice Act;

D. shall grant, deny or withdraw approval from educational programs for failure to meet prescribed standards, if a majority of the board concurs in the decision;

E. shall provide for the examination, licensing and renewal of licenses of applicants;

F. shall conduct hearings upon charges relating to discipline of a licensee or nurse not licensed to practice in New Mexico who is permitted to practice professional registered nursing or licensed practical nursing in New Mexico pursuant to a multistate licensure privilege as provided in the Nurse Licensure Compact or the denial, suspension or revocation of a license in accordance with the procedures of the Uniform Licensing Act;

G. shall cause the prosecution of all persons, including firms, associations, institutions and corporations, violating the Nursing Practice Act and have the power to incur such expense as is necessary therefor;

H. shall keep a record of all proceedings;

I. shall make an annual report to the governor;

J. shall appoint and employ a qualified registered nurse, who shall not be a member of the board, to serve as executive officer to the board, who shall define the duties and responsibilities of the executive officer, except that the power to grant, deny or withdraw approval for schools of nursing or to revoke, suspend or withhold any license authorized by the Nursing Practice Act shall not be delegated by the board;

K. shall provide for such qualified assistants as may be necessary to carry out the provisions of the Nursing Practice Act. Such employees shall be paid a salary commensurate with their duties;

L. shall, for the purpose of protecting the health and well-being of the citizens of New Mexico and promoting current nursing knowledge and practice, adopt rules [and regulations] establishing continuing education requirements as a condition of license renewal and shall study methods of monitoring continuing competence;

M. may appoint advisory committees consisting of at least one member who is a board member and at least two members expert in the pertinent field of health care to assist it in the performance of its duties. Committee members may be reimbursed as provided in the Per Diem and Mileage Act;

N. may adopt and revise rules [and regulations] designed to maintain an inactive status listing for registered nurses and licensed practical nurses;

O. may adopt rules [and regulations] to regulate the advanced practice of professional registered nursing and expanded practice of licensed practical nursing;

P. shall license qualified certified nurse practitioners, certified registered nurse anesthetists and clinical nurse specialists;

Q. shall register nurses not licensed to practice in New Mexico who are permitted to practice professional registered nursing or licensed practical nursing in

New Mexico pursuant to a multistate licensure privilege as provided in the Nurse Licensure Compact; [and]

R. shall adopt rules [and regulations] establishing standards for authorizing prescriptive authority to certified nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists; and

S. shall create and maintain an online registration process for those licensees permitted to practice pursuant to a multistate licensure privilege at no cost to those licensees."

SECTION 4. Section 61-3-14 NMSA 1978 (being Laws 1968, Chapter 44, Section 11, as amended) is amended to read:

"61-3-14. LICENSURE OF REGISTERED NURSES--EXPEDITED LICENSURE.--

A. Applicants for licensure by examination shall be required to pass the national licensing examination for registered nurses. The applicant who successfully passes the examination may be issued by the board a license to practice as a registered nurse.

B. The board may issue a license to practice professional registered nursing without an examination to an applicant who has been duly licensed by taking the national licensing examination for registered nurses under the laws of another state if the applicant meets the qualifications required of registered nurses in this state. From July 1, 2014 through June 30, 2019, upon a determination by the board that an application is complete and approved, the board shall expedite the issuance of a license pursuant to this subsection within five business days.

C. The board may issue a license to practice as a registered nurse to an applicant licensed under the laws of another territory or foreign country if the applicant meets the qualifications required of registered nurses in this state, is proficient in English and passes the national licensing examination for registered nurses.

D. Upon initial licensure to practice as a registered nurse or upon renewal of a license, a licensee may opt to receive a multistate licensure privilege. The board shall issue a single-state license to any licensee who chooses not to receive the multistate licensure privilege.

E. Nursing faculty, including adjunct faculty, practicing in pre-licensure nursing programs approved by the board shall hold nursing licenses issued by the board. The board shall create a separate, expedited license solely for this purpose for those nurses who do not already have a board-issued license.

F. Registered nurses and licensed practical nurses practicing in the state under the multistate licensure privilege shall meet the respective continuing education and professional development requirements of registered nurses and licensed practical nurses licensed in New Mexico and shall submit proof of meeting these requirements to the board in the same manner as required of licensees holding single-state licenses.

G. A registered nurse or licensed practical nurse who practices in the state under a multistate licensure privilege shall register with the board within thirty days of entering the state to practice nursing.

H. As used in this section:

(1) "home state" means the party state that is the nurse's primary state of residence;

(2) "multistate licensure privilege" means a legal authorization associated with a multistate license permitting the practice of nursing as either a registered nurse or a licensed practical or vocational nurse in a remote state;

(3) "party state" means any state that has adopted the Nurse Licensure Compact;

(4) "remote state" means a party state, other than the home state; and

(5) "single-state license" means a nurse license issued by a party state that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other party state."

SECTION 5. Section 61-3-23.3 NMSA 1978 (being Laws 1991, Chapter 190, Section 15, as amended) is amended to read:

"61-3-23.3. CERTIFIED REGISTERED NURSE ANESTHETIST--

QUALIFICATIONS--LICENSURE--PRACTICE--ENDORSEMENT--EXPEDITED LICENSURE.--

A. The board may license for advanced practice as a certified registered nurse anesthetist an applicant who furnishes evidence satisfactory to the board that the applicant:

(1) is a registered nurse;

(2) has successfully completed a nurse anesthesia education program accredited by the council on accreditation of nurse anesthesia [education] educational programs; provided that, if the applicant is initially licensed by the board or a board in another jurisdiction after January 1, 2001, the program shall be at a master's level or higher; and

(3) is certified by the [council on] national board of certification [of] and recertification for nurse anesthetists.

B. A certified registered nurse anesthetist may provide preoperative, intraoperative and postoperative anesthesia care and related services, including ordering of diagnostic tests, in accordance with the current American association of nurse anesthetists' guidelines for nurse anesthesia practice.

C. Certified registered nurse anesthetists shall function in an [interdependent] independent role as a member of a health care team [in which the medical care of the patient is directed by a licensed physician, osteopathic physician, dentist or podiatrist licensed in New Mexico pursuant to Chapter 61, Article 5A, 6, 8 or 10 NMSA 1978. The certified registered nurse anesthetist shall collaborate with the licensed physician, osteopathic physician, dentist or podiatrist concerning the anesthesia care of the patient. As used in this subsection, "collaboration" means the process in which each health care provider contributes the health care provider's respective expertise. Collaboration includes systematic formal planning and evaluation between the health care professionals involved in the collaborative practice arrangement].

D. A certified registered nurse anesthetist who has fulfilled the requirements for prescriptive authority in the area of anesthesia practice is authorized to prescribe and administer therapeutic measures, including dangerous drugs and controlled substances included in Schedules II through V of the Controlled Substances Act within the emergency procedures, perioperative care or perinatal care environments. Dangerous drugs and controlled substances, pursuant to the Controlled Substances Act, that have been prepared, packaged or fabricated by a registered pharmacist or doses of drugs that have been prepackaged by a pharmaceutical manufacturer in accordance with the Pharmacy Act and the New Mexico Drug, Device and Cosmetic Act may be prescribed and administered.

E. A certified registered nurse anesthetist who has fulfilled the requirements for prescriptive authority in the area of anesthesia practice may prescribe in accordance with rules, regulations and guidelines. The board shall adopt rules concerning a prescriptive authority formulary for certified registered nurse anesthetists that shall be based on the scope of practice of certified registered nurse anesthetists. The board, in collaboration with the New Mexico medical board, shall develop the formulary. Certified registered nurse anesthetists who prescribe shall do so in accordance with the prescriptive authority formulary.

F. [From July 1, 2014 through June 30, 2019] Upon a determination by the board that an application is complete and approved, the board shall issue a license to a certified registered nurse anesthetist licensed in another state if the applicant meets the qualifications required of certified registered nurse anesthetists in this state. The board shall expedite the issuance of the license within five business days.

G. A health care facility may adopt policies relating to the providing of anesthesia care.

H. A certified registered nurse anesthetist licensed by the board shall maintain [this] certification with the [American association of] national board of certification and recertification for nurse [anesthetists' council on certification] anesthetists."

SECTION 6. A new section of the Nursing Practice Act is enacted to read:

"[NEW MATERIAL] DATA--STATE OWNERSHIP.--The state of New Mexico owns any data that the board generates."

SECTION 7. A new section of the Nursing Practice Act is enacted to read:

"[NEW MATERIAL] DISCIPLINARY PROCEEDINGS--PROHIBITION.--Advisory and volunteer members of the board shall not participate in any board proceeding related to the discipline of a licensee."

SECTION 8. A new section of the Nursing Practice Act is enacted to read:

"[NEW MATERIAL] INTERSTATE COMMISSION OF NURSE LICENSURE COMPACT ADMINISTRATORS--RULES.--No rule that the interstate commission of nurse licensure compact administrators adopts and that affects the practice of nursing in this state shall be effective in New Mexico unless the board adopts and promulgates that rule in accordance with the State Rules Act."

SECTION 9. A new section of the Nursing Practice Act is enacted to read:

"[NEW MATERIAL] INTERSTATE COMMISSION OF NURSE LICENSURE COMPACT ADMINISTRATORS--RECORDS--FILING WITH BOARD.--The state

compact administrator of the interstate commission of nurse licensure compact administrators shall file with the board any agenda, minutes, report or rulemaking record of that interstate commission. These agendas, minutes, reports and rulemaking records are subject to disclosure pursuant to the Inspection of Public Records Act."

SECTION 10. TEMPORARY PROVISION--PRIOR-APPOINTED BOARD TERMS.--Members of the board of nursing whose terms commenced before July 1, 2019, shall serve out those terms. The governor shall appoint members in accordance with the provisions of Section 2 of this 2019 act to replace members whose terms commenced before July 1, 2019 as those members' terms expire.

SECTION 11. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2019.

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