Bill 457

                    Current Status

Bill Number:               457
Ratification Number:       212
Act Number                 137
Introducing Body:          Senate
Subject:                   Relating to the State Board of
                           Nursing

(A137, R212, S457)

AN ACT TO AMEND SECTIONS 40-33-10, AS AMENDED, 40-33-510, 40-33-930, 40-33-935, AS AMENDED, 40-33-940, AS AMENDED, AND 40-33-950, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE STATE BOARD OF NURSING, SO AS TO DEFINE PRACTICE OF NURSING AND NURSING DIAGNOSIS, TO REGULATE THE PRACTICE OF REGISTERED NURSES, TO ESTABLISH STANDARDS FOR DISCIPLINE OF LICENSEES, TO PROVIDE THAT A VIOLATION OF CHAPTER 40 OR REGULATION OF THE STATE BOARD OF NURSING IS GROUNDS FOR DISCIPLINE, TO PROVIDE THAT A LAPSED LICENSE MAY NOT BE REINSTATED WITHOUT THE PERSON DEMONSTRATING NURSING COMPETENCE, TO PRESCRIBE RENEWAL QUALIFICATIONS, AND PROVIDE GROUNDS FOR DENIAL OF REINSTATEMENT OR DENIAL OF A LICENSE; AND TO AMEND THE 1976 CODE BY ADDING SECTIONS 40-33-931 AND 40-33-941 SO AS TO PROVIDE FOR DISCIPLINE OF LICENSEES, TO PROVIDE FOR REINSTATEMENT OF LAPSED LICENSES, AND TO MAKE IT UNLAWFUL TO PRACTICE NURSING WHEN A LICENSE HAS LAPSED.

Be it enacted by the General Assembly of the State of South Carolina:

Definitions

SECTION 1. Section 40-33-10 of the 1976 Code, as last amended by Act 114 of 1987, is further amended to read:

"Section 40-33-10. For the purposes of this chapter:

(a) 'Board' means the State Board of Nursing for South Carolina.

(b) 'Temporary permit' means a current time-limited document which permits the practice of nursing at the level for which one is seeking licensure.

(c) 'License' means a current document permitting the practice of nursing as a registered nurse or a licensed practical nurse.

(d) 'Registered nurse' means a person to whom the board has issued a license as registered nurse.

(e) 'Licensed practical nurse' means a person to whom the board has issued a license as licensed practical nurse.

(f) 'Practice of nursing' means the provision of services for compensation that assist individuals and groups to obtain or maintain optimal health. Nursing practice is commensurate with the educational preparation and demonstrated competencies of the individual who is accountable to the public for the quality of nursing care. Nursing practice includes the provision of direct care and treatment services including the implementation of a medical regimen as authorized and prescribed by a licensed physician, dentist, or other person authorized by law, teaching, counseling, administration, research, consultation, supervision, delegation, and evaluation of practice. Nursing process includes the assessment and nursing diagnosis of human responses to actual or potential health problems and the planning, intervention, and evaluation of care in the promotion and maintenance of health, the casefinding and nursing management of illness, injury, or infirmity, the restoration of optimum function, or the achievement of a dignified death.

(g) 'Practice of professional nursing' means the performance for compensation of any acts in the health care process involving the process of assessment, intervention, and evaluation. This process includes observation, care, and counsel of the ill, injured, infirm, the promotion and maintenance of health, the administration of medications, and treatments as authorized and prescribed by a licensed physician or a licensed dentist. The application of the nursing process requires substantial specialized independent judgment and skill and is based on knowledge and application of the principles of biophysical and social sciences. The practice of professional nursing includes the teaching and administration, supervision, delegation, and evaluation of nursing practice. A professional nurse may perform additional acts in the extended role requiring special education and training which are agreed to jointly by both the Board of Nursing and the Board of Medical Examiners. Those additional acts agreed to by both boards must be promulgated by the Board of Nursing in its regulations.

(h) 'Practice of practical nursing' means the performance for compensation, under the direction of a registered nurse, licensed physician, or licensed dentist, of acts in health care maintenance, care of the ill, injured, and infirm, and in administering treatments and medications as authorized and prescribed by a licensed physician or licensed dentist, which acts require knowledge, judgment, and skill as prerequisites to licensure under this chapter, and which do not include acts of diagnosis or prescription of therapeutic or corrective measures. A licensed practical nurse may perform additional acts requiring special education and training, approved by the board, which are proper for the licensee to perform and which are recognized by the board through its regulations.

(i)'Lapsed license' means the termination of an individual's privilege to practice nursing due to the individual's failure to renew the nursing license within a specified period of time.

(j) 'Voluntary surrender' means the invalidation of the nursing license at the time of its relinquishment and thereafter. No person whose license is voluntarily surrendered may practice nursing or represent himself to be a registered nurse or a licensed practical nurse until the board takes action.

(k) 'Inactive license' means the temporary retirement of an individual's privilege to practice nursing upon the individual's notice to the board that he does not plan to practice nursing for at least one year.

(l) 'Accreditation' means official authorization or status granted by an agency other than a state board of nursing.

(m) 'Approval' means the process by which the board evaluates and grants official recognition to nursing education programs which meet established uniform and reasonable standards.

(n) 'Nursing diagnosis' means a clinical judgment about an individual, family, or community which is derived through a nursing assessment."

License required to practice

SECTION 2. Section 40-33-510 of the 1976 Code is amended to read:

"Section 40-33-510. It is unlawful for a person to practice registered nursing in this State or to use a title, abbreviation, sign, card, or other device to indicate that he is so practicing, unless he has been licensed under the provisions of this chapter pursuant to the law in force at the time of his authorization as a registered nurse."

Revocation, suspension, and other discipline of licensees

SECTION 3. Section 40-33-930 of the 1976 Code is amended to read:

"Section 40-33-930. The board, if it has reason to believe grounds exist, may order the revocation or suspension of a license to practice nursing as a registered nurse or a licensed practical nurse or privately reprimand the registered nurse or licensed practical nurse or take other reasonable action short of revocation or suspension, such as requiring the licensee to undertake additional professional training subject to the direction and supervision of the board. The board may also impose restraint upon the nursing practice of the licensee as circumstances warrant until the licensee demonstrates to the board adequate professional competence. In addition to any other sanction imposed by the board upon the licensee, the board may require the licensee to pay a civil penalty of up to two thousand dollars to the board for each violation of the provisions of this chapter or of the regulations promulgated by the board, but the total penalty or fine for the violations may not exceed ten thousand dollars. All fines must be remitted to the State Treasurer and deposited in a special fund from which the board must be reimbursed for administrative costs for each case upon the approval of the Budget and Control Board. At any time when the special fund exceeds twenty thousand dollars, all excess funds must be remitted to the General Fund. Fines are payable immediately upon the effective date of discipline. Interest accrues after fines are due at the maximum rate allowed by law. No licensee against whom a fine is levied is eligible for reinstatement until the fine has been paid in full. An action of the board relating to the revocation or suspension of a license, or other action either restricting a license or limiting or otherwise disciplining a licensee, may be taken only after a written complaint of misconduct, as defined in Section 40-33-935, has been filed with the board in accordance with regulations promulgated by the board.

In deciding what discipline is appropriate the board shall consider, along with the nature and circumstances of the offense, the protection of the public, the standards of nursing, and the interests in rehabilitation of the respondent nurse. The board is not limited to considering only those factors."

Review, when discipline is effective

SECTION 4. The 1976 Code is amended by adding:

"Section 40-33-931. A decision by the board to revoke, suspend, or otherwise discipline a licensee must be by majority vote of the total membership of the board and is subject to review as provided by Article 3, Chapter 23 of Title 1 (the Administrative Procedures Act).

A decision by the board to revoke, suspend, or otherwise restrict a license or to limit or otherwise discipline a licensee becomes effective upon delivery of a copy of the decision to the licensee and a petition for review does not operate as a supersedeas."

Grounds for revocation, suspension, or other discipline

SECTION 5. Section 40-33-935 of the 1976 Code, as last amended by Act 114 of 1987, is further amended to read:

"Section 40-33-935. Misconduct, as defined in the regulations, which constitutes grounds for a revocation, suspension, or other restriction of a license or a limitation on or other discipline of a licensee, is a satisfactory showing to the board of any of the following:

(a) That the licensee has committed or been convicted of a felony. In the absence of a conviction, the board may receive evidence to reach an independent conclusion as to the commission of the felony, but the determination may be used only in making the administrative decision regarding the proposed discipline.

(b) That the licensee has violated a federal, state, or local alcohol or drug law. A conviction is not needed to prove misconduct under this paragraph.

(c) That the licensee is engaging in the practice of nursing when judgment or physical ability is impaired by alcohol, drugs, or controlled substances and has declined or been unsuccessful in accomplishing rehabilitation.

(d) That the licensee has participated knowingly in the fraudulent procurement of a license for himself or another person, or has allowed another person to use his license.

(e) That the licensee wilfully or repeatedly has followed a course of conduct which, by reasonable professional or ethical standards, renders him incompetent to assume, perform, or be entrusted with the duties, responsibilities, or trusts which normally devolve upon a licensed practical nurse or a registered nurse.

(f) That the licensee has had his license to practice nursing in another state suspended or revoked or other disciplinary action has been taken against him by another state. In those situations, the action by another state creates a rebuttable presumption that a South Carolina nursing license may be acted upon similarly. The finding may be based solely upon the record in the other state, and there is no requirement for a de novo hearing on the facts established in that proceeding. Other evidence is admissible to support or rebut the above presumption.

(g) That the licensee has violated a section of this chapter or a regulation or order of the board.

(h) Additionally, a nurse who is under investigation for any of the above items of misconduct or incapacity may voluntarily surrender his license to the board. The voluntary surrender invalidates the license at the time of its relinquishment and no person whose license is voluntarily surrendered may practice nursing or represent himself to be a registered nurse or licensed practical nurse until the board takes action. A person practicing as a registered nurse or licensed practical nurse during the period of voluntary license surrender is considered an illegal practitioner and is subject to the penalties provided by this chapter. The surrender of a license may not be considered as an admission of guilt by a panel, court, or other entity in revoking the license of a registered nurse or licensed practical nurse. The surrender is with the understanding that it does not preclude the board from imposing conditions on the acceptance of the proffered surrender, which the licensee must meet before the return of his license, nor does it preclude the board from taking disciplinary action under this section."

Annual renewal of licenses

SECTION 6. Section 40-33-940 of the 1976 Code, as last amended by Act 114 of 1987, is further amended to read:

"Section 40-33-940. The license of every person licensed under the provisions of this chapter to practice as a registered nurse or as a licensed practical nurse in this State must be renewed annually, except as otherwise provided. After January 31, 1993, a licensee who has not practiced nursing for a minimum of nine hundred sixty hours in the preceding five years is not eligible for an active license.

A licensee who allows his license to lapse, by failing to renew the license as provided above, may be reinstated by the board on payment of a reinstatement fee and the current renewal fee, and demonstration of nursing competence as defined in regulations of the board."

Lapsed licenses

SECTION 7. The 1976 Code is amended by adding:

"Section 40-33-941. A licensee who allows his license to lapse, by failing to renew the license, may be reinstated by the board on payment of a reinstatement fee and the current renewal fee and demonstration of nursing competence as defined in the regulations of the board. The board may deny reinstatement based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct.

A person practicing as a registered nurse or licensed practical nurse during the time his license has lapsed is considered an illegal practitioner and is subject to the penalties provided for violation of this chapter."

Temporary retirement of licensees

SECTION 8. Section 40-33-950 of the 1976 Code, as last amended by Act 114 of 1987, is further amended to read:

"Section 40-33-950. A person currently licensed under the provisions of this chapter who does not meet the minimum practice requirement for renewal, desiring to retire from practice temporarily, or who leaves the State, may send to the board a written request for official inactive status. Upon receipt of the request and appropriate fee, the board shall act and place the name of the person on the official inactive list. While remaining on this list, the person is not subject to the payment of any renewal fees and shall not practice nursing in this State. When the person desires to resume practice, an application for a renewal of license and payment of a renewal fee for the current period, and demonstration of nursing competence as defined in regulations of the board, must be made to the board. The board may deny reinstatement or renewal based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct."

Time effective

SECTION 9. This act takes effect upon approval by the Governor.