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Bill Number: 2409 Ratification Number: 159 Act Number 114 Introducing Body: House Subject: Relating to nurses, so as to define temporary permit
(A114, R159, H2409)
AN ACT TO AMEND SECTIONS 40-33-10, 40-33-20, 40-33-50, 40-33-260, 40-33-290, 40-33-520, 40-33-530, 40-33-560, 40-33-720, 40-33-730, 40-33-760, 40-33-910, 40-33-920, 40-33-935, 40-33-940, 40-33-950, 40-33-1120, AND 40-33-1130, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO NURSES, SO AS TO DEFINE TEMPORARY PERMIT, LICENSE, LAPSED LICENSE, VOLUNTARY SURRENDER, INACTIVE LICENSE, ACCREDITATION, INCREASE THE PENALTY FOR UNLICENSED NURSING PRACTICE; AUTHORIZE THE BOARD TO DENY LICENSURE BECAUSE OF INCOMPETENCE OR UNPROFESSIONAL CONDUCT; REPLACE THE TERM "REGISTRATION" WITH "LICENSURE" AND THE TERM "ACCREDITATION OF SCHOOLS OF NURSING" WITH "APPROVAL OF NURSING EDUCATION PROGRAMS"; TO PROVIDE PRACTICAL NURSE EDUCATION; TO AUTHORIZE THE BOARD TO REVOKE OR SUSPEND THE LICENSE OF A PRACTICING NURSE WHO HAS DECLINED OR BEEN UNSUCCESSFUL IN ACCOMPLISHING CHEMICAL ABUSE REHABILITATION; TO ADD SECTION 40-33-220 SO AS TO ENUMERATE THE POWERS OF THE BOARD OF NURSING; AND TO REPEAL SECTIONS 40-33-300, AND 40-33-1140 THROUGH 40-33-1160 RELATING TO ACCREDITATION OF COURSES FOR PRACTICAL NURSES.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 40-33-10 of the 1976 Code is 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 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.
(g) '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.
(h) '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.
(i) '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.
(j) '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 a period of at least one year.
(k) 'Accreditation' means official authorization or status granted by an agency other than a state board of nursing.
(l) 'Approval' means the process by which the Board evaluates and grants official recognition to nursing education programs which meet established uniform and reasonable standards."
Penalty for unlicensed practice
SECTION 2. Section 40-33-20 of the 1976 Code is amended to read:
"Section 40-33-20. It is unlawful for any person to practice as a registered nurse or a practical nurse, to use the abbreviation 'R.N.' or 'L.P.N.' or any sign, card, or device to indicate that a person is a registered nurse or a licensed practical nurse, within the meaning of this chapter, in this State, who fails to comply with the provisions of this chapter, to include a lapsed license, an inactive license, a voluntarily surrendered license, and anyone violating any of the provisions of this chapter is guilty of a misdemeanor and, upon conviction must be fined not less than five hundred dollars or imprisoned for a period of not less than thirty days, or both."
Student and practical nurses may practice pending examination
SECTION 3. Section 40-33-50(4) of the 1976 Code is amended to read:
"(4) As prohibiting the practice of nursing by students enrolled in approved schools of nursing or approved schools of practical nursing, nor by graduates of these schools pending the results of the first licensing examination scheduled by the Board following graduation;".
SECTION 4. The 1976 Code is amended by adding:
"Section 40-33-220. (A) The Board shall enforce the provisions of this chapter.
(B) The Board may:
(1) maintain an office to carry out its work and provide funds, facilities, and equipment for its operation;
(2) use minimum standards as a basis for evaluating safe and effective nursing practice;
(3) publish advisory opinions relating to nursing practice procedures or policies authorized or acquiesced to by any agency, facility, institution, or other organization that employs individuals licensed under this chapter to comply with acceptable standards of nursing practice;
(4) examine, license, and renew the licenses of duly qualified individuals;
(5) develop minimum standards for continued competency of licensees continuing in or returning to practice;
(6) conduct surveys of educational enrollments and licensure and report to the public;
(7) conduct investigations and hearings concerning alleged violations of this chapter;
(8) develop minimum standards for nursing education programs;
(9) approve nursing education programs that meet the prescribed standards;
(10) deny or withdraw approval of nursing education programs that fail to meet the prescribed standards;
(11) approve the qualifications of nurse practitioners and clinical nurse specialists functioning in an extended role;
(12) join organizations that develop and regulate the national nursing licensure examinations and promote the improvement of the
legal standards of the practice of nursing for the protection of the public;
(13) establish policies governing finances and approve an annual budget;
(14) receive and expend funds in addition to that provided in the State General Appropriations Act. The funds must be expended for purposes authorized."
Meetings and quorum
SECTION 5. Section 40-33-260 of the 1976 Code is amended to read:
"Section 40-33-260. The Board shall meet at least quarterly for the purpose of transaction of business.
Four members of the Board constitute a quorum, but no action of the Board is valid unless authorized by the affirmative vote of three members."
SECTION 6. Section 40-33-290 of the 1976 Code is amended to read:
"Section 40-33-290. The Board shall keep a record of all its proceedings, a record of all applicants for licenses and of the action of the Board, and a record of all nurses who have complied with the requirements of this chapter and have been licensed to practice nursing or practical nursing in this State.
Records kept by the Board are prima facie evidence of all matters therein recorded. At all reasonable times, all records must be open to public inspection except as otherwise prohibited by law."
SECTION 7. Section 40-33-520 of the 1976 Code is amended to read:
"Section 40-33-520. The Board shall examine all candidates for licensing as registered nurses as herein provided and pass upon their qualifications to practice nursing as registered nurses in this State and give each successful applicant a license to that effect. The license entitles the holder to practice nursing in this State as a registered nurse and to use the letters 'R.N.' after his name."
Qualifications of applicants for nursing license
SECTION 8. Section 40-33-530 of the 1976 Code is amended to read:
"Section 40-33-530. Each applicant shall furnish evidence satisfactory to the Board that he is at least eighteen years of age, has completed at least four years of work in a high school accredited by the State Board of Education in the state in which the school is located or the equivalent of such work, satisfactory evidence of which must be furnished to the Board, has completed a course of study in an approved nursing education program, and has met other preliminary qualification requirements as the Board may prescribe. The Board may deny licensure based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct."
Licensing of nurses not licensed in this State
SECTION 9. Section 40-33-560 of the 1976 Code is amended to read:
"Section 40-33-560. The Board shall issue licenses without examination to nurses licensed in other states, territories, the District of Columbia, or foreign countries, if the individual qualifications of the nurse meet the requirements of this chapter and the Board and the required fee is paid. The Board may deny licensure based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct."
SECTION 10. Section 40-33-720 of the 1976 Code is amended to read:
"Section 40-33-720. The Board shall examine all candidates for licensing as licensed practical nurses, as hereinafter provided, and shall pass upon their qualifications to practice practical nursing as licensed practical nurses in this State, and shall give each successful applicant a license to that effect. The license entitles the holder to practice practical nursing in this State as a licensed practical nurse and to use the letters 'L.P.N.' after his name."
Qualifications of applicants for practical nursing license
SECTION 11. Section 40-33-730 of the 1976 Code is amended to read:
"Section 40-33-730. Each applicant for a license to practice as a licensed practical nurse shall submit evidence satisfactory to the Board that he is at least eighteen years of age, has successfully completed at least two years of work in an accredited high school or the equivalent of such work, satisfactory evidence of which must be furnished to the Board, has successfully completed the course of study in a nursing education program for practical nurses approved by the Board or has completed a course of study determined by the Board to be the equivalent thereof, and has met such other preliminary qualification requirements as the Board may prescribe. The Board may deny licensure based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct."
Licensing of practical nurses not licensed in this State
SECTION 12. Section 40-33-760 of the 1976 Code is amended to read:
"Section 40-33-760. The Board may issue a license to practice as a licensed practical nurse without examination to any applicant who is a licensed practical nurse or a person entitled to perform similar services under a different title under the laws of another state or territory, the District of Columbia, or a foreign country if, in the opinion of the Board, the applicant meets the requirements for licensed practical nurses in this State. Each applicant shall pay to the Board such fee as it may determine. The Board may deny licensure based on evidence of unlawful acts, incompetence, unprofessional conduct, or other misconduct."
SECTION 13. Section 40-33-910 of the 1976 Code is amended to read:
"Section 40-33-910. Each applicant must pass the examinations administered by the Board in such subjects as may be determined by it."
SECTION 14. Section 40-33-920 of the 1976 Code is amended to read:
"Section 40-33-920. In case of failure at the first examination, the applicant shall have the privilege of reexamination upon application and on payment of the fees fixed by the Board without further Board required study. If one has failed two or more times to pass the licensing examination, he must pursue further study and experience, as prescribed by the Board, in the areas and subjects failed, before he is admitted to a subsequent examination."
Grounds for revocation
SECTION 15. Section 40-33-935 of the 1976 Code is 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 such determination shall be used only in making the administrative decision regarding the proposed discipline.
(b) That the licensee has violated any federal, state, or local alcohol and 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. Provided, that in such situations, the action by another state creates a rebuttable presumption that any South Carolina nursing license should be acted upon similarly. Such 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. However, other evidence is admissible to support or rebut the above presumption.
(g) Additionally, any 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 thereafter 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. Any 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 any license, as provided by this item, may not be considered as an admission of guilt by any panel, court, or other entity in revoking the license of a registered nurse or licensed practical nurse. The surrender will be with the understanding that it shall not preclude the Board from imposing conditions on the acceptance of the proffered surrender, which the licensee must meet prior to the return of his license, nor shall it preclude the Board from taking disciplinary action under this section."
Annual renewal of license
SECTION 16. Section 40-33-940 of the 1976 Code is 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 annually renewed, except as otherwise provided.
Any 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.
Any 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 17. Section 40-33-950 of the 1976 Code is amended to read:
"Section 40-33-950. A person currently licensed under the provisions of this chapter, 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 must be made to the Board."
Survey of institutions with nursing education programs
SECTION 18. Section 40-33-1120 of the 1976 Code is amended to read:
"Section 40-33-1120. A survey of the institution with which the nursing education program is to be affiliated must be made by the executive director or other employee of the Board and a written report of the survey must be submitted to the Board. If, in the opinion of the Board, the basic standards are met by a nursing education program, it shall designate the program as an approved nursing education program."
Periodic surveys of nursing education programs
SECTION 19. Section 40-33-1130 of the 1976 Code is amended to read:
"Section 40-33-1130. As considered necessary, the Board, through its executive director, or other employee, shall survey all nursing education programs in the State. Written reports of surveys must be submitted to the Board. If the Board determines that any
approved nursing education program is not maintaining the standards required by the statutes and by the Board, notice thereof in writing specifying the defect shall immediately be given to the program. A program which fails to correct the defects to the satisfaction of the Board within a reasonable time must be removed from the list of approved nursing education programs."
SECTION 20. Sections 40-33-300, 40-33-1140, 40-33-1150, and 40-33-1160 of the 1976 Code are repealed.
SECTION 21. This act takes effect upon approval by the Governor.