Review urges neutral, data‑driven process for scope‑of‑practice changes; recommends experience floor for APRNs

The Office of Professional Licensure Review (OPLR) briefed the Business and Labor Interim Committee on Aug. 20 with recommendations to streamline scope‑of‑practice decisions and to adjust several health occupations’ regulatory models. Jeff Shumway, director of OPLR, joined by policy analyst Jordan Geege, said the office applied statutory criteria — safety, access and affordability — to evaluate nursing and allied‑health occupations.

OPLR proposed a prespecified, neutral review pathway for scope‑of‑practice changes. Under that model, requests for expanded practice would be evaluated against objective criteria (such as demonstrated safety, patient benefit, and industry need) by a neutral technical panel; promising proposals could be piloted in an existing regulatory sandbox before going to the Legislature. Shumway said the change aims to reduce time‑consuming, adversarial, one‑off legislative fights and to produce evidence‑informed bills.

For speech and hearing occupations (audiologists, speech‑language pathologists and hearing‑instrument specialists), OPLR recommended creating mandatory certification rather than full licensure. Under that approach, practitioners would demonstrate qualifications and periodic currency, but OPLR suggested removing a standing board and reducing administrative renewals; a statutory carve‑out would retain strict requirements for invasive procedures related to feeding and swallowing.

OPLR also examined advanced practice clinicians. The office said Utah has enjoyed rapid growth in the numbers of advanced practice registered nurses (APRNs) and physician assistants (PAs) and that workforce models show current supply meeting forecast demand. But OPLR reported a concern: some APRN graduates enter independent practice with relatively limited clinical experience compared with historical norms. The office contrasted statutory supervised‑experience requirements for PAs (which include a 10,000‑hour supervised‑practice benchmark for full independence in Utah’s model) with more variable practice experience for APRNs.

Shumway emphasized OPLR does not recommend reversing full practice authority granted to APRNs or PAs. Instead, OPLR proposed aligning experience expectations so clinicians with the same independent scope have similar levels of clinical experience. OPLR’s starting suggestion for APRNs was to consider a range (roughly 4,000–6,000 hours total clinical experience, including supervised clinical time and practice) as a reasonable baseline to reduce early‑career competence gaps identified in stakeholder feedback and in a practitioner survey OPLR conducted.

On nurse‑anesthetists (CRNAs), OPLR recommended a narrow, time‑limited prescriptive authority to enable continuity of care around procedures — for example, prescribing for up to five days before and five days after a procedure in rural settings — to address access gaps where a prescribing physician is not available. OPLR cited other states with varying approaches and noted regulators in jurisdictions that allow CRNA prescribing did not report major problems.

The presentation included stakeholder comment at the hearing. Nurse practitioners and nursing leaders cautioned that OPLR’s survey did not capture some pre‑licensure clinical hours that are typical for nursing pathways and urged further refinement. Physician‑group representatives asked OPLR to ensure acuity and setting are factored into safety analyses.

OPLR also suggested a number of incremental deregulatory, modernization and administrative tweaks for allied health professions (occupational therapy, physical therapy, speech/hearing and athletic training) to reduce administrative burden while maintaining public safety. The committee asked OPLR to continue technical work with affected boards and stakeholders to refine proposals and to return draft statutory language in the coming interim period.

Shumway closed by asking lawmakers to consider adopting the proposed neutral review process to make future scope changes more objective and data driven, and to use regulatory sandboxes for time‑limited pilots where appropriate.