OPLER recommends 6,000-hour pre-licensure requirement for APRNs, adjusts PA hours and proposes limited CRNA prescribing; stakeholders raise portability and safe

SALT LAKE CITY — The Business and Labor Interim Committee heard Oct. 15 OPLER—s proposals that would change experience thresholds for APRNs and PAs and add a limited, narrowly defined prescribing authority for certified registered nurse anesthetists (CRNAs).

APRN and PA proposal: OPLER proposed that individuals seeking APRN licensure after July 1, 2028, document 6,000 hours of clinical practice experience prior to licensure. The hours may include clinical placements during nursing and APRN education or employment as a licensed registered nurse. The recommended change is pre-licensure only and, according to OPLER, does not remove APRNs— existing statutory full-practice authority once licensed. For physician assistants, OPLER recommended lowering the PA supervised-hours threshold for independent practice to 8,000 hours; the office said the change aligns the two paths and addresses concerns that some new APRN graduates lacked real-world supervised clinical experience.

CRNA prescribing: OPLER proposed a narrow authority allowing CRNAs to prescribe a five-day supply of a legend or controlled medication directly related to a procedure in which they participated, limited to treatment immediately before or after the procedure, and tied to facility policies. OPLER described the change as targeted to rural hospitals and small clinics where a CRNA may be the most appropriate clinician available for short-term continuity of care until a follow-up with the primary prescriber.

Public and stakeholder reaction: Physician groups and the Utah Society of Anesthesiology opposed the CRNA prescribing provision over concerns about opioid prescribing and community exposure, citing national experience in states that loosened limits. The Utah Medical Association asked for additional coordination language requiring consultation with the operating surgeon. Utah Nurses Association and Utah Nurse Practitioners expressed concern about portability and administrative impact if Utah adds unique hour requirements; they said board-level oversight or accreditation could address educational quality without adding unique Utah-only hours. OPLER said existing reciprocity and DopL provisions allow out-of-state practitioners to obtain Utah licenses if they meet core standards; staff cautioned that the proposed hours could affect roughly 14% of current APRNs who have lower total clinical hours.

Committee process and next steps: OPLER committed to providing technical details, a bar-chart breakdown of hours (clinical-in-school and out-of-school), and proposed statutory text. Committee members asked staff to work on clear re-entry pathways for practitioners who lapse or leave practice and to ensure portability and compact compatibility are addressed in any draft language.