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House approves change letting licensure board vary physician–nurse practitioner supervisory ratios
Summary
The House passed HB 25, allowing the Division of Licensure to consider physician-to-nurse-practitioner supervisory ratios on a case-by-case basis and adding an amendment that the supervised ratio be "not to exceed 6." Supporters said it would increase access in rural areas; opponents pressed for clearer statutory guidelines.
The Utah House passed House Bill 25 on the first day of the 1991 session, approving changes to the nurse prescriptive practice framework that give the Division of Licensure flexibility to set physician-to-nurse-practitioner supervisory arrangements based on local circumstances.
Sponsor Representative Paula F. Julander said the bill removes a fixed statutory ratio and permits the licensure division to evaluate collaborative practices ‘‘on a case-by-case basis’’ — for instance, allowing different arrangements in rural areas where physicians may not be on-site. Under an amendment adopted on the floor, the revised language instructs that supervised relationships may be permitted "not to exceed 6," allowing the division discretion up to six nurse practitioners under a supervising physician in specified circumstances. The amendment was adopted under suspension of the rules.
Opponents urged caution about delegating broad discretion to an administrative board without clearer statutory criteria. Representative Harwood warned that the bill could amount to the legislature ceding policymaking to an administrative body, saying, "we're not going to be a legislature anymore. We will allow others to be the legislature." Several other members asked what objective standards would guide the board in granting exceptions.
Julander and supporters responded that the change is a modest, practical measure intended to expand access and potentially reduce costs, and that existing collaborative protocols would continue to define the scope of practice. She told the chamber the bill "will increase access to health care for many and in many circumstances reduce health care costs."
After debate and a motion to end debate, the House voted with the bill as amended: HB 25 passed with 68 affirmative votes and 3 negative votes. The measure will be transmitted to the Senate. The Division of Licensure was directed to develop implementing rules consistent with the statute and the adopted amendment.
What's next: Senate consideration and administrative rulemaking. Implementing criteria and any further numerical limits will be established in rules the division issues under the statute.
