PRINTER'S NO. 2139
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1617
Session of
2017
INTRODUCED BY TALLMAN, OBERLANDER, WARD, O'BRIEN, MURT,
D. COSTA, LONGIETTI AND DEASY, JUNE 23, 2017
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, JUNE 23, 2017
AN ACT
Amending the act of May 22, 1951 (P.L.317, No.69), entitled "An
act relating to the practice of professional nursing;
providing for the licensing of nurses and for the revocation
and suspension of such licenses, subject to appeal, and for
their reinstatement; providing for the renewal of such
licenses; regulating nursing in general; prescribing
penalties and repealing certain laws," regulating the
practice of diabetes self-management education and training
and the licensure of diabetes educators; and further
providing for penalties.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2 of the act of May 22, 1951 (P.L.317,
No.69), known as The Professional Nursing Law, is amended by
adding clauses to read:
Section 2. Definitions.--When used in this act, the
following words and phrases shall have the following meanings
unless the context provides otherwise:
* * *
(16) "Diabetes self-management education and training" means
a comprehensive collaborative process by which individuals with
or at risk for diabetes gain the knowledge and skills needed to
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modify behavior and successfully self-manage the disease and the
related conditions of the disease.
(17) "Licensed diabetes educator" means a diabetes educator
who holds a current license under this act.
(18) "Practice of diabetes self-management education and
training" means the assessment and development of a plan of care
for an individual with or at risk for diabetes, the
identification of self-management goals for the individual, the
provision of self-management training according to the plan, the
evaluation of the individual's outcome and the recording of a
complete record of the individual's experience and follow-ups.
Section 2. Sections 2.1(f) and (k) and 2.2 of the act are
amended to read:
Section 2.1. State Board of Nursing.--* * *
[(f) The Board is subject to evaluation, review and
termination within the time and in the manner provided in the
act of December 22, 1981 (P.L.508, No.142), known as the "Sunset
Act."]
* * *
(k) The Board shall have the right and duty to establish
rules and regulations for the practice of professional nursing,
the practice of dietetics-nutrition, the practice of diabetes
self-management education and training and the administration of
this act. Copies of such rules and regulations shall be
available for distribution to the public.
* * *
Section 2.2. Communication with Licensees.--The Board shall
communicate with licensees on issues affecting the education,
practice and regulation of nursing [or], dietetics-nutrition and
diabetes self-management education and training on at least an
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annual basis.
Section 3. The act is amended by adding a section to read:
Section 3.2. Licensed Diabetes Educator; License Required;
Use of Title.--(a) It shall be unlawful for any individual to
hold himself or herself forth as a licensed diabetes educator
unless the individual shall first have obtained a license
pursuant to this act. Only an individual who has received a
license as a licensed diabetes educator pursuant to this act may
use the title "licensed diabetes educator."
(b) Nothing in this act relating to the licensure of
diabetes educators shall be construed to limit, restrict or
interfere with a health care practitioner practicing or acting
within the scope of the health care practitioner's license,
registration or certificate, or as otherwise authorized by law,
including using the title authorized by the practitioner's
licensing act.
Section 4. Sections 6, 8 and 11 of the act are amended by
adding subsections to read:
Section 6. Fees; Qualifications for Licensure.--* * *
(b.1) An applicant applying for licensure as a diabetes
educator must pay the fee established by the Board and shall
submit a written application on forms provided by the Board
evidencing and ensuring to the satisfaction of the Board that
the applicant is of good moral character and meets one of the
following requirements:
(1) Is certified by and in good standing with:
(i) the National Certification Board for Diabetes Educators
as a Certified Diabetes Educator; or
(ii) the American Association of Diabetes Educators with
Board-Certified Advanced Diabetes Management certification.
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(2) Meets the National Certification Board for Diabetes
Educators' eligibility requirements, which shall include:
(i) Is one of the following:
(A) A registered nurse.
(B) A physician.
(C) A physician assistant holding active registration with
the National Commission on Certification of Physician
Assistants.
(D) A physical therapist.
(E) An occupational therapist.
(F) A pharmacist.
(G) A clinical psychologist.
(H) An optometrist.
(I) A podiatrist.
(J) A dietician or dietician-nutritionist holding active
registration with the Commission on Dietetic Registration.
(K) A clinical exercise professional holding active
certification with the American College of Sports Medicine
(ACSM) as a Certified Clinical Exercise Physiologist or a
clinical exercise professional holding active certification with
the ACSM as a Registered Clinical Exercise Physiologist.
(L) A health educator holding active certification as a
Master Certified Health Education Specialist with the National
Commission for Health Education Credentialing.
(M) A health professional with a master's degree or higher
in social work from a college or university in the United States
that is accredited by a nationally recognized regional
accrediting body.
(ii) Has a minimum of fifteen (15) hours of continuing
education activities applicable to diabetes within the two (2)
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years prior to applying for licensure;
(iii) has passed the National Certification Board for
Diabetes Educators' Certification Examination for Diabetes
Educators.
(iv) has successfully completed two hundred fifty (250)
hours within a two-year time frame in an education program
specific to diabetes self-management as approved by the Board.
* * *
Section 8. Persons Entitled to Practice.--* * *
(c) The Board shall issue to each person who meets the
diabetes educator licensure requirements of this act a
certificate setting forth that such person is licensed as a
diabetes educator and entitled to use the title "licensed
diabetes educator." A record of all persons licensed as diabetes
educators in this Commonwealth shall be kept in the office of
the Board and shall be open to public inspection and copying
upon payment of a nominal fee for copying the record.
Section 11. Licenses; Duration; Renewal Fee; Inactive
Status.--* * *
(d) A diabetes educator license issued under this act shall
not be renewed unless the licensee applying for renewal submits
proof to the Board that during the two (2) calendar years
immediately preceding the application for renewal the licensee
has satisfactorily completed a minimum of thirty (30) hours of
continuing diabetes education approved by the Board by
regulation.
Section 5. Sections 11.1, 11.2(a), 13(b), 14 and 15.4 of the
act are amended to read:
Section 11.1. Reporting of Multiple Licensure.--Any licensed
professional nurse [or], dietitian-nutritionist or diabetes
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educator of this Commonwealth who is also licensed to practice
nursing [or], dietetics-nutrition or diabetes self-management
education and training in any other state, territory, possession
or country shall report this information to the Board on the
biennial registration application. Any disciplinary action taken
in other states shall be reported to the Board on the biennial
registration application or within ninety (90) days of final
disposition, whichever is sooner. Multiple licensure shall be
noted by the Board on the licensee's record, and such state,
territory, possession or country shall be notified by the Board
of any disciplinary actions taken against said licensee in this
Commonwealth.
Section 11.2. Setting of Fees and Disposition of Fees, Fines
and Civil Penalties.--(a) All fees required under this act
shall be fixed by the Board by regulation and shall be subject
to the act of June 25, 1982 (P.L.633, No.181), known as the
"Regulatory Review Act." If the revenues raised by the fees,
fines and civil penalties imposed under this act are not
sufficient to meet expenditures over a two-year period, the
Board shall increase those fees by regulation so that projected
revenues will meet or exceed projected expenditures. The fees
for licensed diabetes educators shall not exceed the initial
registration fees set for nurses.
* * *
Section 13. Punishment for Violations.--* * *
(b) In addition to any other civil remedy or criminal
penalty provided for in this act, the Board, by a vote of the
majority of the maximum number of the authorized membership of
the Board as provided by law or by a vote of the majority of the
duly qualified and confirmed membership or a minimum of five (5)
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members, whichever is greater, may levy a civil penalty of up to
one thousand dollars ($1,000) on any current licensee who
violates any provision of this act or on any person who
practices nursing [or], holds himself or herself forth as a
licensed dietitian-nutritionist or holds himself or herself
forth as a licensed diabetes educator without being properly
licensed to do so under this act or on the responsible officers
or employes of any corporation, copartnership, institution or
association violating any of the provisions of this act. The
Board shall levy this penalty only after affording the accused
party the opportunity for a hearing, as provided in Title 2 of
the Pennsylvania Consolidated Statutes (relating to
administrative law and procedure).
Section 14. Refusal, Suspension or Revocation of Licenses.--
(a) The Board may refuse, suspend or revoke any license in any
case where the Board shall find that--
(1) The licensee is on repeated occasions negligent or
incompetent in the practice of professional nursing [or],
dietetics-nutrition or diabetes self-management education and
training.
(2) The licensee is unable to practice professional nursing
with reasonable skill and safety to patients by reason of mental
or physical illness or condition or physiological or
psychological dependence upon alcohol, hallucinogenic or
narcotic drugs or other drugs which tend to impair judgment or
coordination, so long as such dependence shall continue. In
enforcing this clause (2), the Board shall, upon probable cause,
have authority to compel a licensee to submit to a mental or
physical examination as designated by it. After notice, hearing,
adjudication and appeal as provided for in section 15, failure
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of a licensee to submit to such examination when directed shall
constitute an admission of the allegations against him or her
unless failure is due to circumstances beyond his or her
control, consequent upon which a default and final order may be
entered without the taking of testimony or presentation of
evidence. A licensee affected under this paragraph shall at
reasonable intervals be afforded an opportunity to demonstrate
that he or she can resume a competent practice of professional
nursing with reasonable skill and safety to patients.
(2.1) The licensee is unable to practice dietetics-nutrition
with reasonable skill and safety to individuals or groups by
reason of mental or physical illness or condition or
physiological or psychological dependence upon alcohol,
hallucinogenic or narcotic drugs or other drugs which tend to
impair judgment or coordination so long as such dependence shall
continue. In enforcing this clause (2.1), the Board shall upon
probable cause have authority to compel a licensee to submit to
a mental or physical examination as designated by it. After
notice, hearing, adjudication and appeal as provided for in
section 15, failure of a licensee to submit to such examination
when directed shall constitute an admission of the allegations
against him or her unless failure is due to circumstances beyond
his or her control, consequent upon which a default and final
order may be entered without the taking of testimony or
presentation of evidence. A licensee affected under this
paragraph shall at reasonable intervals be afforded an
opportunity to demonstrate that he or she can resume a competent
practice of dietetics-nutrition with reasonable skill and safety
to individuals or groups.
(2.2) The licensee is unable to practice diabetes self-
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management education and training with reasonable skill and
safety to individuals or groups by reason of mental or physical
illness or condition or physiological or psychological
dependence upon alcohol, hallucinogenic or narcotic drugs or
other drugs which tend to impair judgment or coordination so
long as such dependence shall continue. In enforcing this clause
(2.2), the Board shall upon probable cause have authority to
compel a licensee to submit to a mental or physical examination
as designated by it. After notice, hearing, adjudication and
appeal as provided for in section 15, failure of a licensee to
submit to such examination when directed shall constitute an
admission of the allegations against him or her unless failure
is due to circumstances beyond his or her control, consequent
upon which a default and final order may be entered without the
taking of testimony or presentation of evidence. A licensee
affected under this paragraph shall at reasonable intervals be
afforded an opportunity to demonstrate that he or she can resume
a competent practice of diabetes self-management education and
training with reasonable skill and safety to individuals or
groups.
(3) The licensee has wilfully or repeatedly violated any of
the provisions of this act or of the regulations of the Board.
(4) The licensee has committed fraud or deceit in:
(i) the practice of nursing, or in securing his or her
admission to such practice or nursing school; [or]
(ii) the practice of dietetics-nutrition or in securing his
or her license as a dietitian-nutritionist[.]; or
(iii) the practice of diabetes self-management education and
training or in securing his or her license as a diabetes
educator.
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(5) The licensee has been convicted, or has pleaded guilty,
or entered a plea of nolo contendere, or has been found guilty
by a judge or jury, of a felony or a crime of moral turpitude,
or has received probation without verdict, disposition in lieu
of trial or an Accelerated Rehabilitative Disposition in the
disposition of felony charges, in the courts of this
Commonwealth, the United States or any other state, territory,
possession or country.
(6) The licensee has his or her license suspended or revoked
or has received other disciplinary action by the proper
licensing authority in another state, territory, possession or
country.
(7) The licensee has acted in such a manner as to present an
immediate and clear danger to the public health or safety.
(8) The licensee possessed, used, acquired or distributed a
controlled substance or caution legend drug for other than an
acceptable medical purpose.
(9) The licensee has been guilty of immoral or
unprofessional conduct. Unprofessional conduct shall include
departure from or failing to conform to an ethical or quality
standard of the profession. The ethical and quality standards of
the profession are those embraced by the professional community
in this Commonwealth. In proceedings based on this clause,
actual injury to a patient or individual or group need not be
established.
(b) When the Board finds that the license of any nurse [or],
dietitian-nutritionist or diabetes educator may be refused,
revoked or suspended under the terms of subsection (a), the
Board may:
(1) Deny the application for a license.
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(2) Administer a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict a license
as determined by the Board.
(4) Require a licensee to submit to the care, counseling or
treatment of a physician or a psychologist designated by the
Board.
(5) Suspend enforcement of its finding thereof and place a
licensee on probation with the right to vacate the probationary
order for noncompliance.
(6) Restore or reissue, in its discretion, a suspended
license to practice professional or practical nursing or
dietetics-nutrition and impose any disciplinary or corrective
measure which it might originally have imposed.
Section 15.4. Injunction or Other Process.--It shall be
unlawful for any person to practice or attempt to offer to
practice nursing [or], to hold himself or herself forth as a
licensed dietitian-nutritionist or to hold himself or herself
forth as a licensed diabetes educator, as defined in this act,
without having at the time of so doing a valid, unexpired,
unrevoked and unsuspended license issued under this act. The
unlawful practice of nursing as defined in this act may be
enjoined by the courts on petition of the Board or the
Commissioner of Professional and Occupational Affairs. In any
such proceeding, it shall not be necessary to show that any
person is individually injured by the actions complained of. If
it is determined that the respondent has engaged in the unlawful
practice of nursing, the court shall enjoin him or her from so
practicing unless and until he or she has been duly licensed.
Procedure in such cases shall be the same as in any other
injunction suit. The remedy by injunction hereby given is in
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addition to any other civil or criminal prosecution and
punishment.
Section 6. The State Board of Nursing shall promulgate all
regulations required to implement this act within two years of
the effective date of this act.
Section 7. This act shall take effect in 90 days.
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