A.R.S. tit. 32 ch. 31 — Arizona Revised Statutes Title 32 Chapter 31 — Regulation Of Health Professions

32-3101. Definitions In this chapter, unless the context otherwise requires: 1. "Certification" means a voluntary process by which a regulatory entity grants recognition to an individual who has met certain prerequisite qualifications specified by that regulatory entity and who may assume or use the word "certified" in a title or designation to perform prescribed health professional tasks. 2. "Grandfather clause" means a provision that is applicable to practitioners who are actively engaged in the regulated health profession before the effective date of a law and that exempts the practitioners from meeting the prerequisite qualifications set forth in the law to perform prescribed occupational tasks. 3. "Health professional group" means any health professional group or organization, any individual or any other interested party that proposes that any health professional group that is not presently regulated be regulated. 4. "Health professions" means professions that are regulated pursuant to chapter 7, 8, 11, 13, 14, 15, 15.1, 16, 17, 18, 19, 19.1, 21, 25, 28, 29, 33, 34, 35, 39 or 41 of this title, title 36, chapter 6, article 7 or title 36, chapter 17. 5. "Inspection" means the periodic examination of practitioners by a state agency in order to ascertain whether the practitioners' occupation is being carried out in a fashion consistent with the public health, safety and welfare. 6. "Licensure" or "license" means an individual, nontransferable authorization to carry on a health activity that would otherwise be unlawful in this state in the absence of the permission and that is based on qualifications that include graduation from an accredited or approved program and acceptable performance on a qualifying examination or a series of examinations. 7. "Practitioner" means an individual who has achieved knowledge and skill by practice and who is actively engaged in a specified health profession. 8. "Public member" means an individual who is not and never has been a member or the spouse of a member of the health profession being regulated and who does not have and never has had a material financial interest in either rendering the health professional service being regulated or an activity directly related to the profession being regulated. 9. "Registration" means the formal notification that, before rendering services, a practitioner must submit to a state agency setting forth the name and address of the practitioner, the location, nature and operation of the health activity to be practiced and, if required by a regulatory entity, a description of the service to be provided. 10. "Regulatory entity" means any board, commission, agency or department of this state that regulates one or more health professions in this state. 11. "State agency" means any department, board, commission or agency of this state. 32-3102. Nonapplicability of chapter This chapter does not: 1. Apply to any regulatory entity legislatively enacted before August 7, 1985, except as provided in this chapter. 2. Apply to or interfere in any way with the practice of religion or any kind of treatment by prayer. 3. Apply to any remedial or technical amendments to any law. 32-3103. Regulation of health professions; legislation; criteria A. Regulation shall not be imposed on any unregulated health profession for the purpose of prohibiting competition, but only for the exclusive purpose of protecting the public interest. All proposed legislation to regulate a health profession for the first time shall be reviewed according to the following criteria. A health profession shall be regulated by this state only if: 1. There is credible evidence that the unregulated practice of that health profession can clearly harm or endanger the public health, safety or welfare and the potential for harm is easily recognizable and not remote or dependent on tenuous argument. 2. The public needs and can reasonably be expected to benefit from an assurance of initial and continuing professional ability. 3. The public cannot be effectively protected by other means in a more cost-beneficial manner. B. After evaluating the criteria prescribed in subsection A of this section and considering governmental and societal costs and benefits, if the legislature finds that it is necessary to regulate a health profession not previously regulated by law, the legislature shall implement the least restrictive alternative method of regulation to address the specific harm or danger identified, consistent with the public interest and the following: 1. If existing common law and statutory civil actions and criminal prohibitions are not sufficient to eradicate existing harm, the regulation shall provide for stricter civil actions and criminal prohibitions. 2. If a service is being performed for individuals that involves a hazard to the public health, safety or welfare, the regulation shall impose inspection requirements and enable an appropriate state agency to enforce violations by injunctive relief in court. 3. If the threat to the public health, safety or economic well-being is relatively small as a result of the operation of the health profession, the regulation shall implement a system of registration. 4. If the consumer may have a substantial basis for relying on the services of a practitioner, the regulation shall implement a system of certification. 5. If it is apparent that adequate regulation cannot be achieved by means other than licensing, the regulation shall implement a system of licensing. 32-3104. Health professional groups; written report; legislative informational hearings; proposed legislation A. A health professional group shall submit a written report explaining the factors prescribed in section 32-3105 to the president of the senate and the speaker of the house of representatives. The report shall be submitted on or before November 1 before the start of the legislative session for which the legislation is proposed, and the health professional group may request informational hearings pursuant to this section. The president of the senate or the speaker of the house of representatives shall assign the written report to the health committee of the house of representatives and the health and human services committee of the senate, or their respective successor committees, and the legislative committees may conduct informational hearings on the written report before the legislative session convenes. The report may be amended after it has been filed but before any hearing on the report. The committees shall study the written report and may take public comment on the report at the informational hearings but shall not vote whether to accept or reject the report filed by the health professional group. A health professional group may seek to introduce legislation in the legislative session regardless of comments, if any, from the informational hearings. B. If a health professional group's report is not heard by a legislative committee pursuant to subsection A of this section, the health professional group may seek to have legislation introduced in the legislative session for certification, registration or licensure. The lack of a hearing shall not be considered as either support or rejection of the health professional group's proposed legislation. C. Unless there is a material change in the proposed certification, registration or licensure, a health professional group is not required to refile a report if the health professional group filed the report within the previous five years. On or before November 1, the health professional group shall notify in writing the speaker of the house of representatives, the president of the senate and the chairpersons of the respective health committees if the health professional group intends to pursue the proposed certification, registration or licensure during the next legislative session and shall reference the specific report that was previously filed on which the health professional group is relying. 32-3105. Health professional groups; proposed regulation; factors A health professional group that is seeking regulation shall explain each of the following factors to the extent requested by the legislative committees: 1. Why regulation is necessary, including: (a) The nature of the potential harm to the public if the health profession is not regulated and the extent to which there is a threat to public health and safety. (b) The extent to which consumers need and will benefit from a method of regulation, identifying competent practitioners and indicating typical employers, if any, of practitioners in the health profession. (c) The extent of autonomy a practitioner has, as indicated by the following: (i) The extent to which the health profession calls for independent judgment and the extent of skill or experience required in making the independent judgment. (ii) The extent to which practitioners are supervised. 2. The efforts made to address the problem, including: (a) Voluntary efforts, if any, by members of the health profession to either: (i) Establish a code of ethics. (ii) Help resolve disputes between health practitioners and consumers. (b) Recourse to and the extent of use of applicable law and whether it could be amended to control the problem. 3. The alternatives considered, including: (a) Regulation of business employers or practitioners rather than employee practitioners. (b) Regulation of the program or service rather than the individual practitioners. (c) Registration of all practitioners. (d) Certification of all practitioners. (e) Other alternatives. (f) Why the use of the alternatives specified in this paragraph would not be adequate to protect the public interest. (g) Why licensing would serve to protect the public interest. 4. The benefit to the public if regulation is granted, including: (a) The extent to which the incidence of specific problems present in the unregulated health profession can reasonably be expected to be reduced by regulation. (b) Whether the public can identify qualified practitioners. (c) The extent to which the public can be confident that qualified practitioners are competent, including: (i) Whether the proposed regulatory entity would be a board composed of members of the profession and public members or a state agency, or both, and, if appropriate, their respective responsibilities in administering the system of registration, certification or licensure, including the composition of the board and the number of public members, if any, the powers and duties of the board or state agency regarding examinations and for cause revocation, suspension and nonrenewal of registrations, certificates or licenses, the adoption of rules and canons of ethics, the conduct of inspections, the receipt of complaints and disciplinary action taken against practitioners and how fees would be levied and collected to pay for the expenses of administering and operating the regulatory system. (ii) If there is a grandfather clause, whether grandfathered practitioners will be required to meet the prerequisite qualifications established by the regulatory entity at a later date. (iii) The nature of the standards proposed for registration, certification or licensure as compared with the standards of other jurisdictions. (iv) Whether the regulatory entity would be authorized to enter into reciprocity agreements with other jurisdictions. (v) The nature and duration of any training, including whether the training includes a substantial amount of supervised field experience, whether training programs exist in this state, if there will be an experience requirement, whether the experience must be acquired under a registered, certified or licensed practitioner, whether there are alternative routes of entry or methods of meeting the prerequisite qualifications, whether all applicants will be required to pass an examination, and if an examination is required, by whom it will be developed and how the costs of development will be met. (d) Assurance of the public that practitioners have maintained their competence, including: (i) Whether the registration, certification or licensure will carry an expiration date. (ii) Whether renewal will be based only on payment of a fee or whether renewal will involve reexamination, peer review or other enforcement. 5. The extent to which regulation might harm the public, including: (a) The extent to which regulation will restrict entry into the health profession, including: (i) Whether the proposed standards are more restrictive than necessary to ensure safe and effective performance. (ii) Whether the proposed legislation requires registered, certified or licensed practitioners in other jurisdictions who relocate to this state to qualify in the same manner as state applicants for registration, certification and licensure if the other jurisdiction has substantially equivalent requirements for registration, certification or licensure as those in this state. (b) Whether there are professions similar to that of the health professional group that should be included in, or portions of the health professional group that should be excluded from, the proposed legislation. 6. The maintenance of standards, including: (a) Whether effective quality assurance standards exist in the health profession, such as legal requirements associated with specific programs that define or enforce standards or a code of ethics. (b) How the proposed legislation will ensure quality, including: (i) The extent to which a code of ethics, if any, will be adopted. (ii) The grounds for suspension or revocation of registration, certification or licensure. 7. A description of the group proposed for regulation, including a list of associations, organizations and other groups representing the practitioners in this state, an estimate of the number of practitioners in each group and whether the groups represent different levels of practice. 8. The expected costs of regulation, including: (a) The impact that registration, certification or licensure will have on the costs of the services to the public. (b) The cost to this state and to the public of implementing the proposed legislation. 32-3106. Health professional groups; increased scope of practice; factors; legislation; notification; definition A. When considering proposed legislation to increase the scope of practice for a health professional group, the legislature shall consider the following factors: 1. Whether current education and training or preparedness or available continuing education and training for that health professional group adequately prepares members of the health professional group for the increased scope of practice sought. 2. Whether increasing the scope of practice will improve patient access to safe and affordable care. 3. Whether increasing the scope of practice will advance health, safety or welfare as defined in section 41-1093. 4. Whether increasing the scope of practice will create a substantial regulatory burden for this state, including the administrative and financial capacity of the regulatory entity that regulates that health professional group. B. Within ten days after the introduction of proposed legislation or an amendment to proposed legislation to increase the scope of practice for a health professional group, the health professional group seeking the increase in the scope of practice shall provide written notification to the regulatory entity that regulates the health professional group regarding the introduction of or amendment to the proposed legislation. C. For the purposes of this section, "increase the scope of practice" means to engage in conduct beyond the authority granted to a health profession by law. 32-3107. Continuing education requirements; evidence of effectiveness Any legislative proposal which contains a continuing education requirement for a health profession shall be accompanied by evidence that such a requirement has been proven effective for the health profession. 32-3108. Grievance process; public testimony Notwithstanding any law to the contrary, a regulatory entity shall allow a person or a representative of a person who has made a complaint or a person or a representative of a person against whom a complaint has been made attending a board disciplinary meeting open to the public to address the board on that complaint on the agenda by filling out a request form before or at the time of the meeting. 32-3121. Definitions In this article, unless the context otherwise requires: 1. "Health profession regulatory board" has the same meaning prescribed in section 32-3201. 2. "Temporary license" means a short-term license issued to a qualified individual to work in this state on a short-term basis by teaching a course, seminar or class, working during the process of receiving a full and active license, working while traveling with a sports or athletic team or providing free services during a declared state or national disaster. 32-3122. Rules A health profession regulatory board may adopt rules to carry out this article. 32-3123. Board delegation; executive director Notwithstanding any other provision of this title, a health profession regulatory board may grant authority to the board's executive director to issue and approve licenses, certifications, registrations, preceptorships, reinstatements or waivers to an applicant or licensee who meets all of the following requirements: 1. Fulfills all requirements of the applicable chapter under this title for licensure, certification, registration, preceptorship, reinstatement or waivers. 2. Has not had a license suspended or revoked by a health profession regulatory board in this or any other jurisdiction. 3. Is not currently under investigation by a health profession regulatory board in this or any other jurisdiction. 4. Has not surrendered a license in lieu of disciplinary action by a health profession regulatory board in this or any other jurisdiction. 5. Has not engaged in any criminal or civil conduct that could be considered unprofessional conduct. 6. Has no disciplinary action on a license issued by a health profession regulatory board in this or any other jurisdiction. 32-3124. Temporary licensure; rules; fee; applicability A. A health profession regulatory board in this state may issue a temporary license to allow an applicant who is not a licensee to practice in this state if the applicant meets all of the following requirements: 1. Holds an active and unrestricted health profession license in a state, territory or possession of the United States. 2. Has never had a health profession license revoked or suspended. 3. Is not the subject of an unresolved complaint against the person's health profession license. 4. Has paid any applicable fees. B. The applicant shall submit to the respective health profession regulatory board a notarized affidavit attesting that the applicant meets the requirements of the respective licensing chapter. The applicant shall notify the board immediately if a circumstance specified in subsection A of this section changes during the application period for a temporary license or while holding a temporary license, at which time the board may suspend, deny or revoke the temporary license. The board may suspend, deny or revoke a temporary license and deny the application for initial licensure if the applicant has misrepresented the attestation required by this subsection or any other portion of the application pursuant to this article. C. A health profession regulatory board shall approve or deny an application under this section within thirty days after an applicant submits a complete application. D. If granted, a temporary license issued pursuant to this section expires the earlier of thirty days after the date the temporary license is granted or on approval or denial of the applicant's license application submitted pursuant to the respective health profession regulatory board. E. For the purpose of meeting the requirements of subsection A of this section, an applicant shall provide the respective health profession regulatory board the name of each state, territory or possession of the United States in which the person is licensed or has held a license, and the board shall verify with the applicable regulatory board that the applicant holds an active and unrestricted license and has never had a license revoked or suspended or surrendered a license for disciplinary reasons. The board may accept the confirmation of this information from each other regulatory board verbally, in writing or through the use of the other regulatory board's website, which shall be followed by either an electronic or hard copy of the verification required. If the board is unable to verify the information within the initial thirty days as required by subsection C of this section, the board may extend the time frame by an additional thirty days to receive the necessary verification. F. The temporary license may not be renewed. G. A health profession regulatory board may not issue more than two temporary licenses to the same applicant within a consecutive twelve-month period. H. A health profession regulatory board may establish an application and fee in rule for temporary licensure under this section. I. This section applies to a health profession regulatory board to the extent that this section does not conflict with the board's current statutory authority relating to temporary licensure.