Introduced Version
Senate Bill 379 History
| Email
Key: Green = existing Code. Red = new code to be enacted
Senate Bill No. 379
(By Senators Beach, Kessler (Mr. President), Blair, Boley, D.
Hall, Miller, Fitzsimmons, Laird and Sypolt)
____________
[Introduced February 27, 2013; referred to the Committee on
Health and Human Resources; and then to the Committee on
Government Organization .]
____________
A BILL to amend and reenact §30-7-15a, §30-7-15b and §30-7-15c of
the Code of West Virginia, 1931, as amended; and to amend and
reenact §30-15-7, §30-15-7a, §30-15-7b and §30-15-7c of said
code, all relating to expanding prescriptive authority of
advanced nurse practitioners and certified nurse-midwives;
and removing the requirement for collaborative relationships
with physicians.
Be it enacted by the Legislature of West Virginia:
That §30-7-15a, §30-7-15b and §30-7-15c of the Code of West
Virginia, 1931, as amended, be amended and reenacted; and that
§30-15-7, §30-15-7a, §30-15-7b and §30-15-7c of said code be
amended and reenacted, all to read as follows:
ARTICLE 7. REGISTERED PROFESSIONAL NURSES.
§30-7-15a. Prescriptive authority for prescription drugs;
coordination with Board of Pharmacy.
(a) The board may, in its discretion, authorize an advanced
practice registered nurse to prescribe prescription drugs in a
collaborative relationship with a physician licensed to practice
in West Virginia and in accordance with applicable state and
federal laws. An authorized advanced practice registered nurse
may write or sign prescriptions or transmit prescriptions verbally
or by other means of communication.
(b) For purposes of this section an agreement to a
collaborative relationship for prescriptive practice between a
physician and an advanced practice registered nurse shall be set
forth in writing. Verification of the agreement shall be filed
with the board by the advanced practice registered nurse. The
board shall forward a copy of the verification to the Board of
Medicine and the Board of Osteopathic Medicine. Collaborative
agreements shall include, but are not limited to, the following:
(1) Mutually agreed upon written guidelines or protocols for
prescriptive authority as it applies to the advanced practice
registered nurse's clinical practice;
(2) Statements describing the individual and shared
responsibilities of the advanced practice registered nurse and the
physician pursuant to the collaborative agreement between them;
(3) Periodic and joint evaluation of prescriptive practice;
and
(4) Periodic and joint review and updating of the written
guidelines or protocols.
(c) (b) The board shall promulgate legislative rules in
accordance with the provisions of chapter twenty-nine-a of this
code governing the eligibility and extent to which an advanced
practice registered nurse may prescribe drugs. Such rules shall
provide, at a minimum, a state formulary classifying those
categories of drugs which shall not be prescribed by advanced
practice registered nurse including, but not limited to, Schedules
I and II of the Uniform Controlled Substances Act,
antineoplastics, radiopharmaceuticals and general anesthetics.
Drugs listed under Schedule III shall be limited to a seventy-two
hour supply without refill. In addition to the above referenced
provisions and restrictions and pursuant to a collaborative
agreement as set forth in subsections (a) and (b) of this section,
the rules and shall permit the prescribing of an annual supply of
any drug, with the exception of controlled substances, which is
prescribed for the treatment of a chronic condition, other than
chronic pain management. For the purposes of this section, a
"chronic condition" is a condition which lasts three months or
more, generally cannot be prevented by vaccines, can be controlled but not cured by medication and does not generally disappear.
These conditions, with the exception of chronic pain, include, but
are not limited to, arthritis, asthma, cardiovascular disease,
cancer, diabetes, epilepsy and seizures, and obesity. The
prescriber authorized in this section shall note on the
prescription the chronic disease being treated.
(d) The board shall consult with other appropriate boards for
the development of the formulary.
(e) (c) The board shall transmit to the Board of Pharmacy a
list of all advanced practice registered nurse with prescriptive
authority. The list shall include:
(1) The name of the authorized advanced practice registered
nurse;
(2) The prescriber's identification number assigned by the
board; and
(3) The effective date of prescriptive authority.
§30-7-15b. Eligibility for prescriptive authority; application;
fee.
An advanced practice registered nurse who applies for
authorization to prescribe drugs shall:
(a) Be licensed and certified in West Virginia as an advanced
practice registered nurse;
(b) Not be less than Be at least eighteen years of age;
(c) Provide the board with evidence of successful completion
of forty-five contact hours of education in pharmacology and
clinical management of drug therapy under a program approved by
the board, fifteen hours of which shall be completed within the
two-year period immediately before the date of application;
(d) Provide the board with evidence that he or she is a
person of good moral character and not addicted to alcohol or the
use of controlled substances; and
(e) Submit a completed, notarized application to the board,
accompanied by a fee as established by the board by rule.
§30-7-15c. Form of prescriptions; termination of authority;
renewal; notification of termination of authority.
(a) Prescriptions authorized by an advanced practice
registered nurse must comply with all applicable state and federal
laws; must be signed by the prescriber with the initials
"A.P.R.N." or the designated certification title of the
prescriber; and must include the prescriber's identification
number assigned by the board or the prescriber's national provider
identifier assigned by the National Provider System pursuant to 45
C. F. R. §162.408.
(b) Prescriptive authorization shall be terminated if the
advanced practice registered nurse has:
(1) Not maintained current authorization as an advanced
practice registered nurse; or
(2) Prescribed outside the advanced practice registered
nurse's scope of practice or has prescribed drugs for other than
therapeutic purposes. or
(3) Has not filed verification of a collaborative agreement
with the board.
(c) Prescriptive authority for an advanced practice
registered nurse must be renewed biennially. Documentation of
eight contact hours of pharmacology during the previous two years
must be submitted at the time of renewal.
(d) The board shall notify the Board of Pharmacy the Board of
Medicine and the Board of Osteopathic Medicine within twenty-four
hours after termination of, or change in, an advanced practice
registered nurse's prescriptive authority.
ARTICLE 15. NURSE-MIDWIVES.
§30-15-7. Standards of practice.
The license to practice nurse-midwifery shall entitle
entitles the holder to practice such the profession according to
the statement of standards of the American College of Nurse-
Midwives. and such holder shall be required to practice in a
collaborative relationship with a licensed physician engaged in
family practice or the specialized field of gynecology or obstetrics, or as a member of the staff of any maternity, newborn
or family planning service approved by the West Virginia
Department of Health and Human Resources, who, as such, shall
practice nurse-midwifery in a collaborative relationship with a
board-certified or board-eligible obstetrician, gynecologist or
the primary-care physician normally directly responsible for
obstetrical and gynecological care in said area of practice.
§30-15-7a. Prescriptive authority for prescription drugs;
promulgation of rules; classification of drugs to
be prescribed; coordination with Board of
Pharmacy.
(a) The board shall, in its discretion, authorize a nurse-
midwife to prescribe prescription drugs in a collaborative
relationship with a physician licensed to practice in West
Virginia and in accordance with applicable state and federal laws.
An authorized nurse-midwife may write or sign prescriptions or
transmit prescriptions verbally or by other means of
communication.
(b) For purposes of this section an agreement to a
collaborative relationship for practice between a physician and a
nurse-midwife shall be set forth in writing. Verification of such
agreement shall be filed with the board by the nurse-midwife. The
board shall forward a copy of such verification to the Board of Medicine. Collaborative agreements shall include, but not be
limited to, the following:
(1) Mutually agreed upon written guidelines or protocols for
prescriptive practice as it applies to the nurse-midwife's
clinical practice;
(2) Statements describing the individual and shared
responsibilities of the nurse-midwife and the physician pursuant
to the collaborative agreement between them;
(3) Periodic and joint evaluation of prescriptive practice;
and
(4) Periodic and joint review and updating of the written
guidelines or protocols.
(c) (b) The board shall promulgate legislative rules in
accordance with the provisions of chapter twenty-nine-a of this
code governing the eligibility and extent to which a nurse-midwife
may prescribe drugs. Such rules shall provide, at a minimum, a
state formulary classifying those categories of drugs which shall
not be prescribed by nurse-midwives, including, but not limited
to, Schedules I and II of the Uniform Controlled Substances
Act, anticoagulants, antineoplastics, radio-pharmaceuticals and
general anesthetics. Drugs listed under schedule III shall be
limited to a seventy-two hour supply without refill.
(d) The board shall consult with other appropriate boards for
development of the formulary.
(e) (c) The board shall transmit to the Board of Pharmacy a
list of all nurse-midwives with prescriptive authority. The list
shall include:
(1) The name of the authorized nurse-midwife;
(2) The prescriber's identification number assigned by the
board; and
(3) The effective date of prescriptive authority.
§30-15-7b. Eligibility for prescriptive authority; application;
fee.
A nurse-midwife who applies for authorization to prescribe
drugs shall:
(a) Be licensed and certified as a nurse-midwife in the State
of West Virginia;
(b) Not be less than Be at least eighteen years of age;
(c) Provide the board with evidence of successful completion
of forty-five contact hours of education in pharmacology and
clinical management of drug therapy under a program approved by
the board, fifteen of which shall be completed within the two-year
period immediately before the date of application;
(d) Provide the board with evidence that he or she is a
person of good moral character and not addicted to alcohol or the
use of controlled substances; and
(e) Submit a completed, notarized application to the board,
accompanied by a fee of $125 as established by the board by rule.
§30-15-7c. Form of prescription; termination of authority;
renewal; notification of termination of authority.
(a) Prescriptions authorized by a nurse-midwife must comply
with all applicable state and federal laws; must be signed by the
prescriber with the initials "C.N.M."; and must include the
prescriber's identification number assigned by the board.
(b) Prescriptive authorization shall be terminated if the
nurse-midwife has:
(1) Not maintained current authorization as a nurse-midwife;
or
(2) Prescribed outside the nurse-midwife's scope of practice
or has prescribed drugs for other than therapeutic purposes. or
(3) Has not filed verification of a collaborative agreement
with the board.
(c) Prescriptive authority for a nurse-midwife must be
renewed biennially. Documentation of eight contact hours of
pharmacology during the previous two years must be submitted at
the time of renewal.
(d) The board shall notify the Board of Pharmacy and the
Board of Medicine within twenty-four hours after termination of,
or change in, a nurse-midwife's prescriptive authority.
NOTE: The purpose of this bill is to allow advanced practice
registered nurses and certified nurse-midwives to practice
independently.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that
would be added.