West Virginia Legislature
2016 Regular Session
Introduced
House Bill 2450
2015 Carryover
(By Delegates Campbell, Eldridge, Householder, Marcum, Ferro, Perry and Summers)
[Introduced January 13, 2016; referred to the
Committee on Health and Human Resources then 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; to amend and reenact §30‑15‑7, §30‑15‑7a, §30‑15‑7b and §30‑15‑7c of said code; and to amend said code by adding thereto a new section, designated §30‑7‑15d, all relating to expanding prescriptive authority of advanced practice registered nurses and certified nurse‑midwives; permitting advanced practice registered nurses to prescribe an annual supply of controlled substances; permitting the signature of an advanced practice registered nurse to have the same force and effect as that of a physician insofar as patient care documentation is concerned; removing the requirement for collaborative relationships with physicians; removing certain notifications; removing the minimum requirements for certain legislative rules; and permitting certain fees to be set by rule.
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; that §30‑15‑7, §30‑15‑7a, §30‑15‑7b and §30‑15‑7c of said code be amended and reenacted; and that said code be amended by adding thereto a new section, designated §30‑7‑15d, 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 propose
legislative rules for legislative approval 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 The rules 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 nurses 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 AA.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.
§30‑7‑15d. Allowance for global signatures on patient care by advanced practice registered nurses.
Whenever any law or rule requires a signature, certification, stamp, verification, affidavit or endorsement by a physician, the signature, certification, stamp, verification, affidavit or endorsement of an advanced practice registered nurse is permitted to have the same force and effect.
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 proposing
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 propose legislative
rules for legislative approval 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 expand the prescriptive authority of advanced practice registered nurses and certified nurse‑midwives and to remove the requirement for collaborative relationships with physicians. The bill permits advanced practice registered nurses to prescribe annual supplies of controlled substances. The bill permits the signature of an advanced practice registered nurse to have the same force and effect as that of a physician insofar as patient care documentation is concerned. The bill removes certain notifications. The bill removes the minimum requirements for certain legislative rules and permits certain fees to be set by rule.
Strike‑throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.
§30-7-15d is new; therefore, it has been completely underscored.