HB4334 SFA Leonhardt 3-8 #1
Bailey 7965
Senators Leonhardt and Williams moved to amend the amendment on pages five through seven by striking out all of section one and inserting in lieu thereof the following:
§30-7-1. Definitions.
As
used in this article the term:
(a)
The practice of "advanced practice registered nurse" is a registered nurse
who has acquired advanced clinical knowledge and skills preparing him or her to
provide direct and indirect care to patients, who has completed a
board-approved graduate-level education program and who has passed a
board-approved national certification examination. An advanced practice
registered nurse shall meet all the requirements set forth by the board by rule
for an advance practice registered nurse which shall include, at a minimum, a
valid license to practice as a certified registered nurse anesthetist, a
certified nurse midwife, a clinical nurse specialist or a certified nurse
practitioner.
(a) “Advanced practice registered nurse” means a registered nurse who has acquired advanced clinical knowledge and skills preparing him or her to provide direct and indirect care to patients as a clinical nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist, or certified nurse specialist, who has completed a board-approved graduate-level education program and who has passed a board-approved national certification examination.
(b) "Board" means the West Virginia Board of Examiners for Registered Professional Nurses;
(c) “Collaborative relationship” means a working relationship, structured through a written agreement, in which an advanced practice registered nurse may prescribe drugs in collaboration with a qualified physician;
(c) (d) The practice of “Practice
of registered professional nursing” or "registered professional
nursing" means the performance for compensation of any service requiring
substantial specialized judgment and skill based on knowledge and application
of principles of nursing derived from the biological, physical and social
sciences, such as responsible supervision of a patient requiring skill in
observation of symptoms and reactions and the accurate recording of the facts,
or the supervision and teaching of other persons with respect to such
principles of nursing, or in the administration of medications and treatments
as prescribed by a licensed physician, or a licensed dentist or
a licensed advanced practice registered nurse, or the application of such
nursing procedures as involve understanding of cause and effect in order to
safeguard life and health of a patient and others; and
(d) "Temporary permit" means a permit authorizing the holder to practice registered professional nursing in this state until such permit is no longer effective or the holder is granted a license by the West Virginia State Board of Examiners for Registered Professional Nurses.;
On page eleven, after section seven, by striking out the remainder of the amendment and inserting in lieu thereof the following:
§30-7-15a. Prescriptive authority for prescription drugs; coordination with Board of Pharmacy; rule-making authority.
(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 this article and all other
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 or 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 thirty day 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 fifteen-b of this article, 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.
(c) The board may promulgate emergency rules to implement the provisions of this article pursuant to section fifteen, article three, chapter twenty-nine-a of this code.
(d) The board shall consult with other appropriate
boards for the development of the formulary.
(e) (d) 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; collaborative relationships and agreements.
(a) An advanced practice registered nurse who
applies for authorization to prescribe drugs shall be eligible to apply
for authorization to prescribe drugs pursuant to section fifteen-a of this
article after satisfying the following requirements:
(a) (1) Be licensed and certified in West
Virginia as an advanced practice registered nurse;
(b) (2) Not be less than Be at
least eighteen years of age;
(c) (3) Provide the board with evidence
of successful completion of Have completed 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 have
been completed within the two-year period immediately before the date of
application prior to entering into a prerequisite collaborative
relationship;
(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
(4) Does not have his or her advanced practice registered nursing license, certification or registration in any jurisdiction suspended, limited or revoked; and
(e) (5) Submit a completed, notarized
application to the board, accompanied by a fee as established by the board by
rule.
(b) The board shall authorize an applicant to prescribe prescription drugs under the terms of a collaborative agreement and in accordance with section fifteen-a of this article and applicable legislative rules if the applicant has met the prerequisites of subsection (a) of this section and the following additional perquisites are satisfied:
(1) The board is satisfied that the collaborating physician is licensed in good standing;
(2) The collaborative agreement is sufficient in form;
(3) The applicant has completed the education requirements; and
(4) The applicant has submitted a completed application on forms developed by the board and paid an application fee established by the board in legislative rule.
(c) A collaborative agreement for a collaborative relationship for prescriptive practice between a physician and an advanced practice registered nurse shall be set forth in writing and include, but not be 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 collaborating physician;
(3) Periodic and joint evaluation of prescriptive practice; and
(4) Periodic joint review and updating of the written guidelines or protocols.
(d) Verification of a collaborative agreement shall be filed with the board by the advanced practice registered nurse with documentation of completion of the education requirements described in subsection (a) of this section. The board shall forward a copy of the verified agreement to the board through which the collaborative physician is licensed.
(e) An advanced practice registered nurse who has practiced at least two years in a duly-documented collaborative relationship with granted prescriptive authority may prescribe prescription drugs without the further requirement of a collaborative relationship, unless the board determines, by order arising out of the board’s complaint process, that a collaborative relationship is necessary for the rehabilitation of a licensee or for protection of the public.
§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 if such an agreement is required.
(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. Global allowance for 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. This section shall not be construed to expand the scope of practice of an advanced practice registered nurse outside his or her area of specialty.;
And,
On page one, by striking out the enacting section and inserting in lieu thereof a new enacting section, to read as follows:
That §30-15-1, §30-15-2, §30-15-3, §30-15-4, §30-15-5, §30-15-6, §30-15-7, §30-15-7a, §30-15-7b, §30-15-7c and §30-15-8, of the Code of West Virginia, 1931, as amended, be repealed; that §16-5-19 of said code be amended and reenacted; that §30-7-1, §30-7-2, §30-7-6, §30-7-7, §30-7-15a, §30-7-15b and §30-7-15c 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:.
Adopted
Rejected