CCS/HCS/SCS/SB 724 - Currently, advanced practice registered nurses have the authority to administer, dispense and prescribe certain drugs while operating under a collaborative practice agreement. This act authorizes advanced practice registered nurses who hold a certificate of controlled substance prescriptive authority from the board of nursing to prescribe controlled substances in schedules III, IV, and V while operating under a collaborative practice agreement. Schedule III narcotic controlled substance prescriptions shall be limited to a 120 hour supply without refill. Certified registered nurse anesthetists do not have this authority. The act contains requirements that must be contained in all collaborative practice agreements including:
• Names, addresses, and phone numbers of the collaborating individuals.
• A list of offices where the collaborating physician has authorized the APRN to prescribe.
• A requirement that notice shall be displayed at all offices where an APRN is prescribing, that informs patients that they may be seen by an APRN.
• All specialty or board certifications.
• The details of the collaboration including geographic proximity, and how absences are handled.
• A description of the prescriptive authority including a list of controlled substances the physician authorizes.
• A list of all other practice agreements involving the collaborating individuals.
• The duration of the agreement.
• A description of the time and manner of the collaborating physician's review of the APRN's prescribing practices
The act modifies requirements for all collaborative arrangements including the following:
• Physicians shall not collaborate with more than three full time APRNs
• APRNs shall practice for one month in a setting where the collaborating physician is continuously present.
• Neither physicians nor APRNs shall be required to enter collaborative practice agreements.
Collaborative practice arrangements shall not delegate the authority to administer schedule II, IV, or V controlled substances to induce sedation or for general anesthesia for therapeutic, diagnostic or surgical procedures.
Certified registered nurse anesthetists shall be permitted to provide anesthesia services without a collaborative practice arrangement provided that he or she is under the supervision of an anesthesiologist, physician, dentist, or podiatrist who is immediately available if needed.
Rules relating to dispensing or distribution of controlled substances by prescription or prescription drug orders under a collaborative practice arrangement shall be subject to the approval of the department of health and senior services and the state board of pharmacy.
The act defines advanced practice registered nurse, certified advanced registered nurse practitioner, certified clinical nurse specialist, certified nurse midwife, and certified registered nurse anesthetist.
The act includes experience and practice requirements that are prerequisites for the board of nursing to grant a certificate of controlled substance prescriptive authority.
Current law requires certain documentation relating to the sale of products containing pseudoephedrine. For non-prescription pseudoephedrine products, this act requires that the photo identification that must currently be provided to the pharmacist must be issued by a state or the federal government, or another acceptable document and that such identification must be furnished prior to purchase. The log currently maintained by pharmacists is modified to now include the signature of the purchaser, the name of the product and the time of the purchase. The act also requires that the log be electronic, rather than written. Logs of required transactions create a rebuttable presumption that the person whose name appears in the logs is the person whose transactions are recorded in the logs. The seller is required to deliver the product directly into the custody of the purchaser.
The act modifies the current gram limits for the sale of pseudoephedrine products. The act provides that the limits do not apply to quantities that must be sold, dispensed or distributed in a pharmacy under a valid prescription. The current 30 day period limit of 9 grams to a person applies without regard to the number of transactions. Within a twenty-four hour period, no person may obtain more than 3.6 grams without regard to the number of transactions.
The act repeals provisions that exempted the liquid and liquid-filled gel capsule forms of pseudoephedrine from recordkeeping and log maintenance requirements.
Pharmacies must submit information regarding sales of certain pseudoephedrine products in accordance with transmission methods and frequencies established by the department of health and senior services. All logs, records and other documents maintained for the dispensing of pseudoephedrine products shall be open for inspection and copying by law enforcement officers whose duty it is to enforce state or federal controlled substance laws.
In addition, this act modifies and adds to the current names of scheduled controlled substances.
The act removes a provision defining Christian Science nurses as those listed as such in the Christian Science Journal and allows them to use the name Christian Science nurse when providing services to those who choose to rely upon healing by spiritual means alone.
This act is similar to SB 1255 (2004), SCS/SB 90 (2005), SS/SCS/SB 566 (2006), SB 511 (2007), and HCS/SCS/SB 732 (2008). CHRIS HOGERTY