Senate Bill No. 471
(By Senators Foster, Laird, Kessler (Acting President), Prezioso,
Wills, Minard, Klempa, Yost and McCabe)
____________
[Introduced February 9, 2011; referred to the Committee on Health
and Human Resources; and then to the Committee on the Judiciary.]
____________
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 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;
promulgation of rules; coordination with Board
of Pharmacy.
(a) The board may, in its discretion, authorize an advanced
nurse practitioner 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 nurse practitioner may
write or sign prescriptions or transmit prescriptions verbally or
by other means of communication.
The Board of Examiners for
Registered Professional Nurses as set forth in section three,
article seven of this chapter has sole authority to govern and
regulate the practice of advanced nurse practitioners.
(b) For purposes of this section an agreement to a
collaborative relationship for prescriptive practice between a
physician and an advanced nurse practitioner shall be set forth
in writing. Verification of such agreement shall be filed with
the board by the advanced nurse practitioner. 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 authority as it applies to the advanced nurse
practitioner's clinical practice;
(2) Statements describing the individual and shared
responsibilities of the advanced nurse practitioner 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
nurse practitioner
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
nurse practitioners, 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 the development of the formulary. is allowed to have
prescriptive authority.
(e) (c) The board shall transmit to the Board of Pharmacy a
list of all advanced nurse practitioners with prescriptive
authority. The list shall include:
(1) The name of the authorized advanced nurse practitioner;
(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 nurse practitioner who applies for authorization
to prescribe drugs shall:
(a) Be licensed
and certified in West Virginia as an
advanced nurse practitioner holding a baccalaureate degree in
science or the arts as a registered professional nurse in West Virginia and recognized in West Virginia as an advanced nurse
practitioner with a graduate degree in nursing from a school of
nursing accredited by a nationally recognized nursing
accreditation body approved by the United States Department of
Education;
(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 of $125.
§30-7-15c. Form of prescriptions; termination of authority;
renewal; notification of termination of authority.
(a) Prescriptions authorized by an advanced nurse
practitioner must comply with all applicable state and federal
laws; must be signed by the prescriber with the initials "A.N.P."
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 CFR §162.408.
(b) Prescriptive authorization shall be terminated if the
advanced nurse practitioner has:
(1) Not maintained current authorization as an advanced
nurse practitioner; or
(2) Prescribed outside the advanced nurse practitioner'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 nurse
practitioner 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, an advanced nurse practitioner's prescriptive
authority.
ARTICLE 15. NURSE-MIDWIVES.
§30-15-7. Practice in accordance with the statement of standards
of the American College of Nurse-Midwives.
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; 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.
The Board of Examiners for Registered
Professional Nurses as set forth in section three, article seven
of this chapter has sole authority to govern and regulate the
practice of nurse-midwives.
(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.
§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 nurse
practitioners 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.