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Introduced Version Senate Bill 471 History

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Key: Green = existing Code. Red = new code to be enacted

Senate Bill No. 471

(By Senators Foster, Laird, Kessler (Acting President), Prezioso, Wills, Minard, Klempa, Yost and McCabe)

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[Introduced February 9, 2011; referred to the Committee on Health and Human Resources; and then to the Committee on the Judiciary.]

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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.

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