HOUSE BILL REPORT
HB 1479
As Passed House:
March 3, 2005
Title: An act relating to independent prescriptive authority for advanced registered nurse practitioners.
Brief Description: Regarding independent prescriptive authority for advanced registered nurse practitioners.
Sponsors: By Representatives Morrell, Campbell, Schual-Berke, Nixon, Cody, Green, Appleton, Clibborn, Simpson and Moeller.
Brief History:
Health Care: 2/10/05, 2/15/05 [DP].
Floor Activity:
Passed House: 3/3/05, 74-23.
Brief Summary of Bill |
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HOUSE COMMITTEE ON HEALTH CARE
Majority Report: Do pass. Signed by 11 members: Representatives Cody, Chair; Campbell, Vice Chair; Morrell, Vice Chair; Curtis, Assistant Ranking Minority Member; Appleton, Clibborn, Green, Lantz, Moeller, Schual-Berke and Skinner.
Minority Report: Do not pass. Signed by 4 members: Representatives Bailey, Ranking Minority Member; Alexander, Condotta and Hinkle.
Staff: Chris Blake (786-7392).
Background:
Advanced registered nurse practitioners (ARNP) are registered nurses with formal specialized
training which qualifies them to function more independently than a registered nurse in a
variety of health care specialties. The ARNPs may have specialties in such areas as
pediatrics, geriatrics, midwifery, anesthesiology, and neonatology. This additional training
allows ARNPs to assume primary care responsibilities for a broad range of patient care
beyond the practice of registered nurses.
The ARNPs may only prescribe legend drugs and controlled substances contained in
Schedule V of the Uniform Controlled Substances Act. There are two exceptions to this
limitation. First, an ARNP who is a certified register nurse anesthetist may select, order, and
administer Schedule II through IV controlled substances for anesthesia services at the request
of a physician, osteopathic physician, dentist, or podiatrist. Second, an ARNP may order or
prescribe Schedule II through IV controlled substances consistent with his or her scope of
practice and in response to a request from a physician or osteopathic physician and an ARNP
to enter into a joint practice arrangement. The joint practice arrangement must describe the
collaboration between the ARNP and the physician or osteopathic physician, including when
consultation shall occur, methods of communication, and documentation of the consultation.
Summary of Bill:
The ARNPs may prescribe Schedule II through IV controlled substances as consistent with
their scope of practice without entering into a joint practice arrangement with a physician or
osteopathic physician. Rulemaking authority related to joint practice arrangements is
removed.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date: The bill takes effect 90 days after adjournment of session in which bill is passed.
Testimony For: Allowing advanced registered nurse practitioners to prescribe drugs without a joint practice arrangement will increase access to health care. Data shows that advanced registered nurse practitioners do not need a joint practice arrangement to practice safely. Obtaining a joint practice arrangement has been difficult for many.
Testimony Against: This would allow advanced registered nurse practitioners to practice as physicians, despite the lack of training.
Persons Testifying: (In support) Representative Morrell, prime sponsor; Dwight Bushue,
Association of Advanced Practice Psychiatric Nurses; Nick Federici, Advanced Registered
Nurse Practitioners United; and Louise Kaplan, Washington State Nurses Association.
(Opposed) Carl Nelson, Washington State Medical Association.