HOUSE BILL REPORT

HB 2451

BYRepresentatives Prentice, D. Sommers, Sprenkle, Rayburn, Ferguson, Day, Moyer, Rector, P. King, Wang, Spanel and Brekke

Authorizing advanced registered nurse practitioners to prescribe certain drugs.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (9)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Brooks, Ranking Republican Member; Cantwell, Morris, Prentice, Sprenkle, Vekich and Wolfe.

Minority Report:  Do not pass.  (1)

      Signed by Representative Chandler.

House Staff:John Welsh (786-7133)

AS REPORTED BY COMMITTEE ON HEALTH CARE JANUARY 30, 1990

BACKGROUND:

The Board of Nursing may grant a license to an advanced registered nurse practitioner with prescriptive authority for Schedule V controlled substances, which are drugs with the lowest addictive properties.  The nurse practitioner must be credentialed with at least 30 hours of training in pharmacology initially, and additionally with 15 hours every two years in connection with license renewal.

Nurses may not otherwise prescribe controlled substances.

Controlled substances are those drugs specified by law with addictive properties according to levels of addiction categorized within schedules.  Schedule I includes drugs with the highest potential for abuse and no acceptable medical use and used primarily in research.  Schedule II includes drugs with a high potential for abuse. Schedule III includes drugs with a lower potential for abuse that may lead to moderate physical dependency but high psychological dependency.  Schedule IV includes drugs with low potential for abuse that may lead to limited physical and psychological dependency.  The drugs on schedules II through IV have acceptable medical uses.

SUMMARY:

SUBSTITUTE BILL:  The Board of Nursing is authorized to regulate by rule the prescriptive privileges for advanced registered nurse practitioners who may prescribe controlled substances on schedules II through V.  The board shall require continuing education as a condition of prescriptive authority, conduct audits, and develop a monitoring system in consultation with the Board of Pharmacy.

Dispensing of these controlled substances is limited to emergency situations and to a 72- hour supply.

The board is required to develop a monitoring system, in consultation with the Board of Pharmacy and Board of Medical Examiners, and conduct random audits, via the use of triplicate prescription forms.

This prescriptive authority continues through June 1994, and the board is required to report in January 1994 to the health care committees of the House of Representatives and Senate with the results of the random audits and monitoring system.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  The substitute bill adds other requirements and conditions for the granting of prescriptive authority. The board is required to adopt rules for prescriptive privileges and for continuing education in pharmacology.  It is also required to develop a monitoring system.  The authority to prescribe continues through June 1994, and a report to the Legislature is required in January 1994 for considering an extension of prescriptive authority.

Fiscal Note:      Requested January 23, 1990.

House Committee ‑ Testified For:    Claire Foote; Don Williams, State Board of Pharmacy; Lars Hennum, Pharmacists of Washington.

House Committee - Testified Against:      No one.

House Committee - Testimony For:    With the shortage and maldistribution of physicians in rural areas, patients often go without necessary medical care, including drugs.  Nurse practitioners, especially in rural areas, must meet patient needs.  These practitioners have training in pharmacology and a requirement for continuing education as well.

House Committee - Testimony Against:      None.