HOUSE BILL REPORT

                 SSB 5805

             As Reported By House Committee On:

                         Health Care

Title:  An act relating to completion of prescriptive authority for advanced registered nurse practitioners.

Brief Description:  Completing the prescriptive authority of advanced registered nurse practitioners.

Sponsors:  Senate Committee on Health & Long‑Term Care (originally sponsored by Senators Thibaudeau, Prentice, Deccio, Kohl‑Welles and Costa).

Brief History:

  Committee Activity:

Health Care:  2/17/00, 2/25/00 [DP].

           Brief Summary of Substitute Bill

$Advanced registered nurse practitioners may order and prescribe legend drugs included in Schedules II through IV Controlled Substances, limited to a 72-hour supply.

$The medical and nursing commissions and osteopathic board must jointly adopt, by consensus, joint practice arrangements.

HOUSE COMMITTEE ON HEALTH CARE

Majority Report:  Do pass.  Signed by 12 members:  Representatives Cody, Democratic Co-Chair; Parlette, Republican Co-Chair; Pflug, Republican Vice Chair; Schual-Berke, Democratic Vice Chair; Alexander; Campbell; Conway; Edmonds; Edwards; Mulliken; Pennington and Ruderman.

Staff:  John Welsh (786-7133).

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 specialities.  ARNPs may have specialities in such areas as pediatrics, geriatrics, midwifery, anesthesiology, neonatology.  They must maintain a current certification in their specialized field in order to practice independently.

ARNPs have authority to prescribe legend drugs and controlled substances contained in Schedule V of the Uniform Controlled Substances Act, Chapter 69.50 RCW.  ARNPs are required to have 30 hours of education in pharmacotherapeutics related to their scope of specialized and advance practice.  All ARNPs, except nurse anesthetists, are prohibited from prescribing schedules I through IV.  Certified registered nurse anesthetists may prescribe schedule II through IV drugs limited to those drugs which are to be directly administered to patients who require anesthesia.

In 1991 legislation proposed expanding the authority of ARNPs to prescribe schedules II through IV.  The Department of Health conducted a sunrise review to analyze issues of health and safety related to this request.

Summary of Bill:

Advanced registered nurse practitioners are given expanded prescriptive authority to include schedule II through IV drugs of the Uniform Controlled Substances Act.  ARNPs may order or prescribe these drugs under joint practice arrangements and collaboration with a physician or osteopathic physician.

The Medical Quality Assurance Commission, the Board of Osteopathic Medicine and Surgery and the Nurse's Quality Assurance Commission are directed to jointly adopt a process and criteria to implement the joint practice arrangements.

The dispensing of schedules II through IV controlled substances is limited to a maximum of a 72-hour supply of the prescribed controlled substance.

Appropriation:  None.

Fiscal Note:  Not requested.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  The Sunrise Review done by the Department of Health had findings which supported the department's recommendations on the need for the bill.  ARNPs practice in rural areas where access of patients to appropriate legend drugs is less available.  ARNPs have substantially the same training in pharmacology as other professions with prescriptive authority.

Testimony Against:  None.

Testified:  Jerry Farley, Mary Moller, Ann Darlington, and Larry Kerschner, Advanced Registered Nurse Practitioners United; and Carl Nelson, Washington State Medical Association.