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: Senators Thibaudeau, Deccio, Benton, Keiser, Pflug, Rockefeller, Prentice, Kohl-Welles, Franklin, McAuliffe and Benson.

Brief History:

Committee Activity: Health & Long-Term Care: 2/7/05, 2/28/05 [DP, DNP, w/oRec].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report: Do pass.Signed by Senators Keiser, Chair; Thibaudeau, Vice Chair; Franklin, Kastama, Kline and Poulsen.

Minority Report: Do not pass.Signed by Senators Johnson and Parlette.

Minority Report: That it be referred without recommendation.Signed by Senator Brandland.

Staff: Stephanie Yurcisin (786-7438)

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

ARNPs have had authority to prescribe legend drugs, and controlled substances contained in Schedule V of the Uniform Controlled Substances Act, Chapter 69.50 RCW for years. In 2000, legislation was passed expanding the prescriptive authority for ARNPs to include schedules II through IV drugs of the Uniform Controlled Substances Act. ARNPs were given this expansion to order or prescribe these drugs under joint practice arrangements and collaboration with a physician or osteopathic physician.

Summary of Bill: All ARNPs may prescribe controlled substances contained in Schedules II through V of the Uniform Controlled Substances Act without entering into joint practice arrangements and without formal collaboration with physicians or osteopathic physicians.

Appropriation: None.

Fiscal Note: Not requested.

Committee/Commission/Task Force Created: No.

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

Testimony For: Allowing ARNPs to prescribe these controlled substances without a joint practice agreement allows for greater access to care, especially for those patients living in rural areas. There have been no disciplinary actions in cases brought against ARNPs for prescription writing since the joint practice agreement arrangement began five years ago. The ARNPs are only allowed to write prescriptions in their scope of practice, which is a further safeguard.

Testimony Against: ARNPs need to have a connection with physicans when prescribing more dangerous, addictive drugs. Current law, which allows them to do this with collaboration, is sufficient.

Who Testified: PRO: Louise Kaplan, Washington State Nursing Association; Donna Poole, Association of Advanced Practicing Psychiatric Nurses; Patty Varley, Advanced Registered Nurse Practitioners United.

CON: Carl Nelson, Washington State Medical Association.