House to consider Senate Bill 65
by C/CPT RICHMOND COMBS
Bill would give nurses prescriptive authority
A measure seeking to give advanced registered nurse practitioners the authority to write prescriptions for certain narcotics passed late last week through the House Health and Welfare committee and will now go to the full House for consideration.
Senate Bill 65, which is co-sponsored by Senator Daniel Mongiardo (D), a Hazard physician, was introduced to the Senate on Jan. 6 and was passed with a 32-4 vote later that same month.
The bill would grant authority to registered nurse practitioners to issue prescriptions for schedule I, II, III, IV and V controlled substances, which includes such drugs as hydrocodone, Valium and Xanax. However, the bill only allows for the issuance of the prescriptions, not dispensing of them.
Registered nurse practitioners, by profession, perform additional medical assistance with gained or added knowledge and skills acquired through an organized program of study and clinical experience.
Senate Bill 65 is co-sponsored, along with Mongiardo, by five other Senators - Senator Gary L. Tapp (R-Waddy); Senator Brett Guthrie (R-Bowling Green); Senator Walter Bevins Jr. (D-Sandy Hook); Senator Denise Harper Angel (D-Louisville); and Senator Joey Pendleton (D-Hopkinsville).
Details of the bill also includes conditions saying that schedule II drugs would be limited to a 72-hour supply with no refills, while phychostimulants would be limited to a 30-day supply. Schedule III drugs would be limited to a 30-day supply with no refills and schedule IV and V drugs would be limited to the original prescription and refills not to exceed a six-month supply.
Other provisions would require the nurse practitioner who would be prescribing the drugs to enter into a written collaborative agreement with a physician, and also require the nurse to obtain certification from the U.S. Drug Enforcement Agency. In addition, the bill, if passed, would require the nurse practitioner and the collaborating doctor to have the same or similar specialty qualifications.
Another condition of the bill would allow the Cabinet for Health and Family Services to provide data to the Board of Nursing concerning nurses who are associated with a physician or nurse practitioner who is under investigation for improper prescribing practices, or are in a geographical area where there is either a trend report or report on a nurse practitioner or physician that points to a substantial possibility that inappropriate prescribing may be occurring.
The bill failed to pass in both the 2004 and 2005 sessions of the General Assembly, and was met then, and now, with a fair amount of opposition.
Following passage of the bill through the Senate, UNITE Executive Director, Karen Engle, issued a statement blasting the notion of adding medical professionals of any kind to the list of those who could prescribe controlled substances.
“This is a bad bill for Kentucky, and especially those living in southern and eastern Kentucky,” Engle said in her statement. “It is difficult enough to enforce existing drug laws without increasing the number of individuals who have authority to prescribe controlled substances.”
Engle also pointed out that the Kentucky Medical Association has “strongly opposed” such widening of the commonwealth's prescriptive authority boundaries, as well as citing data compiled by a legislative research committee in 2004 which reported that states were registered nurse practitioners prescribed controlled substances had higher per capita levels of controlled substances than states where they did not. Engle said in her statement that it was also found during that 2004 study that areas where these prescribing practices were taking place also wielded a higher number of emergency room mentions for narcotics.
“Kentucky does not need another portal for controlled substances given these statements coupled with our current drug diversion problem,” Engle continued. “Allowing Advanced Registered Nurse Practitioners to prescribe controlled substances would only add to the potential for abuse.”
Members of the Senate were meeting earlier in the week in Frankfort, and Mongiardo, along with his co-sponsors, could not be reached for comment on the bill.
According to the Kentucky Board of Nursing, there are 2,953 Advanced Registered Nurse Practitioners across the commonwealth.
story by Sheldon Compton
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