By Joanne Kenna, R.N., J.D., The Health Law Firm
Under new law passed just this month, Advanced Registered Nurse Practitioners (ARNPs) in Florida will be able to prescribe controlled substances beginning January 1, 2017. This increased prescriptive power will be permitted under the supervision and protocol requirements that already exist for ARNPs, and will require that the ARNPs register as controlled substance prescribers (i.e., hold a valid federal controlled substance registry number). ARNPs who are controlled substance prescribers also must indicate this on their practitioner profiles.
There will be some restrictions, limitations and requirements:
• Only ARNPs who have graduated from a program leading to a master’s or doctoral degree in a nursing clinical specialty area with training in specialized practitioner skills will be eligible to prescribe controlled substances.
• ARNPs will only be allowed to issue prescriptions for Schedule II controlled substances for a period limited to a 7-day supply. However, psychiatric ARNPs will not be limited to this 7-day supply limitation when prescribing Schedule II psychiatric drugs.
• A joint committee, composed of three (3) ARNP members, three (3) physician (any combination of M.D. or D.O.) members, and a doctor of pharmacy member, will establish a formulary of controlled substances that an ARNP will not be allowed to prescribe, or will be allowed to prescribe only for specific uses, or in limited quantity, or only if the ARNP has certain specialty certification. The initial formulary recommended by the committee is to be adopted by the Board of Nursing by no later than October 31, 2016.
• The legislature has designated that the formulary must restrict the prescribing of psychiatric mental health controlled substances for children younger than 18 years of age to ARNPs who also are psychiatric nurses (i.e., a master’s or doctoral degree in psychiatric nursing and two (2) years of post-master’s degree clinical experience under the supervision of a physician).
• ARNPs who prescribe controlled substances will be required to complete three (3) hours of continuing education in the safe and effective prescribing of controlled drug prescribing as part of their biennial nursing licensure continuing education requirement.
• ARNPs will not be permitted to prescribe controlled substances in pain management clinics.
Also, ARNPs will be held accountable and subject to disciplinary action by the Board of Nursing if they fail to meet the generally accepted standards of practice for the prescribing of controlled substances and document the requisite medical record information to demonstrate the standards have been met. This would include, but not be restricted to, the necessity of a medical history and physical examination; sufficient justification for the use of a controlled substance; discussion with the patient, surrogate or guardian of the risks benefits of the controlled substance use, including the risks of abuse, addiction and physical dependence; and discussion of the proper administration of the controlled substance.
In addition to ARNPs, the legislature has similarly increased the prescriptive authority for physician assistants (PAs).
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About the Author: Joanne Kenna is a nurse-attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.
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