OK
Oklahoma Senate Bill SB496

Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB496 Compare Versions

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5353 STATE OF OKLAHOMA
5454
5555 1st Session of the 58th Legislature (2021)
5656
5757 SENATE BILL 496 By: McCortney
5858
5959
6060
6161
6262
6363 AS INTRODUCED
6464
6565 An Act relating to Advanced Practice Registe red
6666 Nurses; amending 59 O.S. 2011, Sect ion 353.1, as last
6767 amended by Section 1, Chapter 106, O.S.L. 2018 (59
6868 O.S. Supp. 2020, Section 353.1), which relates to
6969 definitions used in the Oklahoma Pharmacy Act;
7070 modifying and adding definitions; amending 59 O.S.
7171 2011, Section 353.1a, as amended by Se ction 2,
7272 Chapter 106, O.S.L. 2 018 (59 O.S. Supp. 2020, Section
7373 353.1a), which relates to prescriptive authority of
7474 Advanced Practice Registered Nurses; modifying
7575 prescriptive authority of certain Certified Nurse
7676 Practitioners; amending 59 O.S. 2011, Sectio n 567.3a,
7777 as last amended by Section 1, Chapte r 11, O.S.L. 2020
7878 (59 O.S. Supp. 2020, Section 567.3a) , which relates
7979 to definitions used in the Oklahoma Nursing Practice
8080 Act; modifying and adding definitions; amending 59
8181 O.S. 2011, Section 567.4a, as last a mended by Section
8282 8, Chapter 428, O.S.L. 2019 (59 O.S. Supp. 2020,
8383 Section 567.4a), which relates to prescriptive
8484 authority; directing the Oklahoma Board of Nursing to
8585 promulgate certain rules; providing for independe nt
8686 prescriptive authority of Certified Nurse
8787 Practitioners; providing app lication criteria;
8888 stating mentorship requirements; providing exception;
8989 providing eligibility criteria of supervising
9090 physician; construing certain provision; specifying
9191 duration of authority; providing for application
9292 approval, reapplication, fees and prescriptive
9393 authority revocation; limiting practice to certain
9494 geographic areas; providing exception; specifying
9595 applicability of section; amending 59 O.S. 2011,
9696 Section 567.7, as amended by Section 1 , Chapter 190,
9797 O.S.L. 2016 (59 O.S. Supp. 2020, Section 567.7) ,
9898 which relates to license renewal; prescribing certain
9999 fee; requiring certain malpractice insurance;
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151151 amending 63 O.S. 2011, Section 2 -312, which relates
152152 to controlled dangerous substances; modifying
153153 authority of certain Certified Nurse Practitioners to
154154 prescribe and administer controlled dangerous
155155 substances; updating statutory reference; providing
156156 for codification; and providing an effective date .
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160160
161161 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
162162 SECTION 1. AMENDATORY 59 O.S. 2011, Section 353.1, as
163163 last amended by Section 1, Chapter 106, O.S.L. 2018 (59 O.S. Supp.
164164 2020, Section 353.1), is amended to read as f ollows:
165165 Section 353.1. For the purposes of the Oklahoma P harmacy Act:
166166 1. “Accredited program” means those seminars, classes,
167167 meetings, work projects, and other educational courses approved by
168168 the Board State Board of Pharmacy for purposes of continuing
169169 professional education;
170170 2. “Act” means the Oklahoma Pharma cy Act;
171171 3. “Administer” means the direct application of a drug, whether
172172 by injection, inhalation, ingestion or any other means, to the body
173173 of a patient;
174174 4. “Assistant pharmacist ” means any person presently licensed
175175 as an assistant pharmacist in the Stat e of Oklahoma by the Board
176176 pursuant to Section 353.10 of this title and for the purposes of the
177177 Oklahoma Pharmacy Act shall be considered the same as a pharmacist,
178178 except where otherwise specified;
179179 5. “Board” or “State Board” means the State Board of Phar macy;
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231231 6. “Certify” or “certification of a prescription” means the
232232 review of a filled prescription by a licensed pharmacist or a
233233 licensed practitioner with dispensing authority to confirm that the
234234 medication, labeling and packaging of the filled prescripti on are
235235 accurate and meet all requireme nts prescribed by state and federal
236236 law. For the purposes of this paragraph, “licensed practitioner”
237237 shall not include optometrists with dispensing authority;
238238 7. “Chemical” means any medicinal substance, whether simp le or
239239 compound or obtained through the process of the science and art of
240240 chemistry, whether of organic or inorganic origin;
241241 8. “Compounding” means the combining, admixing, mixing,
242242 diluting, pooling, reconstituting or otherwise altering of a drug or
243243 bulk drug substance to create a drug. Compounding includes the
244244 preparation of drugs or devices in anticipation of prescription drug
245245 orders based on rout ine, regularly observed prescribing patterns;
246246 9. “Continuing professional education ” means professional,
247247 pharmaceutical education in the general a reas of the socioeconomic
248248 and legal aspects of health care; the properties and actions of
249249 drugs and dosage forms; and the etiology, characteristics and
250250 therapeutics of the diseased state;
251251 10. “Dangerous drug”, “legend drug”, “prescription drug” or “Rx
252252 Only” means a drug:
253253 a. for human use subject to 21 U.S.C. 353(b)(1), or
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305305 b. is labeled “Prescription Only”, or labeled with the
306306 following statement: “Caution: Federal law restricts
307307 this drug except for use by or on the o rder of a
308308 licensed veterinarian ”.
309309 11. “Director” means the Executive Director of the State Board
310310 of Pharmacy unless context clearly indicates othe rwise;
311311 12. “Dispense” or “dispensing” means the interpretation,
312312 evaluation, and implementation of a prescrip tion drug order,
313313 including the prepara tion and delivery of a drug or device to a
314314 patient or a patient’s agent in a suitable container appropriately
315315 labeled for subsequent administration to, or use b y, a patient.
316316 Dispense includes sell, distribute, leave w ith, give away, dispose
317317 of, deliver or supply;
318318 13. “Dispenser” means a retail pharmacy, hospital pharmacy, a
319319 group of chain pharmacies under commo n ownership and control that do
320320 not act as a wholesale distributor, or any other person authorized
321321 by law to dispense or administer prescription dr ugs, and the
322322 affiliated warehouses or distributions of such entities under common
323323 ownership and control that do not act as a wholesale distributor.
324324 For the purposes of this paragraph, “dispenser” does not mean a
325325 person who dispenses only products to be us ed in animals in
326326 accordance with 21 U.S.C. 360b(a)(5);
327327 14. “Distribute” or “distribution” means the sale, purchase,
328328 trade, delivery, handling, storage, or rece ipt of a product, and
329329
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380380 does not include the dispensing of a product pursuant to a
381381 prescription executed in accordance with 21 U.S.C. 353(b)(1) or the
382382 dispensing of a product approved under 21 U.S.C. 360b(b) ; provided,
383383 taking actual physical possession of a product or title shall not be
384384 required;
385385 15. “Doctor of Pharmacy” means a person licensed by the Board
386386 to engage in the practice of pharmacy. The terms “pharmacist”,
387387 “D.Ph.”, and “Doctor of Pharmacy” shall be interchangeable and shall
388388 have the same meanin g wherever they appear in the Oklahoma Statutes
389389 and the rules promulgated by the Board;
390390 16. “Drug outlet” means all manufacturers, repackagers,
391391 outsourcing facilities, wholesale distributors, third -party
392392 logistics providers, pharmacies, and all other faci lities which are
393393 engaged in dispensing, delivery, distribu tion or storage of
394394 dangerous drugs;
395395 17. “Drugs” means all medicinal substances and preparations
396396 recognized by the United States Pharmacopoeia and National
397397 Formulary, or any revision thereof, and al l substances and
398398 preparations intended for external and/or internal use in the cure,
399399 diagnosis, mitigation, treatment or prevention of disease in humans
400400 or animals and all substances and preparations, othe r than food,
401401 intended to affect the structure or an y function of the body of a
402402 human or animals;
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454454 18. “Drug sample” means a unit of a prescription drug packaged
455455 under the authority and responsibility of the manufacturer that is
456456 not intended to be sold and is intended to promote the sale of the
457457 drug;
458458 19. “Filled prescription” means a packaged prescription
459459 medication to which a label has been affixed which contains such
460460 information as is required by the Oklahoma Pharmacy Act;
461461 20. “Hospital” means any institution licensed as a hospital by
462462 this state for the care and treatment of patients, or a pharmacy
463463 operated by the Oklahoma Department of Veterans Af fairs;
464464 21. “Licensed practitioner” means:
465465 a. an allopathic physician,
466466 b. an osteopathic physician,
467467 c. a podiatric physician,
468468 d. a dentist,
469469 e. a veterinarian or,
470470 f. an optometrist, or
471471 g. a Certified Nurse Practitioner who has obtained
472472 independent prescriptive authority,
473473 licensed to practice and authorized to prescribe dangerous drugs
474474 within the scope of practice of such p ractitioner;
475475 22. “Manufacturer” or “virtual manufacturer” means with respect
476476 to a product:
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528528 a. a person that holds an application approved under 21
529529 U.S.C. 355 or a license issued under 42 U.S.C. 262 for
530530 such product, or if such product is not the subject o f
531531 an approved application or license, the person who
532532 manufactured the prod uct,
533533 b. a co-licensed partner of the person described in
534534 subparagraph a that obtains the product directly from
535535 a person described in this subparagraph or
536536 subparagraph a,
537537 c. an affiliate of a person described in subparagraph a
538538 or b who receives the product directly from a person
539539 described in this subparagraph or in subparagraph a or
540540 b; or
541541 d. a person who contracts with another to manufacture a
542542 product;
543543 23. “Manufacturing” means the production, preparation,
544544 propagation, compounding, con version or processing of a device or a
545545 drug, either directly or indirectly by extraction from substances of
546546 natural origin or independently by means of chemical or biological
547547 synthesis and includes any pa ckaging or repackaging of the
548548 substances or labeling or relabeling of its container, and the
549549 promotion and marketing of such drugs or devices. The term
550550 “manufacturing” also includes the preparation and promotion of
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602602 commercially available products from bul k compounds for resale by
603603 licensed pharmacies, licen sed practitioners or o ther persons;
604604 24. “Medical gas” means those gases including those in liquid
605605 state upon which the manufacturer or distributor has placed one of
606606 several cautions, such as “Rx Only”, in compliance with federal law;
607607 25. “Medical gas order” means an order for medical gas issued
608608 by a licensed prescriber;
609609 26. “Medical gas distributor” means a person licensed to
610610 distribute, transfer, wholesale, deliver or sell medical gases on
611611 drug orders to suppliers or other entities licensed to use,
612612 administer or distribute m edical gas and may also include a patient
613613 or ultimate user;
614614 27. “Medical gas supplier” means a person who dispenses medical
615615 gases on drug orders only to a patient or ultimate user;
616616 28. “Medicine” means any drug or combination of dru gs which has
617617 the property of curing, preventing, treating, diagnosing or
618618 mitigating diseases, or which is used for that purpose;
619619 29. “Nonprescription drugs” means medicines or drugs which are
620620 sold without a prescription and which are prepackaged for use by the
621621 consumer and labeled in accordance with the requirements of the
622622 statutes and regulations of this state and the federal government.
623623 Such items shall also include medical and dental supplies and
624624 bottled or nonbulk chemicals which are sold or offered for sale to
625625 the general public if such articles or preparations meet the
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677677 requirements of the Federal Food, Drug and Cosmetic Act, 21
678678 U.S.C.A., Section 321 et seq.;
679679 30. “Outsourcing facility ”, including “virtual outsourcing
680680 facility” means a facility at one geographic location o r address
681681 that:
682682 a. is engaged in the compounding of sterile drugs,
683683 b. has elected to register as an outsourcing facility,
684684 and
685685 c. complies with all requirements of 21 U.S.C. 353b;
686686 31. “Package” means the smallest individual saleable unit of
687687 product for distribution by a manufacturer or repackager that is
688688 intended by the manufacturer for ultimate sale to the dispenser of
689689 such product. For the purposes of this paragraph, “individual
690690 saleable unit” means the smallest container of a product introduced
691691 into commerce by the manufacturer or repackager that is intended by
692692 the manufacturer or repackager for individual sale to a dispenser;
693693 32. “Person” means an individual, partnership, limited
694694 liability company, corporation or association, unless the context
695695 otherwise requires;
696696 33. “Pharmacist-in-charge” or “PIC” means the pharmacist
697697 licensed in this state responsible for the management control of a
698698 pharmacy and all other aspects of the practi ce of pharmacy in a
699699 licensed pharmacy as defined by Section 353.18 of this title;
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751751 34. “Pharmacy” means a place regularly licensed by the Board of
752752 Pharmacy in which prescriptions, drugs, medicines, chemicals and
753753 poisons are compounded or dispensed or such place where pharmacists
754754 practice the profession of pharmacy, or a pharmacy operated by the
755755 Oklahoma Department of Veterans Affairs;
756756 35. “Pharmacy technician”, “technician”, “Rx tech”, or “tech”
757757 means a person issued a Technician permit by the State Board of
758758 Pharmacy to assist the pharmacist and perform nonjudgmental,
759759 technical, manipulative, non-discretionary functions in the
760760 prescription department under the immediate and direct supervision
761761 of a pharmacist;
762762 36. “Poison” means any substance which when int roduced into the
763763 body, either directly or by absorption, produces violent, morbid or
764764 fatal changes, or which destroys living tissue with which such
765765 substance comes into contact;
766766 37. “Practice of pharmacy” means:
767767 a. the interpretation and evaluation of pre scription
768768 orders,
769769 b. the compounding, dispensing, administering and
770770 labeling of drugs and devices, except labeling by a
771771 manufacturer, repackager or distributor of
772772 nonprescription drugs and commercially packaged legend
773773 drugs and devices,
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825825 c. the participation in drug selection and drug
826826 utilization reviews,
827827 d. the proper and safe s torage of drugs and devices and
828828 the maintenance of proper records thereof,
829829 e. the responsibility for advising by counseling and
830830 providing information, where professionally necessary
831831 or where regulated, of therapeutic values, content,
832832 hazards and use of dru gs and devices,
833833 f. the offering or performing of those acts, services,
834834 operations or transactions necessary in the conduct,
835835 operation, management and control of a pharmacy, or
836836 g. the provision of those acts or services that are
837837 necessary to provide pharmac eutical care;
838838 38. “Preparation” means an article which may or may not contain
839839 sterile products compounded in a licensed pharmacy pursuant to the
840840 order of a licensed prescriber;
841841 39. “Prescriber” means a person licensed in this state who is
842842 authorized to prescribe dangerous drugs within the scope of practice
843843 of the person’s profession;
844844 40. “Prescription” means and includes any order for drug or
845845 medical supplies written or signed, or transmitted by word of mouth,
846846 telephone or other means of communication:
847847 a. by a licensed prescriber,
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899899 b. under the supervision of an Oklahoma licensed
900900 practitioner, supervising physician, by an Oklahoma
901901 licensed advanced practice registered nurse or an
902902 Oklahoma licensed Clinical Nurse Specialist, Certified
903903 Nurse-Midwife or physician assistant, or
904904 c. (1) under the supervision of an Oklahoma licensed
905905 supervising physician, by a Certified Nurse
906906 Practitioner who chooses to practice unde r the
907907 supervision of a physician or who is undergoing a
908908 mentorship as provided by Section 5 of this act ,
909909 or
910910 (2) by a Certified Nurse Practitioner who has
911911 obtained independent prescriptive authority as
912912 provided by Section 5 of this act, or
913913 d. by an Oklahoma licensed wholesaler or distributo r as
914914 authorized in Section 353.29.1 of this title;
915915 41. “Product” means a prescription drug in a finished dosage
916916 form for administration to a patient without substantial further
917917 manufacturing, such as capsules, tablets, and lyophilized products
918918 before reconstitution. “Product” does not include blood components
919919 intended for transfusion, radioactive drugs or biologics and medical
920920 gas;
921921 42. “Repackager”, including “virtual repackager”, means a
922922 person who owns or operates an establishment that repacks and
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974974 relabels a product or package for further sale or distribution
975975 without further transaction;
976976 43. “Sterile drug” means a drug that is intended for parenteral
977977 administration, an ophthalmic or oral inhalation drug in aqueous
978978 format, or a drug that is required to be sterile under state and
979979 federal law;
980980 44. “Supervising physician ” means an individual holding a
981981 current license to practice as a phys ician from the State Board of
982982 Medical Licensure and Supervision, pursuant to the provisions of the
983983 Oklahoma Allopathic Medical and Surgical Licensure and Supervision
984984 Act, or the State Board of Osteopathic Examiners, pursuant to the
985985 provisions of the Oklaho ma Osteopathic Medicine Act, who sup ervises
986986 an advanced practice registered nurse a Certified Nurse Practitioner
987987 who chooses to practice unde r the supervision of a physician or who
988988 is undergoing a mentorship as provided by Section 5 of this act , a
989989 Clinical Nurse Specialist or a Certified Nurse-Midwife, as such
990990 terms are defined in Section 567.3a of thi s title, and who is not in
991991 training as an intern, resident, or fellow. To be eligible to
992992 supervise an advanced practice re gistered nurse, such The
993993 supervising physician shall remain in complian ce with the rules
994994 promulgated by the S tate Board of Medical Licensure and Supervision
995995 or the State Board of Osteopathic Examine rs;
996996 45. “Supportive personnel” means technicians and auxiliary
997997 supportive persons who ar e regularly paid employees of a pharmacy
998998
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10491049 who work and perform tasks in the pharmacy as authorized by Section
10501050 353.18A of this title;
10511051 46. “Third-party logistics provider”, including “virtual third-
10521052 party logistics provider” means an entity that provides or
10531053 coordinates warehousing, or other logisti cs services of a product in
10541054 interstate commerce on behalf of a manufacturer, wholesale
10551055 distributor, or dispenser of a product but does not take ownership
10561056 of the product, nor have respon sibility to direct the sale or
10571057 disposition of the product. For the pur poses of this paragraph,
10581058 “third-party logistics provider” does not include shippers and the
10591059 United States Postal Servic e;
10601060 47. “Wholesale distributor”, including “virtual wholesale
10611061 distributor” means a person other than a manufacturer, a
10621062 manufacturer’s co-licensed partner, a third-party logistics
10631063 provider, or repackager engaged in wholesale distribution as defined
10641064 by 21 U.S.C. 353(e)(4) as amended by the Drug Supply Chain Security
10651065 Act;
10661066 48. “County jail” means a facility opera ted by a county for the
10671067 physical detention and correction of persons charged with, or
10681068 convicted of, criminal offenses or ordinance violations or persons
10691069 found guilty of civil or crimin al contempt;
10701070 49. “State correctional facility” means a facility or
10711071 institution that houses a prisoner population under the jurisdiction
10721072 of the Department of Corrections;
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11241124 50. “Unit dose package” means a package that contains a single
11251125 dose drug with the name, strength, control number , and expiration
11261126 date of that drug on the la bel; and
11271127 51. “Unit of issue package” means a package that provides
11281128 multiple doses of the same drug, but each drug is individually
11291129 separated and includes the name, lot numb er, and expiration date.
11301130 SECTION 2. AMENDATORY 59 O.S. 201 1, Section 353.1a, as
11311131 amended by Section 2, Chapter 106, O.S.L. 2018 (59 O.S. Supp. 2020,
11321132 Section 353.1a), is amended to read as f ollows:
11331133 Section 353.1a. A. Prescribing Prescriptive authority shall be
11341134 allowed, under the medical direction of a supervising physician, for
11351135 an advanced practice nurse Advanced Practice Registered Nurse
11361136 recognized by the Oklahom a Board of Nursing in one of the following
11371137 categories: advanced regi stered nurse practitioners, clinical nurse
11381138 specialists, or certified nurse -midwives as a Clinical Nurse
11391139 Specialist or Certified Nurse-Midwife.
11401140 B. 1. Prescriptive authority shall be allo wed, under the
11411141 medical direction of a supervising physician, for an A dvanced
11421142 Practice Registered Nurse recognized by the Oklahoma Board of
11431143 Nursing as a Certified Nurse Practitioner who chooses to practice
11441144 under the supervision of a physician or who is undergoing a
11451145 mentorship as provided by Section 5 of this act .
11461146 2. Prescriptive authority shall be allowed, independent of the
11471147 medical direction of a supervis ing physician, for an Advanced
11481148
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11991199 Practice Registered Nurse recognized by the Oklahoma Board of
12001200 Nursing as a Certified Nurse Practitioner who has obtained
12011201 independent prescript ive authority as provided by Section 5 of this
12021202 act.
12031203 C. The advanced practice nurse Advanced Practice Registered
12041204 Nurse may write or sign, or transmit by word of mouth, telephone or
12051205 other means of communication an order for drugs or medical supplie s
12061206 that is intended to be filled, compounded, or dispensed by a
12071207 pharmacist. The supervising physician, if applicable, and the
12081208 advanced practice nurse Advanced Practice Registere d Nurse shall be
12091209 identified at the time of origination of the prescription and the
12101210 name of the advanced practice nurse Advanced Practice Registered
12111211 Nurse shall be printed on the prescription label.
12121212 B. D. Pharmacists may dispense prescriptions for non -controlled
12131213 prescription drugs authorized by an advanced practice nurse Advanced
12141214 Practice Registered Nurse or physician assistant, not located in
12151215 Oklahoma, provided that they a re licensed in the state in which they
12161216 are actively prescribing.
12171217 C. E. 1. Pharmacists may only d ispense prescriptions for
12181218 controlled dangerous substances prescribed by an advanced practice
12191219 nurse or physician assistant Advanced Practice Registered Nurse
12201220 licensed in the State of Oklahoma and supervised by an Oklahoma-
12211221 licensed practitioner this state who meets the criteria in
12221222 subsection A or B of this section.
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12741274 2. Pharmacists may only dispens e prescriptions for controlled
12751275 dangerous substances prescribed by a physician assistant licensed in
12761276 this state and supervised by an Oklahoma -licensed supervising
12771277 physician.
12781278 SECTION 3. AMENDATORY 59 O.S. 2011, Section 567.3a, as
12791279 last amended by Section 1, Chapter 11, O.S.L. 2020 (59 O.S. Supp.
12801280 2020, Section 567.3a), is amended to read as follows:
12811281 Section 567.3a. As used in the Oklahoma Nursing Practice Act:
12821282 1. “Board” means the Oklahoma Board of Nursing;
12831283 2. “The practice of nursing ” means the performance of services
12841284 provided for purposes of nurs ing diagnosis and treatment of human
12851285 responses to actual or potential health problems consistent wit h
12861286 educational preparation. Knowledge and skill are the basis fo r
12871287 assessment, analysis, planning, intervent ion, and evaluation used in
12881288 the promotion and mai ntenance of health and nursing management of
12891289 illness, injury, infirmity, restoration or optimal func tion, or
12901290 death with dignity. Practice is based on understanding the human
12911291 condition across the human lifes pan and understanding the
12921292 relationship of the ind ividual within the environment. This
12931293 practice includes execution of the medical regime including th e
12941294 administration of medications and treatments prescribed by any
12951295 person authorized by state law to so presc ribe;
12961296 3. “Registered nursing” means the practice of the full scope of
12971297 nursing which includes, but is not limited to:
12981298
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13491349 a. assessing the health status of individuals, families
13501350 and groups,
13511351 b. analyzing assessment dat a to determine nursing care
13521352 needs,
13531353 c. establishing goals to meet identified health care
13541354 needs,
13551355 d. planning a strategy of ca re,
13561356 e. establishing priorities of nursing intervention to
13571357 implement the strategy of care,
13581358 f. implementing the strategy of care,
13591359 g. delegating such tasks as may safely be perfor med by
13601360 others, consistent with educational prepar ation and
13611361 that do not conflict with the provisions of the
13621362 Oklahoma Nursing Practice Act,
13631363 h. providing safe and effective nursing care rendered
13641364 directly or indirectl y,
13651365 i. evaluating responses to interventions ,
13661366 j. teaching the principles and practice of nurs ing,
13671367 k. managing and supervisin g the practice of nursing,
13681368 l. collaborating with other health profess ionals in the
13691369 management of health care,
13701370 m. performing additiona l nursing functions in accordance
13711371 with knowledge and skills acquired beyond basic
13721372 nursing preparation, and
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14241424 n. delegating those nursing tasks as defined in the rules
14251425 of the Board that may be pe rformed by an advanced
14261426 unlicensed assistive person;
14271427 4. “Licensed practical nursing” means the practice of nursing
14281428 under the supervision or direction of a r egistered nurse, licensed
14291429 physician or dentist. This directed scope of nursing practice
14301430 includes, but is not limited to:
14311431 a. contributing to the assessment of the h ealth status of
14321432 individuals and groups,
14331433 b. participating in the development and modification of
14341434 the plan of care,
14351435 c. implementing the appropriate aspects of the plan of
14361436 care,
14371437 d. delegating such tasks as may safely be performed by
14381438 others, consistent with ed ucational preparation and
14391439 that do not conflict with the Oklahoma Nursing
14401440 Practice Act,
14411441 e. providing safe and effective nurs ing care rendered
14421442 directly or indirectly,
14431443 f. participating in the eva luation of responses to
14441444 interventions,
14451445 g. teaching basic nursing skills and related principles,
14461446
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14971497 h. performing additional nursing procedures in accordance
14981498 with knowledge and skills acquire d through education
14991499 beyond nursing preparation, and
15001500 i. delegating those nursing tasks as defined in the rules
15011501 of the Board that may b e performed by an advanced
15021502 unlicensed assistive person;
15031503 5. “Advanced Practice Registered Nu rse” means a licensed
15041504 Registered Nurse:
15051505 a. who has completed an advanced practice registered
15061506 nursing education program in preparation for one of
15071507 four recognized advanced practice registered nurse
15081508 Advanced Practice Registered Nurse roles,
15091509 b. who has passed a national certification examin ation
15101510 recognized by the Board that measures t he advanced
15111511 practice registered nurse Advanced Practice Registered
15121512 Nurse role and specialty competencies and who
15131513 maintains recertification in the role and specialty
15141514 through a national certification program,
15151515 c. who has acquired advanced clinical knowledge and
15161516 skills in preparation for providing both direct and
15171517 indirect care to patients; howeve r, the defining
15181518 factor for all Advanced Pra ctice Registered Nurses is
15191519 that a significant com ponent of the education and
15201520 practice focuses on direct care of individuals,
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15721572 d. whose practice builds on the competencies of
15731573 Registered Nurses by demonstrating a gre ater depth and
15741574 breadth of knowledge, a grea ter synthesis of data, and
15751575 increased complexity o f skills and interventions, and
15761576 e. who has obtained a license as an Advanced Practice
15771577 Registered Nurse in one of the following roles:
15781578 Certified Registered Nurse An esthetist, Certified
15791579 Nurse-Midwife, Clinical Nurse Specialist, or Certified
15801580 Nurse Practitioner.
15811581 Only those persons who hold a license to practice advanced
15821582 practice registered nursing in this s tate shall have the right to
15831583 use the title “Advanced Practice Re gistered Nurse” and to use the
15841584 abbreviation “APRN”. Only those persons who have obtained a license
15851585 in the following discip lines shall have the right to fulfill the
15861586 roles and use the applicabl e titles: Certified Registered Nurse
15871587 Anesthetist and the abbrev iation “CRNA”, Certified Nurse-Midwife and
15881588 the abbreviation “CNM”, Clinical Nurse Specialist and the
15891589 abbreviation “CNS”, and Certified Nurse Practitioner and the
15901590 abbreviation “CNP”.
15911591 It shall be unlawful for any person to assume the role or use
15921592 the title Advanced Practice Registered Nurse or use the abbreviation
15931593 “APRN” or use the respective specia lty role titles and abbreviatio ns
15941594 or to use any other titles or abbreviations that would reasonably
15951595 lead a person to believe the user is an Advanced Practice Regist ered
15961596
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16471647 Nurse, unless permitted by the Oklahom a Nursing Practice Act. Any
16481648 individual doing so shall be guilty of a misdemeano r, which shall be
16491649 punishable, upon conviction, by imprisonment in the county jail for
16501650 not more than one (1) year or by a fine of not less than One Hundred
16511651 Dollars ($100.00) nor more than One Thousand Dollars ($1,000.00), or
16521652 by both such imprisonment and fine for each offense;
16531653 6. “Certified Nurse Practitioner ” is means an Advanced Practice
16541654 Registered Nurse who performs in an expanded ro le in the delivery of
16551655 health care:
16561656 a. consistent with advanced educational preparation as a
16571657 Certified Nurse Practitioner in an area of specialty,
16581658 b. functions within the Certified Nurse Practi tioner
16591659 scope of practice for the selected area of
16601660 specialization, and
16611661 c. is in accord with the standards fo r Certified Nurse
16621662 Practitioners as identified by the certifying body and
16631663 approved by the Board.
16641664 A Certified Nurse Practitioner shall be eligible, in accordance
16651665 with the scope of practice of the Certified Nurse Pra ctitioner, to
16661666 obtain recognition as authori zed by the Board to prescribe, as
16671667 defined by the rules promulgated by the Board pursuant to this
16681668 section and subject to the medical direction of a su pervising
16691669 physician Section 567.4a of this title and Section 5 of this act.
16701670 This authorization shall not i nclude dispensing drugs, but shall not
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17221722 preclude, subject to federal regulations, the receipt of, the
17231723 signing for, or the dispensing of professional s amples to patients.
17241724 The Certified Nurse Practitioner accepts res ponsibility,
17251725 accountability, and obligation to practice in accordance with usual
17261726 and customary advanced practice registered nursing standards and
17271727 functions as defined by the scope of practice/ role definition
17281728 statements for the Certified Nurse Practitioner;
17291729 7. a. “Clinical Nurse Specialist ” is means an Advanced
17301730 Practice Registered Nurse who holds:
17311731 (1) a master’s degree or higher in nursing with
17321732 clinical specialization preparation to function
17331733 in an expanded role,
17341734 (2) specialty certification from a national
17351735 certifying organization recognized by the Boa rd,
17361736 (3) an Advanced Practice Registered Nurse lic ense
17371737 from the Board, and
17381738 (4) any nurse holding a specialty certification as a
17391739 Clinical Nurse Special ist valid on January 1,
17401740 1994, granted by a national certifying
17411741 organization recognized by the Board, shall be
17421742 deemed to be a Clinical Nurse Specialist under
17431743 the provisions of the Oklahoma Nursing Practice
17441744 Act.
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17961796 b. In the expanded role, the Clinical Nurse Sp ecialist
17971797 performs at an advanced practice level which shall
17981798 include, but not be limited to:
17991799 (1) practicing as an expert clinician in the
18001800 provision of direct nursing care to a selected
18011801 population of patients or clients in any setting ,
18021802 including private prac tice,
18031803 (2) managing the care of patients or clients with
18041804 complex nursing problems,
18051805 (3) enhancing patient or client care by integrating
18061806 the competencies of cl inical practice, education,
18071807 consultation, and research, and
18081808 (4) referring patients or clients to oth er services.
18091809 c. A Clinical Nurse Specialist in accordance with t he
18101810 scope of practice of such Clinical Nurse Specialist
18111811 shall be eligible to obtain recogniti on as authorized
18121812 by the Board to prescribe, as defined by the rules
18131813 promulgated by the Board pursuan t to this section, and
18141814 subject to the medical direction of a sup ervising
18151815 physician. This authorization sha ll not include
18161816 dispensing drugs, but shall not pr eclude, subject to
18171817 federal regulations, the receipt of, the signing for,
18181818 or the dispensing of profes sional samples to patients.
18191819
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18701870 d. The Clinical Nurse Specialist acc epts responsibility,
18711871 accountability, and ob ligation to practice in
18721872 accordance with usual and customary advanced practice
18731873 nursing standards and functions as defined by the
18741874 scope of practice/rol e definition statements for the
18751875 Clinical Nurse Specialist;
18761876 8. “Nurse-Midwife” is means a nurse who has received an
18771877 Advanced Practice Registered Nurse licen se from the Oklahoma Board
18781878 of Nursing who possesses evidence of certification according to the
18791879 requirements of the American College of Nurse -Midwives.
18801880 A Certified Nurse-Midwife in accordance with the scope o f
18811881 practice of such Certified Nurse -Midwife shall be eligible to obtain
18821882 recognition as authorized by the Board to prescribe, as defined by
18831883 the rules promulgated by the Board pursuant to this section and
18841884 subject to the medical direction of a supervising phys ician. This
18851885 authorization shall not include the dispensing of drugs, but shall
18861886 not preclude, subject to federal regulations, the receipt of, the
18871887 signing for, or the dispensing of professional samples to patients.
18881888 The Certified Nurse-Midwife accepts respon sibility,
18891889 accountability, and obligation to pract ice in accordance with usual
18901890 and customary advanced practice registered nursing standards and
18911891 functions as defined by the scope of practice/role definition
18921892 statements for the Certified Nurse-Midwife;
18931893
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19431943
19441944 9. “Nurse-midwifery practice” means providing managemen t of
19451945 care of normal newborns an d women, antepartally, intrapartally,
19461946 postpartally and gynecologicall y, occurring within a health care
19471947 system which provides for medi cal consultation, medical management
19481948 or referral, and is in accord with the standards for nu rse-midwifery
19491949 practice as defined by the American College of Nurse -Midwives;
19501950 10. a. “Certified Registered Nurse Anesthetist ” is an
19511951 Advanced Practice Registered Nurs e who:
19521952 (1) is certified by the National Boa rd of
19531953 Certification and Recertification for Nurse
19541954 Anesthetists as a Certified Re gistered Nurse
19551955 Anesthetist within one (1) year following
19561956 completion of an approved certified registered
19571957 nurse anesthetist Certified Registered Nurse
19581958 Anesthetist education program, and continues to
19591959 maintain such recertificatio n by the National
19601960 Board of Certification and Recertification for
19611961 Nurse Anesthetists, and
19621962 (2) administers anesthesia in collaboration with a
19631963 medical doctor, an osteo pathic physician, a
19641964 podiatric physician or a dentist licensed in this
19651965 state and under condit ions in which timely onsite
19661966 consultation by such doctor, osteopath, podiatric
19671967 physician or dentist i s available.
19681968
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20192019 b. A Certified Registered Nurse Anesthetist, in
20202020 collaboration with a medical doctor, osteopath ic
20212021 physician, podiatric physician or dentist lice nsed in
20222022 this state, and under c onditions in which timely, on-
20232023 site consultation by such medical docto r, osteopathic
20242024 physician, podiatric physician or dentist is
20252025 available, shall be authorized, pursuant to rul es
20262026 adopted by the Oklahoma Board of Nursing, to o rder,
20272027 select, obtain and admini ster legend drugs, Schedules
20282028 II through, III, IV and V controlled substances,
20292029 devices, and medical gases only when engaged in the
20302030 preanesthetic preparation and evaluation; anes thesia
20312031 induction, maintenance and emergence; and
20322032 postanesthesia care. A Certifi ed Registered Nurse
20332033 Anesthetist may order, select, obtain and adminis ter
20342034 drugs only during the perioperative or periobstetrical
20352035 period.
20362036 c. A Certified Registered Nurse Anesthet ist who applies
20372037 for authorization to order, selec t, obtain and
20382038 administer drugs shall:
20392039 (1) be currently recognized as a Certified Registered
20402040 Nurse Anesthetist in this state,
20412041 (2) provide evidence of completion, wit hin the two-
20422042 year period immediately precedi ng the date of
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20942094 application, of a minimum of fifte en (15) units
20952095 of continuing education in advanced pharmacology
20962096 related to the administration of anes thesia as
20972097 recognized by the National Board of Certification
20982098 and Recertification for Nurse Anesthetists, and
20992099 (3) complete and submit a no tarized application, on a
21002100 form prescribed by the Bo ard, accompanied by the
21012101 application fee established pursuant to this
21022102 section.
21032103 d. The authority to order, select, obtain and administe r
21042104 drugs shall be terminated if a Certified Registered
21052105 Nurse Anesthetist has:
21062106 (1) ordered, selected, obtained or administere d drugs
21072107 outside of the Certified Registered Nurse
21082108 Anesthetist scope of practice or ordered,
21092109 selected, obtained or administered drugs for
21102110 other than therapeutic purposes, or
21112111 (2) violated any provision of state laws or rules or
21122112 federal laws or regulations pe rtaining to the
21132113 practice of nursing or the authority to order,
21142114 select, obtain and administer drugs.
21152115 e. The Oklahoma Board of Nursing shall notify the Board
21162116 of Pharmacy after te rmination of or a change in the
21172117
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21682168 authority to order, select, obtain and administe r
21692169 drugs for a Certified Registered Nurse Anesthetist.
21702170 f. The Board shall provide by rule for biennial
21712171 application renewal and reautho rization of authority
21722172 to order, select, obt ain and administer drugs for
21732173 Certified Registered Nurse Anesthetists. At the ti me
21742174 of application renewal, a Certified Registered Nurse
21752175 Anesthetist shall submit documentation of a minimum of
21762176 eight (8) units of con tinuing education, completed
21772177 during the previous two (2) years, in advanced
21782178 pharmacology relating to the administration of
21792179 anesthesia, as recognized by the Council on
21802180 Recertification of Nurse Anesthetists or the Council
21812181 on Certification of Nurse Anesthetis ts.
21822182 g. This paragraph shall not prohibit th e administration
21832183 of local or topical anesthetics as now permitted by
21842184 law. Provided further, nothing in this paragraph
21852185 shall limit the authority of t he Board of Dentistry to
21862186 establish the qualifications for dentis ts who direct
21872187 the administration of anesthe sia.
21882188 h. As used in this parag raph, “collaboration” means an
21892189 agreement between a medical doctor, osteopathic
21902190 physician, podiatric physician or dentist performing
21912191 the procedure or directly involved with the procedur e
21922192
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22432243 and the Certified Registered Nurse Anesth etist working
22442244 jointly toward a common goal provid ing services for
22452245 the same patient. This collaboration involves the
22462246 joint formulation, discussion an d agreement of the
22472247 anesthesia plan by both parties, and the coll aborating
22482248 medical doctor, osteopathic physi cian, podiatric
22492249 physician or dentist performing t he procedure or
22502250 directly involved with the procedure and that. The
22512251 collaborating physician shall re main available for
22522252 timely onsite consultation during the deliver y of
22532253 anesthesia for diagnosis, consultation , and treatment
22542254 of medical conditions;
22552255 11. “Supervising physician” means an individual holding a
22562256 current license to practice as a physi cian from the State Board of
22572257 Medical Licensure and Supervision or the State Board of Osteopathic
22582258 Examiners, who supervises a Ce rtified Nurse Practitioner who chooses
22592259 to practice under the supervision of a physician or who is
22602260 undergoing a mentorship as provided by Section 5 of this act , a
22612261 Clinical Nurse Specialist, or a Certifie d Nurse-Midwife, and who is
22622262 not in training as an inte rn, resident, or fellow. To be eligible
22632263 to supervise such Advanced Practice Registered Nurse, such The
22642264 supervising physician shall remain in compliance with t he rules
22652265 promulgated by the State Board of Medical Licensure and Supervision
22662266 or the State Board o f Osteopathic Examiners;
22672267
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23182318 12. “Supervision of an Advanced Practice Regi stered Nurse with
23192319 prescriptive authority ” means overseeing and accepting
23202320 responsibility for the ordering and transmission by a Certified
23212321 Nurse Practitioner who chooses to practice unde r the supervision of
23222322 a physician or who is undergoing a mentorship as provided by Section
23232323 5 of this act, a Clinical Nurse Specialist, or a Certified Nurse -
23242324 Midwife of written, telephonic, electronic or oral prescriptions for
23252325 drugs and other medical supplies, subject to a defined formulary;
23262326 and
23272327 13. “Advanced Unlicensed Assistant” means any person who has
23282328 successfully completed a certified training program approved by the
23292329 Board that trains the Advanced Unlicensed Assistant to pe rform
23302330 specified technical skills identified by the Board in acute care
23312331 settings under the direction and supervision of the Registered Nurse
23322332 or Licensed Practical Nurse.
23332333 SECTION 4. AMENDATORY 59 O.S. 2011, Section 567.4a, as
23342334 last amended by Section 8, Chapter 428, O.S.L. 2019 (59 O.S. Supp.
23352335 2020, Section 567.4a), is amended to read as follows:
23362336 Section 567.4a. The Oklahoma Board of Nursing may grant
23372337 prescriptive authority through the Advanc ed Practice Registered
23382338 Nurse license to Certified Nurse Practit ioners, Certified Nurse-
23392339 Midwives and Clinical Nurse Specialists who meet the requirements
23402340 for prescriptive authority identified by law and in the Board’s
23412341 rules. The rules regarding prescriptiv e authority recognition
23422342
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23932393 promulgated by the Oklahoma Board of Nu rsing pursuant to paragraphs
23942394 6 through 9, 11 and 12 of Section 567.3a of this title shall:
23952395 1. Define the procedure for documentin g supervision by a
23962396 supervising physician licensed in Oklahoma t o practice by the State
23972397 Board of Medical Licensure and Supervision or the S tate Board of
23982398 Osteopathic Examiners. Such procedure shall include a written
23992399 statement that defines appropriate referral, consultati on, and
24002400 collaboration between the Advanced Practice Registered Nurse,
24012401 recognized to prescribe as defined in paragraphs 6 through 9, 11 and
24022402 12 of Section 567.3a of this title, and the supervising physician.
24032403 The written statement shall include a method of assuring
24042404 availability of the supervising physician through direct contact,
24052405 telecommunications or other appropriate electronic means for
24062406 consultation, assistance with medical emergencies, or patient
24072407 referral. The written statement shall be part of the initial
24082408 application and the renewal application submitted to the Board for
24092409 recognition for prescriptive authority for the Advance d Practice
24102410 Registered Nurse. Changes to the written statement shall be filed
24112411 with the Board within thirty (30) day s of the change and shall be
24122412 effective on filing;
24132413 2. Define the procedure for documenting independent
24142414 prescriptive authority for Certified Nurse Practitioners who have
24152415 obtained independent prescriptive authority as provided by Section 5
24162416 of this act;
24172417
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24682468 3. Define minimal requirements for initial application for
24692469 prescriptive authority which shall in clude, but not be limited to,
24702470 evidence of completion of a minimum of forty-five (45) contact hours
24712471 or three (3) academic credit hours of education in
24722472 pharmacotherapeutics, clinical application, and use of
24732473 pharmacological agents in the prevention of illness , and in the
24742474 restoration and maintenance of healt h in a program beyond basic
24752475 registered nurse preparation, approved by the Board. Such contact
24762476 hours or academic credits shall be obtained within a time period of
24772477 three (3) years immediately preceding the da te of application for
24782478 prescriptive authority;
24792479 3. 4. Define minimal requirements for application for renewal
24802480 of prescriptive authority which shall include, but not be limited
24812481 to, documentation of a minimum of:
24822482 a. fifteen (15) contact hours or one (1) acade mic credit
24832483 hour of education in pharmacotherapeut ics, clinical
24842484 application, and use of pharmacological agents in the
24852485 prevention of illness, and in the rest oration and
24862486 maintenance of health in a program beyond basic
24872487 registered nurse preparation, and
24882488 b. two (2) hours of education in pain management or two
24892489 (2) hours of education in opioid use or addiction,
24902490 unless the Advanced Practice Registered Nurse has
24912491 demonstrated to the satisfaction of the Board that the
24922492
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25432543 Advanced Practice Registered Nurse does not current ly
25442544 hold a valid federal Drug Enforcement Administ ration
25452545 registration number,
25462546 approved by the Board, within the two-year period immediately
25472547 preceding the effective date of application for renewal of
25482548 prescriptive authority;
25492549 4. 5. Require that beginning July 1, 2002, an Advanced Practice
25502550 Registered Nurse shall demonstrate demonstrates successful
25512551 completion of a master’s degree or higher in a clinical nurse
25522552 specialty the Certified Nurse Practi tioner role, Clinical Nurse
25532553 Specialist role or Certified Nurse -Midwife role in order to be
25542554 eligible for initial appli cation for prescriptive authority under
25552555 the provisions of the Oklahoma Nursing Practice Act;
25562556 5. 6. Require an Advanced Practice Registered Nurse to have
25572557 graduated from a program accredited by the Accredita tion Commission
25582558 for Education in Nursing (ACEN) or the Commission of Collegiate
25592559 Nursing Education (CC NE), or a substantia lly equivalent program
25602560 approved by the Board in order to be eligible for initial
25612561 application for prescriptive authority under the provi sions of the
25622562 Oklahoma Nursing Practice Act . As a condition of obtaining
25632563 prescriptive authority, an Advanced Practice Reg istered Nurse shall
25642564 show evidence of annual o n-campus attendance for assessment and
25652565 evaluation of student progress and competence in ad dition to
25662566 completing the required clinical hours i n the graduate program
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26182618 consistent with the most recent edition of the Criteria for
26192619 Evaluation of Nurse Practitioner Programs by the Nat ional Task Force
26202620 on Quality Nurse Practitioner Education ;
26212621 7. Define the method for communicating authority to p rescribe
26222622 or termination of same, an d the formulary to the Board of Pharmacy,
26232623 all pharmacies, and all registered pharmacists;
26242624 6. 8. Define terminology used in such rules;
26252625 7. 9. Define the parameters for the pre scribing practices of
26262626 the Advanced Practice R egistered Nurse;
26272627 8. 10. Define the methods for termination of prescriptive
26282628 authority for the Advanced Practice Registered Nurse; and
26292629 9. 11.
26302630 a. Establish a Formulary Advisory Council that shall
26312631 develop and submit to the Board recommendations for an
26322632 exclusionary formulary that shall list drugs or
26332633 categories of drugs that shall not be prescribed by
26342634 Advanced Practice Registered Nurse recognized to
26352635 prescribe by the Oklahoma Board of Nursing. The
26362636 Formulary Advisory C ouncil shall also develop and
26372637 submit to the Board recommendations for practice-
26382638 specific prescriptive standards for each category of
26392639 Advanced Practice Registered Nurse recognized to
26402640 prescribe by the Oklahoma Board of Nursing pursuant to
26412641 the provisions of th e Oklahoma Nursing Practice Act.
26422642
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26932693 The Board shall either accept or reject the
26942694 recommendations made by the Council. No amendments to
26952695 the recommended exclusionary formulary may be made by
26962696 the Board without the approval of the Formulary
26972697 Advisory Council.
26982698 b. The Formulary Advisory Council shall be compo sed of
26992699 twelve (12) members as follo ws:
27002700 (1) four members, to include a pediatrician, an
27012701 obstetrician-gynecological physician, a general
27022702 internist, and a family practice physician;
27032703 provided that three of such memb ers shall be
27042704 appointed by the Oklahoma State Medical
27052705 Association, and one shall be appointed by the
27062706 Oklahoma Osteopathic Association,
27072707 (2) four members who are registered pharmacists,
27082708 appointed by the Oklahoma Pharmaceutical
27092709 Association, and
27102710 (3) four members, one of whom shall be a Certified
27112711 Nurse Practitioner, one of whom shall be a
27122712 Clinical Nurse Specialist, one of whom shall be a
27132713 Certified Nurse-Midwife, and one of whom shall be
27142714 a current member of the Oklahoma Board of
27152715 Nursing, all of whom shall be appoi nted by the
27162716 Oklahoma Board of Nursing.
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27682768 c. All professional members of the Formul ary Advisory
27692769 Council shall be in active clinical practi ce, at least
27702770 fifty percent (50%) of the time, withi n their defined
27712771 area of specialty. The members of the Formulary
27722772 Advisory Council shall serve at the pleasure of th e
27732773 appointing authority for a term o f three (3) years.
27742774 The terms of the members shall be s taggered. Members
27752775 of the Council may serve beyond the expiration of
27762776 their term of office until a successor is appointed by
27772777 the original appointing authority. A vaca ncy on the
27782778 Council shall be filled for the balance of the
27792779 unexpired term by the original a ppointing authority.
27802780 d. Members of the Council shal l elect a chair and a vice -
27812781 chair from among the membership of the Coun cil. For
27822782 the transaction of business, at lea st seven members,
27832783 with a minimum of two members present from each of the
27842784 identified categories of physicians, pharmacists and
27852785 advanced practice registered nurses Advanced Practice
27862786 Registered Nurses, shall constitute a quorum. The
27872787 Council shall recommend a nd the Board shall approve
27882788 and implement an initial exclusionary formulary on or
27892789 before January 1, 1997. The Council and the Board
27902790 shall annually review the approved exclusionary
27912791 formulary and shall make any ne cessary revisions
27922792
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28432843 utilizing the same procedur es used to develop the
28442844 initial exclusionary formulary.
28452845 SECTION 5. NEW LAW A new section of law to be codified
28462846 in the Oklahoma Statutes as Section 567.4c of Title 59, unless there
28472847 is created a duplication in numbering, reads as follo ws:
28482848 A. An Advanced Practice Registered Nurse recognized by the
28492849 Oklahoma Board of Nursing as a Certified Nurse Practitioner who
28502850 meets the application requirements provided by this subsection may
28512851 apply to the State Board of Me dical Licensure and Supervision for
28522852 authority to prescribe and order independent of supervision. The
28532853 application for independent prescriptive authority shall include
28542854 proof:
28552855 1. That the Certified Nu rse Practitioner has satisfied the
28562856 educational requiremen ts provided by Section 567.5a of Title 59 of
28572857 the Oklahoma Statutes;
28582858 2. That the Certified Nurse Practitioner holds a valid, current
28592859 Advanced Practice Registered Nurse license issued by the Oklahoma
28602860 Board of Nursing, is recognized by the Oklahoma Board of Nursing as
28612861 a Certified Nurse Practit ioner and is in good standing with the
28622862 Oklahoma Board of Nursing;
28632863 3. That the Certified Nu rse Practitioner has completed a
28642864 mentorship as provided by paragraph 1 of subsection B of this
28652865 section or is exempt from a mentor ship as provided by paragraph 2 of
28662866 subsection B of this section. For the purposes of this paragraph,
28672867
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29182918 proof of completion of the mentorship, if applicable, shall include
29192919 a letter of recommendation signed by the supervising physician ; and
29202920 4. Of any physical address or addresses where the Certified
29212921 Nurse Practitioner practices as of the date of application.
29222922 B. 1. A mentorship shall consist of a minimum of eight
29232923 thousand three hundred twenty (8,320) hours of practice with
29242924 prescriptive authority supervised by a physician, less the amount of
29252925 practice hours already accrued as a Certified Nurse Practitioner as
29262926 of the effective date of this act, which must be completed within
29272927 seven (7) years from the date of initiation of the mentorship .
29282928 Practice hours accrued prior to the effective date of this act s hall
29292929 be included regardless of whether the prior supervision arrangement
29302930 would have complied wit h the mentorship requirements provided by
29312931 this subsection or subsection C of this section. While undergoing
29322932 the mentorship, the Certified Nurse Practitioner sh all complete
29332933 annual courses certified by the State Board of Medical Licensure and
29342934 Supervision relating to prescription and administration of
29352935 pharmaceutical drugs.
29362936 2. Notwithstanding the provisions of paragraph 1 of this
29372937 subsection, an Advanced Practice Registered Nurse recognized by the
29382938 Oklahoma Board of Nursing as a Certified Nurse Practitioner who is
29392939 licensed in this state as an Advanced Practice Registered Nurse with
29402940 prescriptive authority on or before the effective date of this act
29412941 and has been nationa lly certified as an Advanced Practice Registered
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29932993 Nurse for four (4) years as of the effective date of this act and is
29942994 in good standing with the Oklahoma Board of Nursing shall not be
29952995 required to undergo a mentorship with a supervising physician .
29962996 C. 1. In order to be eligible to supervise a Certified Nurs e
29972997 Practitioner for purposes of a mento rship under this section, a
29982998 physician must:
29992999 a. meet the definition of a supervising physician under
30003000 Section 567.3a of Title 59 of the Oklahoma Statutes ,
30013001 b. practice in family medicine, and
30023002 c. have been licensed by the State Board of Medical
30033003 Licensure and Supervision or the State Board of
30043004 Osteopathic Examiners for a minimum of five (5) years.
30053005 2. The requirements provided by paragr aph 1 of this subsection
30063006 shall not be construed to apply to a physician who supervises an
30073007 Advanced Practice Registered Nurse not undergoing a mentorship who
30083008 chooses to practice under the supervision of a physician.
30093009 D. The State Board of Medical Licensure and Supervision shall
30103010 review an application for independent prescriptive authority
30113011 submitted under this section and shall approve the application if
30123012 the applicant meets the cri teria provided by subsection A of this
30133013 section. If the applicant does not meet the criteria provided by
30143014 subsection A of this section, the State Board of Medical Licensure
30153015 and Supervision shall deny the application, stati ng the reason or
30163016 reasons for denial. The Board shall mail the approval or denial
30173017
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30683068 letter to the applicant within fourteen (14) calendar days of
30693069 receipt of the application. If the application is denied, the
30703070 applicant may reapply using the process provided by this subsection.
30713071 E. Independent prescriptive authority granted under this
30723072 section shall be valid until the expi ration of the curren t license
30733073 to practice issued by the Oklahoma Board of Nursing and may be
30743074 renewed upon application to the State Board of Medical Licensure and
30753075 Supervision at the same time and for the same period as the renewal
30763076 of the license to practice. The State Board of Medical Licensure
30773077 and Supervision may revoke independent prescriptive authority
30783078 granted under this section for good cause at any time.
30793079 F. The State Board of Medical L icensure and Supervision may
30803080 establish a fee for the review of init ial and renewal applications
30813081 for independent prescriptive authority , not to exceed the fee amount
30823082 established for initial application for licen sure of physician
30833083 assistants.
30843084 G. 1. A Certified Nurse Practitio ner who obtains independent
30853085 prescriptive authority under this section and practices unsupervised
30863086 shall only practice in one or more geographic areas that have been
30873087 designated as Health Professional Shortag e Areas (HPSAs) for primary
30883088 care by the U.S. Department of Health and Human Services ; provided,
30893089 however:
30903090 a. a Certified Nurse Practitio ner licensed on or before
30913091 the effective date of this ac t may continue to
30923092
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31433143 practice at any physical address or addresses where
31443144 the Certified Nurse Practitioner practices as of the
31453145 effective date of this act regardless of whether the
31463146 address or addresses are loca ted in a geographic area
31473147 or areas that are not designated as HPSAs by the U.S.
31483148 Department of Health and Human Services as of the
31493149 effective date of thi s act, or whether such geographic
31503150 area or areas subsequently lose the HPSA designation
31513151 for primary care; and
31523152 b. a Certified Nurse Practitio ner licensed after the
31533153 effective date of this act may continue to practice at
31543154 any physical address or addresses where the Certified
31553155 Nurse Practitioner practices as of the date of
31563156 obtainment of initial independent prescripti ve
31573157 authority that are located in a geographic area or
31583158 areas that have been designated a s HPSAs for primary
31593159 care by the U.S. Department of Health and Human
31603160 Services as of the date of obtainment of initial
31613161 independent prescriptive authority regardless of
31623162 whether the geographic area or areas where the address
31633163 or addresses are located subsequently lose the HPSA
31643164 designation for primary care .
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32163216 2. The requirements provided by paragraph 1 shall not apply to
32173217 a Certified Nurse Practitioner who holds a doctorate degree in
32183218 nursing.
32193219 H. The provisions of this section sh all apply to an Advanced
32203220 Practice Registered Nurse licensed by endorsement as a Certified
32213221 Nurse Practitioner by the Oklahoma Board of Nursing as provided by
32223222 Section 567.5a of Title 59 of the Oklahoma S tatutes.
32233223 SECTION 6. AMENDATORY 59 O.S. 2011, Section 567.7, as
32243224 amended by Section 1 , Chapter 190, O.S.L. 2016 (59 O.S. Supp. 2020,
32253225 Section 567.7), is amended to read as follows:
32263226 Section 567.7. A. Upon expiration of an initial lic ense or
32273227 certificate issued pursuant to the Oklahoma Nursing Practice Act, a
32283228 license or certificate shall be re newed every two (2) years
32293229 according to a schedule published by the Oklahoma Board of Nursing,
32303230 provided that the application is complete and qualif ying criteria
32313231 continues to be met.
32323232 B. A licensee or certificate holder who applies for
32333233 reinstatement of a lic ense or certificate shall meet such
32343234 requirements as the Board may prescribe in its rules.
32353235 C. Any licensee or certificate holder who desires to re tire
32363236 temporarily from the practice of nursing in this state shall submit
32373237 a written request to that effect to t he Board. It shall be the duty
32383238 of the Board to place the name of such licensee or certificate
32393239 holder upon the nonpracticing list in accordance wi th the rules of
32403240
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32913291 the Board. During the period of temporary retirement, the licensee
32923292 or certificate holder shal l not practice nursing, Advanced Practice
32933293 Registered Nursing or practice as an Advanced Unlicensed Assistant
32943294 nor be subject to the payment of any renewal fees. When the
32953295 licensee or certificate holder desires to resume practice, s uch
32963296 licensee or certificat e holder shall meet such requirements as the
32973297 Board may prescribe in its rules.
32983298 D. The Board is authorized t o establish by rule fees to be
32993299 charged for the purpose of implementing and e nforcing the provisions
33003300 of the Oklahoma Nursin g Practice Act; provided, however, no single
33013301 fee for an initial application for licensure or certification, or
33023302 for renewal, reinstatem ent or return to active practice shall exceed
33033303 One Hundred Twenty-five Dollars ($125.00). The application fee for
33043304 a multistate license issued pursu ant to Section 5 of this act shall
33053305 be One Hundred Fifty Dollars ($150.00). The biennial multistate
33063306 license renewal fee shall be One Hundred Twent y-five Dollars
33073307 ($125.00); provided, how ever, that contingent upon implementation of
33083308 the Nurse Licensure Compac t and the Board’s revolving fund balance
33093309 being reconciled at less than the average of three (3) months of
33103310 expenditures, the biennial renewal fee s et forth in Oklahoma
33113311 Administrative Code 485:10-1-3(a)(2) shall increase by Ten Dolla rs
33123312 ($10.00) by operation of law. The Board may reduce the biennial
33133313 renewal fees on a pro rata basis for the specific Registered Nurs e
33143314 and Licensed Practical Nurse biennia l renewal period.
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33663366 Notwithstanding any other provision of this section, the renewal fee
33673367 for a Certified Nurse Practitioner who has obtained independent
33683368 prescriptive authority as provided by Section 5 of this act shall be
33693369 an amount equivalent to the licensure renewal fee imposed on
33703370 osteopathic physicians.
33713371 E. The Executive Director of the B oard shall suspend the
33723372 license or certificate of a person who submits a check, money draft,
33733373 or similar instrument for payment of a fee which i s not honored by
33743374 the financial institution named. The suspension be comes effective
33753375 ten (10) days following delive ry by certified mail of written notice
33763376 of the dishonor and the impending suspension to the person ’s address
33773377 on file. Upon notification of sus pension, the person may reins tate
33783378 the authorization to practice upon payment of the fees and any and
33793379 all costs associated with notice and collection. The suspension
33803380 shall be exempt from the Administrative Procedures Act.
33813381 SECTION 7. NEW LAW A new section of law to be codified
33823382 in the Oklahoma Statutes as Section 567.27 of Title 59, unless there
33833383 is created a duplication in numbering, reads as follows:
33843384 An Advanced Practice Registered Nurse , or his or her employer on
33853385 his or her behalf, shall be required to carry malpractice insurance
33863386 or demonstrate proof of financial responsibility in a minimum amount
33873387 of One Million Dollars ($1,000,000.00) per occurrence and Three
33883388 Million Dollars ($3,000,000.0 0) in the aggregate per year.
33893389
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34403440 SECTION 8. AMENDATORY 6 3 O.S. 2011, Section 2-312, is
34413441 amended to read as follows:
34423442 Section 2-312. A. A physician, podiatrist, optometrist or a
34433443 dentist who has complied with the registration requireme nts of the
34443444 Uniform Controlled Dangerous Substances Act, in good faith and in
34453445 the course of such person’s professional practice only, may
34463446 prescribe and administe r controlled dangerous substances, or may
34473447 cause the same to be administer ed by medical or parame dical
34483448 personnel acting under the direction and supervision of the
34493449 physician, podiatrist, optometrist or dentist, and only may dispense
34503450 controlled dangerous subs tances pursuant to the provisions of
34513451 Sections 355, 355.1 and 355.2 of Tit le 59 of the Oklahoma S tatutes.
34523452 B. A veterinarian w ho has complied with the registration
34533453 requirements of the Uniform Controlled Dangerous Substances Act, in
34543454 good faith and in the cou rse of the professiona l practice of the
34553455 veterinarian only, and not for us e by a human being, may prescribe,
34563456 administer, and dispense controlled dangerous substances and may
34573457 cause them to be administered by an assistant or orderly under the
34583458 direction and supervision of the veter inarian.
34593459 C. An advanced practice nurse Advanced Practice Registered
34603460 Nurse who is recognized to prescri be by the Oklahoma Board of
34613461 Nursing as an advanced registered nurse practitioner, clinical nurse
34623462 specialist or certified nurse-midwife, a Clinical Nurse Specialist
34633463 or a Certified Nurse-Midwife who is subject to medical directio n by
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35153515 a supervising physician , pursuant to Section 567.3a of Title 59 of
35163516 the Oklahoma Statutes, and who has complied with the registration
35173517 requirements of the Un iform Controlled Dange rous Substances Act, in
35183518 good faith and in the cours e of professional pract ice only, may
35193519 prescribe and administer Schedule III, IV and V controlled danger ous
35203520 substances.
35213521 D. 1. An Advanced Practice Registered Nurse who is recognized
35223522 to prescribe by the Okl ahoma Board of Nursing as a Certified Nurse
35233523 Practitioner who chooses to practi ce under the supervision of a
35243524 physician or who is undergoing a mentorship as provided by Section 5
35253525 of this act and therefore is subject to medical direction by a
35263526 supervising physician pursuant to Section 567.3a of Title 59 of the
35273527 Oklahoma Statutes, and has complied with the registration
35283528 requirements of the Uniform Controlled Da ngerous Substances Act, in
35293529 good faith and in the course of professional practice only, may
35303530 prescribe and administer Schedule III, IV and V controlled dangerous
35313531 substances.
35323532 2. An Advanced Practice Registered Nurse who is recognized to
35333533 prescribe by the Okla homa Board of Nursing as a Certified Nurse
35343534 Practitioner and has obtained independent prescriptive authority as
35353535 provided by Section 5 of this act, and has complied with the
35363536 registration requirements of the Uniform Controlled Dangerous
35373537 Substances Act, in good faith and in the course of pr ofessional
35383538 practice only, may prescribe and administer Schedule III, IV and V
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35903590 controlled dangerous substances and may prescribe Schedule II
35913591 controlled dangerous substances solely for the purpose of treating
35923592 attention deficit disorder or attention deficit hyperactivity
35933593 disorder.
35943594 E. An advanced practice nurse Advanced Practice Regis tered
35953595 Nurse who is recognized to order, selec t, obtain and administer
35963596 drugs by the Oklahoma Board of Nursing as a certified registered
35973597 nurse anesthetist Certified Registered Nurse Anesthetist pursuant to
35983598 Section 353.1b of Title 59 of the Oklahoma Statutes and who has
35993599 complied with the registration re quirements of the Uniform
36003600 Controlled Dangerous Substances Act, in good faith and i n the course
36013601 of such practitioner’s professional practice only, may order,
36023602 select, obtain and administer S chedules II through, III, IV and V
36033603 controlled dangerous substances i n a preanesthetic preparation or
36043604 evaluation; anesthesia induction, maintenance or emergence; or
36053605 postanesthesia care setting only. A certified registered nurse
36063606 anesthetist Certified Registered Nurse Anesthetist may order,
36073607 select, obtain and administer such drugs only during the
36083608 perioperative or periobstetrical period.
36093609 E. F. A physician assistant who is recognized to prescribe by
36103610 the State Board of Medical Licensure and Supervision under th e
36113611 medical direction of a supervising physician, pursuant to subsecti on
36123612 D of Section 519.6 of Title 59 of the O klahoma Statutes, and who has
36133613 complied with the registration requirements of the Uniform
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36653665 Controlled Dangerous Substances Act, in good faith and in the course
36663666 of professional practice only, may prescribe and adminis ter Schedule
36673667 II through, III, IV and V controlled dangerous substances.
36683668 SECTION 9. This act shall become effective November 1, 2021.
36693669
36703670 58-1-136 DC 1/19/2021 9:14:43 PM