Oklahoma 2023 2023 Regular Session

Oklahoma Senate Bill SB458 Introduced / Bill

Filed 01/17/2023

                     
 
 
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STATE OF OKLAHOMA 
 
1st Session of the 59th Legislature (2023) 
 
SENATE BILL 458 	By: Stanley 
 
 
 
 
 
AS INTRODUCED 
 
An Act relating to the practice of nursing ; providing 
for independent prescriptive authority of Advanced 
Practice Registered Nurses who meet certain 
requirements; stating application criteria; 
specifying duration of authority; authorizing 
supervision by Advanced Practice Registered Nurse 
with independent prescriptive authority who meets 
certain requirements; authorizing Oklahoma Board of 
Nursing to prescribe additional qualifications; 
providing for application approva l, denial, 
reapplication, fees, and independent prescriptive 
authority revocation; amending 59 O.S. 2021, Section 
353.1, as amended by Section 6, Chap ter 288, O.S.L. 
2022 (59 O.S. Supp. 2022, Section 353.1) , which 
relates to definitions used in the Oklahoma Pharmacy 
Act; modifying and adding definitions; amending 59 
O.S. 2021, Section 353.1a, which relates to 
prescriptive authority of Advanced Practice 
Registered Nurses; modifyi ng prescriptive authority 
of certain Advanced Practice Registered Nurses ; 
amending 59 O.S. 2021, Section 567.3a, which relates 
to definitions used in the Oklahoma N ursing Practice 
Act; modifying and adding definitions; amending 59 
O.S. 2021, Section 567.4a, which relates to 
prescriptive authority; directing the Board to 
promulgate certain rules; amending 59 O.S. 2021, 
Section 567.5a, which relates to Advanced Practice 
Registered Nurse license; providing for independent 
prescriptive authority by endorsement; amending 63 
O.S. 2021, Section 2-312, as amended by Section 2 , 
Chapter 184, O.S.L. 2022 (63 O.S. Supp. 2022, Section 
2-312), which relates to controlled dangerous 
substances; authorizing Certified Nurse Practitioner 
or Clinical Nurse Specialist to prescribe and 
administer certain controlled dangerous substances;   
 
 
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providing for codification; and providing an 
effective date. 
 
 
 
 
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: 
SECTION 1.     NEW LAW     A new section of law to be codified 
in the Oklahoma Statutes as Section 567.4c of Title 59, unless there 
is created a duplication in numbering, reads as follow s: 
A. 1.  An Advanced Practice Registered Nurse recognized by the 
Oklahoma Board of Nursing as a Certified Nurse Practition er or 
Clinical Nurse Specialist who has completed a minimum of two 
thousand (2,000) hours of practice with prescriptive authority 
supervised by a physician or a supervising Advanced Practice 
Registered Nurse may apply to the Oklahoma Board of Nursing for 
authority to prescribe and order independent of supervision. 
2. The application for independent prescriptive authori ty shall 
include proof that the Certified Nurse Practitioner or Clinical 
Nurse Specialist: 
a. has satisfied the educational requirements stated in 
Section 567.5a of Title 59 of the Oklahoma Statutes, 
b. has successfully passed a national certification 
examination recognized by the Board that measures the 
Advanced Practice Registered Nurse role and specialty 
competencies,   
 
 
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c. holds a valid, current license in the appropriate 
Advanced Practice Registered Nurse role issued by the 
Board and is in good standing with the Board , and 
d. has completed a minimum of two thousand (2,000) hours 
of practice with prescriptive authority supervised by 
a physician or supervising Advanced Practice 
Registered Nurse. 
3.  Independent prescriptive authority granted under this 
subsection shall be valid until the expiration of the cu rrent 
license to practice and may be r enewed upon application to the Board 
at the same time and for the same period as the renewal of the 
license to practice. 
B. 1. A Certified Nurse Practitioner or Clinical Nurse 
Specialist who has obtained independent prescriptive authority under 
subsection A of this section and who has completed a minimum of 
eight thousand (8,000) hours of practice with independent 
prescriptive authority may serve as a supervising Advanced Practice 
Registered Nurse. 
2.  Notwithstanding paragraph 1 of this subsection, an Advanced 
Practice Registered Nurse who has been licensed and in practice for 
a minimum of five (5) years as of the effective date of this act 
without a lapse of work , upon obtainment of independent prescri ptive 
authority under subsection A of this section , may serve as a 
supervising Advanced Practice Registered Nurse.   
 
 
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3.  The Board may at its discretion prescribe by rule additional 
qualifications for supervising Advanced Practice Registered Nurses 
including, but not limited to, qualifications pertaining to the 
Advanced Practice Registered Nurse role or specialty. 
C.  The Board shall review any application submitted under this 
section and shall approve or deny the application, stati ng the 
reason or reasons for denial, if denied.  The Board shall mail the 
approval or denial letter to the applicant within fourteen (14) 
calendar days of receip t of the application.  If denied, the 
applicant may reapply using the process prescribed by subsection A 
of this section. 
D.  The Board may suspend or revoke independent prescriptive 
authority granted under this section for good cause at any time. 
E.  The Board may establish a fe e for the review of initial and 
renewal applications under the provisions of this section. 
SECTION 2.     AMENDATORY     59 O.S. 2021 , Section 353.1, as 
amended by Section 6, Chap ter 288, O.S.L. 2022 (59 O.S. Supp. 2022, 
Section 353.1), is amended to r ead as follows: 
Section 353.1. For the purposes of the Ok lahoma Pharmacy Act: 
1.  “Accredited program” means those seminars, classes, 
meetings, work projects, and oth er educational courses approved by 
the Board State Board of Pharmacy for purposes of continuing 
professional education; 
2.  “Act” means the Oklahoma Pharmacy Act;   
 
 
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3.  “Administer” means the direct application of a drug, whethe r 
by injection, inhalation, ingestion or any other means, to the body 
of a patient; 
4.  “Assistant pharmacist” means any person presently licensed 
as an assistant pharmacist in the State of Oklahom a by the Board 
pursuant to Section 353.10 of this title and for the purposes of the 
Oklahoma Pharmacy Act shal l be considered the same as a pharmacist, 
except where otherwise specified; 
5.  “Board” or “State Board” means the State Board of Pharmacy; 
6.  “Certify” or “certification of a prescription ” means the 
review of a filled prescription by a licensed pharmac ist or a 
licensed practitioner with dispensing authority to confirm that the 
medication, labeling an d packaging of the filled prescription are 
accurate and meet all requirements prescribed by state and feder al 
law.  For the purposes of this paragraph, “licensed practitioner” 
shall not include optometrists with dispensing authority; 
7.  “Chemical” means any medicinal substance, whether simple or 
compound or obtained through the process of the science and art o f 
chemistry, whether of organic or inorganic ori gin; 
8.  “Compounding” means the combining, admixing, mixing, 
diluting, pooling, reconstituting or ot herwise altering of a drug or 
bulk drug substance to create a drug.  Compounding includes the 
preparation of drugs or devices in anticipation of prescript ion drug 
orders based on routine, regularly observed prescribing patterns;   
 
 
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9.  “Continuing professiona l education” means professional, 
pharmaceutical education in the general areas of the socioeconomic 
and legal aspects of health care; the properties and actions of 
drugs and dosage forms; and the etiology, characteristics and 
therapeutics of the diseased s tate; 
10.  “Dangerous drug”, “legend drug”, “prescription drug” or “Rx 
Only” means a drug: 
a. for human use subject to 21 U.S.C. 353(b)(1), or 
b. is labeled “Prescription Only”, or labeled with the 
following statement:  “Caution:  Federal law restricts 
this drug except for use by or on the order of a 
licensed veterinarian.”; 
11.  “Director” means the Executive Director of the State Board 
of Pharmacy unless context clearly indicates otherwise; 
12.  “Dispense” or “dispensing” means the interpretation, 
evaluation, and implementation of a prescription drug o rder 
including the preparation and delivery of a drug or de vice to a 
patient or a patient ’s agent in a suitable container appropria tely 
labeled for subsequent administration to, or use by, a patient .  
Dispense includes sell, distribute, leave with, give aw ay, dispose 
of, deliver or supply; 
13.  “Dispenser” means a retail pharmacy, hospital pharmacy, a 
group of chain pharmacies under c ommon ownership and control that do 
not act as a wholesale distributor, or any other person authorized   
 
 
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by law to dispense or administer prescription drugs, and the 
affiliated warehouse s or distributions of such entities und er common 
ownership and control t hat do not act as a wholesale distributor.  
For the purposes of this parag raph, “dispenser” does not mean a 
person who dispenses only products to be used in animals in 
accordance with 21 U.S.C. 360b(a)(5); 
14.  “Distribute” or “distribution” means the sale, purchase, 
trade, delivery, handling, storage, or receipt of a product, and 
does not include the dispensing of a product pur suant to a 
prescription executed in accordance with 21 U.S. C. 353(b)(1) or the 
dispensing of a product approved under 21 U.S.C. 360 b(b); provided, 
taking actual physical possession of a product or title s hall not be 
required; 
15.  “Doctor of Pharmacy” means a person licensed by the Board 
to engage in the practice of pharmacy.  The terms “pharmacist”, 
“D.Ph.”, and “Doctor of Pharmacy” shall be interchangeable and shall 
have the same meaning wherever they a ppear in the Oklahoma Statutes 
and the rules promulga ted by the Board; 
16.  “Drug outlet” means all manufacturer s, repackagers, 
outsourcing faciliti es, wholesale distributors, third-party 
logistics providers, pharmacies, and all other facilities which are 
engaged in dispensing, delivery, distribution or stor age of 
dangerous drugs;   
 
 
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17.  “Drugs” means all medicinal su bstances and preparations 
recognized by the United States Pharmacopoeia and National 
Formulary, or any revision thereof, and all substances an d 
preparations intended for external and/or internal us e in the cure, 
diagnosis, mitigation, treatment or preventi on of disease in humans 
or animals and all substances and preparations, other than food, 
intended to affect the structure or any function of t he body of a 
human or animals; 
18.  “Drug sample” means a unit of a prescription drug packaged 
under the authority and responsibility of the manufac turer that is 
not intended to be sold and is intended to promote the sale of the 
drug; 
19. “Durable medical equipment” has the same meaning as 
provided by Section 2 of this act; 
20. “Filled prescription” means a packaged prescription 
medication to which a label has been affixed which contain s such 
information as is required by the Oklahoma Pharmacy Act; 
21.  “Hospital” means any institution licensed as a hospital by 
this state for the care and treatment of patients, or a pharmacy 
operated by the Oklahoma Department of Vet erans Affairs; 
22.  “Licensed practitioner” means: 
a. an allopathic physician, 
b. an osteopathic physician, 
c. a podiatric physician,   
 
 
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d. a dentist, 
e. a veterinarian or, 
f. an optometrist, or 
g. a Certified Nurse Practitioner or Clinical Nurse 
Specialist who has obtained independent prescriptive 
authority under Section 1 of this act, 
licensed to practice and authorized to prescribe dangerous drugs 
within the scope of practice of such p ractitioner; 
23.  “Manufacturer” or “virtual manufacturer” means with respect 
to a product: 
a. a person that holds an application appr oved under 21 
U.S.C. 355 or a license issued under 42 U.S.C. 262 for 
such product, or if such product is not the subject of 
an approved application or license, the person who 
manufactured the pro duct, 
b. a co-licensed partner of the person described in 
subparagraph a that obtains the product directly from 
a person described in this subpa ragraph or 
subparagraph a of this paragraph, 
c. an affiliate of a person described in subpara graph a 
or b who receives the product directly from a person 
described in this subparagraph or in subparagraph a or 
b of this paragraph, or   
 
 
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d. a person who contracts with another to manufacture a 
product; 
24.  “Manufacturing” means the production, preparation, 
propagation, compounding, conversion or processing of a device or a 
drug, either directly or indirectly by extraction from substances of 
natural origin or independently by means of chemic al or biological 
synthesis and includes any packaging or repackaging of the 
substances or labeling or relabeling of its container, and the 
promotion and marketing of such drug s or devices.  The term 
“manufacturing” also includes the preparation and promoti on of 
commercially available pro ducts from bulk compounds for resale by 
licensed pharmacies, licensed practitioners or other persons; 
25.  “Medical gas” means those gases including those in liquid 
state upon which the manufacturer or distributor has placed one of 
several cautions, such a s “Rx Only”, in compliance with federal l aw; 
26.  “Medical gas order” means an order for medical gas issued 
by a licensed prescriber; 
27.  “Medical gas distributor ” means a person licensed to 
distribute, transfer, wholesale, deliver or sell medical gases o n 
drug orders to suppliers or oth er entities licensed to use, 
administer or distribute medical gas and may also include a patient 
or ultimate user; 
28.  “Medical gas supplier” means a person who di spenses medical 
gases on drug orders only to a patient or ultimate user;   
 
 
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29.  “Medicine” means any drug or combination of drugs which has 
the property of curing, preventing, treating , diagnosing or 
mitigating diseases, or which is used for that purpose; 
30.  “Nonprescription drugs ” means medicines or drug s which are 
sold without a prescription and which are prepackaged for use by the 
consumer and labeled in accordance with the req uirements of the 
statutes and regulati ons of this state and the federal gov ernment.  
Such items shall also include medical and d ental supplies and 
bottled or nonbulk chemicals which are sold or offered for sale to 
the general public if such articles or pre parations meet the 
requirements of the Federal Food, Drug and Cosmetic Act, 21 
U.S.C.A., Section 321 et seq.; 
31.  “Outsourcing facility” including “virtual outsourcing 
facility” means a facility at one geographic location or address 
that: 
a. is engaged in the compounding of sterile dru gs, 
b. has elected to register as an outsourcing facility, 
and 
c. complies with all requirem ents of 21 U.S.C. 353b; 
32.  “Package” means the smallest individual saleable unit of 
product for distribution by a manufact urer or repackager that is 
intended by the manufacturer for ultimate s ale to the dispenser of 
such product.  For the purposes of this paragraph, “individual 
saleable unit” means the smallest container of a product introduced   
 
 
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into commerce by the manufactur er or repackager that is intended by 
the manufacturer or repackager fo r individual sale to a dispenser; 
33.  “Person” means an individual, partnership, limited 
liability company, corporation or association, unless the context 
otherwise requires; 
34.  “Pharmacist-in-charge” or “PIC” means the pharmacist 
licensed in this state responsible for the management control of a 
pharmacy and all other aspects of the practice of pharmacy in a 
licensed pharmacy as defined by Section 353.18 of this title; 
35.  “Pharmacy” means a place regularly licensed by the Board of 
Pharmacy in which prescriptions, drug s, medicines, chemicals and 
poisons are compounded or dispe nsed or such place where pharmacists 
practice the profession of pharmacy, or a pharmacy operated b y the 
Oklahoma Department of V eterans Affairs; 
36.  “Pharmacy technician”, “technician”, “Rx tech”, or “tech” 
means a person issued a Technician permit by the State Board of 
Pharmacy to assist the pharmacist and perform nonjudgmental, 
technical, manipulative, non-discretionary functions in the 
prescription department under the immediate and direct super vision 
of a pharmacist; 
37.  “Poison” means any substance which when introduced into the 
body, either directly or by absorption, produces violent, morbid or 
fatal changes, or wh ich destroys living tissue with which such 
substance comes into contact;   
 
 
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38.  “Practice of pharmacy” means: 
a. the interpretation and evaluation of prescription 
orders, 
b. the compounding, dispensing, administering and 
labeling of drugs and devices, except labeling by a 
manufacturer, repackager or distributor of 
nonprescription drugs and commercially packaged legend 
drugs and devices, 
c. the participation in drug selection and drug 
utilization reviews, 
d. the proper and safe storage of drugs and de vices and 
the maintenance of proper r ecords thereof, 
e. the responsibility for advising by counseling and 
providing information, where professionally necessary 
or where regulated, of therapeutic values, content, 
hazards and use of drugs and devices, 
f. the offering or performing of those ac ts, services, 
operations or transactions necessary in the conduct, 
operation, management and control of a pharmacy, or 
g. the provision of those acts or services t hat are 
necessary to provide pharmaceutical care; 
39.  “Preparation” means an article which may or may not contain 
sterile products compounded in a licensed pharmacy pursuant to the 
order of a licensed prescriber;   
 
 
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40.  “Prescriber” means a person licensed in this state who is 
authorized to prescribe dangerous drugs within the scope of p ractice 
of the person’s profession; 
41.  “Prescription” means and includes any order for drug or 
medical supplies written or signed, or transmitted by word of mouth, 
telephone or other means of communication: 
a. by a licensed prescriber, 
b. under the supervision of an Oklahoma licensed 
practitioner, an Oklahoma licensed advanced practice 
registered nurse or an Oklahoma license d a supervising 
physician, by a physician assistant or a Certified 
Nurse-Midwife licensed in this state , or 
c. (1) under the supervision of a supervising physician 
or supervising Advanced Practice Registered 
Nurse, by a Certified Nurse Practitioner or 
Clinical Nurse Specialist licensed in this state 
who has not obtained independent prescriptive 
authority under Section 1 of this act, or 
(2) by a Certified Nurse Practitioner or Clinical 
Nurse Specialist licensed in this state who has 
obtained independent prescriptive authority under 
Section 1 of this act, or 
d. by an Oklahoma licensed wholesaler or distributo r as 
authorized in Section 353.29.1 of this title;   
 
 
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42.  “Product” means a prescription drug in a finished dosage 
form for administration to a patient w ithout substantial further 
manufacturing, such as capsules, tablets, and lyophilized products 
before reconstitution.  “Product” does not include blo od components 
intended for transfusion, radioactive drugs or biologics and med ical 
gas; 
43.  “Repackager”, including “virtual repackager”, means a 
person who owns or operates an establishment that repac ks and 
relabels a product or package for further sale or distribution 
without further transaction; 
44.  “Sterile drug” means a drug that is intended for p arenteral 
administration, an ophthalmic or oral inhalati on drug in aqueous 
format, or a drug that is required to be sterile under state and 
federal law; 
45. “Supervising Advanced Practice Registered Nurse” has the 
same meaning as provided by S ection 567.3a of this title; 
46.  “Supervising physician ” means an individual holding a 
current license to practice as a physician from the State Board of 
Medical Licensure and Supervision, pursuant to the provisions of the 
Oklahoma Allopathic Medical and Surgical Licensur e and Supervision 
Act, or the State Board of Osteop athic Examiners, pursuant to t he 
provisions of the Oklahoma Osteopathic Medicine Act, who supervises 
an advanced practice registered nurse:   
 
 
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a. a Certified Nurse Practitioner or Clinical Nurse 
Specialist as defined in Section 567.3a of this title 
who has not obtained independent prescriptive 
authority under Section 1 of this act, or 
b. a Certified Nurse-Midwife as defined in Section 567.3a 
of this title, 
and who is not in trai ning as an intern, resident, or fellow .  To be 
eligible to supervise an advanced practice registered nurse, such 
The supervising physician shall remain in compliance with the rules 
promulgated by the State Board of Medical Li censure and Supervision 
or the State Board of O steopathic Examiners; 
46. 47.  “Supportive personnel ” means technicians and auxiliary 
supportive persons who are regularly paid employees of a pharma cy 
who work and perform ta sks in the pharmacy as authorized by Section 
353.18A of this title; 
47. 48.  “Third-party logistics provider” including “virtual 
third-party logistics provider” means an entity that provides or 
coordinates warehousing, or other logi stics services of a product in 
interstate commerce on beh alf of a manufacturer, wholesale 
distributor, or dispenser of a produc t but does not take ownership 
of the product, nor h ave responsibility to direct the sale or 
disposition of the product.  For the purposes of this paragraph, 
“third-party logistics provid er” does not include shippers and the 
United States Postal Service;   
 
 
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48. 49.  “Wholesale distributor ” including “virtual wholesale 
distributor” means a person other than a manufacturer, a 
manufacturer’s co-licensed partner, a thir d-party logistics 
provider, or repackager engaged in wholesale distribution as defined 
by 21 U.S.C. 353(e)(4) as amended by the Drug Supply Chain Se curity 
Act; 
49. 50.  “County jail” means a facility operated by a county for 
the physical detention and correct ion of persons charged with, or 
convicted of, criminal o ffenses or ordinance violations or per sons 
found guilty of civil or criminal contempt; 
50. 51.  “State correctional facility ” means a facility or 
institution that houses a p risoner population under the j urisdiction 
of the Department of Corrections; 
51. 52.  “Unit dose package” means a package that contains a 
single dose drug with the name, str ength, control number, and 
expiration date of that drug on the label; and 
52. 53.  “Unit of issue package” means a package that provides 
multiple doses of the same drug, but each drug is individually 
separated and includes the name, lot number, and expirat ion date. 
SECTION 3.     AMENDATORY     59 O.S. 20 21, Section 353.1a, is 
amended to read as f ollows: 
Section 353.1a.  A. Prescribing 1.  Prescriptive authority 
shall be allowed, under th e medical direction of a supervising 
physician or supervising Advanced Practice R egistered Nurse, for an   
 
 
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advanced practice nurse a licensed Advanced Practice Registered 
Nurse recognized by the Oklahom a Board of Nursing in one of the 
following categories:  advanced registered nurse practitioners, 
clinical nurse specialists, or certified nurse -midwives as a 
Certified Nurse Practitioner or Clinical Nurse Specialist who has 
not obtained independent prescriptive authority under Section 1 of 
this act. 
2.  Prescriptive authority shall be allowed, independent of the 
medical direction of a supervising physician or supervising Advanced 
Practice Registered Nurse, for a licensed Advanced Practice 
Registered Nurse recognized by the Oklahoma Board of Nursing as a 
Certified Nurse Practitioner or Clinical Nurse Specialist who has 
obtained independent prescriptive authority under Section 1 of this 
act. 
B. Prescriptive authority shall be allowed , under the medical 
direction of a supervising physician , for a licensed Advanced 
Practice Registered Nurse recognized by the Oklahoma Board of 
Nursing as a Certified Nurse Practitioner. 
C. The advanced practice nurse Advanced Practice Registere d 
Nurse may write or sign, or transmit by word of mouth, telephone or 
other means of communication an order for drugs or medical supplie s 
that is intended to be filled, compounded, or dis pensed by a 
pharmacist.  The supervising physician or supervising Advanced 
Practice Registered Nurse, if applicable, and the advanced practice   
 
 
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nurse prescribing Advanced Practice Registered Nurse shall be 
identified at the time of origination of the prescription and the 
name of the advanced practice nurse prescribing Advanced Practice 
Registered Nurse shall be printed on the prescription label. 
B. D.  Pharmacists may dispense prescriptions for non-controlled 
prescription drugs authorized by an advanced practice nurse Advanced 
Practice Registered Nurse or physician assistant, not located in 
Oklahoma this state, provided that they are licensed in the state in 
which they are actively prescribing. 
C. E. 1. Pharmacists may only dispense prescriptions for 
controlled dangerous substances prescribed by an advanced practice 
nurse or physician assistant Advanced Practice Registered Nurse 
licensed in the State of Oklahoma and supervised by an Oklahoma-
licensed practitioner this state who meets the criteria in paragraph 
1 or 2 of subsection A of this section or who meets the criteria in 
subsection B of this section. 
2.  Pharmacists may only dis pense prescriptions for contro lled 
dangerous substances prescribed by a physician assistant licensed in 
this state and supervised by a supervising physician licensed in 
this state. 
SECTION 4.     AMENDATORY     59 O.S. 2021, Section 567.3a, is 
amended to read as follows: 
Section 567.3a. As used in the Oklahoma Nursing Practice Act: 
1.  “Board” means the Oklahoma Board of Nursing;   
 
 
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2. “The practice of nursing ” means the performance of services 
provided for purposes of nursing diagnosis and treatment of human 
responses to actual or potential health problems consistent wit h 
educational preparation.  Knowledge and skill are the basis fo r 
assessment, analysis, planning, intervention, and evaluation used in 
the promotion and maintenance of healt h and nursing management of 
illness, injury, infirmity, restoration or optimal func tion, or 
death with dignity.  Practice is based on understanding the human 
condition across the human lifespan and understanding the 
relationship of the individual within th e environment.  This 
practice includes execution of the medical regime including th e 
administration of medications and treatments prescribed by any 
person authorized by state law to so prescribe; 
3. “Registered nursing” means the practice of the full scop e of 
nursing which includes, but is not limited to: 
a. assessing the health status of individuals, families 
and groups, 
b. analyzing assessment dat a to determine nursing care 
needs, 
c. establishing goals to meet identified health care 
needs, 
d. planning a strategy of care, 
e. establishing priorities of nursing intervention to 
implement the strategy of care,   
 
 
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f. implementing the strategy of care, 
g. delegating such tasks as may safely be performed by 
others, consistent with educational preparation and 
that do not conflict with the p rovisions of the 
Oklahoma Nursing Practice Act, 
h. providing safe and effective nursing care rendered 
directly or indirectl y, 
i. evaluating responses to interventions, 
j. teaching the principles and practice of nursing, 
k. managing and supervising the prac tice of nursing, 
l. collaborating with other health profess ionals in the 
management of health care, 
m. performing additiona l nursing functions in accordance 
with knowledge and skills acquired beyond basic 
nursing preparation, and 
n. delegating those nursin g tasks as defined in the rules 
of the Board that may be pe rformed by an advanced 
unlicensed assistive person; 
4.  “Licensed practical nursing” means the practice of nursing 
under the supervision or direction of a registered nurse, licensed 
physician or dentist.  This directed scope of nursing practice 
includes, but is not limited to: 
a. contributing to the assessment of the h ealth status of 
individuals and groups,   
 
 
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b. participating in the development and modification of 
the plan of care, 
c. implementing the appropriate aspects of the plan of 
care, 
d. delegating such tasks as may safely be performed by 
others, consistent with ed ucational preparation and 
that do not conflict with the Oklahoma Nursing 
Practice Act, 
e. providing safe and effective nursing care r endered 
directly or indirectly, 
f. participating in the eva luation of responses to 
interventions, 
g. teaching basic nursing skills and related principles, 
h. performing additional nursing procedures in accordance 
with knowledge and skills acquired through education 
beyond nursing preparation, and 
i. delegating those nursing tasks as defined in the rules 
of the Board that may b e performed by an advanced 
unlicensed assistive per son; 
5.  “Advanced Practice Registered Nurse ” means a licensed 
Registered Nurse: 
a. who has completed an advanced practice registered 
nursing education program in preparation for one of   
 
 
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four recognized advanced practice registered nurse 
Advanced Practice Registered Nurse roles, 
b. who has passed a national certif ication examination 
recognized by the Board that measures the advanced 
practice registered nurse Advanced Practice Registered 
Nurse role and specialty competencies and who 
maintains recertification in the role and specialty 
through a national certification program, 
c. who has acquired adv anced clinical knowledge and 
skills in preparation for providing both direct and 
indirect care to patients; howeve r, the defining 
factor for all Advanced Practice Re gistered Nurses is 
that a significant component of the edu cation and 
practice focuses on di rect care of individuals, 
d. whose practice builds on the competencies of 
Registered Nurses by demonstrating a gre ater depth and 
breadth of knowledge, a greater synt hesis of data, and 
increased complexity of skills and inte rventions, and 
e. who has obtained a license as an Advanced Practice 
Registered Nurse in one of the following roles:  
Certified Registered Nurse An esthetist, Certified 
Nurse-Midwife, Clinical Nurse Specialist, or Certified 
Nurse Practitioner.   
 
 
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Only those persons who hold a license to pract ice advanced 
practice registered nursing in this s tate shall have the right to 
use the title “Advanced Practice Re gistered Nurse” and to use the 
abbreviation “APRN”. Only those persons who have obtained a license 
in the following disciplines shall have th e right to fulfill the 
roles and use the applicabl e titles:  Certified Registered Nurse 
Anesthetist and the abbrev iation “CRNA”, Certified Nurse-Midwife and 
the abbreviation “CNM”, Clinical Nurse Specialist and the 
abbreviation “CNS”, and Certified Nurse P ractitioner and the 
abbreviation “CNP”. 
It shall be unlawful for any person to assume the role or use 
the title Advanced Practice Registered Nurse or use the abbrevi ation 
“APRN” or use the respective specialty role titles a nd abbreviations 
or to use any other titles or abbreviations that would reasonably 
lead a person to believe the user is an Advanced Practice Regist ered 
Nurse, unless permitted by the Oklahoma Nursin g Practice Act.  Any 
individual doing so shall be guilty o f a misdemeanor, which shall be 
punishable, upon conviction, by imprisonment in the county jail for 
not more than one (1) year or by a fine of not less than One Hundred 
Dollars ($100.00) nor more th an One Thousand Dollars ($1,000.00), or 
by both such imprisonment and fine for each offense ; 
6. “Certified Nurse Practitioner” is means an Advanced Practice 
Registered Nurse who performs in an expanded ro le in the delivery of 
health care:   
 
 
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a. consistent with advanced educational preparation as a 
Certified Nurse Practitioner in an area of special ty, 
b. functions within the Certified Nurse Practi tioner 
scope of practice for the selected area of 
specialization, and 
c. is in accord with the standards for Certif ied Nurse 
Practitioners as identified by the certifying bo dy and 
approved by the Board. 
A Certified Nurse Practitioner shall be eligible, in accordance 
with the scope of practice of the Certified Nurse Pra ctitioner, to 
obtain recognition as authorized by t he Board to prescribe, as 
defined by the rules promulgated by the Board pursuant to this 
section and subject to the medical direction of a su pervising 
physician Section 567.4a of this title and Section 1 of this act.  
This authorization shall not include d ispensing drugs, but shall not 
preclude, subject to federa l regulations, the receipt of, th e 
signing for, or the dispensing of professional s amples to patients. 
The Certified Nurse Practitioner accepts res ponsibility, 
accountability, and obligation to prac tice in accordance with usual 
and customary advanced pract ice registered nursing standards and 
functions as defined by the scope of practice/ role definition 
statements for the Certified Nurse Practitioner; 
7.  a. “Clinical Nurse Specialist ” is means an Advanced 
Practice Registered Nurse who holds:   
 
 
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(1) a master’s degree or higher in nursing with 
clinical specialization preparation to function 
in an expanded role, 
(2) specialty certification from a national 
certifying organization recognized by the Board, 
(3) an Advanced Practice Registered Nurse license 
from the Board, and 
(4) any nurse holding a specialty certification as a 
Clinical Nurse Specia list valid on January 1, 
1994, granted by a national certifying 
organization recognized by the Board, shall be 
deemed to be a Clinical Nurse Specialist under 
the provisions of the Oklahoma Nursing Practice 
Act. 
b. In the expanded role, the Clinical Nurse S pecialist 
performs at an advanced practice level which shall 
include, but not be limited to: 
(1) practicing as an expert clinician in the 
provision of direct nursing care to a selected 
population of patien ts or clients in any setting, 
including private pra ctice, 
(2) managing the care of patients or clients with 
complex nursing problems,   
 
 
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(3) enhancing patient or client c are by integrating 
the competencies of clinical practice, education, 
consultation, and re search, and 
(4) referring patients or clients to ot her services. 
c. A Clinical Nurse Specialist in accordance with t he 
scope of practice of such Clinical Nurse Special ist 
shall be eligible to obtain recognition as authorized 
by the Board to prescribe, as d efined by the rules 
promulgated by the Board pursua nt to this section, and 
subject to the medical direction of a sup ervising 
physician Section 567.4a of this title and Section 1 
of this act.  This authorization shall not i nclude 
dispensing drugs, but shall not preclude, subject to 
federal regulations, the receipt of, the signing for, 
or the dispensing of profes sional samples to patients. 
d. The Clinical Nurse Specialist acc epts responsibility, 
accountability, and obligation to practice in 
accordance with usual and customary advanced practice 
nursing standards and functions as defined by the 
scope of practice/rol e definition statements for the 
Clinical Nurse Specialist; 
8.  “Nurse-Midwife” is means a nurse who has received an 
Advanced Practice Registered Nurs e license from the Oklahoma Board   
 
 
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of Nursing who possesses evidence of certification according to the 
requirements of the American College of Nurse -Midwives. 
A Certified Nurse-Midwife in accordance with the scope of 
practice of such Certified Nurse -Midwife shall be eligible to obtain 
recognition as authori zed by the Board to prescribe, as defined by 
the rules promulgated by the Board pursuant to this section and 
subject to the medical direction of a supervising physician .  This 
authorization shall not inclu de the dispensing of drugs, but shall 
not preclude, subject to federal regulations, the receipt of, the 
signing for, or the dispensing of professional samples to patients . 
The Certified Nurse-Midwife accepts responsibility , 
accountability, and obligation t o practice in accordance with usual 
and customary advanced practice registered nursing standards and 
functions as defined by the scope of practice/role definition 
statements for the Certified Nurse-Midwife; 
9.  “Nurse-midwifery practice” means providing management of 
care of normal newborns and women, ante partally, intrapartally, 
postpartally and gynecologicall y, occurring within a health care 
system which provides for med ical consultation, medical management 
or referral, and is in accord with the standards for nurse-midwifery 
practice as defined by the Ame rican College of Nurse -Midwives; 
10. a. “Certified Registered Nurse Anesthetist ” is an 
Advanced Practice Registered Nur se who:   
 
 
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(1) is certified by the National Board of 
Certification and Recertification f or Nurse 
Anesthetists as a Certified Registered Nur se 
Anesthetist within one (1) year following 
completion of an approved certified registered 
nurse anesthetist Certified Registered Nurse 
Anesthetist education program, and continues to 
maintain such recert ification by the National 
Board of Certification an d Recertification for 
Nurse Anesthetists, and 
(2) administers anesthesia in collaboration with a 
medical doctor, an oste opathic physician, a 
podiatric physician or a dentis t licensed in this 
state and under conditions in which timely onsite 
consultation by such doctor, osteopath, podiatric 
physician or dentist i s available. 
b. A Certified Registered Nurse Anesthetist, in 
collaboration with a medical doctor, osteopathic 
physician, podiatric physician or dent ist licensed in 
this state, and under conditions in which timely, on-
site consultation by such medical docto r, osteopathic 
physician, podiatric physician or dentist is 
available, shall be authorized, pursuant to rules 
adopted by the Oklahoma Board of Nursi ng, to order,   
 
 
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select, obtain and administer legend drugs, Schedules 
II through, III, IV, and V controlled substances, 
devices, and medical gases only when engaged in the 
preanesthetic preparation and evaluation; anesthesia 
induction, maintenance and emergence; and 
postanesthesia care.  A Certified Register ed Nurse 
Anesthetist may order, select, obtain and adminis ter 
drugs only during the perioperative or periobstetrical 
period. 
c. A Certified Registered Nurse Anesthetist who applies 
for authorization to order, select, obtain and 
administer drugs shall: 
(1) be currently recognized as a Certified Registered 
Nurse Anesthetist in this state, 
(2) provide evidence of completion, wi thin the two-
year period immediately preceding the d ate of 
application, of a minimum of fifteen (15) units 
of continuing education in a dvanced pharmacology 
related to the administration of anes thesia as 
recognized by the National Board of Certification 
and Recertification for Nurse Anesthetists, and 
(3) complete and submit a no tarized application, on a 
form prescribed by the Board, accomp anied by the   
 
 
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application fee established pursuant to this 
section. 
d. The authority to order, select, obtain and administ er 
drugs shall be terminated if a Certified Register ed 
Nurse Anesthetist has: 
(1) ordered, selected, obtained or administered drugs 
outside of the Certified Registered Nurse 
Anesthetist scope of practice or ordered, 
selected, obtained or administered drugs for 
other than therapeutic purposes, or 
(2) violated any provision of st ate laws or rules or 
federal laws or regulations pertaining to the 
practice of nursing or the authority to order, 
select, obtain and administer drugs. 
e. The Oklahoma Board of Nursing shall notify the Board 
of Pharmacy after terminatio n of or a change in t he 
authority to order, select, obtain and administer 
drugs for a Certified Registered Nurse Anesthetist. 
f. The Board shall provide by rule for biennial 
application renewal and reauth orization of authority 
to order, select, obtain and administer drugs for 
Certified Registered Nurse Anesthetists.  At the time 
of application renewal, a Certified Registered Nurse 
Anesthetist shall submit documentation of a minimum of   
 
 
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eight (8) units of co ntinuing education, completed 
during the previous tw o (2) years, in advan ced 
pharmacology relating to the administration of 
anesthesia, as recognized by the Council on 
Recertification of Nurse Anesthetists or the Council 
on Certification of Nurse Anestheti sts. 
g. This paragraph shall not prohibit the admini stration 
of local or topical anesthetics as now permitted by 
law.  Provided further , nothing in this paragraph 
shall limit the authority of t he Board of Dentistry to 
establish the qualifications for denti sts who direct 
the administration of anesthesia. 
h. As used in this parag raph, “collaboration” means an 
agreement between a medical doc tor, osteopathic 
physician, podiatric physician or dentist performing 
the procedure or directly involved with the procedu re 
and the Certified Registered Nurse Anesthetist wo rking 
jointly toward a common goal providing services for 
the same patient.  This c ollaboration involves the 
joint formulation, discussion an d agreement of the 
anesthesia plan by both parties, and the col laborating 
medical doctor, osteopathic physician, po diatric 
physician or dentist performing the procedure or 
directly involved with the procedure and that.  The   
 
 
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collaborating physician shall re main available for 
timely onsite consultation during the delive ry of 
anesthesia for diagnosis, consultation, and tr eatment 
of medical conditions; 
11. “Supervising Advanced Practice Registered Nurse” means an 
Advanced Practice Registered Nurse holding a current license to 
practice who has obtained independent prescriptive authority under 
Section 1 of this act and who otherwise meets the qualification s of 
a supervising Advanced Practice Registered Nur se under Section 1 of 
this act who supervises a Certified Nurse Practitioner or a Clinical 
Nurse Specialist who has not obtained independent prescriptive 
authority under Section 1 of this act ; 
12. “Supervising physician” means an individual holding a 
current license to practice as a physi cian from the State Board of 
Medical Licensure and Supervision or the State Board of Osteopathic 
Examiners, who supervises : 
a. a Certified Nurse Practitioner , or a Clinical Nurse 
Specialist who has not obtained independent 
prescriptive authority under Section 1 of this act, or 
b. a Certified Nurse-Midwife, 
and who is not in training as an intern, resident, or fellow.  To be 
eligible to supervise such Advanced Practice Regis tered Nurse, such 
The supervising physician shall remain in compliance with t he rules   
 
 
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promulgated by the State Board of Medical Licensure and Supervision 
or the State Board of Osteopathic Examiners; 
12. 13. “Supervision of an Advanced Practice Registered Nurse 
with prescriptive authority” means overseeing and accepting 
responsibility for the ordering and transmission by: 
a. a Certified Nurse Practitioner , or a Clinical Nurse 
Specialist who has not obtained independent 
prescriptive authority under Section 1 of this act, or 
b. a Certified Nurse-Midwife, 
of written, telephonic, electronic or oral prescriptions for drugs 
and other medical supplies, subject to a defined fo rmulary; and 
13. 14. “Advanced Unlicensed Assistant ” means any person who 
has successfully completed a certified training program approved by 
the Board that trains the Advanced Unlicensed Assistant to perform 
specified technical skills identified by the B oard in acute care 
settings under the direction and supervision of the Registered Nurse 
or Licensed Practical Nurse. 
SECTION 5.     AMENDATORY    59 O.S. 2021, Section 567.4a, is 
amended to read as follows: 
Section 567.4a. The Oklahoma Board of Nursing may grant 
prescriptive authority through the Advanc ed Practice Registered 
Nurse license to Certified Nurse Practitioners, Certified Nurse-
Midwives, and Clinical Nurse Specialists who meet the requirements 
for prescriptive authority identif ied by law and in the Board’s   
 
 
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rules. The rules regarding prescriptiv e authority recognition 
promulgated by the Oklahoma Board of Nursing pursuant to paragraphs 
6 through 9, 11 and 12 of Section 567.3a of this ti tle shall: 
1.  Define the procedure for docu menting supervision by a 
supervising physician licensed in Oklahoma t o practice by the State 
Board of Medical Licensure and Supervision or the State Board of 
Osteopathic Examiners or a supervising Advanced Practice Registered 
Nurse, if applicable.  Such procedure shall i nclude a written 
statement that defines appropriate referral, consultati on, and 
collaboration between the Advanced Practice Registered Nurse, 
recognized to prescribe as defined in paragraphs 6 through 9, 11 and 
12 of Section 567.3a of this title, and the s upervising physician or 
supervising Advanced Practice Registered Nurse, if applicable.  The 
written statement shall include a method of assuring availability of 
the supervising physician or supervising Advanced Practice 
Registered Nurse through direct contact, telecommun ications or other 
appropriate electronic means for consul tation, assistance with 
medical emergencies, or patient referral.  The written statement 
shall be part of the initial application and the renewal application 
submitted to the Board for recognition fo r prescriptive authority 
for the Advanced Practice Regist ered Nurse.  Changes to the written 
statement shall be filed with the Board within thirty (30) day s of 
the change and shall be effective on filing;   
 
 
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2. Define the procedure for documenting independent 
prescriptive authority for Certified Nurse Practitioners and 
Clinical Nurse Specialists who have obtained independent 
prescriptive authority unde r the Section 1 of this act; 
3. Define minimal requirements for initial application for 
prescriptive authority which shall in clude, but not be limited to, 
evidence of completion of a minimum of forty-five (45) contact ho urs 
or three (3) academic credit hours of education in 
pharmacotherapeutics, clinical application, and use of 
pharmacological agents in the prevention of illness , and in the 
restoration and maintenance of health in a program beyond basic 
registered nurse preparation, approved by the Board.  Such contact 
hours or academic credits shall be obtained within a time period of 
three (3) years immediately preceding the da te of application for 
prescriptive authority ; 
3. 4. Define minimal requirements for applicatio n for renewal 
of prescriptive authority which shall include, but not be limited 
to, documentation of a minimum of: 
a. fifteen (15) contact hours or one (1) acade mic credit 
hour of education in pharmacother apeutics, clinical 
application, and use of pharmaco logical agents in the 
prevention of illness, and in the rest oration and 
maintenance of health in a program beyond basic 
registered nurse preparation, and   
 
 
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b. two (2) hours of education in pain management or two 
(2) hours of education in opioid use or addict ion, 
unless the Advanced Practice Registered Nurse has 
demonstrated to the satisfaction of the Board that the 
Advanced Practice Registered Nurse does not current ly 
hold a valid federal Drug Enforcement Adm inistration 
registration number, 
approved by the Board, within the two-year period immediately 
preceding the effective date of application for renewal of 
prescriptive authority; 
4. 5. Require that beginning July 1, 2002, an Advanced Practice 
Registered Nurse shall demonstrate demonstrates successful 
completion of a master’s degree or higher in a clinical nurse 
specialty one of the four Advanced Practice Registered Nurs e roles 
in order to be eligible for initial application fo r prescriptive 
authority under the provisions of the Oklahoma Nursing Practice Act; 
5. 6.  Require an Advanced Practice Registered Nurse to have 
graduated from a program accredited by the Accredita tion Commission 
for Education in Nursing (ACEN) or the Commission on Collegiate 
Nursing Education (CCNE), or a substantially equivalent program 
approved by the Board in order to be eligible for initial 
application for prescriptive authority under the provi sions of the 
Oklahoma Nursing Practice Act .  As a condition of obtaining 
prescriptive authority, an Advanced Practice Registered Nurse shall   
 
 
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show evidence of annual on -campus attendance for assessment and 
evaluation of student progress and competence in ad dition to 
completing the required clinical hours in the graduate program 
consistent with the national standard; 
7. Define the method for communicating authority to pr escribe 
or termination of same, an d the formulary to the Board of Pharmacy, 
all pharmacies, and all registered pharmacists; 
6. 8. Define terminology used in such rules; 
7. 9. Define the parameters for the prescribing practices of 
the Advanced Practice Re gistered Nurse; 
8. 10. Define the methods for termination of prescriptive 
authority for the Advanced Practice Registered Nurse; and 
9. 11. a. Establish a Formulary Advisory Coun cil that shall 
develop and submit to the Board recommendations for an 
exclusionary formulary that shall list drugs or 
categories of drugs that shall not be prescribed by 
Advanced Practice Registered Nurse recognized to 
prescribe by the Oklahoma Board of Nu rsing.  The 
Formulary Advisory Council shall also develop and 
submit to the Board recommendations for practice-
specific prescriptive standards for each category of 
Advanced Practice Registered Nurse recognized to 
prescribe by the Oklahoma Board of Nursing pursuant to 
the provisions of the Oklahoma Nursing Practice Act.    
 
 
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The Board shall either accept or reject the 
recommendations made by the Council.  No amendments to 
the recommended exclusionary formulary may be made by 
the Board without the approval of the Formulary 
Advisory Council. 
b. The Formulary Advisory Council shall be compos ed of 
twelve (12) members as follo ws: 
(1) four members, to include a pediatrician, an 
obstetrician-gynecological physician, a general 
internist, and a family practice physician; 
provided that three of such members shall be 
appointed by the Oklahoma State M edical 
Association, and one shall be appointed by the 
Oklahoma Osteopathic Association, 
(2) four members who are registered pharmacists, 
appointed by the Oklahoma Pharmaceutical 
Association, and 
(3) four members, one of whom shall be a Certified 
Nurse Practitioner, one of whom shall be a 
Clinical Nurse Specialist, one of whom shall be a 
Certified Nurse-Midwife, and one of whom shall be 
a current member of the Oklahoma Board of 
Nursing, all of whom shall be appointed by the 
Oklahoma Board of Nursing.   
 
 
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c. All professional members of the Formul ary Advisory 
Council shall be in active clinical practi ce, at least 
fifty percent (50%) of the time, withi n their defined 
area of specialty.  Th e members of the Formulary 
Advisory Council shall serve at the pleasure of the 
appointing authority for a term o f three (3) years.  
The terms of the members shall be s taggered.  Members 
of the Council may serve beyond the expiration of 
their term of office until a successor is appointed by 
the original appointing authority.  A vacan cy on the 
Council shall be filled for the balance of the 
unexpired term by the original a ppointing authority. 
d. Members of the Council shal l elect a chair and a vice -
chair from among the membership of the Council. For 
the transaction of business, at leas t seven members, 
with a minimum of two members present from each of the 
identified categories of physicians, pharmacists and 
advanced practice registered nurses Advanced Practice 
Registered Nurses, shall constitute a quorum.  The 
Council shall recommend an d the Board shall approve 
and implement an initial exclusionary formulary on or 
before January 1, 1997.  The Council and the Board 
shall annually review the approved exclusionary 
formulary and shall make any necessary revisions   
 
 
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utilizing the same procedure s used to develop the 
initial exclusionary formulary. 
SECTION 6.     AMENDATORY    59 O.S. 2021, Section 567.5a, is 
amended to read as fo llows: 
Section 567.5a. A.  All applicants for a license to practice a s 
an Advanced Practice Registered Nurse shall be subject to Section 
567.8 of this title. 
B.  An applicant for an initial license to practice as an 
Advanced Practice Registered Nurse shal l: 
1.  Submit a completed written application and appropriate fees 
as established by the Board; 
2.  Submit a criminal history records check that compl ies with 
Section 567.18 of this title; 
3.  Hold a current Registered Nurse license in this state; 
4.  Have completed an advanced practice registered nursing 
education program in one of the four advanced practice regi stered 
nurse Advanced Practice Registere d Nurse roles and a specialty area 
recognized by the Board.  Effective January 1, 2016, the applic ant 
shall have completed an ac credited graduate level advanced practice 
registered nursing education program in at lea st one of the 
following population foci:  family/individual across the lifespan, 
adult-gerontology, neonatal, pediatrics, women ’s health/gender-
related, or psychiatric/ mental health;   
 
 
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5.  Be currently certified in an advanced practice specialty 
certification consistent with educational preparatio n and by a 
national certifying body recognized by the Board; and 
6.  Provide any and all other evi dence as required by the Board 
in its rules. 
C.  The Board may issue a license by endorsement to an Advanced 
Practice Registered Nurse licensed under the laws of another state 
if the applicant meets the qualifications for licensure in this 
state.  An applicant by endorsement shall: 
1.  Submit a completed written application and appr opriate fees 
as established by the Board ; 
2.  Hold a current Registered Nurse li cense in this state; 
3.  Hold recognition as an Advanced Practice Registered Nurse in 
a state or territory; 
4.  Have completed a n advanced practice registered nursing 
education program in one of the four roles and a specialty area 
recognized by the Board. Effective January 1, 2016, the applicant 
shall have completed an accredited graduate level advanc ed practice 
registered nursing education program in at least one of the 
following population foci:  family/individual across the lifespan, 
adult-gerontology, neonatal, pediatrics, women’s health/gender-
related, or psychiatric/mental health;   
 
 
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5.  Be currently certified in an advanced pra ctice specialty 
certification consistent with ed ucational preparation and by a 
national certifying body recognized by the Board; 
6.  Meet continued competency requirements as set forth in Board 
rules; and 
7.  Provide any and a ll other evidence as required by the Board 
in its rules. 
D.  The Board may iss ue prescriptive authority recognition by 
endorsement to an Advanced Practice Reg istered Nurse licensed as an 
APRN-CNP, APRN-CNS, or APRN-CNM under the laws of another state if 
the applicant meets the requirem ents set forth in this section.  An 
applicant for prescriptive authority recognition by endorsement 
shall: 
1.  Submit a complete d written application and appropriate fees 
as established by the Board; 
2.  Hold current Registere d Nurse and Advanced Practice 
Registered Nurse licenses (APRN-CNP, APRN-CNS, or APRN-CNM) in the 
state; 
3.  Hold current licensure or recognition as an Advanc ed 
Practice Registered Nurse in the same role and specialty with 
prescribing privileges in another state or territory; 
4.  Submit documentation verifying successful completion of a 
graduate level advanced practice re gistered nursing education 
program that included an academic course in pharmacotherapeutic   
 
 
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management, and didactic and clinical preparati on for prescribing 
incorporated throughout the program; 
5.  Submit: 
a. a written statement from an Oklahoma licensed 
physician or supervising Advanced Practice Registered 
Nurse supervising prescriptive authority as required 
by the Board in its rules , if the applicant is a 
Certified Nurse Practitioner or Clinical Nurse 
Specialist, 
b. a written statement from an Oklahoma licensed 
physician supervising prescriptive authority as 
required by the Board in its rules , if the applicant 
is a Certified Nurse -Midwife, or 
c. submit documentation that the applicant meets the 
requirements for independ ent prescriptive authority 
under Section 1 of this act; 
6.  Meet continued competency requirements as set forth in Board 
rules; and 
7.  Provide any and all other evide nce as required by the Board 
in its rules. 
E.  An Advanced Practice Registered Nurs e license issued under 
this section shall be renewed concurrently with the regis tered nurse 
license provided that qualifying criteria c ontinue to be met.   
 
 
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F.  The Board may reinstate a license as set forth in Boa rd 
rules. 
SECTION 7.     AMENDATORY     63 O.S. 2021, Section 2-312, as 
amended by Section 2 , Chapter 184, O.S.L. 2022 (63 O.S. Supp. 2022, 
Section 2-312), is amended to read a s follows: 
Section 2-312. A.  A physician, podiatrist, optometrist or a 
dentist who has complied with the registration requirements of the 
Uniform Controlled Dangerous Substan ces Act, in good faith and in 
the course of such person’s professional practice only, may 
prescribe and administer controlled dangerous substances, or may 
cause the same to be administer ed by medical or paramedical 
personnel acting under the direction and supervision of the 
physician, podiatrist , optometrist or dentist, and only may d ispense 
controlled dangerous substa nces pursuant to the provisions of 
Sections 355.1 and 355.2 of Title 59 of the Oklahoma Statutes. 
B.  A veterinarian who has complied wi th the registration 
requirements of the Uniform Controlled Dangerous Substances Act, in 
good faith and in the cours e of the professiona l practice of the 
veterinarian only, and not for use by a human being, may prescribe, 
administer, and dispense controlled dangerous substances and may 
cause them to be administered by an assistant or o rderly under the 
direction and supervision of the veter inarian. 
C.  1. An advanced practice nurse Advanced Practice Registered 
Nurse who is recognized to prescribe by the Oklahoma Board of   
 
 
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Nursing as an advanced registered nurse practitioner, clinical nurse 
specialist or certified nurse-midwife, a Certified Nurse 
Practitioner or Clinical Nurse Specialist but who has not obtained 
independent prescriptive authority under Section 1 of this act and 
therefore is subject to medical direction by a supervising 
physician, or supervising Advanced Prac tice Registered Nurse 
pursuant to Section 567.3a of Title 59 of the Oklahoma St atutes, and 
who has complied with the re gistration requirements of the Unif orm 
Controlled Dangerous Substances Act, in good faith and in the cours e 
of professional practi ce only, may prescribe and administer Schedule 
III, IV and V controlled dangerous subs tances. 
2.  An Advanced Practice Registered Nurse wh o is recognized to 
prescribe by the Okla homa Board of Nursing as a Certified Nurse 
Practitioner or Clinical Nurse Specialist who has obtained 
independent prescriptive authority under Section 1 of this act, and 
who has complied with the regis tration requirements of th e Uniform 
Controlled Dangerous Subs tances Act, in good faith and in the course 
of professional practice only, may prescribe and administer Schedule 
III, IV, and V controlled dangerous substances. 
D. An Advanced Practice Registered Nurse wh o is recognized to 
prescribe by the Okla homa Board of Nursing as a Certified Nurse-
Midwife, who is subject to medical direction by a supervising 
physician pursuant to Section 567.3a of Title 59 of the Oklahoma 
Statutes, and who has complied with the registration requirements of   
 
 
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the Uniform Controlled Dangerous Substances Act, in good faith and 
in the course of professional practice only, may prescribe and 
administer Schedule III, IV, and V controlled dangerous sub stances. 
E. An advanced practice nurse Advanced Practice Register ed 
Nurse who is recognized to order , select, obtain and administer 
drugs by the Oklahoma Board of Nursing as a certified registered 
nurse anesthetist Certified Registered Nurse Anesthetist pursuant to 
Section 353.1b of Title 59 of the Oklahoma Statutes and who has 
complied with the registra tion requirements of the Uniform 
Controlled Dangerous Substances Act, in good faith and i n the course 
of such practitioner’s professional practice only, may order, 
select, obtain and administer S chedules II through, III, IV, and V 
controlled dangerous subst ances in a preanesthetic preparation or 
evaluation; anesthesia induction, maintenance or emergence; or 
postanesthesia care setting only.  A certified registered nurse 
anesthetist Certified Registered Nurse Anesthetist may order, 
select, obtain and administ er such drugs only during the 
perioperative or periobstetrical period. 
E. F.  A physician assistant who is recognized to prescribe by 
the State Board of Medical Licensure and Supervision under th e 
medical direction of a s upervising physician, pursuant to Section 
519.6 of Title 59 of the O klahoma Statutes, and who has complied 
with the registration requirements of the Uniform Controlled 
Dangerous Substances Act, in good faith and in the course of   
 
 
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professional practice only, may prescribe and administe r Schedule II 
through V Schedules II, III, IV, and V controlled dangerous 
substances. 
SECTION 8.  This act shall become effective November 1, 2023. 
 
59-1-759 DC 1/17/2023 11:08:41 AM