OK
Oklahoma Senate Bill SB569

Oklahoma 2025 Regular Session

Oklahoma Senate Bill SB569 Compare Versions

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5353 STATE OF OKLAHOMA
5454
5555 1st Session of the 60th Legislature (2025)
5656
5757 SENATE BILL 569 By: Stanley
5858
5959
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6262
6363 AS INTRODUCED
6464
6565 An Act relating to the practice of nursing; providing
6666 for independent prescriptive authority of Advanced
6767 Practice Registered Nurses who meet certain
6868 requirements; stating application criteria;
6969 specifying duration of authority; providing for
7070 application approval, denial, reapplication, fees,
7171 and independent prescriptive authority revocation;
7272 prescribing certain malpractice insurance
7373 requirements; directing promulgation of certain
7474 advertising rules; providing certain construction;
7575 directing certain boards to make specified
7676 information available online; amending 59 O.S. 2021,
7777 Section 353.1, as amended by Section 6, Chapter 288,
7878 O.S.L. 2022 (59 O.S. Supp. 2024, Section 353.1),
7979 which relates to definitions used in the Oklahoma
8080 Pharmacy Act; modifying and adding definitions;
8181 amending 59 O.S. 2021, Section 353.1a, which relates
8282 to prescriptive authority of Advanced Practice
8383 Registered Nurses; modif ying prescriptive authority
8484 of certain Advanced Practice Registered Nurses;
8585 updating statutory language; amending 59 O.S. 2021,
8686 Section 567.3a, which relates to definitions used in
8787 the Oklahoma Nursing Practice Act; modifying and
8888 adding definitions; amendi ng 59 O.S. 2021, Section
8989 567.4a, which relates to prescriptive authority;
9090 specifying authority of the Oklahoma Board of Nursing
9191 to grant prescriptive authority; directing the Board
9292 to promulgate certain rules; clarifying certain
9393 educational requirement; re quiring the Formulary
9494 Advisory Council to develop, update, and publish
9595 certain guidelines; modifying references; conforming
9696 language; amending 59 O.S. 2021, Section 567.5a , as
9797 amended by Section 1, Chapter 94, O.S.L. 2024 (59
9898 O.S. Supp. 2024, Section 567.5 a), which relates to
9999 Advanced Practice Registered Nurse license; providing
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151151 for independent prescriptive authority by
152152 endorsement; amending 63 O.S. 2021, Section 2 -312, as
153153 amended by Section 2, Chapter 184, O.S.L. 2022 (63
154154 O.S. Supp. 2024, Section 2-312), which relates to
155155 controlled dangerous substances; conforming language
156156 relating to supervision requirement; updating
157157 statutory references and language; providing for
158158 codification; and providing an effective date .
159159
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163163
164164
165165 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
166166 SECTION 1. NEW LAW A new section of law to be codified
167167 in the Oklahoma Statutes as Section 567.4c of Title 59, unless there
168168 is created a duplication in numbering, reads as follows:
169169 A. 1. An Advanced Practice Registered Nurse recognized by the
170170 Oklahoma Board of Nursing as a Certified N urse Practitioner,
171171 Clinical Nurse Specialist, or Certified Nurse -Midwife who has
172172 completed a minimum of three (3) years of practice with prescriptive
173173 authority supervised by a ph ysician may apply to the Oklahoma Board
174174 of Nursing for authority to prescribe and order independent of
175175 supervision.
176176 2. The application for independent prescriptive authority shall
177177 include proof that the Certified Nurse Practitioner, Clinical Nurse
178178 Specialist, or Certified Nurse -Midwife:
179179 a. holds a valid, current license in the appr opriate
180180 Advanced Practice Registered Nurse role issued by the
181181 Board and is in good standing with the Board, and
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233233 b. has completed a minimum of three (3) years of practice
234234 with prescriptive authority supervised by a physician.
235235 3. Independent prescriptive authority granted under this
236236 subsection shall be valid until the expiration of the current
237237 license to practice and may be renewed upon application to the Board
238238 at the same time and for the same period as the renewal of the
239239 license to practice.
240240 B. The Board shall review any application submitted under this
241241 section and shall approve or deny the application, stating the
242242 reason or reasons for denial, if denied. If denied, the applican t
243243 may reapply using the process prescribed by subsection A of this
244244 section.
245245 C. The Board may suspend or revoke independent prescriptive
246246 authority granted under this section for good cause at any time.
247247 D. The Board may establish a fee for the review of in itial and
248248 renewal applications under the provisions of this section.
249249 SECTION 2. NEW LAW A new section of law to be codified
250250 in the Oklahoma Statutes as Section 567. 5b of Title 59, unless there
251251 is created a duplication in numbering, reads as follows:
252252 A. An Advanced Practice Registered Nurse, or the employer of
253253 the Advanced Practice Registered Nurse on his or her behalf, shall
254254 carry malpractice insurance or demonstrate proof of financial
255255 responsibility in a minimum amount of One Milli on Dollars
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307307 ($1,000,000.00) per occurrence and Three Million Dollars
308308 ($3,000,000.00) in the aggregate per year.
309309 B. An Advanced Practice Registered Nurse who is employed by or
310310 under contract with a federal agency that carries malpractice
311311 insurance in any amount on behalf of the Advanced Practice
312312 Registered Nurse shall be deemed in compliance with subsection A of
313313 this section when practicing under such federal employment or
314314 contract. However, to the extent the Advanced Practice Registered
315315 Nurse practices outside of such federal employment or contract, the
316316 Advanced Practice Registered Nurse, or his or her employer, shall
317317 comply with subsection A of this section.
318318 SECTION 3. NEW LAW A new section of law to be codified
319319 in the Oklahoma Stat utes as Section 567.5 c of Title 59, unless there
320320 is created a duplication in numbering, reads as follows:
321321 A. The Oklahoma Board of Nursing shall promulgate rules
322322 governing advertising of health care services by Advanced Practice
323323 Registered Nurses to include, but not be limited to, the specialty
324324 areas or types of health care service s Advanced Practice Registered
325325 Nurses may advertise based on their training or experience.
326326 B. Nothing in this act shall be construed to allow an Advanced
327327 Practice Registered Nur se to perform any medical service or
328328 prescribe any medication beyond those authorized under state law or
329329 in a manner otherwise inconsistent with state law.
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381381 SECTION 4. NEW LAW A new section of law to be codified
382382 in the Oklahoma Statu tes as Section 479 of Title 59, unless there is
383383 created a duplication in numbe ring, reads as follows:
384384 The State Board of Medical Licensure and Supervision and the
385385 State Board of Osteopathic Examiners shall make available, and keep
386386 updated, in a conspicuous location on the website of each Board a
387387 list of physicians who are available to supervise Advanced Practice
388388 Registered Nurses. The Boards shall develop procedures necessary
389389 for the implementation of this section.
390390 SECTION 5. AMENDATORY 59 O.S. 2021, Section 353.1, as
391391 amended by Section 6, Chapter 288, O.S. L. 2022 (59 O.S. Supp. 202 4,
392392 Section 353.1), is amended to read as follows:
393393 Section 353.1. For the purposes of the Oklahoma Pharmacy Act:
394394 1. “Accredited program” means those seminars, classes,
395395 meetings, work projects, and other educational courses approved by
396396 the Board State Board of Pharmacy for purposes of continuing
397397 professional education;
398398 2. “Act” means the Oklahoma Pharmacy Act;
399399 3. “Administer” means the direct applicatio n of a drug, whether
400400 by injection, inhalation, ingestion , or any other means, to the body
401401 of a patient;
402402 4. “Assistant pharmacist ” means any person presently licensed
403403 as an assistant pharmacist in the State of Oklahoma this state by
404404 the Board pursuant to S ection 353.10 of this title and for the
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456456 purposes of the Oklahoma Pharmacy Act shall be considered the same
457457 as a pharmacist, except where otherwise specified;
458458 5. “Board” or “State Board” means the State Board of Pharmacy;
459459 6. “Certify” or “certification of a prescription” means the
460460 review of a filled prescription by a licensed pharm acist or a
461461 licensed practitioner with dispensing authority to confirm that the
462462 medication, labeling , and packaging of the filled prescription are
463463 accurate and meet all requiremen ts prescribed by state and federal
464464 law. For the purposes of this paragraph, “licensed practitioner ”
465465 shall not include optometrists with dispensing authority;
466466 7. “Chemical” means any medicinal substance, whether simple or
467467 compound or obtained through the process of the science and art of
468468 chemistry, whether of organic or inorganic o rigin;
469469 8. “Compounding” means the combining, admixing, mixing,
470470 diluting, pooling, reconstituting , or otherwise altering of a drug
471471 or bulk drug substance to create a drug. Compounding includes the
472472 preparation of drugs or devices in anticipation of prescription drug
473473 orders based on routine, regularly observed prescribing patterns;
474474 9. “Continuing professional education ” means professional,
475475 pharmaceutical education in the general a reas of the socioeconomic
476476 and legal aspects of health care; the properties and actions of
477477 drugs and dosage forms; and the etiology, characteristics , and
478478 therapeutics of the diseased state;
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530530 10. “Dangerous drug”, “legend drug”, “prescription drug”, or
531531 “Rx Only” means a drug:
532532 a. for human use subject to 21 U.S.C. , Section 353(b)(1),
533533 or
534534 b. is labeled “Prescription Only”, or labeled with the
535535 following statement: “Caution: Federal law restricts
536536 this drug except for to use by or on the order of a
537537 licensed veterinarian.”;
538538 11. “Director” means the Executive Director of the State Board
539539 of Pharmacy unless context clearly indicates otherwise;
540540 12. “Dispense” or “dispensing” means the interpretation,
541541 evaluation, and implementation of a prescription drug order
542542 including the preparation and delivery of a drug or device to a
543543 patient or a patient ’s agent in a suitable container appropriately
544544 labeled for subsequent administration to, or use by, a patient.
545545 Dispense includes sell, distribute, leave with, give away, dispose
546546 of, deliver, or supply;
547547 13. “Dispenser” means a retail pharmacy, hospital pha rmacy, a
548548 group of chain pharmacies under common ownership and control that do
549549 not act as a wholesale distributor, or any other person authorized
550550 by law to dispense or administer prescription drugs, and the
551551 affiliated warehouses or distributions of such entities under common
552552 ownership and control that do not act as a wholesale distributor.
553553 For the purposes of this paragraph, “dispenser” dispenser does not
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605605 mean a person who dispens es only products to be used in animals in
606606 accordance with 21 U.S.C. , Section 360b(a)(5);
607607 14. “Distribute” or “distribution” means the sale, purchase,
608608 trade, delivery, handling, storage, or receipt of a product, and
609609 does not include the dispensing of a pro duct pursuant to a
610610 prescription executed in accordance with 21 U.S.C. , Section
611611 353(b)(1) or the dispensing of a product approved under 21 U.S.C. ,
612612 Section 360b(b); provided, taking actual physical possession of a
613613 product or title shall not be required;
614614 15. “Doctor of Pharmacy” means a person licensed by the Board
615615 to engage in the practice of pharmacy. The terms “pharmacist”,
616616 “D.Ph.”, and “Doctor of Pharmacy” shall be interchangeable and shall
617617 have the same meaning wherever they appear in the Oklahoma Statu tes
618618 and the rules promulgated by the Board;
619619 16. “Drug outlet” means all manufacturers, repackagers,
620620 outsourcing facilities, wholesale distributors, third -party
621621 logistics providers, pharmacies, and all other facilities which are
622622 engaged in dispensing, deli very, distribution, or storage of
623623 dangerous drugs;
624624 17. “Drugs” means all medicinal substances and preparations
625625 recognized by the United States Pharmacopoeia Pharmacopeia and
626626 National Formulary, or any revision thereof, and all substances and
627627 preparations intended for external and/or internal use in the cure,
628628 diagnosis, mitigation, treatment , or prevention of disease in humans
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680680 or animals and all substances and preparations, other than food,
681681 intended to affect the structure or any function of the body of a
682682 human or animals;
683683 18. “Drug sample” means a unit of a prescription drug packag ed
684684 under the authority and responsibility of the manufacturer that is
685685 not intended to be sold and is intended to promote the sale of the
686686 drug;
687687 19. “Durable medical equipment ” has the same meaning as
688688 provided by Section 2 of this act Section 375.2 of this title ;
689689 20. “Filled prescription” means a packaged prescription
690690 medication to which a label has been affixed which contains such
691691 information as is required by the Oklahoma Pharma cy Act;
692692 21. “Hospital” means any institution licensed as a hospital by
693693 this state for the care and treatment of patients, or a pharmacy
694694 operated by the Oklahoma Department of Veterans Affairs;
695695 22. “Licensed practitioner ” means:
696696 a. an allopathic physician ,
697697 b. an osteopathic physician,
698698 c. a podiatric physician,
699699 d. a dentist,
700700 e. a veterinarian or,
701701 f. an optometrist, or
702702 g. an Advanced Practice Registered Nurse ,
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754754 licensed to practice and authorized to prescribe dangerous drugs
755755 within the scope of practice of su ch practitioner;
756756 23. “Manufacturer” or “virtual manufacturer ” means with respect
757757 to a product:
758758 a. a person that holds an application approved under 21
759759 U.S.C., Section 355 or a license issued under 42
760760 U.S.C., Section 262 for such product, or if such
761761 product is not the subject of an approved application
762762 or license, the person who manufactured the product,
763763 b. a co-licensed partner of the person described in
764764 subparagraph a of this paragraph that obtains the
765765 product directly from a person described in this
766766 subparagraph or subparagraph a of this paragraph,
767767 c. an affiliate of a person desc ribed in subparagraph a
768768 or b of this paragraph who receives the product
769769 directly from a person described in this subparagraph
770770 or in subparagraph a or b of this paragraph, or
771771 d. a person who contracts with another to manufacture a
772772 product;
773773 24. “Manufacturing” means the production, preparation,
774774 propagation, compounding, conversion , or processing of a device or a
775775 drug, either directly or indirectly by extraction from substances of
776776 natural origin or independently by means of chemical or biological
777777 synthesis and includes any packaging or repackaging of the
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829829 substances or labeling or relabeling of its container, and the
830830 promotion and marketing of such drugs or devices. The term
831831 “manufacturing” manufacturing also includes the preparation and
832832 promotion of commercially available products from bulk compounds for
833833 resale by licensed pharmacies, licensed practitioners , or other
834834 persons;
835835 25. “Medical gas” means those gases including those in li quid
836836 state upon which the manufacturer or distributor has placed one of
837837 several cautions, such as “Rx Only”, in compliance with federal law;
838838 26. “Medical gas order” means an order for medical gas issued
839839 by a licensed prescriber;
840840 27. “Medical gas distribu tor” means a person licensed to
841841 distribute, transfer, wholesale, deliver , or sell medical gases on
842842 drug orders to suppliers or other entities licensed to use,
843843 administer, or distribute medical gas and may also include a patient
844844 or ultimate user;
845845 28. “Medical gas supplier” means a person who dispenses medical
846846 gases on drug orders on ly to a patient or ultimate user;
847847 29. “Medicine” means any drug or combination of drugs which has
848848 the property of curing, preventing, treating, diagnosing , or
849849 mitigating diseases, or which is used for that purpose;
850850 30. “Nonprescription drugs ” means medicines or drugs which are
851851 sold without a prescription and which are prepackaged for use by the
852852 consumer and labeled in accordance with the requirements of the
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904904 statutes and regulati ons of this state and the federal government.
905905 Such items shall also include m edical and dental supplies and
906906 bottled or nonbulk chemicals which are sold or offered for sale to
907907 the general public if such articles or preparations meet the
908908 requirements of the Federal Food, Drug, and Cosmetic Act, 21
909909 U.S.C.A., Section 321 et seq.;
910910 31. “Outsourcing facility ” including “virtual outsourcing
911911 facility” means a facility at one geographic location or address
912912 that:
913913 a. is engaged in the compounding of sterile drugs,
914914 b. has elected to register as an outsourcing facility,
915915 and
916916 c. complies with all requirements of 21 U.S.C. , Section
917917 353b;
918918 32. “Package” means the smallest individual saleable unit of
919919 product for distribution by a manufacturer or repackager that is
920920 intended by the manufacturer for ultimate sale to the dispenser of
921921 such product. For the purposes of this paragraph, “individual
922922 saleable unit” means the smallest container of a product introduced
923923 into commerce by the manufacturer or repackager that is intended by
924924 the manufacturer or repackager for individual sale to a dispenser;
925925 33. “Person” means an individual, partnership, limited
926926 liability company, corporation , or association, unless the context
927927 otherwise requires;
928928
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979979 34. “Pharmacist-in-charge” or “PIC” means the pharmacist
980980 licensed in this state responsible for the management control of a
981981 pharmacy and all other aspects of the practice of pharmacy in a
982982 licensed pharmacy as defined provided by Section 353.18 of this
983983 title;
984984 35. “Pharmacy” means a place regularly li censed by the State
985985 Board of Pharmacy in which prescriptions, drugs, medicines ,
986986 chemicals, and poisons are compounded or dispensed or such place
987987 where pharmacists practice the profession of pharmacy, or a pharmacy
988988 operated by the Oklahoma Department of Vet erans Affairs;
989989 36. “Pharmacy technician”, “technician”, “Rx tech”, or “tech”
990990 means a person issued a Technician technician permit by the State
991991 Board of Pharmacy to assist the pharmacist and perform
992992 nonjudgmental, technical, manipulative, non -discretionary functions
993993 in the prescription department under the immediate and direct
994994 supervision of a pharmacist;
995995 37. “Poison” means any substance which when introduced into the
996996 body, either directly or by absorption, produces violent, morbid , or
997997 fatal changes, or wh ich destroys living tissue with which such
998998 substance comes into contact;
999999 38. “Practice of pharmacy ” means:
10001000 a. the interpretation and evaluation of prescription
10011001 orders,
10021002
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10531053 b. the compounding, dispensing, administering , and
10541054 labeling of drugs and devices, excep t labeling by a
10551055 manufacturer, repackager , or distributor of
10561056 nonprescription drugs and commercially packaged legend
10571057 drugs and devices,
10581058 c. the participation in drug selection and drug
10591059 utilization reviews,
10601060 d. the proper and safe storage of drugs and devices a nd
10611061 the maintenance of proper records thereof,
10621062 e. the responsibility for advising by counseling and
10631063 providing information, where professionally necessary
10641064 or where regulated, of therapeutic values, content,
10651065 hazards, and use of drugs and devices,
10661066 f. the offering or performing of those acts, services,
10671067 operations, or transactions necessa ry in the conduct,
10681068 operation, management , and control of a pharmacy, or
10691069 g. the provision of those acts or services that are
10701070 necessary to provide pharmaceutical care;
10711071 39. “Preparation” means an article which may or may not contain
10721072 sterile products compounded in a licensed pharmacy pursuant to the
10731073 order of a licensed prescriber;
10741074 40. “Prescriber” means a person licensed in this state who is
10751075 authorized to prescribe dangerous drugs w ithin the scope of practice
10761076 of the person’s profession;
10771077
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11281128 41. “Prescription” means and includes any order for drug or
11291129 medical supplies written or signed, or transmitted by word of mouth,
11301130 telephone, or other means of communication:
11311131 a. by a licensed prescribe r,
11321132 b. under the supervision of an Oklahoma licensed
11331133 practitioner, an Oklahoma licensed advanced practice
11341134 registered nurse or an Oklahoma licensed by a
11351135 physician assistant pursuant to a practice agreement ,
11361136 or
11371137 c. (1) under the supervision of a supervising ph ysician,
11381138 by a Certified Nurse Practitioner, Clinical Nurse
11391139 Specialist, or Certified Nurse-Midwife licensed
11401140 in this state who has not obtained independent
11411141 prescriptive authority under Section 1 of this
11421142 act, or
11431143 (2) by a Certified Nurse Practitioner, Clinical Nurse
11441144 Specialist, or Certified Nurse -Midwife licensed
11451145 in this state who has obtained independent
11461146 prescriptive authority under Section 1 of this
11471147 act, or
11481148 d. by an Oklahoma licensed wholesaler or distributor as
11491149 authorized in Section 353.29.1 of this title;
11501150 42. “Product” means a prescription drug in a finished dosage
11511151 form for administration to a patient without substantial further
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12031203 manufacturing, such as capsules, tablets, and lyophilized products
12041204 before reconstitution. “Product” Product does not include bloo d
12051205 components intended for transfusion, radioactive drugs or biologics
12061206 and medical gas;
12071207 43. “Repackager”, including “virtual repackager”, means a
12081208 person who owns or operates an establishment that repacks and
12091209 relabels a product or package for further sale o r distribution
12101210 without further transaction;
12111211 44. “Sterile drug” means a drug that is intended for parenteral
12121212 administration, an ophthalmic or oral inhalation drug in aqueous
12131213 format, or a drug that is required to be sterile under state and
12141214 federal law;
12151215 45. “Supervising physician ” means an individual holding a
12161216 current license to practice as a physician from the State Board of
12171217 Medical Licensure and Supervision, pursuant to the provisions of the
12181218 Oklahoma Allopathic Medical and Surgical Licensure and Supervisio n
12191219 Act, or the State Board of Osteopathic Examiners, pursuant to the
12201220 provisions of the Oklahoma Osteopathic Medicine Act, who supervises
12211221 an advanced practice registered nurse a Certified Nurse
12221222 Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife
12231223 as defined in Section 567.3a of this title who has not obtained
12241224 independent prescriptive authority under Section 1 of this act ,
12251225 and who is not in training as an intern, resident, or fellow. To be
12261226 eligible to supervise an advanced practice registered n urse, such
12271227
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12781278 The supervising physician shall remain in compliance with the rules
12791279 promulgated by the State Board of Medical Licensure and Supervision
12801280 or the State Board of Osteopathic Examiners;
12811281 46. “Supportive personnel ” means technicians and auxiliary
12821282 supportive persons who are regularly paid employees of a pharmacy
12831283 who work and perform tasks in the pharmacy as authorized by Section
12841284 353.18A of this title;
12851285 47. “Third-party logistics provider ” including “virtual third-
12861286 party logistics provider ” means an entity that provides or
12871287 coordinates warehousing, or other logistics services of a p roduct in
12881288 interstate commerce on behalf of a manufacturer, wholesale
12891289 distributor, or dispenser of a product but does not take ownership
12901290 of the product, nor have responsibility to direct the sale or
12911291 disposition of the product. For the purposes of this paragraph,
12921292 “third-party logistics provider ” third-party logistics provider does
12931293 not include shippers and the United States Postal Service;
12941294 48. “Wholesale distributor ” including “virtual wholesale
12951295 distributor” means a person other than a manufacturer, a
12961296 manufacturer’s co-licensed partner, a third -party logistics
12971297 provider, or repackager engaged in wholesale distribution as defined
12981298 by 21 U.S.C., Section 353(e)(4) as amended by the Drug Supply Chain
12991299 Security Act;
13001300 49. “County jail” means a facility operated by a county for the
13011301 physical detention and correction of persons charged with, or
13021302
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13531353 convicted of, criminal offenses or ordinance violations or persons
13541354 found guilty of civil or criminal c ontempt;
13551355 50. “State correctional facility ” means a facility or
13561356 institution that houses a prisoner population under the jurisdiction
13571357 of the Department of Corrections;
13581358 51. “Unit dose package” means a package that contains a single
13591359 dose drug with the name, strength, control number, and expiration
13601360 date of that drug on the label; and
13611361 52. “Unit of issue package ” means a package that provides
13621362 multiple doses of the same drug, but each drug is individually
13631363 separated and includes the name, lot number, and expirati on date.
13641364 SECTION 6. AMENDATORY 59 O.S. 2021, Section 353.1a, is
13651365 amended to read as follows:
13661366 Section 353.1a. A. Prescribing 1. Prescriptive authority
13671367 shall be allowed, under the medical direction of a current
13681368 supervision agreement with a supervising physician, for an advanced
13691369 practice nurse a licensed Advanced Practice Registered Nurse
13701370 recognized by the Oklahoma Board of Nursing in one of the following
13711371 categories: advanced registered nurse practitioners, clinical nurse
13721372 specialists, or certified nurse -midwives as a Certified Nurse
13731373 Practitioner, Clinical Nu rse Specialist, or Certified Nurse -Midwife
13741374 who has not obtained independent prescriptive authority under
13751375 Section 1 of this act.
13761376
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14271427 2. Prescriptive authority shall be allowed, indep endent of a
14281428 current supervision agreement with a supervising physician, for a
14291429 licensed Advanced Practice Registered Nurse recognized by the
14301430 Oklahoma Board of Nursing as a Certified Nurse Practitioner,
14311431 Clinical Nurse Specialist, or Certified Nurse -Midwife who has
14321432 obtained independent prescriptive authority under Section 1 of this
14331433 act.
14341434 B. The advanced practice nurse Advanced Practice Registered
14351435 Nurse may write or sign, or transmit by word of mouth, telephone , or
14361436 other means of communication an order for drug s or medical supplies
14371437 that is intended to be filled, compounded, or dispensed by a
14381438 pharmacist. The supervising physician , if applicable, and the
14391439 advanced practice nurse prescribing Advanced Practice Registered
14401440 Nurse shall be identified at the time of orig ination of the
14411441 prescription and the name of the advanced practice nurse prescribing
14421442 Advanced Practice Registered Nurse shall be printed on the
14431443 prescription label.
14441444 B. C. Pharmacists may dispense prescriptions for non -controlled
14451445 prescription drugs authorize d by an advanced practice nurse Advanced
14461446 Practice Registered Nurse or physician assistant, not located in
14471447 Oklahoma this state, provided that they are licensed in the state in
14481448 which they are actively prescribing.
14491449 C. D. 1. Pharmacists may only dispense pre scriptions for
14501450 controlled dangerous substances prescribed by an advanced practice
14511451
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15021502 nurse or physician assistant Advanced Practice Registered Nurse
15031503 licensed in the State of Oklahoma and supervised by an Oklahoma -
15041504 licensed practitioner this state who meets the criteria in paragraph
15051505 1 or 2 of subsection A of this section.
15061506 2. Pharmacists may only dispense prescriptions for controlled
15071507 dangerous substances prescribed by a physician assistant licensed in
15081508 this state pursuant to a practice agreement .
15091509 SECTION 7. AMENDATORY 59 O.S. 2021, Section 567.3a, is
15101510 amended to read as follows:
15111511 Section 567.3a. As used in the Oklahoma Nursing Practice Act:
15121512 1. “Board” means the Oklahoma Board of Nursing;
15131513 2. “The practice of nursing ” means the performance of services
15141514 provided for purposes of nursing diagnosis and treatment of human
15151515 responses to actual or potential health problems consistent with
15161516 educational preparation. Knowledge and skill are the basis for
15171517 assessment, analysis, planning, intervention, an d evaluation used in
15181518 the promotion and maintenance of health and nursing manag ement of
15191519 illness, injury, infirmity, restoration or of optimal function, or
15201520 death with dignity. Practice is based on understanding the human
15211521 condition across the human lifespan and understanding the
15221522 relationship of the individual within the environment. This
15231523 practice includes execution of the medical regime including the
15241524 administration of medications and treatments prescribed by any
15251525 person authorized by state law to so prescribe ;
15261526
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15771577 3. “Registered nursing” means the practice of the full scope of
15781578 nursing which includes, but is not limited to:
15791579 a. assessing the health status of individuals, families ,
15801580 and groups,
15811581 b. analyzing assessment data to determine nursing care
15821582 needs,
15831583 c. establishing goals to meet identified health care
15841584 needs,
15851585 d. planning a strategy of care,
15861586 e. establishing priorities of nursing intervention to
15871587 implement the strategy of care,
15881588 f. implementing the strategy of care,
15891589 g. delegating such tasks as may safely be performed by
15901590 others, consistent with educational preparation and
15911591 that do not conflict w ith the provisions of the
15921592 Oklahoma Nursing Practice Act,
15931593 h. providing safe and effective nursing care rendered
15941594 directly or indirectly,
15951595 i. evaluating responses to interventions,
15961596 j. teaching the principles and practice of nursing,
15971597 k. managing and supervising the practice of nursing,
15981598 l. collaborating with other health professionals in the
15991599 management of health care,
16001600
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16511651 m. performing additional nursing functions in accordance
16521652 with knowledge and skills acquired beyond basic
16531653 nursing preparation, and
16541654 n. delegating those nursing tasks as defined in the rules
16551655 of the Board that may be performed by an advanced
16561656 unlicensed assistive person Advanced Unlicensed
16571657 Assistant;
16581658 4. “Licensed practical nurs ing” means the practice of nursing
16591659 under the supervision or direction of a registered nurse Registered
16601660 Nurse, licensed physician , or dentist. This directed scope of
16611661 nursing practice includes, but is not limited to:
16621662 a. contributing to the assessment of the health status of
16631663 individuals and groups,
16641664 b. participating in the development and modification of
16651665 the plan of care,
16661666 c. implementing the appropriate aspects of the plan of
16671667 care,
16681668 d. delegating such tasks as may safely be performed by
16691669 others, consistent with educational preparation and
16701670 that do not conflict with the Oklahoma Nursing
16711671 Practice Act,
16721672 e. providing safe and effective nursing care rendered
16731673 directly or indirectly,
16741674
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17251725 f. participating in the evaluation of responses to
17261726 interventions,
17271727 g. teaching basic nursi ng skills and related principles,
17281728 h. performing additional nursing procedures in accordance
17291729 with knowledge and skills acquired through education
17301730 beyond nursing preparation, and
17311731 i. delegating those nursing tasks as defined in the rules
17321732 of the Board that may be performed by an advanced
17331733 unlicensed assistive person Advanced Unlicensed
17341734 Assistant;
17351735 5. “Advanced Practice Registered Nurse ” means a licensed
17361736 Registered Nurse:
17371737 a. who has completed an advanced practice registered
17381738 nursing education program in preparatio n for one of
17391739 four recognized advanced practice registered nurse
17401740 Advanced Practice Registered Nurse roles,
17411741 b. who has passed a national certification examination
17421742 recognized by the Board that measures the advanced
17431743 practice registered nurse Advanced Practice Registered
17441744 Nurse role and specialty competencies and who
17451745 maintains recertification in the role and specialty
17461746 through a national certification program,
17471747 c. who has acquired advanced clinical knowledge and
17481748 skills in preparation for providing both direct and
17491749
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18001800 indirect care to patients; however, the defining
18011801 factor for all Advanced Practi ce Registered Nurses is
18021802 that a significant component of the education and
18031803 practice focuses on direct care of individuals,
18041804 d. whose practice builds on the competencies of
18051805 Registered Nurses by demonstrating a greater depth and
18061806 breadth of knowledge, a greater synthesis of data, and
18071807 increased complexity of skills and interventions, and
18081808 e. who has obtained a license as an Advanced Practice
18091809 Registered Nurse in one of the following roles :
18101810 Certified Registered Nurse Anesthetist, Certified
18111811 Nurse-Midwife, Clinical Nurse Specialist, or Certified
18121812 Nurse Practitioner.
18131813 Only those persons who hold a license to practice advanced
18141814 practice registered nursing in this state shall have the right to
18151815 use the title “Advanced Practice Registered Nurse ” Advanced Practice
18161816 Registered Nurse and to use the abbreviation “APRN”. Only those
18171817 persons who have obtained a license in the following disciplines
18181818 shall have the right to fulfill the roles and use the applic able
18191819 titles: Certified Registered Nurse Anesthetist and the abbreviation
18201820 “CRNA”, Certified Nurse-Midwife and the abbreviation “CNM”, Clinical
18211821 Nurse Specialist and the abbreviation “CNS”, and Certified Nurse
18221822 Practitioner and the abbreviation “CNP”.
18231823
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18731873
18741874 It shall be unlawful for any person to assume the role or use
18751875 the title Advanced Practice Registered Nurse or use the abbreviation
18761876 “APRN” APRN or use the respective specialty role titles and
18771877 abbreviations or to use any other titles or abbreviations that would
18781878 reasonably lead a person to believe the user is an Advanced Practice
18791879 Registered Nurse, unless permitted by the Oklahoma Nursing Practice
18801880 Act. Any individual doing so shall be guilty of a misdemeanor,
18811881 which shall be punishable, upon conviction, by imprisonmen t in the
18821882 county jail for not more than one (1) year or by a fine of not less
18831883 than One Hundred Dollars ($100.00) nor more than One Thousand
18841884 Dollars ($1,000.00), or by both such imprisonment and fine for each
18851885 offense;
18861886 6. “Certified Nurse Practitioner ” is means an Advanced Practice
18871887 Registered Nurse who performs in an expanded role in the delivery of
18881888 health care:
18891889 a. consistent with advanced educational preparation as a
18901890 Certified Nurse Practitioner in an area of specialty,
18911891 b. functions within the Certified Nurs e Practitioner
18921892 scope of practice for the selected area of
18931893 specialization, and
18941894 c. is in accord with the standards for Certified Nurse
18951895 Practitioners as identified by the certifying body and
18961896 approved by the Board.
18971897
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19471947
19481948 A Certified Nurse Practitioner shall be eligi ble, in accordance
19491949 with the scope of practice of the Certified Nurse Practitio ner, to
19501950 obtain recognition as authorized by the Board to prescribe, as
19511951 defined by the rules promulgated by the Board pursuant to this
19521952 section and subject to the medical direction of a supervising
19531953 physician Section 567.4a of this title and Section 1 of this act .
19541954 This authorization shall not include dispensing drugs, but shall not
19551955 preclude, subject to federal regulations, the receipt of, the
19561956 signing for, or the dispensing of profes sional samples to patients.
19571957 The Certified Nurse Practitioner accepts responsib ility,
19581958 accountability, and obligation to practice in accordance with usual
19591959 and customary advanced practice registered nursing standards and
19601960 functions as defined by the scope of p ractice/role definition
19611961 statements for the Certified Nurse Practitioner;
19621962 7. a. “Clinical Nurse Specialist ” is means an Advanced
19631963 Practice Registered Nurse who holds:
19641964 (1) a master’s degree or higher in nursing with
19651965 clinical specialization preparation to func tion
19661966 in an expanded role,
19671967 (2) specialty certification from a national
19681968 certifying organization recognized by the Board,
19691969 and
19701970 (3) an Advanced Practice Registered Nurse license
19711971 from the Board, and.
19721972
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20222022
20232023 (4) any
20242024 Any nurse holding a specialty certification as a
20252025 Clinical Nurse Specialist valid on January 1, 1994,
20262026 granted by a national certifying organization
20272027 recognized by the Board, shall be deemed to be a
20282028 Clinical Nurse Specialist under the provisions of the
20292029 Oklahoma Nursing Practice Act.
20302030 b. In the expanded role, the Clinical Nurse Specialist
20312031 performs at an advanced practice level which shall
20322032 include, but not be limited to:
20332033 (1) practicing as an expert clinician in the
20342034 provision of direct nursing care to a selected
20352035 population of patients or clients in any setting,
20362036 including private practice,
20372037 (2) managing the care of patients or clients with
20382038 complex nursing problems,
20392039 (3) enhancing patient or client care by integrating
20402040 the competencies of clinical practice, education,
20412041 consultation, and research, and
20422042 (4) referring patients or clients to other services.
20432043 c. A Clinical Nurse Specialist in accordance wit h the
20442044 scope of practice of such Clinical Nurse Specialist
20452045 shall be eligible to obtain recognition as authorized
20462046 by the Board to prescribe, as defined by the rules
20472047
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20972097
20982098 promulgated by the Board pursuant to this section, and
20992099 subject to the medical direction of a supervising
21002100 physician Section 567.4a of this title and Section 1
21012101 of this act. This authorization shall not include
21022102 dispensing drugs, but shall not preclude, subject to
21032103 federal regulations, the receipt of, the signing for,
21042104 or the dispensing of professional samples to patients.
21052105 d. The Clinical Nurse Specialist accepts responsibility,
21062106 accountability, and obligation to practice in
21072107 accordance with usual and customary advanced practice
21082108 nursing standards and functions as defined by the
21092109 scope of practice/role definition statements for the
21102110 Clinical Nurse Specialist;
21112111 8. “Nurse-Midwife” is “Certified Nurse-Midwife” means a nurse
21122112 who has received an Advanced Practice Registered Nurse license from
21132113 the Oklahoma Board of Nursing who possesses evidence of
21142114 certification according to the requirements of the American College
21152115 of Nurse-Midwives.
21162116 A Certified Nurse-Midwife in accordance with the scope of
21172117 practice of such Certified Nurse -Midwife shall be eligible to obtain
21182118 recognition as authorized by the Board to prescribe, as defined by
21192119 the rules promulgated by the Board pursuant to this section and
21202120 subject to the medical direction of a supervising physician Section
21212121 567.4a of this title and Section 1 of this act. This authorization
21222122
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21732173 shall not include the dispensing of drugs, but shall not preclude,
21742174 subject to federal regulations, the receipt of, the signing for, or
21752175 the dispensing of professional samples to patients.
21762176 The Certified Nurse-Midwife accepts responsibility,
21772177 accountability, and obligation to practice in accordance with usual
21782178 and customary advanced practice registered nursing standards and
21792179 functions as defined by the scope of practice/role definition
21802180 statements for the Certified Nurse -Midwife;
21812181 9. “Nurse-midwifery practice” means providing management of
21822182 care of normal newbo rns and women, antepartally, intrapartally,
21832183 postpartally, and gynecologically, occurring within a health care
21842184 system which provides for medical consultation, medical management ,
21852185 or referral, and is in accord with the standards for nurse -midwifery
21862186 practice as defined by the American College of Nurse -Midwives;
21872187 10. a. “Certified Registered Nurse Anesthetist ” is means an
21882188 Advanced Practice Registered Nurse who:
21892189 (1) is certified by the National Board of
21902190 Certification and Recertification for Nurse
21912191 Anesthetists as a Certified Registered Nurse
21922192 Anesthetist within one (1) year following
21932193 completion of an approved certified registered
21942194 nurse anesthetist Certified Registered Nurse
21952195 Anesthetist education program, and continues to
21962196 maintain such recertification by the National
21972197
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22482248 Board of Certification and Recertification for
22492249 Nurse Anesthetists, and
22502250 (2) administers anesthesia in collaboration with a
22512251 medical doctor, an osteopathic physician, a
22522252 podiatric physician, or a dentist licensed in
22532253 this state and under conditions in which ti mely
22542254 onsite on-site consultation by such doctor,
22552255 osteopath, podiatric physician , or dentist is
22562256 available.
22572257 b. A Certified Registered Nurse Anesthetist, in
22582258 collaboration with a med ical doctor, osteopathic
22592259 physician, podiatric physician , or dentist licensed in
22602260 this state, and under conditions in which timely, on -
22612261 site consultation by such medical doctor, osteopathic
22622262 physician, podiatric physician , or dentist is
22632263 available, shall be aut horized, pursuant to rules
22642264 adopted by the Oklahoma Board of Nursing, to order,
22652265 select, obtain, and administer legend drugs, Schedules
22662266 II through V controlled substances, devices, and
22672267 medical gases only when engaged in the preanesthetic
22682268 preparation and eval uation; anesthesia induction,
22692269 maintenance, and emergence; and postanesthesia care.
22702270 A Certified Registered Nurse Anesthetist may order,
22712271
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23222322 select, obtain, and administer drugs only during the
23232323 perioperative or periobstetrical period.
23242324 c. A Certified Registered Nurse Anesthetist who applies
23252325 for authorization to order, select, obtain , and
23262326 administer drugs shall:
23272327 (1) be currently recognized as a Certified Registered
23282328 Nurse Anesthetist in this state,
23292329 (2) provide evidence of completion, within the two -
23302330 year period immediately preceding the date of
23312331 application, of a minimum of fifteen (15) units
23322332 of continuing education in advanced pharmacology
23332333 related to the administration of anesthesia as
23342334 recognized by the National Board of Certification
23352335 and Recertification for Nurse An esthetists, and
23362336 (3) complete and submit a notarized application, on a
23372337 form prescribed by the Board, accompanied by the
23382338 application fee established pursuant to this
23392339 section.
23402340 d. The authority to order, select, obtain , and administer
23412341 drugs shall be terminated if a Certified Registered
23422342 Nurse Anesthetist has:
23432343 (1) ordered, selected, obtained , or administered
23442344 drugs outside of the Certified Registered Nurse
23452345 Anesthetist scope of practice or ordered,
23462346
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23972397 selected, obtained, or administered drugs for
23982398 other than therapeuti c purposes, or
23992399 (2) violated any provision of state laws or rules or
24002400 federal laws or regulations pertaining to the
24012401 practice of nursing or the authority to order,
24022402 select, obtain, and administer drugs.
24032403 e. The Oklahoma Board of Nursing shall notify the State
24042404 Board of Pharmacy after termination of or a change in
24052405 the authority to order, select, obtain , and administer
24062406 drugs for a Certified Registered Nurse Anesthetist.
24072407 f. The Board shall provide by rule for biennial
24082408 application renewal and reauthorization of autho rity
24092409 to order, select, obtain , and administer drugs for
24102410 Certified Registered N urse Anesthetists. At the time
24112411 of application renewal, a Certified Registered Nurse
24122412 Anesthetist shall submit documentation of a minimum of
24132413 eight (8) units of continuing educatio n, completed
24142414 during the previous two (2) years, in advanced
24152415 pharmacology relating to the administration of
24162416 anesthesia, as recognized by the Council on
24172417 Recertification of Nurse Anesthetists or the Council
24182418 on Certification of Nurse Anesthetists National Board
24192419 of Certification and Recertification for Nurse
24202420 Anesthetists.
24212421
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24722472 g. This paragraph shall not prohibit the administration
24732473 of local or topical anesthetics as now permitted by
24742474 law. Provided further, nothing in this paragraph
24752475 shall limit the authority of the Bo ard of Dentistry to
24762476 establish the qualifications for dentists who direct
24772477 the administration of anesthesia.
24782478 h. As used in this paragraph, “collaboration” means an
24792479 agreement between a medical doctor, osteopathic
24802480 physician, podiatric physician , or dentist performing
24812481 the procedure or directly involved with the procedure
24822482 and the Certified Registered Nurse Anesthetist working
24832483 jointly toward a common goal providing services for
24842484 the same patient. This collaboration involves the
24852485 joint formulation, discussion , and agreement of the
24862486 anesthesia plan by both parties, and the collaborating
24872487 medical doctor, osteopathic physician, podiatric
24882488 physician, or dentist performing the procedure or
24892489 directly involved with the procedure and that
24902490 collaborating physician shall remain ava ilable for
24912491 timely onsite on-site consultation during the delivery
24922492 of anesthesia for diagnosis, consultation, and
24932493 treatment of medical conditions;
24942494 11. “Supervising physician ” means an individual holding a
24952495 current license to practice as a physician from the State Board of
24962496
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25472547 Medical Licensure and Supervision or the State Board of Osteopathic
25482548 Examiners, who supervises a Certified Nurse Practitioner, a Clinical
25492549 Nurse Specialist, or a Certified Nurse -Midwife who has not obtained
25502550 independent prescriptive authority under Section 1 of this act , and
25512551 who is not in training as an intern, resident , or fellow. To be
25522552 eligible to supervise such Advanced Practice Registered Nurse, such
25532553 The supervising physician shall remain in compliance with the rules
25542554 promulgated by the Sta te Board of Medical Licensure and Supervision
25552555 or the State Board of Osteopathic Examiners;
25562556 12. “Supervision of an Advanced Practice Registered Nurse with
25572557 prescriptive authority ” means overseeing and accepting
25582558 responsibility for the ordering and transmissi on by assuring
25592559 availability of the supervising physician to a Certified Nurse
25602560 Practitioner, a Clinical Nurse Specialist, or a Certified Nurse -
25612561 Midwife of who has not obtained independent prescriptive authority
25622562 under Section 1 of this act through direct contact,
25632563 telecommunications, or other appropriate electronic means for
25642564 consultation, assistance with medical emergencies, or patient
25652565 referral with respect to written, telephonic, electronic , or oral
25662566 prescriptions for drugs and other medical supplies, subject t o a
25672567 defined formulary; and
25682568 13. “Advanced Unlicensed Assistant ” means any person who has
25692569 successfully completed a certified training program approved by the
25702570 Board that trains the Advanced Unlicensed Assistant to perform
25712571
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26222622 specified technical skills identifie d by the Board in acute care
26232623 settings under the direction and supervision of the Registered Nurse
26242624 or Licensed Practical Nurse.
26252625 SECTION 8. AMENDATORY 59 O.S. 2021, Section 567.4a, is
26262626 amended to read as follows:
26272627 Section 567.4a. The Oklahoma Board of Nursing may grant
26282628 prescriptive authority through the Advanc ed Practice Registered
26292629 Nurse license to Certified Nurse Practitioners, Clinical Nurse
26302630 Specialists, and Certified Nurse -Midwives who meet the requirements
26312631 for prescriptive authori ty identified by law and in the Board ’s
26322632 rules. The rules regarding prescriptive authority recognition
26332633 promulgated by the Oklahoma Board of Nursing pursuant to paragraphs
26342634 6 through 9, 11 and 12 of this section, Section 567.3a of this
26352635 title, and Section 1 of this act shall:
26362636 1. Define the procedure for documenting supervision by a
26372637 supervising physician licensed in Oklahoma to practice by the State
26382638 Board of Medical Licensure and Supervision or the State Board of
26392639 Osteopathic Examiners , as defined in Section 56 7.3a of this title,
26402640 of a Certified Nurse Practitioner, Clinical Nurse Specialist, or
26412641 Certified Nurse-Midwife who has not obtained independent
26422642 prescriptive authority under Section 1 of this act . Such procedure
26432643 shall include a written statement that defines appropriate referral,
26442644 consultation, and collaboration between the Advanced Pr actice
26452645 Registered Nurse, recognized to prescribe as defined in paragraphs 6
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26972697 through 9, 11 and 12 of Section 567.3a of this title, and the
26982698 supervising physician. The written stat ement shall include a method
26992699 of assuring availability of the supervising physician through direct
27002700 contact, telecommunications , or other appropriate electronic means
27012701 for consultation, assistance with medical emergencies, or patient
27022702 referral. The written st atement shall be part of the initial
27032703 application and the renewal application s ubmitted to the Board for
27042704 recognition for prescriptive authority for the Advanced Practice
27052705 Registered Nurse. Changes to the written statement shall be filed
27062706 with the Board withi n thirty (30) days of the change and shall be
27072707 effective on filing;
27082708 2. Define the procedure for documenting independent
27092709 prescriptive authority for Certified Nurse Practitioners, Clinical
27102710 Nurse Specialists, and Certified Nurse -Midwives who have obtained
27112711 independent prescriptive authority under Section 1 of this act;
27122712 3. Define minimal requirements for initial application for
27132713 prescriptive authority which shall include, but not be limited to,
27142714 evidence of completion of a minimum of forty -five (45) contact hours
27152715 or three (3) academic credit hours of education in
27162716 pharmacotherapeutics, clinical application, and use of
27172717 pharmacological agents in the prevention of illness, and in the
27182718 restoration and maintenance of health in a program beyond basic
27192719 registered nurse prep aration, approved by the Board. Such contact
27202720 hours or academic credits shall be obtained within a time period of
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27722772 three (3) years immediately preceding the date of application for
27732773 prescriptive authority;
27742774 3. 4. Define minimal requirements for application f or renewal
27752775 of prescriptive authority which shall include, but not be limited
27762776 to, documentation of a minimum of:
27772777 a. fifteen (15) contact hours or one (1) academic credit
27782778 hour of education in pharmacotherapeutics, clinical
27792779 application, and use of pharmacolog ical agents in the
27802780 prevention of illness, and in the restoration and
27812781 maintenance of health in a program beyond basic
27822782 registered nurse preparation, and
27832783 b. two (2) hours of education in pain management or two
27842784 (2) hours of education in opioid use or addiction ,
27852785 unless the Advanced Practice Registered Nurse has
27862786 demonstrated to the satisfaction of the Board that the
27872787 Advanced Practice Registered Nurse does not currently
27882788 hold a valid federal Drug Enforcement Administration
27892789 registration number,
27902790 approved by the Board , within the two-year period immediately
27912791 preceding the effective date of appli cation for renewal of
27922792 prescriptive authority;
27932793 4. 5. Require that beginning July 1, 2002, an Advanced Practice
27942794 Registered Nurse shall demonstrate demonstrates successful
27952795 completion of a master’s degree or higher in a clinical nurse
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28472847 specialty one of the following Advanced Practice Registered Nurse
28482848 roles:
28492849 a. Certified Nurse Practitioner,
28502850 b. Clinical Nurse Specialist, or
28512851 c. Certified Nurse-Midwife,
28522852 in order to be eligible for initial application for prescriptive
28532853 authority under the provisions of the Oklahoma N ursing Practice Act;
28542854 5. 6. Define the method for communicating authority to
28552855 prescribe or termination of same, and the formulary to the State
28562856 Board of Pharmacy, all pharmacies, a nd all registered pharmacists;
28572857 6. 7. Define terminology used in such rules;
28582858 7. 8. Define the parameters for the prescribing practices of
28592859 the Advanced Practice Registered Nurse;
28602860 8. 9. Define the methods for termination of prescriptive
28612861 authority for the Advanced Practice Registered Nurse; and
28622862 9. 10. a. Establish a Formulary Advisor y Council that
28632863 shall develop and submit to the Board recommendations
28642864 for an exclusionary formulary that shall list drugs or
28652865 categories of drugs that shall not be prescribed by an
28662866 Advanced Practice Registered Nurse recognized to
28672867 prescribe by the Oklahoma Board of Nursing. The
28682868 Formulary Advisory Council shall also develop and
28692869 submit to the Board recommendations for practice -
28702870 specific prescriptive standards for each category of
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29222922 Advanced Practice Registered Nurse recognized to
29232923 prescribe by the Oklahoma Board of Nursing pursuant to
29242924 the provisions of the Oklahoma Nursing Practice Act.
29252925 The Board shall either accept or reject the
29262926 recommendations made by the Council. No amendments to
29272927 the recommended exclusionary formulary may be made by
29282928 the Board without the approval of the Formulary
29292929 Advisory Council.
29302930 b. In addition to the other powers and duties of the
29312931 Formulary Advisory Council prescribed by this
29322932 paragraph, the Formulary Advisory Council shall
29332933 develop guidelines for supervising physicians on best
29342934 practices for the supervision of Advanced Practice
29352935 Registered Nurses who have not obtained independent
29362936 prescriptive authority. The supervision guidelines
29372937 shall be published on the Board ’s website and the
29382938 Formulary Advisory Council shall periodically update
29392939 the guidelines as necessary.
29402940 c. The Formulary Advisory Council shall be composed of
29412941 twelve (12) members as follows:
29422942 (1) four members, to include a pediatrician, an
29432943 obstetrician-gynecological physician, a general
29442944 internist, and a family practice physician;
29452945 provided, that three of such members shall be
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29972997 appointed by the Oklahoma State Medical
29982998 Association, and one shall be appointed by the
29992999 Oklahoma Osteopathic Association,
30003000 (2) four members who are r egistered pharmacists,
30013001 appointed by the Oklahoma Pharmaceutical
30023002 Pharmacists Association, and
30033003 (3) four members, one of whom shall be a Certified
30043004 Nurse Practitioner, one of whom shall be a
30053005 Clinical Nurse Specialist, one of whom shall be a
30063006 Certified Nurse-Midwife, and one of whom shall be
30073007 a current member of the Oklahoma Board of
30083008 Nursing, all of whom shall be appointed by the
30093009 Oklahoma Board of Nursing.
30103010 c. d. All professional members of the Formulary Advisory
30113011 Council shall be in active clinical practice, at lea st
30123012 fifty percent (50%) of the time, within their defined
30133013 area of specialty. The members of the Formulary
30143014 Advisory Council shall serve at the pleasure of the
30153015 appointing authority for a term of three (3) years.
30163016 The terms of the members shall be staggered. Members
30173017 of the Council may serve beyond the expiration of
30183018 their term of office until a successor is appointed by
30193019 the original appointing authority. A vacancy on the
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30713071 Council shall be filled for the balance of the
30723072 unexpired term by the original appointing authority.
30733073 d. e. Members of the Council shall elect a chair and a
30743074 vice-chair vice chair from among the membership of the
30753075 Council. For the transaction of business, at least
30763076 seven members, with a minimum of two members present
30773077 from each of the identified ca tegories of physicians,
30783078 pharmacists, and advanced practice registered nurses
30793079 Advanced Practice Registered Nurses , shall constitute
30803080 a quorum. The Council shall recommend and the Board
30813081 shall approve and implement an initial exclusionary
30823082 formulary on or befo re January 1, 1997. The Council
30833083 and the Board shall annually review the approved
30843084 exclusionary formulary and shall make any necessary
30853085 revisions utilizing the same procedures used to
30863086 develop the initial exclusionary formulary.
30873087 SECTION 9. AMENDATORY 59 O.S. 2021, Section 567.5a , as
30883088 amended by Section 1, Chapt er 94, O.S.L. 2024 (59 O.S. Supp. 2024,
30893089 Section 567.5a), is amended to read as follows:
30903090 Section 567.5a. A. All applicants for a license to practice as
30913091 an Advanced Practice Regi stered Nurse shall be subject to Section
30923092 567.8 of this title.
30933093 B. An applicant for an initial license to practice as an
30943094 Advanced Practice Registered Nurse shall:
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31463146 1. Submit a completed written application and appropriate fees
31473147 as established by the Oklahoma Board of Nursing;
31483148 2. Submit a criminal history records check that complies w ith
31493149 Section 567.18 of this title;
31503150 3. Hold a current Registered Nurse license in this state;
31513151 4. Have completed an advanced practice registered nursing
31523152 education program in one o f the four advanced practice registered
31533153 nurse Advanced Practice Registered Nurse roles and a specialty area
31543154 recognized by the Board. Effective January 1, 2016, the applicant
31553155 shall have completed an accredited graduate level advanced practice
31563156 registered nursing education program in at least one of the
31573157 following population foci: fam ily/individual across the lifespan,
31583158 adult-gerontology, neonatal, pediatrics, women ’s health/gender-
31593159 related, or psychiatric/mental health;
31603160 5. Be currently certified in an advance d practice specialty
31613161 certification consistent with educational preparation and by a
31623162 national certifying body recognized by the Board; and
31633163 6. Provide any and all other evidence as required by the Board
31643164 in its rules.
31653165 C. The Board may issue a license by end orsement to an Advanced
31663166 Practice Registered Nurse licensed under the laws of a nother state
31673167 if the applicant meets the qualifications for licensure in this
31683168 state. An applicant by endorsement shall:
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32203220 1. Submit a completed written application and appropriate fees
32213221 as established by the Board;
32223222 2. Submit a criminal history records check that complies with
32233223 Section 567.18 of this title;
32243224 3. Hold a current Registered Nurse license in this state;
32253225 4. Hold recognition as an Advanced Practice Registered Nurse in
32263226 a state or territory;
32273227 5. Have completed an advanced practice registered nursing
32283228 education program in one of the four roles and a specialty area
32293229 recognized by the Board. Effective January 1, 2016, the applicant
32303230 shall have completed an accredited graduate leve l advanced practice
32313231 registered nursing education program in at least one of the
32323232 following population foci: family/individual across the lifespan,
32333233 adult-gerontology, neonatal, pediatrics, women ’s health/gender-
32343234 related, or psychiatric/mental health;
32353235 6. Be currently certified in an advanced practice specialty
32363236 certification consistent with educational preparation and by a
32373237 national certifying body recognized by the Board;
32383238 7. Meet continued competency requirements as set forth in Board
32393239 rules; and
32403240 8. Provide any and all other evidence as required by the Board
32413241 in its rules.
32423242 D. The Board may issue prescriptive authority recognition by
32433243 endorsement to an Advanced Practice Registered Nurse licensed as an
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32953295 APRN-CNP Advanced Practice Registered Nurse -Certified Nurse
32963296 Practitioner (APRN-CNP), APRN-CNS Advanced Practice Registered
32973297 Nurse-Clinical Nurse Specialist (APRN -CNS), or APRN-CNM Advanced
32983298 Practice Registered Nurse -Certified Nurse-Midwife (APRN-CNM) under
32993299 the laws of another state if the applicant meets the requireme nts
33003300 set forth in this section. An applicant for prescriptive authority
33013301 recognition by endorsement shall:
33023302 1. Submit a completed written application and appropriate fees
33033303 as established by the Board;
33043304 2. Hold current Registered Nurse and Advanced Practice
33053305 Registered Nurse licenses (APRN -CNP, APRN-CNS, or APRN-CNM) in the
33063306 state;
33073307 3. Hold current licensure or recognition as an Advanced
33083308 Practice Registered Nurse in the same role and specialty with
33093309 prescribing privileges in another state or territory;
33103310 4. Submit documentation verifying successful completion of a
33113311 graduate level graduate-level advanced practice registered nursing
33123312 education program that included an academic course in
33133313 pharmacotherapeutic management, and didactic and clinical
33143314 preparation for prescribi ng incorporated throughout the program;
33153315 5. Submit a written statement from an Oklahoma licensed
33163316 physician supervising prescriptive authority as required by the
33173317 Board in its rules, or submit documentation that the applicant meets
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33693369 the requirements for indep endent prescriptive authority under
33703370 Section 1 of this act ;
33713371 6. Meet continued competency requirements as set forth in Board
33723372 rules; and
33733373 7. Provide any and all other evidence as required by the Board
33743374 in its rules.
33753375 E. An Advanced Practice Registered Nurse l icense issued under
33763376 this section shall be renewed concurrently with the registered nurse
33773377 Registered Nurse license, provided that qualifying criteria continue
33783378 to be met.
33793379 F. The Board may reinstate a license as set forth in Board
33803380 rules.
33813381 SECTION 10. AMENDATORY 63 O.S. 2021, Section 2 -312, as
33823382 amended by Section 2, Chapter 184, O.S.L. 2022 (63 O.S. Supp. 202 4,
33833383 Section 2-312), is amended to read as follows:
33843384 Section 2-312. A. A physician, podiatrist, optometrist , or a
33853385 dentist who has complied with the registration requirements of the
33863386 Uniform Controlled Dangerous Substances Act, in good faith and in
33873387 the course of such person ’s professional practice only, may
33883388 prescribe and administer controlled dangerous substances, or may
33893389 cause the same to be administered by medical or paramedical
33903390 personnel acting under the direction and supervision of the
33913391 physician, podiatrist, optometrist , or dentist, and only may
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34433443 dispense controlled dangerous substances pursuant to the provisions
34443444 of Sections 355.1 and 3 55.2 of Title 59 of the Oklahoma Statutes.
34453445 B. A veterinarian who has complied with the registration
34463446 requirements of the Uniform Controlled Dangerous Substances Act, in
34473447 good faith and in the course of the professional practice of the
34483448 veterinarian only, and not for use by a human being, may prescribe,
34493449 administer, and dispense controlled dangerous substances and may
34503450 cause them to be administered by an assistant or orderly under the
34513451 direction and supervision of the veterinarian.
34523452 C. 1. An advanced practice nu rse Advanced Practice Registered
34533453 Nurse who is recognized to prescribe by the O klahoma Board of
34543454 Nursing as an advanced registered nurse practitioner, clinical nurse
34553455 specialist or certified nurse -midwife, a Certified Nurse
34563456 Practitioner, Clinical Nurse Specia list, or Certified Nurse -Midwife
34573457 but who has not obtained independent prescriptive authority under
34583458 Section 1 of this act and therefore is subject to medical direction
34593459 by a current supervision agreement with a supervising physician,
34603460 pursuant to Section 567. 3a of Title 59 of the Oklahoma Statutes, and
34613461 who has complied with the registr ation requirements of the Uniform
34623462 Controlled Dangerous Substances Act, in good faith and in the course
34633463 of professional practice only, may prescribe and administer Schedule
34643464 III, IV, and V controlled dangerous substances.
34653465 2. An Advanced Practice Registered Nurse who is recognized to
34663466 prescribe by the Oklahoma Board of Nursing as a Certified Nurse
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35183518 Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife
35193519 who has obtained independent prescriptive authority under Section 1
35203520 of this act, and who has comp lied with the registration requirements
35213521 of the Uniform Controlled Dangerous Substances Act, in good faith
35223522 and in the course of professional practice only, may prescribe and
35233523 administer Schedule III, IV, and V controlled dangerous substances.
35243524 D. An advanced practice nurse Advanced Practice Registered
35253525 Nurse who is recognized to order, select, obtain , and administer
35263526 drugs by the Oklahoma Board of Nursing as a certified registered
35273527 nurse anesthetist Certified Registered Nurse Anesthetist pursuant to
35283528 Section 353.1b of Title 59 of the Oklahoma Statutes and who has
35293529 complied with the registration requirements of the Uniform
35303530 Controlled Dangerous Substances Act, in good faith and in the cours e
35313531 of such practitioner ’s professional practice only, may order,
35323532 select, obtain, and administer Schedules II through V controlled
35333533 dangerous substances in a preanesthetic preparation or evaluation;
35343534 anesthesia induction, maintenance , or emergence; or postanes thesia
35353535 care setting only. A certified registered nurse anesthetist
35363536 Certified Registered Nurse Anesthetist may order, select, obtain ,
35373537 and administer such drugs only during the perioperative or
35383538 periobstetrical period.
35393539 E. A physician assistant who is recogn ized to prescribe by the
35403540 State Board of Medical Licensure and Supervision under the medical
35413541 direction of a supervising physician, pursuant to Section 519.6 of
35423542
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35933593 Title 59 of the Oklahoma Statutes, and who has complied with the
35943594 registration requirements of the Uniform Controlled Dangerous
35953595 Substances Act, in good faith and in the course of professional
35963596 practice only, may prescribe and administer Schedule II through V
35973597 controlled dangerous substances.
35983598 SECTION 11. This act shall become effective Nov ember 1, 2025.
35993599
36003600 60-1-87 DC 1/13/2025 5:38:20 PM