Req. No. 87 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 60th Legislature (2025) SENATE BILL 569 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; providing for application approval, denial, reapplication, fees, and independent prescriptive authority revocation; prescribing certain malpractice insurance requirements; directing promulgation of certain advertising rules; providing certain construction; directing certain boards to make specified information available online; amending 59 O.S. 2021, Section 353.1, as amended by Section 6, Chapter 288, O.S.L. 2022 (59 O.S. Supp. 2024, 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; modif ying prescriptive authority of certain Advanced Practice Registered Nurses; updating statutory language; amending 59 O.S. 2021, Section 567.3a, which relates to definitions used in the Oklahoma Nursing Practice Act; modifying and adding definitions; amendi ng 59 O.S. 2021, Section 567.4a, which relates to prescriptive authority; specifying authority of the Oklahoma Board of Nursing to grant prescriptive authority; directing the Board to promulgate certain rules; clarifying certain educational requirement; re quiring the Formulary Advisory Council to develop, update, and publish certain guidelines; modifying references; conforming language; amending 59 O.S. 2021, Section 567.5a , as amended by Section 1, Chapter 94, O.S.L. 2024 (59 O.S. Supp. 2024, Section 567.5 a), which relates to Advanced Practice Registered Nurse license; providing Req. No. 87 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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. 2024, Section 2-312), which relates to controlled dangerous substances; conforming language relating to supervision requirement; updating statutory references and language; 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 follows: A. 1. An Advanced Practice Registered Nurse recognized by the Oklahoma Board of Nursing as a Certified N urse Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife who has completed a minimum of three (3) years of practice with prescriptive authority supervised by a ph ysician may apply to the Oklahoma Board of Nursing for authority to prescribe and order independent of supervision. 2. The application for independent prescriptive authority shall include proof that the Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife: a. holds a valid, current license in the appr opriate Advanced Practice Registered Nurse role issued by the Board and is in good standing with the Board, and Req. No. 87 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. has completed a minimum of three (3) years of practice with prescriptive authority supervised by a physician. 3. Independent prescriptive authority granted under this subsection shall be valid until the expiration of the current license to practice and may be renewed upon application to the Board at the same time and for the same period as the renewal of the license to practice. B. The Board shall review any application submitted under this section and shall approve or deny the application, stating the reason or reasons for denial, if denied. If denied, the applican t may reapply using the process prescribed by subsection A of this section. C. The Board may suspend or revoke independent prescriptive authority granted under this section for good cause at any time. D. The Board may establish a fee for the review of in itial and renewal applications under the provisions of this section. SECTION 2. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 567. 5b of Title 59, unless there is created a duplication in numbering, reads as follows: A. An Advanced Practice Registered Nurse, or the employer of the Advanced Practice Registered Nurse on his or her behalf, shall carry malpractice insurance or demonstrate proof of financial responsibility in a minimum amount of One Milli on Dollars Req. No. 87 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ($1,000,000.00) per occurrence and Three Million Dollars ($3,000,000.00) in the aggregate per year. B. An Advanced Practice Registered Nurse who is employed by or under contract with a federal agency that carries malpractice insurance in any amount on behalf of the Advanced Practice Registered Nurse shall be deemed in compliance with subsection A of this section when practicing under such federal employment or contract. However, to the extent the Advanced Practice Registered Nurse practices outside of such federal employment or contract, the Advanced Practice Registered Nurse, or his or her employer, shall comply with subsection A of this section. SECTION 3. NEW LAW A new section of law to be codified in the Oklahoma Stat utes as Section 567.5 c of Title 59, unless there is created a duplication in numbering, reads as follows: A. The Oklahoma Board of Nursing shall promulgate rules governing advertising of health care services by Advanced Practice Registered Nurses to include, but not be limited to, the specialty areas or types of health care service s Advanced Practice Registered Nurses may advertise based on their training or experience. B. Nothing in this act shall be construed to allow an Advanced Practice Registered Nur se to perform any medical service or prescribe any medication beyond those authorized under state law or in a manner otherwise inconsistent with state law. Req. No. 87 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 4. NEW LAW A new section of law to be codified in the Oklahoma Statu tes as Section 479 of Title 59, unless there is created a duplication in numbe ring, reads as follows: The State Board of Medical Licensure and Supervision and the State Board of Osteopathic Examiners shall make available, and keep updated, in a conspicuous location on the website of each Board a list of physicians who are available to supervise Advanced Practice Registered Nurses. The Boards shall develop procedures necessary for the implementation of this section. SECTION 5. AMENDATORY 59 O.S. 2021, Section 353.1, as amended by Section 6, Chapter 288, O.S. L. 2022 (59 O.S. Supp. 202 4, Section 353.1), is amended to read as follows: Section 353.1. For the purposes of the Oklahoma Pharmacy Act: 1. “Accredited program” means those seminars, classes, meetings, work projects, and other educational courses approved by the Board State Board of Pharmacy for purposes of continuing professional education; 2. “Act” means the Oklahoma Pharmacy Act; 3. “Administer” means the direct applicatio n of a drug, whether 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 Oklahoma this state by the Board pursuant to S ection 353.10 of this title and for the Req. No. 87 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 purposes of the Oklahoma Pharmacy Act shall 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 pharm acist or a licensed practitioner with dispensing authority to confirm that the medication, labeling , and packaging of the filled prescription are accurate and meet all requiremen ts prescribed by state and federal 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 of chemistry, whether of organic or inorganic o rigin; 8. “Compounding” means the combining, admixing, mixing, diluting, pooling, reconstituting , or otherwise altering of a drug or bulk drug substance to create a drug. Compounding includes the preparation of drugs or devices in anticipation of prescription drug orders based on routine, regularly observed prescribing patterns; 9. “Continuing professional education ” means professional, pharmaceutical education in the general a reas 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 state; Req. No. 87 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 10. “Dangerous drug”, “legend drug”, “prescription drug”, or “Rx Only” means a drug: a. for human use subject to 21 U.S.C. , Section 353(b)(1), or b. is labeled “Prescription Only”, or labeled with the following statement: “Caution: Federal law restricts this drug except for to 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 order including the preparation and delivery of a drug or device to a patient or a patient ’s agent in a suitable container appropriately labeled for subsequent administration to, or use by, a patient. Dispense includes sell, distribute, leave with, give away, dispose of, deliver, or supply; 13. “Dispenser” means a retail pharmacy, hospital pha rmacy, a group of chain pharmacies under common ownership and control that do not act as a wholesale distributor, or any other person authorized by law to dispense or administer prescription drugs, and the affiliated warehouses or distributions of such entities under common ownership and control that do not act as a wholesale distributor. For the purposes of this paragraph, “dispenser” dispenser does not Req. No. 87 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 mean a person who dispens es only products to be used in animals in accordance with 21 U.S.C. , Section 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 pro duct pursuant to a prescription executed in accordance with 21 U.S.C. , Section 353(b)(1) or the dispensing of a product approved under 21 U.S.C. , Section 360b(b); provided, taking actual physical possession of a product or title shall 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 appear in the Oklahoma Statu tes and the rules promulgated by the Board; 16. “Drug outlet” means all manufacturers, repackagers, outsourcing facilities, wholesale distributors, third -party logistics providers, pharmacies, and all other facilities which are engaged in dispensing, deli very, distribution, or storage of dangerous drugs; 17. “Drugs” means all medicinal substances and preparations recognized by the United States Pharmacopoeia Pharmacopeia and National Formulary, or any revision thereof, and all substances and preparations intended for external and/or internal use in the cure, diagnosis, mitigation, treatment , or prevention of disease in humans Req. No. 87 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 or animals and all substances and preparations, other than food, intended to affect the structure or any function of the body of a human or animals; 18. “Drug sample” means a unit of a prescription drug packag ed under the authority and responsibility of the manufacturer 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 Section 375.2 of this title ; 20. “Filled prescription” means a packaged prescription medication to which a label has been affixed which contains such information as is required by the Oklahoma Pharma cy 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 Veterans Affairs; 22. “Licensed practitioner ” means: a. an allopathic physician , b. an osteopathic physician, c. a podiatric physician, d. a dentist, e. a veterinarian or, f. an optometrist, or g. an Advanced Practice Registered Nurse , Req. No. 87 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 licensed to practice and authorized to prescribe dangerous drugs within the scope of practice of su ch practitioner; 23. “Manufacturer” or “virtual manufacturer ” means with respect to a product: a. a person that holds an application approved under 21 U.S.C., Section 355 or a license issued under 42 U.S.C., Section 262 for such product, or if such product is not the subject of an approved application or license, the person who manufactured the product, b. a co-licensed partner of the person described in subparagraph a of this paragraph that obtains the product directly from a person described in this subparagraph or subparagraph a of this paragraph, c. an affiliate of a person desc ribed in subparagraph a or b of this paragraph who receives the product directly from a person described in this subparagraph or in subparagraph a or b of this paragraph, or 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 chemical or biological synthesis and includes any packaging or repackaging of the Req. No. 87 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 substances or labeling or relabeling of its container, and the promotion and marketing of such drugs or devices. The term “manufacturing” manufacturing also includes the preparation and promotion of commercially available products from bulk compounds for resale by licensed pharmacies, licensed practitioners , or other persons; 25. “Medical gas” means those gases including those in li quid state upon which the manufacturer or distributor has placed one of several cautions, such as “Rx Only”, in compliance with federal law; 26. “Medical gas order” means an order for medical gas issued by a licensed prescriber; 27. “Medical gas distribu tor” means a person licensed to distribute, transfer, wholesale, deliver , or sell medical gases on drug orders to suppliers or other 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 dispenses medical gases on drug orders on ly to a patient or ultimate user; 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 drugs which are sold without a prescription and which are prepackaged for use by the consumer and labeled in accordance with the requirements of the Req. No. 87 Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 statutes and regulati ons of this state and the federal government. Such items shall also include m edical and dental supplies and bottled or nonbulk chemicals which are sold or offered for sale to the general public if such articles or preparations 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 drugs, b. has elected to register as an outsourcing facility, and c. complies with all requirements of 21 U.S.C. , Section 353b; 32. “Package” means the smallest individual saleable unit of product for distribution by a manufacturer or repackager that is intended by the manufacturer for ultimate sale to the dispenser of such product. For the purposes of this paragraph, “individual saleable unit” means the smallest container of a product introduced into commerce by the manufacturer or repackager that is intended by the manufacturer or repackager for individual sale to a dispenser; 33. “Person” means an individual, partnership, limited liability company, corporation , or association, unless the context otherwise requires; Req. No. 87 Page 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 provided by Section 353.18 of this title; 35. “Pharmacy” means a place regularly li censed by the State Board of Pharmacy in which prescriptions, drugs, medicines , chemicals, and poisons are compounded or dispensed or such place where pharmacists practice the profession of pharmacy, or a pharmacy operated by the Oklahoma Department of Vet erans Affairs; 36. “Pharmacy technician”, “technician”, “Rx tech”, or “tech” means a person issued a Technician 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 supervision 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; 38. “Practice of pharmacy ” means: a. the interpretation and evaluation of prescription orders, Req. No. 87 Page 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. the compounding, dispensing, administering , and labeling of drugs and devices, excep t 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 devices a nd the maintenance of proper records 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 acts, services, operations, or transactions necessa ry in the conduct, operation, management , and control of a pharmacy, or g. the provision of those acts or services that 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; 40. “Prescriber” means a person licensed in this state who is authorized to prescribe dangerous drugs w ithin the scope of practice of the person’s profession; Req. No. 87 Page 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 prescribe r, b. under the supervision of an Oklahoma licensed practitioner, an Oklahoma licensed advanced practice registered nurse or an Oklahoma licensed by a physician assistant pursuant to a practice agreement , or c. (1) under the supervision of a supervising ph ysician, by a Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife licensed in this state who has not obtained independent prescriptive authority under Section 1 of this act, or (2) by a Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife licensed in this state who has obtained independent prescriptive authority under Section 1 of this act, or d. by an Oklahoma licensed wholesaler or distributor as authorized in Section 353.29.1 of this title; 42. “Product” means a prescription drug in a finished dosage form for administration to a patient without substantial further Req. No. 87 Page 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 manufacturing, such as capsules, tablets, and lyophilized products before reconstitution. “Product” Product does not include bloo d components intended for transfusion, radioactive drugs or biologics and medical gas; 43. “Repackager”, including “virtual repackager”, means a person who owns or operates an establishment that repacks and relabels a product or package for further sale o r distribution without further transaction; 44. “Sterile drug” means a drug that is intended for parenteral administration, an ophthalmic or oral inhalation drug in aqueous format, or a drug that is required to be sterile under state and federal law; 45. “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 Licensure and Supervisio n Act, or the State Board of Osteopathic Examiners, pursuant to the provisions of the Oklahoma Osteopathic Medicine Act, who supervises an advanced practice registered nurse a Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife as defined in Section 567.3a of this title who has not obtained independent prescriptive authority under Section 1 of this act , and who is not in training as an intern, resident, or fellow. To be eligible to supervise an advanced practice registered n urse, such Req. No. 87 Page 17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 The supervising physician shall remain in compliance with the rules promulgated by the State Board of Medical Licensure and Supervision or the State Board of Osteopathic Examiners; 46. “Supportive personnel ” means technicians and auxiliary supportive persons who are regularly paid employees of a pharmacy who work and perform tasks in the pharmacy as authorized by Section 353.18A of this title; 47. “Third-party logistics provider ” including “virtual third- party logistics provider ” means an entity that provides or coordinates warehousing, or other logistics services of a p roduct in interstate commerce on behalf of a manufacturer, wholesale distributor, or dispenser of a product but does not take ownership of the product, nor have responsibility to direct the sale or disposition of the product. For the purposes of this paragraph, “third-party logistics provider ” third-party logistics provider does not include shippers and the United States Postal Service; 48. “Wholesale distributor ” including “virtual wholesale distributor” means a person other than a manufacturer, a manufacturer’s co-licensed partner, a third -party logistics provider, or repackager engaged in wholesale distribution as defined by 21 U.S.C., Section 353(e)(4) as amended by the Drug Supply Chain Security Act; 49. “County jail” means a facility operated by a county for the physical detention and correction of persons charged with, or Req. No. 87 Page 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 convicted of, criminal offenses or ordinance violations or persons found guilty of civil or criminal c ontempt; 50. “State correctional facility ” means a facility or institution that houses a prisoner population under the jurisdiction of the Department of Corrections; 51. “Unit dose package” means a package that contains a single dose drug with the name, strength, control number, and expiration date of that drug on the label; and 52. “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 expirati on date. SECTION 6. AMENDATORY 59 O.S. 2021, Section 353.1a, is amended to read as follows: Section 353.1a. A. Prescribing 1. Prescriptive authority shall be allowed, under the medical direction of a current supervision agreement with a supervising physician, for an advanced practice nurse a licensed Advanced Practice Registered Nurse recognized by the Oklahoma 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, Clinical Nu rse Specialist, or Certified Nurse -Midwife who has not obtained independent prescriptive authority under Section 1 of this act. Req. No. 87 Page 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Prescriptive authority shall be allowed, indep endent of a current supervision agreement with a supervising physician, for a licensed Advanced Practice Registered Nurse recognized by the Oklahoma Board of Nursing as a Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife who has obtained independent prescriptive authority under Section 1 of this act. B. The advanced practice nurse Advanced Practice Registered Nurse may write or sign, or transmit by word of mouth, telephone , or other means of communication an order for drug s or medical supplies that is intended to be filled, compounded, or dispensed by a pharmacist. The supervising physician , if applicable, and the advanced practice nurse prescribing Advanced Practice Registered Nurse shall be identified at the time of orig ination of the prescription and the name of the advanced practice nurse prescribing Advanced Practice Registered Nurse shall be printed on the prescription label. B. C. Pharmacists may dispense prescriptions for non -controlled prescription drugs authorize d 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. D. 1. Pharmacists may only dispense pre scriptions for controlled dangerous substances prescribed by an advanced practice Req. No. 87 Page 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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. 2. Pharmacists may only dispense prescriptions for controlled dangerous substances prescribed by a physician assistant licensed in this state pursuant to a practice agreement . SECTION 7. 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; 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 with educational preparation. Knowledge and skill are the basis for assessment, analysis, planning, intervention, an d evaluation used in the promotion and maintenance of health and nursing manag ement of illness, injury, infirmity, restoration or of optimal function, or death with dignity. Practice is based on understanding the human condition across the human lifespan and understanding the relationship of the individual within the environment. This practice includes execution of the medical regime including the administration of medications and treatments prescribed by any person authorized by state law to so prescribe ; Req. No. 87 Page 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 3. “Registered nursing” means the practice of the full scope of nursing which includes, but is not limited to: a. assessing the health status of individuals, families , and groups, b. analyzing assessment data 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, 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 w ith the provisions of the Oklahoma Nursing Practice Act, h. providing safe and effective nursing care rendered directly or indirectly, i. evaluating responses to interventions, j. teaching the principles and practice of nursing, k. managing and supervising the practice of nursing, l. collaborating with other health professionals in the management of health care, Req. No. 87 Page 22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 m. performing additional nursing functions in accordance with knowledge and skills acquired beyond basic nursing preparation, and n. delegating those nursing tasks as defined in the rules of the Board that may be performed by an advanced unlicensed assistive person Advanced Unlicensed Assistant; 4. “Licensed practical nurs ing” means the practice of nursing under the supervision or direction of a registered nurse 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 health status of individuals and groups, 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 educational preparation and that do not conflict with the Oklahoma Nursing Practice Act, e. providing safe and effective nursing care rendered directly or indirectly, Req. No. 87 Page 23 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 f. participating in the evaluation of responses to interventions, g. teaching basic nursi ng 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 be performed by an advanced unlicensed assistive person Advanced Unlicensed Assistant; 5. “Advanced Practice Registered Nurse ” means a licensed Registered Nurse: a. who has completed an advanced practice registered nursing education program in preparatio n for one of four recognized advanced practice registered nurse Advanced Practice Registered Nurse roles, b. who has passed a national certification 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 advanced clinical knowledge and skills in preparation for providing both direct and Req. No. 87 Page 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 indirect care to patients; however, the defining factor for all Advanced Practi ce Registered Nurses is that a significant component of the education and practice focuses on direct care of individuals, d. whose practice builds on the competencies of Registered Nurses by demonstrating a greater depth and breadth of knowledge, a greater synthesis of data, and increased complexity of skills and interventions, and e. who has obtained a license as an Advanced Practice Registered Nurse in one of the following roles : Certified Registered Nurse Anesthetist, Certified Nurse-Midwife, Clinical Nurse Specialist, or Certified Nurse Practitioner. Only those persons who hold a license to practice advanced practice registered nursing in this state shall have the right to use the title “Advanced Practice Registered Nurse ” Advanced Practice Registered Nurse and to use the abbreviation “APRN”. Only those persons who have obtained a license in the following disciplines shall have the right to fulfill the roles and use the applic able titles: Certified Registered Nurse Anesthetist and the abbreviation “CRNA”, Certified Nurse-Midwife and the abbreviation “CNM”, Clinical Nurse Specialist and the abbreviation “CNS”, and Certified Nurse Practitioner and the abbreviation “CNP”. Req. No. 87 Page 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 It shall be unlawful for any person to assume the role or use the title Advanced Practice Registered Nurse or use the abbreviation “APRN” APRN or use the respective specialty role titles and abbreviations or to use any other titles or abbreviations that would reasonably lead a person to believe the user is an Advanced Practice Registered Nurse, unless permitted by the Oklahoma Nursing Practice Act. Any individual doing so shall be guilty of a misdemeanor, which shall be punishable, upon conviction, by imprisonmen t 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 than 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 role in the delivery of health care: a. consistent with advanced educational preparation as a Certified Nurse Practitioner in an area of specialty, b. functions within the Certified Nurs e Practitioner scope of practice for the selected area of specialization, and c. is in accord with the standards for Certified Nurse Practitioners as identified by the certifying body and approved by the Board. Req. No. 87 Page 26 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 A Certified Nurse Practitioner shall be eligi ble, in accordance with the scope of practice of the Certified Nurse Practitio ner, to obtain recognition as authorized 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 Section 567.4a of this title and Section 1 of this act . This authorization shall not include 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. The Certified Nurse Practitioner accepts responsib ility, accountability, and obligation to practice in accordance with usual and customary advanced practice registered nursing standards and functions as defined by the scope of p ractice/role definition statements for the Certified Nurse Practitioner; 7. a. “Clinical Nurse Specialist ” is means an Advanced Practice Registered Nurse who holds: (1) a master’s degree or higher in nursing with clinical specialization preparation to func tion in an expanded role, (2) specialty certification from a national certifying organization recognized by the Board, and (3) an Advanced Practice Registered Nurse license from the Board, and. Req. No. 87 Page 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (4) any Any nurse holding a specialty certification as a Clinical Nurse Specialist 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 Specialist 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 patients or clients in any setting, including private practice, (2) managing the care of patients or clients with complex nursing problems, (3) enhancing patient or client care by integrating the competencies of clinical practice, education, consultation, and research, and (4) referring patients or clients to other services. c. A Clinical Nurse Specialist in accordance wit h the scope of practice of such Clinical Nurse Specialist shall be eligible to obtain recognition as authorized by the Board to prescribe, as defined by the rules Req. No. 87 Page 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 promulgated by the Board pursuant to this section, and subject to the medical direction of a supervising physician Section 567.4a of this title and Section 1 of this act. This authorization shall not include dispensing drugs, but shall not preclude, subject to federal regulations, the receipt of, the signing for, or the dispensing of professional samples to patients. d. The Clinical Nurse Specialist accepts 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/role definition statements for the Clinical Nurse Specialist; 8. “Nurse-Midwife” is “Certified Nurse-Midwife” means a nurse who has received an Advanced Practice Registered Nurse license from the Oklahoma Board 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 authorized 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 Section 567.4a of this title and Section 1 of this act. This authorization Req. No. 87 Page 29 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 shall not include 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 to 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 newbo rns and women, antepartally, intrapartally, postpartally, and gynecologically, occurring within a health care system which provides for medical consultation, medical management , or referral, and is in accord with the standards for nurse -midwifery practice as defined by the American College of Nurse -Midwives; 10. a. “Certified Registered Nurse Anesthetist ” is means an Advanced Practice Registered Nurse who: (1) is certified by the National Board of Certification and Recertification for Nurse Anesthetists as a Certified Registered Nurse 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 recertification by the National Req. No. 87 Page 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Board of Certification and Recertification for Nurse Anesthetists, and (2) administers anesthesia in collaboration with a medical doctor, an osteopathic physician, a podiatric physician, or a dentist licensed in this state and under conditions in which ti mely onsite on-site consultation by such doctor, osteopath, podiatric physician , or dentist is available. b. A Certified Registered Nurse Anesthetist, in collaboration with a med ical doctor, osteopathic physician, podiatric physician , or dentist licensed in this state, and under conditions in which timely, on - site consultation by such medical doctor, osteopathic physician, podiatric physician , or dentist is available, shall be aut horized, pursuant to rules adopted by the Oklahoma Board of Nursing, to order, select, obtain, and administer legend drugs, Schedules II through V controlled substances, devices, and medical gases only when engaged in the preanesthetic preparation and eval uation; anesthesia induction, maintenance, and emergence; and postanesthesia care. A Certified Registered Nurse Anesthetist may order, Req. No. 87 Page 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 select, obtain, and administer 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, within the two - year period immediately preceding the date of application, of a minimum of fifteen (15) units of continuing education in advanced pharmacology related to the administration of anesthesia as recognized by the National Board of Certification and Recertification for Nurse An esthetists, and (3) complete and submit a notarized application, on a form prescribed by the Board, accompanied by the application fee established pursuant to this section. d. The authority to order, select, obtain , and administer drugs shall be terminated if a Certified Registered Nurse Anesthetist has: (1) ordered, selected, obtained , or administered drugs outside of the Certified Registered Nurse Anesthetist scope of practice or ordered, Req. No. 87 Page 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 selected, obtained, or administered drugs for other than therapeuti c purposes, or (2) violated any provision of state 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 State Board of Pharmacy after termination of or a change in the 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 reauthorization of autho rity to order, select, obtain , and administer drugs for Certified Registered N urse Anesthetists. At the time of application renewal, a Certified Registered Nurse Anesthetist shall submit documentation of a minimum of eight (8) units of continuing educatio n, completed during the previous two (2) years, in advanced pharmacology relating to the administration of anesthesia, as recognized by the Council on Recertification of Nurse Anesthetists or the Council on Certification of Nurse Anesthetists National Board of Certification and Recertification for Nurse Anesthetists. Req. No. 87 Page 33 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 g. This paragraph shall not prohibit the administration of local or topical anesthetics as now permitted by law. Provided further, nothing in this paragraph shall limit the authority of the Bo ard of Dentistry to establish the qualifications for dentists who direct the administration of anesthesia. h. As used in this paragraph, “collaboration” means an agreement between a medical doctor, osteopathic physician, podiatric physician , or dentist performing the procedure or directly involved with the procedure and the Certified Registered Nurse Anesthetist working jointly toward a common goal providing services for the same patient. This collaboration involves the joint formulation, discussion , and agreement of the anesthesia plan by both parties, and the collaborating medical doctor, osteopathic physician, podiatric physician, or dentist performing the procedure or directly involved with the procedure and that collaborating physician shall remain ava ilable for timely onsite on-site consultation during the delivery of anesthesia for diagnosis, consultation, and treatment of medical conditions; 11. “Supervising physician ” means an individual holding a current license to practice as a physician from the State Board of Req. No. 87 Page 34 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Medical Licensure and Supervision or the State Board of Osteopathic Examiners, who supervises a Certified Nurse Practitioner, a Clinical Nurse Specialist, or a Certified Nurse -Midwife who has not obtained independent prescriptive authority under Section 1 of this act , and who is not in training as an intern, resident , or fellow. To be eligible to supervise such Advanced Practice Registered Nurse, such The supervising physician shall remain in compliance with the rules promulgated by the Sta te Board of Medical Licensure and Supervision or the State Board of Osteopathic Examiners; 12. “Supervision of an Advanced Practice Registered Nurse with prescriptive authority ” means overseeing and accepting responsibility for the ordering and transmissi on by assuring availability of the supervising physician to a Certified Nurse Practitioner, a Clinical Nurse Specialist, or a Certified Nurse - Midwife of who has not obtained independent prescriptive authority under Section 1 of this act through direct contact, telecommunications, or other appropriate electronic means for consultation, assistance with medical emergencies, or patient referral with respect to written, telephonic, electronic , or oral prescriptions for drugs and other medical supplies, subject t o a defined formulary; and 13. “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 Req. No. 87 Page 35 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 specified technical skills identifie d by the Board in acute care settings under the direction and supervision of the Registered Nurse or Licensed Practical Nurse. SECTION 8. 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, Clinical Nurse Specialists, and Certified Nurse -Midwives who meet the requirements for prescriptive authori ty identified by law and in the Board ’s rules. The rules regarding prescriptive authority recognition promulgated by the Oklahoma Board of Nursing pursuant to paragraphs 6 through 9, 11 and 12 of this section, Section 567.3a of this title, and Section 1 of this act shall: 1. Define the procedure for documenting supervision by a supervising physician licensed in Oklahoma to practice by the State Board of Medical Licensure and Supervision or the State Board of Osteopathic Examiners , as defined in Section 56 7.3a of this title, of a Certified Nurse Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife who has not obtained independent prescriptive authority under Section 1 of this act . Such procedure shall include a written statement that defines appropriate referral, consultation, and collaboration between the Advanced Pr actice Registered Nurse, recognized to prescribe as defined in paragraphs 6 Req. No. 87 Page 36 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 through 9, 11 and 12 of Section 567.3a of this title, and the supervising physician. The written stat ement shall include a method of assuring availability of the supervising physician through direct contact, telecommunications , or other appropriate electronic means for consultation, assistance with medical emergencies, or patient referral. The written st atement shall be part of the initial application and the renewal application s ubmitted to the Board for recognition for prescriptive authority for the Advanced Practice Registered Nurse. Changes to the written statement shall be filed with the Board withi n thirty (30) days of the change and shall be effective on filing; 2. Define the procedure for documenting independent prescriptive authority for Certified Nurse Practitioners, Clinical Nurse Specialists, and Certified Nurse -Midwives who have obtained independent prescriptive authority under Section 1 of this act; 3. Define minimal requirements for initial application for prescriptive authority which shall include, but not be limited to, evidence of completion of a minimum of forty -five (45) contact hours 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 prep aration, approved by the Board. Such contact hours or academic credits shall be obtained within a time period of Req. No. 87 Page 37 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 three (3) years immediately preceding the date of application for prescriptive authority; 3. 4. Define minimal requirements for application f or 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) academic credit hour of education in pharmacotherapeutics, clinical application, and use of pharmacolog ical agents in the prevention of illness, and in the restoration and maintenance of health in a program beyond basic registered nurse preparation, and b. two (2) hours of education in pain management or two (2) hours of education in opioid use or addiction , unless the Advanced Practice Registered Nurse has demonstrated to the satisfaction of the Board that the Advanced Practice Registered Nurse does not currently hold a valid federal Drug Enforcement Administration registration number, approved by the Board , within the two-year period immediately preceding the effective date of appli cation 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 Req. No. 87 Page 38 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 specialty one of the following Advanced Practice Registered Nurse roles: a. Certified Nurse Practitioner, b. Clinical Nurse Specialist, or c. Certified Nurse-Midwife, in order to be eligible for initial application for prescriptive authority under the provisions of the Oklahoma N ursing Practice Act; 5. 6. Define the method for communicating authority to prescribe or termination of same, and the formulary to the State Board of Pharmacy, all pharmacies, a nd all registered pharmacists; 6. 7. Define terminology used in such rules; 7. 8. Define the parameters for the prescribing practices of the Advanced Practice Registered Nurse; 8. 9. Define the methods for termination of prescriptive authority for the Advanced Practice Registered Nurse; and 9. 10. a. Establish a Formulary Advisor y Council 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 an Advanced Practice Registered Nurse recognized to prescribe by the Oklahoma Board of Nursing. The Formulary Advisory Council shall also develop and submit to the Board recommendations for practice - specific prescriptive standards for each category of Req. No. 87 Page 39 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Advanced Practice Registered Nurse recognized to prescribe by the Oklahoma Board of Nursing pursuant to the provisions of the Oklahoma Nursing Practice Act. 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. In addition to the other powers and duties of the Formulary Advisory Council prescribed by this paragraph, the Formulary Advisory Council shall develop guidelines for supervising physicians on best practices for the supervision of Advanced Practice Registered Nurses who have not obtained independent prescriptive authority. The supervision guidelines shall be published on the Board ’s website and the Formulary Advisory Council shall periodically update the guidelines as necessary. c. The Formulary Advisory Council shall be composed of twelve (12) members as follows: (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 Req. No. 87 Page 40 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 appointed by the Oklahoma State Medical Association, and one shall be appointed by the Oklahoma Osteopathic Association, (2) four members who are r egistered pharmacists, appointed by the Oklahoma Pharmaceutical Pharmacists 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. c. d. All professional members of the Formulary Advisory Council shall be in active clinical practice, at lea st fifty percent (50%) of the time, within their defined area of specialty. The members of the Formulary Advisory Council shall serve at the pleasure of the appointing authority for a term of three (3) years. The terms of the members shall be staggered. 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 vacancy on the Req. No. 87 Page 41 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Council shall be filled for the balance of the unexpired term by the original appointing authority. d. e. Members of the Council shall elect a chair and a vice-chair vice chair from among the membership of the Council. For the transaction of business, at least seven members, with a minimum of two members present from each of the identified ca tegories of physicians, pharmacists, and advanced practice registered nurses Advanced Practice Registered Nurses , shall constitute a quorum. The Council shall recommend and the Board shall approve and implement an initial exclusionary formulary on or befo re January 1, 1997. The Council and the Board shall annually review the approved exclusionary formulary and shall make any necessary revisions utilizing the same procedures used to develop the initial exclusionary formulary. SECTION 9. AMENDATORY 59 O.S. 2021, Section 567.5a , as amended by Section 1, Chapt er 94, O.S.L. 2024 (59 O.S. Supp. 2024, Section 567.5a), is amended to read as follows: Section 567.5a. A. All applicants for a license to practice as an Advanced Practice Regi stered 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 shall: Req. No. 87 Page 42 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. Submit a completed written application and appropriate fees as established by the Oklahoma Board of Nursing; 2. Submit a criminal history records check that complies w ith 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 o f the four advanced practice registered nurse Advanced Practice Registered Nurse roles and a specialty area recognized by the Board. Effective January 1, 2016, the applicant shall have completed an accredited graduate level advanced practice registered nursing education program in at least one of the following population foci: fam ily/individual across the lifespan, adult-gerontology, neonatal, pediatrics, women ’s health/gender- related, or psychiatric/mental health; 5. Be currently certified in an advance d practice specialty certification consistent with educational preparation and by a national certifying body recognized by the Board; and 6. Provide any and all other evidence as required by the Board in its rules. C. The Board may issue a license by end orsement to an Advanced Practice Registered Nurse licensed under the laws of a nother state if the applicant meets the qualifications for licensure in this state. An applicant by endorsement shall: Req. No. 87 Page 43 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. Submit a completed written application and appropriate fees as established by the Board; 2. Submit a criminal history records check that complies with Section 567.18 of this title; 3. Hold a current Registered Nurse license in this state; 4. Hold recognition as an Advanced Practice Registered Nurse in a state or territory; 5. Have completed an 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 leve l advanced 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; 6. Be currently certified in an advanced practice specialty certification consistent with educational preparation and by a national certifying body recognized by the Board; 7. Meet continued competency requirements as set forth in Board rules; and 8. Provide any and all other evidence as required by the Board in its rules. D. The Board may issue prescriptive authority recognition by endorsement to an Advanced Practice Registered Nurse licensed as an Req. No. 87 Page 44 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 APRN-CNP Advanced Practice Registered Nurse -Certified Nurse Practitioner (APRN-CNP), APRN-CNS Advanced Practice Registered Nurse-Clinical Nurse Specialist (APRN -CNS), or APRN-CNM Advanced Practice Registered Nurse -Certified Nurse-Midwife (APRN-CNM) under the laws of another state if the applicant meets the requireme nts set forth in this section. An applicant for prescriptive authority recognition by endorsement shall: 1. Submit a completed written application and appropriate fees as established by the Board; 2. Hold current Registered 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 Advanced 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 graduate-level advanced practice registered nursing education program that included an academic course in pharmacotherapeutic management, and didactic and clinical preparation for prescribi ng incorporated throughout the program; 5. Submit a written statement from an Oklahoma licensed physician supervising prescriptive authority as required by the Board in its rules, or submit documentation that the applicant meets Req. No. 87 Page 45 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 the requirements for indep endent 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 evidence as required by the Board in its rules. E. An Advanced Practice Registered Nurse l icense issued under this section shall be renewed concurrently with the registered nurse Registered Nurse license, provided that qualifying criteria continue to be met. F. The Board may reinstate a license as set forth in Board rules. SECTION 10. AMENDATORY 63 O.S. 2021, Section 2 -312, as amended by Section 2, Chapter 184, O.S.L. 2022 (63 O.S. Supp. 202 4, Section 2-312), is amended to read as follows: Section 2-312. A. A physician, podiatrist, optometrist , or a dentist who has complied with the registration requirements of the Uniform Controlled Dangerous Substances 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 administered by medical or paramedical personnel acting under the direction and supervision of the physician, podiatrist, optometrist , or dentist, and only may Req. No. 87 Page 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 dispense controlled dangerous substances pursuant to the provisions of Sections 355.1 and 3 55.2 of Title 59 of the Oklahoma Statutes. B. A veterinarian who has complied with the registration requirements of the Uniform Controlled Dangerous Substances Act, in good faith and in the course of the professional 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 orderly under the direction and supervision of the veterinarian. C. 1. An advanced practice nu rse Advanced Practice Registered Nurse who is recognized to prescribe by the O klahoma Board of Nursing as an advanced registered nurse practitioner, clinical nurse specialist or certified nurse -midwife, a Certified Nurse Practitioner, Clinical Nurse Specia list, or Certified Nurse -Midwife but who has not obtained independent prescriptive authority under Section 1 of this act and therefore is subject to medical direction by a current supervision agreement with a supervising physician, pursuant to Section 567. 3a of Title 59 of the Oklahoma Statutes, and who has complied with the registr ation requirements of 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 substances. 2. An Advanced Practice Registered Nurse who is recognized to prescribe by the Oklahoma Board of Nursing as a Certified Nurse Req. No. 87 Page 47 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Practitioner, Clinical Nurse Specialist, or Certified Nurse -Midwife who has obtained independent prescriptive authority under Section 1 of this act, and who has comp lied with the registration requirements of 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 substances. D. An advanced practice nurse Advanced Practice Registered 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 registration requirements of the Uniform Controlled Dangerous Substances Act, in good faith and in the cours e of such practitioner ’s professional practice only, may order, select, obtain, and administer Schedules II through V controlled dangerous substances in a preanesthetic preparation or evaluation; anesthesia induction, maintenance , or emergence; or postanes thesia care setting only. A certified registered nurse anesthetist Certified Registered Nurse Anesthetist may order, select, obtain , and administer such drugs only during the perioperative or periobstetrical period. E. A physician assistant who is recogn ized to prescribe by the State Board of Medical Licensure and Supervision under the medical direction of a supervising physician, pursuant to Section 519.6 of Req. No. 87 Page 48 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Title 59 of the Oklahoma Statutes, and who has complied with the registration requirements of the Uniform Controlled Dangerous Substances Act, in good faith and in the course of professional practice only, may prescribe and administer Schedule II through V controlled dangerous substances. SECTION 11. This act shall become effective Nov ember 1, 2025. 60-1-87 DC 1/13/2025 5:38:20 PM