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Sub. S. B. No. 89 As Reported by the Senate Health, Human Services and Aging CommitteeAs Reported by the Senate Health, Human Services and Aging Committee
128th General Assembly | Regular Session | 2009-2010 |
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Cosponsors:
Senators Fedor, Cafaro, Schiavoni, Miller, R., Miller, D., Kearney, Turner, Sawyer, Wilson, Wagoner, Gillmor, Schuring
A BILL
To amend sections 3333.28, 4723.01, 4723.06, 4723.48,
4723.482, and
4723.50; to amend, for the purpose
of adopting new section numbers as indicated in
parentheses, sections 4723.484 (4723.485) and
4723.485 (4723.486); and to enact new section
4723.484 and section 3333.29 of the
Revised Code
regarding prescriptive
authority of out-of-state
advanced practice
nurses, cooperation among
hospitals and state
institutions of higher
education with nursing
education programs, and
allocations from the Nurse
Education Assistance
Fund.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3333.28, 4723.01, 4723.06, 4723.48,
4723.482, and
4723.50 be amended; sections 4723.484 (4723.485),
and 4723.485 (4723.486) be amended for the purpose of adopting new
section numbers as indicated in parentheses; and new section
4723.484 and section 3333.29 of the Revised Code be
enacted to
read as follows:
Sec. 3333.28. (A) The chancellor of the Ohio board of
regents shall establish
the nurse education
assistance program,
the purpose of which shall be to make loans to students
enrolled
in prelicensure nurse education programs at institutions approved
by
the board of
nursing under section 4723.06 of the Revised Code
and
postlicensure nurse education programs approved by the
chancellor under section 3333.04 of the Revised Code or offered by
an institution holding a certificate of authorization issued under
Chapter 1713. of the Revised Code. The board of
nursing shall
assist the chancellor in administering the program.
(B) There is hereby created in the state treasury the
nurse
education assistance fund, which shall consist of all money
transferred to it pursuant to section 4743.05 of the Revised
Code.
The fund shall be used by the chancellor for loans made under
division (A) of this section and for expenses
of
administering the
loan program.
(C) Between July 1, 2005, and Until January 1, 2012, the
chancellor
shall distribute money in the nurse education
assistance fund in
the following manner:
(1)(a) Fifty per cent of available funds shall be awarded as
loans to registered nurses enrolled in postlicensure nurse
education programs described in division (A) of this section. To
be eligible for a loan, the applicant shall provide the chancellor
with a letter of intent to practice as a faculty member at a
prelicensure or postlicensure program for nursing in this state
upon completion of the applicant's academic program.
(b) If the borrower of a loan under division (C)(1)(a) of
this section secures employment as a faculty member of an approved
nursing education program in this state within six months
following graduation from an approved nurse education program, the
chancellor may forgive the principal and interest of the student's
loans received under division (C)(1)(a) of this section at a rate
of twenty-five per cent per year, for a maximum of four years, for
each year in which the borrower is so employed. A deferment of the
service obligation, and other conditions regarding the forgiveness
of loans may be granted as provided by the rules adopted under
division (D)(7) of this section.
(c) Loans awarded under division (C)(1)(a) of this section
shall be awarded on the basis of the student's expected family
contribution, with preference given to those applicants with the
lowest expected family contribution. However, the chancellor may
consider other factors the chancellor determines relevant in
ranking the applications.
(d) Each loan awarded to a student under division (C)(1)(a)
of this section shall be not less than five thousand dollars per
year.
(2) Twenty-five per cent of available funds shall be awarded
to students enrolled in prelicensure nurse education programs for
registered nurses, as defined in section 4723.01 of the Revised
Code.
(3) Twenty-five per cent of available funds shall be awarded
to students enrolled in prelicensure professional nurse education
programs for licensed practical nurses, as defined in section
4723.01 of the Revised Code, or as determined by the chancellor
with
preference given to nurse education programs aimed at
increasing enrollment in an
area of need.
After January 1, 2012, the chancellor shall determine the
manner in which to distribute loans under this section.
(D) Subject to the requirements specified in division (C) of
this section, the chancellor shall adopt
rules in accordance with
Chapter 119. of the Revised Code establishing:
(1) Eligibility criteria for receipt of a loan;
(2) Loan application procedures;
(3) The amounts in which loans may be made and the total
amount that may be loaned to an individual;
(4) The total amount of loans that can be made each year;
(5) The percentage of the money in the fund that must
remain
in the fund at all times as a fund balance;
(6) Interest and principal repayment schedules;
(7) Conditions under which a portion of principal and
interest obligations incurred by an individual under the program
will be forgiven;
(8) Ways that the program may be used to encourage
individuals who are members of minority groups to enter the
nursing profession;
(9) Any other matters incidental to the operation of the
program.
(E) The obligation to repay a portion of the principal and
interest on a loan made under this section shall be forgiven if
the recipient of the loan meets the criteria for forgiveness
established by division (C)(1)(b) of this section, in the case of
loans awarded under division (C)(1)(a) of this section, or by the
chancellor under the
rule adopted under division (D)(7) of this
section, in the case of other loans awarded under this section.
(F) The receipt of a loan under this section shall not
affect
a student's eligibility for assistance, or the amount of
that
assistance, granted under section 3333.12, 3333.122, 3333.22,
3333.26,
3333.27, 5910.03, 5910.032, or 5919.34 of the Revised
Code, but
the rules of the chancellor may
provide for taking
assistance received under those sections into consideration
when
determining a student's eligibility for a loan under this
section.
Sec. 3333.29. (A) As used in this section, "state institution
of higher education" has the same meaning as in section 3345.011
of the Revised Code.
(B) The chancellor of the Ohio board of regents shall
establish, within the Ohio skills bank, a mechanism to facilitate
communication, cooperation, and partnerships among state
institutions of higher education with nursing education programs
and between state institutions of higher education and hospitals
in this state to meet regional and statewide nursing education
needs.
Sec. 4723.01. As used in this chapter:
(A)
"Registered nurse" means an individual who holds a
current, valid license issued under this chapter that authorizes
the practice of nursing as a registered nurse.
(B)
"Practice of nursing as a registered nurse" means
providing to individuals and groups nursing care requiring
specialized knowledge, judgment, and skill derived from the
principles of biological, physical, behavioral, social, and
nursing sciences. Such nursing care includes:
(1) Identifying patterns of human responses to actual or
potential health problems amenable to a nursing regimen;
(2) Executing a nursing regimen through the selection,
performance, management, and evaluation of nursing actions;
(3) Assessing health status for the purpose of providing
nursing care;
(4) Providing health counseling and health teaching;
(5) Administering medications, treatments, and executing
regimens authorized by an individual who is
authorized to practice
in this state and is acting within the course of the
individual's
professional practice;
(6) Teaching, administering, supervising, delegating, and
evaluating nursing practice.
(C)
"Nursing regimen" may include preventative,
restorative,
and health-promotion activities.
(D)
"Assessing health status" means the collection of data
through nursing assessment techniques, which may include
interviews, observation, and physical evaluations for the purpose
of providing nursing care.
(E)
"Licensed practical nurse" means an individual who
holds
a current, valid license issued under this chapter that
authorizes
the practice of nursing as a licensed practical nurse.
(F)
"The practice of nursing as a licensed practical
nurse"
means providing to individuals and groups nursing care
requiring
the application of basic knowledge of the biological,
physical,
behavioral, social, and nursing sciences at the
direction of a
licensed physician, dentist, podiatrist,
optometrist,
chiropractor, or registered nurse. Such nursing
care includes:
(1) Observation, patient teaching, and care in a diversity
of
health care settings;
(2) Contributions to the planning, implementation, and
evaluation of nursing;
(3) Administration of medications and treatments
authorized
by an individual who is
authorized to practice in this state and
is acting within the course of the
individual's professional
practice, except that administration of
intravenous therapy shall
be performed only in accordance with section
4723.17 or 4723.171
of the Revised Code. Medications may be administered by a
licensed
practical nurse upon proof of completion of a course in
medication
administration approved by the board of nursing.
(4) Administration to an adult of intravenous therapy
authorized by an individual who is authorized to practice in this
state and is acting within the course of the individual's
professional
practice, on the condition that the licensed
practical nurse is authorized
under section 4723.17 or 4723.171 of
the Revised Code to perform intravenous therapy
and performs
intravenous
therapy only in accordance with those sections;
(5) Delegation of nursing tasks as directed by a registered
nurse;
(6) Teaching nursing tasks to licensed practical nurses and
individuals to whom the licensed practical nurse is authorized to
delegate nursing tasks as directed by a registered nurse.
(G)
"Certified registered
nurse anesthetist" means a
registered nurse who holds a valid
certificate of authority issued
under this chapter that
authorizes the practice of nursing as a
certified registered
nurse anesthetist in accordance with section
4723.43 of the
Revised Code and rules adopted by the board of
nursing.
(H)
"Clinical nurse specialist" means a registered
nurse who
holds a valid certificate of authority issued under
this chapter
that authorizes the practice of nursing as a
clinical nurse
specialist in accordance with section 4723.43 of
the Revised Code
and rules adopted by the board
of nursing.
(I)
"Certified nurse-midwife" means a registered nurse who
holds a valid certificate of authority issued under this chapter
that authorizes the practice of nursing as a certified
nurse-midwife in
accordance with section 4723.43 of the Revised
Code and rules adopted by the board of nursing.
(J)
"Certified nurse practitioner" means a registered nurse
who holds a valid certificate of authority issued under this
chapter that authorizes the practice of nursing as a certified
nurse
practitioner in accordance with section 4723.43 of the
Revised Code and rules adopted by the board of
nursing.
(K)
"Physician" means an individual
authorized under Chapter
4731. of
the Revised Code to practice
medicine and surgery or
osteopathic medicine and surgery, except as used in divisions (C)
and (D) of section 4723.482 of the Revised Code.
(L)
"Collaboration" or
"collaborating" means the
following:
(1) In the case of a clinical nurse specialist, except
as
provided in division (L)(3) of this section, or a
certified nurse
practitioner, that one or more podiatrists acting
within the scope
of
practice of podiatry in accordance with section 4731.51 of the
Revised Code and with whom the nurse has entered into a
standard
care arrangement or one or more physicians
with whom the nurse has
entered into a
standard care arrangement are continuously
available to communicate with the clinical nurse specialist or
certified nurse practitioner either in person or by radio,
telephone, or
other form of telecommunication;
(2) In the case of a certified nurse-midwife, that one
or
more physicians with whom the certified nurse-midwife has entered
into
a standard care arrangement are
continuously available to
communicate with the certified nurse-midwife
either in person or
by radio, telephone, or other form of
telecommunication;
(3) In the case of a clinical nurse specialist who practices
the nursing specialty of mental health or psychiatric
mental
health without being authorized to prescribe drugs and therapeutic
devices, that one or more physicians are
continuously
available to
communicate with the nurse either in person or by radio,
telephone, or other form of telecommunication.
(M)
"Supervision," as it pertains to a certified
registered
nurse
anesthetist, means that the certified
registered nurse
anesthetist is under the direction of a podiatrist acting
within
the podiatrist's scope of practice in accordance with section
4731.51
of the Revised
Code, a dentist acting within the dentist's
scope of practice in accordance with Chapter
4715. of the Revised
Code, or a physician, and, when administering
anesthesia, the
certified registered nurse anesthetist is in the immediate
presence of the podiatrist, dentist, or physician.
(N)
"Standard care arrangement" means a
written, formal guide
for
planning and evaluating a patient's health care that
is
developed
by one or more collaborating
physicians or podiatrists
and a
clinical nurse
specialist, certified nurse-midwife, or
certified
nurse practitioner and meets
the requirements of section
4723.431
of the
Revised Code.
(O)
"Advanced practice nurse" means a
certified registered
nurse anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner.
(P)
"Dialysis care" means the care and procedures that a
dialysis technician is authorized to provide and perform, as
specified in
section 4723.72 of the Revised Code.
(Q)
"Dialysis technician" means an individual who holds a
current, valid certificate or temporary certificate issued under
this chapter
that authorizes the individual to practice as a
dialysis technician in
accordance with section 4723.72 of the
Revised Code.
(R) "Certified community health worker" means an individual
who holds a current, valid certificate as a community health
worker issued by the board of nursing under section 4723.85 of the
Revised Code.
Sec. 4723.06. (A) The board of nursing shall:
(1) Administer and enforce the provisions of this chapter,
including the taking of disciplinary action for violations of
section 4723.28 of the Revised Code, any other provisions of this
chapter, or rules adopted under this chapter;
(2) Develop criteria that an applicant must meet
to be
eligible to sit for the examination for licensure to practice as a
registered nurse or as a licensed practical nurse;
(3) Issue and renew nursing licenses, dialysis technician
certificates, and community health worker certificates, as
provided in this chapter;
(4) Define the minimum curricula and standards for
educational programs of the schools of professional nursing and
schools of practical nursing in this state;
(5) Survey, inspect, and grant full approval to
prelicensure
nursing education programs that
meet the standards established by
rules adopted under section
4723.07 of the Revised Code.
Prelicensure nursing education
programs include, but are not
limited to, associate degree,
baccalaureate degree, diploma, and
doctor of nursing programs
leading to initial licensure to
practice nursing as a registered
nurse and practical nurse
programs leading to initial licensure
to practice nursing as a
licensed practical nurse.
(6) Grant conditional approval, by a vote of a quorum of
the
board, to a new prelicensure nursing education program or a
program that is being
reestablished after having ceased to
operate, if the program meets and
maintains
the minimum standards
of the
board established by rules adopted under section 4723.07 of
the
Revised Code. If the board does not grant conditional
approval,
it shall hold an adjudication under Chapter 119. of
the
Revised Code to
consider conditional approval of the program. If
the board grants conditional approval, at its first meeting after
the first class has completed the program, the board shall
determine whether to grant full approval to the program. If the
board
does not
grant full approval or if it
appears that the
program has failed to meet and maintain
standards established by
rules adopted under section 4723.07 of
the Revised Code, the board
shall hold an adjudication
under Chapter
119. of the Revised Code
to consider the program. Based on
results of the adjudication,
the
board may continue or
withdraw
conditional approval, or grant
full
approval.
(7) Place on provisional approval, for a period of time
specified by the board, a program that has ceased
to meet and
maintain the minimum standards of the board
established by rules
adopted under section 4723.07 of the Revised
Code. At the end of
the period, the board shall reconsider
whether the program meets
the standards and
shall
grant full approval if it does. If it
does
not, the board may
withdraw approval, pursuant to an
adjudication
under
Chapter 119. of
the Revised Code.
(8) Approve continuing nursing education programs and
courses
under standards established in rules adopted under
section
4723.07
of the Revised Code;
(9) Approve peer support programs, under rules
adopted under
section 4723.07 of the Revised Code, for nurses, for dialysis
technicians, and for certified community health workers;
(10) Establish a program for monitoring
chemical dependency
in
accordance with section 4723.35 of the Revised Code;
(11) Establish the practice intervention and improvement
program in
accordance with section 4723.282 of the Revised Code;
(12) Issue and renew certificates of authority to practice
nursing
as a
certified registered nurse anesthetist, clinical
nurse specialist, certified
nurse-midwife, or certified nurse
practitioner;
(13) Approve under section 4723.46 of the
Revised Code
national certifying organizations for examination and
certification of
certified registered nurse anesthetists, clinical
nurse specialists, certified
nurse-midwives, or certified nurse
practitioners;
(14) Issue and renew certificates to prescribe in accordance
with
sections 4723.48 and 4723.485 4723.486 of the Revised Code;
(15) Grant approval to the planned classroom and clinical
study required by section 4723.483 4723.482 of the Revised Code to
be
eligible for a certificate to prescribe;
(16) Make an annual edition of
the formulary established in
rules adopted under section
4723.50 of the Revised Code available
to the public either
in printed form or by electronic means and,
as soon as possible after
any revision of the formulary becomes
effective, make the
revision available to the public in printed
form or by
electronic means;
(17) Provide guidance and make recommendations to the
general
assembly,
the governor, state agencies, and the federal
government
with respect to the
regulation of the practice of
nursing and the
enforcement of this chapter;
(18) Make an annual report to the governor, which shall be
open for public inspection;
(19) Maintain and have open for public inspection the
following records:
(a) A record of all its meetings and proceedings;
(b) A file of holders of nursing licenses,
registrations,
and
certificates granted under this chapter; dialysis
technician
certificates granted under this chapter; and community health
worker certificates granted under this chapter. The file
shall be
maintained in the form prescribed by rule of the board.
(c) A list of prelicensure nursing education programs
approved by the board;
(d) A list of approved peer support programs for nurses,
dialysis
technicians, and certified community health workers.
(B) The board may fulfill the requirement of division
(A)(8)
of this section by authorizing persons who meet the
standards
established in rules adopted under
section 4723.07 of the Revised
Code to approve continuing nursing
education programs and courses.
Persons so authorized shall
approve continuing nursing education
programs and courses in
accordance with standards established in
rules adopted under
section 4723.07 of the Revised Code.
Persons seeking authorization to approve continuing nursing
education programs and courses shall apply to the board and pay
the appropriate fee established under section 4723.08 of the
Revised Code. Authorizations to approve continuing nursing
education programs and courses shall expire, and may be renewed
according to the schedule established in rules adopted under
section 4723.07 of the Revised Code.
In addition to approving continuing nursing education
programs under division (A)(8) of this section, the board may
sponsor continuing education activities that are directly related
to the statutes and rules pertaining to the practice of nursing in
this state.
Sec. 4723.48. (A) A clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner seeking authority
to prescribe
drugs and
therapeutic devices shall file with the
board of nursing a written
application for a certificate to
prescribe. The board of nursing
shall issue a certificate to
prescribe to each applicant who meets
the requirements specified
in section 4723.482 or 4723.484 4723.485 of the
Revised Code.
Except as provided in division (B) of this section, the
initial
certificate to prescribe that the board issues to an
applicant shall be issued
as an externship certificate. Under an
externship certificate,
the nurse may obtain
experience in
prescribing drugs and therapeutic devices by
participating in an
externship that evaluates the nurse's
competence, knowledge, and
skill in pharmacokinetic principles and
their clinical application
to the specialty being practiced.
During the externship, the
nurse may prescribe drugs and
therapeutic devices only when one or
more physicians are providing
supervision in accordance with
rules
adopted under section 4723.50
of the Revised Code.
After completing the
externship, the holder of an externship
certificate may apply for a new
certificate
to prescribe. On
receipt of the new certificate, the nurse may
prescribe drugs and
therapeutic devices in collaboration with one
or more physicians
or podiatrists.
(B) In the case of an applicant who
on May
17,
2000, was
approved
to
prescribe
drugs and therapeutic devices under section
4723.56 of the Revised Code, as that section existed on that date,
the initial certificate
to prescribe that the
board issues to the
applicant under this section
shall not be an externship
certificate.
The applicant shall be issued
a certificate to
prescribe that permits
the recipient to prescribe
drugs and
therapeutic devices in
collaboration with one or more
physicians
or podiatrists.
In the case of an applicant who meets the requirements of
division (C) of section 4723.482 of the Revised Code, the initial
certificate to prescribe that the board issues to the applicant
under this section shall not be an externship certificate. The
applicant shall be issued a certificate to prescribe that permits
the recipient to prescribe drugs and therapeutic devices in
collaboration with one or more physicians or podiatrists.
Sec. 4723.482. (A) An Except as provided in divisions (C)
and (D) of
this section, an applicant shall include with the
application
submitted under section
4723.48 of the Revised Code
all of the
following:
(1) Subject to section 4723.483 of the Revised Code,
evidence
of
holding a current, valid certificate of authority issued under
this chapter to practice as a
clinical
nurse specialist, certified
nurse-midwife, or certified nurse practitioner;
(2) Except for a person who on May 17, 2000, was approved to
prescribe drugs and
therapeutic devices under section 4723.56 of
the Revised Code, as that section existed on that date,
evidence
of successfully completing the instruction in
advanced
pharmacology and related topics specified in division
(B) of this
section;
(3) The fee required by section 4723.08 of the Revised
Code
for
a certificate to prescribe;
(4) Any additional information the board of nursing requires
pursuant to
rules adopted under section 4723.50 of the Revised
Code.
(B) All of the following apply to the instruction required
under
division (A)(2) of this section:
(1) The instruction must be obtained not longer than three
years
before the application for the certificate to prescribe is
filed.
(2) The instruction must be obtained through a course of
study
consisting of planned classroom and clinical study that is
approved
by the board of nursing in accordance with standards
established in
rules adopted under section 4723.50 of the Revised
Code.
(3) The content of the instruction must be specific to the
applicant's nursing specialty and include all of the following:
(a) A minimum of thirty contact hours of training in advanced
pharmacology that includes pharmacokinetic principles and clinical
application
and the use of
drugs and therapeutic devices in the
prevention of illness and
maintenance of health;
(b) Training in the fiscal and ethical implications of
prescribing drugs and therapeutic devices;
(c) Training in the state and federal laws that apply to the
authority to prescribe;
(d) Any additional training required pursuant to rules
adopted
under section 4723.50 of the Revised Code.
(C) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (D) of this section, shall include
with
the application submitted under section 4723.48 of the
Revised
Code all of the following:
(1) Subject to section 4723.483 of the Revised Code, evidence
of holding a current, valid certificate of authority issued under
this chapter to practice as a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to
prescribe therapeutic devices and drugs,
including at least some controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, including
at least some controlled substances, in conjunction
with that
employment.
(4) If the applicant includes the evidence described in
division (C)(3)(a) of this section, documentation from a licensed
physician
in a form acceptable to the board that the prescribing
component
of the nurse's practice was
overseen or supervised by
a licensed physician
in the other jurisdiction;
(5) If the applicant includes the evidence described in
division (C)(3)(b) of this section, documentation from a licensed
physician
employed by the United States government in a form
acceptable to
the board that the prescribing component of the
nurse's practice
was overseen or supervised by a licensed
physician employed by the United
States government;
(6) Evidence of having completed a two-hour course of
instruction approved by the board in the laws of this state that
govern drugs and prescriptive authority;
(7)
Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(D) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (C) of this section, shall include
with
the application submitted under section 4723.48 of the
Revised
Code all of the following:
(1) Subject to section 4723.483 of the Revised Code, evidence
of holding a current, valid certificate of authority issued under
this chapter to practice as a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to
prescribe therapeutic devices and drugs,
excluding controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, excluding
controlled substances, in conjunction
with that employment.
(4) If the applicant includes the evidence described in
division (D)(3)(a) of this section, documentation from a licensed
physician
in a form acceptable to the board that the prescribing
component
of the nurse's practice was
overseen or supervised by
a licensed physician
in the other jurisdiction;
(5) If the applicant includes the evidence described in
division (D)(3)(b) of this section, documentation from a licensed
physician
employed by the United States government in a form
acceptable to
the board that the prescribing component of the
nurse's practice
was overseen or supervised by a licensed
physician employed by the United
States government;
(6) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
Sec. 4723.484. (A) Except as provided in division (B) of this
section, to
successfully complete an externship as required under
section
4723.485 of the Revised Code, the holder of an externship
certificate must complete at least one thousand five hundred hours
during which the certificate holder's prescribing practices are
supervised in accordance with division (A) of
section 4723.48 of
the Revised Code.
(B) A holder of an externship certificate who obtained the
certificate by meeting the requirements of division (D) of section
4723.482 of the Revised Code, to successfully complete an
externship as required under section 4723.485 of the Revised Code,
must do both of the following:
(1) Complete at least five hundred hours during which the
certificate holder's prescribing practices are supervised in
accordance with division
(A) of section 4723.48 of the Revised
Code;
(2) Complete a two-hour course of instruction approved by the
board of nursing in the laws of this state that govern drugs and
prescriptive authority.
Sec. 4723.484 4723.485. (A) A certificate to prescribe
issued under
section 4723.48 of the Revised Code as an externship
certificate
is valid for not more than one year, unless earlier
suspended or revoked by
the
board of nursing. The certificate may
be extended for an additional year if
the
holder submits to the
board evidence of continued
participation in an externship. If an
externship is terminated for any
reason, the nurse shall notify
the board.
(B) To be eligible for a certificate to prescribe after
receiving an externship certificate, an applicant shall include
with the
application submitted
under section 4723.48 of the
Revised Code all of the
following:
(1) A statement from a supervising physician attesting to the
applicant's successful completion of the externship;
(2) The fee required by section 4723.08 of the Revised
Code
for
a certificate to prescribe;
(3) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
Sec. 4723.485 4723.486. (A) A certificate to prescribe
issued under
section 4723.48 of the Revised Code that is not
issued as an
externship certificate is valid for two years, unless
otherwise provided in
rules adopted under section 4723.50 of the
Revised Code or earlier suspended or
revoked by the board. The
board of nursing shall renew certificates to
prescribe according
to procedures and a renewal schedule
established in rules adopted
under section 4723.50 of the Revised
Code.
(B) The board may renew a certificate to prescribe if the
holder
submits to the board all of the following:
(1) Evidence of having completed during the previous two
years
at least twelve hours of continuing education in advanced
pharmacology, or, if the certificate has been held for less than a
full renewal period, the number of hours required by the board in
rules adopted under section 4723.50 of the Revised Code;
(2) The fee required under section 4723.08 of the Revised
Code
for renewal of a certificate to prescribe;
(3) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(C) The continuing education in pharmacology required under
division (B)(1) of this section must be received from an
accredited institution recognized by the board. The hours of
continuing
education required are in addition to any other
continuing education
requirement that must be completed pursuant
to this chapter.
Sec. 4723.50. (A) In accordance with Chapter 119. of
the
Revised Code, the board of nursing shall adopt
rules as necessary
to implement the provisions of this chapter pertaining to
the
authority of clinical nurse
specialists, certified nurse-midwives,
and certified nurse practitioners
to prescribe drugs and
therapeutic devices and the issuance and renewal of
certificates
to prescribe. Initial rules
shall be adopted not later than twenty
months after the effective date of
this section May 17, 2000.
The board shall adopt rules that are consistent with
the
recommendations the board receives from the committee on
prescriptive
governance pursuant to section 4723.492 of the
Revised Code. After reviewing
a recommendation submitted by the
committee, the board may either adopt the
recommendation as a rule
or ask the committee to reconsider and resubmit the
recommendation. The board shall not adopt any rule that does not
conform to a
recommendation made by the committee.
(B) The board shall adopt rules under this section that do
all of the
following:
(1) Establish a formulary
listing the types of drugs and
therapeutic devices that may be
prescribed by a clinical nurse
specialist, certified nurse-midwife, or
certified nurse
practitioner.
The formulary may include
controlled substances, as
defined in section 3719.01 of the
Revised Code. The formulary
shall not
permit the prescribing of any drug or device to perform
or induce an
abortion.
(2) Establish safety standards to be followed by a nurse when
personally
furnishing to patients complete or partial supplies of
antibiotics,
antifungals, scabicides, contraceptives, prenatal
vitamins, antihypertensives, drugs and devices used in the
treatment of diabetes, drugs and devices used in the treatment of
asthma, and drugs used in the treatment of dyslipidemia.
(3) Establish criteria for the components of the standard
care
arrangements described in section
4723.431 of the Revised
Code that apply to a nurse's
authority to prescribe. The rules
shall be
consistent with that section and include all of the
following:
(a) Quality assurance standards;
(b) Standards for periodic review by a collaborating
physician or podiatrist of the records of patients treated by the
nurse;
(c) Acceptable travel time between the location at which the
nurse is engaging in the prescribing components of the nurse's
practice and
the
location of
the nurse's collaborating physician
or podiatrist;
(d) Any other criteria recommended by the
committee on
prescriptive governance.
(4) Establish standards and procedures for issuance and
renewal of a
certificate to prescribe, including specification of
any additional
information the board may require under division
(A)(4), (C)(7), or (D)(6) of section 4723.482 or division (B)(3)
of section
4723.484 4723.485 of the Revised Code;
(5) Establish requirements for board approval of the
instruction in advanced pharmacology and related topics required
by
section 4723.482 of the Revised Code;
(6) Establish requirements for board approval of the two-hour
course of instruction in the laws of this state as required under
division (C)(6) of section 4723.482 of the Revised Code and
division (B)(2) of section 4723.484 of the Revised Code;
(7) Establish standards and procedures for the appropriate
conduct of an externship required by division (B)(1) of
as
described in section 4723.484
of the Revised Code, including
the
following:
(a) Standards and procedures to be used in evaluating a
nurse's
participation
in an externship. Regardless of the method
of evaluation used, a nurse shall
not be required to participate
in an externship longer than one thousand eight
hundred hours.;
(b) Standards and procedures for the supervision that a
physician
must
provide during an externship, including supervision
provided by
working with the nurse and
supervision provided by
making timely reviews of the records of
patients treated by the
nurse. The manner in which supervision
must be provided
may vary
according to the location where the nurse is
practicing and with
the nurse's level of experience.
Section 2. That existing sections 3333.28, 4723.01, 4723.06,
4723.48, 4723.482,
4723.484, 4723.485, and 4723.50 of the Revised
Code are hereby repealed.
Section 3. Notwithstanding the requirement of division (A) of
section 4723.50 of the Revised Code that the Board of Nursing
adopt rules consistent with the recommendations the Board receives
from the Committee on Prescriptive Governance, the Board shall
amend the rules that were adopted under section 4723.50 of the
Revised Code to reflect the amendment by this act of sections
4723.48 and
4723.482 and the enactment by this act of new section
4723.484 of the Revised Code. Until the rules have
been amended
accordingly, the Board shall not enforce any rule
that is
inconsistent with sections 4723.48 and 4723.482 of the
Revised
Code as amended by this act and new section 4723.484 as enacted by
this act.
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