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1 STATE OF OKLAHOMA
1
2 1st Session of the 60th Legislature (2025)
2
3 SENATE BILL 569 By: Stanley
3
4
4
5
5
6 AS INTRODUCED
6
7 An Act relating to the practice of nursing; providing
7 for independent prescriptive authority of Advanced
8 Practice Registered Nurses who meet certain
8 requirements; stating application criteria;
9 specifying duration of authority; providing for
9 application approval, denial, reapplication, fees,
10 and independent prescriptive authority revocation;
10 prescribing certain malpractice insurance
11 requirements; directing promulgation of certain
11 advertising rules; providing certain construction;
12 directing certain boards to make specified
12 information available online; amending 59 O.S. 2021,
13 Section 353.1, as amended by Section 6, Chapter 288,
13 O.S.L. 2022 (59 O.S. Supp. 2024, Section 353.1),
14 which relates to definitions used in the Oklahoma
14 Pharmacy Act; modifying and adding definitions;
15 amending 59 O.S. 2021, Section 353.1a, which relates
15 to prescriptive authority of Advanced Practice
16 Registered Nurses; modifying prescriptive authority
16 of certain Advanced Practice Registered Nurses;
17 updating statutory language; amending 59 O.S. 2021,
17 Section 567.3a, which relates to definitions used in
18 the Oklahoma Nursing Practice Act; modifying and
18 adding definitions; amending 59 O.S. 2021, Section
19 567.4a, which relates to prescriptive authority;
19 specifying authority of the Oklahoma Board of Nursing
20 to grant prescriptive authority; directing the Board
20 to promulgate certain rules; clarifying certain
21 educational requirement; requiring the Formulary
21 Advisory Council to develop, update, and publish
22 certain guidelines; modifying references; conforming
22 language; amending 59 O.S. 2021, Section 567.5a, as
23 amended by Section 1, Chapter 94, O.S.L. 2024 (59
23 O.S. Supp. 2024, Section 567.5a), which relates to
24 Advanced Practice Registered Nurse license; providing
24
Req. No. 87 Page 1
1 for independent prescriptive authority by
1 endorsement; amending 63 O.S. 2021, Section 2-312, as
2 amended by Section 2, Chapter 184, O.S.L. 2022 (63
2 O.S. Supp. 2024, Section 2-312), which relates to
3 controlled dangerous substances; conforming language
3 relating to supervision requirement; updating
4 statutory references and language; providing for
4 codification; and providing an effective date.
5
5
6
6
7
7
8 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
8
9 SECTION 1. NEW LAW A new section of law to be codified
9
10 in the Oklahoma Statutes as Section 567.4c of Title 59, unless there
10
11 is created a duplication in numbering, reads as follows:
11
12 A. 1. An Advanced Practice Registered Nurse recognized by the
12
13 Oklahoma Board of Nursing as a Certified Nurse Practitioner,
13
14 Clinical Nurse Specialist, or Certified Nurse-Midwife who has
14
15 completed a minimum of three (3) years of practice with prescriptive
15
16 authority supervised by a physician may apply to the Oklahoma Board
16
17 of Nursing for authority to prescribe and order independent of
17
18 supervision.
18
19 2. The application for independent prescriptive authority shall
19
20 include proof that the Certified Nurse Practitioner, Clinical Nurse
20
21 Specialist, or Certified Nurse-Midwife:
21
22 a. holds a valid, current license in the appropriate
22
23 Advanced Practice Registered Nurse role issued by the
23
24 Board and is in good standing with the Board, and
24
Req. No. 87 Page 2
1 b. has completed a minimum of three (3) years of practice
1
2 with prescriptive authority supervised by a physician.
2
3 3. Independent prescriptive authority granted under this
3
4 subsection shall be valid until the expiration of the current
4
5 license to practice and may be renewed upon application to the Board
5
6 at the same time and for the same period as the renewal of the
6
7 license to practice.
7
8 B. The Board shall review any application submitted under this
8
9 section and shall approve or deny the application, stating the
9
10 reason or reasons for denial, if denied. If denied, the applicant
10
11 may reapply using the process prescribed by subsection A of this
11
12 section.
12
13 C. The Board may suspend or revoke independent prescriptive
13
14 authority granted under this section for good cause at any time.
14
15 D. The Board may establish a fee for the review of initial and
15
16 renewal applications under the provisions of this section.
16
17 SECTION 2. NEW LAW A new section of law to be codified
17
18 in the Oklahoma Statutes as Section 567.5b of Title 59, unless there
18
19 is created a duplication in numbering, reads as follows:
19
20 A. An Advanced Practice Registered Nurse, or the employer of
20
21 the Advanced Practice Registered Nurse on his or her behalf, shall
21
22 carry malpractice insurance or demonstrate proof of financial
22
23 responsibility in a minimum amount of One Million Dollars
23
24
24
Req. No. 87 Page 3
1 ($1,000,000.00) per occurrence and Three Million Dollars
1
2 ($3,000,000.00) in the aggregate per year.
2
3 B. An Advanced Practice Registered Nurse who is employed by or
3
4 under contract with a federal agency that carries malpractice
4
5 insurance in any amount on behalf of the Advanced Practice
5
6 Registered Nurse shall be deemed in compliance with subsection A of
6
7 this section when practicing under such federal employment or
7
8 contract. However, to the extent the Advanced Practice Registered
8
9 Nurse practices outside of such federal employment or contract, the
9
10 Advanced Practice Registered Nurse, or his or her employer, shall
10
11 comply with subsection A of this section.
11
12 SECTION 3. NEW LAW A new section of law to be codified
12
13 in the Oklahoma Statutes as Section 567.5c of Title 59, unless there
13
14 is created a duplication in numbering, reads as follows:
14
15 A. The Oklahoma Board of Nursing shall promulgate rules
15
16 governing advertising of health care services by Advanced Practice
16
17 Registered Nurses to include, but not be limited to, the specialty
17
18 areas or types of health care services Advanced Practice Registered
18
19 Nurses may advertise based on their training or experience.
19
20 B. Nothing in this act shall be construed to allow an Advanced
20
21 Practice Registered Nurse to perform any medical service or
21
22 prescribe any medication beyond those authorized under state law or
22
23 in a manner otherwise inconsistent with state law.
23
24
24
Req. No. 87 Page 4
1 SECTION 4. NEW LAW A new section of law to be codified
1
2 in the Oklahoma Statutes as Section 479 of Title 59, unless there is
2
3 created a duplication in numbering, reads as follows:
3
4 The State Board of Medical Licensure and Supervision and the
4
5 State Board of Osteopathic Examiners shall make available, and keep
5
6 updated, in a conspicuous location on the website of each Board a
6
7 list of physicians who are available to supervise Advanced Practice
7
8 Registered Nurses. The Boards shall develop procedures necessary
8
9 for the implementation of this section.
9
10 SECTION 5. AMENDATORY 59 O.S. 2021, Section 353.1, as
10
11 amended by Section 6, Chapter 288, O.S.L. 2022 (59 O.S. Supp. 2024,
11
12 Section 353.1), is amended to read as follows:
12
13 Section 353.1. For the purposes of the Oklahoma Pharmacy Act:
13
14 1. "Accredited program" means those seminars, classes,
14
15 meetings, work projects, and other educational courses approved by
15
16 the Board State Board of Pharmacy for purposes of continuing
16
17 professional education;
17
18 2. "Act" means the Oklahoma Pharmacy Act;
18
19 3. "Administer" means the direct application of a drug, whether
19
20 by injection, inhalation, ingestion, or any other means, to the body
20
21 of a patient;
21
22 4. "Assistant pharmacist" means any person presently licensed
22
23 as an assistant pharmacist in the State of Oklahoma this state by
23
24 the Board pursuant to Section 353.10 of this title and for the
24
Req. No. 87 Page 5
1 purposes of the Oklahoma Pharmacy Act shall be considered the same
1
2 as a pharmacist, except where otherwise specified;
2
3 5. "Board" or "State Board" means the State Board of Pharmacy;
3
4 6. "Certify" or "certification of a prescription" means the
4
5 review of a filled prescription by a licensed pharmacist or a
5
6 licensed practitioner with dispensing authority to confirm that the
6
7 medication, labeling, and packaging of the filled prescription are
7
8 accurate and meet all requirements prescribed by state and federal
8
9 law. For the purposes of this paragraph, "licensed practitioner"
9
10 shall not include optometrists with dispensing authority;
10
11 7. "Chemical" means any medicinal substance, whether simple or
11
12 compound or obtained through the process of the science and art of
12
13 chemistry, whether of organic or inorganic origin;
13
14 8. "Compounding" means the combining, admixing, mixing,
14
15 diluting, pooling, reconstituting, or otherwise altering of a drug
15
16 or bulk drug substance to create a drug. Compounding includes the
16
17 preparation of drugs or devices in anticipation of prescription drug
17
18 orders based on routine, regularly observed prescribing patterns;
18
19 9. "Continuing professional education" means professional,
19
20 pharmaceutical education in the general areas of the socioeconomic
20
21 and legal aspects of health care; the properties and actions of
21
22 drugs and dosage forms; and the etiology, characteristics, and
22
23 therapeutics of the diseased state;
23
24
24
Req. No. 87 Page 6
1 10. "Dangerous drug", "legend drug", "prescription drug", or
1
2 "Rx Only" means a drug:
2
3 a. for human use subject to 21 U.S.C., Section 353(b)(1),
3
4 or
4
5 b. is labeled "Prescription Only", or labeled with the
5
6 following statement: "Caution: Federal law restricts
6
7 this drug except for to use by or on the order of a
7
8 licensed veterinarian.";
8
9 11. "Director" means the Executive Director of the State Board
9
10 of Pharmacy unless context clearly indicates otherwise;
10
11 12. "Dispense" or "dispensing" means the interpretation,
11
12 evaluation, and implementation of a prescription drug order
12
13 including the preparation and delivery of a drug or device to a
13
14 patient or a patient's agent in a suitable container appropriately
14
15 labeled for subsequent administration to, or use by, a patient.
15
16 Dispense includes sell, distribute, leave with, give away, dispose
16
17 of, deliver, or supply;
17
18 13. "Dispenser" means a retail pharmacy, hospital pharmacy, a
18
19 group of chain pharmacies under common ownership and control that do
19
20 not act as a wholesale distributor, or any other person authorized
20
21 by law to dispense or administer prescription drugs, and the
21
22 affiliated warehouses or distributions of such entities under common
22
23 ownership and control that do not act as a wholesale distributor.
23
24 For the purposes of this paragraph, "dispenser" dispenser does not
24
Req. No. 87 Page 7
1 mean a person who dispenses only products to be used in animals in
1
2 accordance with 21 U.S.C., Section 360b(a)(5);
2
3 14. "Distribute" or "distribution" means the sale, purchase,
3
4 trade, delivery, handling, storage, or receipt of a product, and
4
5 does not include the dispensing of a product pursuant to a
5
6 prescription executed in accordance with 21 U.S.C., Section
6
7 353(b)(1) or the dispensing of a product approved under 21 U.S.C.,
7
8 Section 360b(b); provided, taking actual physical possession of a
8
9 product or title shall not be required;
9
10 15. "Doctor of Pharmacy" means a person licensed by the Board
10
11 to engage in the practice of pharmacy. The terms "pharmacist",
11
12 "D.Ph.", and "Doctor of Pharmacy" shall be interchangeable and shall
12
13 have the same meaning wherever they appear in the Oklahoma Statutes
13
14 and the rules promulgated by the Board;
14
15 16. "Drug outlet" means all manufacturers, repackagers,
15
16 outsourcing facilities, wholesale distributors, third-party
16
17 logistics providers, pharmacies, and all other facilities which are
17
18 engaged in dispensing, delivery, distribution, or storage of
18
19 dangerous drugs;
19
20 17. "Drugs" means all medicinal substances and preparations
20
21 recognized by the United States Pharmacopoeia Pharmacopeia and
21
22 National Formulary, or any revision thereof, and all substances and
22
23 preparations intended for external and/or internal use in the cure,
23
24 diagnosis, mitigation, treatment, or prevention of disease in humans
24
Req. No. 87 Page 8
1 or animals and all substances and preparations, other than food,
1
2 intended to affect the structure or any function of the body of a
2
3 human or animals;
3
4 18. "Drug sample" means a unit of a prescription drug packaged
4
5 under the authority and responsibility of the manufacturer that is
5
6 not intended to be sold and is intended to promote the sale of the
6
7 drug;
7
8 19. "Durable medical equipment" has the same meaning as
8
9 provided by Section 2 of this act Section 375.2 of this title;
9
10 20. "Filled prescription" means a packaged prescription
10
11 medication to which a label has been affixed which contains such
11
12 information as is required by the Oklahoma Pharmacy Act;
12
13 21. "Hospital" means any institution licensed as a hospital by
13
14 this state for the care and treatment of patients, or a pharmacy
14
15 operated by the Oklahoma Department of Veterans Affairs;
15
16 22. "Licensed practitioner" means:
16
17 a. an allopathic physician,
17
18 b. an osteopathic physician,
18
19 c. a podiatric physician,
19
20 d. a dentist,
20
21 e. a veterinarian or,
21
22 f. an optometrist, or
22
23 g. an Advanced Practice Registered Nurse,
23
24
24
Req. No. 87 Page 9
1 licensed to practice and authorized to prescribe dangerous drugs
1
2 within the scope of practice of such practitioner;
2
3 23. "Manufacturer" or "virtual manufacturer" means with respect
3
4 to a product:
4
5 a. a person that holds an application approved under 21
5
6 U.S.C., Section 355 or a license issued under 42
6
7 U.S.C., Section 262 for such product, or if such
7
8 product is not the subject of an approved application
8
9 or license, the person who manufactured the product,
9
10 b. a co-licensed partner of the person described in
10
11 subparagraph a of this paragraph that obtains the
11
12 product directly from a person described in this
12
13 subparagraph or subparagraph a of this paragraph,
13
14 c. an affiliate of a person described in subparagraph a
14
15 or b of this paragraph who receives the product
15
16 directly from a person described in this subparagraph
16
17 or in subparagraph a or b of this paragraph, or
17
18 d. a person who contracts with another to manufacture a
18
19 product;
19
20 24. "Manufacturing" means the production, preparation,
20
21 propagation, compounding, conversion, or processing of a device or a
21
22 drug, either directly or indirectly by extraction from substances of
22
23 natural origin or independently by means of chemical or biological
23
24 synthesis and includes any packaging or repackaging of the
24
Req. No. 87 Page 10
1 substances or labeling or relabeling of its container, and the
1
2 promotion and marketing of such drugs or devices. The term
2
3 "manufacturing" manufacturing also includes the preparation and
3
4 promotion of commercially available products from bulk compounds for
4
5 resale by licensed pharmacies, licensed practitioners, or other
5
6 persons;
6
7 25. "Medical gas" means those gases including those in liquid
7
8 state upon which the manufacturer or distributor has placed one of
8
9 several cautions, such as "Rx Only", in compliance with federal law;
9
10 26. "Medical gas order" means an order for medical gas issued
10
11 by a licensed prescriber;
11
12 27. "Medical gas distributor" means a person licensed to
12
13 distribute, transfer, wholesale, deliver, or sell medical gases on
13
14 drug orders to suppliers or other entities licensed to use,
14
15 administer, or distribute medical gas and may also include a patient
15
16 or ultimate user;
16
17 28. "Medical gas supplier" means a person who dispenses medical
17
18 gases on drug orders only to a patient or ultimate user;
18
19 29. "Medicine" means any drug or combination of drugs which has
19
20 the property of curing, preventing, treating, diagnosing, or
20
21 mitigating diseases, or which is used for that purpose;
21
22 30. "Nonprescription drugs" means medicines or drugs which are
22
23 sold without a prescription and which are prepackaged for use by the
23
24 consumer and labeled in accordance with the requirements of the
24
Req. No. 87 Page 11
1 statutes and regulations of this state and the federal government.
1
2 Such items shall also include medical and dental supplies and
2
3 bottled or nonbulk chemicals which are sold or offered for sale to
3
4 the general public if such articles or preparations meet the
4
5 requirements of the Federal Food, Drug, and Cosmetic Act, 21
5
6 U.S.C.A., Section 321 et seq.;
6
7 31. "Outsourcing facility" including "virtual outsourcing
7
8 facility" means a facility at one geographic location or address
8
9 that:
9
10 a. is engaged in the compounding of sterile drugs,
10
11 b. has elected to register as an outsourcing facility,
11
12 and
12
13 c. complies with all requirements of 21 U.S.C., Section
13
14 353b;
14
15 32. "Package" means the smallest individual saleable unit of
15
16 product for distribution by a manufacturer or repackager that is
16
17 intended by the manufacturer for ultimate sale to the dispenser of
17
18 such product. For the purposes of this paragraph, "individual
18
19 saleable unit" means the smallest container of a product introduced
19
20 into commerce by the manufacturer or repackager that is intended by
20
21 the manufacturer or repackager for individual sale to a dispenser;
21
22 33. "Person" means an individual, partnership, limited
22
23 liability company, corporation, or association, unless the context
23
24 otherwise requires;
24
Req. No. 87 Page 12
1 34. "Pharmacist-in-charge" or "PIC" means the pharmacist
1
2 licensed in this state responsible for the management control of a
2
3 pharmacy and all other aspects of the practice of pharmacy in a
3
4 licensed pharmacy as defined provided by Section 353.18 of this
4
5 title;
5
6 35. "Pharmacy" means a place regularly licensed by the State
6
7 Board of Pharmacy in which prescriptions, drugs, medicines,
7
8 chemicals, and poisons are compounded or dispensed or such place
8
9 where pharmacists practice the profession of pharmacy, or a pharmacy
9
10 operated by the Oklahoma Department of Veterans Affairs;
10
11 36. "Pharmacy technician", "technician", "Rx tech", or "tech"
11
12 means a person issued a Technician technician permit by the State
12
13 Board of Pharmacy to assist the pharmacist and perform
13
14 nonjudgmental, technical, manipulative, non-discretionary functions
14
15 in the prescription department under the immediate and direct
15
16 supervision of a pharmacist;
16
17 37. "Poison" means any substance which when introduced into the
17
18 body, either directly or by absorption, produces violent, morbid, or
18
19 fatal changes, or which destroys living tissue with which such
19
20 substance comes into contact;
20
21 38. "Practice of pharmacy" means:
21
22 a. the interpretation and evaluation of prescription
22
23 orders,
23
24
24
Req. No. 87 Page 13
1 b. the compounding, dispensing, administering, and
1
2 labeling of drugs and devices, except labeling by a
2
3 manufacturer, repackager, or distributor of
3
4 nonprescription drugs and commercially packaged legend
4
5 drugs and devices,
5
6 c. the participation in drug selection and drug
6
7 utilization reviews,
7
8 d. the proper and safe storage of drugs and devices and
8
9 the maintenance of proper records thereof,
9
10 e. the responsibility for advising by counseling and
10
11 providing information, where professionally necessary
11
12 or where regulated, of therapeutic values, content,
12
13 hazards, and use of drugs and devices,
13
14 f. the offering or performing of those acts, services,
14
15 operations, or transactions necessary in the conduct,
15
16 operation, management, and control of a pharmacy, or
16
17 g. the provision of those acts or services that are
17
18 necessary to provide pharmaceutical care;
18
19 39. "Preparation" means an article which may or may not contain
19
20 sterile products compounded in a licensed pharmacy pursuant to the
20
21 order of a licensed prescriber;
21
22 40. "Prescriber" means a person licensed in this state who is
22
23 authorized to prescribe dangerous drugs within the scope of practice
23
24 of the person's profession;
24
Req. No. 87 Page 14
1 41. "Prescription" means and includes any order for drug or
1
2 medical supplies written or signed, or transmitted by word of mouth,
2
3 telephone, or other means of communication:
3
4 a. by a licensed prescriber,
4
5 b. under the supervision of an Oklahoma licensed
5
6 practitioner, an Oklahoma licensed advanced practice
6
7 registered nurse or an Oklahoma licensed by a
7
8 physician assistant pursuant to a practice agreement,
8
9 or
9
10 c. (1) under the supervision of a supervising physician,
10
11 by a Certified Nurse Practitioner, Clinical Nurse
11
12 Specialist, or Certified Nurse-Midwife licensed
12
13 in this state who has not obtained independent
13
14 prescriptive authority under Section 1 of this
14
15 act, or
15
16 (2) by a Certified Nurse Practitioner, Clinical Nurse
16
17 Specialist, or Certified Nurse-Midwife licensed
17
18 in this state who has obtained independent
18
19 prescriptive authority under Section 1 of this
19
20 act, or
20
21 d. by an Oklahoma licensed wholesaler or distributor as
21
22 authorized in Section 353.29.1 of this title;
22
23 42. "Product" means a prescription drug in a finished dosage
23
24 form for administration to a patient without substantial further
24
Req. No. 87 Page 15
1 manufacturing, such as capsules, tablets, and lyophilized products
1
2 before reconstitution. "Product" Product does not include blood
2
3 components intended for transfusion, radioactive drugs or biologics
3
4 and medical gas;
4
5 43. "Repackager", including "virtual repackager", means a
5
6 person who owns or operates an establishment that repacks and
6
7 relabels a product or package for further sale or distribution
7
8 without further transaction;
8
9 44. "Sterile drug" means a drug that is intended for parenteral
9
10 administration, an ophthalmic or oral inhalation drug in aqueous
10
11 format, or a drug that is required to be sterile under state and
11
12 federal law;
12
13 45. "Supervising physician" means an individual holding a
13
14 current license to practice as a physician from the State Board of
14
15 Medical Licensure and Supervision, pursuant to the provisions of the
15
16 Oklahoma Allopathic Medical and Surgical Licensure and Supervision
16
17 Act, or the State Board of Osteopathic Examiners, pursuant to the
17
18 provisions of the Oklahoma Osteopathic Medicine Act, who supervises
18
19 an advanced practice registered nurse a Certified Nurse
19
20 Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
20
21 as defined in Section 567.3a of this title who has not obtained
21
22 independent prescriptive authority under Section 1 of this act,
22
23 and who is not in training as an intern, resident, or fellow. To be
23
24 eligible to supervise an advanced practice registered nurse, such
24
Req. No. 87 Page 16
1 The supervising physician shall remain in compliance with the rules
1
2 promulgated by the State Board of Medical Licensure and Supervision
2
3 or the State Board of Osteopathic Examiners;
3
4 46. "Supportive personnel" means technicians and auxiliary
4
5 supportive persons who are regularly paid employees of a pharmacy
5
6 who work and perform tasks in the pharmacy as authorized by Section
6
7 353.18A of this title;
7
8 47. "Third-party logistics provider" including "virtual third-
8
9 party logistics provider" means an entity that provides or
9
10 coordinates warehousing, or other logistics services of a product in
10
11 interstate commerce on behalf of a manufacturer, wholesale
11
12 distributor, or dispenser of a product but does not take ownership
12
13 of the product, nor have responsibility to direct the sale or
13
14 disposition of the product. For the purposes of this paragraph,
14
15 "third-party logistics provider" third-party logistics provider does
15
16 not include shippers and the United States Postal Service;
16
17 48. "Wholesale distributor" including "virtual wholesale
17
18 distributor" means a person other than a manufacturer, a
18
19 manufacturer's co-licensed partner, a third-party logistics
19
20 provider, or repackager engaged in wholesale distribution as defined
20
21 by 21 U.S.C., Section 353(e)(4) as amended by the Drug Supply Chain
21
22 Security Act;
22
23 49. "County jail" means a facility operated by a county for the
23
24 physical detention and correction of persons charged with, or
24
Req. No. 87 Page 17
1 convicted of, criminal offenses or ordinance violations or persons
1
2 found guilty of civil or criminal contempt;
2
3 50. "State correctional facility" means a facility or
3
4 institution that houses a prisoner population under the jurisdiction
4
5 of the Department of Corrections;
5
6 51. "Unit dose package" means a package that contains a single
6
7 dose drug with the name, strength, control number, and expiration
7
8 date of that drug on the label; and
8
9 52. "Unit of issue package" means a package that provides
9
10 multiple doses of the same drug, but each drug is individually
10
11 separated and includes the name, lot number, and expiration date.
11
12 SECTION 6. AMENDATORY 59 O.S. 2021, Section 353.1a, is
12
13 amended to read as follows:
13
14 Section 353.1a. A. Prescribing 1. Prescriptive authority
14
15 shall be allowed, under the medical direction of a current
15
16 supervision agreement with a supervising physician, for an advanced
16
17 practice nurse a licensed Advanced Practice Registered Nurse
17
18 recognized by the Oklahoma Board of Nursing in one of the following
18
19 categories: advanced registered nurse practitioners, clinical nurse
19
20 specialists, or certified nurse-midwives as a Certified Nurse
20
21 Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
21
22 who has not obtained independent prescriptive authority under
22
23 Section 1 of this act.
23
24
24
Req. No. 87 Page 18
1 2. Prescriptive authority shall be allowed, independent of a
1
2 current supervision agreement with a supervising physician, for a
2
3 licensed Advanced Practice Registered Nurse recognized by the
3
4 Oklahoma Board of Nursing as a Certified Nurse Practitioner,
4
5 Clinical Nurse Specialist, or Certified Nurse-Midwife who has
5
6 obtained independent prescriptive authority under Section 1 of this
6
7 act.
7
8 B. The advanced practice nurse Advanced Practice Registered
8
9 Nurse may write or sign, or transmit by word of mouth, telephone, or
9
10 other means of communication an order for drugs or medical supplies
10
11 that is intended to be filled, compounded, or dispensed by a
11
12 pharmacist. The supervising physician, if applicable, and the
12
13 advanced practice nurse prescribing Advanced Practice Registered
13
14 Nurse shall be identified at the time of origination of the
14
15 prescription and the name of the advanced practice nurse prescribing
15
16 Advanced Practice Registered Nurse shall be printed on the
16
17 prescription label.
17
18 B. C. Pharmacists may dispense prescriptions for non-controlled
18
19 prescription drugs authorized by an advanced practice nurse Advanced
19
20 Practice Registered Nurse or physician assistant, not located in
20
21 Oklahoma this state, provided that they are licensed in the state in
21
22 which they are actively prescribing.
22
23 C. D. 1. Pharmacists may only dispense prescriptions for
23
24 controlled dangerous substances prescribed by an advanced practice
24
Req. No. 87 Page 19
1 nurse or physician assistant Advanced Practice Registered Nurse
1
2 licensed in the State of Oklahoma and supervised by an Oklahoma-
2
3 licensed practitioner this state who meets the criteria in paragraph
3
4 1 or 2 of subsection A of this section.
4
5 2. Pharmacists may only dispense prescriptions for controlled
5
6 dangerous substances prescribed by a physician assistant licensed in
6
7 this state pursuant to a practice agreement.
7
8 SECTION 7. AMENDATORY 59 O.S. 2021, Section 567.3a, is
8
9 amended to read as follows:
9
10 Section 567.3a. As used in the Oklahoma Nursing Practice Act:
10
11 1. "Board" means the Oklahoma Board of Nursing;
11
12 2. "The practice of nursing" means the performance of services
12
13 provided for purposes of nursing diagnosis and treatment of human
13
14 responses to actual or potential health problems consistent with
14
15 educational preparation. Knowledge and skill are the basis for
15
16 assessment, analysis, planning, intervention, and evaluation used in
16
17 the promotion and maintenance of health and nursing management of
17
18 illness, injury, infirmity, restoration or of optimal function, or
18
19 death with dignity. Practice is based on understanding the human
19
20 condition across the human lifespan and understanding the
20
21 relationship of the individual within the environment. This
21
22 practice includes execution of the medical regime including the
22
23 administration of medications and treatments prescribed by any
23
24 person authorized by state law to so prescribe;
24
Req. No. 87 Page 20
1 3. "Registered nursing" means the practice of the full scope of
1
2 nursing which includes, but is not limited to:
2
3 a. assessing the health status of individuals, families,
3
4 and groups,
4
5 b. analyzing assessment data to determine nursing care
5
6 needs,
6
7 c. establishing goals to meet identified health care
7
8 needs,
8
9 d. planning a strategy of care,
9
10 e. establishing priorities of nursing intervention to
10
11 implement the strategy of care,
11
12 f. implementing the strategy of care,
12
13 g. delegating such tasks as may safely be performed by
13
14 others, consistent with educational preparation and
14
15 that do not conflict with the provisions of the
15
16 Oklahoma Nursing Practice Act,
16
17 h. providing safe and effective nursing care rendered
17
18 directly or indirectly,
18
19 i. evaluating responses to interventions,
19
20 j. teaching the principles and practice of nursing,
20
21 k. managing and supervising the practice of nursing,
21
22 l. collaborating with other health professionals in the
22
23 management of health care,
23
24
24
Req. No. 87 Page 21
1 m. performing additional nursing functions in accordance
1
2 with knowledge and skills acquired beyond basic
2
3 nursing preparation, and
3
4 n. delegating those nursing tasks as defined in the rules
4
5 of the Board that may be performed by an advanced
5
6 unlicensed assistive person Advanced Unlicensed
6
7 Assistant;
7
8 4. "Licensed practical nursing" means the practice of nursing
8
9 under the supervision or direction of a registered nurse Registered
9
10 Nurse, licensed physician, or dentist. This directed scope of
10
11 nursing practice includes, but is not limited to:
11
12 a. contributing to the assessment of the health status of
12
13 individuals and groups,
13
14 b. participating in the development and modification of
14
15 the plan of care,
15
16 c. implementing the appropriate aspects of the plan of
16
17 care,
17
18 d. delegating such tasks as may safely be performed by
18
19 others, consistent with educational preparation and
19
20 that do not conflict with the Oklahoma Nursing
20
21 Practice Act,
21
22 e. providing safe and effective nursing care rendered
22
23 directly or indirectly,
23
24
24
Req. No. 87 Page 22
1 f. participating in the evaluation of responses to
1
2 interventions,
2
3 g. teaching basic nursing skills and related principles,
3
4 h. performing additional nursing procedures in accordance
4
5 with knowledge and skills acquired through education
5
6 beyond nursing preparation, and
6
7 i. delegating those nursing tasks as defined in the rules
7
8 of the Board that may be performed by an advanced
8
9 unlicensed assistive person Advanced Unlicensed
9
10 Assistant;
10
11 5. "Advanced Practice Registered Nurse" means a licensed
11
12 Registered Nurse:
12
13 a. who has completed an advanced practice registered
13
14 nursing education program in preparation for one of
14
15 four recognized advanced practice registered nurse
15
16 Advanced Practice Registered Nurse roles,
16
17 b. who has passed a national certification examination
17
18 recognized by the Board that measures the advanced
18
19 practice registered nurse Advanced Practice Registered
19
20 Nurse role and specialty competencies and who
20
21 maintains recertification in the role and specialty
21
22 through a national certification program,
22
23 c. who has acquired advanced clinical knowledge and
23
24 skills in preparation for providing both direct and
24
Req. No. 87 Page 23
1 indirect care to patients; however, the defining
1
2 factor for all Advanced Practice Registered Nurses is
2
3 that a significant component of the education and
3
4 practice focuses on direct care of individuals,
4
5 d. whose practice builds on the competencies of
5
6 Registered Nurses by demonstrating a greater depth and
6
7 breadth of knowledge, a greater synthesis of data, and
7
8 increased complexity of skills and interventions, and
8
9 e. who has obtained a license as an Advanced Practice
9
10 Registered Nurse in one of the following roles:
10
11 Certified Registered Nurse Anesthetist, Certified
11
12 Nurse-Midwife, Clinical Nurse Specialist, or Certified
12
13 Nurse Practitioner.
13
14 Only those persons who hold a license to practice advanced
14
15 practice registered nursing in this state shall have the right to
15
16 use the title "Advanced Practice Registered Nurse" Advanced Practice
16
17 Registered Nurse and to use the abbreviation "APRN". Only those
17
18 persons who have obtained a license in the following disciplines
18
19 shall have the right to fulfill the roles and use the applicable
19
20 titles: Certified Registered Nurse Anesthetist and the abbreviation
20
21 "CRNA", Certified Nurse-Midwife and the abbreviation "CNM", Clinical
21
22 Nurse Specialist and the abbreviation "CNS", and Certified Nurse
22
23 Practitioner and the abbreviation "CNP".
23
24
24
Req. No. 87 Page 24
1 It shall be unlawful for any person to assume the role or use
1
2 the title Advanced Practice Registered Nurse or use the abbreviation
2
3 "APRN" APRN or use the respective specialty role titles and
3
4 abbreviations or to use any other titles or abbreviations that would
4
5 reasonably lead a person to believe the user is an Advanced Practice
5
6 Registered Nurse, unless permitted by the Oklahoma Nursing Practice
6
7 Act. Any individual doing so shall be guilty of a misdemeanor,
7
8 which shall be punishable, upon conviction, by imprisonment in the
8
9 county jail for not more than one (1) year or by a fine of not less
9
10 than One Hundred Dollars ($100.00) nor more than One Thousand
10
11 Dollars ($1,000.00), or by both such imprisonment and fine for each
11
12 offense;
12
13 6. "Certified Nurse Practitioner" is means an Advanced Practice
13
14 Registered Nurse who performs in an expanded role in the delivery of
14
15 health care:
15
16 a. consistent with advanced educational preparation as a
16
17 Certified Nurse Practitioner in an area of specialty,
17
18 b. functions within the Certified Nurse Practitioner
18
19 scope of practice for the selected area of
19
20 specialization, and
20
21 c. is in accord with the standards for Certified Nurse
21
22 Practitioners as identified by the certifying body and
22
23 approved by the Board.
23
24
24
Req. No. 87 Page 25
1 A Certified Nurse Practitioner shall be eligible, in accordance
1
2 with the scope of practice of the Certified Nurse Practitioner, to
2
3 obtain recognition as authorized by the Board to prescribe, as
3
4 defined by the rules promulgated by the Board pursuant to this
4
5 section and subject to the medical direction of a supervising
5
6 physician Section 567.4a of this title and Section 1 of this act.
6
7 This authorization shall not include dispensing drugs, but shall not
7
8 preclude, subject to federal regulations, the receipt of, the
8
9 signing for, or the dispensing of professional samples to patients.
9
10 The Certified Nurse Practitioner accepts responsibility,
10
11 accountability, and obligation to practice in accordance with usual
11
12 and customary advanced practice registered nursing standards and
12
13 functions as defined by the scope of practice/role definition
13
14 statements for the Certified Nurse Practitioner;
14
15 7. a. "Clinical Nurse Specialist" is means an Advanced
15
16 Practice Registered Nurse who holds:
16
17 (1) a master's degree or higher in nursing with
17
18 clinical specialization preparation to function
18
19 in an expanded role,
19
20 (2) specialty certification from a national
20
21 certifying organization recognized by the Board,
21
22 and
22
23 (3) an Advanced Practice Registered Nurse license
23
24 from the Board, and.
24
Req. No. 87 Page 26
1 (4) any
1
2 Any nurse holding a specialty certification as a
2
3 Clinical Nurse Specialist valid on January 1, 1994,
3
4 granted by a national certifying organization
4
5 recognized by the Board, shall be deemed to be a
5
6 Clinical Nurse Specialist under the provisions of the
6
7 Oklahoma Nursing Practice Act.
7
8 b. In the expanded role, the Clinical Nurse Specialist
8
9 performs at an advanced practice level which shall
9
10 include, but not be limited to:
10
11 (1) practicing as an expert clinician in the
11
12 provision of direct nursing care to a selected
12
13 population of patients or clients in any setting,
13
14 including private practice,
14
15 (2) managing the care of patients or clients with
15
16 complex nursing problems,
16
17 (3) enhancing patient or client care by integrating
17
18 the competencies of clinical practice, education,
18
19 consultation, and research, and
19
20 (4) referring patients or clients to other services.
20
21 c. A Clinical Nurse Specialist in accordance with the
21
22 scope of practice of such Clinical Nurse Specialist
22
23 shall be eligible to obtain recognition as authorized
23
24 by the Board to prescribe, as defined by the rules
24
Req. No. 87 Page 27
1 promulgated by the Board pursuant to this section, and
1
2 subject to the medical direction of a supervising
2
3 physician Section 567.4a of this title and Section 1
3
4 of this act. This authorization shall not include
4
5 dispensing drugs, but shall not preclude, subject to
5
6 federal regulations, the receipt of, the signing for,
6
7 or the dispensing of professional samples to patients.
7
8 d. The Clinical Nurse Specialist accepts responsibility,
8
9 accountability, and obligation to practice in
9
10 accordance with usual and customary advanced practice
10
11 nursing standards and functions as defined by the
11
12 scope of practice/role definition statements for the
12
13 Clinical Nurse Specialist;
13
14 8. "Nurse-Midwife" is "Certified Nurse-Midwife" means a nurse
14
15 who has received an Advanced Practice Registered Nurse license from
15
16 the Oklahoma Board of Nursing who possesses evidence of
16
17 certification according to the requirements of the American College
17
18 of Nurse-Midwives.
18
19 A Certified Nurse-Midwife in accordance with the scope of
19
20 practice of such Certified Nurse-Midwife shall be eligible to obtain
20
21 recognition as authorized by the Board to prescribe, as defined by
21
22 the rules promulgated by the Board pursuant to this section and
22
23 subject to the medical direction of a supervising physician Section
23
24 567.4a of this title and Section 1 of this act. This authorization
24
Req. No. 87 Page 28
1 shall not include the dispensing of drugs, but shall not preclude,
1
2 subject to federal regulations, the receipt of, the signing for, or
2
3 the dispensing of professional samples to patients.
3
4 The Certified Nurse-Midwife accepts responsibility,
4
5 accountability, and obligation to practice in accordance with usual
5
6 and customary advanced practice registered nursing standards and
6
7 functions as defined by the scope of practice/role definition
7
8 statements for the Certified Nurse-Midwife;
8
9 9. "Nurse-midwifery practice" means providing management of
9
10 care of normal newborns and women, antepartally, intrapartally,
10
11 postpartally, and gynecologically, occurring within a health care
11
12 system which provides for medical consultation, medical management,
12
13 or referral, and is in accord with the standards for nurse-midwifery
13
14 practice as defined by the American College of Nurse-Midwives;
14
15 10. a. "Certified Registered Nurse Anesthetist" is means an
15
16 Advanced Practice Registered Nurse who:
16
17 (1) is certified by the National Board of
17
18 Certification and Recertification for Nurse
18
19 Anesthetists as a Certified Registered Nurse
19
20 Anesthetist within one (1) year following
20
21 completion of an approved certified registered
21
22 nurse anesthetist Certified Registered Nurse
22
23 Anesthetist education program, and continues to
23
24 maintain such recertification by the National
24
Req. No. 87 Page 29
1 Board of Certification and Recertification for
1
2 Nurse Anesthetists, and
2
3 (2) administers anesthesia in collaboration with a
3
4 medical doctor, an osteopathic physician, a
4
5 podiatric physician, or a dentist licensed in
5
6 this state and under conditions in which timely
6
7 onsite on-site consultation by such doctor,
7
8 osteopath, podiatric physician, or dentist is
8
9 available.
9
10 b. A Certified Registered Nurse Anesthetist, in
10
11 collaboration with a medical doctor, osteopathic
11
12 physician, podiatric physician, or dentist licensed in
12
13 this state, and under conditions in which timely, on-
13
14 site consultation by such medical doctor, osteopathic
14
15 physician, podiatric physician, or dentist is
15
16 available, shall be authorized, pursuant to rules
16
17 adopted by the Oklahoma Board of Nursing, to order,
17
18 select, obtain, and administer legend drugs, Schedules
18
19 II through V controlled substances, devices, and
19
20 medical gases only when engaged in the preanesthetic
20
21 preparation and evaluation; anesthesia induction,
21
22 maintenance, and emergence; and postanesthesia care.
22
23 A Certified Registered Nurse Anesthetist may order,
23
24
24
Req. No. 87 Page 30
1 select, obtain, and administer drugs only during the
1
2 perioperative or periobstetrical period.
2
3 c. A Certified Registered Nurse Anesthetist who applies
3
4 for authorization to order, select, obtain, and
4
5 administer drugs shall:
5
6 (1) be currently recognized as a Certified Registered
6
7 Nurse Anesthetist in this state,
7
8 (2) provide evidence of completion, within the two-
8
9 year period immediately preceding the date of
9
10 application, of a minimum of fifteen (15) units
10
11 of continuing education in advanced pharmacology
11
12 related to the administration of anesthesia as
12
13 recognized by the National Board of Certification
13
14 and Recertification for Nurse Anesthetists, and
14
15 (3) complete and submit a notarized application, on a
15
16 form prescribed by the Board, accompanied by the
16
17 application fee established pursuant to this
17
18 section.
18
19 d. The authority to order, select, obtain, and administer
19
20 drugs shall be terminated if a Certified Registered
20
21 Nurse Anesthetist has:
21
22 (1) ordered, selected, obtained, or administered
22
23 drugs outside of the Certified Registered Nurse
23
24 Anesthetist scope of practice or ordered,
24
Req. No. 87 Page 31
1 selected, obtained, or administered drugs for
1
2 other than therapeutic purposes, or
2
3 (2) violated any provision of state laws or rules or
3
4 federal laws or regulations pertaining to the
4
5 practice of nursing or the authority to order,
5
6 select, obtain, and administer drugs.
6
7 e. The Oklahoma Board of Nursing shall notify the State
7
8 Board of Pharmacy after termination of or a change in
8
9 the authority to order, select, obtain, and administer
9
10 drugs for a Certified Registered Nurse Anesthetist.
10
11 f. The Board shall provide by rule for biennial
11
12 application renewal and reauthorization of authority
12
13 to order, select, obtain, and administer drugs for
13
14 Certified Registered Nurse Anesthetists. At the time
14
15 of application renewal, a Certified Registered Nurse
15
16 Anesthetist shall submit documentation of a minimum of
16
17 eight (8) units of continuing education, completed
17
18 during the previous two (2) years, in advanced
18
19 pharmacology relating to the administration of
19
20 anesthesia, as recognized by the Council on
20
21 Recertification of Nurse Anesthetists or the Council
21
22 on Certification of Nurse Anesthetists National Board
22
23 of Certification and Recertification for Nurse
23
24 Anesthetists.
24
Req. No. 87 Page 32
1 g. This paragraph shall not prohibit the administration
1
2 of local or topical anesthetics as now permitted by
2
3 law. Provided further, nothing in this paragraph
3
4 shall limit the authority of the Board of Dentistry to
4
5 establish the qualifications for dentists who direct
5
6 the administration of anesthesia.
6
7 h. As used in this paragraph, "collaboration" means an
7
8 agreement between a medical doctor, osteopathic
8
9 physician, podiatric physician, or dentist performing
9
10 the procedure or directly involved with the procedure
10
11 and the Certified Registered Nurse Anesthetist working
11
12 jointly toward a common goal providing services for
12
13 the same patient. This collaboration involves the
13
14 joint formulation, discussion, and agreement of the
14
15 anesthesia plan by both parties, and the collaborating
15
16 medical doctor, osteopathic physician, podiatric
16
17 physician, or dentist performing the procedure or
17
18 directly involved with the procedure and that
18
19 collaborating physician shall remain available for
19
20 timely onsite on-site consultation during the delivery
20
21 of anesthesia for diagnosis, consultation, and
21
22 treatment of medical conditions;
22
23 11. "Supervising physician" means an individual holding a
23
24 current license to practice as a physician from the State Board of
24
Req. No. 87 Page 33
1 Medical Licensure and Supervision or the State Board of Osteopathic
1
2 Examiners, who supervises a Certified Nurse Practitioner, a Clinical
2
3 Nurse Specialist, or a Certified Nurse-Midwife who has not obtained
3
4 independent prescriptive authority under Section 1 of this act, and
4
5 who is not in training as an intern, resident, or fellow. To be
5
6 eligible to supervise such Advanced Practice Registered Nurse, such
6
7 The supervising physician shall remain in compliance with the rules
7
8 promulgated by the State Board of Medical Licensure and Supervision
8
9 or the State Board of Osteopathic Examiners;
9
10 12. "Supervision of an Advanced Practice Registered Nurse with
10
11 prescriptive authority" means overseeing and accepting
11
12 responsibility for the ordering and transmission by assuring
12
13 availability of the supervising physician to a Certified Nurse
13
14 Practitioner, a Clinical Nurse Specialist, or a Certified Nurse-
14
15 Midwife of who has not obtained independent prescriptive authority
15
16 under Section 1 of this act through direct contact,
16
17 telecommunications, or other appropriate electronic means for
17
18 consultation, assistance with medical emergencies, or patient
18
19 referral with respect to written, telephonic, electronic, or oral
19
20 prescriptions for drugs and other medical supplies, subject to a
20
21 defined formulary; and
21
22 13. "Advanced Unlicensed Assistant" means any person who has
22
23 successfully completed a certified training program approved by the
23
24 Board that trains the Advanced Unlicensed Assistant to perform
24
Req. No. 87 Page 34
1 specified technical skills identified by the Board in acute care
1
2 settings under the direction and supervision of the Registered Nurse
2
3 or Licensed Practical Nurse.
3
4 SECTION 8. AMENDATORY 59 O.S. 2021, Section 567.4a, is
4
5 amended to read as follows:
5
6 Section 567.4a. The Oklahoma Board of Nursing may grant
6
7 prescriptive authority through the Advanced Practice Registered
7
8 Nurse license to Certified Nurse Practitioners, Clinical Nurse
8
9 Specialists, and Certified Nurse-Midwives who meet the requirements
9
10 for prescriptive authority identified by law and in the Board's
10
11 rules. The rules regarding prescriptive authority recognition
11
12 promulgated by the Oklahoma Board of Nursing pursuant to paragraphs
12
13 6 through 9, 11 and 12 of this section, Section 567.3a of this
13
14 title, and Section 1 of this act shall:
14
15 1. Define the procedure for documenting supervision by a
15
16 supervising physician licensed in Oklahoma to practice by the State
16
17 Board of Medical Licensure and Supervision or the State Board of
17
18 Osteopathic Examiners, as defined in Section 567.3a of this title,
18
19 of a Certified Nurse Practitioner, Clinical Nurse Specialist, or
19
20 Certified Nurse-Midwife who has not obtained independent
20
21 prescriptive authority under Section 1 of this act. Such procedure
21
22 shall include a written statement that defines appropriate referral,
22
23 consultation, and collaboration between the Advanced Practice
23
24 Registered Nurse, recognized to prescribe as defined in paragraphs 6
24
Req. No. 87 Page 35
1 through 9, 11 and 12 of Section 567.3a of this title, and the
1
2 supervising physician. The written statement shall include a method
2
3 of assuring availability of the supervising physician through direct
3
4 contact, telecommunications, or other appropriate electronic means
4
5 for consultation, assistance with medical emergencies, or patient
5
6 referral. The written statement shall be part of the initial
6
7 application and the renewal application submitted to the Board for
7
8 recognition for prescriptive authority for the Advanced Practice
8
9 Registered Nurse. Changes to the written statement shall be filed
9
10 with the Board within thirty (30) days of the change and shall be
10
11 effective on filing;
11
12 2. Define the procedure for documenting independent
12
13 prescriptive authority for Certified Nurse Practitioners, Clinical
13
14 Nurse Specialists, and Certified Nurse-Midwives who have obtained
14
15 independent prescriptive authority under Section 1 of this act;
15
16 3. Define minimal requirements for initial application for
16
17 prescriptive authority which shall include, but not be limited to,
17
18 evidence of completion of a minimum of forty-five (45) contact hours
18
19 or three (3) academic credit hours of education in
19
20 pharmacotherapeutics, clinical application, and use of
20
21 pharmacological agents in the prevention of illness, and in the
21
22 restoration and maintenance of health in a program beyond basic
22
23 registered nurse preparation, approved by the Board. Such contact
23
24 hours or academic credits shall be obtained within a time period of
24
Req. No. 87 Page 36
1 three (3) years immediately preceding the date of application for
1
2 prescriptive authority;
2
3 3. 4. Define minimal requirements for application for renewal
3
4 of prescriptive authority which shall include, but not be limited
4
5 to, documentation of a minimum of:
5
6 a. fifteen (15) contact hours or one (1) academic credit
6
7 hour of education in pharmacotherapeutics, clinical
7
8 application, and use of pharmacological agents in the
8
9 prevention of illness, and in the restoration and
9
10 maintenance of health in a program beyond basic
10
11 registered nurse preparation, and
11
12 b. two (2) hours of education in pain management or two
12
13 (2) hours of education in opioid use or addiction,
13
14 unless the Advanced Practice Registered Nurse has
14
15 demonstrated to the satisfaction of the Board that the
15
16 Advanced Practice Registered Nurse does not currently
16
17 hold a valid federal Drug Enforcement Administration
17
18 registration number,
18
19 approved by the Board, within the two-year period immediately
19
20 preceding the effective date of application for renewal of
20
21 prescriptive authority;
21
22 4. 5. Require that beginning July 1, 2002, an Advanced Practice
22
23 Registered Nurse shall demonstrate demonstrates successful
23
24 completion of a master's degree or higher in a clinical nurse
24
Req. No. 87 Page 37
1 specialty one of the following Advanced Practice Registered Nurse
1
2 roles:
2
3 a. Certified Nurse Practitioner,
3
4 b. Clinical Nurse Specialist, or
4
5 c. Certified Nurse-Midwife,
5
6 in order to be eligible for initial application for prescriptive
6
7 authority under the provisions of the Oklahoma Nursing Practice Act;
7
8 5. 6. Define the method for communicating authority to
8
9 prescribe or termination of same, and the formulary to the State
9
10 Board of Pharmacy, all pharmacies, and all registered pharmacists;
10
11 6. 7. Define terminology used in such rules;
11
12 7. 8. Define the parameters for the prescribing practices of
12
13 the Advanced Practice Registered Nurse;
13
14 8. 9. Define the methods for termination of prescriptive
14
15 authority for the Advanced Practice Registered Nurse; and
15
16 9. 10. a. Establish a Formulary Advisory Council that
16
17 shall develop and submit to the Board recommendations
17
18 for an exclusionary formulary that shall list drugs or
18
19 categories of drugs that shall not be prescribed by an
19
20 Advanced Practice Registered Nurse recognized to
20
21 prescribe by the Oklahoma Board of Nursing. The
21
22 Formulary Advisory Council shall also develop and
22
23 submit to the Board recommendations for practice-
23
24 specific prescriptive standards for each category of
24
Req. No. 87 Page 38
1 Advanced Practice Registered Nurse recognized to
1
2 prescribe by the Oklahoma Board of Nursing pursuant to
2
3 the provisions of the Oklahoma Nursing Practice Act.
3
4 The Board shall either accept or reject the
4
5 recommendations made by the Council. No amendments to
5
6 the recommended exclusionary formulary may be made by
6
7 the Board without the approval of the Formulary
7
8 Advisory Council.
8
9 b. In addition to the other powers and duties of the
9
10 Formulary Advisory Council prescribed by this
10
11 paragraph, the Formulary Advisory Council shall
11
12 develop guidelines for supervising physicians on best
12
13 practices for the supervision of Advanced Practice
13
14 Registered Nurses who have not obtained independent
14
15 prescriptive authority. The supervision guidelines
15
16 shall be published on the Board's website and the
16
17 Formulary Advisory Council shall periodically update
17
18 the guidelines as necessary.
18
19 c. The Formulary Advisory Council shall be composed of
19
20 twelve (12) members as follows:
20
21 (1) four members, to include a pediatrician, an
21
22 obstetrician-gynecological physician, a general
22
23 internist, and a family practice physician;
23
24 provided, that three of such members shall be
24
Req. No. 87 Page 39
1 appointed by the Oklahoma State Medical
1
2 Association, and one shall be appointed by the
2
3 Oklahoma Osteopathic Association,
3
4 (2) four members who are registered pharmacists,
4
5 appointed by the Oklahoma Pharmaceutical
5
6 Pharmacists Association, and
6
7 (3) four members, one of whom shall be a Certified
7
8 Nurse Practitioner, one of whom shall be a
8
9 Clinical Nurse Specialist, one of whom shall be a
9
10 Certified Nurse-Midwife, and one of whom shall be
10
11 a current member of the Oklahoma Board of
11
12 Nursing, all of whom shall be appointed by the
12
13 Oklahoma Board of Nursing.
13
14 c. d. All professional members of the Formulary Advisory
14
15 Council shall be in active clinical practice, at least
15
16 fifty percent (50%) of the time, within their defined
16
17 area of specialty. The members of the Formulary
17
18 Advisory Council shall serve at the pleasure of the
18
19 appointing authority for a term of three (3) years.
19
20 The terms of the members shall be staggered. Members
20
21 of the Council may serve beyond the expiration of
21
22 their term of office until a successor is appointed by
22
23 the original appointing authority. A vacancy on the
23
24
24
Req. No. 87 Page 40
1 Council shall be filled for the balance of the
1
2 unexpired term by the original appointing authority.
2
3 d. e. Members of the Council shall elect a chair and a
3
4 vice-chair vice chair from among the membership of the
4
5 Council. For the transaction of business, at least
5
6 seven members, with a minimum of two members present
6
7 from each of the identified categories of physicians,
7
8 pharmacists, and advanced practice registered nurses
8
9 Advanced Practice Registered Nurses, shall constitute
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10 a quorum. The Council shall recommend and the Board
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11 shall approve and implement an initial exclusionary
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12 formulary on or before January 1, 1997. The Council
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13 and the Board shall annually review the approved
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14 exclusionary formulary and shall make any necessary
14
15 revisions utilizing the same procedures used to
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16 develop the initial exclusionary formulary.
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17 SECTION 9. AMENDATORY 59 O.S. 2021, Section 567.5a, as
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18 amended by Section 1, Chapter 94, O.S.L. 2024 (59 O.S. Supp. 2024,
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19 Section 567.5a), is amended to read as follows:
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20 Section 567.5a. A. All applicants for a license to practice as
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21 an Advanced Practice Registered Nurse shall be subject to Section
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22 567.8 of this title.
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23 B. An applicant for an initial license to practice as an
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24 Advanced Practice Registered Nurse shall:
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Req. No. 87 Page 41
1 1. Submit a completed written application and appropriate fees
1
2 as established by the Oklahoma Board of Nursing;
2
3 2. Submit a criminal history records check that complies with
3
4 Section 567.18 of this title;
4
5 3. Hold a current Registered Nurse license in this state;
5
6 4. Have completed an advanced practice registered nursing
6
7 education program in one of the four advanced practice registered
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8 nurse Advanced Practice Registered Nurse roles and a specialty area
8
9 recognized by the Board. Effective January 1, 2016, the applicant
9
10 shall have completed an accredited graduate level advanced practice
10
11 registered nursing education program in at least one of the
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12 following population foci: family/individual across the lifespan,
12
13 adult-gerontology, neonatal, pediatrics, women's health/gender-
13
14 related, or psychiatric/mental health;
14
15 5. Be currently certified in an advanced practice specialty
15
16 certification consistent with educational preparation and by a
16
17 national certifying body recognized by the Board; and
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18 6. Provide any and all other evidence as required by the Board
18
19 in its rules.
19
20 C. The Board may issue a license by endorsement to an Advanced
20
21 Practice Registered Nurse licensed under the laws of another state
21
22 if the applicant meets the qualifications for licensure in this
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23 state. An applicant by endorsement shall:
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24
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Req. No. 87 Page 42
1 1. Submit a completed written application and appropriate fees
1
2 as established by the Board;
2
3 2. Submit a criminal history records check that complies with
3
4 Section 567.18 of this title;
4
5 3. Hold a current Registered Nurse license in this state;
5
6 4. Hold recognition as an Advanced Practice Registered Nurse in
6
7 a state or territory;
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8 5. Have completed an advanced practice registered nursing
8
9 education program in one of the four roles and a specialty area
9
10 recognized by the Board. Effective January 1, 2016, the applicant
10
11 shall have completed an accredited graduate level advanced practice
11
12 registered nursing education program in at least one of the
12
13 following population foci: family/individual across the lifespan,
13
14 adult-gerontology, neonatal, pediatrics, women's health/gender-
14
15 related, or psychiatric/mental health;
15
16 6. Be currently certified in an advanced practice specialty
16
17 certification consistent with educational preparation and by a
17
18 national certifying body recognized by the Board;
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19 7. Meet continued competency requirements as set forth in Board
19
20 rules; and
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21 8. Provide any and all other evidence as required by the Board
21
22 in its rules.
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23 D. The Board may issue prescriptive authority recognition by
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24 endorsement to an Advanced Practice Registered Nurse licensed as an
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Req. No. 87 Page 43
1 APRN-CNP Advanced Practice Registered Nurse-Certified Nurse
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2 Practitioner (APRN-CNP), APRN-CNS Advanced Practice Registered
2
3 Nurse-Clinical Nurse Specialist (APRN-CNS), or APRN-CNM Advanced
3
4 Practice Registered Nurse-Certified Nurse-Midwife (APRN-CNM) under
4
5 the laws of another state if the applicant meets the requirements
5
6 set forth in this section. An applicant for prescriptive authority
6
7 recognition by endorsement shall:
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8 1. Submit a completed written application and appropriate fees
8
9 as established by the Board;
9
10 2. Hold current Registered Nurse and Advanced Practice
10
11 Registered Nurse licenses (APRN-CNP, APRN-CNS, or APRN-CNM) in the
11
12 state;
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13 3. Hold current licensure or recognition as an Advanced
13
14 Practice Registered Nurse in the same role and specialty with
14
15 prescribing privileges in another state or territory;
15
16 4. Submit documentation verifying successful completion of a
16
17 graduate level graduate-level advanced practice registered nursing
17
18 education program that included an academic course in
18
19 pharmacotherapeutic management, and didactic and clinical
19
20 preparation for prescribing incorporated throughout the program;
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21 5. Submit a written statement from an Oklahoma licensed
21
22 physician supervising prescriptive authority as required by the
22
23 Board in its rules, or submit documentation that the applicant meets
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24
24
Req. No. 87 Page 44
1 the requirements for independent prescriptive authority under
1
2 Section 1 of this act;
2
3 6. Meet continued competency requirements as set forth in Board
3
4 rules; and
4
5 7. Provide any and all other evidence as required by the Board
5
6 in its rules.
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7 E. An Advanced Practice Registered Nurse license issued under
7
8 this section shall be renewed concurrently with the registered nurse
8
9 Registered Nurse license, provided that qualifying criteria continue
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10 to be met.
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11 F. The Board may reinstate a license as set forth in Board
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12 rules.
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13 SECTION 10. AMENDATORY 63 O.S. 2021, Section 2-312, as
13
14 amended by Section 2, Chapter 184, O.S.L. 2022 (63 O.S. Supp. 2024,
14
15 Section 2-312), is amended to read as follows:
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16 Section 2-312. A. A physician, podiatrist, optometrist, or a
16
17 dentist who has complied with the registration requirements of the
17
18 Uniform Controlled Dangerous Substances Act, in good faith and in
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19 the course of such person's professional practice only, may
19
20 prescribe and administer controlled dangerous substances, or may
20
21 cause the same to be administered by medical or paramedical
21
22 personnel acting under the direction and supervision of the
22
23 physician, podiatrist, optometrist, or dentist, and only may
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24
24
Req. No. 87 Page 45
1 dispense controlled dangerous substances pursuant to the provisions
1
2 of Sections 355.1 and 355.2 of Title 59 of the Oklahoma Statutes.
2
3 B. A veterinarian who has complied with the registration
3
4 requirements of the Uniform Controlled Dangerous Substances Act, in
4
5 good faith and in the course of the professional practice of the
5
6 veterinarian only, and not for use by a human being, may prescribe,
6
7 administer, and dispense controlled dangerous substances and may
7
8 cause them to be administered by an assistant or orderly under the
8
9 direction and supervision of the veterinarian.
9
10 C. 1. An advanced practice nurse Advanced Practice Registered
10
11 Nurse who is recognized to prescribe by the Oklahoma Board of
11
12 Nursing as an advanced registered nurse practitioner, clinical nurse
12
13 specialist or certified nurse-midwife, a Certified Nurse
13
14 Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
14
15 but who has not obtained independent prescriptive authority under
15
16 Section 1 of this act and therefore is subject to medical direction
16
17 by a current supervision agreement with a supervising physician,
17
18 pursuant to Section 567.3a of Title 59 of the Oklahoma Statutes, and
18
19 who has complied with the registration requirements of the Uniform
19
20 Controlled Dangerous Substances Act, in good faith and in the course
20
21 of professional practice only, may prescribe and administer Schedule
21
22 III, IV, and V controlled dangerous substances.
22
23 2. An Advanced Practice Registered Nurse who is recognized to
23
24 prescribe by the Oklahoma Board of Nursing as a Certified Nurse
24
Req. No. 87 Page 46
1 Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
1
2 who has obtained independent prescriptive authority under Section 1
2
3 of this act, and who has complied with the registration requirements
3
4 of the Uniform Controlled Dangerous Substances Act, in good faith
4
5 and in the course of professional practice only, may prescribe and
5
6 administer Schedule III, IV, and V controlled dangerous substances.
6
7 D. An advanced practice nurse Advanced Practice Registered
7
8 Nurse who is recognized to order, select, obtain, and administer
8
9 drugs by the Oklahoma Board of Nursing as a certified registered
9
10 nurse anesthetist Certified Registered Nurse Anesthetist pursuant to
10
11 Section 353.1b of Title 59 of the Oklahoma Statutes and who has
11
12 complied with the registration requirements of the Uniform
12
13 Controlled Dangerous Substances Act, in good faith and in the course
13
14 of such practitioner's professional practice only, may order,
14
15 select, obtain, and administer Schedules II through V controlled
15
16 dangerous substances in a preanesthetic preparation or evaluation;
16
17 anesthesia induction, maintenance, or emergence; or postanesthesia
17
18 care setting only. A certified registered nurse anesthetist
18
19 Certified Registered Nurse Anesthetist may order, select, obtain,
19
20 and administer such drugs only during the perioperative or
20
21 periobstetrical period.
21
22 E. A physician assistant who is recognized to prescribe by the
22
23 State Board of Medical Licensure and Supervision under the medical
23
24 direction of a supervising physician, pursuant to Section 519.6 of
24
Req. No. 87 Page 47
1 Title 59 of the Oklahoma Statutes, and who has complied with the
1
2 registration requirements of the Uniform Controlled Dangerous
2
3 Substances Act, in good faith and in the course of professional
3
4 practice only, may prescribe and administer Schedule II through V
4
5 controlled dangerous substances.
5
6 SECTION 11. This act shall become effective November 1, 2025.
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8 60-1-87 DC 1/19/2025 5:38:54 AM
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Req. No. 87 Page 48Every fact on this page links to its source, starting with the official bill record.