Advanced Practice Nursing Council

of Southeast Florida

Legislation, Politics, & Updates

CONTROLLED SUBSTANCES ISSUE

1. 4/6/04 SB2072 did not pass the Senate Health Committee last week so it is dead again this year. Go to Florida Nurses' Association to read about further updates. If you do not receive the legislative updates from FNA, e-mail attention Bibi Lowton and ask to be put on the ARNP e-mail list.

NURSE PRACTICE ACT/RULES & REGULATIONS 4/6/04

1. It is important to be knowledgeable about your legal authority and rules to practice. The following comments are provided as suggestions, not as specific legal advice. Links are provided so you can go to each legal document source.

a. The Nurse Practice Act which is the statutory authority providing the legal basis for advanced practice nursing can be found in Chapter 464.003 at: http://www.doh.state.fl.us/mqa/nursing/nur_statutes.html. Functions for several categories of Advanced Registered Nurse Practitioners were listed in the statutes in Section 464.012(3), F.S. when the original statutes were written. You should review the functions that were authorized by legislation more than 15 years ago. Even though certain functions were legislated, we are still having problems performing some of them. Go to the web site above and review such.

b. The statutes authorized a further development of these A.R.N.P. functions which was done in administrative Rules 64B9-4.009 & 64B9-4.010. These rules specifically address protocols and practice agreements, and can be reviewed at: http://www.doh.state.fl.us/mqa/nursing/nur_home.html.

c. "A.R.N.P. Protocol - Suggested Format and Information" - This document provides a guide in writing protocols to submit to DOH. You can this example to keep your protocol very GENERAL!!!!! Remember, you are submitting your protocol as a legal document of "your" practice. It will be the basis for your collaborative practice!!! Our recommendations are to follow the legal requirements by writing your protocol in general terms using this guideline. Review at: http//www.doh.statefl.us/mqa/nursing/ProtocolFmt&Instrs.htm

d. "A.R.N.P. Protocol- (format sample written by FSBON)"- This document provides another VERY SPECIFIC guideline in writing protocols. A.R.N.P.s need to have written protocols with physicians, osteopaths, etc. for legal authority of medical delegation to perform "additional acts". "Additional acts" is referring to those areas of advanced practice which were not considered to be traditional nursing when the Nurse Practice Act was revised 15 years ago. This document addresses the writing of a protocol for additional acts; however, it includes content/examples generic to basic nursing. It also suggests that you cite a reference as a guideline for clinical practice be included which is not recommended by our Council. Keep your protocol as general as possible for you will held to the document which you submit. If you submit a reference, you will be held to the guidelines in the reference. The sample provided by the FSBON is not a good example of an advanced practice nursing protocol to be sent to the DOH. Review at: http://www.doh.state.fl.us/mqa/nursing/ProtocolSample.htm

FIND LEGISLATION

1. For updated news of any legislation or progress of a bill, you can contact Florida Nurses' Association via the internet, and go to the legislative news on the FNA site.

2. You can also easily communicate with your legislators by going to the FNA Website and when you get to the FNA home page, select legislative section, and then click on Capital Wiz. Capital Wiz is a program where you enter your zip code, find your legislators, and then e-mail them from within the Capital Wiz program. Instructions help you along. Just know your zip code, and what you plan to say regarding which issue. Hint: If you e-mail a legislator, make sure your correspondence includes your name, your role, type practice site, and a few succinct, rational comments why you are writing them.

MEDICAID PRESCRIPTIONS

1. From Barbara Lumpkin, FNA, "I have had some notices from ARNPs in various areas of the State that they are having some Medicaid prescriptions denied. I called the Director of the State Medicaid Pharmacy Program and he assures me that there has been no change in Medicaid rules or policies regarding ARNP prescriptions. He mentioned two possible causes for a denial. The first is that the Medicaid patient is in a Medicaid HMO and many HMOs still require the DEA number of a collaborating physician on prescriptions. The other possible problem is the prescriber may unknowingly write more than four prescriptions for brand name drugs within a one month period. Exceptions to this limited can be made on request following the procedure in your provider manual. Therefore if there are still problems with Medicaid prescriptions please let me know by giving me the name of the pharmacy as well as your name and location. If there are problems we will work with Medicaid Representatives in AHCA to address the problem." E-mail Barbara Lumpkin at FNA.

2. In July 1, 2001, Medicaid began requiring practitioners who prescribe drugs to use counterfeit-proof prescription blanks when writing prescriptions for Medicaid patients. This is part of Medicaid’s ongoing effort to fight fraud and abuse. Prescriptions that are transmitted by fax, electronic means, or telephone are exempt from this new requirement. For additional information about the counterfeit-proof prescription blank program, and for a list of approved vendors please visit the Consultec website. You also may address questions by calling AHCA’s Bureau of Pharmacy Services at 850-487-4441. (Communication from FNA 6/18/2001 via e-mail)