South Florida Hospital News
Monday July 16, 2018
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January 2009 - Volume 5 - Issue 7

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Legal Update - ARNP Controlled Substance Prescribing; Is 2009 the Year?

Florida is currently one of two states which does not permit Advanced Registered Nurse Practitioners (ARNPs) to prescribe controlled substances, but that may change in 2009. In December, Senate professional staff presented the findings of Interim Report 2009-117 to the members of the Senate Health Regulation Committee. The report is the result of a study done at the request of Senate President Jeff Atwater. The study recommended:

that the Legislature consider extending authority to Florida-licensed ARNPs who have attained certification in a nursing specialty from a nationally recognized certifying entity to prescribe controlled substances under protocols and within the scope of practice for their specialty.

For 15 years ARNPs have unsuccessfully sought the ability to prescribe controlled substances for their patients who need them. The positive results presented could be a catalyst for the success of this legislative reform during the 2009 Legislative Session.

There are 13,000 ARNPs licensed in Florida. ARNPs are nurses with specialized advanced training in their area of expertise. They have advanced degrees and hold nationally recognized certifications in their area of specialty. Certified Registered Nurse Anesthetists, Certified Nurse Midwives, and Nurse Practitioners are licensed as ARNPs. These practitioners provide cost-effective, quality care in primary care settings and have high levels of patient satisfaction.

In Florida there is a shortage of primary care providers and problems with access to care. The report concluded that ARNPs are highly competent primary care providers and could reduce delays and costs for patients requiring controlled substances.

ARNPs are prevented from meeting the full needs of their patients because they may not prescribe controlled substances. Patients who see an ARNP for an acute or chronic illness must wait to be re-assessed by a physician in order to get their needed prescription. Proponents of the proposed legislation argue it would decrease repetitive visits to heath care providers, increase the efficiency of office practices, decrease unnecessary ER visits, and facilitate the flow of patients through our hospital systems. The legislation would allow for the provision of comprehensive care in Florida’s underserved areas, both urban and rural. Various associations are supportive of the proposed legislation including the Florida Nurses Association, the Florida Hospital Association, and the Florida Retail Federation.

Opponents of the proposed legislation argue it would be unsafe to permit additional prescribers of drugs which have a high potential for abuse. The report concluded that ARNPs are no more likely to be subject to diversion or improper prescribing than any other type of prescribing healthcare provider. The report points out ARNPs are legally required to have a protocol with a supervising physician. These protocols are filed with the Department of Health, reviewed by the Board of Nursing, and are available online under the practitioner’s profile.

At the conclusion of the presentation to the committee, there was heated debate amongst the Senators, and despite the positive recommendations of the report, no committee bill will be filed. Senator Mike Bennett announced he would file the bill and Senator Jones and Democratic Leader Lawson spoke in support of the proposal. The debate regarding ARNP controlled substance prescribing promises to continue into the 2009 Legislative Session.

Anna Small is an attorney with Broad and Cassel’s Tallahassee office and is a member of the statewide firm’s Health Law Practice Group. She can be reached at (850) 681-6810 or asmall@broadandcassel.com.
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