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