A bill has been introduced in the Legislature by State Sen. David Hinkins (R-Orangeville) to allow an advanced practice registered nurse to prescribe a Schedule II controlled substance without supervision by a consulting physician.
Under the provisions of Senate Bill 58, a nurse must meet certain experience requirements and consult the Controlled Substance Database.
Sen. Hinkins reported the bill was passed out of committee but has been sent back twice to make changes in the language. The Nurse Practitioner Amendments third substitute is now being reworked in the Senate Business and Labor Committee. Sen. Curtis Bramble (R-Provo) is the substitute sponsor. Sen. Hinkins said, “We need to meet in the middle and it’s easier to do it in committee. If we can get consensus, it will fly through.”
But Utah Nurse Practitioners Association President Dallen Ormond said the bill is getting bogged down with new language and is, “getting really cluttered up.” He said some lawmakers were uncomfortable with the first version of the bill because of the overdose problem in Utah and around the nation. “Targeting us for the opioid problem is probably a little misguided,” he added, pointing to statistics that show fewer overdoses in states like Nevada where nurse practitioners have been granted full practice.
Ormond says the Utah Medical Association was “adamantly opposed” to the first version of the bill which would grant full practice authority without caveats. The UMA supports the third substitute which would prohibit an advanced practice nurse from establishing an independent pain clinic without a consultation and referral plan jointly developed with a consulting physician.
No current standards
Utah does not currently have standards for pain clinics and an effort is being made to insert some guidelines into the legislation. Ormond says one provision would require general practice clinics to be classified and regulated as pain clinics if 50 percent of patients complain of pain, which is not uncommon.
The legislation also includes a provision that when treating an injured worker, the advanced practice registered nurse follows guidelines developed by the Worker’s Compensation System. Ormond said insurance companies shouldn’t be allowed to dictate regulations.
Ormond believes these issues should not be included in the Nurse Practitioners Legislation but should be addressed separately. “We are currently trying to negotiate to find a way to make legislators comfortable and also give Nurse Practitioners full practice authority, he said.”