Ohio House Bill 216: How it affects Standard Care Agreements (SCA), controlled substances, prescribing and formulary. Learn more on this info graphic created and shared by the Ohio Association of Advanced Practice Nurses (OAAPN).

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STANDARD CARE ARRANGEMENT

  • ELIMINATES that an SCA contain a procedure for regular review of referrals by the nurse to other health care professionals and the  care outcomes for a random sample of all patients seen by the nurse. Existing regulations require this element to be included in the  SCA. This will remain in place until the Board changes its rules.
  • ELIMINATES that an SCA contain a policy for care of infants up to age one and recommendations for collaborating physician visits  for children from birth to age three, if the nurse regularly provides services to infants. Existing regulations require this element to be  included in the SCA. This will remain in place until the Board changes its rules.
  • REQUIRES the collaborating physician or podiatrist to provide written or electronic notice of termination of the collaborating  relationship, and requires the APRN to subsequently notify the Board of Nursing of termination
    • CNS, CNM, CNP may practice without a collaborating physician or podiatrist for no more than 120 days if the physician  or podiatrist terminates the collaboration before the SCA expires. The 120 day period starts on the date the nurse  submits the notice to the Board of Nursing. The nurse must notify the Board of the termination “as soon as practicable”  by submitting a copy of the notice of termination.
  • REQUIRES nurse’s employer to retain the SCA on file o Existing regulations require a copy of the SCA to be retained on file at each site where the nurse practices. This will  remain in place until the Board changes its rules.
  • REQUIRES CNSs whose nursing specialty is mental health or psychiatric mental health to enter an SCA (previously was not  required for non-prescribing CNSs in this specialty area)
    • Collaborating physician must practice in one of the following specialties: A specialty that is the same as or similar to the nurse’s nursing specialty, Pediatrics, Primary Care or Family Practice

CONTROLLED SUBSTANCES

  • An APRN to prescribe a schedule II  controlled substance only under certain  conditions or from specified locations.  These conditions include all of the  following:
    • The patient has a terminal condition  (current law – did not change)
    • Any physician can issue the patient’s  initial prescription, does not have to  be the collaborating physician  (previously was collaborating  physician only)
    • The prescription is for an amount that  does not exceed that necessary for the  patient’s use in a single 72 hour period  (previously was 24 hour period)
  • The locations from which an APRN may  prescribe a schedule II controlled  substance includes: hospitals, nursing  homes, hospice care programs,  ambulatory surgical facilities, freestanding  birthing centers, and now residential care  facilities.

PRESCRIBING

  • ELIMINATES CTP/CTP-E
  • The APRN license grants each type of  APRN (other than CRNA) the authority  to prescribe or personally furnish most  drugs and therapeutic devices
  • ELIMINATES conditions governing an  APRN furnishing a sample drug or  therapeutic device, unless the drug or  device is listed on the exclusionary  formulary
  • Applicants may apply for the APRN  license up to five years after completion  of 45 hours of advanced pharmacology  (previously was three years)
  • Collaborating physicians or podiatrists  may now collaborate with up to five  nurses in the prescribing component  of their practices (previously was  three nurses)

FORMULARY

  • The formulary is now EXCLUSIONARY.  It is to include only those drugs or  devices that the APRN is not authorized  to prescribe or furnish
  • CPG will develop a recommended  exclusionary formulary and submit it to  the Board of Nursing at least twice a  year for Board approval

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