RPN: PRESCRIBER - S.B. 104 (S-4): FLOOR ANALYSIS

Senate Bill 104 (Substitute S-4 as reported by the Committee of the Whole)

Sponsor: Senator John J.H. Schwarz, M.D.

Committee: Health Policy and Senior Citizens

CONTENT

The bill would amend the Public Health Code to include in the definition of "prescriber" a licensed registered professional nurse (RPN) with specialty certification who was a nurse midwife or a nurse practitioner and filed with the Department of Consumer and Industry Services both an emergency plan for the management and referral to appropriate medical services of a patient who experienced an adverse drug reaction, and a collaborative agreement between the RPN and one or more physicians. A physician could not enter into a collaborative agreement with more than 10 RPNs at any one time. The bill specifies that a physician who entered into a collaborative agreement would not be responsible for acts or omissions of the RPN in prescribing drugs and otherwise providing health care treatment and service to patients.

If an RPN's specialty certification were issued after January 1, 1993, he or she would have to possess a master's degree in advanced practice nursing from an accredited college or university. An RPN also would have to complete at least a one-year prescribing internship, during which he or she could prescribe only under the delegated authority of a physician or an RPN prescriber. This requirement would be met if a licensed physician certified to the Department that the RPN had fulfilled the requirement for a prescribing internship. An RPN prescriber biennially would have to complete at least 20 hours of continuing education in pharmacology.

If an RPN prescriber determined from interviewing or examining a patient that the patient required medical care outside of the RPN's scope of practice, the RPN could not attempt to provide that medical care and promptly would have to advise the patient to seek evaluation by an appropriate physician for diagnosis and possible treatment.

An RPN could prescribe a Schedule 2 controlled substance only as specified in the bill. An RPN with specialty certification could not do the following: order magnetic resonance imaging or computerized axial tomography imaging studies; prescribe antineoplastic drugs; prescribe a drug or device for a pregnant woman with the intention of causing a miscarriage or fetal death; prescribe or dispense drugs outside of a licensed health care provider's private practice office or a licensed health care facility, home health agency, clinic, or agency, except by telephone for patients who were a part of the RPN's established practice; or prescribe a drug whose primary pharmacological effect was psychotropic.

MCL 333.17708 - Legislative Analyst: N. Nagata

FISCAL IMPACT

The bill would have no fiscal impact on State or local government. If one assumes that a patient actually needs a given drug so prescribed, then the "type" of prescriber should have no effect on overall costs.

Date Completed: 2-11-98 - Fiscal Analyst: J. Walker

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This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.