HISTORIC LEGISLATION PASSES – CONTROLLED SUBSTANCE PRESCRIPTIVE AUTHORITY FOR ALL FLORIDA ARNPs INCLUDING CRNAs
The 2016 regular legislative session ended at 6:45 p.m. Friday, March 11, 2016, after the House and Senate passed an $82.3 billion budget. Each chamber approved the spending plan for the year that begins July 1 by broad, bipartisan margins.
After a last-minute episode of intrigue and confusion, the Florida Legislature approved a measure that would expand the drug-prescribing powers of ALL Advanced Registered Nurse Practitioners (ARNPs) including Certified Registered Nurse Anesthetists (CRNAs) and Physician Assistants (PAs) to include controlled substance prescribing. FANA, along with other many other state organizations, has been battling for this right for over two decades. This is truly history in the making! The Florida Association of Nurse Anesthetists thanks you for all your support in advancing the practice of Certified Registered Nurse Anesthetists in the State of Florida!
In summary, here is a brief look at the major health care issues that passed and failed in the 2016 session. FANA will update you with a more comprehensive review after the Governor’s veto period has passed.
- HB 423 – ARNP/PA Controlled Substance Prescribing by Rep. Cary Pigman (R-Avon Park) and Sen. Denise Grimsley (R-Sebring) allows ARNPs and PAs to prescribe controlled substances under existing supervision and protocol requirements, and subject to a formulary to be developed by a committee made up of ARNPs, MDs and a pharmacist. The formulary does not apply to controlled substances ordered by a CRNA for preanesthetic, anesthetic or post-anesthetic recovery purposes. Prescriptions for Schedule II controlled substances are limited to a 7 day supply except for psychiatric medications prescribed by a psychiatric nurse. Psychiatric medications for patients younger than 18 years old may only be prescribed by a psychiatric nurse. The bill also allows the AANA to conduct continuing education classes required by this bill. FANA strongly supported this historic piece of legislation which took over two decades to pass the Florida Legislature. Your calls and emails on the issue really put the pressure on, and FANA wants to thank you for your advocacy.
- HB 1241 – Ordering by Rep. Rene Placencia (R-Orlando) and Sen. Denise Grimsley (R-Sebring) amends existing Florida law to make it clear that ARNPs and PAs can order medications, including controlled substances, for administration to patients in hospitals, ambulatory surgery centers and nursing homes. The Florida Association of Nurse Anesthetists supported this legislation and was quickly able to resolve a last minute regulatory issue to ensure passage.
- HB 221 – Balance Billing by Rep. Carlos Trujillo (R-Miami) and Sen. Rene Garcia (R-Hialeah). This legislation prohibits most “balance billing” practices by health care providers of non-emergency services who do not participate in a patient’s health plan or network. The bill also sets up a dispute-resolution process that proponents say would help shield patients from unexpected bills and leave it to health care providers and insurers to work out payment issues when consumers use a provider not in their health insurer’s network.
- HB 1061 – Multi-State Nurse Licensure Compact by Cary Pigman (R-Avon Park) and Sen. Denise Grimsley (R-Sebring) allows Florida to enter into the “Nurse Licensure Compact” for RNs and LPNs with more than two dozen other states, and allows nurses to receive multi-state licenses to practice in any of the states that are part of the compact. FANA supported this legislation.
- HB 1175 – Health Care Cost Transparency by Rep. Chris Sprowls (R-Clearwater) and Sen. Rob Bradley (R-Orange Park). This legislation requires hospitals and other health facilities to post information on their websites concerning the cost and quality of services. The bill also requires facilities and practitioners to provide, upon request, a good faith estimate of anticipated charges for non-emergency services to be provided to a patient.
- HB 7087 – Telehealth by Rep. Chris Sprowls (R-Clearwater), Sen. Aaron Bean (R-Jacksonville and Sen. Arthenia Joyner (D-Tampa) creates a task force to study issues related to Telehealth.
- HB 977 – Behavioral Health Workforce by Rep. Kathleen Peters (R-St. Petersburg), Sen. Denise Grimsley (R-Sebring) and Sen. Jack Latvala (R-Clearwater) addresses workforce issues regarding mental and substance abuse disorders. The bill allows a psychiatric nurse within the framework of an established protocol with a psychiatrist to prescribe psychotropic controlled substances for the treatment of mental disorders.
- SB 1144 – Certificates of Need by Sen. Don Gaetz (R-Destin) and HB 437 by Rep. Chris Sprowls (R-Clearwater). The bill would have revised the Florida CON process for various types of health care facilities.
- HB 37 – Direct Primary Care by Rep. Fred Costello (R-Port Orange) and SB 212 by Don Gaetz (R-Destin). This bill would have allowed direct primary care agreements between doctors and patients without the use of health insurance as a reimbursement mechanism.
- HB 85 – Recovery Care Services by Rep. Heather Fitzenhagen (R-Fort Meyers) and SB 212 by Don Gaetz (R-Destin), would have allowed longer stays at ambulatory surgical centers.
- Florida Surgeon General John Armstrong, appointed in 2012 by Gov. Rick Scott to lead the Florida Department of Health, was not confirmed by the Senate, and was replaced by Acting Surgeon Dr. General Celeste Phillips.