(1) The board may authorize an advanced practice registered nurse who is listed on the advanced practice registry, has a license in good standing without disciplinary sanctions issued pursuant to section 12-255-110, and has fulfilled requirements established by the board pursuant to this section to prescribe controlled substances or prescription drugs as defined in section 12-280-103.
(2) (a) The board shall adopt rules to implement this section.
(b) Rules adopted pursuant to this section shall reflect current, accepted professional standards for the safe and effective use of controlled substances and prescription drugs.
(3) (a) An advanced practice registered nurse may be granted authority to prescribe prescription drugs and controlled substances to provide treatment to clients within the role and population focus of the advanced practice registered nurse.
(b) (I) An advanced practice registered nurse who has been granted authority to prescribe prescription drugs and controlled substances under this part 1 may advise the nurse's patients of their option to have the symptom or purpose for which a prescription is being issued included on the prescription order.
(II) A nurse's failure to advise a patient under subsection (3)(b)(I) of this section is neither:
Grounds for any disciplinary action against the nurse's professional license issuedunder this part 1; nor
Grounds for any civil action against a nurse in a negligence or tort action; nor(C) Evidence in any civil action against a nurse.
(4) (a) An advanced practice registered nurse applying for prescriptive authority shall provide evidence to the board of the following:
An appropriate graduate degree as determined by the board pursuant to section 12255-111 (3)(a);
Satisfactory completion of specific educational requirements in the use of controlledsubstances and prescription drugs, as established by the board, either as part of a degree program or in addition to a degree program;
National certification from a nationally recognized accrediting agency, as definedby the board by rule pursuant to section 12-255-111 (3)(b), unless the board grants an exception;
Professional liability insurance as required by section 12-255-113;
Inclusion on the advanced practice registry pursuant to section 12-255-111; and
A signed attestation stating that the advanced practice registered nurse has completed at least three years of combined clinical work experience as a professional nurse or as an advanced practice registered nurse.
(b) Upon satisfaction of the requirements set forth in subsection (4)(a) of this section, the board may grant provisional prescriptive authority to an advanced practice registered nurse. The provisional prescriptive authority that is granted is limited to those patients and medications appropriate to the advanced practice registered nurse's role and population focus. In order to retain provisional prescriptive authority and obtain and retain full prescriptive authority pursuant to this subsection (4) for patients and medications appropriate for the advanced practice registered nurse's role and population focus, an advanced practice registered nurse shall satisfy the following requirements:
(I) (A) Once the provisional prescriptive authority is granted, the advanced practice registered nurse must obtain seven hundred fifty hours of documented experience in a mutually structured prescribing mentorship either with a physician or with an advanced practice registered nurse who has full prescriptive authority and experience in prescribing medications. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice registered nurse.
Remote communication with the mentor is permissible within the mentorship as longas the communication is synchronous. Synchronous communication does not include communication by e-mail.
The physician or advanced practice registered nurse serving as a mentor shall notrequire payment or employment as a condition of entering into the mentorship relationship, but the mentor may request reimbursement of reasonable expenses and time spent as a result of the mentorship relationship.
Upon successful completion of the mentorship period, the mentor shall provide thementor's signature and attestation to verify that the advanced practice registered nurse has successfully completed the mentorship within the required period after the provisional prescriptive authority was granted.
If an advanced practice registered nurse with provisional prescriptive authority failsto complete the mentorship required by this subsection (4)(b)(I) within three years or otherwise fails to demonstrate competence as determined by the board, the advanced practice registered nurse's provisional prescriptive authority expires for failure to comply with the statutory requirements.
Repealed.
The advanced practice registered nurse shall maintain professional liability insurance as required by section 12-255-113.
The advanced practice registered nurse shall maintain national certification, as specified in subsection (4)(a)(III) of this section, unless the board grants an exception.
(c) An advanced practice registered nurse who was granted prescriptive authority prior to July 1, 2010, shall satisfy the following requirements in order to retain prescriptive authority:
(Deleted by amendment, L. 2020.)
The advanced practice registered nurse shall maintain professional liability insuranceas required by section 12-255-113.
The advanced practice registered nurse shall maintain national certification, as specified in subsection (4)(a)(III) of this section, unless:
The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2010, and has not obtained national certification;
The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2008, and has not completed a graduate degree as specified in section 12255-111 (3)(a); or
The board grants an exception.
In order to obtain provisional prescriptive authority and obtain and retain full prescriptive authority in this state, an advanced practice registered nurse from another state must meet the requirements of this section or substantially equivalent requirements, as determined by the board.
Repealed.
Once an advanced practice registered nurse obtains full prescriptive authority pursuant to this subsection (4), the advanced practice registered nurse is not required to maintain or update an articulated plan as described in subsection (4)(b)(II) or (4)(c)(I) of this section.
An advanced practice registered nurse who obtains prescriptive authority pursuant tothis section shall be assigned a specific identifier by the state board of nursing. This identifier shall be available to the Colorado medical board and the state board of pharmacy. The state board of nursing shall establish a mechanism to assure that the prescriptive authority of an advanced practice registered nurse may be readily verified.
(a) An advanced practice registered nurse with prescriptive authority pursuant to this section is subject to the limitations on prescribing opioids specified in section 12-30-109.
(b) This subsection (6) is repealed, effective September 1, 2021.
(7) (a) The scope of practice for an advanced practice registered nurse may be determined by the board in accordance with this part 1.
The board may consider information provided by nursing, medical, or other healthprofessional organizations, associations, or regulatory boards.
(I) Prescriptive authority by an advanced practice registered nurse shall be limited tothose patients appropriate to the nurse's scope of practice. Prescriptive authority may be limited or withdrawn and the advanced practice registered nurse may be subject to further disciplinary action in accordance with this part 1 if the nurse has prescribed outside the nurse's scope of practice or for other than a therapeutic purpose.
(II) Nothing in this section shall be construed to require a registered nurse to obtain prescriptive authority to deliver anesthesia care.
All prescriptions must comply with applicable federal and state laws, including article 280 of this title 12 and part 2 of article 18 of title 18.
Nothing in this section shall be construed to permit dispensing or distribution, asdefined in section 12-280-103 (14) and (15), by an advanced practice registered nurse, except for samples, under article 280 of this title 12 and the federal "Prescription Drug Marketing Act of 1987", Pub.L. 100-293, as amended.
An advanced practice registered nurse registered pursuant to section 12-255-111 isnot required to apply for or obtain prescriptive authority.
Nothing in this section shall limit the practice of nursing by any nurse, includingadvanced practice registered nurses.
An advanced practice registered nurse shall not accept any direct or indirect benefitfrom a pharmaceutical manufacturer or pharmaceutical representative for prescribing a specific medication to a patient. For the purposes of this section, a direct or indirect benefit does not include a benefit offered to an advanced practice registered nurse regardless of whether the specific medication is being prescribed.
Source: L. 2019: Entire title R&RE with relocations, (HB 19-1172), ch. 136, p. 1329, § 1, effective October 1; (12) added, (SB 19-228), ch. 276, p. 2610, § 16, effective October 1. L. 2020: (1), (3)(a), (3)(b)(I), IP(4)(a), (4)(a)(VI), IP(4)(b), (4)(b)(I), (4)(b)(III), (4)(b)(IV), (4)(c), (4)(d), (5), (6)(a), (7)(a), (7)(c)(I), (9), (10), (11), and (12) amended; (4)(b)(II) and (4)(e) repealed; and (4)(f) added, (HB 20-1216), ch. 190, p. 872, § 14, effective July 1; (3)(b), (7)(a), and (7)(c)(I) amended, (HB 20-1183), ch. 157, p. 679, § 10, effective July 1.
Editor's note: (1) This section is similar to former § 12-38-111.6 as it existed prior to 2019.
(2) (a) Before its relocation in 2019, this section was amended in SB 19-228. Those amendments were superseded by the repeal and reenactment of this title 12, effective October 1, 2019. For those amendments to the former section in effect from May 23, 2019, to October 1, 2019, see SB 19-228, chapter 276, Session Laws of Colorado 2019.
(b) Before its relocation in 2019, this section was amended in SB 19-079. Those amendments were superseded by the repeal and reenactment of this title 12, effective October 1, 2019. For those amendments to the former section in effect from August 2, 2019, to October 1, 2019, see SB 19-079, chapter 86, Session Laws of Colorado 2019.
(3) Amendments to subsections (3)(b)(I), (7)(a), and (7)(c)(I) of this section by HB 201183 and HB 20-1216 were harmonized.
Cross references: For the legislative declaration in HB 20-1216, see section 1 of chapter 190, Session Laws of Colorado 2020.