CHARLESTON, W.Va. — A bill that would grant advanced practice registered nurses “full practice authority” has met opposition from law enforcement as discussion begins in the Senate.
The West Virginia Sheriff’s Association said it takes no issue with APRNs operating outside of a collaborative agreement with physicians in hopes of improving health care access in underserved areas, but most oppose the bill in its current form.
“We don’t try to step in and direct doctors or nurses about what they should and shouldn’t do in the treatment of their patients and so it seems like a contradiction when we stand up and say we have concerns,” Raleigh County Sheriff Steve Tanner, president of the association said. “Our concerns are not with the qualifications or standards, desires or intentions of these nurses, but it’s specifically in that nurses would be allowed to issue supplies of Schedule II drugs.”
Under the provisions of H.B. 4334, APRNs would have the prescriptive authority to issue 72 hours worth of a Schedule II drug like oxycodone with no refill, 30 days worth of a Schedule III drug with no refill and 30 days of an ADD drug with no refill.
“With more of these drugs being available on the street, we’re increasing our epidemic and not decreasing it,” Tanner said. “We are making more of an opportunity to abuse these drugs rather than making the drugs more scarce or more controlled.”
There are approximately 2000 APRNs in the state, around 860 of those would meet the requirements to have prescriptive authority and 70 percent of that number would have a licence from the DEA to prescribe Scheduled II drugs, according to the WV Nurses Association.
The legislation causes a multitude of issues because of the full prescriptive authority, according to the association, which includes how to protect APRNs who are threatened by addicts who threaten bodily harm when denied drugs as doctors are now.
AARP West Virginia released a statement in favor of the bill.
“Every state with full practice authority permits nurse practitioners to prescribe controlled substances Schedules II – V. With the limited practice authority safeguards in place in the West Virginia legislation, there is absolutely no evidence to suggest that limited Schedule II authority for nurse practitioners would contribute to the prescribing epidemic in the Mountain State,” said Beth Baldwin, President of the West Virginia Nurses Association,” part of the release said.
Tanner also has concerns that there has been no research into if the system law enforcement currently uses to track prescription habits in order to prevent individuals from going to multiple doctors at once could handle an influx of APRNs joining.
“What is our data base and how much can we add to that,” he asked. “It’s not just the system, but also the pharmacists that enter the data into the system and law enforcement. As this increases, do we have the resources within law enforcement to handle this increase in prescriptions and being able to watch for doctor and then nurse shopping.”
Data tying full practice authority to more prescription being filed or not is inconclusive as some state with the legislation find themselves toward the top of that statistic per 100 people, while others find themselves at the bottom. Also, more states have granted full practice authority since the CDC’s last released data on the issue.
The timing of the opposition after passage in the House is because the association was unaware of the legislation until the 72-20 vote in favor of the legislation Saturday.
With the last day of the Regular Legislative Session approaching, Tanner said they have no time to conduct any research or ask law enforcement officers in the 21 states and D.C. with full prescriptive authority how it affected their fight against prescription drugs.
“By the time, I’m afraid, we do our research, get our documentation together, have an argument to articulate and say we’ve looked at the history in D.C. and these [21] other states, I think that the bill would maybe have maybe already gone through passed and be up for signature.”
This is why the association is requesting that the Senate put a stop to the legislation and then work together next year on a compromise that will meet the healthcare needs of rural areas while taking into account the state’s prescription drug abuse.
The bill is set to be taken up in its first of two committee stops, the Senate Committee on Health and Human Resources, Thursday.