BILL NUMBER: SB 614 CHAPTERED
BILL TEXT
CHAPTER 266
FILED WITH SECRETARY OF STATE SEPTEMBER 22, 2005
APPROVED BY GOVERNOR SEPTEMBER 22, 2005
PASSED THE SENATE AUGUST 30, 2005
PASSED THE ASSEMBLY JULY 7, 2005
AMENDED IN ASSEMBLY MAY 31, 2005
AMENDED IN SENATE APRIL 7, 2005
INTRODUCED BY Senator Figueroa
FEBRUARY 22, 2005
An act to amend Section 2746.51 of the Business and Professions
Code, relating to nursing.
LEGISLATIVE COUNSEL'S DIGEST
SB 614, Figueroa Certified nurse-midwives.
Existing law, the Nursing Practice Act, authorizes the Board of
Registered Nursing to issue a certificate to practice
nurse-midwifery. The act describes the scope of practice authorized
by the certificate, including that a certified nurse-midwife may
furnish or order Schedule III, IV, or V controlled substances, and if
ordered in a hospital, Schedule II controlled substances.
This bill would delete the requirement that Schedule II controlled
substances be ordered in a hospital. The bill would authorize a
certified nurse-midwife to furnish or order Schedule II controlled
substances under conditions applicable to Schedule III, IV, or V
controlled substances. The bill would require that a certified
nurse-midwife with an active furnishing number provide specified
documentation of continuing education relating to Schedule II
controlled substances.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2746.51 of the Business and Professions Code is
amended to read:
2746.51. (a) Neither this chapter nor any other provision of law
shall be construed to prohibit a certified nurse-midwife from
furnishing or ordering drugs or devices, including controlled
substances classified in Schedule II, III, IV, or V under the
California Uniform Controlled Substances Act (Division 10 (commencing
with Section 11000) of the Health and Safety Code), when all of the
following apply:
(1) The drugs or devices are furnished or ordered incidentally to
the provision of any of the following:
(A) Family planning services, as defined in Section 14503 of the
Welfare and Institutions Code.
(B) Routine health care or perinatal care, as defined in
subdivision (d) of Section 123485 of the Health and Safety Code.
(C) Care rendered, consistent with the certified nurse-midwife's
educational preparation or for which clinical competency has been
established and maintained, to persons within a facility specified in
subdivision (a), (b), (c), (d), (i), or (j) of Section 1206 of the
Health and Safety Code, a clinic as specified in Section 1204 of the
Health and Safety Code, a general acute care hospital as defined in
subdivision (a) of Section 1250 of the Health and Safety Code, a
licensed birth center as defined in Section 1204.3 of the Health and
Safety Code, or a special hospital specified as a maternity hospital
in subdivision (f) of Section 1250 of the Health and Safety Code.
(2) The drugs or devices are furnished or ordered by a certified
nurse-midwife in accordance with standardized procedures or
protocols. For purposes of this section, standardized procedure means
a document, including protocols, developed and approved by the
supervising physician and surgeon, the certified nurse-midwife, and
the facility administrator or his or her designee. The standardized
procedure covering the furnishing or ordering of drugs or devices
shall specify all of the following:
(A) Which certified nurse-midwife may furnish or order drugs or
devices.
(B) Which drugs or devices may be furnished or ordered and under
what circumstances.
(C) The extent of physician and surgeon supervision.
(D) The method of periodic review of the certified nurse-midwife's
competence, including peer review, and review of the provisions of
the standardized procedure.
(3) If Schedule II or III controlled substances, as defined in
Sections 11055 and 11056 of the Health and Safety Code, are furnished
or ordered by a certified nurse-midwife, the controlled substances
shall be furnished or ordered in accordance with a patient-specific
protocol approved by the treating or supervising physician and
surgeon. For Schedule II controlled substance protocols, the
provision for furnishing the Schedule II controlled substance shall
address the diagnosis of the illness, injury, or condition for which
the Schedule II controlled substance is to be furnished.
(4) The furnishing or ordering of drugs or devices by a certified
nurse-midwife occurs under physician and surgeon supervision. For
purposes of this section, no physician and surgeon shall supervise
more than four certified nurse-midwives at one time. Physician and
surgeon supervision shall not be construed to require the physical
presence of the physician, but does include all of the following:
(A) Collaboration on the development of the standardized procedure
or protocol.
(B) Approval of the standardized procedure or protocol.
(C) Availability by telephonic contact at the time of patient
examination by the certified nurse-midwife.
(b) (1) The furnishing or ordering of drugs or devices by a
certified nurse-midwife is conditional on the issuance by the board
of a number to the applicant who has successfully completed the
requirements of paragraph (2). The number shall be included on all
transmittals of orders for drugs or devices by the certified
nurse-midwife. The board shall maintain a list of the certified
nurse-midwives that it has certified pursuant to this paragraph and
the number it has issued to each one. The board shall make the list
available to the California State Board of Pharmacy upon its request.
Every certified nurse-midwife who is authorized pursuant to this
section to furnish or issue a drug order for a controlled substance
shall register with the United States Drug Enforcement
Administration.
(2) The board has certified in accordance with paragraph (1) that
the certified nurse-midwife has satisfactorily completed at least six
months of physician and surgeon supervised experience in the
furnishing or ordering of drugs or devices and a course in
pharmacology covering the drugs or devices to be furnished or ordered
under this section. The board shall establish the requirements for
satisfactory completion of this paragraph.
(3) A copy of the standardized procedure or protocol relating to
the furnishing or ordering of controlled substances by a certified
nurse-midwife shall be provided upon request to any licensed
pharmacist who is uncertain of the authority of the certified
nurse-midwife to perform these functions.
(4) Certified nurse-midwives who are certified by the board and
hold an active furnishing number, who are currently authorized
through standardized procedures or protocols to furnish Schedule II
controlled substances, and who are registered with the United States
Drug Enforcement Agency shall provide documentation of continuing
education specific to the use of Schedule II controlled substances in
settings other than a hospital based on standards developed by the
board.
(c) Drugs or devices furnished or ordered by a certified
nurse-midwife may include Schedule II controlled substances under the
California Uniform Controlled Substances Act (Division 10
(commencing with Section 11000) of the Health and Safety Code) under
the following conditions:
(1) The drugs and devices are furnished or ordered in accordance
with requirements referenced in paragraphs (2) to (4), inclusive, of
subdivision (a) and in paragraphs (1) to (3), inclusive, of
subdivision (b).
(2) When Schedule II controlled substances, as defined in Section
11055 of the Health and Safety Code, are furnished or ordered by a
certified nurse-midwife, the controlled substances shall be furnished
or ordered in accordance with a patient-specific protocol approved
by the treating or supervising physician and surgeon.
(d) Furnishing of drugs or devices by a certified nurse-midwife
means the act of making a pharmaceutical agent or agents available to
the patient in strict accordance with a standardized procedure or
protocol. Use of the term "furnishing" in this section shall include
the following:
(1) The ordering of a drug or device in accordance with the
standardized procedure or protocol.
(2) Transmitting an order of a supervising physician and surgeon.
(e) "Drug order" or "order" for purposes of this section means an
order for medication or for a drug or device that is dispensed to or
for an ultimate user, issued by a certified nurse-midwife as an
individual practitioner, within the meaning of Section 1306.03 of
Title 21 of the Code of Federal Regulations. Notwithstanding any
other provision of law, (1) a drug order issued pursuant to this
section shall be treated in the same manner as a prescription of the
supervising physician; (2) all references to "prescription" in this
code and the Health and Safety Code shall include drug orders issued
by certified nurse-midwives; and (3) the signature of a certified
nurse-midwife on a drug order issued in accordance with this section
shall be deemed to be the signature of a prescriber for purposes of
this code and the Health and Safety Code.