NEW
JERSEY REGISTER
VOLUME
35, NUMBER 1
MONDAY, JANUARY 6, 2003
RULE ADOPTION
LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF MEDICAL EXAMINERS
CERTIFIED NURSE MIDWIVES; PRESCRIPTIVE AUTHORITY
Adopted
Amendment: N.J.A.C. 13:35-2A.11
Proposed:
December 3, 2001 at 33 N.J.R. 4063(a).
Adopted:
May 8, 2002 by the State Board of Medical Examiners, William
V. Harrer, President.
Filed:
November 27, 2002 as R.2003 d.1, with substantive changes
not requiring additional public notice and comment (see
N.J.A.C. 1:30-6.3).
Authority:
N.J.S.A. 45:9-2 and 45:10-22.
Effective
Date: January 6, 2003.
Expiration Date: September 20, 2004.
Summary
of Public Comments and Agency Responses:
The
official comment period ended February 1, 2002 and the
Board received 43 comments from the following individuals.
1.
Trinisha Chapman, MPH, SM
2. Tanya Lewellyn
3. Karen Jefferson, CM, NYU, Bellevue, Gouverneur Midwifery
Service
4. Christopher Mulhauser, Engineering Technician
5. Jeffrey Cassaro
6. Emily Zuzik
7. Whitney Hall, Student CM
8. Diane M. Presnick, CNM, BS
9. Benjamin Ratliff
10. Ann J. Aulisi
11. Marcus Kettles, Program Director Unity of New York
12. Shauna M. Batty
13. Rose Pach
14. Judy Berk Levine, CNM
15. Peter Beeton
16. Anthony Yadao, MD
17. John Cahill, MD
18. Erica Ciancia, CNM
19. Rizza Cea, CNM
20. Lesley Sansolo, CNM
21. Laurie Silberstein, CM
22. Sarah Seroussi, Graphic Designer
23. Dawn Sheggeby, Director, Post Production A Day in
the Life of Africa
24. Deborah Cibelli, CNM
25. Jennifer Castle, Concerned Citizen
26. Russel S. Medbery, Jr., MSN, FNP, CNM
27. Angela Ferrari, CNM
28. Sage Clark, CM, MS
29. Bevin Cahill, CM
30. Katherine Carr, CNM, PhD, Faculty, State University
of New York, Downstate Midwifery Education Program
31. Nancy Campau, MS, CNM
32. Leslie Cashon, CNM
33. Rochel Lieberman, CM
34. Sabrina Hellman, CNM
35. Carol Bues, CNM
36. Jennifer Drawbridge, CNM, MSN, Secretary, Maine Chapter,
American College of Nurse-Midwives
37. Emalie Gibbons-Baker, CNM, MSM
38. Sadie Jones, Student Nurse Midwife, SUNY Downstate
Medical Center
39. Susanna Westbrook, Student Nurse Midwife, Yale School
of Nursing
40. Harriet W. McKinley, CNM
41. Susan Brockmann, CM, MPH
42. Monika Narweska
43. Elizabeth Emma
COMMENT:
The commenters believe that the Board should allow certified
midwives (CM) to obtain prescriptive authority. The commenters
contend that a CM meets all the requirements of the amended
rule, except for being a registered professional nurse.
The commenters argue that the American College of Nurse-Midwives,
the American Certifying Council of the American College
of Midwives and the American College of Obstetricians
and Gynecologists consider a CM as equal to a certified
nurse midwife (CNM). The education, certifying mechanism
and scope of practice are the same for CMs and CNMs. The
commenters argue that other states that license CMs have
given them prescriptive authority and that the Drug Enforcement
Agency provides DEA numbers to CMs. The commenters request
that the Board provide CMs with prescriptive authority.
RESPONSE:
N.J.S.A. 45:10-17 et seq. authorizes CNMs, who meet the
statutory requirements, to prescribe drugs. The statute
specifically states that certified nurse midwives may
be granted prescriptive authority. The statute is silent
as to certified midwives. Absent specific legislative
authorization, the Board may not grant prescriptive authority
to certified midwives as the commenters request.
Summary
of Agency-Initiated Changes:
Upon
review of the proposal, the Board has decided to not adopt
the deletion of the phrases "(as defined by the National
Task Force on the Continuing Education Unit)" or "pharmacology
or" in N.J.A.C. 13:35-2A.11(a). These phrases are included
in N.J.S.A. 45:10-19, and the Board believes that the
rule should mirror the language in that statute.
Federal
Standards Statement
A Federal standards analysis is not required because the
adopted amendment does not involve any Federal standards
or requirements.
Full
text of the adoption follows:
<<
NJ ADC 13:35-2A.11 >>
13:35-2A.11
Prescriptive authorization (a) A CNM who is currently
registered with the Board of Medical Examiners may apply
for authorization to prescribe drugs (as used within this
section, the term "drugs" shall include drugs, medicine
and devices). The CNM shall make application on forms
prescribed by the Board and shall demonstrate:
1.-2.
(No change.)
3.
Evidence of satisfactory completion of a minimum of 30
contact hours << + (as defined by the National Task Force
on the Continuing Education Unit)+>> in << +pharmacology
or+>> a pharmacology course offered by a college or university
accredited by an accrediting association recognized by
the U.S. Department of Education. The pharmacology course
shall include instruction in fundamentals of pharmacology
and therapeutics including principles and terminology
of pharmaco-dynamics and pharmaco-kinetics. The pharmacology
course shall have been completed within the two years
immediately preceding the date on which the application
is made.
(b)
Notwithstanding (a) above, a CNM who holds prescriptive
authorization in another state shall be authorized to
prescribe drugs in New Jersey, even if the pharmacology
course was completed more than two years prior to the
date on which the certified nurse midwife makes application
for authorization to prescribe drugs in New Jersey, if
the CNM submits proof to the Committee that he or she:
1.
Holds current prescriptive authorization, without disciplinary
restrictions, in another state;
2.
Is a registered professional nurse in New Jersey;
3.
Is licensed as a CNM in New Jersey; and
4.
Has completed 30 contact hours in a pharmacology course
offered by a college or university accredited by an accrediting
association recognized by the U.S. Department of Education.
(c)
Prescriptive authorization obtained pursuant to (a) above
shall be valid for a period of two years. In order to
renew prescriptive authorization, a CNM shall make application
for renewal on forms provided by the Board and shall demonstrate:
1. Current registration with the Board as a CNM; and
2.
A.C.N.M. or A.C.C. certification. Recodify existing (c)-(e)
as (d)-(f) (No change in text.)
(g)
A CNM shall provide the following on all prescription
blanks:
1.-8.
(No change.)
9.
Every prescription blank shall be imprinted with the words
"substitution permissible" and "do not substitute" and
shall contain space for the CNM's initials next to the
chosen option, in addition to the space required for the
signature in (g)8 above.