NEW JERSEY REGISTER
VOLUME 33, NUMBER 22
MONDAY, DECEMBER 3, 2001
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF MEDICAL EXAMINERS
CERTIFIED NURSE MIDWIFES: PRESCRIPTIVE AUTHORITY


Proposed Amendment: N.J.A.C. 13:35-2A.11

Authorized By: State Board of Medical Examiners, William Roeder, Executive Director.

Authority: N.J.S.A. 45:9-2 and 45:10-22.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2001-448.

Submit comments by February 1, 2002 to:

William Roeder, Executive Director
State Board of Medical Examiners
PO Box 183
Trenton, NJ 08625-0183

The agency proposal follows:

Summary

Pursuant to its rulemaking powers found in N.J.S.A. 45:9-2, and specifically N.J.S.A. 45:10-22, the State Board of Medical Examiners (the Board) proposes amendments to N.J.A.C. 13:35-2A.11 concerning the educational requirements of certified nurse midwives to prescribe medication.

N.J.A.C. 13:35-2A.11 sets forth the standards a certified nurse midwife must satisfy in order to obtain Board authorization to prescribe drugs. N.J.A.C. 13:35-2A.11(a)3 outlines the educational requirements a certified nurse midwife must complete if he or she wishes to obtain Board authorization to prescribe drugs. The rule currently requires satisfactory completion of 30 contact hours, in a pharmacology course, as defined by the National Task Force on the Continuing Education Unit. The rule is amended to remove reference to the National Task Force on the Continuing Education Unit because the Board believes that the term "contact hour" is a generally recognized term. The rule is further amended to require that the certified nurse midwife take a pharmacology course from a college or university which is accredited by an accrediting agency that is recognized by the United States Department of Education. This course must include instruction in the fundamentals of pharmacology and therapeutics, including principles and terminology of pharmaco-dynamics and pharmaco-kinetics.

N.J.A.C. 13:35-2A.11(b) is a new subsection which will permit a certified nurse midwife, who has prescriptive authorization in another state, to qualify for prescriptive authorization in New Jersey even if he or she took the required pharmacology course more than two years prior to the date of application. Such an applicant would be required to submit proof to the Committee that he or she currently holds prescriptive authorization in another state and is not subject to any disciplinary restrictions, is a registered professional nurse in New Jersey, is licensed as a certified nurse midwife in New Jersey and has completed a 30-hour pharmacology course offered by a college or university.

The current provisions at N.J.A.C. 13:35-2A.11(b) are proposed for recodification as subsection (c) and are amended to no longer require seven contact hours of continuing education requirement for certified nurse midwives who have prescriptive authorization.

The remaining subsections (c) through (f) are recodified as (d) through (g).

As the Board has provided a 60-day comment period on this notice of proposal, this notice is excepted from the rulemaking calendar requirement pursuant to N.J.A.C. 1:30-3.3(a)5.

Social Impact

The Board believes that the proposed amendment will have a positive impact in that it clarifies what education a certified nurse midwife must obtain before he or she will be authorized by the Board to prescribe drugs. The amendment allows certified nurse midwives who have prescriptive authorization in another state to qualify for prescriptive authorization in New Jersey even if the nurse midwife took a pharmacology course more than two years prior to application. This amendment will enable certified nurse midwives who have been practicing with prescriptive authorization in another state to practice with prescriptive authorization in New Jersey, without requiring said certified nurse midwife to retake training that would otherwise be required for certified nurse midwives seeking initial authorization to prescribe drugs.

Economic Impact

The Board does not expect that the proposed amendment will economically impact licensees or the general public. The amendment merely outlines what education a certified nurse midwife must obtain before the certified nurse midwife will be eligible for authorization to prescribe drugs. While a pharmacology course sponsor may charge students a fee to attend the course, the Board does not determine the cost of these courses.

Federal Standards Statement

A Federal standards analysis is not required because the proposed amendment does not involve any Federal standards or requirements.

Jobs Impact

The Board does not believe that the proposed amendment will result in the generation or loss of jobs in the State.

Agriculture Industry Impact

The Board does not believe that the proposed amendment will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

If, for the purposes of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., the approximately 350 licensed certified nurse midwives are deemed "small businesses," then the following analysis applies:

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the proposed amendment including the kinds of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the amendment with an indication of the varying impact on small businesses of differing types and sizes and to outline the manner in which the rules have been designed to minimize any adverse economic impact upon small businesses.

The costs imposed on small businesses by the amendment are the same costs that are imposed on all businesses as outlined in the Economic Impact statement above.

The Board does not believe that licensees will need to employ any professional services to comply with the requirements of the proposed amendment.

The proposed amendment does not impose any recordkeeping or reporting requirements. The amendment does, however, impose a compliance requirement in that certified nurse midwives who wish to obtain Board authorization to prescribe drugs must take educational courses as outlined in the rule. The Board believes that since the proposed amendment provides for the effective training of certified nurse midwives who wish to prescribe drugs, the amendment should be applied uniformly to all licensees.

Full text of the proposal 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 <<-in an accredited institution of higher education approved by the Commission on Higher Education or acceptable to the Board (hereinafter, "qualifying education").->> <<+ 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.+>> <<-Qualifying education must->> <<+The pharmacology course shall+>> have been <<-obtained->> <<+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.+>>

<<-(b)->><<+(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 <<- prescribed->> <<+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 <<-in good standing; and->><<+.+>>

<<-3. Evidence of the satisfactory completion of seven contact hours (as defined by the National Task Force on the Continuing Education Unit) of continuing education, or equivalent education, in pharmacology and drug management (hereinafter "continuing education"). Continuing education must have been obtained within the two-year period immediately preceding the date of the renewal application.->>

Recodify existing (c)-(e) as <<+(d)-(f)+>> (No change in text.)

<<-(f)->><<+(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 <<-(f)8->><<+(g)8+>> above.


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Posted December 3, 2001