It is enacted by the General Assembly as follows:
SECTION 1. Section 5-34-3 of the General Laws in Chapter 5-34 entitled "NURSES" is hereby amended to read as follows:
5-34-3. Definitions. --
(a) "Approval" means: process whereby the board of nursing evaluates and grants official recognition to basic nursing education programs which meet established criteria and standards.
(b) "Certified registered nurse practitioner" is an {DEL expanded DEL} {ADD advanced ADD} role utilizing independent knowledge of physical assessment and management of health care and illnesses. The practice includes prescriptive privileges. The practice includes collaboration with other licensed health care professionals including but not limited to physicians, pharmacists, podiatrists, dentists and nurses.
(c) "Health" means: optimum well-being.
(d) "Health" care means: those services provided to promote the optimum well-being of individuals.
(e) "Licensed" means status of qualified individuals who have completed a designated process by which the board of nursing grants permission to individuals accountable and/or responsible for the practice of nursing and to engage in that practice, prohibiting all others from legally doing so.
(f) "Nursing" means the provision of services that are essential to the promotion, maintenance, restoration of health throughout the continuum of life. It provides care and support of individuals and families during periods of wellness, illness, and injury, as well as incorporates the appropriate medical plan of care as prescribed by a duly licensed physician, dentist, or podiatrist. It is a distinct component of health services. Nursing practice is based on specialized knowledge, judgment, and nursing skills acquired through educational preparation in nursing and in the biological, physical, social, and behavioral sciences.
(g) "Practical nursing" is practiced by licensed practical nurses (L.P.N.s).It is an integral part of nursing based on a knowledge and skill level commensurate with education. It includes promotion, maintenance, and restoration of health and utilizes standardized procedures leading to predictable outcomes which are in accord with the professional nurse regimen under the direction of a professional nurse. In situations where professional nurses are not employed, the licensed practical nurse functions under the direction of a duly licensed physician, dentist, or podiatrist. Each L.P.N. is responsible for the nursing care rendered.
(h) "Professional nursing" is practiced by registered nurses (R.N.s). The practice of professional nursing is a dynamic process of assessment of an individual's health status, identification of health care needs, determination of health care goals with the individual and/or family participation and the development of a plan of nursing care to achieve these goals. Nursing actions, including teaching and counseling, are directed toward the promotion, maintenance, and restoration of health and evaluation of the individual's response to nursing actions and the medical regimen of care. The professional nurse provides care and support of individuals and families during periods of wellness and injury, as well as incorporating where appropriate, the medical plan of care as prescribed by a duly licensed physician, dentist or podiatrist or other licensed health care providers authorized by law to prescribe. Each R.N. is directly accountable and responsible to the consumer for the nursing care rendered.
(i) "Psychiatric and mental health nurse clinical specialist" is an {DEL expanded DEL} {ADD advanced ADD}role utilizing independent knowledge and management of mental health and illnesses. {ADD The practice including prescription privileges of certain legend medications and controlled substances from Schedule IV. ADD} The practice may include collaboration with other licensed health care professionals, including but not limited to psychiatrists, psychologists, physicians, pharmacists, and nurses. The psychiatric and mental health clinical specialist {DEL is DEL} {ADD has a ADD} masters-{DEL prepared DEL} {ADD degree in nursing ADD}, has an active license as a registered nurse and is certified by a national body as approved by the Rhode Island board of nurse registration and nursing education.
SECTION 2. Chapter 5-34 of the General Laws entitled "NURSES" is hereby amended by adding thereto the following section:
{ADD5-34-41. Process for prescriptive privileges of the psychiatric and mental health nurse clinical specialist. -- ADD{ {ADD Prescriptive privileges for the psychiatric and mental health nurse clinical specialist:
(a) Shall be granted under the governance and supervision of the division of professional regulations, board of nurse registration and nurse education; and
(b) Shall include prescription of certain psychotropic and certain legend medications; and prescription of controlled substances from Schedule IV, that shall be set forth in regulations by the director with the advice and consent of the formulary committee established by this section; and
(c) Shall not include controlled substances from Schedule I, II, III and V and those certain legend medications not otherwise included in subsection (b) of this section.
The director of the department of health shall establish a formulary committee to develop a formulary to carry out the provisions of this section. The formulary shall be updated annually by the formulary committee. Each setting may further restrict the formulary according to their own protocols. Said committee shall consist of two (2) psychiatrists from a list submitted by the R.I. Medical Society, two (2) psychiatric and mental health nurse clinical specialists, from a list submitted by the R.I. State Nurses Association, one (1) pharmacist, from a list submitted by the R.I.Pharmacists Association, and one (1) who shall be the department of health's chair of the board of pharmacy or designee. The committee shall submit a completed formulary to the director of the department of health of the state of R.I. by September 1, 1997.
Each committee member shall initially be appointed for a one (1) year term by the director of the department of health. At the expiration of the one (1) year term, one (1) psychiatrist shall be appointed for a three (3) year term and one (1) psychiatrist shall be appointed for a two (2) year term; one (1) psychiatric and mental health nurse clinical specialist shall be appointed for a three (3) year term and one (1) psychiatric and mental health nurse clinical specialist shall be appointed for a two (2) year term; the pharmacists shall be appointed to a three (3) year term. Subsequently, each appointment shall be for three (3) years with no member serving more than two (2) consecutive three (3) year terms.
A psychiatric and mental health nurse clinical specialist as stated in section 5-34-3 of the general laws of the state of Rhode Island, shall be permitted to prescribe from the formulary established by the formulary committee in accordance with annually updated guidelines, written in collaboration with the medical director or physician consultant of their individual establishments. ADD}
{ADD Provided, however, that a psychiatric and mental health nurse clinical specialist in independent practice shall not have prescriptive privileges.
To qualify for prescriptive privileges a psychiatric and mental health nurse clinical specialist, as stated in section 5-34-3 of the general laws of Rhode Island, shall submit on forms provided by the board of nurse registration and nursing education, verified by oath, that the applicant has evidence of completion of thirty (30) hours of education in pharmacology of psychotropic drugs and certain legend medications within the three (3) year period immediately prior to date of application. To maintain prescriptive privileges the psychiatric and mental health nurse clinical specialist must submit upon request of the board of nurse registration and nursing education evidence of thirty (30) hours continuing education in pharmacology of psychotropic drugs every six (6) years. ADD}
SECTION 3. This act shall take effect upon passage.
