STATE BOARD OF NURSING [49 PA. CODE CH. 21] CRNP Prescriptive Authority Fees [33 Pa.B. 4462] The State Board of Nursing (Board) proposes to amend § 21.253 (relating to fees) by implementing certain application and renewal fees for certified registered nurse practitioners who wish to prescribe and dispense drugs, to read as set forth in Annex A.
Effective Date
The proposed amendment will be effective upon publication of the final-form rulemaking in the Pennsylvania Bulletin.
Statutory Authority
The proposed amendment is authorized under section 11.2(a) and (d) of the Professional Nursing Law (act) (63 P. S. § 221.2(a) and (d)).
Background and Purpose
Under the act of December 9, 2002 (P. L. 1567, No. 206), the final-form rulemaking jointly promulgated by the State Boards of Medicine and Nursing, at 30 Pa.B. 5943 (November 18, 2000), established that qualified CRNPs may prescribe and dispense drugs under section 8.3 of the Professional Nursing Law (63 P. S. § 218.3) and §§ 21.283--21.287 (relating to CRNP practice). A CRNP may not prescribe and dispense drugs without prior approval by the Board. CRNPs wishing to prescribe drugs are required to apply for prescriptive authority approval by submitting an application to the Board demonstrating successful completion of not less than 45 hours of coursework in advanced pharmacology and a signed, written collaborative agreement between the prescribing CRNP and a supervising physician. See §§ 21.283(2) and 21.285 (relating to prescribing and dispensing drugs; and collaborative agreement). Successful applicants are issued prescriptive authority approval.
Sections 11.2(a) and (d) of the act require the Board to set fees by regulation so that revenues meet or exceed expenditures over a biennial period. General operating expenses of the Board are funded through biennial license renewal fees. Expenses related to applications or services which are provided directly to individual licensees or applicants are excluded from general operating revenues and are funded through fees in which the actual cost of providing the service forms the basis for the fee. Actual cost calculations are based upon the following formula:
Number of minutes to perform the function
×
Pay rate for the classification of the personnel performing the function
+
A proportionate share of administrative overheadAs a result of the regulations providing for prescriptive authority, the Board proposes to implement three new fees for the application for prescriptive authority, each additional collaborative agreement for prescriptive authority and biennial renewal of prescriptive authority. The application and additional collaborative agreement fees are proposed to reflect the actual cost of providing these services. The biennial renewal fee will ensure that the current revenues raised by fees, fines and civil penalties are sufficient to meet projected expenditures and that adequate revenues are raised to meet the required enforcement efforts, as the Board is required by law to support its operations from revenue it generates from fees, fines and civil penalties.
In this proposal, fees for the services identified would be implemented to allocate costs to those who use the service or application. The Board would continue to apportion its enforcement and operating costs to the general licensing population when the Board makes its biennial reconciliation of revenues and expenditures.
Description of Proposed Amendments
The following table outlines the affected application fees and proposed changes:
Current Proposed Application/Service Fee Fee Application for prescriptive
authoritynone $90 Additional collaborative
agreement for prescriptive
authoritynone $75 Biennial renewal of prescriptive
authoritynone $50 Fiscal Impact and Paperwork Requirements
The proposed amendment will have no adverse fiscal impact on the Commonwealth or its political subdivisions. The fees will have a modest fiscal impact on those members of the private sector who apply for services from the Board. The proposed amendment will impose no additional paperwork requirements upon the Commonwealth, political subdivisions or the private sector.
Sunset Date
The Board continuously monitors the cost effectiveness of its regulations. Therefore, no sunset date has been assigned.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on August 26, 2003, the Board submitted a copy of this proposed rulemaking to the Independent Regulatory Review Commission (IRRC), the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. In addition to submitting the proposed rulemaking, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board. A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act (71 P. S. § 745.5(g)), if IRRC has comments, recommendations or objections regarding any portion of the proposed rulemaking, it will notify the Board approximately 30 days from the close of the public comment period. The notification will specify the regulatory review criteria that have not been met. The Regulatory Review Act specifies detailed procedures for review of comments, recommendations and objections by the Board, the General Assembly and the Governor prior to publication of the regulations.
Public Comment
Interested persons are invited to submit written comments, recommendations or objections regarding this proposed rulemaking to Ann Steffanic, Administrative Assistant, State Board of Nursing, P. O. Box 2649, Harrisburg, PA 17105-2649, within 30 days following publication of this proposed rulemaking in the Pennsylvania Bulletin. Reference No. 16A-5116 (Prescriptive Authority Fees) when submitting comments.
JANET HUNTER SHIELDS, MSN, CRNP, CS,
ChairpersonFiscal Note: 16A-5116. No fiscal impact; (8) recommends adoption.
Annex A TITLE 49. PROFESSIONAL AND
VOCATIONAL STANDARDSPART I. DEPARTMENT OF STATE Subpart A. PROFESSIONAL AND
OCCUPATIONAL AFFAIRSCHAPTER 21. STATE BOARD OF NURSING Subchapter C. CERTIFIED REGISTERED
NURSE PRACTIONERSGENERAL PROVISIONS § 21.253. Fees.
The following fees are charged by the Board:
* * * * * Application for prescriptive authority $90 Each additional collaborative agreement for
prescriptive authority$75 Biennial renewal of prescriptive authority $50 [Pa.B. Doc. No. 03-1745. Filed for public inspection September 5, 2003, 9:00 a.m.]
