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Kentucky Board of Nursing procedures  in place for eligible APRNs to request exemption from CAPA-CS

During the 2023 Regular Session, the Governor signed into law Senate Bill (SB) 94. In part, SB 94 amends Kentucky Revised Statutes (KRS) 314.042 to provide for Collaborative Agreement for Prescriptive Authority-Controlled Substances (“CAPA-CS”) exemption for an APRN who has prescribed controlled substances for four years, is in good standing, and meets other statutory requirements.

 

Please be advised, as part of the SB 94, “the review request shall include the payment of a fee set by the board through the promulgation of an administrative regulation.” See Kentucky Acts Chapter 73 (SB 94), Section 1(14)(b)(4). A regulatory fee has not been formally approved by the Kentucky General Assembly and it is not yet definite; however, the Kentucky Board of Nursing (“Board”) has proposed an amendment to Kentucky Administrative Regulation 201 KAR 20:240 to establish a fee of $50 to process the exemption request. An APRN may choose to wait to request the exemption until after the general assembly approves the requested fee, and Board staff anticipates the regulatory process should take 4-6 months.

 

However, please be advised an APRN may choose to request that Board staff process an exemption request at this time, but the APRN must agree to remit the to-be-determined statutory fee when it is ultimately set by the General Assembly; or the APRN may agree to pay $50 toward fee today. Regardless, KBN Staff cannot begin to process the exemption request until the APRN has agreed to pay the fee.

 

Please note the fee is not refundable, and paying the fee does not guarantee that the exemption will be granted.

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HOW TO SUBMIT AN EXEMPTION REQUEST

 

 Log in to your KBN Nurse Portal Account: https://kybn.boardsofnursing.org/kybn

  • Go to the bottom of your Nurse Portal Dashboard to Other Applications and choose Apply. 

    • Select ‘APRN-Exemption from a CAPA-CS (After Four Years) Need Fee.’

      • There is an option within the application to pay now or pay when the regulation 201 KAR 20:057 is in effect.

  • After application is completed, reviewed and approved, all CAPA-CS’ on file will be rescinded.

    • There will be a notification placed on the License Verification Portal stating:

      • Has independent prescriptive authority for controlled substances per KRS 314.042.

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Governor signs SB 94: Law that ends need for CAPA-CS will go into effect in late June

FRANKFORT, Ky. March 23, 2023 -- As the veto period for the Kentucky General Assembly's 2023 Legislative session neared its end, SB 94 was signed by Governor Andy Beshear.  

 

The new law will officially go into effect June 29, 2023.

 

In the meantime, the Board of Nursing will have opportunity to craft and implement regulations for those wishing to obtain a new CAPA-CS and set up procedures for those who wish to be released from the need for a CAPA-CS.

It is estimated that there are over 3000 APRNs who  will be eligible to immediately seek release from CAPA-CS requirements. 

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APRNs are urged to follow KANPNM's listserv and www.kanpnm.org website for news about developments concerning the path and processes to prescribing CAPA-CS independently.

SB 94 passes Ky House 92-1! Bill to end need for CAPA-CS is on way to Governor to be signed into law

FRANKFORT, Ky. -- Big news from the capitol city where KANPNM's bill to end the need for a CAPA-CS passes the State House with a resounding vote of 92-1.

SB 94, sponsored by Senator Julie Raque Adams and carried in the House by Representative Russell Webber moved quickly among the Friday Orders of the Day.  

This epic milestone for APRNs in the state comes after extensive negotiations and collaboration with the Kentucky Medical Association to create policy that moves access to care forward as it strengthens oversight of all prescribers and dispensers through creation of Controlled Substances Prescribing Council.

Agreement between KANPNM and KMA was reached, allowing both groups to appear in support of SB 94 and testify before committees in the Senate and House as a united front.

Dr. Beth Partin's Testimony on SB 94 

I come to you today bearing good news! 

 

After 5 months of frank, honest, respectful, and thoughtful discussions, the Kentucky Association of Nurse Practitioners and Nurse Midwives and the Kentucky Medical Association have come to an agreement on the bill language in SB 94. Thank you to Dr. Swikert, Cory Meadows, and John Cooper for your participation on the negotiation team. As a member of the negotiation team, I can say the tenor of the meetings over the past months were more reflective of the everyday good relationships that physicians and nurse practitioners enjoy and my hope is that our organizations may now move forward with that spirit of cooperation in the future. 

 

These are the key provisions of SB 94

  • APRNs who wish to prescribe scheduled drugs, must maintain a CAPA-CS for 4 years before they will be eligible to prescribe without a CAPA-CS. 

  • In the first year of a CAPA-CS, the APRN and collaborating physician must meet quarterly in person or by video conferencing to review the APRN’s reverse KASPER. 

  • After the first year, the APRN and the physician must meet in person or by video conferencing every 6 months to review the reverse KASPER. 

 

  • After 4 years, APRNs who wish to prescribe without a CAPA-CS, must send a request to KBN. KBN will check to make sure the APRN’s license is in good standing and then notify the APRN in writing that they are no longer required to maintain a CAPA-CS. 

 

  • APRNs who have had a CAPA-CS for 4 or more years may send a request to KBN, after the bill has gone into effect. These APRNs will be grandfathered and allowed to prescribe controlled substances without a CAPA-CS, once their licenses have been reviewed by KBN and found to be in good standing. 

 

The bill also creates the Controlled Substance Prescribing Council that is chaired by the OIG and whose members include a representative from the Office of Drug Control Policy, physicians, APRNs, dentists, an optometrist, podiatrist, and pharmacist.  The function of the Council is to discuss and make recommendations on matters relating to safe and appropriate prescribing and dispensing of controlled drugs. The Council will help to shine light on problem areas in the state so they may be addressed, as well as identify new ways we may improve policies related to prescribing and dispensing controlled substances. The Council is tasked with:

  • reviewing aggregate KASPER data by provider type and county. 

  • making recommendations regarding how to improve KASPER data collection.

  • making recommendations to licensure boards on how to better enforce laws and correct inappropriate prescribing.

  • communicating recommendations to the licensure boards, with the boards required to respond within 90 days to the council’s recommendation.

  • requesting information, if needed, from the licensure boards regarding their investigation and enforcement procedures. 

  • submitting an annual report to the Governor and the LRC.

  • making policy recommendations to the legislative and executive branches to improve prescribing and enforcement practices. 

SB 94 is about improving access to care for Kentuckians and safe prescribing of scheduled drugs. It is good policy. 

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REPRESENTATIVE RUSSELL WEBBER

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ELIZABETH PARTIN, KANPNM PRESIDENT

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DR. SWIKERT, SENATOR JULIE RAQUE ADAMS, BETH PARTIN, CATHY WAITS

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