As the final days of the Kentucky General Assembly's 2024 Session roll up on the horizon, several key APRN bills continue to make progress along the legislative process.
Members should be alert to notifications and Calls-to-Action by the Association as the pace of bills coming up for votes increases ahead of the end of session.
Stay tuned for more updates and information on the listserv and by text when it is time to advise your legislators as to how to vote on these important policy matters.
Opportunity to Establish Freestanding Birthing Centers in Kentucky
CLICK HERE to read the Talking Points for "The Mary Carol Akers Birth Centers Act."
HB 199 – J. Nemes, K. Bratcher, S. Bratcher, B. Chester-Burton, D. Fister, D. Grossberg, J. Hodgson, C. Massaroni, R. Palumbo, M. Proctor, S. Rawlings, S. Stalker, L. Willner
SB 103 – S. Funke Frommeyer, J. Schickel, J. Adams, C. Armstrong, D. Harper Angel, G. Neal, M. Nemes, R. Thomas, L. Tichenor, R. Webb, G. Williams, M. Wilson
BILL ACTION: HB 199 has cleared the House Licensing, Occupations, & Administrative Regulations Committee and has had its second reading in the House. This bill may be up for a House Floor vote soon.
Modernization of the Kentucky Board of Nursing
HB 459 – K. Moser, R. Raymer, S. Bratcher, B. Chester-Burton, S. Dietz, B. McCool, J. Nemes, R. Palumbo, K. Timoney, W. Williams
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Significantly broadens the number of nursing organization who can nominate nurses to fill KBN seats, including KANPNM who will nominate for 2 NP seats on KBN.
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Assures a better distribution of KBN members among nurses in active clinical practice vs. those in educational settings.
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Creates a provisional APRN applicant license to create work opportunities while the APRN is waiting for final licensure.
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Removes the APRN Council, which is duplicative now since SB 94 passage in 2023.
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Gives KBN greater flexibility in hiring additional personnel.
BILL ACTION: HB 459 was reported unanimously from House Health Services Committee and has passed out of the House, 96-0. It has been assigned to Senate Health Services Committee.
Easing Prior Authorization Constraints on Health Care Providers
HB 317 – K. Moser, R. Duvall, C. Aull, K. Banta, D. Bentley, T. Bojanowski, S. Bratcher, A. Camuel, A. Gentry, D. Grossberg, M. Hart, R. Palumbo, J. Raymond, R. Roberts, T. Smith, S. Stalker, K. Timoney, R. White, W. Williams
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Exemptions would apply to a broad range of healthcare professionals, including APRNs.
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Creates an exemption from Prior Authorization for any healthcare provider who had a 90% approval rate for PA on that particular health care service.
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Eligibility for the exemption would be reviewed every six months.
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Establishes parameters for rescission of the eligibility and appeal rights for the provider.
BILL ACTION: HB 317 has had its second reading and has been returned to the House Banking & Insurance Committee.
Decriminalizing Errors made by Health Care Providers
HB 159 – P. Flannery, J. Nemes, D. Bentley, K. Bratcher, R. Duvall, D. Elliott, D. Lewis, K. Moser, A. Neighbors, R. Raymer, W. Williams
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Health care provider is defined broadly and includes APRNs.
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Protects the health care provider from criminal liability for any harm caused by an act or omission in providing a health care service.
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The only exceptions are for gross negligence or willful, malicious, intentional misconduct.
BILL ACTION: HB 159 was passed out of the House 94-0, was reported favorably from Senate Judiciary committee, received its second reading in the Senate and has been reported to the Rules Committee. Mostly likely up for Senate floor vote soon.
Protecting Health Care Providers from Violence in the Workplace
HB 194 – K. Moser, S. Dietz, C. Aull, D. Bentley, J. Blanton, J. Bray, B. Chester-Burton, C. Fugate, D. Hale, K. King, W. Lawrence, A. Neighbors, R. Palumbo, M. Pollock, P. Pratt, S. Riley, R. Roarx, T. Smith, W. Thomas, K. Timoney, T. Truett, W. Williams
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Defines an attack with a deadly or dangerous weapon or intentionally causing harm as a third-degree felony when committed against a healthcare provider defined in KRS 311.821 which includes APRNs or a person employed or under contract with a hospital.
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Applies if the event occurs on hospital premises or in a hospital-owned outpatient facility.
BILL ACTION: HB 159 passed out of the House 95-0, was reported favorably from Senate Judiciary committee, received its second reading in the Senate and has been reported to the Consent Orders. Mostly likely up for Senate floor vote soon.
Supporting New Mothers and Babies (Momnibus Bill)
HB 10 – K. Moser, N. Tate, C. Aull, K. Banta, D. Bentley, T. Bojanowski, K. Bratcher, G. Brown Jr., L. Burke, E. Callaway, B. Chester-Burton, J. Decker, S. Dietz, R. Duvall, D. Elliott, K. Fleming, D. Grossberg, M. Hart, K. Herron, M. Imes, K. King, A. Neighbors, R. Palumbo, R. Raymer, J. Raymond, R. Roarx, T. Smith, S. Stalker, C. Stevenson, W. Thomas, K. Timoney, T. Truett, L. Willner, N. Wilson, S. Witten
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A very broad and far-reaching bill to support maternal and child health.
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It includes: A lifeline program for mothers dealing with a mental illness or intellectual disability to offer a hot line during business hours for healthcare providers to receive consultation and referral information; require the HANDS program to provide information on lactation, breastfeeding and infant safe sleeping and that mothers can participate in person or via telehealth; require insurers to establish a special enrollment period during pregnancy; require insurers who cover dependents to also cover maternity care; requires Medicaid and KCHIP to cover maternity care; require Medicaid and all insurance carriers to cover lactation consultation and breastfeeding equipment; require Medicaid to study doula certification programs nationally.
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BILL ACTION: HB 10 passed out of the House 90-0, has been received in the Senate and assigned to Senate Health Services Committee.
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.
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.
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
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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.
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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.
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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.
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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.
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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:
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reviewing aggregate KASPER data by provider type and county.
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making recommendations regarding how to improve KASPER data collection.
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making recommendations to licensure boards on how to better enforce laws and correct inappropriate prescribing.
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communicating recommendations to the licensure boards, with the boards required to respond within 90 days to the council’s recommendation.
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requesting information, if needed, from the licensure boards regarding their investigation and enforcement procedures.
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submitting an annual report to the Governor and the LRC.
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making policy recommendations to the legislative and executive branches to improve prescribing and enforcement practices.
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SB 94 is about improving access to care for Kentuckians and safe prescribing of scheduled drugs. It is good policy.
