Advanced registered nurse practitioners (“ARNPs”) will soon have new Iowa Board of Nursing (“the Board”) rules to comply with. The rules, ARC 4132C, have been adopted by the Board; however, they are currently undergoing the rulemaking process and are not yet finalized. ARC 4132C will replace the current rules found at 655 Iowa Administrative Code chapter 7. In light of ARC 4132C, ARNPs should be particularly cognizant of licensure requirements, scope of practice issues, prescribing of controlled substances, and compliance with the Prescription Monitoring Program (“PMP”).
Licensure requirements for ARNPs are detailed in a new section of the rules. This section provides further detail than the current rules in addressing roles and certifications of ARNPs. Specifically, the rules set forth certain population foci that require additional certification:
1. Women’s health/gender-related
2. Family (individual across the lifespan)
3. Psychiatric mental health
4. Adult/gerontology
5. Pediatrics
6. Neonatal
Once the appropriate applications are processed with the Board and an ARNP is licensed in his or her respective population focus, an ARNP shall practice only within the scope of that population focus and in compliance with the applicable standard of care. ARC 4132C provides that an ARNP may:
1. Assess health status;
2. Obtain a relevant health and medical history;
3. Perform physical examinations;
4. Order preventive and diagnostic procedures;
5. Formulate a differential diagnosis;
6. Develop a treatment plan;
7. Receive third-party reimbursement;
8. Maintain hospital privileges; and
9. Promote health maintenance.
Although the Board provides that an ARNP has the authority to practice according to the above-stated activities, an ARNP must still consider whether those activities fall within the extent of the ARNP’s education, experience, and respective population focus.
An example of one important scope of practice consideration is whether it is proper for an ARNP to prescribe, administer, or dispense controlled substances. This practice falls within the scope of practice of an ARNP, however, an analysis should be done to determine whether a specific individual has the authority based on his or her education, experience, and population focus in order to avoid potential disciplinary action by the Board. If an ARNP prescribes, administers, or dispenses controlled substances within the scope of his or her practice, then the PMP must be utilized according to the Board of Nursing, Board of Pharmacy, and any other applicable law.
As these rules are not yet finalized, we will continue to monitor any additional revisions to ARC 4132C and how these may affect an ARNP’s practice. If you have questions about how ARC 4132C may apply to your practice, please contact any BrownWinick attorney in the Health Law Practice Group.
The Iowa Board of Nursing has posted ARC 4132C with highlighted amendments in response to public comments here: https://nursing.iowa.gov/whats-new/board-votes-adopt-arc-4132c-chapter-7-advanced-registered-nurse-practitioners.