Monday, February 14, 2011

Florida Medical Directors Association's Recent Position Statement Regarding Nurse Practitioner Prescriptive Rights

Finally, we are getting the support we need in order to take complete care of our patients. I'm still not sure I am in total agreement with the wording of some of the below, but I will take what I can get! Read the below article that I found on the Florida Nurse Practitioner Network website and let me know what you think!

"FMDA Position Statement
Prescriptive Authority for Advanced Registered Nurse Practitioners (ARNPs) and Physician Assistants (PAs) in the State of Florida
The Florida Medical Directors Association (FMDA), in the interest of the highest quality of care for residents in the long-term care continuum (LTCC), is presenting this position statement regarding the prescription of controlled substances by advanced registered nurse practitioners (ARNPs) and physician assistants (PAs) in the state of Florida. FMDA recommends that, with the written permission of his or her collaborating/supervising physician(s) and successful completion of mandatory continuing education that ARNPs and PAs be granted the legal authority to prescribe controlled substances in long-term care settings, including skilled nursing facilities, home care, assisted living, residential care, and hospice programs. These settings are very well-regulated and controlled by current federal and state governance, as well as other credentialing organizations.
Florida and Alabama are currently the only two states where ARNPs and PAs do not have prescribing authority for controlled substances. The other 48 states have given prescribing authority in varying degrees to both of these health care providers, and the evidence shows that their prescribing practice habits have been found to mirror those of their physician colleagues.
FMDA understands that ARNPs and PAs are often the “front line” health-care providers for patients in the LTCC, where pain medications are often indicated. The inability of these health-care providers to prescribe controlled substances can affect the timely administration of medications for the relief of pain and other medical conditions. This has the potential to impact the quality of life for this vulnerable group of patients.
FMDA’s position is that ARNPs and PAs in long-term care settings would be able to prescribe controlled substances only if this was specifically written into their protocol or practice agreement by their collaborating/supervising physician(s). Hence, this would be an option, not a mandate. Individual physicians would ultimately decide which, if any, of the controlled substances could be prescribed by which, if any, ARNPs and PAs in their practice. Furthermore, individual ARNPs/PAs would not be mandated to pursue DEA licensure.
FMDA further proposes that, to further improve quality of care by enhancing the safe and effective prescribing practice of these providers, ARNPs and PAs applying for initial DEA provider numbers in the state of Florida must complete an initial 8-hour controlled substance CME/CEU course. This is a requirement for all prescribers in some states. In addition, all ARNP/PA prescribers would be required to have a 2-hour biennial CME/CEU course on the prescription of controlled substances. This is consistent with current license renewal requirements for Florida physicians (MDs/DOs).
In summary, the Florida Medical Directors Association recommends that the Florida legislature grant prescribing authority of controlled substances to ARNPs and PAs in the LTCC pursuant to fulfilling the CME/CEU requirements and obtaining the specific written permission of their collaborating/supervising physician(s). We believe that this measure would provide for significantly improved access and quality of care for patients in long-term care settings.
Started in 1990, the Florida Medical Directors Association is the official state chapter of the American Medical Directors Association and is a Specialty Society of the Florida Medical Association. It is based in West Palm Beach, Fla.
FMDA represents nearly 250 medical directors, attending physicians, physician assistants, and advanced registered nurse practitioners in Florida’s post acute-care continuum, including sub-acute care, hospice, skilled nursing, and assisted living facilities, as well as in continuing-care retirement communities.
The mission of FMDA is to promote the highest-quality care in the post-acute continuum by providing leadership, professional education, and advocacy."


  1. I guess it's a start, but a really small one compared to the rest of the country, except Alabama.
    It almost feels like they said, let's throw the NP's a bread crumb so they go away. Anybody who works in a clinic, hospital or any acute setting is still restricted from performing their job.

  2. Nurse practitioners need to be given the legal ability to operate independently in all 50 states without a MD on site.. that will bring down costs

  3. It's not all bad. When you look at the big picture. I'm in the process of becoming a Nurse Practitioner and when your butt and career are the line it is somewhat a good thing to have the doctor be there to back up your diagnoses.

    1. Anonymous5:25 AM

      That's what you say now, because you are not practicing. I've been an ARNP for almost 8 years, and its getting a little tiring not able to work independently.

  4. Anonymous9:23 PM

    Have anyone ever thought of presenting a Class Action Suit against the FMA, i.e. Florida Nurses Association, American Academy of Nurse Practitions, etc. It appears odd to me that it has so far taken 17 years with no results to get what other states have had for so long. The states that I previously have held licenses have been way ahead of Florida. How come they could do it and we can't?