The Board of Nursing approved the following actions regarding Chapter 36 Board of Nursing Administrative Code (Rules):
Public Hearing: April 4, 2023 @ 10:00 am
Comment Period Ends: May 15, 2023
Session Law 2021-3, Section 2.9.(a), permits “immunizing pharmacists” (as defined by statute) to administer long-acting injectable medications to adults pursuant to prescription. The law became effective on October 1, 2021, and the Board of Pharmacy adopted a temporary rule (21 NCAC 46 .2514) to implement the section, as permitted by the statute. Because of the placement of the long-acting injectable authority in the “immunizing pharmacist” statute (90-85.15B), a permanent rule governing the administration of these drugs was required to be approved by both the Board of Pharmacy and the Medical Board. The Board of Pharmacy proposed adoption of a permanent version of Rule .2514. The proposed rule put appropriate standards in place for training, recordkeeping and other requirements needed to ensure that the drugs are administered with adequate protection of the public health, safety, and welfare (NC Register, Volume 36, Issue 16, pages 1393).After successfully completing the rulemaking process, amended rule 21 NCAC 46 .2507 and permanent rule 21 NCAC 46 .2514 became effective July 1, 2022.The Board of Nursing Administrative Code 21 NCAC 36 .0221 (e) reads: “Pharmacists may administer drugs in accordance with 21 NCAC 46 .2507.” Based on adoption of permanent rule 21 NCAC 46 .2514, the Board of Nursing rule needs to be amended to include the new reference.
Proposed Amendments for 21 NCAC 36 .0120, .0220, .0233 .0302, .0303, .0309, .0317, .0318, .0320, .0321, .0322, .0323. The Education and Practice Committee, with the goal of assuring that the NCBON Administrative Code (Rules) regulating pre-licensure nursing education programs are current, consistent, and conducive to the preparation of nurses able to provide safe, effective, care now and in the future, carefully reviewed the literature, resources from NCSBN, rules and practices of other nursing regulatory bodies, and testimony from NC education, regulatory and practice stakeholders.
Submissions for Permanent Rule
Clinical Nurse Specialists (CNSs) can be recognized in North Carolina without national certification. Currently, CNSs may submit evidence of meeting requirements equivalent to national certification if no clinical nurse specialist certification is available in the specialty. A portfolio process has been used if no national CNS certification is available in the CNS’s specialty and the CNS completed their academic preparation prior to 07-01-2015. No portfolio has been submitted since August 2020. The Board approved amendments to Rules to eliminate the portfolio route for new CNS recognition and align certification and continuing education with the requirements for other Advanced Practice Registered Nurse roles of Certified Registered Nurse Anesthetist, Certified Nurse Midwives and Nurse Practitioners.
Continuing Education (CE), does not align with requirements for Nurse Practitioners nationally nor does it align with the continuing education requirements for North Carolina Physician’s Assistants under a similar structure. North Carolina requires more continuing education of their Nurse Practitioners than any other state, with Illinois the closest state requiring 40 hours annually. Additionally, Nurse Practitioners in North Carolina are required to have more continuing education than any other licensed healthcare professional in this state. The clinical pharmacist is the next closest in requiring 35 hours annually. The proposed amendment would require 50 contact hours of continuing education every 2 years as opposed to every year. This amendment also specifies maintaining national certification as defined in 21 NCAC .0801(8) will meet the continuing education requirements for Nurse Practitioners biennially.
At the outset of the COVID-19 pandemic in March 2020, the North Carolina Secretary of Health and Human Services and the State Health Director proposed that the Boards of Nursing, Pharmacy and the Medical Board adopt a COVID-19 Drug Preservation Rule. At that time, there were many drugs with a suspected potential to treat COVID-19. The rule was drafted to ensure that a supply of those drugs also remained available for patients who were prescribed those drugs for other conditions. On August 15, 2022, the declared state of emergency ended in North Carolina. With that change, the North Carolina Secretary of Health and Human Services and the State Health Director have agreed that there is no current need for this rule. The Board of Nursing understands that the Medical Board and the Board of Pharmacy are considering repealing their analogous rules.
Public Hearings are held at the North Carolina Board of Nursing office located at 4516 Lake Boone Trail, Raleigh, NC 27607.
Persons may submit objections or public comment related to these rules by contacting:
Angela Ellis, Chief Administrative Officer/APA Coordinator
North Carolina Board of Nursing
P.O. Box 2129
Raleigh, NC 27602-2129
“Public comment” is defined by § 150B-21.3A(a)(5) as a written objection to all or part of a rule. Additionally, pursuant to § 150B-21.3A(c)(2), in order for the Rules Review Commission to determine whether the public comment has merit, the public comment must address the specific substance of the rule and address any of the standards of Commission review, as set forth in § 150B-21.9(a).
Procedure for Subjecting a Proposed Rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission. If the Rules Review Commission receives written and signed objections in accordance with § 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in § 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, call a Commission staff attorney at (919) 431-3000.
