Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 27 BOARD OF NURSING
10.27.07 Practice
of the Nurse Practitioner
Authority: Health
Occupations Article, §§ 8-205(a)(1), (2), (4), and (5) and 8-302; Health
General Article §§4-208(a), 4-212, 5-601(c)-(e), 5-608(c), 10-616, 10-628,
13-701, 13-704; Family Law Article, §2-301; Transportation Article §§
13-616(a)and (b)and 13- 704, Annotated Code of Maryland; and Chapter 468, 2015
Legislative Session
Notice of Proposed Action
The Secretary of Health and Mental Hygiene
proposes to amend Regulations .01—.03, and .09, repeal Regulations .04 and .08,
amend and recodify Regulations .05—.07 to be Regulations .04—.06, and recodify
Regulations .10 and .11 to be Regulations .07 and .08 under COMAR 10.27.07
Practice of the Nurse Practitioner.
This action was considered and approved by the
Board at its regular meeting on July 28, 2015, notice of which was placed on
the Board’s web site on June 1 and July 1, 2015, pursuant to General Provisions
Article, §3-302(c), Annotated Code of Maryland.
Statement of Purpose
The
purpose of this action is to :
(1) Repeal the definition for “Attestation”;
(2) Define “Mentor in accordance with Chapter 468, 2015 Legislative Session;
(3) Add additional independent functions that nurse practitioners may perform;
(4) Repeal Regulation .04 and the requirement for an attestation;
(5) Repeal Regulation .08 that required a list of nurse practitioner
competencies;
(6) Add the identification of a mentor to application requirements
(7) Add a requirement for continuous national certification;
(8) Require current national certification for renewal; and
(9) Make clarifying, stylistic, and technical changes.
Comparison to Federal Standards
There is
no corresponding federal standard to this proposed action.
Estimate of Economic Impact
The proposed action has no economic impact.
Economic Impact on Small Businesses
The
proposed action has minimal or no economic impact on small businesses.
Impact on Individuals with Disabilities
The
proposed action has no impact on individuals with disabilities.
Opportunity for Public Comment
Comments
may be sent to Michele Phinney, Director, Office of Regulation and Policy
Coordination, Department of Health and Mental Hygiene, 201 West Preston Street,
Room 512, Baltimore, MD 21201, or call 410-767-6499 TTY: 800-735-2258, or email
to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted
through October 19, 2015. A public hearing has not been scheduled.
Economic Impact Statement Part C
A. Fiscal Year in which regulations will become
effective: FY 2016
B. Does the budget for the fiscal year in which
regulations become effective contain funds to implement the regulations?
C. If 'yes', state whether general, special
(exact name), or federal funds will be used:
D. If 'no', identify the source(s) of funds
necessary for implementation of these regulations:
E. If these regulations have no economic impact
under Part A, indicate reason briefly:
The regulations establish independent practice
for nurse practitioners. They do not create any additional financial burden for
nurse practitioners, their employers, or any other entity.
F. If these regulations have minimal or no
economic impact on small businesses under Part B, indicate the reason and
attach small business worksheet.
Small businesses do not regulate nurse
practitioners.
G. Small Business Worksheet:
Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 27 BOARD OF NURSING
10.27.07 Practice of the Nurse Practitioner
Authority: Health Occupations
Article, §§ 8-205(a)(1), (2), (4), and (5) and 8-302; Health General Article
§§4-208(a), 4-212, 5-601(c)-(e), 5-608(c), 10-616, 10-628, 13-701,
13-704; Family Law Article, §2-301; Transportation Article §§ 13-616(a)and
(b)and 13- 704, Annotated Code of Maryland; and Chapter 468, 2015 Legislative
Session
10.27.07.01 (June 5, 2015)
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
[(1)
“Attestation” means a statement of intent.]
[(2)]
(1)—[(4)] (3) (text unchanged)
(4) “Mentor” means a certified nurse
practitioner or physician, licensed in Maryland, who:
(a) Has 3 or more years of clinical
practice experience;
(b) Will be available for advice,
consultation, and collaboration, as needed, for 18 months beginning on the date
an application is received by the Board from an applicant who has never been
certified in this or any other State.
(5) "Nurse practitioner"
means a registered nurse who [by reason of certification under these
regulations may engage in the activities authorized by these regulations]
is certified by the Board to practice as a nurse practitioner in accordance
with this chapter.
(6)—(9) (text unchanged)
.02 Nurse Practitioner - Scope and
Standards of Practice.
A. A nurse practitioner may [perform]
independently perform the following functions:
(1)—(13) (text unchanged)
(14) Refer patients to appropriate
licensed physicians or other health care providers as needed; [and]
(15) In accordance with COMAR
20.31.03.01, certify that the utility client has a serious illness or the need
for life-support equipment; and
[(15)]
(16) (text unchanged)
B. A psychiatric nurse practitioner
together with a physician is authorized to sign applications:
(1) In accordance with Health
General Article, §10-615, Annotated Code of Maryland, to admit a minor to a
facility for treatment of a mental disorder; and
(2) In accordance with Health
General Article, §10-616, Annotated Code of Maryland, to involuntarily admit an
individual to a facility for treatment of a mental disorder.
[B.]
C.—[E.] F. (text unchanged)
.03 Certification.
A. (text unchanged)
B. An applicant for certification as
a nurse practitioner shall:
(1)—(2) (text unchanged)
(3) As part of the application,
submit to the Board:
(a) Documentation that the applicant
has graduated from a Board-approved educational program for nurse
practitioners; [and]
(b) Documentation of certification
as a nurse practitioner by a [nationally recognized] national
certifying body recognized by the Board;
(c) Identification of a designated
mentor for 18 months as defined in Regulation .01 of this chapter; and
(4) Pay all fees established by the
Board[; and]
[(5)
Pass a Board-approved examination].
C. The Board shall:
(1) (text unchanged)
(2) Include on the nurse
practitioner's registered nursing license an indication that the licensee is
certified as a nurse practitioner and [a designation of] designate
the nurse practitioner's area of specialization.
D. (text unchanged)
[.05] .04 Renewal of
Certification.
A.—B. (text unchanged)
C. A nurse practitioner shall
maintain an active certification while practicing.
D. Certification shall be deemed to
have lapsed if the Board does not have a record of a current active
certification at renewal.
[.06] .05 Practice Before
Maryland Certification.
A. A registered nurse who has
completed a Board-approved educational program for nurse practitioners and who
has applied to take a Board-approved national certifying examination, may
practice as a nurse practitioner graduate before certification in this State upon
approval of the Board if the nurse has:
(1)—(4) (text unchanged)
(5) Presented evidence of submission
of an application to take a Board-approved national certification
examination; and
(6) Provided the name of a certified
nurse practitioner, who has an active unencumbered Maryland or compact RN
State license, who will directly supervise the nurse practitioner graduate.
B. If a certified nurse practitioner
is not available in the graduate's practice setting, as required in §A(6) of
this regulation, a physician may provide this direct supervision if the nurse
practitioner graduate provides the Board with the name of a certified nurse
practitioner, who has an active unencumbered Maryland or compact RN State
license, with whom the nurse practitioner graduate has regular
consultation.
C.—D. (text unchanged)
[.07] .06 Education.
A. (text unchanged)
B. An applicant for certification
shall be a graduate from a Board-approved nationally accredited education
program for nurse practitioners in a school of nursing that:
[(1)
Has been approved by the Board;]
[(2)]
(1) (text unchanged)
[(3)]
(2) Is accredited by a nursing accrediting body recognized by the United
States Department of Education, [or] the Council for
Higher Education Accreditation, or any other national accrediting body
recognized by the Board;
[(4)]
(3)—[(5)] (4) (text unchanged)
[(6)]
(5) Has a didactic and clinical curriculum that, at a minimum, includes
advanced courses in:
(a) (text unchanged)
(b) Physical and health assessment; [and]
(c)—(d) (text unchanged)
[(7)]
(6)—[(8)] (7) (text unchanged)
C. [Continuing Competence.]
To be a Board-approved education program the program shall:
(1)—(2) (text unchanged)
[.10] .07—[.11] .08 (text
unchanged)
.09 Unlawful Practices.
Unless authorized to practice as a
nurse practitioner under Health Occupations Article, Title 8, Annotated Code of
Maryland, an individual may not:
A.—B. (text unchanged)
C. Use the abbreviation [“N.P.”,
“C.R.N. P.”] “NP”, “CRNP”, “CNP”, or any other words, letters, or
symbols with the intent to represent that the individual practices as a nurse
practitioner.
VAN T. MITCHELL
Secretary of Health and Mental
Hygiene
