Gov. Stitt Vetoes Bill Aimed At Allowing Nurse Practitioners To Prescribe Drugs Without A Doctor's Supervision

Gov. Stitt vetoed legislation on Friday that would have allowed nurse practitioners who meet certain criteria to apply for authority to prescribe medications without the need for doctor supervision.

The bill's author, State Senator Brenda Stanley, (R-Midwest City) said Senate Bill 458 was meant to increase healthcare access across the state, especially in areas with few physicians. But others argue while there is a dire need for healthcare professionals, this legislation is not the right fix.

“28 other states don't have physician oversight. Why can't Oklahoma be that way?,” asked Stanley on the Senate floor on March 19.

While the bill had the support of Advanced Practice Registered Nurses (APRNs) the President of the Oklahoma State Medical Association dismissed the bill saying it could lead to more rural nurses leaving.

“In other states where we've tried this, the nurse practitioners in rural areas actually leave those areas and go to the urban areas, unfortunately,” said Dr. Diane Heaton, President of the Oklahoma State Medical Association

In his veto message, Stitt said that while he understands the challenges facing rural communities when it comes to healthcare access, he did not see SB 458 as the right solution.

"Although I am aware of the state's healthcare access and workforce challenges, especially in rural communities, SB 458 is not a prudent solution.

SB 458 would do one primary thing: enable Advanced Practice Registered Nurses (APRNs) who meet certain criteria to apply for authority to prescribe independent of physician supervision. And that's my biggest concern. While APRNS already have the ability to set up clinics in rural Oklahoma and practice in primary care settings, I don't believe APRNs should be able to prescribe Schedules III through V controlled substances without physician supervision. Further, this bill would allow APRNs to have full practice and prescriptive authority in all specialty categories absent supervision.

That part of the bill that would have mandated that the medical licensure boards collaborate to promulgate uniform rules (1) governing supervision requirements and (2) imposing a reasonable limit on the monetary amount a supervising physician may charge for supervision was good and should be explored.

Finally, I'd also ask that the Legislature explore other ways to attract frontline healthcare workers to rural communities across the state. A tax credit for qualifying practitioners in rural areas of the state is one such idea. For these reasons, I have vetoed SB 458."

Related Story: Legislation To Allow Nurse Practitioners To Prescribe Drugs Without A Doctor's Supervision Heads To Governors Desk