Certification and licensure

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Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.

LEARNING RESOURCES


Required Readings

· American Association of Nurse Practitioners. (2020). 


State practice environment

Links to an external site.
. https://www.aanp.org/advocacy/state/state-practice-environment

· On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.

· American Psychiatric Association. (2020). 


Telepsychiatry

Links to an external site.
. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry

· Buppert, C. (2021). 
Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

· Chapter 1, “What Is a Nurse Practitioner?”

· Chapter 2, “Nurse Practitioner Scope of Practice”

· Chapter 3, “State Regulation of the Nurse Practitioner Practice”

· Chapter 4, “Federal Regulation of the Nurse Practitioner Profession”

· Chapter 5, “Prescribing”

· Centers for Disease Control and Prevention. (2020). 


Using telehealth to expand access to essential health services during the COVID-19 pandemic

Links to an external site.
. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

· Centers for Medicare & Medicaid Services. (2019). 


National provider identifier standard (NPI)

Links to an external site.
. https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand

· The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

· Drug Enforcement Administration Diversion Control Division. (2020). 


Registration

Links to an external site.
. https://www.deadiversion.usdoj.gov/drugreg/index.html

· This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.

· After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.

· National Panel for Psychiatric Mental Health NP Competencies. (2003). 


Psychiatric-mental health nurse practitioner competenciesLinks to an external site.


. National Organization of Nurse Practitioner Faculties (NONPF).  https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf

· Stewart, J. G., & DeNisco, S. M. (2019). 
Role development for the nurse practitioner (2nd ed.)
Jones & Bartlett Learning.

· Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”

· Nurse Practitioner Core Competencies

· Nurse Practitioners’ Unique Role

· Chapter 13, “Quality, Safety, and Prescriptive Authority”

· Substance Abuse and Mental Health Services Administration. (2020). 


Become a buprenorphine waivered practitioner

Links to an external site.
. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver

· This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).

· After you
 obtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration
 (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.

· Zakhari, R. (2021). 
The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

· Chapter 2, “The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice”

· Chapter 3, “Theoretical Foundations of Care and Nonpharmacological Therapies”

THE QUESTION

· Review practice agreements in the state of Texas

· Identify whether Texas requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.

· Research the following:

· How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in the state of Texas?

· What is the application process for certification in Texas?

· What is Texas state’s board of nursing website?

· How does Texas define the scope of practice of a nurse practitioner?

· What is included in the state of Texas practice agreement?

· How do one get a DEA license in the state of Texas?

· Does state of Texas have a prescription monitoring program (PMP)?

· How does Texas describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

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