Senate Committee Votes to Give Urban Nurse Practitioners Dispensing Powers

Pushed by Portland clinic chain ZoomCare, Senate Bill 8 has the support of the Oregon Nurses’ Association but is opposed by the pharmacists’ association

Editor's Note: SB 8 only expands urban nurse practitioners' right to dispense medication. They already had the power to prescribe. This article has been changed from a previous version.

February 6, 2013 -- The Senate Health Committee unanimously passed a bill Monday that would allow nurse practitioners across the state to both dispense medicine.

Senate Bill 8 could go to a full senate vote as early as tomorrow when it’s expected to pass. The bill would then be heard before the appropriate House committee.
 
Nurse practitioners have had the ability to dispense medicine for about a decade in rural counties, where access to doctors and pharmacies may be limited.
 
The Portland-based clinic chain ZoomCare pushed the bill because its medical model often uses lower-cost medical providers such as nurse practitioners and physician’s assistants to provide basic care.
 
“There’s a gap, our colleagues, nurse practitioners can’t dispense medication,” said Dr. Dave Sanders, CEO of ZoomCare.
 
ZoomCare employs about 5 to 10 nurse practitioners and 25 to 30 physician’s assistants as well as 10 doctors, Sanders said.
 
Last year, the Legislature passed a bill expanding the power to dispense medicine to physician’s assistants, but kept in place geographic restrictions on nurse practitioners.
 
Both nurse practitioners and physician’s assistants are considered mid-level medical providers, requiring usually two years beyond a college education. Physician’s assistants are licensed by the state medical board while nurse practitioners fall under the board of nursing.
 
The spokesman for the Oregon State Pharmacy Association, Bill Cross, testified against the bill, arguing that nurse practitioners are not as qualified as pharmacists to dispense prescription drugs and there is no need for this service in urban areas.
 
What constitutes rural in the current law has a complicated technical definition, but Oregon generally follows statistical definitions outlined by the U.S. Census Bureau, which includes 11 Oregon counties in six urban centers, from Portland and Eugene to Bend and Corvallis.
 
“There aren’t many pharmacies in rural areas, as an access issue. We don’t have that issue in urban areas. Pharmacies are open 24/7 and within 5 miles, wherever you go,” Cross said.
 
“As with any profession, they think that they are better than anyone else can be at dispensing prescriptions. But that isn’t how our modern medical delivery system works anymore,” ZoomCare spokesman Len Bergstein told The Lund Report. “It’s a
competition issue. They’re worried about their share of the market.”
 
Cross also argued that the state should be careful lowering the bar for narcotic prescriptions, given the state’s history of prescription drug abuse. Physician’s assistants were explicitly prohibited from prescribing and dispensing any narcotic stronger than codeine. Nurse practitioners in rural areas who dispense under the existing law are not under this restriction.
 
Sanders said he was satisfied with the restrictions placed on physician’s assistants after last year’s legislation, but nurse practitioners who work in rural already dispense such narcotics with few reported problems. He later added ZoomCare has a policy of not prescribing strong narcotic drugs.
 
The executive director of the Oregon Nurses Association, Susan King, also testified before the committee in favor of the bill, noting that in the last three years, there have only been five complaints involving nurse practitioners dispensing medication, none of
which resulted in disciplinary action.
 
“After 10 years, if there was a problem, we would have heard about it,” said Sen. Jeff Kruse, R-Roseburg.
 
Kruse mentioned another bill would be coming before the Senate Health Committee this session that would be looking to tighten the state's prescription drug monitoring program.
 
 
 
Image for this story by Ayena (public domain) via Wikimedia Commons.
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