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Nurse Practitioners', Physician Assistants' Prescribing Authority In Jeopardy

Florida is the only state that does not allow nurse practitioners to prescribe controlled substances, according to the Florida Association of Nurse Practitioners.
Florida is the only state that does not allow nurse practitioners to prescribe controlled substances, according to the Florida Association of Nurse Practitioners.

About 25,000 nurse practitioners and physician assistants may still be unable to prescribe medications if a Senate bill does not pass before the end of the legislative session on Friday.

Florida is the only state that does not allow nurse practitioners to prescribe controlled substances, which include painkillers such as Vicodin and OxyContin, and amphetamines used for ADHD. Florida is also one of two states that does not permit physician's assistants the same privilege.

Senate bill, SB676, sponsored by Sen. Denise Grimsley, R-Sebring, has stalled in the legislature. The House companion bill, HB423, sponsored by Rep. Cary Pigman, R-Avon Park, passed 117-2 on March 2.

Passage of the bill would allow nurse practitioners to help fill the void of primary-care doctors in Florida, said Susan Lynch, CEO of the Florida Association of Nurse Practitioners.

Florida has the third-largest population in the country with nearly 20 million people, according to U.S. Census. As of 2015, about 20 percent of the state's population is over the age of 65, compared to about 15 percent nationally.

Exacerbating the problem, nearly half of Florida physicians are expected to retire in the next 10 years, according to the Florida Association of Nurse Practioners.  

Florida also saw more people sign up for health care under the Affordable Care Actduring the last open enrollment period than any other state. 

Lynch said she believes the reason Florida has held out on giving nurse practitioners prescribing privileges is the actions of organized medicine, which has left patients disadvantaged.

There are about 6,000 physician's assistants in Florida and 18,000 nurse practitioners who, under current law, cannot prescribe controlled substances. These include pain medications, psychiatric medications, prescription cough medications, as well as hormone and pain medications.

“We’re getting there,” she said. “We’re getting stronger and our numbers are growing every year.”

In January, Sen. Arthenia Joyner voiced concern during a Senate committee hearing about opening up privileges to the state's nurse practitioners and the state’s physician’s assistants, who would also gain prescribing privileges with the passage of the bills.

"I know in rural communities it’s a problem, but I have to weigh the safety of the public versus the need and I know that this is dicey," she said. "I'm afraid to open the door to allow another 25,000 people to be able to prescribe these drugs."

Grimsley said issues like pill mills were created by doctors, not nurse practitioners. In addition, the bill has safety provisions, such as the committee to determine which drugs cannot be prescribed or only prescribed under certain conditions.

Meanwhile, Florida's primary care providers and patients are stuck waiting; waiting for care and waiting to see if Florida will follow suit with the rest of the country by allowing nurse practitioners and physicians assistants to practice autonomously.

Ariella is a reporter for WUFT News and can be contacted by calling 352-392-6397 or emailing news@wuft.org.