Q. Where do I find the CRNP regulations?

A. http://www.pacode.com/secure/data/049/chapter21/chap21toc.html

Q. How did SB1208 (Act 206 of 2002) change the CRNP regulations?

A. The CRNP regulations are still in the process of being revised (as of 1/06) based on the changes from Act 206. The draft regulations are expected to be published for public comment in the Pennsylvania Bulletin in the Spring of 2006. Act 206 of 2002, signed into law on December 9, 2002, amended the Professional Nursing Law (RN Law) and repealed sections of the Medical Practice Act to:

• Provide for the exclusive regulation of CRNPs by the State Board of Nursing.
• Requires a masters degree and national certification for initial CRNP licensure after Feb 2005.
• Removed the “in collaboration with and under the direction of a physician” language.
• Defines “collaboration" as “a process in which a certified registered nurse practitioner works with one or more physicians to deliver health care services within the scope of the certified registered nurse practitioner's expertise. The process includes all of the following: (i) Immediate availability of a licensed physician to a certified registered nurse practitioner through direct communications or by radio, telephone or telecommunications. (ii) A predetermined plan for emergency services.(iii) A physician available to a certified registered nurse practitioner on a regularly scheduled basis for referrals, review of the standards of medical practice incorporating consultation and chart review, drug and other medical protocols within the practice setting, periodic updating in medical diagnosis and therapeutics and cosigning records when necessary to document accountability by both parties.”
• Defines scope of practice for CRNPs
  • “A certified registered nurse practitioner, while functioning in the expanded role as a professional nurse, shall practice within the scope of practice of the particular clinical specialty area in which the nurse is certified by the board.
  • A certified registered nurse practitioner may perform acts of medical diagnosis in collaboration with a physician and in accordance with regulations promulgated by the board.
  • A certified registered nurse practitioner may prescribe medical therapeutic or corrective measures if the nurse is acting in accordance with the provisions of section 8.3 of this act.
  • Nothing in this section shall be construed to limit or prohibit a certified registered nurse practitioner from engaging in those activities which normally constitute the practice of nursing as defined in section 2 of this act.”

For further explanation of the changes in the law, see the State Board’s “Special Notice for CRNPs—Act 206 of 2002” at:
http://www.dos.state.pa.us...

Q. How do I get an NP license in Pennsylvania?

A. RN and CRNP licensure information can be found on the State Board of Nursing website, (under Licensure Information link) at:
http://www.dos.state.pa.us/bpoa/cwp/view.asp?a=1104&q=432883

Q. How do I get Prescriptive Authority?

A. Download and complete the forms on the Bon’s updated website. The prescriptive authority information includes the current application form, pharmacology course verification form, and the Board-approved Collaborative Agreement Form (which is on pages 5 and 6):
http://www.dos.state.pa.us...

Please see the BON’s Special Notice “Frequently Asked Questions On CRNP Prescriptive Authority” at:
http://www.dos.state.pa.us...

Q. What happens if I need to make changes to my collaborative agreement?

A. A Prescriptive Authority Collaborative Agreement Change Form must be submitted for:

• termination of agreement
• additional substitute physician(s)
• deletion of substitute physician(s)
• change in drug schedule (s)
• change of primary practice location

The form can be downloaded from the BON website at:
http://www.dos.state.pa.us...

Q. What are the fees for CRNP licensure and prescriptive authority?

A. The fees were finalized on December 9, 2005. Certification is the fee for the initial CRNP “license”. http://www.pabulletin.com/secure/data/vol35/35-50/2270.html

Q. How do I renew my NP license and prescriptive authority?

A. In Pennsylvania we have an RN "license" and CRNP "certification" from the state, not a 2nd license, even though it is commonly referred to as a CRNP license. This should not be confused with national certification which is required to get a new CRNP “license” effective 2/05.

For those who are newly licensed CRNPs, your CRNP will renew when your next RN license is renewed. (So for many people it is less than 2 years, depending on when your RN renewal and initial CRNP licensure fall. Yes, you have to pay the renewal fee.) Thereafter, they will always renew at the same time. If you have prescriptive authority, it will also renew at the same time, regardless of when you initially obtained it. (This is assuming your collaborative agreement is still in effect. If it is not, you have an obligation to notify the BON with the change form as noted above.)

Until now, prescriptive authority has automatically renewed with your CRNP license. Now that the fees are in place, a renewal for prescriptive authority will come with your CRNP license renewal. This is effective with the April 2006 renewal cycle since the fees were approved in Dec 2005. Fees will NOT be retroactive. Those who already have prescriptive authority with a collaborative agreement will not be charged an application fee, only the renewal fee when the time comes to renew.

Please see next question regarding continuing education requirements for CRNP license and prescriptive authority renewal.

Q. What are the new requirements for continuing education for CRNPs?

A. The continuing education regulations for CRNPs were finalized on Dec. 4, 2004. Please see the Special Notice “Updated Special Notice for CRNPs on Continuing Education” on the Board of Nursing website at:
http://www.dos.state.pa.us...

“Beginning with the April 30, 2007 renewal, CRNPs will be required to verify that they have completed at least 30 hours of continuing education in the two years preceding the renewal (from April 30, 2005 to April 30, 2007). CRNPs renewing in April and October 2005 and April and October 2006 will not be required to show that they have completed 30 hours of continuing education in the previous biennium. However, CRNPs renewing in 2005 and 2006 should begin to accumulate continuing education hours from Board-approved providers following the renewal, so that they will have completed 30 hours within the two-year period preceding their next biennial renewal.”

The continuing education requirement for prescriptive authority is 16 of those 30 hours must be pharmacology credits in the 2 year renewal period. Please see below for the approved CE providers.

The NP will be required to sign a statement saying he or she has met the continuing education requirements when the CRNP license is renewed. Not every NP will have to submit proof (actual certificates). Only those who are audited (something like 5 or 10% of those renewing each time will be audited).

The actual CE regulations can be found at:
http://www.pabulletin.com/secure/data/vol34/34-49/2140.html

Q. What CE programs are approved by the BON?

A. According to the regulations, the following continuing education providers are approved:

(i) Board-approved CRNP programs (i.e the program has applied to the BON for approval)
(ii) The American Nurses Credentialing Center's Commission on Accreditation (ANCC)
(iii) The American Academy of Nurse Practitioners (AANP)
(iv) The National Association of Pediatric Nurse Practitioners (NAPNP)
(v) The American Medical Association (AMA) (These are the physician CME programs that are ACCME credits)

The 16 hours of pharmacology continuing education needs to specify pharmacology. Most NP conferences now split out the number of hours that are pharmacology. The AMA's CME (ACCME) is not able to do that.

One easy way to obtain AANP-approved pharmacology hours is the "Prescribers Letter". See their website for more information. www.prescribersletter.com

For more information, please see the Resources and FAQ pages.