2834.  The Legislature finds that various and conflicting
definitions of the nurse practitioner are being created by state
agencies and private organizations within California.  The
Legislature also finds that the public is harmed by conflicting usage
of the title of nurse practitioner and lack of correspondence
between use of the title and qualifications of the registered nurse
using the title.  Therefore, the Legislature finds the public
interest served by determination of the legitimate use of the title
"nurse practitioner" by registered nurses.


2835.  No person shall advertise or hold himself out as a "nurse
practitioner" who is not a nurse licensed under this chapter and does
not, in addition, meet the standards for a nurse practitioner
established by the board.


2835.5.  On and after January 1, 1985, any registered nurse who is
holding himself or herself out as a nurse practitioner or who desires
to hold himself or herself out as a nurse practitioner shall, within
the time prescribed by the board and prior to his or her next
license renewal or the issuance of an initial license, submit
educational, experience, and other credentials and information as the
board may require for it to determine that the person qualifies to
use the title "nurse practitioner," pursuant to the standards and
qualifications established by the board.
   Upon finding that a person is qualified to hold himself or herself
out as a nurse practitioner, the board shall appropriately indicate
on the license issued or renewed, that the person is qualified to use
the title "nurse practitioner."  The board shall also issue to each
qualified person a certificate evidencing that the person is
qualified to use the title "nurse practitioner."
   Any person who has been found to be qualified by the board to use
the title "nurse practitioner" prior to the effective date of this
section, shall not be required to submit any further qualifications
or information to the board and shall be deemed to have met the
requirements of this section.


2836.  The board shall establish categories of nurse practitioners
and standards for nurses to hold themselves out as nurse
practitioners in each category.  Such standards shall take into
account the types of advanced levels of nursing practice which are or
may be performed and the clinical and didactic education,
experience, or both needed to practice safely at those levels.  In
setting such standards, the board shall consult with nurse
practitioners, physicians and surgeons with expertise in the nurse
practitioner field, and health care organizations utilizing nurse
practitioners.  Established standards shall apply to persons without
regard to the date of meeting such standards.  If the board sets
standards for use of nurse practitioner titles which include
completion of an academically affiliated program, it shall provide
equivalent standards for registered nurses who have not completed
such a program.



2836.1.  Neither this chapter nor any other provision of law shall
be construed to prohibit a nurse practitioner from furnishing or
ordering drugs or devices when all of the following apply:
   (a) The drugs or devices are furnished or ordered by a nurse
practitioner in accordance with standardized procedures or protocols
developed by the nurse practitioner and his or her supervising
physician and surgeon under any of the following circumstances:
   (1) When furnished or ordered incidental to the provision of
family planning services.
   (2) When furnished or ordered incidental to the provision of
routine health care or prenatal care.
   (3) When rendered to essentially healthy persons.
   (b) The nurse practitioner is functioning pursuant to standardized
procedure, as defined by Section 2725, or protocol.  The
standardized procedure or protocol shall be developed and approved by
the supervising physician and surgeon, the nurse practitioner, and
the facility administrator or his or her designee.
   (c) The standardized procedure or protocol covering the furnishing
of drugs or devices shall specify which nurse practitioners may
furnish or order drugs or devices, which drugs or devices may be
furnished or ordered, under what circumstances, the extent of
physician and surgeon supervision, the method of periodic review of
the nurse practitioner's competence, including peer review, and
review of the provisions of the standardized procedure.
   (d) The furnishing or ordering of drugs or devices by a nurse
practitioner occurs under physician and surgeon supervision.
Physician and surgeon supervision shall not be construed to require
the physical presence of the physician, but does include (1)
collaboration on the development of the standardized procedure, (2)
approval of the standardized procedure, and (3) availability by
telephonic contact at the time of patient examination by the nurse
practitioner.
   (e) For purposes of this section, no physician and surgeon shall
supervise more than four nurse practitioners at one time.
   (f) Drugs or devices furnished or ordered by a nurse practitioner
may include Schedule III through Schedule V controlled substances
under the California Uniform Controlled Substances Act (Division 10
(commencing with Section 11000) of the Health and Safety Code) and
shall be further limited to those drugs agreed upon by the nurse
practitioner and physician and surgeon and specified in the
standardized procedure.  When Schedule III controlled substances, as
defined in Section 11056 of the Health and Safety Code, are furnished
or ordered by a nurse practitioner, the controlled substances shall
be furnished or ordered in accordance with a patient-specific
protocol approved by the treating or supervising physician.  A copy
of the section of the nurse practitioner's standardized procedure
relating to controlled substances shall be provided upon request, to
any licensed pharmacist who dispenses drugs or devices, when there is
uncertainty about the nurse practitioner furnishing the order.
   (g) The board has certified in accordance with Section 2836.3 that
the nurse practitioner has satisfactorily completed (1) at least six
month's physician and surgeon-supervised experience in the
furnishing or ordering of drugs or devices and (2) a course in
pharmacology covering the drugs or devices to be furnished or ordered
under this section.  The board shall establish the requirements for
satisfactory completion of this subdivision.
   (h) Use of the term "furnishing" in this section, in health
facilities defined in subdivisions (b), (c), (d), (e), and (i) of
Section 1250 of the Health and Safety Code, shall include (1) the
ordering of a drug or device in accordance with the standardized
procedure and (2) transmitting an order of a supervising physician
and surgeon.
   (i) Nothing in this section, nor any other provision of law, shall
be construed to authorize a nurse practitioner in solo practice to
furnish drugs or devices, under any circumstances.
   (j) "Drug order" or "order" for purposes of this section means an
order for medication which is dispensed to or for an ultimate user,
issued by a nurse practitioner as an individual practitioner, within
the meaning of Section 1306.02 of Title 21 of the Code of Federal
Regulations.  Notwithstanding any other provision of law, (1) a drug
order issued pursuant to this section shall be treated in the same
manner as a prescription of the supervising physician; (2) all
references to "prescription" in this code and the Health and Safety
Code shall include drug orders issued by nurse practitioners; and (3)
the signature of a nurse practitioner on a drug order issued in
accordance with this section shall be deemed to be the signature of a
prescriber for purposes of this code and the Health and Safety Code.



2836.2.  Furnishing or ordering of drugs or devices by nurse
practitioners is defined to mean the act of making a pharmaceutical
agent or agents available to the patient in strict accordance with a
standardized procedure.  All nurse practitioners who are authorized
pursuant to Section 2831.1 to furnish or issue drug orders for
controlled substances shall register with the United States Drug
Enforcement Administration.



2836.3.  (a) The furnishing of drugs or devices by nurse
practitioners is conditional on issuance by the board of a number to
the nurse applicant who has successfully completed the requirements
of subdivision (g) of Section 2836.1.  The number shall be included
on all transmittals of orders for drugs or devices by the nurse
practitioner.  The board shall make the list of numbers issued
available to the Board of Pharmacy.  The board may charge the
applicant a fee to cover all necessary costs to implement this
section.
   (b) The number shall be renewable at the time of the applicant's
registered nurse license renewal.
   (c) The board may revoke, suspend, or deny issuance of the numbers
for incompetence or gross negligence in the performance of functions
specified in Sections  2836.1 and 2836.2.



2837.  Nothing in this article shall be construed to limit the
current scope of practice of a registered nurse authorized pursuant
to this chapter.