HAR §16-89-132. Prerequisite for activation of inactive licenses

(a) This section shall apply to a registered or a licensed practical nurse applying to activate the nurse's license which has been inactive for more than five years, and who has not practiced in the U.S. or a U.S. territory during that period, and is ordered by the board to verify continuing competency. (b) The nurse shall be required to: (1) Submit an application prescribed by the board with the required fee(s); and (2) Retake and pass the NCLEX-RN or NCLEX-PN, whichever is applicable; or (3) Successfully complete a refresher course which must first be approved by the board. The course shall consist of at least sixty clock hours of didactic and sixty clock hours of clinical practice recognized by an approved provider and designed for the practical nurse or registered nurse who is returning to practice after more than five years absence from nursing practice. The nurse shall submit appropriate documentation to verify successful completion of the refresher course. (c) The nurse shall not practice nursing, represent the nurse to be a registered nurse or a licensed practical nurse currently licensed to actively practice nursing, verbally or in writing, or in any way imply that the nurse holds a current active license, until the nurse's license is activated by the board. (d) The following units of measurement shall be used in calculating continuing education hours. Should the units of measurement change, the board shall note the change in its minutes until such time that its rules can be amended: §16-89-132 89-53 (1) 1 contact hour = 60 minutes of instruction; (2) 1 contact hour = 60 minutes of clinical or laboratory practice in an informal offering or a minimum of fifty minutes of actual organized instruction; (3) 1 continuing education unit (CEU) = 10 contact hours of instruction; (4) 1 continuing medical education unit (CME) = 1 contact hour of instruction; (5) Academic credit will be converted to contact hours as follows: (A) One quarter academic credit equals 12.5 contact hours; or (B) One semester academic credit equals 15 contact hours. (6) Contact hour equivalencies shall be as follows: (A) 1 continuing education unit = 10 contact hours. (B) 1 continuing medical education credit = 60 minutes; or (C) 1 American Medical Association credit = 60 minutes; (e) The board may grant a waiver from activation requirements as provided in subsection (b) to a registered nurse or practical nurse if the nurse qualifies under one of the following and provides documents verifying that the nurse: (1) Was enrolled full time in the past two or more years in a nursing program recognized by the board leading to an associate degree, diploma, baccalaureate, or masters degree in nursing science; or (2) Was or is a U.S. government employee who worked or is working outside the U.S. as a practical nurse or registered nurse or is assigned to active military duty outside the United States as a nurse during the entire reporting period. The nurse shall submit evidence satisfactory to the board of nursing practice while in government service or active duty with the military. (f) A waiver provides for an extension of time or exemption from some or all of the activation requirements. Any nurse who wishes to activate his or her inactive license may request an application for a waiver from the board. The board shall approve or deny an application for waiver after its review of a completed application and supporting documents as requested by the board. The board shall not grant a waiver from activation requirements for more than one biennium, unless there are unusual circumstances including, but not limited to, a national emergency. (g) The board shall activate the inactive license to active status when the nurse has completed all requirements to the satisfaction of the board. (h) If requested by the board, the nurse shall submit legible copies of documents which may include, but are not be limited to, certificates of completion of continuing education offerings, transcripts of courses taken, course descriptions, and the name, telephone number and mailing address of the nurse's employer to §16-89-132 89-54 verify registered or practical nursing practice. The board may require the nurse to submit a job description to verify the nurse's employment in a nursing position which meets the board's requirements. (i) If the nurse is required by the board to submit the required documents within a specific, time frame the board may grant an extension of time on a case-by-case basis in cases of hardship beyond the nurse's control. The nurse shall submit a written request for an extension of time and provides justification for the request. [Eff 12/27/10; am and comp 3/28/13; am and comp 10/27/18] (Auth: HRS §§26-9(k), 436B-4, 436B-7) (Imp: HRS §457-8.6) 89-55 Amendments to and compilation of Chapter 16-89, Hawaii Administrative Rules, on the Summary page dated September 6, 2018, were adopted on September 6, 2018, following a public hearing held on September 6, 2018, after public notice was given in the Star Advertiser, The Garden Island, The Maui News, West Hawaii Today, and Hawaii Tribune-Herald on July 30, 2018. They shall take effect ten days after filing with the Office of the Lieutenant Governor. /s/ Thomas Joslyn Thomas Joslyn., M.S., CRNA Vice Chairperson Board of Nursing APPROVED AS TO FORM: Date /s/ Shari Wong Deputy Attorney General APPROVED: Date 10/9/18 /s/ Catherine P. Awakuni Colon CATHERINE P. AWAKUNI-COLÓN, Director Commerce and Consumer Affairs APPROVED: Date 10/17/18 /s/ David Y Ige DAVID Y. IGE Governor State of Hawaii 10/17/18 Filed BOARD OF NURSING STATE OF HAWAII PROFESSIONAL AND VOCATIONAL LICENSING DIVISION DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS P.O. Box 3469 HONOLULU, HAWAII 96801 cca.hawaii.gov/pvl EXHIBIT A CATHERINE P. AWAKUNI COLόN DIRECTOR CELIA C. SUZUKI LICENSING ADMINISTRATOR DAVID Y. IGE GOVERNOR SHAN TSUTSUI LT. GOVERNOR August 2016 EXCLUSIONARY FORMULARY FOR ADVANCED PRACTICE REGISTERED NURSES GRANTED PRESCRIPTIVE AUTHORITY FOR CONTROLLED SUBSTANCES 2016 Legislation: At its August 4, 2016 meeting, the Board of Nursing (“Board”) amended the exclusionary formulary for Advanced Practice Registered Nurses with prescriptive authority based on the following amended laws: • Act 183, SLH 2016 Relating to Advanced Practice Registered Nurses. One of the amendments in this measure clarifies that an APRN with prescriptive authority may dispense non- controlled substances, in addition to manufacturers’ prepackaged samples of over the counter drugs, to patients under their care. • Act 230, SLH 2016 Relating to Medical Marijuana. One of the amendments in this measure allows APRNs with prescriptive authority and who are registered with the Department of Public Safety, Narcotics Enforcement Division, to qualify their patient(s) for medical marijuana pursuant to the Medical Marijuana Program under the Department of Health. Go to health.hawaii.gov/medicalmarijuana/ for updated information on this program and its requirements. • Act 92, SLH 2016 Relating to the Joint Formulary Advisory Committee. The Joint Formulary Advisory Committee (“JFAC”) was repealed allowing the Board of Nursing the authority to determine the applicable formulary or exclusionary formulary for APRNs with prescriptive authority. Drugs that may be prescribed and administered by an APRN with prescriptive authority: An APRN with prescriptive authority may prescribe and administer the following drugs within their specialty and for which drugs that are not excluded in this formulary. • Over-the-counter drugs; • Legend (non-controlled substances) drugs; and • Controlled substances EXHIBIT A Drugs that may be requested, received, and dispensed by an APRN with prescriptive authority: An APRN with prescriptive authority may request, receive, and dispense the following drugs within their specialty and for which drugs that are not excluded in this formulary: • Manufacturers’ prepackaged samples of over-the-counter drugs; and • Non-controlled legend drugs Exclusionary Formulary: The exclusionary formulary that an APRN with prescriptive authority shall NOT prescribe, administer or dispense, shall consist of: • Investigational drugs except as part of an IRB-approved clinical trial; • Stimulants and hormones for treatment of obesity; • Human Growth hormones, anabolic steroids, or hormones for performance enhancement or decreasing the impact of aging; • Methadone for maintenance or detoxification of a narcotic-dependent person as restricted in HRS 329-121; and • Medical marijuana as restricted in HRS section 329-121 (see below: Medical Marijuana). Medical Marijuana: An APRN with prescriptive authority who is also registered with the Hawaii State Department of Public Safety, Narcotics Enforcement Division may certify/qualify his/her patient for medical marijuana if: • The qualifying patient has been diagnosed by the APRN as having a debilitating medical condition; • The APRN has certified in writing that in the APRN’s professional opinion, the potential benefits of the medical use of marijuana would likely outweigh the health risks for the particular qualifying patient; and • The amount of marijuana possessed by the qualifying patient does not exceed an adequate supply. The APRN with prescriptive authority accepts full responsibility, accountability, and obligation to practice in accordance with APRN standards and functions as defined by the scope of practice/role definition statements for the APRN’s category and specialty. The scope and standards shall include the statutes and rules established by the Board, the standards of the national certifying body, recognized by the Board, by which the APRN is currently certified, standards of the National Council of State Boards of Nursing Model Act and Rules, and generally accepted standards of practice in prescribing Schedules ll to V, including that of the U.S. Drug Enforcement Agency, the Department of Public Safety, Narcotics Enforcement Division and other applicable state and federal laws and regulations and this Exclusionary Formulary.