NCBON
The Board of Nursing approved the following actions regarding Chapter 36 Board of Nursing Administrative Code (Rules):
NCBON | 21 NCAC 36 .0807 Continuing Education CE (Amend)
Public Hearing: February 27, 2024 @ 10:00 am
Comment Period Ends: April 1, 2024
The NC Medical Board presented a proposed amendment to 21 NCAC 36 .0807 Continuing Education (CE) at the annual meeting of the Joint Sub Committee in November 2023. The proposed amendment regarding Nurse Practitioners clarifies that licensees who complete the federally required Medication Access and Expansion Training (MATE) training will have also satisfied the state mandated controlled substance prescribing CME for that reporting cycle.
21 NCAC 36 .0229 (Adoption) and 21 NCAC 36 .0810 (Amendment)
Public Hearing: August 21, 2024 @ 2:00 pm
Comment Period Ends: August 30, 2024
On April 23, 2024, Duke University Health System and Atrium Health (“Petitioners”) filed two petitions requesting the Board proceed with permanent rulemaking pursuant to 21 NCAC 36 .0121(a). Both petitions meet all foundational requirements of this Rule detailing the reasoning for the request. Petitioners also filed a proposed amendment in 21 NCAC 36 .0810(2)(c), which relates to NP practice, with the NC Medical Board for their consideration. The proposed language for adoption and amendment were also attached with each petition. NC General Statutes specify that a physician may issue a portable do not resuscitate (“DNR”) order and determine a person’s death. See NCGS §90-21.17(b) and §90-323. However, practice and other statutory provisions imply that these two medical tasks may be performed under the supervision of or delegated by a physician. The effect of both rules would be to clarify that these acts may be delegated to NPs and licensed nurses to promote and improve access to end-of-life care.
On May 23, 2024, Petitioner’s request and proposed rule language were presented to the Board. In 21 NCAC 36 .0810(c)(2), the Board voted to amend the language of this Rule to clarify the NP’s authority to issue DNR orders and pronounce death pursuant to the terms of a Collaborative Practice Agreement (“CPA”). The additional language in the proposed amendment specifies that DNR orders and pronouncement of death may be performed by an NP under the supervision of a physician by way of a CPA. The Board also voted to proceed with rulemaking of a new rule, 21 NCAC 36 .0229 Determination and Pronouncement of Death, for specific language that expressly permits physicians to delegate this act to RNs and LPNs. The language of this new rule is consistent with the Board’s position statement on Death and Resuscitation and would provide legal authority for this medical act to be delegated to RNs and LPNs as a responsibility that the nurse can safely accept.
Midwifery
The Midwifery Joint Committee approved the following actions regarding Chapter 33 Midwifery Joint Committee Administrative Code (Rules):
Midwifery I Midwifery Joint Committee Permanent Rules
Public Hearing: July 9, 2024 @ 1:00 pm
Comment Period Ends: August 16, 2024
In accordance with § 150B-21.1(a)(2), the Midwifery Joint Committee (MJC) submits proposed Chapter 33 permanent rules addressing “the effective date of a recent act of the General Assembly or the United States Congress”. On May 16, 2023, Senate Bill 20/Session Law 2023-14 Care for Women, Children and Families Act was enacted. Subsequently, Senate Bill 389 Technical Changes to the Midwifery Statutes was enacted, granting authority to the MJC to adopt, amend, and repeal rules necessary to administer the provisions of the Article. Legislation directed the MJC to adopt rules to address the Certified Nurse Midwife (CNM) approval to practice independently and in transition to independent practice. These rules include working under a collaborative provider agreement, prescribing authority, and rules governing planned births outside of hospital settings attended by CNMs. Portions of this law became effective October 1, 2023. Temporary rules were adopted by the MJC to protect the health and safety of the public, clarify the MJC’s requirements for midwifery practice and meet the legislature’s charge to promulgate rules to carry out this Law. Permanent rules are proposed for adoption to replace the current temporary rules.
Public Hearings are held at the North Carolina Board of Nursing office located at 4516 Lake Boone Trail, Raleigh, NC 27607.
Persons may submit objections or public comment related to these rules by contacting:
Angela Ellis, Chief Administrative Officer/APA Coordinator
North Carolina Board of Nursing
P.O. Box 2129
Raleigh, NC 27602-2129
email : lawsrules@ncbon.com
“Public comment” is defined by § 150B-21.3A(a)(5) as a written objection to all or part of a rule. Additionally, pursuant to § 150B-21.3A(c)(2), in order for the Rules Review Commission to determine whether the public comment has merit, the public comment must address the specific substance of the rule and address any of the standards of Commission review, as set forth in § 150B-21.9(a).
Procedure for Subjecting a Proposed Rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission. If the Rules Review Commission receives written and signed objections in accordance with § 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in § 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, call a Commission staff attorney at (919) 431-3000.