From KBN Notification to Licensees

You can now upload and store your Continuing Education (CE) documents in the Manage Profile section of the KBN Nurse Portal. Uploading CE is optional and not required for license renewal; however, if you are selected for the CE Audit after the renewal period ends, you will be required to upload all CE documentation at that time.

Continuing Education (CE) Requirements for Kentucky Nurses

• Annual CE Requirements for Renewal: All nurses must complete their CE between November 1 – October 31 each year for license renewal.
• Record retention: CE documents must be kept for 5 years in case of an audit.
• KBN Free CE Courses (Including the one-time content-specific requirement in Alzheimer's Disease and other forms of Dementia due October 31, 2027.):
  • Free course available on the KBN website.

To enter CE in your Nurse Portal account, follow these steps (screenshots attached):

• Log in to your KBN Nurse Portal Account
  • https://kybn.boardsofnursing.org/kybn/
• Select ‘Manage Profile’.
  • Select ‘Continuing Education’.
• Select ‘+Add Continuing Education’.
  • Select ‘License Type’.
  • Enter ‘CE Provider’, if entering CE Course.
    • Leave blank if reporting ‘Other Type of CE’.
  • Enter ‘Course Title’ or ‘Other Type of CE’.
    • If entering ‘Other Type of CE’ type in one of the options listed in the blue box above.
  • Enter ‘Completion Date’.
  • Enter ‘CE Hours Earned’, if entering CE Course.
    • Leave blank if reporting ‘Other Type of CE’.
  • Select ‘Upload’ to select the CE certificate or proof of other CE type earned.
    • Select ‘+Add File’.
      • Select document.
      • Select ‘Save’.
  • Select ‘Save’ for the CE to be submitted.
• To add another CE, select ‘+Add Continuing Education’.
  • Follow steps above (NOTE: Each CE must be entered individually.)

Please do not reply to this email. This mailbox is not monitored for replies.

Best regards,

Professional Practice Branch

Kentucky Board of Nursing

Kentucky Boards of Medical Licensure, Nursing, and Pharmacy

Issue Joint Statement on Retail IV Therapy Clinics

Frankfort, KY — [October 30, 2024] — In response to the rising trend of retail IV therapy clinics, the

Kentucky Boards of Medical Licensure, Nursing, and Pharmacy have collaboratively issued a statement

highlighting critical concerns regarding patient safety and regulatory compliance in this emerging sector.

Retail IV therapy clinics have proliferated across the state, often offering a variety of pre-selected IV

“cocktails” that include a mix of saline, vitamins, minerals, amino acids, and sometimes prescription

medications.

While these services claim to alleviate conditions such as dehydration, migraines, and to

enhance athletic recovery, the Boards emphasize that IV therapy is a medical practice requiring licensed

professionals.

A copy of the joint statement could be found here

Key Concerns Include:

1. Qualified Sta\: Diagnosis and treatment should only be conducted by licensed healthcare

providers.

2. Scope of Practice: Administration of IV medications must follow stringent safety standards; many

compounds are not FDA-approved.

3. Legal Compliance: Healthcare professionals must adhere to their defined scope of practice and

cannot delegate responsibilities to unlicensed individuals.

4. Patient Safety: Monitoring by qualified practitioners is essential to mitigate complications during

IV administration.

5. Regulatory Compliance: All compounding practices must be overseen by a licensed pharmacist,

with limitations on the number of additives used.

6. Non-Practitioner Restrictions: Non-practitioners are prohibited from possessing legend

medications.

7. Delegation of Responsibilities: Only Physicians and Advanced Practice Registered Nurses

(APRNs) are authorized to diagnose and prescribe treatments.

8. Patient Participation: Patients should seek professional guidance before making decisions

regarding their medical treatment.

9. Record Keeping: Comprehensive evaluations and documentation must precede any IV therapy

administration.

Call to Action:

The Boards urge all licensed professionals to review their legal responsibilities and ensure compliance

with both state and federal regulations. The practice of unlicensed IV therapy is not only unethical but

also illegal.

As the landscape of retail IV therapy evolves, it is imperative that Kentucky healthcare providers uphold

the highest standards of practice to safeguard patient health and safety

FOR IMMEDIATE RELEASE

KENTUCKY BOARD OF NURSING

Kelly Jenkins, Executive Director

Michael S. Rodman, Executive Director

Christopher P. Harlow, Executive Director

# # # 

The Kentucky Association of Nurse Practitioners and Nurse-Midwives will be submitting 4 nominees to the Governor to fill 2 APRN appointment slots. So that the terms of these 2 APRNs do not expire at the same time, the terms for these first nominees from KANPNM will be staggered – one term for 4 years and one term for 2 years. Subsequent appointment terms will be 4 years. 

The nominees selected must be in different population foci, have at least 5 years of nursing experience, and engaged in advanced nursing clinical practice. 

Board members are not permitted to serve on any professional board of directors while serving on the Board of Nursing. 

According to KRS 314.121 (3)(k) … By August 1, 2024, the Kentucky Association of Nurse Practitioners and Nurse-Midwives shall submit to the Governor the names of qualified individuals for appointments of two (2) advanced practice registered nurses. The appointed individuals shall be certified in different population foci and shall be actively engaged in advanced nursing clinical practice. Two (2) names of qualified individuals shall be submitted to the Governor for each position. The Governor shall appoint one (1) advanced practice registered nurse from the two (2) names submitted in one (1) population focus for an initial term of four (4) years and shall also appoint one (1) advanced practice registered nurse from the two (2) names submitted in another population focus for an initial term of two (2) years. The Governor shall make each appointment as necessary by October 1, 2024. Successive termsfor each advanced registered nurse practitioner shall be four (4) years. The two (2) advanced practice registered nurses shall be certified in a different population focus. Thereafter, on March 1 of the year in which the term of an advanced practice registered nurse expires, the Kentucky Association of Nurse Practitioners and Nurse-Midwives shall submit to the Governor the names of two (2) qualified individuals, from which the Governor shall make the appointment as necessary by July 1.

There are certain responsibilities that come with this working appointment.  Please keep these in mind when you apply:

·  The Board members meet in person at the KBN office on the even months typically the third or fourth Thursday.  

·   Committee and Council meetings meet on the odd months typically on Thursday’s and Fridays again the third or fourth week.  

·   Board members are required to rotate serving on hearing panels which are scheduled for 2 days every month. 

·   Pre-reading of meeting materials is a must!

Nominees should understand the laws governing their practice and have clinical expertise. Analytical and critical thinking skills are important, and nominees must be able to utilize these skills to evaluate clinical guidelines, research, evidence-based practice and health care policies as applied to APRN, RN, LPN, CMA, SRNA, DT, and LCPM practice. 

The Board credentials or licenses all these professionals. Proficiency in communication, professional integrity and a commitment to mentoring and supporting nurses are all characteristics important to being a Kentucky Board of Nursing member.  

Serving on the Board of Nursing is a big responsibility, but it’s also an honor. It takes a sincere commitment to the profession and protecting the public. That public includes nurses. We know there are many qualified APRNs who can serve. 

We hope you will submit your nomination.

Nominations for these appointments will be accepted by the Kentucky Association of Nurse Practitioners and Nurse-Midwives between June 2 and June 30, 2024.

TO SUMBIT A NOMINATION

Email your nomination materials to KANPNM Executive Director Jill York at 

Jill.kanpnm@gmail.com

Please submit a short statement explaining why you would like to serve along with your CV. 

We look forward to hearing from you!

The KANPNM Board Selection Committee

SAMHSA

Read article at SAMHSA site: https://www.samhsa.gov/medications-substance-use-disorders/provider-support-services/recommendations-curricular-elements-substance-use-disorders-training

Recommendations for Curricular Elements in Substance Use Disorders Training

The United States faces a crisis of deaths from opioids, stimulants, synthetic agents, tobacco and alcohol.1 These deaths represent a mere fraction of the total number of Americans harmed by substance misuse, and many people suffer daily from chronic use disorders. The long-term effects of substance misuse impact individuals, families, and communities. This is further compounded by changing patterns of substance misuse, as well as an increasing incidence of polysubstance use. The rise in fentanyl use or exposure, concurrent substance misuse, as well as overdose deaths, necessitates consideration of educational elements that promote understanding of SUDs, as well as their identification, treatment, and management.

Buprenorphine Waiver Changes

For more information on the elimination of the buprenorphine waiver program, contact SAMHSA's Center for Substance Abuse Treatment (CSAT) at 866-BUP-CSAT (866-287-2728) or providersupport@samhsa.hhs.gov.

Federal and state policy over the last decade has sought to overcome the long-term effects of substance misuse impacting individuals, families, communities, and those charged with resource allocation. Most recently, Section 1263 of the ‘Consolidated Appropriations Act of 2023’2 otherwise known as the Medication Access and Training Expansion (MATE) Act, requires new or renewing Drug Enforcement Administration (DEA) registrants, as of June 27, 2023, to have completed a total of at least 8 hours of training on opioid or other substance use disorders, as well as the safe pharmacological management of dental pain.

Practitioners can meet this requirement in one of three ways:

The 8 required hours of training can occur through classroom situations, seminars at professional society meetings, virtual platforms, or via other accredited continuing education sources. Practitioners who previously took training to meet the requirements of the DATA-2000 waiver to prescribe buprenorphine can count this training towards the 8-hour training requirement. Additionally, the 8 hours do not have to be completed in one session and can be satisfied through cumulative CME hours, as long as the training is provided by or approved by one of the following organizations:

While Section 1263 of the ‘Consolidated Appropriations Act of 2023’ gave the Assistant Secretary for Mental Health and Substance Use the authority to also approve specific training organizations for this purpose, at the present time, SAMHSA has elected not to undertake a lengthy rulemaking process. This would potentially set up a burdensome system for applications, review and approval. SAMHSA estimates that based on the categories listed above, over 2,000 organizations may be eligible to provide the training.5,6

Even though SAMHSA has elected not to pursue the option to approve specific training organizations, the agency will continue to support training and technical assistance as part of its efforts to expand and enhance the behavioral health workforce. This is achieved through provision of the Provider Clinical Support System and other related grant programs, as well as evidence-based publications available in the SAMHSA store. Given the urgency of the nation’s overdose crisis, the importance of practitioners receiving training in substance use disorders (SUD) cannot be overstated. Incorporating training on SUD into routine healthcare will enable practitioners to screen more widely for substance use disorders, treat pain appropriately, prevent substance misuse, and engage people in life-saving interventions.

All members of an individual’s care team play a pivotal role in educating their patients and colleagues; screening, diagnosing, and treating patients; and modeling positive attitudes to reduce the stigma attached to SUDs. Research demonstrates that SUD educational interventions, using various approaches and durations, produce a positive impact on learner’s knowledge, skills, and attitudes.13 Studies also reveal that simply increasing exposure to individuals with use disorders does not provide the formative knowledge required to identify, treat or even prevent SUDs without engagement in a comprehensive didactic curriculum.7

This guide does not establish legally binding standards for substance use disorder curricula.  Rather, the purpose of this guide is to describe recommended core elements and content of substance use disorder curricula for those entities authorized to provide the substance use disorder training required under the MATE Act. It may also act as a guide to those DEA registrants who seek information on SUD-related education.

Consideration of core elements is important because there is wide heterogeneity in SUD curricula across educational providers and institutions.6 This can adversely impact patient care and confuse practitioners. Indeed, a lack of preparedness has been identified as a barrier in the provision of buprenorphine to patients with opioid use disorder by early career family physicians.8,9 Moreover, a lack of appropriate education has also been shown to foster negative attitudes towards the provision of medications to treat substance use disorders, but not preventative counseling.10,11,12 Inadequate or poorly delivered training adversely impact patient-practitioner dialogues and contribute to the under-treatment of SUDs by primary care and specialty providers.13,14 Comprehensive teaching on SUDs, addiction, pain management, and treatment modalities has the potential to overcome these deficits and to positively impact practitioners and their patients.15

Therefore, SAMHSA recommends that graduate health professional curricula and continuing education address the core elements of training listed below to ensure that practitioners have the knowledge, skills and competencies to diagnose and treat SUDs. Recommended training would incorporate culturally competent collaboration and clinical practice, as well as Risk Evaluation and Mitigation Strategies.16 Core elements for consideration also ensure prescribers understand the risks and role of medications to effectively treat pain, screen for substance use and related risk factors for substance use, as well as the impact of trauma, historical biases, and stigma as barriers to engaging patients into treatment. In this way, educational activities should be designed for, and measure changes in, one or more of the following elements:

Training and content that incorporate opportunities to fully integrate knowledge into practice will facilitate screening and case finding, and will assure practitioners, no matter their discipline or clinical practice setting, are competent in the skills needed to screen, counsel, refer, and coordinate care for patients with these disorders. The recommended core curricular elements, below, were developed with input from accrediting bodies, through listening sessions with educators, written feedback from stakeholders, engagement with the Department of Health and Human Services Behavioral Health Coordinating Committee Opioid Prescriber Education Workgroup, and close review of the National Academies of Medicine 3Cs Framework for Pain and Unhealthy Substance Use: Minimum Core Competencies for Interprofessional Education and Practice.17

As an overarching concept, SAMHSA recommends that content should be related to the prevention, recognition, and care of people with substance use disorders including those with concurrent pain and/or psychiatric and medical co-morbidities. Categorized for organizational purposes, recommended core curricular training elements could therefore include:

The elements above, provide a basic overview of SUD identification, management and evidence-based care, as well as pain management.9 They highlight the importance of recognizing, preventing, and caring for people with substance use disorders including those with concurrent pain and/or psychiatric and medical co-morbidities. Moreover, they can also form the basis, where appropriate, for creating performance evaluation criteria as recommended educational activities should be designed for, and measure changes in learners’ competence (i.e. applied knowledge, strategies), and/or learner performance (i.e. can demonstrate a change in practice or processes), and/or patient health (i.e. how patients respond to a change), and/or community or population health (i.e. how groups of people respond to a change).

Over the past several years, professional societies and researchers have proposed and created example longitudinal addiction medicine curricula.28 This is augmented by a multitude of evidence-based resources that address discrete elements of the continuum of substance use disorders in an interactive and evidence-based manner. Such resources include: the Coalition of Physician Education in SUD; the UCSF Smoking Cessation Leadership Center; NIH Training Resources; Providers’ Clinical Support System for Medication Assisted Treatment; the FDA Opioid Risk Evaluation and Mitigation Strategies; CDC modules on pain management; and SAMHSA’s Evidence-Based Practices Resource Center. The availability of existing resources decreases the burden of implementing new educational activities while also exposing learners to evidence-based, public health resources.

SAMHSA urges the integration of evidence-based practice into clinical education, and as new evidence or information becomes available, SAMHSA reserves the right to update these recommendations. This is because effective education lays the foundation for optimal patient management, and never has there been a greater need for a widely disseminated, knowledgeable and compassionate workforce capable of diagnosing and managing SUDs. SAMHSA encourages all practitioners to screen for and to treat substance use disorders. Further information about buprenorphine and the management of SUDs can be found on the SAMHSA website.

The SAMHSA store offers free resources that provide practical information: SAMHSA’s Quick Start Guide and Buprenorphine Quick Start Pocket Guide provide advice on initiating treatment with buprenorphine among those individuals who screen positive for opioid use disorder. For more comprehensive information, please refer to TIP 63: Medication for Opioid Use Disorder and Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings. Finally, the Providers Clinical Support System can provide free technical assistance as needed.

1 Blanco, C., Wiley, T.R.A., Lloyd, J.J. et al. America’s opioid crisis: the need for an integrated public health approach. Transl Psychiatry 10, 167 (2020). https://doi.org/10.1038/s41398-020-0847-1

2 See https://www.congress.gov/117/bills/hr2617/BILLS-117hr2617enr.pdf

3 Practitioners who previously took training to meet the requirements of the DATA-2000 waiver to prescribe buprenorphine can count this training towards the 8-hour training requirement.

4 Section 1263. Requiring Prescribers Of Controlled Substances To Complete Training. The Consolidated Appropriations Act, 2023. For the statutory language of P.L. 117-328.

5 See https://www.accme.org/news-releases/accme-data-report-shows-steady-growth-accredited-continuing-medical-education-2019

6 See https://ccepr.ada.org/national-approval-section#sort=%40cenasprovider%20ascending

7 Tetrault, J. Improving Health Professions Education to Treat Addiction: The Time Has Come. The Josiah Macy Jr Foundation, News and Commentary. May 2018.

8 DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA Jr. Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians. Rural Remote Health. 2015;15:3019.

9 Tong ST, Hochheimer CJ, Peterson LE, Krist AH. Buprenorphine Provision by Early Career Family Physicians. Ann Fam Med. 2018;16(5):443-446. doi:10.1370/afm.2261

10 Ober AJ, Watkins KE, Hunter SB, Ewing B, Lamp K, Lind M, et al. Assessing and improving organizational readiness to implement substance use disorder treatment in primary care: findings from the SUMMIT study. BMC Fam Pract. 2017;18(1):107.

11 Alanis-Hirsch K, Croff R, Ford JH 2nd, Johnson K, Chalk M, Schmidt L, et al. Extended-release naltrexone: A qualitative analysis of barriers to routine use. J Subst Abuse Treat. 2016;62:68–73.

12 Louie DL, Assefa MT, McGovern MP. Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review. BMC Fam Pract. 2019;20(1):157. Published 2019 Nov 15. doi:10.1186/s12875-019-1047-z

13 Kennedy-Hendricks A, Busch SH, McGinty EE, et al. Primary care physicians' perspectives on the prescription opioid epidemic. Drug Alcohol Depend. 2016;165:61-70. doi:10.1016/j.drugalcdep.2016.05.010

14 Press KR, Zornberg GZ, Geller G, Carrese J, Fingerhood MI. What patients with addiction disorders need from their primary care physicians: A qualitative study. Subst Abus. 2016;37(2):349-355. doi:10.1080/08897077.2015.1080785

15 Hoffman, J. (2018, September 10). Most Doctors Are Ill-Equipped to Deal With the Opioid Epidemic. Few Medical Teach Addiction. The New York Times, p. D1.

16 Holmboe, E., S. Singer, K. Chappell, K. Assadi, A. Salman, and the Education and Training Working Group of the National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic. 2022. The 3Cs Framework for Pain and Unhealthy Substance Use: Minimum Core Competencies for Interprofessional Education and Practice. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://doi.org/10.31478/202206a.

17 Holmboe E, Singer S, Chappell K, Assadi K, Salman A. The 3Cs Framework for Pain and Unhealthy Substance Use: Minimum Core Competencies for Interprofessional Education and Practice. NAM Perspect. 2022 Jun 6;2022:10.31478/202206a. doi: 10.31478/202206a. PMID: 36177204; PMCID: PMC9499381.

18 The American Society of Addiction Medicine. The ASAM Fundamentals of Addiction Medicine Recognition Program: Competencies and Curriculum Learning Objectives. 2015

19 American Society of Addiction Medicine. ASAM Standards of Care for Addiction Specialists. 2014

20The Patient Care Process for Delivering Comprehensive Medication Management (CMM): Optimizing Medication Use in Patient-Centered, Team-Based Care Settings. CMM in Primary Care Research Team

21 Substance Abuse and Mental Health Services Administration (SAMHSA): Treating Concurrent Substance Use Among Adults. SAMHSA Publication No. PEP21-06-02-002. Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2021.

22 The State of Massachusetts. Recommendations From The Governor’s Medical Education Working Group On Prescription Drug Misuse. Medical Education Core Competencies for the Prevention and Management of Prescription Drug Misuse. 2015

23 Wandner, L. D., Prasad, R., Ramezani, A., Malcore, S. A., & Kerns, R. D. (2019). Core competencies for the emerging specialty of pain psychology. American Psychologist, 74(4), 432–444. https://doi.org/10.1037/amp0000330

24 Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1

25 Tran T, Ball J, Bratberg JP, DeSimone EM, Franko TS, Hill LG, Sharp CPK, Palombi L, Ventricelli D, Farrell D, Gandhi N, Moore T. Report of the 2020 Special Committee on Substance Use and Pharmacy Education. Am J Pharm Educ. 2020 Nov;84(11):8421. doi: 10.5688/ajpe8421. Epub 2020 Nov 2. PMID: 34283760; PMCID: PMC7712728.

26 Servis M, Fishman SM, Wallace MS, Henry SG, Ziedonis D, Ciccarone D, Knight KR, Shoptaw S, Dowling P, Suchard JR, Shah S, Singh N, Cedarquist LC, Alem N, Copenhaver DJ, Westervelt M, Willis BC. Responding to the Opioid Epidemic: Educational Competencies for Pain and Substance Use Disorder from the Medical Schools of the University of California. Pain Med. 2021 Feb 4;22(1):60-66. doi: 10.1093/pm/pnaa399. PMID: 33316051; PMCID: PMC8921611.

27 Rutkowski, Beth. (2019). Specific disciplines addressing substance use: AMERSA in the 21st century. Substance Abuse. 40. 1-4. 10.1080/08897077.2019.1686726.

28 The American Academy of Family Physicians, Recommended Curriculum Guidelines for Family Medicine Residents: Substance Use Disorders. Accessed on 01/26/2021.

How does Federal removal of X-Waiver (DEA-X) requirement effect Kentucky APRNs?

New Federal law ends requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD).

Regulatory changes will be needed in Kentucky as a result 

KY Regs and Laws on prescribing limits, educational preparation remain in effect

Section 1262 of the Consolidated Appropriations Act, 2023 (also known as Omnibus bill), removes the federal requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD). With this provision, and effective immediately, SAMHSA will no longer be accepting NOIs (waiver applications).


From SAMHSA website

The Kentucky Board of Nursing's General Council Jeffrey R. Prather, explains the steps that the board must now take to update state regulations in regard to this DEA-X waiver change.

Prather explains, "As you are aware, the President signed the omnibus appropriations bill on December 29, 2022. The House passed the measure on December 23, 2022, after it was passed by the Senate on December 22, 2022. With the bill’s passage, the requirement that healthcare providers possess a Drug Enforcement Administration (DEA) X-waiver to prescribe buprenorphine to treat opioid use disorder (OUD) was eliminated, effective immediately.

The process to amend Kentucky Regulations

KBN Board staff is reviewing the repeal of the X-waiver requirement and the potential necessitated regulatory changes to comply with its elimination. Any proposed regulatory changes will need to be reviewed and recommended by the Kentucky APRN Council and the Practice Committee to be presented to the full Board.

Once the Board has voted on any accepted changes, the amendments will be filed with the legislative research commission for promulgation. The full Board is currently scheduled to meet again in February. Assuming the Board passes approved amendments, the regulations would likely be filed in March.

Once filed, there will be a two-month comment period, before it goes before the legislative committees for consideration. Unfortunately, the process can be complicated. It is too early for Board staff to provide an estimated timeline for the promulgation, or a date that any amendments might take effect.

X-Waiver is only requirement eliminated, other prescribing and education requirements are still in effect

Moreover, APRN prescription limits are also mandated by Kentucky statute. The Board may have input, but any statutory changes would have to come from the General Assembly and signed into law by the Governor.

KBN feels compelled to caution APRNs who may consider prescribing buprenorphine without having sufficient training and education. All nurses are “responsible and accountable for making decisions that are based upon the individuals' educational preparation and experience and shall practice with reasonable skill and safety.” See KRS 314.021(2). The x-waiver is the only requirement that has been eliminated. Any other prescribing requirements under state and federal statute and regulation are still in effect. 

Federal bill adds new training requirements

The bill also introduced new training requirements for all prescribers. These requirements will not go into effect until June 21, 2023. The DEA and Substance Abuse and Health Services Administration (SAMHSA) are working to provide further guidance. The Board understands that the DEA will follow up with additional information on these requirements in the near future."

KANPNM appreciates KBN's efforts to provide information to our members on this issue and its evolving implications and impact on Kentucky regulation and law.

Should you require additional information, please contact Brittany Click, APRN, Professional Consultant at the Kentucky Board of Nursing at (502) 229-6114.

Kentucky Board of Nursing website

# # # # # # #

Nurse licensure renewal takes place each year between September 15 and October 31. Once you have that KBN license renewal in place, remember to update your DEA registration with your renewed Kentucky license expiration date. 

Wendy Fletcher, DNP, APRN recently urged members to act quickly to get their renewal license information updates in place as it can be a time consuming task and missing the deadline can be costly to you and your patients.

Says Dr. Fletcher, "This is your friendly annual reminder to update your DEA registration with your renewed KY license expiration date as you receive your new license. Please don’t wait until the last minute to renew, as updating your credentials with the DEA, Medicaid, and payers can take some time. A lapse of even one day can be costly to you and a detriment to your patients who may not be able to see you or fill prescriptions if your paperwork is not in order." 

Thanks Dr. Fletcher for the timely reminder and easy to follow how-to instructions!

CABINET FOR HEALTH AND FAMILY SERVICES

Department for Medicaid Services 

March 16, 2022

KY Medicaid plans to reinstate the need for Prior Authorization for services for Inpatient and Outpatient Hospital services effective 5/1/22. Only those services performed due to a COVID diagnosis will not require PA. We are sending the notice to all known provider associations and information will be posted on the websites to get the information out. 

Prior Authorization Guidance

Updated March 16, 2022 

• Medicaid Fee-for-Service (FFS) and Managed Care Organizations (MCOs) may require prior authorization (PA) for all inpatient and outpatient Medicaid services provided by Kentucky Medicaid enrolled inpatient hospital providers (Provider Type 01) except for admissions with a COVID diagnosis, effective May 1, 2022.
  
• FFS and MCOs may require PA, for provider type 93, Rehabilitation Distinct Part Unit, effective May 1, 2022.
  
• FFS and MCOs may require PA, for provider type 12, Skilled Nursing Facilities, effective May 1, 2022.
  
• PA for Medicaid covered substance use and behavioral health services continues to be waived.
  
• FFS and MCOs may require a PA for an outpatient service/procedure at other outpatient facilities or other Medicaid service based on their Utilization Management program, except for individuals with a COVID diagnosis. Please refer to the FFS or MCO’s specific PA guidelines.
  
• PA remains in place for all pharmacy benefits and products listed on the physician administered drug lists, except for medication assisted treatment (MAT) products (i.e. Sublocade).
  
• To facilitate provider payment, requirements for prior authorization of non-Kentucky Medicaid enrolled providers will remain in place.
  
• FFS and MCOs will continue to monitor for fraud, waste, and abuse (FWA) activity.
  

CLICK HERE to view the official notification from CHFS.

Nurses selected at random for the audit will be notified by CE Broker

The KBN has partnered with CE Broker to be the official CE tracking system.  Beginning in early February, CE Broker will send notices via email to nurses who were randomly selected for the CE audit.  This audit covers the earning period of November 1, 2020 – October 31, 2021.

Information on the CE Audit is available on the KBN website athttps://kbn.ky.gov/Education/Pages/CE-Audit-CE-Broker.aspx.  Nurses may register for a free basic account at  https://cebroker.com/ky/account/basic/.  Although CE Broker offers accounts with additional features for a fee, the only account needed to report and upload proof of CE compliance is the Free basic account.

READ THE KBN MEMO with information on the audit.

If you have further questions concerning the audit or the processes, please contact:

Michelle Gary

Michelle Gary 

Practice Assistant

Continuing Competency Coordinator

Kentucky Board of Nursing

312 Whittington Parkway, Suite 300

Louisville, KY  40222

(502) 429-3333

michellea.gary@ky.gov

MEMORANDUM

VIEW ACTUAL MEMORANDUM DOCUMENT

TO: All Advanced Practical Registered Nurses (APRNs) licensed or practicing within Kentucky 

FROM: Kelly R. Jenkins, Executive Director, Kentucky Board of Nursing 

DATE: January 24, 2022 

RE: CAPA-CS & CAPA-NS Reinstatement /DEA Registration 

On March 31, 2020, by Order of the Secretary of State, the CAPA-CS and the CAPA-NS requirements related to APRN prescribing of medications were suspended due to the COVID-19 state of emergency. The Kentucky Board of Nursing has advised APRNs that they will be afforded a 30-day grace period to comply with the requirements once they are reinstated. On January 13, 2022, the Kentucky General Assembly declined to extend the Order, and it ended on January 15, 2022 at 12:01 AM. 

Therefore, by close of business on Monday, February 14, 2022, all APRNs must come into compliance with the reinstated collaborative agreement requirements under Kentucky Revised Statutes (KRS) 314.042(8, 10) and 201 KAR 20:057. 

• KRS 314.042 License to practice as an advanced practice registered nurse -- Application -- Renewal -- Reinstatement -- Use of "APRN" -- Prescriptive authority under CAPA-NS and CAPA-CS -- Exemption from CAPA-NS requirement --Administrative regulations.

o See, https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=51271 

• 201 KAR 20:057. Scope and standards of practice of advanced practice registered nurses.

o See, https://apps.legislature.ky.gov/law/kar/201/020/057.pdf 

Prescribing of Non-Scheduled Legend Drugs (NS) 

An APRN may enter into a collaborative agreement for prescriptive authority for non-scheduled drugs (CAPA-NS) with a licensed Kentucky physician upon receiving licensure. 

If you have entered into a collaborative agreement, you must have the following document on file with KBN:

• A Notification of a CAPA-NS form 

Prescribing of Controlled Substances (CS) 

An APRN may not enter into a collaborative agreement for prescriptive authority for controlled substances (CAPA-CS) with a licensed Kentucky physician until one year from date of licensure. For example if your license was issued on January 5, 2022, then you may not enter into a CAPA-CS agreement until January 5, 2023. 

If you have been prescribing for one or more years, you must have the following documents on file with KBN: 

• A Notification of a CAPA-CS Form, 

• KASPER Master Account, and 

• DEA Registration.

o If you are an APRN who has been licensed for less than one year, please see the note below regarding the DEA registration. 

If you have met the above requirements, you are in compliance with the statutory and regulatory provisions for prescriptive authority. If the documents listed above are not on file at KBN, you must upload them through the APRN Portal. The links to access the APRN Portal are below: 

• APRN Portal/APRN Update: https://kbn.ky.gov/Pages/advanced-practice-registered-nurse.aspx\ 

• APRN Portal/Update Instructions: https://kbn.ky.gov/Practice/Pages/APRN-Update-Instructions.aspx 

• You can verify whether the KBN has these documents on file through the online validation service: https://kbn.ky.gov/General/Pages/Validation.aspx 

An APRN may not enter into a CAPA-CS with a licensed Kentucky physician until one year from date of licensure. An APRN who has not met the one year requirement will have until February 14, 2022 to assist their patients in finding another healthcare professional for medical conditions that require the prescribing of controlled substances. 

Please note DEA staff has advised that APRN’s who have not met the one-year license requirement will not have their DEA registration retired. Regardless, the APRN will not be able to prescribe controlled substances until the one-year requirement has been met. Moreover, these APRNs will not forfeit their certification fee of $888. If you have any questions regarding the status of your DEA registration, please contact Chad Killian at Chad.E.Killian@dea.gov or (502) 216-2743. 

________________________________ 

Kelly R. Jenkins MSN,RN,NE-BC 

Executive Director 

Kentucky Board of Nursing 

CAPA-CS Waiver in Governor's Executive Orders Ends January 15, 2022.

The CAPA-CS Waiver that has allowed APRNs to prescribe controlled substances during the pandemic will sunset on Friday, January 15, 2022.

Providers who have been prescribing under the waiver, which was part of the Governor's pandemic response Executive Orders, must cease until the provider has a current prescribing agreement for controlled substances in place with the Kentucky Board of Nursing.

Memorandum from KBN on Reinstatement of CAPA-CS and CAPS-NS Requirements

APRN Portal/ APRN Update page at KBN.

END OF CAPA-CS WAIVER ITEMS TO CONSIDER

Here is a message from Cathy Waits that accompanied some early alerts about the end of the CAPA-CS waiver and what it means to APRN providers who have been using its provisions to extend access to care in their communities. 

Important message applicable to all Kentucky APRNs prescribing!

CAPA-CS Waiver ends January 15, 2022

When the CAPA-CS Waiver in Governor’s Executive Orders ends on January 15, 2022, please do not prescribe nonscheduled drugs or controlled substances without an up-to-date KBN acknowledged collaborative agreement.

You may have already rescinded your CAPA-NS with KBN. You do not have to renew a CAPA-NS if you have met the criteria for rescinding. 

CAPA and DEA certification

ALL prescribers of Controlled meds MUST have a CAPA-CS that has been reported to KBN. If you applied for a DEA cert and have been prescribing without a CAPA-CS,  you must renew your CAPA-CS immediately.  

If you have been prescribing CS and have not been licensed for one year, you must stop immediately and establish an agreement with a physician collaborator after you have been licensed for one year. You will also have to terminate your DEA certification. After the year is up, you will need to reapply for the DEA certification.

Do not trust others to look after your license

If you have an employer agreement, be aware that is not necessarily a CAPA-NS or CS! The safest thing to do is to use the KBN documents and have the physician you are working with sign them. Then, upload the completed documents via the KBN portal.

Please, please take care of your own license! Do not, for instance, let an office manager take care of these very important details that affect YOUR LICENSE.  You need to keep a hard copy and a cell phone available picture of your CAPA-NS, CS and DEA. 

CAPA-CS and its barriers to care needs to end

Finally, let’s get rid of the CAPA once and for all! The circumstances and actions in Frankfort on February 13 that resulted in the CAPA-CS waiver being cut from further extension was first discovered and alerted by our KANPNM lobbyists.

Decisions made by the legislature affect all 10,000 of Kentucky’s APRNs — not just our KANPNM membership! 

Your voice needs to be heard in Frankfort! If you are not a member, please join. Do it for lots of reasons -- like our Association fellowship, our regional meetings, our nationally recognized annual conference and more -- but please let your voice be heard in the Kentucky Advanced Practice PAC! You can make a simple one-time or monthly contribution to promote access to care. KAP-PAC fuels our advocacy efforts and helps keep our pro-patient policy goals in front of legislators.         

KAP-PAC puts your money where your passion is  --  promoting patient care. 

kap-pac.com is at your fingertips. Strike a blow to ending the barriers of CAPA-CS in Kentucky with a donation today.

Catherine Waits, MSN, APRN, FNP-BC, C-GRH
Family/ Women’s Health Nurse Practitioner

The original website news article  "CE audit to KBN via CE Broker due Feb 23" follows below:

CE audit to KBN via "CE Broker" due Feb. 23

New CE Tracking System allows document uploads to complete process

Those selected for CE Audit have been notified by email

The Kentucky Board of Nursing CE Audit notifications were sent via email by CE Broker on February 1, 2021. CE Broker is now the official CE tracking system of the Kentucky Board of Nursing. 

This notification is genuine and is not Spam, a scam or phishing attempt.  If you were selected to undergo the 2020 CE Audit from the Kentucky Board of Nursing (KBN) you may follow the steps to provide the necessary documentation as noted on the KBN website.

The link to the appropriate web page is as follow: https://mail.google.com/mail/u/0/?tab=rm&ogbl#inbox/FMfcgxwLsJzmbhZxtnxdJRBwlkfVZJWT 

All APRNs must upload the following items: 

• A copy of their national nursing certification initially obtained, renewed, or in effect during the entire earning period; and 

• CE completion certificate from an approved CE provider, for at least five (5) contact hours in pharmacology completed during the earning period. (The CE completion certificate must list the APRN’s name and indicate the number of contact hours designated as pharmacology.) 

APRNs with a CAPA-CS must upload the following items:

• A copy of their national nursing certification initially obtained, renewed, or in effect during the entire earning period; 

• CE completion certificates from an approved CE provider, for at least five (5) contact hours in pharmacology completed during the earning period. (The CE completion certificate must list the APRN’s name and indicate the number of contact hours designated as pharmacology.); and 

• CE completion certificates from an approved CE provider, for at least (1.5) contact hours related to the use of the KASPER system, pain management or addiction disorders. These hours may count toward the five (5) contact hours in pharmacology

The deadline to report and upload documentation for the CE audit is February 23, 2021.

Should you have questions related to the KBN CE audit, please contact Michelle Gary, CE Competency Coordinator through email at MichelleA.Gary@ky.gov

 Please note that email and call volume is high during this time period so we would request patience.  All calls and emails will be returned just as soon as possible.

Thank you.

Myra Goldman, MSN, RN, APRN, FNP-C

Professional Support Branch Manager/APRN Education/Practice Consultant 

Kentucky Board of Nursing

Mandatory Electronic Prescribing of Controlled Substances is Coming 

Are You Ready?

(EPCS article 08-14-2020)

Kentucky Revised Statute 218A.182 mandates the electronic prescribing of controlled substances (EPCS) in Kentucky effective January 1, 2021. The Kentucky mandate is similar to the federal Medicare Part D EPCS mandate effective January 1, 2021, but applies to all controlled substances prescribed in Kentucky - regardless of payer. 

Some controlled substance prescriptions will be exempt from the Kentucky EPCS mandate. The complete list of exceptions is found in KRS 218A.182. Examples include:

• Prescriptions issued by veterinarians
• Prescriptions issued for hospice patients or residents of a nursing facility
• Prescriptions issued during a temporary technological or electrical failure
• Prescriptions issued for extemporaneous compounding 
• Prescriptions issued by practitioners who have received a temporary EPCS waiver from the Cabinet for Health and Family Services (CHFS)

A practitioner who is unable to comply with the EPCS mandate may petition the cabinet for a temporary waiver based on: 

• Economic hardship
• Technological limitations outside the practitioner’s control
• Other exceptional circumstances

Practitioners who wish to seek an initial temporary waiver must submit a completed Temporary Exemption Form (see link below) to the cabinet no later than November 1, 2020.

Additional information regarding EPCS prescription requirements and temporary waivers are available in Kentucky Administrative Regulation 902 KAR 55:130 and on the CHFS-OIG Drug Enforcement website.

If you have an Electronic Health Record (EHR) system that is not currently EPCS certified, you should contact your EHR vendor as soon as possible to determine how to implement EPCS. If you prescribe controlled substances in Kentucky, please take the appropriate steps now to ensure compliance with the Kentucky EPCS mandate.  Failure to do so may result in penalties, including licensure board referral and fines.

Helpful Links:

EPCS Temporary Exemption Request Form: https://chfs.ky.gov/agencies/os/oig/dai/deppb/Documents/EPCSTemporaryExemptionForm.pdf. 

KRS 218A.281: https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=49590.

KAR 902 55:130: https://apps.legislature.ky.gov/law/kar/902/055/130.pdf. 

CHFS-OIG Drug Enforcement: https://chfs.ky.gov/agencies/os/oig/dai/deppb/Pages/default.aspx.

DEA EPCS Website: https://www.deadiversion.usdoj.gov/ecomm/e_rx/.