Key Notes:

  • Ohio licensure laws and prescribing authority for APRNs changed effective April 6, 2017.
  • Ohio’s laws governing standard care arrangements were revised on April 6, 2017, and will undergo further changes effective September 28, 2018.
  • Standard care arrangements should be updated in accordance with the new laws.

Ohio’s laws pertaining to advanced practice registered nurses (APRNs), which were last revised on April 6, 2017, will undergo further changes effective September 28, 2018. APRNs, physicians and health care institutions should review and update their standard care arrangements, policies and procedures, as applicable, to ensure compliance with the revised laws.

Changes Effective September 28, 2018

  • Clinical nurse specialists and nurse practitioners who are certified as psychiatric-mental health clinical nurse specialists or nurse practitioners, as applicable, by the American Nurses Credentialing Center may enter into standard care arrangements with physicians (but not podiatrists) who practice in the specialties of psychiatry, pediatrics, primary care or family practice, or a specialty that is the same as or similar to the nurse’s.
  • Standard care arrangements may permit an APRN to refer a patient to a physician or podiatrist who is not the collaborating physician or podiatrist and to obtain a consultation with a physician or podiatrist who is not the collaborating physician or podiatrist.

Earlier Changes Effective April 6, 2017

  • Ohio replaced its nurse practitioner certificate of authority with an APRN license that authorizes a registered nurse with advanced education and training to practice as a certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife or certified nurse practitioner. As a result, an APRN must now hold both an RN license and an APRN license.
  • The certificate to prescribe and initial externship certificate were eliminated. APRNs, other than certified registered nurse anesthetists, may prescribe and furnish most drugs as part of the APRN license without need for a separate certificate to prescribe. Additionally, the APRN drug formulary was changed from a list of drugs an APRN can prescribe to an exclusionary formula specifying the drugs and devices an APRN is not authorized to prescribe or furnish.
  • Physicians and podiatrists may now collaborate at the same time with up to five APRNs in the prescribing component of an APRN’s practice (the previous limit was three APRNs).
  • An APRN may continue to practice under an existing standard care arrangement without a collaborating physician or podiatrist for up to 120 days after the physician or podiatrist terminates the collaboration and the nurse notifies the Ohio Board of Nursing of the termination.
  • Standard care arrangements no longer need to include the following provisions:
    • A procedure for regular review of referrals by the nurse to other health care professionals and the care outcomes for a random sample of patients seen by the APRN.
    • A policy for care of infants up to age one and recommendations for collaborating physician visits for children from birth to age three.
  • The requirement that a copy of an APRN’s standard care arrangement be retained on file at each site where the APRN practices was changed to require that the standard care arrangement instead be retained on file by the APRN’s employer.

APRNs and physicians who have not yet updated their standard care arrangements in light of these earlier changes to the laws should do so now as they make revisions to comply with the upcoming changes.