The HB 423 of Controlled substances was signed into law on April 14, 2016, and took effect on January 1, 2017. The bill “allows ARNPs and PAs to prescribe controlled substances under existing supervision and protocol requirements, and subject to a formulary to be developed by a committee under the Board of Nursing” (Miller, 2021). This house bill has several limitations on prescribing controlled substances, such as the number of days allowed to prescribe schedule II controlled medications, only master or doctoral degree nurses may prescribe certain medications, and more.

House Bill 21 – Controlled Substances Education
HB 21 of controlled substances education requires providers registered to the DEA and authorized to prescribe controlled substances to take a board-approved two-hour continuing education course on prescribing controlled substances before their licensure renewal (Miller, 2021). This bill has reinforced the requirements of education and regulation of controlled substances. Prescribers are able to review a patient’s controlled substance dispensing history before prescribing a controlled substance for a patient who is 16 years of age or older by using the Electronic-Florida Online Reporting of Controlled Substances Evaluation Program (E-FORCSE), also known as the database. HB bill 21 also requires clinics exempt from registering must now apply to the DOH for a certificate of exemption (Miller, 2021).

HB 831 Electronic Prescribing
HB 831 requires practitioners that use electronic health records (EHR) to electronically transmit prescriptions for medicinal drugs upon renewal of the health care practitioner’s license or by July 1, 2021, whichever is earlier (Miller, 2021). Any practitioner who does not have access to an EHR system may continue to provide written prescriptions to their patients for medicinal drugs.

Find the BB related to prescribing Durable Medical Equipment and Home Health Services. Make sure to discuss the impact of the Affordable Care Act or any other bills that have affected providers and/or patients?
The law policy had prevented Nurse Practitioners from prescribing durable medical equipment as well as admit patients to home health care. Because of the CARES act, they have removed this barrier for Nurse practitioners to allow privileges of home health care services. The restrictions are in which Medicare requires a physician to approve orders of DME (Durable Medical Equipment) order and in which NP have had a face to face with a Medicare patient within six months of the order. However, due to the CARE act, Np, CNS, and PA’s are allowed now to certify home health care services under Medicare (Swan et al., 2015).

Health Bill 607 independent practice
Health Bill 607 allows advanced practice registered nurses to provide primary care without the supervision of a physician and work autonomously. Signed on March 11, 2020, the bill allows APRN’s to practice in a defined field of primary care autonomously which allows them to: Prescribe, dispense and administer any drug, initiate optimal plan of care and therapies, order diagnostic exams as well as OT and PT. In some health care institutions, autonomous APRNs will be allowed to admit, and manage care of patients. The biggest change that came with this bill is that APRN’s will be allowed to sign or certify any document that was required to be provided by a physician. In order to qualify for autonomous practice, the APRN will need to have completed at least 3000 hours within five years under the application/ supervision of an MD or DO. In addition, APRN must have completed three graduate level hours in differential diagnosis and three hours in pharmacology.

View the following presentation/s on You Tube. Be prepared to comment and discuss on the videos.
Dr. Cary Pigman is the main person that is responsible for the promotion and advancement of HB 607. He proposed the bill several times in which he had supported this bill not only with evidence on the high quality care that APRN’s render as well as anecdotal experience in collaboration with APRN’s. Due to the provider shortage in Florida and the increase in population especially the geriatric community in the coming years, the move of granting autonomous practice for APRNs is the best optimal approach to answer these concerns.

Discuss why states that removed barriers to practice have more NPs practicing in rural areas.
Distinguish the differences in practice for government and nongovernment APRNs. (Military and VA)
The practice of government APRNs (military and VA) differs from those in non-governmental organizations. APRNs in the government, including those in the military and the Veteran Affairs (VA), can practice to the full extent of their educations, training, and certification regardless of any restriction put forward by their state (“Office of Public and Intergovernmental Affairs,” 2016).
Examine the literature and discuss the evidence regarding quality and effectiveness of care provided by NP’s, patient outcomes compared to MD’s, patient satisfaction, and healthcare costs in the United States.
NPs exercising full practice authority provide more effective and quality primary care to patients, but there is no difference between them and medical doctors (Ortiz et al., 2018). However, Morrison-Beedy (2015) holds that nurse practitioners are a vital indicator of patients’ satisfaction, safety, and reduced emergency room visit, which goes a long way in reducing the health care cost both to the patient and government.
Full Practice Bill 972.
What is it? How will this impact future practices?
What does independence in practice, autonomy and collaborative practice mean throughout the country.
Allowing the APRNs to exercise full practice authority will impact the nursing practice in several ways including giving them the autonomy to diagnose, issue orders for diagnostic tests, and interpreting the results.
Collaborative Agreement
The collaborative agreement refers to a written contract establishing the joint practice for NPs and physicians in a complementary and collaborative framework. Rather than serving under the domination of the other, both parties collaborate to deliver quality patient care.

Involuntary Admission:
What is the involuntary admission?
Involuntary admission occurs when mental health patients get admitted to a hospital’s mental unit against their will.
What is the law in the state of Florida for involuntary admission?
The Baker Act is one of the laws that restrict involuntary admission. Based on this law, a patient must meet specific criteria before admission. Among them is that there should be evidence of the patient being mentally ill. There also ought to have existed a case of refusal to voluntary examination. The other criterion is the presence of evidence of the patient suffering without healthcare attention
How do these laws vary from state to state?
Some states dictate who can initiate a hold with options ranging from a professional health care provider, judge, police, or a layperson. They also differ based on the decision to hold a person (Maniaci et al., 2019). Some may require the person to be jailed for the sake of individual and public safety, while others may require specific interventions.
How does it affect NPs in Florida?
Florida, which recently allowed NPs full practice after meeting specific qualifications, allows these professionals to conduct involuntary examinations and admit patients with mental illnesses.