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House approves expanded prescriptive authority for advanced-practice nurses after debate
Summary
The House passed HB351, which merges advanced-practice and prescriptive nurse licensing and allows advanced-practice registered nurses (APRNs) to prescribe Schedule II drugs under a required consultation/referral agreement with a physician; the bill passed 64–8 after extended debate over training and patient safety.
The Utah House on Feb. 26 passed House Bill 351, a broad update to the Nurse Practice Act that merges advanced-practice and prescriptive licensing and permits advanced-practice registered nurses to prescribe Schedule II medications when they meet licensing criteria and maintain a formal consultation and referral agreement with a physician.
Proponents said the change will reduce duplication in licensing, clarify the practice scope for roughly 20,000 licensed nurses in Utah and improve access to care in rural and underserved areas. “In order to prescribe these Schedule II medications, they have to have a referral and consultation agreement with a physician so that if there is a problem, they are able to do that,” said an on-record sponsor during floor debate.
Opponents pressed safety and training concerns. Representative Alexander said he remained worried about whether nurses will receive the ongoing, consistent pharmacology training necessary as drug options multiply: “Im worried about training,” he said, urging further safeguards before expanding prescriptive authority.
Supporters pointed to existing precedents for expanded prescriptive roles and oversight mechanisms. Backers noted APRNs had prescribed Schedule III drugs for years with no reported systemic abuse and argued that the bill establishes quality review requirements and clearer peer-review processes. Representative Tanner described the change as an important step for modernizing practice and helping rural clinics.
The bill also creates a restricted account and gives the Division of Occupational and Professional Licensing (DOPL) authority for enforcement and a fund for monitoring and education, language supporters said is consistent with other professional licensing statutes.
After extended exchanges on training, liability and the practical effect in rural areas, House members voted to pass HB351 64–8. The bill will now move to the Senate for consideration.
