Colorado Certification and Licensure Plan for APRNs

I reside in Colorado and I will discuss the process for receiving certification and licensure for the APRN. First, Colorado allows for full practice with no physician collaboration (https://www.aanp.org/advocacy/colorado).

1.  How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?

In Colorado, first you need to have a registered nurse license before applying for your APRN. The website for the Colorado Board of Nursing is called DORA, Department of Regulatory Agencies (https://dora.colorado.gov/). The next few lines are taken from the application checklist on DORA:

            Provide information regarding other healthcare licenses you may have held.

● Upload verification of your National Certification (AANP, ANCCC, PNCB, AMCB, NCC, etc.)

● Select your population focus. If you declare multiple populations, you must upload additional

national certification(s) that correlate with each population focus.

● Declare your primary state of residence (PSOR).

● Attest to holding professional liability insurance.                                                                           (https://dpo.colorado.gov/Nursing/APNApplications).

Also, the other certification process is applying for your RXN, for prescriptive authority the Colorado statue is as follows:

  • Satisfactory completion of specific educational requirements in the use of controlled substances and prescription drugs, as established by the board, either as part of the degree program or additional degree program.
  • Professional liability insurance
  • Signed attestation that she or he as completed at least three years of combined clinical work experience as a professional or as an advanced practice nurse. Citation: Colo.Rev.Code Ann.statute 12-255-111(2)and(3) and 12-255-112(4)(a) (Buppert, p. 147).

2. What is the application process for certification in your state? The application is all on line and I cannot show you the forms for the application process.

3. What is your state board’s nursing website? https://dora.colorado.gov/ after getting to the website the licensee will click on the “Apply for License” icon and then search for the nursing tab and it will take you to all licenses available to nurses aides, RNs, LPNs, and APRNs

4. How does your state define the scope of practice of a nurse practitioner? According to Buppert, Colorado defines scope of practice as this:

The board shall establish the advanced practice registry and shall require that a nurse applying for registration identify his or her role and population focus. The board shall establish reasonable criteria for designation for specific role and population foci based on currently accepted professional standards. A nurse who is included in the APRN registry has the right to use the title “advanced practice nurse”, “clinical nurse specialist”, “certified registered nurse anesthetist”, or “C.R.N.A.”, or “N.P.”, respectively. It is unlawful for any person to use any of the titles or abbreviations listed in this subsection (2) unless included in the registry and authorized by the board to do so. Citation: Colo. Rev.Stat.Ann.statute 12-255-111(2) (p.21).

5. What is included in your state practice agreement?

            It appears that if you want to have prescriptive authority as an APRN in Colorado you must also apply for your RXN as stated in the previous section. One has to apply for both licensures:

● Select your population focus, if applicable. If you declare multiple populations you must upload additional national certification that correlates with each population focus.

● Attest to holding an active RN license for at least 3 years.

Original applicants for a provisional prescriptive authority must:

● Attest to the completion of 750 hours of prescribing experience while engaged in a mutually-structured mentorship with a Colorado-licensed physician or advanced practice nurse with full prescriptive authority with a corresponding focus (https://dpo.colorado.gov/Nursing/APNApplications).

There is a correction to Buppert that needs to be pointed out. According Buppert the NP must spend 1000 hours with another NP in that specialty or psychiatrist. Due to the shortage of PMHNPs in Colorado the state had to reduce the hours so more NPs could be licensed more expediently.

6. How do you get a DEA license?

            Once the NP receives a Colorado license he or she may apply on the Drug Enforcement Agency’s website https://www.deadiversion.usdoj.gov/.

7. Does your state of a prescription monitoring program (PMP)?

            Yes, prescribers must establish an account with the PMP of Colorado.

            Pharmacies upload prescription data every regular business day for controlled medications listed in Schedules II to V that are dispensed to Colorado patients. Prescribers and pharmacists with registered accounts may access information on patients under their care up to three members of their healthcare teams (https://dpo.colorado.gov/PDMP/About).

8. How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

According to Buppert, Colorado NPs have “explicit legal authority to prescribe/ No physician involvement required” (p.210). NP’s may prescribe class Schedule II to V drugs.

References:

American Association of Nurse Practitioners. (2020). State practice environment.

https://www.aanp.org/advocacy/state/state-practice-environment.

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones &

Bartlett Learning.

Colorado Board of Nursing. https://dora.colorado.gov/.

Colorado Board of Nursing. https://dpo.colorado.gov/Nursing/APNApplications.

Due to life situations relating to my spouse, I will likely move to Colorado within one year of being licensed in Virginia.  It’s good to know that Colorado is a full practice state, including Schedule II medications. This is good for me as a psychiatric nurse practitioner because many people end up being referred to psychiatry because they’re taking ADHD medication which is often schedule II (Sonenberg et al., 2017)

After doing some research, I can see that Colorado also has an opioid crisis, especially regarding the rural population. There have been pilot programs that increase the practice authority relating to opiates for both nurse practitioners and physician assistants.  The increased practice authority allowed for greater access to treatment for opiate use disorder by more than doubling the number of providers, specialty for Suboxone type medications (Sorrell et al., 2020).

References

Sorrell, T. R., Weber, M., Alvarez, A., Beste, N., Hollins, U., Amura, C. R., & Cook, P. F. (2020). From policy to practice: Pilot program increases access to medication for opioid use disorder in rural Colorado. Journal of Substance Abuse Treatment114, 108027. https://doi.org/10.1016/j.jsat.2020.108027

Sonenberg, A., & Knepper, H. J. (2017). Considering disparities: How do nurse practitioner regulatory policies, access to care, and health outcomes vary across four states? Nursing Outlook65(2), 143–153. https://doi.org/10.1016/j.outlook.2016.10.005

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