AS Title 8, Chapter 68: Nursing

Article 1. Board of Nursing. Chapter 68. Nursing. Sec. 08.68.010. Creation and membership of Board of Nursing. There is created a Board of Nursing, consisting of seven members appointed by the governor as follows: (1) one member shall be a licensed practical nurse who is currently engaged in licensed practical nursing and has practiced for at least two years immediately preceding appointment; (2) one member shall be a registered nurse engaged in nursing education at the associate, baccalaureate, or graduate degree level at an institution that holds national nursing accreditation; (3) one member shall be an advanced practice registered nurse who is currently engaged in advanced practice registered nursing and has practiced for at least four years immediately preceding appointment; (4) two members shall be registered nurses at large who are currently engaged in registered nursing and have practiced for at least four years immediately preceding appointment; and (5) two members shall be persons who have no direct financial interest in the health care industry. Secs. 08.68.020 , 08.68.030. Term of office; limitation on term of service. [Repealed, § 49 ch 94 SLA 1987. For current law, see AS 08.01.035 .] Sec. 08.68.040. Source of appointments. [Repealed, § 46 ch 102 SLA 1976.] Sec. 08.68.050. Removal of board members. [Repealed, § 49 ch 94 SLA 1987. For current law, see AS 08.01.020 .] Sec. 08.68.060. Qualifications of registered nurse and licensed practical nurse board members. [Repealed, § 15 ch 29 SLA 2014.] Sec. 08.68.070. Election of officers. The board shall annually elect a chairman and secretary from among its members. Sec. 08.68.080. Meetings. The board shall meet at least four times a year. Sec. 08.68.090. Quorum. A majority of the board constitutes a quorum. Sec. 08.68.100. Duties and powers of board. (a) The board shall (1) adopt regulations necessary to implement this chapter, including regulations (A) pertaining to practice as an advanced practice registered nurse, including requirements for an advanced practice registered nurse to practice as a certified registered nurse anesthetist, certified clinical nurse specialist, certified nurse practitioner, or certified nurse midwife; regulations for an advanced practice registered nurse who holds a valid federal Drug Enforcement Administration registration number must address training in pain management and opioid use and addiction; (B) necessary to implement AS 08.68.331 — 08.68.336 relating to certified nurse aides in order to protect the health, safety, and welfare of clients served by nurse aides; (C) pertaining to retired nurse status; (D) establishing criteria for approval of practical nurse education programs that are not accredited by a national nursing accrediting body; and (E) establishing guidelines for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug to a person without conducting a physical examination under AS 08.68.710 ; the guidelines must include a nationally recognized model policy for standards of care of a patient who is at a different location than the advanced practice registered nurse; (2) approve curricula and adopt standards for basic education programs that prepare persons for licensing under AS 08.68.190 ; (3) provide for surveys of the basic nursing education programs in the state at the times it considers necessary; (4) approve education programs that meet the requirements of this chapter and of the board, and deny, revoke, or suspend approval of education programs for failure to meet the requirements; (5) examine, license, and renew the licenses of qualified applicants; (6) prescribe requirements for competence before a former registered, advanced practice registered, or licensed practical nurse may resume the practice of nursing under this chapter; (7) define by regulation the qualifications and duties of the executive administrator and delegate authority to the executive administrator that is necessary to conduct board business; (8) develop reasonable and uniform standards for nursing practice; (9) publish advisory opinions regarding whether nursing practice procedures or policies comply with acceptable standards of nursing practice as defined under this chapter; (10) require applicants under this chapter to submit fingerprints and the fees required by the Department of Public Safety under AS 12.62.160 for criminal justice information and a national criminal history record check; the department shall submit the fingerprints and fees to the Department of Public Safety for a report of criminal justice information under AS 12.62 and a national criminal history record check under AS 12.62.400 ; (11) require that a licensed advanced practice registered nurse who has a federal Drug Enforcement Administration registration number register with the controlled substance prescription database under AS 17.30.200 (n). (b) The board may (1) conduct hearings upon charges of alleged violations of this chapter or regulations adopted under it; (2) invoke, or request the department to invoke, disciplinary action against a licensee; (3) prescribe requirements for competence to continue practice. Sec. 08.68.110. Appointment of executive officer. [Repealed, § 3 ch 59 SLA 1966.] Sec. 08.68.111. Executive administrator of the board. (a) The Department of Commerce, Community, and Economic Development, in consultation with the board, shall employ a licensed registered nurse who holds, at a minimum, a master's degree in nursing and who is not a member of the board to serve as executive administrator of the board. (b) The executive administrator shall perform duties as prescribed by the board. (c) [Repealed by § 29 ch 14 SLA 1982.] (d) [Repealed by § 1 ch 129 SLA 1974.] Secs. 08.68.120 — 08.68.130. Bond; disposition of fees. [Repealed, § 3 ch 59 SLA 1966.] Sec. 08.68.140. Applicability of Administrative Procedure Act. Except as specified in AS 08.68.333 (f), the board shall comply with AS 44.62 (Administrative Procedure Act). Sec. 08.68.150. Expenses. Members of the board are entitled to the per diem and travel expenses allowed by law. Article 2. Examination and Licensing. Sec. 08.68.160. License required. A person practicing or offering to practice registered, advanced practice registered, or practical nursing in the state shall submit evidence of qualification to practice and shall be licensed under this chapter. Sec. 08.68.165. Malpractice insurance. [Repealed, § 40 ch 177 SLA 1978.] Sec. 08.68.170. Qualifications of registered or practical nurse applicants. (a) An applicant for a license to practice registered nursing shall submit to the board, on forms and in the manner prescribed by the board, written evidence, verified by oath, that the applicant has successfully completed a registered nurse education program accredited by a national nursing accrediting body and approved by the board. (b) An applicant for a license to practice practical nursing shall submit to the board, on forms and in the manner prescribed by the board, written evidence, verified by oath, that the applicant has successfully completed (1) a practical nurse education program accredited by a national nursing accrediting body; (2) a practical nurse education program that meets the criteria established by the board under AS 08.68.100 ; or (3) a registered nurse education program accredited by a national nursing accrediting body and approved by the board and, if the applicant has failed the registered nurse licensing examination, a practical nurse scope of practice course approved by the board. (c) An applicant for a license to practice advanced practice registered nursing shall submit to the board, on forms and in the manner prescribed by the board, written evidence, verified by oath, that the applicant (1) is licensed as a registered nurse in the state; and (2) has successfully completed an advanced practice registered nurse education program that meets the criteria established by the board under AS 08.68.100 . Sec. 08.68.180. Qualifications of certain practical nurse applicants. [Repealed, § 15 ch 29 SLA 2014.] Sec. 08.68.190. License by examination. (a) An applicant for a license to practice (1) registered or practical nursing shall pass a registered nursing or practical nursing licensing examination as prescribed by the board; (2) advanced practice registered nursing shall pass an advanced practice registered nursing certification examination as prescribed by the board. (b) If an applicant meets the qualifications set out in AS 08.68.170 for the license for which the applicant applied, the board shall issue a license to practice (1) registered or practical nursing to an applicant who passes the licensing examination to practice registered or practical nursing; or (2) advanced practice registered nursing to an applicant who passes the advanced practice registered nursing certification examination to practice advanced practice registered nursing. Sec. 08.68.200. License by endorsement. (a) The board may issue a license by endorsement to practice as a registered, advanced practice registered, or practical nurse, whichever is appropriate, to an applicant who has worked as a nurse within the past five years if the applicant is licensed as a registered, advanced practice registered, or practical nurse under the laws of another state if, in the opinion of the board, the applicant meets the qualifications required for licensing in the state and meets the requirements of AS 08.68.170 . (b) The board may issue a license by endorsement to practice as a registered, advanced practice registered, or practical nurse, whichever is appropriate, to an applicant who has not worked as a nurse within the past five years if the applicant meets the requirements of (a) of this section and (1) meets the continuing competency requirements of the board; or (2) completes a course of study approved by the board. Sec. 08.68.210. Temporary permits. (a) The board may issue a temporary permit, nonrenewable and valid for a period not exceeding six months, to an applicant for a license by endorsement if the applicant (1) submits proof satisfactory to the board that the applicant is currently licensed in another state under AS 08.68.200 (a); (2) meets the requirements of AS 08.68.170 ; and (3) pays the required fee. (b) The board may issue a nonrenewable permit to an applicant for license by examination if the applicant meets the qualifications of AS 08.68.170 . The permit is valid for a period not to exceed six months or the date on which the results of the licensing examination taken by the applicant are received by the applicant, whichever is sooner. If the applicant does not take the examination for which the applicant is scheduled, the permit lapses on the day of the examination. (c) The board may issue a nonrenewable temporary permit, valid for a period not to exceed six months, to a person applying for reinstatement of a lapsed license under AS 08.68.251 if the person meets the requirements established by the board in regulation. Sec. 08.68.220. Fees. The Department of Commerce, Community, and Economic Development shall set fees under AS 08.01.065 for each of the following: (1) registered nursing: (A) application; (B) license by examination; (C) license by endorsement; (D) license renewal; (E) temporary permit; (2) practical nursing: (A) application; (B) license by examination; (C) license by endorsement; (D) license renewal; (E) temporary permit; (3) advanced practice registered nursing: (A) application; (B) license by certification examination; (C) license by endorsement; (D) license renewal; (E) temporary permit. Sec. 08.68.230. Use of title and abbreviation. (a) A person licensed to practice registered nursing in the state may use the title “registered nurse” and the abbreviation “R.N”. (b) A person licensed to practice practical nursing in the state may use the title “licensed practical nurse” and the abbreviation “L.P.N.” (c) [Repealed, § 15 ch 29 SLA 2014.] (d) A person who holds a temporary permit to practice as a licensed practical nurse shall use the title “Temporary Licensed Practical Nurse” and the abbreviation “TLPN.” (e) A person licensed to practice advanced practice registered nursing in the state may use the title “advanced practice registered nurse” and the abbreviation “APRN.” (f) A person licensed to practice advanced practice registered nursing in the state as a (1) certified registered nurse anesthetist may use the title “certified registered nurse anesthetist” and the abbreviation “CRNA”; (2) certified clinical nurse specialist may use the title “clinical nurse specialist” and the abbreviation “CNS”; (3) certified nurse practitioner may use the title “certified nurse practitioner” and the abbreviation “CNP”; or (4) certified nurse midwife may use the title “certified nurse midwife” and the abbreviation “CNM.” Sec. 08.68.240. Nurses licensed or holding temporary permits under previous law. [Repealed, § 15 ch 29 SLA 2014.] Sec. 08.68.250. Renewal of license. [Repealed, § 3 ch 81 SLA 1969. For current law, see AS 08.01.100 .] Sec. 08.68.251. Lapsed licenses. (a) A lapsed license may be reinstated if it has not remained lapsed for more than five years by payment of the license fees for the current renewal period and the penalty fee. The board, by regulation, shall establish continuing competency and criminal background check requirements for reinstatement of a lapsed license. (b) If a license is lapsed for more than five years, in addition to the requirements in (a) of this section, (1) the board shall require the applicant to complete a course of study approved by the board or to pass an examination prescribed by the board, and to pay the fees prescribed by this chapter; or (2) if the board determines that the person applying for reinstatement was actively employed in nursing in another state or jurisdiction during the time that the license has lapsed in this state, the license that has lapsed may be reinstated by payment of fees and completion of the other requirements in (a) of this section. Sec. 08.68.260. Inactive nurses. [Repealed, § 29 ch 14 SLA 1982. For current law, see AS 08.68.251 .] Sec. 08.68.265. Supervision of practical nurses. A practical nurse shall work under the supervision of a licensed registered or advanced practice registered nurse, a licensed physician, a licensed physician assistant, or a licensed dentist. Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board may deny, suspend, or revoke the license of a person who (1) has obtained or attempted to obtain a license to practice nursing by fraud or deceit; (2) has been convicted of a felony or other crime if the felony or other crime is substantially related to the qualifications, functions, or duties of the licensee; (3) habitually abuses alcoholic beverages, or illegally uses controlled substances; (4) has impersonated a registered, advanced practice registered, or practical nurse; (5) has intentionally or negligently engaged in conduct that has resulted in a significant risk to the health or safety of a client or in injury to a client; (6) practices or attempts to practice nursing while afflicted with physical or mental illness, deterioration, or disability that interferes with the individual's performance of nursing functions; (7) is guilty of unprofessional conduct as defined by regulations adopted by the board; (8) has wilfully or repeatedly violated a provision of this chapter or regulations adopted under this chapter or AS 08.01 ; (9) is professionally incompetent; (10) denies care or treatment to a patient or person seeking assistance if the sole reason for the denial is the failure or refusal of the patient or person seeking assistance to agree to arbitrate as provided in AS 09.55.535 (a); (11) has prescribed or dispensed an opioid in excess of the maximum dosage authorized under AS 08.68.705 ; or (12) has procured, sold, prescribed, or dispensed drugs in violation of a law, regardless of whether there has been a criminal action or harm to the patient. Sec. 08.68.275. Disciplinary sanctions. (a) The board may take the following disciplinary actions singly or in combination: (1) permanently revoke a license or permit to practice; (2) suspend a license for a stated period of time; (3) censure a licensee; (4) issue a letter of reprimand; (5) impose limitations or conditions on the professional practice of a licensee; (6) impose peer review; (7) impose professional education requirements until a satisfactory degree of skill has been attained in those aspects of professional practice determined by the board to need improvement; (8) impose probation and require the licensee to report regularly to the board upon matters involving the basis for the probation; (9) accept a voluntary surrender of a license. (b) The board may withdraw probation status if it finds that the deficiencies that required the sanction have been remedied. (c) The board may summarily suspend a license before final hearing or during the appeals process if the board finds that the licensee poses a clear and immediate danger to the public health and safety. A person whose license is suspended under this section is entitled to a hearing conducted by the office of administrative hearings ( AS 44.64.010 ) within seven days after the effective date of the order. If, after a hearing, the board upholds the suspension, the licensee may appeal the suspension to a court of competent jurisdiction. (d) The board may reinstate a license that has been suspended or revoked if the board finds, after a hearing, that the applicant is able to practice with skill and safety. (e) The board may return a license that has been voluntarily surrendered if the board determines that the licensee is competent to resume practice and that the applicable renewal fees are paid. (f) The board shall seek consistency in the application of disciplinary sanctions. A significant departure from prior decisions involving similar situations shall be explained in the findings of fact or order. Sec. 08.68.276. Continuing competence required. A license to practice nursing may not be renewed unless the nurse has complied with continuing competence requirements established by the board by regulation. The board shall adopt regulations for renewal of a license of an advanced practice registered nurse. The regulations must require that a licensee receive not less than two hours of education in pain management and opioid use and addiction in the two years preceding an application for renewal of a license unless the licensee has demonstrated to the satisfaction of the board that the licensee does not currently hold a valid federal Drug Enforcement Administration registration number. Sec. 08.68.277. Duty of employers to report. (a) An employer of a nurse licensed under this chapter or a nurse aide certified under this chapter practicing within the scope of that license or certification that discharges or suspends a nurse or nurse aide or conditions or restricts the practice of a nurse or nurse aide shall, within seven working days after the action, report to the board the name and address of the person and the reason for the action. An employer shall report to the board the name and address of a nurse or nurse aide who resigns while under investigation by the employer. The requirement of an employer to report under this section applies only to a discharge, suspension, or restriction of practice that is based on a ground allowing action by the board under AS 08.68.270 or 08.68.334 or for conduct prohibited under AS 08.68.340 . (b) Upon receipt of a report under (a) of this section, the board shall investigate the matter and take appropriate action under AS 08.68.275 . Sec. 08.68.278. Immunity for certain reports to the board. A person who, in good faith, reports information to the board relating to alleged incidents of incompetent, unprofessional, or unlawful conduct of a nurse licensed under this chapter, a nurse aide certified under this chapter, or an employer of a nurse licensed under this chapter or a nurse aide certified under this chapter who reports to the board the information required under AS 08.68.277 is not liable in a civil action for damages resulting from the reporting of the information. Sec. 08.68.279. Whistleblower protection for nurses concerning delegated duties. An employer may not discharge, threaten, or otherwise discriminate against a nurse employed by the employer regarding the nurse's compensation, terms, conditions, location, or privileges of employment for the nurse's refusal to perform a task involving nursing care delegated to the nurse by the nurse's superior if (1) the nurse alleges that the task was improperly delegated; (2) the nurse reports the attempted improper delegation to the board within 24 hours after the attempted delegation was made; and (3) the board finds that the task was improperly delegated. Article 3. Nursing Education Programs. Sec. 08.68.280. Nursing education program prohibited unless approved. A person, institution, or agency may not conduct a nursing education program that prepares persons for examination or licensing unless the program is approved by the board. A program may be approved by the board only if it is established through an approved postsecondary educational institution. Sec. 08.68.290. Application for accreditation. An institution desiring to conduct a nursing education program to prepare registered, advanced practice registered, or practical nurses shall apply to the board and submit evidence that it is prepared to (1) carry out the curriculum approved by the board for registered nursing, advanced practice registered nursing, or practical nursing; and (2) meet other standards established by law and by the board. Secs. 08.68.300 — 08.68.320. Accreditation by board. [Repealed, § 29 ch 14 SLA 1982.] Sec. 08.68.330. List of approved programs. The board shall prepare, maintain, and from time to time publish a list of approved nursing education programs in the state. Article 4. Certified Nurse Aides. Sec. 08.68.331. Certification of nurse aides. (a) The board or the Department of Commerce, Community, and Economic Development, as designated by the board, shall issue certification as a nurse aide to qualified applicants. The board, after consultation with affected agencies, may adopt regulations regarding the certification of nurse aides, including (1) the training, educational, and other qualifications for certification that will ensure that the nurse aides are competent to perform the tasks of their occupation; (2) application, certification, renewal, and revocation procedures; and (3) maintenance of a registry of certified nurse aides. (b) The board may (1) conduct hearings upon charges of alleged violations of this chapter or regulations adopted under it; and (2) invoke, or request the department to invoke, disciplinary action under AS 08.01.075 against a certified nurse aide. Sec. 08.68.332. Use of title. (a) A person may not use the title “certified nurse aide” or the abbreviation “C.N.A.” unless the person is certified under this chapter. (b) A person who knowingly violates this section is guilty of a class B misdemeanor. In this subsection, “knowingly” has the meaning given in AS 11.81.900 (a). Sec. 08.68.333. Registry of certified nurse aides. (a) The board shall maintain a registry of certified nurse aides. At a minimum, this registry must include the information required under federal regulations that are applicable to nurse aides found to have committed abuse, neglect, or misappropriation of property in connection with their employment by a facility participating in the Medicaid or Medicare program. (b) If the board finds that a certified nurse aide has committed abuse, neglect, or misappropriation of property in connection with employment as a nurse aide, the board shall revoke the nurse aide's certification and enter the finding in the registry. (c) Upon receiving a notice of a finding under AS 47.05.055 that a certified nurse aide has committed abuse, neglect, or misappropriation of property, the board shall immediately revoke the nurse aide's certification without a hearing, enter the finding in the registry, and notify the nurse aide of the revocation and entry of the finding. Notice is considered given when delivered personally to the nurse aide or deposited in the United States mail addressed to the nurse aide's last known mailing address on file with the board. The department shall retain proof of mailing. (d) If the certified nurse aide is employed in a skilled nursing facility or a nursing facility, other than an intermediate care facility for persons with intellectual and developmental disabilities, that is participating in the Medicaid or Medicare program, only the state survey and certification agency may make, and report to the board, a finding that the certified nurse aide has committed abuse, neglect, or misappropriation of property in connection with the nurse aide's employment at the facility. (e) The board shall establish procedures under which a finding under AS 47.05.055 that a certified nurse aide has committed abuse, neglect, or misappropriation of property and the resulting revocation of certification will be removed from the registry if the certified nurse aide requests a hearing and can establish mistaken identity or the finding has been set aside by the reporting agency or by a court of competent jurisdiction. (f) AS 44.62.330 — 44.62.630 do not apply to actions taken under (c) of this section. Sec. 08.68.334. Grounds for denial, suspension, or revocation of certificate. The board may deny a certification to, or impose a disciplinary sanction authorized under AS 08.01.075 against, a person who (1) has obtained or attempted to obtain certification as a nurse aide by fraud, deceit, or intentional misrepresentation; (2) has been convicted of a crime substantially related to the qualifications, functions, or duties of a certified nurse aide; (3) has impersonated a registered, advanced practice registered, or practical nurse or other licensed health care provider; (4) has intentionally or negligently engaged in conduct that has resulted in a significant risk to the health or safety of a client or in injury to a client; (5) is incapable of working as a certified nurse aide with reasonable skill, competence, and safety for the public because of (A) professional incompetence; (B) addiction or severe dependency on alcohol or a drug that impairs the licensee's ability to practice safely; (C) physical or mental disability; or (D) other factors determined by the board; (6) has knowingly or repeatedly failed to comply with this chapter, a regulation adopted under this chapter, or with an order of the board; or (7) has misappropriated the property of, abused, or neglected a client. Sec. 08.68.335. Immunity for certain reports to the board. A person who, in good faith, reports information to the board relating to alleged incidents of incompetent, unprofessional, or unlawful conduct of a certified nurse aide is not liable in a civil action for damages resulting from the reporting of the information. Sec. 08.68.336. Fees. The Department of Commerce, Community, and Economic Development shall set fees under AS 08.01.065 for certified nurse aides for each of the following: (1) application; (2) examination; (3) certification; and (4) renewal of certification. Article 5. Unlawful Acts. Sec. 08.68.340. Prohibited conduct. (a) It is a class B misdemeanor for a person to (1) practice nursing under a diploma, license, or record that is unlawfully obtained, signed, or issued; (2) practice or offer to practice nursing without a license, unless the person is practicing within the scope of a delegation properly made under AS 08.68.805 or is giving necessary aid to the ill, injured, or infirm in an emergency; (3) employ as a nurse a person who is not licensed to practice nursing; (4) use in connection with the person's name a designation that implies that the person is a licensed nurse unless the person is licensed; (5) practice nursing during the time that the person's license is suspended or revoked; (6) practice nursing with knowledge that the person's license has lapsed; (7) conduct a nursing education program and represent or imply that it is accredited by the board, unless the program has been accredited by the board. (b) It is a class A misdemeanor for a person to knowingly or intentionally do any of the acts described in (a)(1) — (5) and (7) of this section. (c) It is a violation for a person to practice nursing during the time that the person's license has lapsed if the person does not know that the license has lapsed. Sec. 08.68.350. Punishment for misdemeanor. [Repealed, § 29 ch 14 SLA 1982.] Sec. 08.68.360. Unlicensed practice a public nuisance. The practice of registered, advanced practice registered, or practical nursing for compensation by a person who is not licensed, or whose license is suspended, or revoked, or expired, is declared to be inimical to the public welfare and to constitute a public nuisance. Sec. 08.68.370. Application for injunction. The board may apply for an injunction in a competent court to enjoin a person not licensed or whose license is suspended or revoked or expired from practicing registered, advanced practice registered, or practical nursing. The court may issue a temporary injunction enjoining the defendant from practicing registered, advanced practice registered, or practical nursing. Sec. 08.68.380. Issuance of injunction. If it is established that the defendant has been or is practicing registered, advanced practice registered, or practical nursing without a license or has been or is practicing nursing after the defendant's license has been suspended or revoked, or has expired, the court may enjoin the defendant from further practice. Sec. 08.68.390. Remedy not exclusive. If a person violates an injunction issued under this section, the person may be punished for contempt of court. The injunction proceeding is in addition to other penalties and remedies provided in this chapter. Sec. 08.68.395. [Renumbered as AS 08.68.700 .] Sec. 08.68.400. [Renumbered as AS 08.68.800 .] Sec. 08.68.405. [Renumbered as AS 08.68.805 .] Sec. 08.68.410. [Renumbered as AS 08.68.850 .] Article 6. Miscellaneous Provisions. Sec. 08.68.700. Determination of death by registered nurse. (a) A registered nurse licensed under this chapter may make a determination and pronouncement of death of a person under the following circumstances: (1) an attending physician, an attending advanced practice registered nurse, or an attending physician assistant has documented in the person's medical or clinical record that the person's death is anticipated due to illness, infirmity, or disease; this prognosis is valid for purposes of this section for not more than 120 days from the date of the documentation; (2) at the time of documentation under (1) of this subsection, the physician, the advanced practice registered nurse, or the physician assistant authorized in writing a specific registered nurse or nurses to make a determination and pronouncement of the person's death; however, if the person is in a health care facility and the health care facility has complied with (d) of this section, the physician, the advanced practice registered nurse, or the physician assistant may authorize all nurses employed by the facility to make a determination and pronouncement of the person's death. (b) A registered nurse who has determined and pronounced death under this section shall document the clinical criteria for the determination and pronouncement in the person's medical or clinical record and notify the physician, the advanced practice registered nurse, or the physician assistant who determined that the prognosis for the patient was for an anticipated death. The registered nurse shall sign the death certificate, which must include the (1) name of the deceased; (2) presence of a contagious disease, if known; and (3) date and time of death. (c) Except as otherwise provided under AS 18.50.230 , a physician or physician assistant licensed under AS 08.64 or an advanced practice registered nurse licensed under this chapter shall certify a death determined under (b) of this section within 24 hours after the pronouncement by the registered nurse. (d) In a health care facility in which a physician, an advanced practice registered nurse, or a physician assistant chooses to proceed under (a) of this section, written policies and procedures shall be adopted that provide for the determination and pronouncement of death by a registered nurse authorized by a physician, an advanced practice registered nurse, or a physician assistant under this section. A registered nurse employed by a health care facility and authorized by a physician, an advanced practice registered nurse, or a physician assistant to make a determination and pronouncement of death under this section may not make the determination or pronouncement unless the facility has written policies and procedures implementing and ensuring compliance with this section. (e) Notwithstanding AS 08.68.800 (a)(1), this section applies to a qualified nurse described in AS 08.68.800 (a)(1) who is employed by a federal health care facility. (f) The Department of Health may adopt regulations to implement this section. (g) In this section, (1) “determination of death” means observation and assessment that a person is dead, as defined in AS 09.68.120 ; (2) “health care facility” means a private, municipal, state, or federal hospital, psychiatric hospital, tuberculosis hospital, skilled nursing facility, kidney disease treatment center (excluding freestanding hemodialysis units), intermediate care facility, or Alaska Pioneers' Home or Alaska Veterans' Home administered by the Department of Family and Community Services under AS 47.55 . Sec. 08.68.705. Maximum dosage for opioid prescriptions. (a) An advanced practice registered nurse may not issue (1) an initial prescription for an opioid that exceeds a seven-day supply to an adult patient for outpatient use; (2) a prescription for an opioid that exceeds a seven-day supply to a minor; at the time an advanced practice registered nurse writes a prescription for an opioid for a minor, the advanced practice registered nurse shall discuss with the parent or guardian of the minor why the prescription is necessary and the risks associated with opioid use. (b) Notwithstanding (a) of this section, an advanced practice registered nurse may issue a prescription for an opioid that exceeds a seven-day supply to an adult or minor patient if, in the professional judgment of the advanced practice registered nurse, more than a seven-day supply of an opioid is necessary for (1) the patient's acute medical condition, chronic pain management, pain associated with cancer, or pain experienced while the patient is in palliative care; the advanced practice registered nurse may write a prescription for an opioid for the quantity needed to treat the patient's medical condition, chronic pain, pain associated with cancer, or pain experienced while the patient is in palliative care; the advanced practice registered nurse shall document in the patient's medical record the condition triggering the prescription of an opioid in a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative was not appropriate to address the medical condition; or (2) a patient who is unable to access a practitioner within the time necessary for a refill of the seven-day supply because of a logistical or travel barrier; the advanced practice registered nurse may write a prescription for an opioid for the quantity needed to treat the patient for the time that the patient is unable to access a practitioner; the advanced practice registered nurse shall document in the patient's medical record the reason for the prescription of an opioid in a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative was not appropriate to address the medical condition; in this paragraph, “practitioner” has the meaning given in AS 11.71.900 . (c) This section does not authorize an advanced practice registered nurse to prescribe a controlled substance if the advanced practice registered nurse is not otherwise authorized to prescribe a controlled substance under policies, procedures, or regulations issued or adopted by the board. (d) In this section, (1) “adult” means (A) an individual who has reached 18 years of age; or (B) an emancipated minor; (2) “emancipated minor” means a minor whose disabilities have been removed for general purposes under AS 09.55.590 ; (3) “minor” means an individual under 18 years of age who is not an emancipated minor. Sec. 08.68.710. Prescription of drugs without physical examination. (a) The board may not impose disciplinary sanctions on an advanced practice registered nurse for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug that is not a controlled substance to a person without conducting a physical examination if (1) the advanced practice registered nurse or another licensed health care provider in the medical practice is available to provide follow-up care; and (2) the advanced practice registered nurse requests that the person consent to sending a copy of all records of the encounter to the person's primary care provider if the prescribing advanced practice registered nurse is not the person's primary care provider and, if the person consents, the advanced practice registered nurse sends the records to the person's primary care provider. (b) The board may not impose disciplinary sanctions on an advanced practice registered nurse for prescribing, dispensing, or administering a prescription drug that is a controlled substance if the requirements under (a) of this section and AS 08.68.705 are met and the advanced practice registered nurse prescribes, dispenses, or administers the controlled substance. (c) Notwithstanding (a) and (b) of this section, an advanced practice registered nurse may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the advanced practice registered nurse does not have a prior provider-patient relationship. (d) In this section, (1) “controlled substance” has the meaning given in AS 11.71.900 ; (2) “prescription drug” has the meaning given in AS 08.80.480 ; (3) “primary care provider” has the meaning given in AS 21.07.250 . Article 7. General Provisions. Sec. 08.68.800. Exceptions to application of chapter. (a) This chapter does not apply to (1) a qualified nurse licensed in another state employed by the United States government or a bureau, or agency, or division of the United States government while in the discharge of official duties; (2) nursing service given temporarily in the event of a public emergency, epidemic, or disaster; (3) the practice of nursing by a student enrolled in a nursing education program accredited by the board when the practice is in connection with the student's course of study; (4) the practice of nursing by an individual enrolled in an approved program or course of study approved by the board to satisfy the requirements of AS 08.68.251 ; (5) the practice of nursing by a nurse licensed in another state who engages in nursing education or nursing consultation activities, if these activities and contact with clients do not exceed 20 working days within a licensing period; or (6) the practice of nursing by a nurse licensed in another state whose employment responsibilities include transporting patients into, out of, or through this state; however, this exception is valid for a period not to exceed 48 hours for each transport. (b) In this section, the word “nurses” includes registered and practical nurses, and “nursing” means registered and practical nursing. Sec. 08.68.805. Delegation of nursing functions. A registered, advanced practice registered, or practical nurse licensed under this chapter may delegate nursing duties to other persons, including unlicensed assistive personnel, under regulations adopted by the board. A person to whom the nursing duties are delegated may perform the delegated duties without a license or certificate under this chapter if the person meets the applicable requirements established by the board. Sec. 08.68.850. Definitions. In this chapter, (1) “advanced practice registered nurse” means a registered nurse licensed to practice in the state who, because of specialized education and experience, is certified to perform acts of medical diagnosis and the prescription and dispensing of medical, therapeutic, or corrective measures under regulations adopted by the board; (2) “board” means the Board of Nursing; (3) “certified nurse aide” is a person who is certified as a nurse aide by the board; (4) “incompetent” means that a nurse does not possess the skills, knowledge, and awareness of the nurse's limitations and abilities to safely practice nursing; (5) “licensed practical nurse” is equivalent to the title “licensed vocational nurse” and to the name suffix abbreviations L.P.N. and L.V.N.; (6) “licensed registered nurse” is equivalent to the common title “registered nurse” and the name suffix abbreviation R.N.; (7) [Repealed, § 60 ch 33 SLA 2016.] (8) “opioid” includes the opium and opiate substances and opium and opiate derivatives listed in AS 11.71.140 and 11.71.160; (9) “practice of advanced practice registered nursing” includes, in addition to the practice of registered nursing, the performance of acts of medical diagnosis and the prescription and dispensing of medical, therapeutic, or corrective measures under regulations adopted by the board; (10) “practice of practical nursing” means the performance for compensation or personal profit of nursing functions that do not require the substantial specialized skill, judgment, and knowledge of a registered nurse; (11) “practice of registered nursing” means the performance for compensation or personal profit of acts of professional service that requires substantial specialized knowledge, judgment, and skill based on the principles of biological, physiological, behavioral, and sociological sciences in assessing and responding to the health needs of individuals, families, or communities through services that include (A) assessment of problems, counseling, and teaching (i) clients to maintain health or prevent illness; and (ii) in the care of the ill, injured, or infirm; (B) administration, supervision, delegation, and evaluation of nursing practice; (C) teaching others the skills of nursing; (D) execution of a medical regimen as prescribed by a person authorized by the state to practice medicine; (E) performance of other acts that require education and training that are recognized by the nursing profession as properly performed by registered nurses; (F) performance of acts of medical diagnosis and the prescription of medical therapeutic or corrective measures under regulations adopted by the board; (12) “unlicensed assistive personnel” means persons, such as orderlies, assistants, attendants, technicians, members of a nursing client's immediate family, or the guardian of a nursing client, who are not licensed to practice practical nursing, registered nursing, medicine, or any other health occupation that requires a license in this state.