Relating to the regulation of the provision of elective intravenous therapy.

Contracts

• Medical Director Agreements: You must audit your Medical Director's total supervision load immediately. The law removes the exception for facility-based supervision; elective IV therapy Prescriptive Authority Agreements (PAAs) now count toward the physician's statutory cap (typically 7 FTEs). If your Medical Director supervises more than 7 mid-levels across all their clients, your contract puts them in violation of the Medical Practice Act.
• Prescriptive Authority Agreements (PAA): Ensure a valid, site-specific PAA is executed and physically present (or digitally accessible) on-site for every APRN or PA.

Hiring/Training

• Staffing Restrictions: You must cease using Licensed Vocational Nurses (LVNs) and Paramedics/EMTs for the administration of elective IV therapy. The law restricts administration to Physicians, PAs, APRNs, and Registered Nurses (RNs).
• Scope of Practice: RNs cannot independently order IV therapy. They must administer only under a specific order or protocol established by a Physician, PA, or APRN.

Reporting & Record-Keeping

• Patient Charting: Every patient record must evidence an order from an authorized provider (MD/DO, PA, APRN). "Standing orders" utilized by RNs without a PAA framework are no longer sufficient.
• Delegation Protocols: Written protocols must be updated to explicitly exclude LVNs and Paramedics from IV insertion and administration duties.

Fees & Costs

• Labor Costs: Expect a significant increase in payroll expenses as you replace LVNs/Paramedics with RNs.
• Medical Director Fees: Due to the strict cap on how many mid-levels a physician can supervise, the supply of available Medical Directors will plummet. Expect retainer fees for compliant Medical Directors to increase substantially.